District Health Society Dhubri, Assam

Draft

DISTRICT HEALTH SOCIETY DHUBRI, ASSAM.

Prepared By DPMU, NRHM, Dhubri

DHUBRI/DHAP/2010-11 1

CHAPTER CONTENT PAGE

- EXECUTIVE SUMMARY 3-5

1 BACKGROUND 6-22

2 PROCESS FOR PLAN DEVELOPMENT 23-24

3 SITUATION ANALYSIS OF THE DISTRICT 25-44

4 PROGRESS MADE DURING 2005-06, 06-07, 07-08 & 08-09 45-67

5 CURRENT STATUS AND GOAL 68-76

6 GOAL, OBJECTIVES, STRATEGIES AND ACTIVITIES UNDER DIFFERENT 77 COMPONENTS OF NRHM PART A: RCH PROGRAMME 78-104

PART B: NRHM ADDITIONALITIES 105-121

PART C: UIP 122-139

PART D: NATIONAL DISEASE CONTROL PROGRAMME 140-192

PART E INTERSECTORAL CONVERGENCE 193

7 MONITORING AND EVALUATION/ HMIS 194-208

8 WORK PLAN 209-237

9 SUMMARY BUDGET 238

PART A: RCH PROGRAMME 239

PART B: NRHM ADDITIONALITIES 240-241

PART C: UIP 242-249

PART D: NATIONAL DISEASE CONTROL PROGRAMME 250-256

PART E: INTERSECTORAL CONVERGENCE 257

10 DETAILED BUDGET (ANNEXURE 3 E) 258-291

ANNEXURES

DHUBRI/DHAP/2010-11 2 EXECUTIVE SUMMARY

Dhubri district PIP for the year of 2010-11 (Programme Implementation Plan) prepared under NRHM is a synopsis of various tasks and activities that are to be executed in the financial year 2010-11. The PIP is primed considering the Goals and main objectives of NRHM, in order to enhance the health scenario of the district.

The main goals of NRHM in Dhubri district are Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR), Prevention and control of communicable and non-communicable diseases, including locally endemic diseases, an increase of contraceptive prevalence rate among eligible couples etc .

To achieve these goals we have adopted some strategies and that are:

Maternal Health:

1. To provide quality antenatal care to all pregnant woman by increasing the access through existing Govt. facilities. 2. To provide quality antenatal care to all pregnant woman in inaccessible and uncovered areas 3. Quality improvement of the ANC. 4. To increase awareness amongst the mothers and communities about the need of ANC. 5. Increasing the access through facility strengthening. 6. Social mobilization for institutional deliveries (Janani Suraksha Yojana) 7. Referral of obstetric emergencies 8. To improve the comprehensive EmOC in the CHCs and FRU. 9. Awareness of communities and PRIs about facilities having comprehensive EmOC facilities. 10. Capacity building of ANM/GNM by SBA training : 11. Ensure post partum care by AWW/ANM/LHV 12. Operatonalize services for diagnosis & Treatment at CHC/DH 13. Capacity building ANM/SN and Medical Officer & Lab Tech for managing RTI/STI 14. Promote communication activities for prevention and early care seeking for RTI/STI. 15. Increase the access to safe abortion in Govt. facilities.

CHILD HEALTH 1. Strengthening of the Govt facilities to provide newborn care.

2. Introduce a communication package of home-based newborn care by ASHA, AWW, ANM, CBO, and FNGO.

3. Referral of sick neonates who cannot be managed at home.

DHUBRI/DHAP/2010-11 3 4. Declaring Mother and Child Health Month during the month of September and March (bi- annually).

5. To increase awareness amongst mothers on benefits of breast-feeding upto 6 months and need of complementary feeding from 6 month onwards.

6. To raise awareness amongst mothers and communities on diarrhea.

7. Making ORS and zinc tablets available in remote/rural/tribal areas and difficult to reach areas through depot holders.

8. Strengthen facilities at PHC, CHC, SDH and DH.

9. To raise awareness amongst mothers and communities on ARI.

10. Promote referral services of severe cases of ARI and diarrhoea.

11. To prevent and treat anemia in children.

12. To work closely with ICDS functionaries to reduce malnutrition.

FAMILY PLANNING 1. To raise awareness amongst the couples and communities about the advantage of contraceptives and small family.

2. Increase the number of service delivery points.

3. Improve the service delivery to provide quality male and female sterilization.

4. To raise awareness among the community regarding Non Scalpel Vasectomy.

ADOLESCENT HEALTH 1. Community awareness by BCC.

2. To educate and raise awareness amongst the adolescent boys and girls about human physiology, RTI, STI, HIV/AIDS, EC and safe sex.

3. To assess service delivery by identifying institutions and also identifying counselors.

4. Required models, charts of human anatomy as teaching aids to be used.

5. A booklet will be developed on adolescent health including all the components preferably in local languages.

6. Ensure service delivery and infrastructure facility

7. To prevent and treat anemia in adolescents.

DHUBRI/DHAP/2010-11 4 Programme Management Arrangement: The DPMU (District Programme Management Unit) consist of one Management specialists, Media Expert, Accounts Manager, Data Manager, Drug Store Manager, Computer Assistant and they are working under the guidance of Joint Director of Health Services cum Member Secretary, DHS, Dhubri. Moreover the whole activities are supervised by Deputy Commissioner cum Chairman, DHS, Dhubri. For Strengthening the NRHM activities and to build skill and capacity of Top level officials to middle level officials example - DPMU, BPMU, ASHA, ANM, GNM, AWW, MO etc sensitize orientation training is proposed in the PIP. In the Block PHC level Block Programme Manager, Block accounts Manager are also appointed. Pharmacists, Lab Technicians, PHC Accountant, Asst. BPM, GNM, ANM, ASHA, ASHA Supervisor etc are alos posted in the PHCs, SDs, SHC, SCs and in the PIP requirement for additional skill manpower like MO, Specialists, BPM, GNM, ANM has been proposed.

BUDGET

The district proposes a total budget of Rs. 16,92,81,623.23 in the PIP for the year 2010-11. The budget summary is as follows: Summary of Budget

Programme Amount ( In Rs.Cr)

RCHII Flexipool 32,345,665.23

NRHM Mission Flexipool 10,99,21,450.00

Immunization(UIP) 6,018,968.00

National Disease Control Programme 0.00

(i) NVBDCP 7,469,840.00

(ii) RNTCP 7,974,000.00

(iii) NPCB 1,771,000.00

(iv) NLEP 943,100.00

(v) IDSP 1,121,600.00

(vi) NTCP 1,216,000.00

(vii) NMHP 500,000.00

Total 16,92,81,623.23

DHUBRI/DHAP/2010-11 5 CHAPTER- 1 BACKGROUND

1.1 THE DISTRICT AT A GLANCE:

Dhubri District - the gateway of western Assam happened to be in the past a meeting place of different racial groups which mingled together and formed a unique Cultural Heritage and

Historical Background. The growth of blended culture in this region particularly in case of

Language, Art and Religion is due to continuous process of assimilation of various races, caste & creed of local people, invaders & migrated people. Dhubri District is bounded both by inter-state and international border i.e. West Bengal and Bangladesh in the west, Goalpara and Bogaigoan district of Assam and Garo Hills district of Meghalaya in the east, Kokrajhar district in the north,

Bangladesh and state of Meghalaya in the south. Covering an area of 2,838 Sq. Kms. including forests, riverines, hills etc. the district has become the most densely populated district in India with a density of 584 persons per Sq. Km. (As per 2001 census).

Dhubri District is bounded both by inter-state and international border i.e. West Bengal and Bangladesh in the west, Goalpara and Bogaigoan district of Assam and Garo Hills district of

Meghalaya in the east, Kokrajhar district in the north, Bangladesh and state of Meghalaya in the south.

This district is located on the globe between 89.42 to 90.12 degree east longitude and

26.22 to 25.28 degree north latitude. The district is situated at 30 meters above the sea level on average. General topography of Dhubri district is plain with patches of small hillocks like

Tokorabandha, Dudhnath, Chandardinga, Boukumari, Boropahar, Chakrasila etc. All these are situated in the north eastern part of the district. Mighty river Brahmaputra is flowing through this district from east to west with its tributaries like Champabati, Gourang, Gadadhar, Gangadhar,

Tipkai, Sankosh,Silai, Jinjiram etc.

DHUBRI/DHAP/2010-11 6

DHUBRI/DHAP/2010-11 7 Table:1 Demography Characteristics of the District:

Total Population : 16, 37, 344 Nos

Male 8,41,044 Nos. (51.37 %) Female 7,96,300 Nos. (48.63 %) Sex Ratio 1000 : 947 General Population 12,36,054 Nos. (92.76%)

Schedule Caste 64,161 Nos. (4.82%)

Schedule Tribe 32,260 Nos. (2.42%)

Urban Population 1,61,981 Nos. (12.16%) Rural Population 11,70,494 Nos. (87.84%) Density 577 Nos. per Sq. Km. Percentage of Decadal growth rate (91-01) +23.42 Crude Birth Rate 31% Crude Death Rate 9% Maternal Mortality Rate 4/1000 Infant Mortality Rate 78/1000 Literate Person 6,25,369 Nos. (48.2%) Male 3,73,446 Nos. (55.91%) Female 2,51,923 Nos. (40.04%) http://dhubri.gov.in/demography_dhubri.htm AS PER 2001 CENSUS Table: 2 Administration of the District:

The present Dhubri District with an area of 2838 sq. km. has three Sub-divisions viz. (a) Dhubri(Sadar), (b) Bilasipara and (c) South Salmara/Mankachar

1. Revenue Circle : 8 Nos. 2.Tahsil : 7 Nos. 3. Sub Tahsil : 2 Nos. 4. Revenue Village : 1374 Nos. (Prior to BTAD) 5. Model Village : 3 Nos. 6. Revenue Village : 1133 Nos. (Excluding BTAD) 7. Anchalik Panchayat : 14 Nos. 8. Mahkuma Parishad : 3 Nos. 9. Municipal Board : 1 No. 10 . Gaon Panchayat : 172 Nos. (Prior to BTAD) 11 . Development Block : 14 Nos. 12 . Gaon Panchayat : 168 Nos. (Excluding BTAD) 13 . Police Outpost : 7 Nos. 14 . Basic Town : 4 Nos. 15 . Govt. Raliway Police Outpost : 2 Nos. 16 . Police Station : 8 Nos. 17 . Regular Fire Service Station : 2 Nos. 18 . Police Watchpost : 36 Nos. 19. Border Outpost : 35 Nos. 20 . River Police Outpost : 3 Nos.

DHUBRI/DHAP/2010-11 8 Table: 1.2. District wise Total Population Data, 2001.

NAME Total Male Female Sex Ratio Total 26655528 13777037 12878491 935 ASSAM Rural 23216288 11939945 11276343 944 PC of Rural 87.10 86.67 87.56 Total 1637344 841044 796300 947 Dhubri Rural 1444901 741574 703327 948 PC of Rural 88.25 88.17 88.32 (Source Census, 2001) Table: 1.3. District wise SC & ST Population Data, 2001.

SC Population ST Population NAME Sex Sex Total Male Female Total Male Female Ratio Ratio Total 1825949 943674 882275 935 3308570 1678117 1630453 972 ASSAM Rural 1553691 802548 751143 936 3154546 1598267 1556279 974 Total 63208 32734 30474 931 32523 16278 16245 998 Dhubri Rural 33559 17403 16156 928 31783 15878 15905 1002 (Source Census, 2001) Table: 1.4. District wise Female population data in the age group 1549

Name TOTAL RURAL URBAN

ASSAM 6574794 5634885 939909

Dhubri 371860 320706 51154 (Source Census, 2001) Table: 1.5. District wise 0 – 6 years population data NAME Total Male Female Total 4498075 2289116 2208959 ASSAM Rural 4104407 2086499 2017908 Total 340182 173081 167101 Dhubri Rural 314345 159874 154471 (Source Census, 2001) Table: 1.6. District wise Literacy Rate NAME Total Male Female

ASSAM Total 63.25 71.28 54.61 Rural 59.73 68.22 50.70 Total 48.21 55.91 40.04 Dhubri Rural 43.90 51.72 35.61 (Source Census, 2001)

DHUBRI/DHAP/2010-11 9

Table: 1.7. Government/ Private Health institutions in the District Sl. No. (A) Government of Health Institutions No 1. District Civil Hospital 1 2. Sub-Divisional Civil Hospital 1 3. Primary Health Centre 7 4. Community Health Centre 5 5. Mini PHC 11 6. Subsidiary Health Centre 4 7. State dispensary 11 8. First Referral Unit 1 9. Dhubri Health & Maternity Centre 1 10. Urban Health Centre 1 11. Sub Centre 246 (FW =233 & SC =13) (B) Private Health Institution 1. Tea Garden Hospital 2

Table: 1.8. Block PHC Wise List of Health Institution in Dhubri District . Block PHC Health Institutions 200 beded Dhubri Civil Hospital Dhubri Health Maternity Centre, Dhubri Dhubri Chest Hospital Gauripur CHC Dharmasala PHC Dharmasala BPHC Geramari MPHC Durahati Med SC Bhogdahar Med SC Alomganj Med SC FW SC – 31 Golakganj PHC Dumurdaha MPHC Dhepdhepi MPHC Moterjhar MPHC Bherbhangi SD Golakganj BPHC Kachokhana SD Paglahat Med SC Kamandanga Med SC Ratidaha Med SC FW SC – 28 Halakura PHC & CHC Agomoni CHC Halkura BPHC Satrasal MPHC Boterhat SD FW SC – 25

DHUBRI/DHAP/2010-11 10 Raniganj PHC Bilasipara SHC Sapatgram SHC Santipur MPHC Lakhiganj SD Raniganj BPHC Futkibari SD Bogribari SD Borkanda Med SC Nayaralga Med SC FW SC – 46 Chapor PHC/CHC/FRU Rangamati/Champabati MPHC Chapor BPHC Salkocha SHC Bahalpur SD FW SC- 17 South Salmara PHC Tumni CHC Jaruwa MPHC Chirakuti MPHC South Salmara BPHC Fakirganj MPHC Medartari SD Jamadarhat Med SC Patakata Med SC FW SC- 44 Gazarikandi PHC Mankachar CHC Sukchar MPHC Sadullabari SHC Kakripara SD Gazarikandi BPHC Jhawdanga SD Fekamari Med SC Baghapara/Sadullabari Med SC Hazirhat Med SC FW SC- 42

DHUBRI/DHAP/2010-11 11 Table: 1.9 Block PHC Wise List of Sub Centers in Dhubri District.

if in rented Sub building, Centre whether Govt with No Sl Name of the Name of Sub under Functional Whether /Rented building Remarks No Block PHC Center construction (Yes/No) FW/MNP (Yes/No) (neither by NRHM or Govt nor 12th Finance Rented) Commission Dharmasala 12th Finance 1 Patamari Govt Yes FW PHC Commission Dharmasala 12th Finance 2 Bhogdahar Govt Yes Medical PHC Commission Dharmasala 3 Reserverchar Rented Yes FW PHC Dharmasala 4 Char Bhasani Rented Yes FW PHC Dharmasala (Land not handed 5 Airanjangla Rented NRHM-1 Yes FW PHC over) Dharmasala Bidyapara 6 Rented NRHM-3 Yes FW PHC Vatigaon In place of Dharmasala 7 Motir Char Rented Yes FW Ghegraralga in PHC NRHM-1 Dharmasala 12th Finance 8 Howrarpaar Rented Yes FW PHC Commission Dharmasala 9 Silghagri Rented Yes FW PHC Dharmasala 12th Finance 10 Gaspara Govt Yes FW PHC Commission Dharmasala 11 Dubirpar Rented NRHM-3 Yes FW PHC Dharmasala 12 Tistarpar Rented NRHM-3 Yes FW PHC Temporary Dharmasala arrangement 13 Singimari Govt NRHM-1 Yes FW PHC (Land not handed over) Dharmasala 12th Finance Temporary 14 Durahati Govt Yes Medical PHC Commission arrangement Dharmasala 15 Kacharihat Govt Yes FW PHC Dharmasala 16 Soulmari Rented NRHM-2 Yes FW PHC Dharmasala Temporary 17 Pestirpar Govt Yes FW PHC arrangement Dharmasala 18 Kachuarkhas Rented NRHM-3 Yes FW PHC Dharmasala 12th Finance 19 Adabari Govt Yes FW PHC Commission

SC running In Dharmasala 20 Bidaypara Pt - I Rented NRHM-2 Yes FW GP PHC Members House

DHUBRI/DHAP/2010-11 12 Dharmasala 21 Modhusoulmari Govt Yes FW PHC Dharmasala 12th Finance 22 Folimari Rented Yes FW PHC Commission Dharmasala 12th Finance 23 Tiamari Rented Yes FW PHC Commission Dharmasala 12th Finance 24 Madaikhali Govt Yes FW PHC Commission

In place of SC Nowarchar,(NRHM- Dharmasala running in 1) but repated in 25 South Geramari Rented NRHM-2 Yes FW PHC ANMs NRHM2, SC may house be changed from NRHM-2,

Dharmasala 12th Finance Ghegrar in place of 26 Ghageralga Rented Yes FW PHC Commission Boraibari SC

Dharmasala 27 Jhaleralga Govt Yes FW PHC Dharmasala 28 Boraibari Govt Yes FW PHC Dharmasala 12th Finance 29 Alomganj Govt Yes Medical Temp arrangment PHC Commission Dharmasala Rangamati 12th Finance 30 Govt Yes FW Temp arrangment PHC (Panbari) Commission Dharmasala 31 Bolodmara Govt Yes FW PHC

Dharmasala 12th Finance 32 Nauarchar Rented Yes FW in place of silarpar PHC Commission

Dharmasala 33 Silairpar Govt Yes FW PHC Dharmasala 34 Darchauka Govt Yes FW PHC Proposed for Golakganj NRHM-2 in SC in Dilapidated 35 Ratiadaha SC Govt Yes Medical PHC place of condition Majerchar Golakganj 36 Balajan SC Govt Yes FW PHC Golakganj 37 South Raipur SC Govt Yes FW PHC Golakganj 12th Finance in place of 38 Khudimari SC Rented Yes FW PHC Commission Horiorkuti Golakganj 12th Finance 39 Sukatikata SC Rented Yes FW In place of Balajan PHC Commission

Golakganj 12th Finance Gaikhowa SC in 40 Gaikhowa SC Rented Yes FW PHC Commission place of S.Raipur

Lalkura SC Golakganj selected in place of 41 Lalkura SC Rented Yes FW PHC Gaikhowa in NRHM-1

DHUBRI/DHAP/2010-11 13 Golakganj 42 Hariarkuti SC Govt Yes FW PHC Golakganj 43 Chapgarh SC Govt Yes FW PHC Golakganj 12th Finance in place of 44 Sahebganj SC Rented Yes FW PHC Commission Chapgarh Golakganj 45 Binnachara SC Govt NRHM-1 Yes FW PHC Golakganj Bishkhowa-IV 46 Govt Yes FW PHC SC Golakganj 12th Finance 47 Bishkhowa SC Govt Yes FW PHC Commission Golakganj 48 Kanuri SC Govt Yes FW PHC Golakganj 49 Rakhalpat SC Govt Yes FW PHC Golakganj 50 Sonahat SC Govt Yes FW PHC Golakganj 51 Pratapganj SC Govt Yes FW PHC Golakganj 12th Finance 52 Paglahat SC Govt Yes Medical PHC Commission Golakganj 53 Bisondoi SC Govt Yes FW PHC Golakganj 12th Finance 54 B.N. Chariali SC Rented Yes FW PHC Commission Golakganj 55 Dafarpur SC Govt Yes FW PHC Golakganj 56 Ujanpetla SC Govt Yes FW PHC Golakganj 57 Bhatipetla SC Govt Yes FW PHC Golakganj 58 Madhyapetla SC Govt Yes FW PHC Golakganj 12th Finance 59 Majerchar SC Rented Yes FW PHC Commission Golakganj Borochoraikhola 12th Finance 60 Rented Yes FW PHC SC Commission Golakganj 61 Bathuatuli SC Govt Yes FW PHC Golakganj 62 Kamandanga SC Govt Yes Medical PHC Golakganj 63 Pokalagi SC Rented NRHM-2 Yes FW PHC Golakganj attached with 64 Dhepdhepi SC Govt Yes FW PHC MPHC Golakganj attached with 65 Dumardaha Govt Yes FW PHC MPHC Halakura 66 Ranpagli Govt Yes FW PHC Halakura 67 Chagolia Pt-II Govt Yes FW PHC Halakura 68 Pokalagi Pt-II Govt Yes FW Dilapidated PHC

DHUBRI/DHAP/2010-11 14 Halakura 69 Gharialdanga Govt Yes FW PHC Halakura 70 Kherbari Pt-IV Govt Yes FW PHC Halakura 71 Jhaskal Pt- III Govt Yes FW PHC Halakura 72 Lohajani Rented NRHM-1 Yes FW PHC Halakura 73 Kherbari Pt – III Govt Yes FW PHC Halakura 74 Paborchara Govt Yes FW PHC Halakura 12th Finance 75 Talli Pt - II Rented Yes FW PHC Commission Halakura 76 Shimlabari Rented NRHM-2 Yes FW PHC Halakura Bidyardabri Pt – 12th Finance 77 Rented Yes FW PHC III Commission Halakura 78 Koimari Pt-I Rented NRHM-1 Yes FW PHC Halakura 12th Finance 79 Atgharitari Rented Yes FW PHC Commission Halakura 12th Finance 80 Kaldoba Pt- III Rented Yes FW PHC Commission Halakura Uttarmara 12th Finance 81 Rented Yes FW PHC Godadhar Commission Halakura 82 Bhamondanga Rented NRHM-3 Yes FW PHC Halakura 12th Finance 83 Moisa Pt- I Rented Yes FW PHC Commission Halakura 84 Kathatoli Rented NRHM-2 Yes FW PHC Halakura 85 Kherbari Pt - I Govt Yes FW PHC Halakura 86 Bauserkuti Rented NRHM-3 Yes FW PHC Halakura 87 Pokalagi Pt - III Rented NRHM-2 Yes FW PHC Halakura 88 Chotoguma SC Rented NRHM-2 Yes FW PHC Halakura 89 Kaimmati SC Rented NRHM-2 Yes FW PHC Halakura 90 Banyaguri SC Rented NRHM-2 Yes FW PHC Raniganj 91 Dhemdhema Govt NRHM-1 Yes FW Temp arrangment PHC Raniganj 92 Rokakhata Govt NRHM-1 Yes FW Temp arrangment PHC Raniganj 93 Rabontary Govt Yes FW PHC Raniganj 12th Finance 94 Murabari Govt Yes FW PHC Commission Raniganj 95 Koimari Govt Yes FW PHC

DHUBRI/DHAP/2010-11 15 Raniganj 12th Finance 96 Barogiraipar Govt Yes FW PHC Commission Raniganj 97 Buchirchar Govt Yes FW PHC Raniganj 98 Kazaikata Pt – V Govt Yes FW PHC Raniganj Chechapani 99 Govt Yes FW PHC (Aisakati) Raniganj 100 Dhanpur Govt NRHM-2 Yes FW Temp arrangment PHC Raniganj 12th Finance 101 Mayarchar Govt Yes FW PHC Commission Raniganj 12th Finance 102 Kazaikata Pt – IV Govt Yes FW PHC Commission Raniganj 12th Finance 103 Piazbari Govt Yes FW PHC Commission Raniganj 104 Fasatpur Panbari Rented NRHM-3 Yes FW PHC Raniganj Chechapani Pt – 105 Rented Yes FW PHC I Raniganj 106 Pub Sadhubhasa Rented Yes FW PHC Raniganj 107 Ambari Rented NRHM-2 Yes FW PHC Raniganj 108 Chotogiraipar Govt Yes FW PHC Raniganj 109 Maspara Rented Yes FW PHC Raniganj 110 Suripara Rented NRHM-1 Yes FW PHC Raniganj 111 Hatipota Rented NRHM-3 Yes FW PHC Raniganj 112 Sagunmari Rented NRHM-2 Yes FW PHC Raniganj 113 Lutapara Rented Yes FW PHC Raniganj 114 Bhuterkanda Rented Yes FW PHC Raniganj 12th Finance 115 Gobordhanpara Rented Yes FW PHC Commission Raniganj 116 Howdartary Rented Yes FW PHC Raniganj 12th Finance 117 Tamakubari Govt Yes FW PHC Commission Raniganj 118 Kadamtola Rented NRHM-3 Yes FW PHC Raniganj 119 Kalipara Rented Yes FW PHC Raniganj 120 Kachuagaon Rented NRHM-1 Yes FW PHC Raniganj 121 Gutipara Rented Yes FW PHC Raniganj 122 Thakureralga Rented Yes FW PHC

DHUBRI/DHAP/2010-11 16 Raniganj Andamari 12th Finance 123 Rented Yes FW PHC Kalairchar Commission Raniganj 124 Saildhora Rented Yes FW PHC Raniganj Masaneralga 125 Rented NRHM-3 Yes FW PHC santipur Raniganj 126 Choudhurirchar Rented Yes FW PHC Raniganj 127 Masaneralga Rented NRHM-2 Yes FW PHC Raniganj 128 Jharnarchar Rented Yes FW PHC Raniganj 129 Patakata Rented Yes FW PHC Raniganj 130 Chuapata Pt-V Rented NRHM-3 Yes FW PHC Raniganj 131 Choitara Rented Yes FW PHC Raniganj 132 Katholipara Rented Yes FW PHC Raniganj 133 Khankhowa Govt Yes FW Temp arrangement PHC Raniganj 134 Bogribari Govt Yes FW attached with SD PHC Raniganj 135 Sapatgram Govt Yes FW attached with SHC PHC Raniganj 136 Futkibari Govt Yes FW attached with SD PHC Raniganj 137 Borkanda (Med) Govt Yes Medical PHC Raniganj Nayar Alga 138 Govt Yes Medical PHC (Med)

139 Chapor PHC Bahalpur Govt Yes FW

140 Chapor PHC Simalabari Govt Yes FW Dilapidated

141 Chapor PHC Arearjhar Govt Yes FW

142 Chapor PHC Islamari Govt Yes FW Dilapidated

143 Chapor PHC Santoshpur Govt NRHM-2 Yes FW Dilapidated

144 Chapor PHC Noonmati Govt NRHM-2 Yes FW Dilapidated

145 Chapor PHC Falimari Govt Yes FW

146 Chapor PHC Batordol Govt Yes FW

147 Chapor PHC Kaljani Govt NRHM-2 Yes FW Dilapidated

148 Chapor PHC Champabati Govt Yes FW

149 Chapor PHC Hardamara Govt Yes FW

DHUBRI/DHAP/2010-11 17 150 Chapor PHC Dhirghat Rented Yes FW

151 Chapor PHC Soulmari Rented NRHM-1 Yes FW

152 Chapor PHC Kurshamari Rented NRHM-1 Yes FW

153 Chapor PHC Barunitara Govt Yes FW Dilapidated

154 Chapor PHC Jalikuria Rented Yes FW

155 Chapor PHC Haridal Rented Yes FW

Gazarikandi Kalapani 156 Govt Yes FW Attached with SHC PHC Gazarikandi Kuchnimara 157 Govt Yes FW PHC Gazarikandi Bhurakata 158 Govt Yes FW PHC Gazarikandi Manullapara 159 Govt Yes FW PHC Gazarikandi Borkona 160 Govt Yes FW Temp arrangment PHC Gazarikandi Borairalga 161 Govt Yes FW PHC Gazarikandi Kokradanga 162 Rented NRHM-3 Yes FW PHC Gazarikandi Kanaimara 163 Rented NRHM-3 Yes FW PHC Gazarikandi Purandiara 164 Rented NRHM-1 Yes FW PHC Gazarikandi Fulerchar 165 Rented NRHM-3 Yes FW PHC Gazarikandi Diara Bazar 166 Govt Yes FW PHC Gazarikandi Bengirvita 12th Finance 167 Govt Yes FW PHC Commission Gazarikandi Dharakoba 168 Govt Yes FW PHC Gazarikandi Gokulpur 12th Finance 169 Govt Yes FW PHC Commission Gazarikandi Berabhanga 12th Finance 170 Govt Yes FW PHC Commission Gazarikandi Bamunpara 12th Finance 171 Govt Yes FW PHC Commission Gazarikandi Kukurmara 172 Govt Yes FW PHC Gazarikandi Sunarpara 173 Rented NRHM-3 Yes FW PHC Gazarikandi Bormanpara 174 Govt Yes FW PHC Gazarikandi Bangrirchar 12th Finance 175 Govt Yes FW PHC Commission Gazarikandi Molakhowa 12th Finance 176 Govt Yes FW PHC Commission

DHUBRI/DHAP/2010-11 18 Gazarikandi Thakuronbari 177 Rented NRHM-2 Yes FW PHC Gazarikandi K.K.M Para 178 Rented NRHM-2 Yes FW PHC Gazarikandi Jhograrchar 179 Rented NRHM-2 Yes FW PHC

SC Gazarikandi running in 180 Jhalerchar Rented NRHM-2 Yes FW PHC a private house

Gazarikandi Pipulbari Bazar 181 Govt Yes FW PHC Gazarikandi Firingirchar 12th Finance 182 Govt Yes FW PHC Commission Gazarikandi Pankata 183 Govt Yes FW PHC Gazarikandi Teporpara 12th Finance 184 Govt Yes FW PHC Commission Gazarikandi Bheramara 185 Rented NRHM-3 No FW PHC Gazarikandi Pipulbari Pt – II 186 Rented NRHM-3 Yes FW PHC Gazarikandi Jordanga 187 Rented NRHM-2 Yes FW PHC Gazarikandi Dakergaon 188 Rented NRHM-2 Yes FW PHC Gazarikandi Tangaon 189 Govt Yes FW PHC Gazarikandi Pubergaon 190 Rented NRHM-1 Yes FW PHC Gazarikandi Bamuneralga 191 Rented NRHM-3 Yes FW PHC Gazarikandi Jhowdanga 192 Govt Yes FW attached with SD PHC Gazarikandi Kakripara 193 Govt Yes FW attached with SD PHC Gazarikandi Takimari 194 Rented NRHM-3 No FW PHC Khopatia Gazarikandi 12th Finance 195 Govt Yes FW PHC Commission

Gazarikandi Jewali 196 Govt Yes FW PHC Charbetbari Gazarikandi 12th Finance 197 Govt Yes FW PHC Commission Fekamari (Med) Gazarikandi 198 Govt Yes Medical PHC

Baghapara Gazarikandi (Med) 199 Govt Yes Medical PHC Sadullabari

Hazirhat (Med) Gazarikandi 200 Govt Yes Medical PHC

DHUBRI/DHAP/2010-11 19 South 201 Salmara Bauskata Govt Yes FW PHC

South 202 Salmara Muthakhowa -II Govt Yes FW PHC South 203 Salmara Bhalukkandi Govt Yes FW PHC South 204 Salmara Jaruachar Govt Yes FW Damaged PHC South 12th Finance 205 Salmara Ravatori Govt Yes FW Commission PHC South Erroted by 206 Salmara Muhurirchar Govt Yes FW Brahmaputra PHC South 12th Finance 207 Salmara Simlakandi Rented Yes FW Commission PHC South 208 Salmara Airkata Rented NRHM-1 Yes FW PHC South 209 Salmara Padmeralga – II Govt Yes FW Damaged PHC Proposed for South NRHM-2 in 210 Salmara Chirakuti Rented Yes FW place of PHC Simlakandi South 12th Finance 211 Salmara Poyesti Dimatola Rented Yes FW Commission PHC South 212 Salmara Chtonisanpur Rented NRHM-2 Yes FW PHC South 12th Finance 213 Salmara Kushbari Rented Yes FW Commission PHC South 12th Finance 214 Salmara Bolodmari Rented Yes FW Commission PHC South 215 Salmara Medortary Govt Yes FW attached with SD PHC South 216 Salmara Katiaralga-III Rented NRHM-3 Yes FW PHC Proposed for South NRHM-2 in 217 Salmara Golaperalga Rented Yes FW place of PHC Kushbari South 218 Salmara Satdubi Rented NRHM-2 Yes FW PHC Proposed for South NRHM-2 in 219 Salmara Salkata Rented Yes FW place of PHC Monirchar South 220 Salmara Salapara-I Rented NRHM-3 Yes FW PHC

DHUBRI/DHAP/2010-11 20 South 221 Salmara Ambari Rented NRHM-3 Yes FW PHC South 222 Salmara Natineralga Rented NRHM-3 Yes FW PHC South 223 Salmara River Block – III Rented Yes FW PHC South Tumni 224 Salmara Rented NRHM-3 Yes FW Dewakandi PHC South 225 Salmara Dhenerkuti Rented NRHM-1 Yes FW PHC South 226 Salmara Chottobilpara Rented NRHM-3 Yes FW PHC South 227 Salmara Namasershow Rented NRHM-3 Yes FW PHC South 228 Salmara Radhuramchola Rented NRHM-1 Yes FW PHC South 229 Salmara Ravarchola Rented NRHM-3 Yes FW PHC South 230 Salmara Folimari Rented NRHM-3 Yes FW PHC South 231 Salmara Podmeralga – I Rented NRHM-2 Yes FW PHC South 232 Salmara Feskumari Rented NRHM-1 Yes FW PHC South 233 Salmara Kathdanga Rented NRHM-3 Yes FW PHC South 12th Finance 234 Salmara Monirchar Rented Yes FW Commission PHC South Muthakhowa Pt – 235 Salmara Rented Yes FW III PHC South 236 Salmara Satsia Rented NRHM-2 Yes FW PHC South Chalbandhar 237 Salmara Rented Yes FW Char PHC South 12th Finance 238 Salmara Gosaidubi Rented Yes FW Commission PHC South 239 Salmara Mathakata Rented NRHM-3 Yes FW PHC South 240 Salmara Sundarpara Rented NRHM-2 Yes FW PHC South 241 Salmara Nayaparowa Rented NRHM-3 Yes FW PHC South Majerchar 12th Finance 242 Salmara Rented Yes FW Chalakurarchar Commission PHC

DHUBRI/DHAP/2010-11 21 South 12th Finance 243 Salmara Fulkakata Rented Yes FW Commission PHC South Tangvita River 244 Salmara Rented NRHM-3 Yes FW Block-9 PHC South 12th Finance 245 Salmara Patakata (Med) Govt Yes Medical Damaged Commission PHC South Jamadarhat 246 Salmara Govt Yes Medical Erroted (Med) PHC

DHUBRI/DHAP/2010-11 22

CHAPTER- 2 Process for Plan Development

Preparation of an absolute DHAP (District Health Action Plan) is big deal. The whole process is depended on the capacity of the officials of DPMU, incrages of all National Diseases Control Programme and BPMU. Before going to do a plan it is essential to acquire the technical know how of the subjects. Keeping in mind the NRHM in joint collaboration with RRC North East designed a 4 days Capacity Building workshop for the officials of district. It was organized at SIHFW, Khanapara, Guwahati 10 th November to 13 th November 2009. The course models are developed by PHRN, Chhattisgarh (Public Health Resource Network The following officials of Dhubri represented for the district . Sl. No Name Designation 1 Dr. Nural Amin SDM & HO(HQ) 2 Dr. A. Bose SDM &HO- Raniganj PHC 3 Kurshed Alom DPM- NRHM 4 Maruf Alom DME-NRHM 5 Rabindra Borkakati DDM- NRHM Dhubri

In the 4 days training emphasised given on Learning by Doing approach . Almost every lecture followed by Group Works. During the first day DHAP of 2009-10 were reviewed by Mission Director of NRHM and Regional Director of RRC, NE. As per discussion with Joint Director of Health Services cum Member Secretary, DHS Dhubri a one day Capacity Building Workshop for the in-charge of All National Diseases Control Programme, BPMU consisting SDM & HO, BPM, BAM and BEE was organized on 10 th December 2009 at Joint Director of Health Services Conference Hall, Dhubri. All the major topics like preparation of Village Health Action Plan, Training Plan, Quality Assurance, Monitoring Plan, IEC/BCC, PPP, and HIMS are covered. Instruction has been received from MD of NRHM vide email to attend Guwahati on 18 th & 19 th December 2009 along with the draft copy of DHAP 2010-11. .All the related information, data & format were collected from respective sources like National Diseases Control Programme incharge, NFHS, DLHS, Censes of India various website etc. Instruction of DO Letter of MD on Planning Process 2010-11, vide no; 109”)/2008-NRHM- I dt 8 th October 2009, Letter No 6-34/2009/NVBDCP (P & C) 2010-11, dt 14-10-09 issued by Joint director Dr. P.K Srivastava and Letter No. M-11015/1/2009- M & E dt 9 th October 2009 issued by Director (Stats) were circulated to respective Programme officials and followed strictly while activities were proposed in DHAP 2010-11.

DHUBRI/DHAP/2010-11 23

District planning team fixed a date for submission of draft copy of Block Health Action Plan (BHAP) along with 5 nos of Village Health Plansand Institutional plans to district and accordingly all the BPHC has submitted. District planning team conducted a detailed study and analysed the Goal-objective- strategy- activity-budget etc of respective Block. Comparing all the plans a summarize DHAP for the year 2010-11 is prepared at district. During preparation of DHAP special instruction, guideline and direction were frequently received from State Programme Manager of NRHM via e-mail and over mobile phone also. Moreover, DHAP of 2007-08, 2008-09 and 2009-10 were the main reference for us, the last 3 years DHAP work like an encyclopaedia in preparation of DHAP 2010-11 of Dhubri.

DHUBRI/DHAP/2010-11 24 CHAPTER- 3 Situational Analysis Table: 3.1 District Profile– ≤ 400,000 (urban) currently under NRHM (Template1)

Dhubri Assam S.No. Background Characteristics Number % to total Number 1 Geographic Area (in Sq. Kms) 2797.78 3.56 % 78438 2 Number of blocks 14 6.39 % 219 3 Size of Villages (2001 Census) 26247 1-500 532 501-2000 638 2001 -5000 181 5000+ 8 4 Number of towns 5 5 Total Population (2001) 1637344 6.14 % 26655528 -Urban 192443 5.59 % 3439240 -Rural 1444901 6.22 % 23216288 6 Sex Ratio (F/M*1000) • Population Sex Ratio 947:1000 935 • Child Sex Ratio 965:1000 Decadal Growth rate 23.4 (DLHS III) 15.4 (SRS,09) 7 Density- per sq. km. 584 340 8 Literacy Rate (6+ Pop) 48.21 63.25 -Male 55.91 71.28 -Female 40.04 54.61 9 SC population 63208 4.8% 1825949 ST population 32523 2.4% 3308570 No. of Primary schools 1470 No. of Anganwadi Centres 1792 10 Length of road per 100 sq. km. 12 No of villages having access to safe drinking 1359 water facility 13 No of households having sanitation facility 42360 (Specify Type –sewer, septic tank) 14 Population below poverty line 1171392 15 Health Status

Morbidity Male Female Child

Mortality MMR 480/100000 IMR 64/1000 16 Health Resources- Facilities (Specify level of Facility like Subcentre) Personnel (Sanctioned Vacancy) Finances (Requirement and Releases) 17. 1.Birth rate and death rate 1. 23.9 (BR) 2. Fertility rate. & 8.6 (DR) 3. Disease maximum Disability. 2. 2.7 (Ind) 4.High Risk Groups 18. B.To link with the nutritional determinants -

1. % of Infants with low birth weight. 2. Weight for Age no. above 90%, 3. No between 60%-80%, 4. No. below 60% weight for age

DHUBRI/DHAP/2010-11 25 Table: 3.2 Public Health Infrastructure in the District (Template2)

Number Sl.No. Health Facility Govt. Building Rented House 1 District Civil Hospital 1 Nil 2 Sub-Divisional Hospital 1 Nil 3 Primary Health Centre 7 Nil 4 Community Health Centre 5 Nil 5 Mini PHC 11 Nil 6 Subsidiary Health Centre 4 Nil 7 State dispensary 11 Nil 8 First Referral Unit 1 Nil 9 Dhubri Health & Maternity Cnetre 1 Nil 10 Urban Health Centre 0 1 11 No. of Sub-Centre in Dhubri District 120 126 12 No. of FW sub-centre 107 126 13 No. of Medical sub-centre 13 Nil (Sources; Jt.DHS, Dhubri)

Table: 3.2.1 Sub Centre (SC) Building Situation

PHC wise Sanction SC Govt. Building Rented Dharmasala PHC 34 17 17 Raniganj PHC 48 21 27 Golokganj PHC 31 22 9 Chapor PHC 17 12 5 Halakura PHC 25 9 16 South Salmara PHC 46 10 36 Gazarikandi PHC 45 29 16 Total 246 120 126 (Sources; Jt.DHS, Dhubri)

DHUBRI/DHAP/2010-11 26 Table: 3.3.1 Vacancy Posiion of Officers/Staffs under the Establishment Joint Director of Health Services, Dhubri as 30.11.09 Sl No Cat egory of Post Sanction Stregth Staff in Position Vacancy 1 Jt. DHS 1 1 0 2 CM & HO (CD) 1 1 Attaching at MMC, Guwahati 3 Addl CM & HO (FW) 1 1 0 4 Supdt. Civil Hospital 1 1 0 5 SDM & HO & Its cadre 25 20 5 6 Sr. M & HO 48 31 17 7 M & HO-1 66 39 27 8 MO (Ayur) 20 19 1 9 Dental Surgeon 3 3 0 10 MO (Homeo) 2 2 0 11 PMA 1 1 0 12 SI 10 10 0 13 RHI 8 6 2 14 Health Asstt. 9 9 0 15 Vacinator 37 37 0 16 Driver 16 15 1 17 ANM 57 46 11 18 LHV 8 4 4 19 Opth Asstt 11 11 0 20 Cinema Operator 2 2 0 21 TB Health Visitor 2 2 0 22 Radiographar 7 5 2 23 Dresser 17 15 2 24 Lab Tech 29 29 0 25 Matron 1 0 1 26 Asstt Matron 1 0 1 27 Ward Sister 10 7 3 28 PHN 5 5 1 attached to Golaghat 29 PNO 1 1 0 30 Sister Tutor 4 4 0 31 Staff Nurse 78 53 25 32 BCG Technician 7 7 0 33 NMS 2 2 0 34 NMA 13 13 0 35 HE 11 11 0 36 Pharmacist 53 53 0 37 Gr-IV 216 211 5 38 Sweeper 63 54 9 39 Handyman 3 3 0 40 Dark Room Attendant 3 3 0 41 Head Assistant 1 0 1 42 UDA 15 15 0 43 LDA 24 21 3 44 M.L.O 1 1 0 45 Head Pharamist 1 1 0 46 Sr. Inspector of Drugs 1 1 0 47 Inpector of Drugs 1 1 0 48 Food Inspector 1 1 0 49 Asstt. Public Analysist 1 1 0 50 Research Asstt 1 1 1 duputed at Morigaon 51 Statistical Asstt 2 2 0 52 Statistical Computor 1 0 1 53 Statistical Clerk 2 1 1

DHUBRI/DHAP/2010-11 27

Table: 3.3.2 Manpower Position in the Establishment of Addl.CM & HO (FW), Dhubri as on 11/12/2009 Sl Category of post No. of Sanction post InPosition Vacant Position No 1 Addl. CM & HO (FW) 1 1 0 2 DIO 1 1 0 3 Sr. M & HO 7 4 3 4 M & HO-I 6 1 5 5 Adminsitrative Officer 1 0 1 6 Asstt. Accountant 1 1 0 7 Cashier 1 1 0 8 UDA 12 12 0 Dist. Extension & Media 9 1 1 0 Officer Dy. Extension & Media 10 2 1 1 Officer 11 L.D.Asstt 3 2 1 12 S.I.(FW & UIP) 2 2 0 13 Steno Typist 1 0 1 14 Projectionist 1 0 1 15 D.P.H.N.S 1 1 0 16 Ref Mechanic 1 1 0 Artist cum 17 1 1 0 Photographer 18 Lab. Technician 3 3 0 19 Pharmacist 1 1 0 20 B.E.E 7 7 0 21 Computer 7 1 6 22 Field worker 5 5 0 Field & Evaluation 23 1 1 0 Worker 24 LHV 20 8 12 25 U.E.E 1 1 0 26 A.N.M 267 180 87 27 O.T. Nurse 2 1 1 28 Dhai 3 3 0 29 Driver 7 6 1 30 Gr-IV 18 8 10

Table 3.3.4 : Doctors Position of Dhubri District as on 11.12.09

Sl Sanctioned Name of Post Staff in Position Vacancy No Strength 1 Jt. DHS 1 1 0 2 CM & HO (CD) 1 1 0 3 Addl CM & HO (FW) 1 1 0 4 Supdt. Civil Hospital 1 1 0 5 Dy. Supdt 5 4 1 6 DIO (FW) 1 1 0 7 SDM & HO 19 14 5 8 Sr. M & HO 48 31 17 9 M & HO-1 66 40 26 10 MO (Ayur) 20 19 1 11 Dental Surgeon 3 3 0 12 MO (Homeo) 2 2 0 Total 168 118 50

DHUBRI/DHAP/2010-11 28 Table: 3.3.5 Staffs position of the District Health Society, NRHM, Dhubri as on 11.12.09 Sl Designation No. of Position Vacant Remarks No 1 District Programme Manager 1 0

2 District Media Expert 1 0 District Warehouse Store 3 1 0 Manager 4 District Accounts Manager 1 0

5 District Data Manager 1 0

6 Computer Assistant 1 0

7 Peon 1 0 Daily Basis

8 Block Programme Manager 7 1

9 Block Accounts Manager 9 0 Block PHC Accountant cum 10 16 2 Asstt BPM 11 Consultant Paedrieatic 2 0

12 Consultant Anaesthist 0 2

13 MO (MBBS) 4 0

14 MO (MBBS) 1 yr rural posting 23 14

15 MO (Ayur) 17 0

16 RHP 10 0

17 Lab Tech 14 0

18 Pharmacist 7 0

19 GNM including MMU unit 69 0

20 ANM 230 0

21 Radio Graphar for MMU 1 0

22 Lab Tech for MMU 1 0

23 Pharmacist for MMU 1 0

24 Driver 3 0

25 Handyman 2 0

Table : 3.3.6 : PHC Wise Manpower Position of Malaria Deptt. As On 7.12.09

Dharmasala PHC Sanction In positon Vacant SMI 0 0 0 MI 1 1 0 Lab Tech 2 1 1 SI 5 5 0 SW 19 18 1 Driver 0 0 0

DHUBRI/DHAP/2010-11 29 Golakganj PHC Sanction In positon Vacant SMI 1 1 0 MI 0 0 0 Lab Tech 1 1 0 SI 3 1 2 SW 15 15 0 Driver 0 0 0 Raniganj PHC Sanction In positon Vacant SMI 0 0 0 MI 1 1 0 Lab Tech 1 2 0 SI 5 5 0 SW 21 18 3 Driver 0 0 0 Halakura PHC Sanction In positon Vacant SMI 0 0 0 MI 1 1 0 Lab Tech 1 0 0 SI 2 2 0 SW 9 9 0 Driver 0 0 0 Chapor PHC Sanction In positon Vacant SMI 0 0 0 MI 1 1 0 Lab Tech 1 1 0 SI 3 3 0 SW 7 7 0 Driver 0 0 0 South Salamara PHC Sanction In positon Vacant SMI 1 1 0 MI 0 0 0 Lab Tech 1 1 0 SI 3 3 0 SW 15 11 4 Driver 0 0 0 Gazarikandi PHC Sanction In positon Vacant SMI 1 0 1 MI 1 1 0 Lab Tech 1 1 0 SI 4 4 0 SW 18 17 1 Driver 0 0 0 District Head Quarter DMO 1 1 0 MI 1 1 0 AMO 1 1 0 Sr. Asstt 2 2 0 Jr. Asstt 2 2 0 SFW 4 2 2 FW 9 7 2 Driver 4 3 1 Night Chowkidar 4 1 3 Peon 2 1 1 Van Cleaner 3 3 0

DHUBRI/DHAP/2010-11 30 Table: 3.4. Functionality of District Hospitals, CHCs, PHCs and SubCenters (In terms of availability of critical staff position) As On 11/12/2009 (Template4)

Sl. Name of the Post Health Sanctioned strength Staff in Vacancy Remarks No Instistutionwise of Doctors/staff position

1 2 3 4 5 DHUBRI SUB-DIVISION 200 BEDED DIST. CIVIL HOSPITAL, DHUBRI 1 Supdt. 1 1 0 2 Dy. Supdt. 1 1 0 3 SDM & HO 4 4 0 4 Sr. M & HO 13 12 1 5 M & HO 6 6 0 6 M.O. (Ayr) 1 1 0 7 B.D.S. 1 1 0 8 M.O. (Homeo) 1 1 0 10 A.N.M. (G) 2 2 0 11 G.N.M. 37 33 4 12 GNM (NRHM) 0 12 0 13 SI (PH) 1 0 1 14 Gr. IV 57 50 7 15 Pharmacist 9 9 0 16 Driver 2 2 0 DIST. HEAD QUARTER 1 Jt. Director, DHS 1 1 0 2 CM& HO (CD) 1 1 0 3 SDM & HO 4 4 0 4 E.U. 1 1 0 5 MO (Ayur) 1 1 0 6 SI (PH) 1 1 0 7 P.M.A. 1 1 0 8 RHI 1 1 0 9 Grade-IV 17 15 2 Total Vacinator(posted under Different 10 PHC) 51 42 9 Total Driver Excluding DMEO(posted 11 in different Institution of Dhubri) 18 15 3 74 BEDED CHEST HOSPITAL, DHUBRI 1 Dy Suptd. 1 1 0 2 SDM & HO 1 1 0 3 Sr. M&HO (DTC) 1 1 0 4 M&HOI 1 1 0 5 Staff Nurse 8 6 2 6 Gr.IV 19 18 1 7 Sweeper 4 4 0 8 Pharmacist 2 2 0 9 Driver 2 2 0 DHARMASALA PHC 1 SDM&HO 1 1 0 2 Sr. M & HO 2 0 2 3 MO under NRHM 0 1 0

DHUBRI/DHAP/2010-11 31 4 A.N.M. (G) 1 1 0 5 G.N.M. 2 0 2 6 Gr.IV 2 2 0 7 Sweeper 1 1 0 9 Pharmacist 1 1 0 10 SI (PH) 1 1 0 11 RHI(PH) 1 1 0 12 Health Assistant(PH) 2 2 0 GAURIPUR CHC & SHC/F W.M./C 6 BEDED 1 Sr. M & HO 2 2 0 2 M & HOI 3 1 2 3 M.O. (Ayr) 1 1 0 4 A.N.M. (G) 2 2 0 5 G.N.M. 3 2 1 6 Gr.IV 9 7 2 7 Sweeper 2 2 0 8 Pharmacist 2 2 0 9 GNM (NRHM) 0 4 0 10 SI (PH) 1 1 0 11 Health Assistant(PH) 1 1 0 20 BEDED MATERNITY CENTRE, DHUBRI 1 Sr. M & HO 1 1 0 2 M & HOI 2 2 0 3 Ward Sister 1 1 0 4 G.N.M. 1 1 0 5 Gr.IV 8 8 0 6 Sweeper 1 1 0 7 GNM (NRHM) 0 3 0 TOWN STATE DISPENSARY Attached to CM 1 Sr. M & HO 1 1 0 carcade 2 M&HOI 1 1 0 3 Pharmacist 1 1 0 4 Gr.IV 2 2 0 5 Sweeper 1 1 0 GERAMARI MINI PHC 1 M&HOI 1 1 0 2 M.O. (Ayr) 1 1 0 3 MO (Ayur) under NRHM 0 1 0 4 A.N.M. (G) 1 1 0 5 Gr.IV 2 2 0 6 Sweeper 1 1 0 7 Pharmacist 1 1 0 ALOMGANJ MEDICAL SUB-CENTRE 1 A.N.M. (G) 1 1 0 2 ANM (NRHM) 0 1 0 3 Gr.IV 1 0 1 DURAHATI MEDICAL SUB-CENTRE 1 A.N.M. (G) 1 1 0 2 ANM (NRHM) 0 1 0 3 Gr.IV 1 1 0 BHOGDAHAR MEDICAL SUB-CENTRE 1 A.N.M. (G) 1 1 0

DHUBRI/DHAP/2010-11 32 2 Gr.IV 1 1 0 HALAKURA PHC 1 SDM&HO 1 1 0 2 Sr. M&HO 2 1 1 3 M&HOI 1 0 1 4 M.O. (Ayr.) 1 1 0 5 A.N.M. (G) 4 3 1 6 Gr.IV 5 4 1 7 Sweeper 2 1 1 8 Pharmacist 1 1 0 9 SI (PH) 1 0 1 10 Health Assistant(PH) 1 1 0 11 Driver 1 1 0 HALAKURA CHC 1 Sr. M&HO 1 1 0 2 MO under NRHM 0 1 0 3 G.N.M. 4 3 1 4 GNM (NRHM) 0 2 0 AGOMANI C.H.C. 1 Sr. M&HO 1 0 1 2 M&HO 4 4 0 3 M.O. (Ayr.) 1 1 0 4 G.N.M. 4 3 1 5 A.N.M. (G) 1 1 0 6 RHI (PH) 1 0 1 7 Gr.IV 4 4 0 8 Sweeper 1 1 0 9 Pharmacist 1 1 0 10 GNM (NRHM) 0 5 0 SATRASAL MINI P.H.C. 1 attached to 1 M&HOI 2 2 0 Goalpara CH 2 GNM (NRHM) 0 2 0 3 Gr.IV 1 1 0 4 Sweeper 1 1 0 5 Pharmacist 1 1 0 BOTERHAT S/D 1 M&HOI 1 0 1 2 Gr.IV 2 2 0 3 Sweeper 1 0 1 4 Pharmacist 1 1 0 GOLAKGANJ P.H.C. & 8 BEDED M/C F.W. 1 SDM&HO 1 1 0 2 Sr. M&HO 2 1 0 3 M&HOI 1 0 1 4 MO under NRHM 0 1 0 5 M.O. (Ayr.) 1 1 0 6 MO (Ayur) under NRHM 0 1 0 7 GNM (NRHM) 0 6 0 8 Pharmacist 2 1 1 9 SI (PH) 1 0 1 DHEPDHEPI MINI P.H.C. 1 M&HOI 1 0 1

DHUBRI/DHAP/2010-11 33 2 MO under NRHM 0 1 0 3 M.O. (Ayr.) 1 1 0 4 A.N.M. (G) 1 1 0 5 Gr.IV 4 3 1 6 Sweeper 2 2 0 7 Pharmacist 1 1 0 8 RHI (PH) 1 1 0 DUMARDAHA MINI PHC 1 M&HOI 1 1 0 2 Gr.IV 1 1 0 3 Sweeper 1 1 0 4 Pharmacist 1 1 0 MOTERJHAR S/D 1 M&HOI 1 1 0 2 MO under NRHM 0 1 0 3 A.N.M. (G) 1 1 0 4 Gr.IV 2 1 1 5 Sweeper 1 1 0 6 Pharmacist 1 1 0 KACHOKHAN S/D 1 M&HOI 1 0 1 2 MO (Ayur) 1 1 0 3 MO under NRHM 0 1 0 4 Lab Tech under NRHM 0 1 0 5 Pharmacist 1 1 0 6 GNM under NRHM 0 2 0 7 ANM 2 2 0 8 Gr-IV 1 1 0 RATIADAHA MEDICAL S/C 1 A.N.M. (G) 1 1 0 2 ANM (NRHM) 0 1 0 3 Gr.IV 1 1 0 PAGLAHAT MEDICAL. S/C 1 A.N.M. (G) 1 1 0 2 ANM (NRHM) 0 1 0 3 Gr.IV 1 1 0 BERBHANGI SD 1 M&HOI 1 1 0 2 MO under NRHM 0 1 0 3 Gr.IV 1 1 0 4 Sweeper 1 0 1 5 Pharmacist 1 1 0 BILASIPARA SUB-DIVISION CHAPOR PHC 1 SDM&HO 1 1 0 2 Sr. M & HO 2 1 1 3 M&H.O.-I 2 0 2 4 M.O. (Ayr) 1 1 0 5 Dental Surgeon 1 1 0 6 Pharmacist 2 2 0 7 A.N.M. 5 4 1 8 SI (PH) 1 0 1 9 RHI (PH) 1 0 1

DHUBRI/DHAP/2010-11 34 10 Gr.IV 6 5 1 11 Sweeper 2 1 1 12 Driver 2 2 0 CHAPOR CHC (FRU) 1 Deputy Supdt. 1 1 0 2 Sr. M & HO 2 1 1 3 M&H.O.-I 2 2 0 4 Pharmacist 1 1 0 5 Staff Nurse 7 5 2 6 GNM (NRHM) 0 4 0 7 A.N.M. 1 1 0 8 Gr.IV 2 2 0 BAHALPUR S/D

1 M&H.O.-I 1 1 0 2 MO under NRHM 0 1 0 4 Pharmacist 1 1 0 5 GNM (NRHM) 0 1 0 6 Gr.IV 1 1 0 7 Sweeper 1 1 0 SALKOCHA SHC 6 BEDED M/C 1 M&H.O. -I 1 1 0 2 MO under NRHM 0 2 0 3 Pharmacist 1 1 0 4 Gr.IV 2 2 0 5 Sweeper 1 0 1 RANIGANJ PHC 1 S.D.M. & H.O. 1 1 0 2 Sr. M & HO 2 2 0 3 M.O. (Ayr) 1 1 0 4 Pharmacist 1 1 0 5 A.N.M.(G) 4 4 0 6 GNM (NRHM) 0 2 0 7 Health Assistant(PH) 1 1 0 8 SI (PH) 1 1 0 9 Gr.IV 5 4 1 10 Sweeper 1 1 0 11 Driver 1 1 0 FUTKIBARI S/D deputed 1 M&H.O.-I 1 1 0 Goalpara CH 2 MO (Ayur) under NRHM 0 1 0 3 Pharmacist 1 1 0 6 M.O. (Ayr) NRHM 0 1 0 7 Gr.IV 1 1 0 8 Sweeper 1 1 0 LAKHIGANJ S/D Attached to 1 M&H.O.-I 1 1 0 Jothat 2 MO under NRHM 0 2 0 3 M.O. (Ayr.) NRHM 0 1 0 4 Pharmacist 1 1 0

DHUBRI/DHAP/2010-11 35 5 Gr.IV 1 1 0 6 Sweeper 1 1 0 BILASIPARA SUB-DIVISION (HQ) Attached to 1 SDM&HO-I 1 1 0 Dhubri CH BILASIPARA S.H.C. & F.W. 12 BEDED M/C 1 Sr. M & HO 1 1 0 2 M&H.O.-I 4 3 1 3 M.O. (Ayr.) 1 1 0 4 MO (Ayur) under NRHM 0 1 0 5 Health Assistant(PH) 1 1 0 6 Pharmacist 1 1 0 7 A.N.M. (G) 1 1 0 8 Gr.IV 3 3 0 9 Sweeper 2 2 0 BAGRIBARI S/D 1 M & H.O.-I 1 1 0 2 MO under NRHM 0 2 0 3 Pharmacist 1 1 0 4 A.N.M. 1 1 0 5 Gr.IV 1 1 0 6 Sweeper 1 1 0 SAPATGRAM S.H.C. & F.W. 6 BEDED M/C 1 M&H.O.-I 3 1 2 2 M.O. (Ayr.) 1 1 0 3 Pharmacist 1 1 0 4 Staff Nurse 1 0 1 5 Gr.IV 2 2 0 6 Sweeper 1 0 1 BARKANDA MEDICAL. SUB-CENTRE 1 M.O. (Ayr.) 1 0 1 2 MO (Ayur) under NRHM 0 1 0 3 A.N.M.=1 1 1 0 4 Gr.IV 1 1 0 NAYERALGA MEDICAL. SUB-CENTRE 1 A.N.M.-=1 1 1 0 2 Gr.IV 1 1 0 SANTIPUR MPHC 1 M & HO-1 1 0 1 2 MO (Ayur) under NRHM 0 1 0 HATSINGIMARI SUB-DIVISION SDCH 1 Dy. Supdt. 1 1 0 On commuted 2 SDM & HO 1 1 0 leave 3 Sr. M & HO 4 1 3 4 M & HO 2 0 2 5 MO (Ayur) under NRHM 0 1 0 6 Pharmacist 2 0 2 7 Metron 1 0 1 8 W.Sister 2 0 2 9 Radigraphar 2 0 2 10 Lab Tech 1 0 1

DHUBRI/DHAP/2010-11 36 11 Acctt cum cashier 1 1 0 12 UDA 1 1 0 13 LDA 1 1 0 14 Gr-IV 12 12 0 SOUTH SALMARA PHC 1 SDM&HO 1 0 1 2 Sr. M & HO 2 1 1 3 M&H.O.-I 3 0 3 4 M.O (Ayur) 1 1 0 5 MO under NRHM 0 1 0 6 A.N.M. (G) 5 1 4 7 Gr.IV 9 8 1 8 Sweeper 2 2 0 9 Pharmacist 1 1 0 10 SI (PH) 1 1 0 11 RHI (PH) 1 1 0 SOUTH SALMARA CHC 1 Deputy Supdt. 1 0 1 2 Sr. M & HO 3 0 3 3 MO under NRHM 0 1 0 4 MO (Ayur) under NRHM 0 2 0 5 G.N.M. 4 0 4 6 Driver 1 1 0 JARUA MPHC 1 M & HO 1 0 1 2 MO under NRHM 0 1 0 3 Pharmacist 1 1 0 4 Gr-IV 1 1 0 FAKIRGANJ MPHC 1 M & HO-1 1 1 0 2 MO under NRHM 0 1 0 3 Lab Tech 1 1 0 4 Gr-IV 1 1 0 CHIRAKUTI MPHC 1 M & HO-1 1 0 1 2 MO under NRHM 0 1 0 3 MO (Ayur) 0 1 0 4 Pharmacist 1 1 0 5 Gr-IV 1 0 1 MEDARTARI MINI PHC 1 M.O. (Ayur) 1 1 0 2 MO under NRHM 0 1 0 3 RHI (PH) 1 1 0 4 Gr.IV 1 1 0 5 Sweeper 1 1 0 6 Pharmacist 1 1 0 PATAKATA MEDICAL S/C 1 A.N.M. (G) 1 0 1 2 ANM (NRHM) 0 2 0 3 Gr.IV 1 1 0 JAMADARHAT MEDICAL S/C 1 A.N.M. (G) 1 0 1 2 Gr.IV 1 1 0

DHUBRI/DHAP/2010-11 37 GAJARIKANDI PHC 1 SDM&HO 1 0 1 2 Sr. M & HO 2 2 0 3 M.O. (Ayr) 1 1 0 4 MO under NRHM 0 1 0 5 GNM (NRHM) 0 3 0 attaced at 6 SI (PH) 1 1 0 Gauripur CHC 7 RHI (PH) 1 1 0 1 nos. H/A attached in 8 Health Assistant(PH) 2 2 0 Sukchar MPHC HATSINGIMARI SHS 1 Sr. M & HO 1 1 0 2 HEB. Sr. M&HO 1 0 1 3 A.N.M. (G) 1 1 0 4 Staff Nurse 3 2 1 5 Gr.IV 4 3 1 6 Sweeper 1 1 0 7 Pharmacist 2 2 0 SDM&HO (HQ) HATSINGIMARI 1 Gr.IV 5 3 2 MANKACHAR CHC/FRU 1 Sr. M & HO 1 1 0 2 M&HO-I 3 3 0 3 Staff Nurse 3 0 3 4 GNM (NRHM) 0 5 0 5 Gr.IV 6 6 0 6 Sweeper 2 1 1 7 Pharmacist 2 2 0 MANKACHAR MINI PHC 1 Sr. M & HO 1 1 0 2 M&HO-I 2 0 2 3 A.N.M. (G) 1 1 0 MANKACHAR S/D 1 A.N.M. (G) 2 0 2 JHOWDANGA MINI PHC 1 M & HO – I 1 1 0 2 MO under NRHM 0 1 0 3 Gr.IV 1 1 0 4 Sweeper 1 1 0 KAKRIPARA MINI PHC 1 M.O. (Ayur) 1 1 0 2 MO under NRHM 0 1 0 3 Gr.IV 1 1 0 4 Sweeper 1 1 0 5 Pharmacist 1 1 0 SADULLABARI S.H.C. 1 M&HO-I 1 0 1 2 MO (Ayur) under NRHM 0 1 0 3 A.N.M. (G) 1 1 0 4 Gr.IV 3 2 1 SUKHCHAR MINI PHC

DHUBRI/DHAP/2010-11 38 1 M & HO-I 1 1 0 2 M.O. (Ayur) 1 1 0 3 Gr.IV 4 4 0 4 Sweeper 1 1 0 5 Pharmacist 1 1 0 ADARSHAMANJURIGAON MEDICAL S/C 1 M.O. (Ayur) 1 0 1 2 M.O under NRHM 0 1 0 BAGHAPARA MEDICAL S/C 1 A.N.M. (G) 1 0 1 2 Gr.IV 1 1 0 HAZIRHAT MEDICAL S/C 1 A.N.M. (G) 1 1 0 3 Gr.IV 1 1 0 FEKAMARI MEDICAL S/C 1 A.N.M. (G) 1 1 0 2 Gr.IV 1 1 0

DHUBRI/DHAP/2010-11 39 Table: 3.5. Status of Logistics in Dhubri District (Template-5)

Logistics Elements Description Availability of a dedicated District warehouse for health Yes, Zonal Drug Ware House, department Dhubri Stock outs of any vital supplies in last year . - Indenting Systems (from peripheral facilities to districts) Respective Institution makes their indents with last months receipt, expenditure and balance in hands. In case of Sub Center their indents comes through their respective PHC with countersigned & submitted to the district. Existence of a functional system for assessing Quality of Yes Vaccine

Table: 3.6 Status of Logistics (Details about the training institution/s) (Template6) Details about the training institution/s Name of the Institution: FHW/GNM training Centre, Dhubri Key issues

Physical Infrastructures Availability of lecture halls = No Lecture hall Training faculty = 7, deputation = 4 • 2 Class rooms is there for Residential accommodation for taking class. Trainees (men and women) = • There is one room for all Dining hall = Not Available faculties. Furniture’s, = Not Sufficient • There is a Hostel for Girls. Safe drinking water and electricity etc = Not Available • Electricity from Hospital

Provide details of Faculty (Sanctioned and In-position) with Sanction post = 8 (Sister tutor/PHN) designation and specialization In Position = 7 (Sister Tutor = 3 & PHN = 4) Availability of Teaching Aids, computers etc. Computer = 2 Assessment of availability of common audio visual aids at the facility Laser Printer = 1 OHP = 2 Availability of annual training plans for the last year and There is no Annual training plans, achievements of the plan? 46 nos. of GNM students completed 3 years course in the year 2005-2006. Training activities under NRHM: GNM trainees admitted on 25.5.06 for 3 years 6 months=48 nos i) Orientation / sterilization workshops on NRHM - District level officers of related departments, sub district ANM trainees admitted on 21.3.07 level officers, elected PRIs, field NGOs, faculty of for 18 months=32 nos. ANMTCs/DTCs, block panchayat and Gram panchayat

ii) Training for strengthening of health system - ASHA training - Skill based trainings

The districts are required to indicate the trainings conducted for all categories of health personnels with reference to the training load. The cumulative number of trained manpower and the number of trained during the current year along with percentage of achievement may be specified.

DHUBRI/DHAP/2010-11 40 Table: 3.7 BCC Infrastructures in Dhubri District (Template7)

Human Resources for BCC i.e. District Media officers, No Dy Media officers and block level staff Any trainings the staff has undergone in media planning or material development in past five years

Any functional Mass media audio- visual aids such as Yes, LCD Projector-1 16 mm projectors, Video cameras, VCD/DVD players -Did the district prepare a BCC plan in the past year? No -If yes, what BCC activities were planned and undertaken? -In the absence of plan, find out what BCC activities were undertaken? Are there other institutions available in the private No sector for conducting communication activities using modern media or folk media???

Table 3.8 Details of ICDS programme in Dhubri District (Template9)

Name of the Number of CDPOs and Superviso AWWs AW helpers Block with ICDS AWCs ACDPOs rs Sl No Programme S F S IP S IP S IP S IP

1 Gauripur 198 198 2 1 9 9 198 198 198 198

2 Agomoni 151 151 1 1 6 5 151 151 151 151

3 Golakganj 115 115 1 1 4 4 115 115 115 115

4 Rupshi 146 146 1 1 5 5 146 146 146 96

5 Debitola 164 164 1 1 6 6 164 164 164 164

6 Bilasipara 103 102 1 1 3 2 103 102 103 102

7 Mahamaya 121 121 1 1 5 3 121 121 121 121

8 Nayeralga 77 77 1 1 3 3 77 77 77 77

9 Chapor-Salkocha 115 115 1 1 3 3 115 115 115 115

10 S.Salmara 109 109 1 1 3 3 109 108 109 108

11 Jamadarhat 78 76 1 1 1 1 78 76 78 78

12 Fekamari 139 139 1 1 4 3 139 139 139 139

13 Mankachar 152 152 1 1 5 2 152 152 152 150

14 Birsing Jarua 127 127 1 1 4 3 127 127 127 127

Total 1795 1792 15 14 61 52 1795 1791 1795 1741 (Source ICDS, Dhubri Office) S = Sanctioned; F =Functioned and IP = In Position

DHUBRI/DHAP/2010-11 41 Table: 3.9 Elected representatives to Panchayat institutions

Total Total ZP Total BDC/Mandal Total Panchayat Name of the block panchayat members members Pradhans Femal villages Male Male Female Male Female e A. Dhubri Sub Division 1 Gauirpur 150 10 5 2 Debitola 60 5 1 3 Rupshi 110 5 6 7 6 4 Golakganj 100 5 5 5 Agomoni 130 11 2 6 Hatidhura 40 4 0 Sub Total (A) 590 7 6 40 19 B. Bilasipara Sub Division 7 Chapor Salkocha 120 6 6 8 Bilasipara 100 6 4 5 2 9 Nayeralga 90 7 2 10 Mahamaya 120 6 6 Sub Total (B) 430 5 2 25 18 C. Hatsingimari Sub Division 11 Mankachar 150 9 6 12 Fekamari 140 10 4 13 South Salmara 130 4 4 10 3 14 Jamdarhat 90 7 2 15 Birsing Jorua 150 9 6 Sub Total (C) 660 4 4 45 21 (Source : ZP Office, Dhubri) Total Panchyat Villages = 1680 Tatal No. of Panchyat = 168 Total ZP Members = 28 (Male = 16, Female = 12) Total Panchyat Pradhan = 168 (Male = 110, Female = 58)

Table: 3.10 NAME OF THE NGOs WORKING IN HEALTH SECTOR IN THE DHUBRI DISTRICT: (Template11)

Sl Names of NGOs Address Remarks No P.O.-Gauripur Dist-Dhubri Gauripur Vivekananda Club, 1 (Mother NGO of DHS, MNGO, Dhubri Gauripur Dhubri) North Easr Zone Welfare 2 Developments Society, Hatsingimari, Gazarikandi FNGO, Gazarikandi PHC Hatsingimari Social Activites voluntary 3 Mankachar, Gazarikandi FNGO, South Salmara Organisation, Mankachar Legal Social Development 4 Dharmasala, Dhubri FNGO, Dharmasala PHC Organisation, Dharmasala A Society for Human Resource 5 Nayahat Bazar, Dhubri FNGO, Raniganj PHC Overall Management

DHUBRI/DHAP/2010-11 42 Table: 3.11 Key RCH Indicators

Key Indicators, Reproductive and Child Health – Rapid Household Survey (RCHRHS) For 199899 & 200204

ASSAM DHUBRI INDICATORS 199899 200204 199899 200204

Marriage below 18 28.7 23.8 59.0 33.8

Birth order 3+ 45.9 40.6 52.7 50.9 Know all FP * 42.6 24.2 71.1 15.7 CPR any mode** 28.4 28.7 26.2 19.6

Unmet need 37.6 22.5 36.4 29.8 ANC 56.0 61.5 37.8 37.8 Full ANC 24.8 42.6 18.5 23.6

Institutional Delivery 23.8 26.8 11.5 10.6

Safe Delivery 31.9 33.2 17.4 13.0 MMR 398*** 490**** Full Vaccination 46.7 19.3 83.7 14.0

No Vaccination 11.6 23.6 1.6 28.2 Aware AIDSFemale 37.7 49.1 19.7 20.4

RTISTIFemale 28.5 24.3 42.4 21.8 Aware AIDSMale 57.7 34.7

RTISTIMale 15.1 1.3 RWANM 7.7 3.1 12.3 4.2

The above table shows the comparative data of different parameters of different health indicators of Assam, and Dhubri district.

DHUBRI/DHAP/2010-11 43 Table 3.12: Key Health Indicators of Dhubri District [Source: DLHS-2(02-04)& DLHS-3(07-08)]

Assam Dhubri Indicators DLHS3 DLHS2 DLHS3 DLHS2 Marriage and Fertlity Marriage below 18 21.8 25.8 38.2 38.1 Birth Order 3 and above NA NA 32.9 53.0 % of births to women during age 15-19 out of total births 5.2 - 17.0 - Currently used Family Planning Methods (Currently married women, age 1549) Any Method (%) 49.7 55.6 32.7 42.5 Any modern Method (%) 31.2 26.9 23.6 17.3 Female Sterlization (%) 10.7 11.6 2.2 4.5 Total Unmet need 26.1 23.6 37.2 32.4 Maternal Health Mothers registered for ANC in the first trimaster during the last 39.4 38.5 20.7 - pregnancy (%) Mothers who had at least 3 ANC visits during the last 45.1 39.4 21.9 20.9 pregnancy (%) Mothers who got atleast one TT injection when they were 69.3 55.0 40.4 31.9 pregnant with their last live birth/still birth (%) Institutional births (%) 35.3 23.2 15.8 8.5 Delivery at home assisted by a doctor/nurse/LHV/ANM (%) 7.7 9.2 3.8 3.0 Child Immunization Children (12-23 months) who have received BCG (%) 80.5 61.3 73.7 38.0 Children (12-23 months) who have received Measles Vaccine 65.2 33.7 43.4 18.8 (%) Children (12-23 months) fully immunizaed 48.0 16.0 23.2 8.4 Child feeding practices Children breastfed within one hour of birth (%) 65.7 50.6 70.0 - Knowledge of HIV/AIDS and RTI/STI among Ever Married Women (age 1549) Women heard of HIV/AIDS (%) 54.8 44.0 41.6 15.2 Women heard of RTI/STI (%) 16.8 21.8 4.4 19.2 Knowledge of HIV/AIDS and RTI/STI among Unmarried Women (age 1524) Women heard of HIV/AIDS (%) 72.2 - 54.5 - Women heard of RTI/STI (%) 13.5 - 4.0 - Women Facilitated/Motivated by ASHA for

Ante-natal Care (%) NA NA 13.3 -

Delivery at Health facility (%) NA NA 7.7 -

Use of Family Planning Methods NA NA 7.2 -

DHUBRI/DHAP/2010-11 44

CHAPTER 4 Progress Made During 20052009 Table 4.1: Status of ASHA Block PHC wise (Excluding BTAD)

Status of Estimated Status of ASHA during Status of AHSA Sl. Name of PHC Population as ASHA during 0809 during 0910 as No on Nov 2009 0708 (Exculding on Jan’10 BTAD) 1 South Salmara PHC 332656 230 230 282 2 Halakura PHC 170500 150 150 172 3 Golakganj PHC 267224 200 225 266 4 Dharmasala PHC 322157 260 229 289 5 Raniganj PHC 323724 234 203 303 6 Chapor PHC 136200 140 125 139 7 Gazarikandi PHC 298692 230 204 275 Total 1851153 1444 1366 1726

Name of the Block No of ASHA Received Training Sl PHC 1st Module 2nd Module 3rd Module 4th Module 5th Module 1 Dharmasala BPHC 229 229 229 229 229 2 Golakganj BPHC 206 206 206 206 206 3 Halakura BPHC 160 160 160 160 160 4 Raniganj BPHC 201 201 201 201 201 5 Chapor BPHC 140 139 139 139 124 6 Gazarikandi BPHC 204 204 204 204 200 7 South Salmara BPHC 230 230 230 230 220 District Total 1370 1369 1369 1369 1340

Table 4.2: No. of VHND Observed Block PHC Wise during 0607, 0708, 0809 & 0910 (upto Jan’10)

Name of the BPHC/ No of VHND No of VHND No of VHND No of VHND Sl Urban Center/ 200910 (upto 200607 200708 200809 Reporting Unit Jan’10) 1 Dharmasala BPHC 133 2877 2652 2086 2 Golakganj BPHC 3 679 2117 1666 3 Halakura BPHC 232 927 1599 1569 4 Raniganj BPHC 68 2193 2051 1652 5 Chapor BPHC 195 1516 1533 1240 6 Gazarikandi BPHC 66 1582 1894 1530

7 South Salmara BPHC 300 1414 2188 2327

Total: 997 11188 14034 12070

DHUBRI/DHAP/2010-11 45 Table 4.3: Status of Village Health and Sanitation Committee of Dhubri District during 0809 and 0910 (upto June’09)

No. of VHSC No. of VHSC No. of VHSC No. of VHSC Sl Achieveme Achievem Name of Block PHC formed Acct Open formed Acct Open No nt PC ent PC during 0809 during 0809 during 0910 during 0910 1 Golakganj PHC 219 219 100.00% 209 209 100%

2 Dharmasala PHC 212 212 100.00% 212 212 100%

3 Halakura PHC 150 150 100.00% 160 160 100%

4 Chapor PHC 124 124 100.00% 124 124 100%

5 Raniganj PHC 201 196 97.51% 197 197 100%

6 South Salmara PHC 226 226 100.00% 223 223 100%

7 Gazarikandi PHC 190 179 94.21% 185 185 100%

Total 1322 1306 98.79% 1310 1310 100%

Table 4. 4: INSTITUTION WISE DELIVERY REPORTS OF DHUBRI DISTRICT

Year: 200506

Sl. Name of PHC/District Home Delivery Institutional Delivery Grand Total No Hospital 1 Dharmasala 2621 27 2648 2 Golokganj 1630 241 1871 3 Halakura 1369 194 1563 4 Raniganj 1633 199 1832 5 Chapor 1184 59 1243 6 South Salmara 1045 0 1045 7 Gazakandi 916 74 990 8 Dhubri Civil Hospital 0 2896 2896 Total 10398 3690 14088

Year : 200607

Sl. Name of PHC/District Home Delivery Institutional Delivery Grand Total No Hospital 1 Dharmasala 3080 338 3418 2 Golokganj 1921 453 2374 3 Halakura 1561 495 2056 4 Raniganj 2490 553 3043 5 Chapor 1310 252 1562 6 South Salmara 1588 0 1588 7 Gazakandi 1664 335 1999 8 Dhubri Urban 0 2568 2568 Total 13614 4994 18608

DHUBRI/DHAP/2010-11 46 Year: 200708 Nam e of the Home Institutional Grand Sl No. Name of PHC/Urban Unit Institution Delivery Delivery Total Dhubri CH 3448 1 Dhubri Urban 37 3945 20 Bed MC. Dhubri 460 Chapor FRU 764 Bahalpur SD 45 Salkocha SHC 133 Jalikura SC 3 2 Chapor PHC Soulmari SC 1735 7 2716 Champabati SC 26 Noonmati SC 1 Dhirghat SC 1 Bamungaon SC 1 Agomoni CHC 661 Halakura CHC 883 3 Halakura PHC 1424 3229 Satrasal SD 86 Boterhat SD 175 Gouripur CHC 419 Dharmasala PHC 719 4 Dharmasala PHC 2737 3971 Kazigaon SD 57 Debitola SD 39 Mankachar CHC 306 5 Gazarikandi PHC 1749 3530 Gazarikandi PHC 1475 6 Golakganj PHC Golakganj PHC 1769 1024 2793 Raniganj PHC 266 Bilasipara SHC 759 7 Raniganj PHC Sapatgram SHC 2340 258 3722 Lakhiganj SD 91 Futkibari SD 8 8 South Salmara PHC Bolodmara SC 3630 3 3633 Total 15421 12118 27539

Year: 200809 Sl No. Name of PHC Name of Institution Home Institutional Total Dhubri Civil Hospital 4102 1 Dhubri Urban 0 4517 20 Beded Mat. Cen. 415 Chapor FRU 642 2 Chapor PHC Bahalpur SD 1195 56 2069 Salkocha SHC 176 Agomoni CHC 651 Halakura CHC 1299 3 Halakura PHC 1064 3278 Satrasal SD 93 Boterhat SD 171 Gouripur CHC 399 4 Dharmasala PHC 2314 3368 Dharmasala PHC 655 Mankachar CHC 632 5 Gazarikandi PHC 2034 4173 Gazarikandi PHC 1507 Golakganj PHC 1261 Tamarhat MPHC 609 6 Golakganj PHC 1624 3547 Kachokhan SD 48 Moterjhar SD 5 Raniganj PHC 176 Bilasipara SHC 828 7 Raniganj PHC Sapatgram SHC 2554 231 3976 Lakhiganj SD 142 Futkibari SD 45 8 South Salmara BPHC 2780 0 2780 Total 13565 14143 27708

DHUBRI/DHAP/2010-11 47

Year: 200910 (Upto Jan’10)

Sl Home Institution Name of PHC Name of Institution Total No. Delivery Delivery Dhubri Civil Hospital 4054 1 Dhubri Urban 0 4355 20 Beded Mat. Cen. Dhubri 301

Chapor FRU 731

2 Chapor PHC Bahalpur SD 916 36 1788

Salkocha SHC 105

Agomoni CHC 594

Halakura CHC 1315 3 Halakura PHC 646 2797 Satrasal MPHC 110

Boterhat SD 132

Dharmasala Gouripur CHC 331 4 1971 2780 PHC Dharmasala PHC 478

Mankachar CHC 783 Gazarikandi 5 1960 4305 PHC Gazarikandi PHC 1562

Golakganj PHC 1248

Tamarhat MPHC 616 Golakganj 6 1135 3416 PHC Kachokhan SD 200 Moterjhar SD 147 Dhepdhepi MPHC 70

Raniganj PHC 127

Bilasipara SHC 997

7 Raniganj PHC Sapatgram SHC 2196 202 3722

Lakhiganj SD 136

Futkibari SD 64 South Salmara 8 2652 0 2652 PHC

Total 11476 14339 25815

DHUBRI/DHAP/2010-11 48 Table 4. 5: JSY BENEFICIARIES OF DHUBRI DISTRICT

Year : 200506 Name of Health Home Institutional Total Institution Delivery Delivery Chapor PHC 30 8 38 Gazarikandi PHC 157 9 166 Raniganj PHC 22 0 22 Total 209 17 226

Year : 200607 Name of PHC Name of Health Home Institutional Total Institution Delivery Delivery Chapor PHC 82 Salkocha SHC 5 Chapor PHC 996 1307 Bohalpur SD 6 Chapor FRU 218 Golakganj PHC Golakganj PHC 1526 416 1942 Halakura PHC 406 Agomoni CHC 134 Halakura PHC 993 1565 Boterhat SD 31 Satrasal SD 1 Dharmasala PHC 96 Dharmasala PHC 1340 1588 Gauripur CHC 152 Gazarikandi PHC Gazarikandi PHC 2238 358 2596 Raniganj PHC 100 Raniganj PHC Bilasipara SHC 1017 324 1618 Sapatgram SHC 177 South Salmara PHC S.Salmara PHC 2753 0 2753 Dhubri Urban 100 464 Urban Unit Dhubri Civil Hosp 962 1803 Dhubri 20 Bed MC 277 Total 10963 4209 15172

Year : 200708 Sl No. Name of PHC Name of Institution Institutional Delivery Dhubri Civil Hospital 2996 1 Dhubri Urban 20 Bed Maternity centre, Dhubri. 467 Chapor FRU 688 Bahalpur SD 45 Salkocha SHC 130 Jalikura SC 3 2 Chapor PHC Soulmari SC 7 Champabati SC 10 Noonmati SC 1 Dhirghat SC 1 Bamungaon SC 1 Agomoni CHC 738 Halakura CHC 879 3 Halakura PHC Satrasal SD 88 Boterhat SD 193 Gouripur CHC 282 Dharmasala PHC 719 4 Dharmasala PHC KazigaonSD 46 Debitola SD 7 Mankachar CHC 258 5 Gazarikandi PHC Gazarikandi PHC 1179 6 Golakganj PHC Golakganj PHC 1007 Raniganj PHC 203 Bilasipara SHC 564 7 Raniganj PHC Sapatgram SHC 181 Lakhiganj SD 58 Futkibari SD 1 8 South Salmara PHC Bolodmara SC 3 Total 10755

DHUBRI/DHAP/2010-11 49

Year : 200809 Sl Name of PHC Name of Institution Total No. Dhubri Civil Hospital 3201 1 Dhubri Urban 20 Beded Mat. Cen. Dhubri 405 Chapor FRU 379 2 Chapor PHC Bahalpur SD 60 Salkocha SHC 146 Agomoni CHC 591 Halakura CHC 1124 3 Halakura PHC Satrasal SD 75 Boterhat SD 174 Dharmasala Gouripur CHC 436 4 PHC Dharmasala PHC 610 Gazarikandi Mankachar CHC 426 5 PHC Gazarikandi PHC 757 Golakganj PHC 1259 Tamathat MPHC 473 6 Golakganj PHC Kachokhana SD 48 Moterjhar SD 0 Raniganj PHC 176 Bilasipara SHC 730 7 Raniganj PHC Sapatgram SHC 204 Lakhiganj SD 143 Futkibari SD 50 Total 11467

Year: 200910 (Upto Jan’10)

Sl Name of Name of April May June July Aug Sept Oct Nov Dec Jan Total No. PHC Institution Dhubri Civil 195 134 207 492 465 211 1031 856 0 0 3591 Dhubri Hospital 1 Urban 20 Beded Mat. 31 13 14 20 36 0 35 40 46 37 272 Cen Chapor FRU 0 0 0 216 161 91 72 55 70 92 757 Chapor 2 Bahalpur SD 0 0 0 10 4 5 2 2 5 0 28 PHC Salkocha SHC 0 0 0 10 5 24 3 5 14 14 75

Agomoni CHC 3 0 39 144 22 89 104 12 0 0 413

Halakura CHC 0 0 137 513 180 4 223 168 0 0 1225 Halakura 3 PHC Satrasal MPHC 0 0 0 38 30 0 17 0 0 0 85

Boterhat SD 0 0 0 43 41 0 32 0 0 0 116

Gouripur CHC 0 1 1 92 38 1 2 35 0 0 170 Dharmasala 4 PHC Dharmasala 0 0 149 27 0 0 172 62 0 0 410 PHC Mankachar CHC 0 0 255 0 195 0 193 0 97 0 740 Gazarikandi 5 PHC Gazarikandi 0 0 0 494 423 0 0 0 436 1353 PHC 0

DHUBRI/DHAP/2010-11 50 Sl Name of Name of April May June July Aug Sept Oct Nov Dec Jan Total No. PHC Institution Golakganj PHC 0 0 197 0 86 0 114 223 164 0 784 Tamathat MPHC 0 48 223 0 0 0 161 0 72 0 504 Golakganj 6 Kachokhana SD 14 6 9 0 0 0 82 0 35 0 146 PHC Moterjhar SD 0 0 25 10 4 0 33 23 0 0 95 Dhepdhepi 0 0 0 4 0 0 51 0 11 0 66 MPHC Raniganj PHC 0 0 30 12 14 11 12 0 31 21 131 Bilasipara SHC 1 0 58 257 97 6 0 0 309 220 948 Raniganj 7 Sapatgram SHC 15 8 50 7 4 0 50 10 35 15 194 PHC Lakhiganj SD 0 0 41 10 18 2 0 0 0 74 145 Futkibari SD 4 3 5 4 9 3 7 0 0 0 35 Total 263 213 1440 2403 1832 447 2396 1491 1325 473 12283

DHUBRI/DHAP/2010-11 51 Table 4. 6: STATUS OF CIVIL WORK UNDER NRHM, DHUBRI AS ON 5.11.09

STATUS OF CIVIL WORK UNDER NRHM, DHUBRI DISTRICT AS ON 31.7.09

Rs. 30 Thousand allotted for Maintenance & Repairing of Health Institution (as reported by BPHC Incharge) Sl Name of Name of Implementing Fund Financial Type Progress Remarks No Block PHC Institution/SC Agency alloted year of of work per work in % age institution Madaikhali 1 HMC 0.30 lac ‘05-06 M&R 100% Completed Dharmasala S/C PHC 2 Alomganj S/C HMC 0.30 lac ‘05-06 M&R 100% Completed

3 Golakganj Ratiadaha S/C HMC 0.30 lac ‘05-06 M&R 100% Completed 4 PHC Biskhowa S/C HMC 0.30 lac ‘05-06 M&R 100% Completed Chapor 5 Airarjhar S/C HMC 0.30 lac ‘05-06 M&R 100% Completed PHC

6 Raniganj Borogirai S/C HMC 0.30 lac ‘05-06 M&R 100% Completed 7 PHC Borkanda S/C HMC 0.30 lac ‘05-06 M&R 100% Completed

8 Halakura Chagolia S/C HMC 0.30 lac ‘05-06 M&R 100% Completed 9 PHC Ranpagli S/C HMC 0.30 lac ‘05-06 M&R 100% Completed Gazarikandi 10 Fekamari S/C HMC 0.30 lac ‘05-06 M&R 100% Completed PHC

Rs. 50 Thousand allotted for Maintenance & Repairing of Health Institution during 200506 (as reported by BPHC Incharge & inspection report of JE, NRHM) Sl Name of Block Name of Implementi Fund Progres Remarks No PHC Institution ng Agency allotted per s of institution work in % Age South Salmara 1 Medartari SC HMC 0.50 lac 100% completed PHC Dharmasala 2 Geramari MPHC HMC 0.50 lac 100% Completed PHC Kachokhana 3 Golakganj PHC HMC 0.50 lac 100% Completed MPHC Dhepdhepi 4 Golakganj PHC HMC 0.50 lac 100% Completed MPHC 5 Chapor PHC Salkocha MPHC HMC 0.50 lac 100% Completed Sapatgram 6 Raniganj PHC HMC 0.50 lac 100% Completed MPHC 7 Raniganj PHC Lakhiganj MPHC HMC 0.50 lac 100% Completed 8 Raniganj PHC Futkibari MPHC HMC 0.50 lac 100% Completed 9 Halakura PHC Boterhat SD HMC 0.50 lac 100% Completed Gazarikandi Jhowdanga 10 HMC 0.50 lac 100% Completed PHC MPHC

DHUBRI/DHAP/2010-11 52

Rs. 1 lakh allotted for Maintenance & Repairing of Health Institution (as reported by BPHC Incharge & inspection report of JE, NRHM) Fund Type Progress of Name of Implementing Financial Sl.No alloted per of work in % Remarks Institution Agency year institution work Age 1 Halakura PHC HMC 1 lac ‘06-07 MSR 100% Completed 2 Golakganj PHC HMC 1 lac ‘06-07 M&R 100% Completed 3 Dharmasala PHC HMC 1 lac ‘06-07 M&R 100% Completed 4 Raniganj PHC HMC 1 lac ‘06-07 MSR 100% Completed South Salmara 5 HMC 1 lac ‘06-07 M&R 100% Completed PHC Completed only staff 6 Gazarikandi PHC HMC 1 lac ‘06-07 M&R 100% quarter repaired. 7 Chapor PHC HMC 1 lac ‘06-07 M&R 100% Completed

Rs. 1 lakh allotted for M aintenance & Repairing of Health Institution (as reported by BPHC Incharge & inspection report of JE, NRHM) Sl Name of Name of Implementing Fund Financial Type Progress Remarks No Block PHC Institution Agency alloted year of of work per work in % Age institution 1 Rangpagli S/C HMC 1 lac 06-07 MSR 100% Completed 2 Chagolia S/C HMC 1 lac 06-07 MSR 100% Completed Halakura Gharialdanga 3 PHC HMC 1 lac 06-07 MSR 100% Completed S/C 4 Kharbari S/C HMC 1 lac 06-07 MSR 100% Completed 5 Protapganj S/C HMC 1 lac 06-07 MSR 100% Completed 6 Rakhalpat S/C HMC 1 lac 06-07 MSR 100% Completed South Raipur 7 HMC 1 lac 06-07 MSR 100% completed S/C Bishkhowa 8 HMC 1 lac 06-07 MSR 100% completed Golakganj Bazar S/C PHC 9 Sonahat S/C HMC 1 lac 06-07 MSR 100% Completed 10 Harirhat S/C HMC 1 lac 06-07 MSR 100% Completed Madhyapetla 11 HMC 1 lac 06-07 MSR 100% Completed S/C 12 Chaghar S/C HMC 1 lac 06-07 MSR 100% Completed 13 Debitola S/C HMC 1 lac 06-07 MSR 100% Completed Madhusoulmari 14 HMC 1 lac 06-07 MSR 100% completed S/C 15 Dharmasala Baraibari S/C HMC 1 lac 06-07 MSR 100% Completed PHC 16 Jhaleralga S/C HMC 1 lac 06-07 MSR 100% Completed 17 Madaikhali S/C HMC 1 lac 06-07 MSR 100% Completed 18 Gaspara S/C HMC 1 lac 06-07 MSR 100% Completed 19 Bahalpur S/C HMC 1 lac 06-07 MSR 100% Completed 20 Chapor Arerjhar S/C HMC 1 lac 06-07 MSR 100% Completed 21 PHC Nunmati S/C HMC 1 lac 06-07 MSR 100% Completed 22 Falimari S/C HMC 1 lac 06-07 MSR 100% Completed 23 Raniganj Chotogiraj S/C HMC 1 lac 06-07 MSR 100% Completed,

DHUBRI/DHAP/2010-11 53 PHC Tamokobari 24 HMC 1 lac 06-07 MSR 100% Completed S/C 25 Rabantari S/C HMC 1 lac 06-07 MSR 100% Completed 26 Silabari S/C HMC 1 lac 06-07 MSR 100% Completed 27 Kaimari S/C HMC 1 lac 06-07 MSR 100% Completed 28 Buchirchar S/C HMC 1 lac 06-07 MSR 100% Completed 29 Aysakati S/C HMC 1 lac 06-07 MSR 100% Completed 30 Bauskata S/C HMC 1 lac 06-07 MSR 100% Completed Muthakhowa 31 HMC 1 lac 06-07 MSR 100% Completed South S/C Bhalukkandi 32 Salmara HMC 1 lac 06-07 MSR 100% Completed PHC S/C 33 Salkata S/C HMC 1 lac 06-07 MSR 100% completed 34 Medertari S/C HMC 1 lac 06-07 MSR 100% Completed 35 Kalapani S/C HMC 1 lac 06-07 MSR 100% completed Kuchnimara 36 HMC 1 lac 06-07 MSR 100% completed S/C Manullapara 37 Gazarikandi HMC 1 lac 06-07 MSR 100% completed PHC S/C 38 Borona S/C HMC 1 lac 06-07 MSR 100% Completed 39 Borealga S/C HMC 1 lac 06-07 MSR 100% Completed 40 Kukurmara S/C HMC 1 lac 06-07 MSR 100% Completed

Rs. 2 lakh allotted for Maintenance & Repairing of Health Institution (as reported JE, NRHM) Sl Name of Name of Implement Fund Financial Type Progress Remarks No Block PHC Institution ing alloted per year of of work Agency institution work in % Age 1 Agomoni CHC HMC 2 lac 06-07 M&R 100% Completed Halakura PHC 2 Halakura CHC HMC 2 lac 06-07 M&R 100% Completed Dharmasala 3 Gauripur CHC HMC 2 lac 06-07 M&R 100% Completed PHC 4 Chapor PHC Chapor CHC HMC 2 lac 06-07 M&R 100% Completed

Rs. 5 Lakhs allotted for Up gradation of BPHC to 24x 7deli very Services during the year 06 07, Sources : PWD report as on 24.9.08 & AE, NRHM report as on 05.05.09 Sl Name of Implementi Fund Financ Type of work Progress Remarks No Institution ng Agency alloted per ial of work institution year in % Age Dhepdhepi Dist Const. 24x 7Hr Delivery 1 5.0 lac 06-07 100% completed MPHC Committ. Service Kachokhana Dist Const. 24x 7Hr Delivery 2 5.0 lac 06-07 100% completed SD Committ. Service Dist Const. 24x 7Hr Delivery 3 Satrasal SD 5.0 lac 06-07 100% completed Committ. Service Dist Const. 24x 7Hr Delivery 4 Salkocha SHC 5.0 lac 06-07 100% completed Committ. Service Dist Const. 24x 7Hr Delivery 5 Lakhiganj SD 5.0 lac 06-07 100% completed Committ. Service

DHUBRI/DHAP/2010-11 54

Rs. 5 Lakhs allotted for Up gradation of BPHC to 24x 7 delivery Services during the year 07 08, Sources : PWD report as on 31.7.09 Sl Name of Implementing Fund Finan Type of work Progress Remarks No Institution Agency alloted per cial of work in institution year % Age Dist Const. 24x 7Hr Delivery 1 Moterjhar SD 5.0 lac 07-08 100% completed Committ. Service Sadullabari Dist Const. 07-08 24x 7Hr Delivery 2 5.0 lac 100% completed SHC Committ. Service Dist Const. 24x 7Hr Delivery Work Just 3 Kakripara SD 5.0 lac 07-08 100% Committ. Service completed Dist Const. 24x 7Hr Delivery Work 4 Basbari SD 5.0 lac 07-08 100% Committ. Service completed Sapatgram Dist Const. 24x 7Hr Delivery Works 5 5.0 lac 07-08 100% SHC Committ. Service completed

Rs. 6 Lakhs allotted for Up gradation of PHCs to 24x 7delivery Servic es during the year 08 09, Sources : PWD report as on 31.01.10 Fund Finan Progress Sl Name of Implementing alloted per cial of work in Remarks No Institution Agency Type of work institution year % Age Dumardaha Dist Const. 24x 7Hr Delivery Work 1 6.0 lac 08-09 100% MPHC Committ. Service completed Bogribari Dist Const. 24x 7Hr Delivery Work 2 6.0 lac 08-09 100% SD Committ. Service completed Berbhangi Dist Const. 24x 7Hr Delivery Work in 3 6.0 lac 08-09 90% SD Committ. Service progress Jhowdanga Dist Const. 24x 7Hr Delivery Work 4 6.0 lac 08-09 100% SD Committ. Service completed Dist Const. 24x 7Hr Delivery 5 Boterhat SD 6.0 lac 08-09 57% completed Committ. Service

Rs. 6 Lakhs allotted for Up gradation of PHCs to 24x 7delivery Services during the yea r 08 09 , Source : PWD report as on 31.01.10

Fund Sl Name of Health Implementing Financial Progress of work alloted per Type of work Remarks No Inst Agency year in % Age institution

Dist Const. 24x 7Hr Delivery Work in 1 Jarua MPHC 6.0 lac 08-09 45% Committ. Service progress Dist Const. 24x 7Hr Delivery Work in 2 Bilasipara SHC 6.0 lac 08-09 55% Committ. Service progress Dist Const. 24x 7Hr Delivery Work in 3 Futkibari SD 6.0 lac 08-09 13% Committ. Service progress Dist Const. 24x 7Hr Delivery Work in 4 Santipur MPHC 6.0 lac 08-09 70% Committ. Service progress Dist Const. 24x 7Hr Delivery Work in 5 Tamarhat MPHC 6.0 lac 08-09 40% Committ. Service progress Dist Const. 24x 7Hr Delivery Work in 6 Geramari MPHC 6.0 lac 08-09 41% Committ. Service progress

DHUBRI/DHAP/2010-11 55

Rs. 5.3 Lakhs allotted for Up gradation of 24X7 hr delivery of BPHC during the year 0506 and 0708 under NRHM Sources : AE, NRHM as on 24.7.08 Sl Name of Implementi Fund Financial Type of work Progress Remarks No Institution ng Agency Allotted per year of work in institution % Upgradation to 1 Raniganj PHC HMC 5.3 lac ‘05-06 100% Completed 24 hr delivery Upgradation to 2 Golakganj PHC HMC 5.3 lac ‘05-06 100% Work completed 24 hr delivery Dist. Const. Upgradation to 3. Dharmasala PHC 5.3 Lac ‘07-08 100% Work completed Committee 24 hr delivery

Rs.7.4 lakhs allotted for Up gradation of Health Institution to 24 x 7 hr Delivery services as on 31.03.08 Sl Name of Implementing Fund Financial Type of work Progr ess Remarks No Institution Agency alloted year of work in % Age 20 beds MC Town & Country Upgradation to 24 1 7.4 L 06-07 100% Completed Dhubri Planning hr delivery Completed Agomoni Dist. Const. Upgradation to 24 2 7.4 L ’07-08 100% and handed CHC Committee hr delivery over

Rs. 14.9 La khs allotted for Up gradation of BPHC to FRU during the year 2006 2007 (Source : PWD building report as on 30.05.09 and AE, NRHM report as on 24.9.08) Sl Name of Implementi Fund Type of Progress of Remarks No Institution ng Agency allotted work work in percentage PWD BPHC to 1 Golakganj PHC 14.9 lac 100% Work completed Building FRU BPHC to 2 Gazarikandi PHC HMC 14.9 lac 100% Work completed FRU

Repairing of Doctor's Quarter and Staff Quarter during 07 08 (Source : PWD building report as on 30.5.09 & AE, NRHM report as 31.3.09) Name of Progress Fund Implementin Sl No Institution/PHC/CHC/SD Type of work of work Remarks alloted g Agency etc in % age 1 Gauripur CHC PWD (B) Doctors & Staff Quarter 100% Work completed 2 Chapor CHC PWD (B) Doctors & Staff Quarter 100% Work completed 3 Raniganj PHC PWD (B) Doctors & Staff Quarter 100% Work completed 4 Halakura CHC PWD (B) Doctors & Staff Quarter 100% Work completed 5 Satrasal MPHC PWD (B) Doctors & Staff Quarter 100% Work completed 6 Boterhat SD PWD (B) Doctors & Staff Quarter 100% Work completed 7 Gazarikandi PHC PWD (B) Doctors & Staff Quarter 100% Work completed

Repairing of Doctor's Quarter and Staff Quarter during 08 09 (Source : PWD report as 31.01.10 ) Name of Implementin Progress Fund Sl No Institution/PHC/CHC/SD g Agency in Type of work of work Remarks alloted etc 200809 in % age 1 Dharmasala PHC 6.0 L PWD (B) Doctors & Staff Quarter 100% Work completed 2 Lakhiganj SD 6.0 L PWD (B) Doctors & Staff Quarter 58% Work progress 3 Salkocha SHC 6.0 L PWD (B) Doctors & Staff Quarter 100% Work completed 4 Bilasipara SHC 6.0 L PWD (B) Doctors & Staff Quarter 100% Work completed 5 Futkibari SD 6.0 L PWD (B) Doctors & Staff Quarter 100% Work completed 6 Geramari MPHC 6.0 L PWD (B) Doctors & Staff Quarter 100% Work completed

DHUBRI/DHAP/2010-11 56

Construction of Stabilization Unit during 0809, Source : PWD report as on 31.01.10 Name of Fund Implementi Type of Progress of work Sl No Institution/PHC/CHC/SD Remarks alloted ng Agency work in % age etc 1 Dharmasala BPHC, 40% 2 Golakgnaj BPHC 100% 3 Raniganj BPHC, 85% 4 Gazarikandi BPHC, 30% 5 Chapor CHC, 60% Gauripur CHC, 6 Dist Const Stabilization 11% 4.2 L 7 Halakura CHC, Committ unit 100% 8 Agomoni CHC, 60% 9 Mankachar CHC, 35% 10 Sapatrgam SHC, 75% 11 Bilasipara SHC and 85% 12 20 beded Maternity Centre 20%

Construction / Upgradtion of Twon SD to FRU during 0809 Name of Progress of Fund Implementin Sl No Institution/PHC/CH Type of work work in % Remarks alloted g Agency C/SD etc age Construction of Ground floor of 2 9two) st R.C.C Bldg (with a provision of Assam Type 1 st floor) Const 1 Town SD 14.43 L for upgradation of town 70% Work in progress Committ state dispensary to FRU standard in the campus of Old Civil hospital, Dhubri

DHUBRI/DHAP/2010-11 57 Table 4. 7: Status of Civil Work Implemented by PWD Building

Rural Health Block Pooling Complex during 2006 07 (Source : PWD report as on 31 .1 2.09) Progress of Sl Name of Name of Fund Implement ing Type of work in % Remarks No Block PHC Institution alloted Agency work age Block Chapor Chapor PWD 1 100 L Pooling 100% Work completed PHC CHC (Building) Complex Block Gazarikandi Mankachar PWD 2 100 L Pooling 100% Work completed PHC CHC (Building) Complex Block Halakura Halakura PWD 3 100 L Pooling 86% Work in progress PHC CHC (Building) Complex

CHC to IPHS standard during 0607 (Source : PWD building report as on 31.7.09) Fund Sl Name of Implementi Progress of alloted per A.A letter no Remarks No Institution ng Agency work in % age institution NRHM/ESTIMATE/DHUBRI/40 Chapor PWD 1 40 L 5/2996 100% Work completed CHC (Building) dtd. 23-10-06 Mankachar PWD Work completed and Handed 2 40 L 100% CHC (Building) over Halakura PWD 3 40 L 100% Work completed CHC (Building) NRHM/ESTIMATE/DHUBRI/40 Gauripur PWD Work completed and Handed 4 40 L 5/5659 100% CHC (Building) over dtd. 5-12-06

Construction of Doctor's Quarter and Nurses Quarter during 06 07 (Source : PWD building report as on 5.11.09) Progress Sl Name of Fund Implementin of work in Institution/PHC/CHC/SD etc Type of work Remarks No alloted g Agency % age Doctors & Nurse 1 Golakganj PHC 28.80 L PWD (B) 100% Work completed Quarter (Assam Type) Doctors Qtr (1unit) & 2 Bilasipara SHC 28.80 L PWD (B) 100% Work completed Nurse Qtr (3 unit) Doctors Qtr (1unit) & 3 Gauripur CHC 28.80 L PWD (B) 100% Work completed Nurse Qtr (3unit) Doctors Qtr (1unit) & Work completed 4 South Salmara CHC 28.80 L PWD (B) 100% Nurse Qtr (3 unit) except electrification Doctors Qtr (1unit) & 5 Bogribari SD 28.80L PWD (B) 100% Work completed Nurse Qtr (3 unit) Doctors Qtr (1unit) & 6 Dhepdhepi MPHC 28.80L PWD (B) 100% Work completed Nurse Qtr (3 unit)

Construction of 200 beded Civil Hospital, Dhubri (Source : AE report as on 31.1.10) Name of Progress Fund Implementin Sl No Institution/PHC/CH Type of work of work Remarks alloted g Agency C/SD etc in % age Construction of 200 1 Dhubri Civil hospital PWD (B) 74% Work in progress beded Civil hospital

DHUBRI/DHAP/2010-11 58

RCC GNM School cum Hostel Building for 100 Nursing students (Source : PWD building report as on 31.12.09) Name of Progress Fund Implementin Sl No Institution/PHC/CH Type of work of work Remarks alloted g Agency C/SD etc in % age RCC GNM School cum 1 Dhubri Civil Hospital PWD (B) 43% Work in progress Hostel Building

Construction of Wards in Dhubri District During 2008 09 (Source : PWD report as on 31.01.10) Name of Progress Fund Implementin Sl No Institution/PHC/CH Type of work of work Remarks alloted g Agency C/SD etc in % age 1 Salkocha SHC Assam Type Ward 80% Work in progress 2 Lakhiganj SD 70% Work in progress 3 Satrasala MPHC 70% Work in progress

Table 4. 8: Perormance Of Mobile Mdical Unit, Dhubri During 0809 & 0910 (Upto Jan’10) During 09 10 Month During 0809 Total (upto Jan’10) No of Camps held 60 79 139 No of Patient Treated 9878 12597 22475 No of ANC 540 765 1305 No of PNC 469 117 586 No of X -Ray 3 0 3 No of USG 0 3 3 No of ECG 0 0 0 No of Patient examined for Blood Test 361 252 613 No of Patient examined for Uri ne Test 201 108 309 No of Patient examined for Stool Test 0 79 79

Table 4.9: Performance Of Boat Clinic Service , Dhubri during 0708, 0809 & 0910 (upto Jan’10)

During During During 09 10 Total

0708 0809 (upto Jan’10) No. of camps 11 143 173 327 Genral Health Checkup 2083 23129 20165 45377 ANC 106 772 426 1304 PNC 39 515 43 597 Routine Immunization 223 2253 3167 5643 (BCG+OPVII+OPVIII+B+DTI+DTII+Measles+TTI + TT2) Vitamin A 5 15 21 41 Family Planning 43 1189 1334 2566 IPPIP 0 0 0 0 Sppl Vacnation 0 0 0 0

DHUBRI/DHAP/2010-11 59 Table 4.10: Performance Of Evening Opd Services, Dhubri during 0809 & 0910 (Upto Jan’10)

During 0809 During 0910 Sl Name of the Inst No Day Evening % over Day Evening % over Day OPD OPD Day OPD OPD OPD OPD

1 Chapor FRU 39524 8758 22.16% 51055 14029 27.48%

Dhubri Civil 2 Hospital/Dhubri Health & 106854 13351 62.92% 38075 11078 29.10% Maternity Centre 3 Golakganj PHC 19171 2994 15.62% 29450 5982 20.31%

4 Mankachar CHC 20902 2950 14.11% 37377 7310 19.56%

5 Agomoni CHC 10200 2272 22.27% 15319 4690 30.62%

6 Gauripur CHC 11768 1260 10.71% 21589 2690 12.46%

7 Bilasipara SHC 18279 2052 11.23% 32267 5516 17.09%

Total 226698 33637 14.84% 225132 51295 39.82%

Table 4.11: Status of Training/workshop conducted by DHS, Dhubri

Sl. Name of the Training Trainee Duration During the No year 1 ASHA facilitator Training

2 BTT Training for 1 st Module Block Training Team 3 ASHA induction Training 1 st Phase at ASHA BPHC 4 ASHA induction Training 2 nd Phase at ASHA BPHC 4 BTT Training for 2 nd ,3 rd ,4 th & 5 th Block Training Team 6 Days 2007-08 Module 5 Workshop for NRHM staff BPMU/MO(ayur) 2 Days 2007-08

6 Management of Immunization ANM 1 day 2007-08

DHUBRI/DHAP/2010-11 60 Table 4.12: UIP performance Report of Dhubri District

PW BCG PC DPT PC OPV PC Measles PC TT PC target year year Infant Infant Target Target

39175 35335 90.20% 28589 72.98% 28589 72.98% 27126 69.24% 44602 39036 87.52% 2004-05 2004-05

38906 43300 111.29% 29940 76.95% 29940 76.95% 28609 73.53% 46285 38660 83.53% 2005-06 2005-06

38906 41238 105.99% 40484 104.06% 40484 104.06% 25224 64.83% 46285 40301 87.07% 2006-07 2006-07

49356 50150 101.61% 42251 86% 42251 86% 44207 90% 54840 49485 90.24% 2007-08 2007-08

42479 47107 110.89% 39576 93.17% 39576 93.17% 36511 85.95% 50184 41529 82.75% 2008-09 2008-09

50723 35530 70.05% 32528 64.13% 32365 63.81% 31357 61.82% 57622 38837 67.40% (Upto Jan’10) Jan’10) 2009-10 2009-10

Table 4.13: Family Welfare Performance of Dhubri District

YEAR METHOD TARGET ACHIEVEMENT PERCENTAGE Sterilisation 3500 28 0.80% I.U.D/Copper -T (insertion) 4000 703 17.57% 2006-2007 O.P.(User) 3000 1689 56.30% C.C.(User 4000 1979 49.47% Sterilisation 1352 37 2.73% I.U.D/Copper-T (insertion) 2459 665 27.04% 2007-2008 O.P.(User) 2828 1675 59.23% C.C.(User 3073 1512 49.20% Sterilisation 7800 1525 19.55% I.U.D/Copper -T (insertion) 3900 680 17.44% 2008-2009 O.P.(User) 3000 2433 81.10% C.C.(User) 3100 2444 78.84% Sterilisation 9800 777 7.93% 2009-2010 I.U.D/Copper-T (insertion) 4900 971 19.82% (Upto Jan’10) O.P.(User) 4700 2875 61.17% C.C.(User) 4700 2685 57.13%

DHUBRI/DHAP/2010-11 61 Table 4.14: Status Report of Majoni Scheme as on 31 st Jan’10 of Dhubri District

No of Girl Child born No of No of Fixed during the month beneficiaries Total Fund Sl Reporting Month Deposite (Source Live Birth - submitted Utilised issued HMIS Report) application form 1 Feb-09 375 10 5 25,000.00 2 Mar-09 478 6 0 0.00 3 Apr-09 437 7 0 0.00 4 May-09 364 3 0 0.00 5 Jun-09 354 195 0 0.00 6 Jul-09 495 277 99 495,000.00 7 Aug-09 645 94 96 480,000.00 8 Sep-09 851 193 85 425,000.00 9 Oct-09 832 94 60 300,000.00 10 Nov-09 719 407 25 125,000.00 11 Dec-09 629 385 326 1,630,000.00 12 Jan-10 638 114 0 0.00 Total 6817 1785 696 3,480 ,000.00

Table 4.15: Status Report of Mamoni Scheme as on 30th Nov'09 of Dhubri District

Total No of Total no release of Total no of PW completed Pregnant Payment for mamoni ANC visit Name of the BPHC Women Scheme Fund Utilization Register for 1st 2nd 1st 2nd 3rd ANC Installment Installment Golakganj BPHC 6042 6015 5494 3463 226 106 166,000.00 Dharmasla BPHC 6536 6508 3592 3301 162 148 155,000.00 Halakura BPHC 3364 1142 1354 1991 336 63 199,500.00 Raniganj BPHC 7280 6606 1815 2381 400 0 200,000.00 Chapor BPHC 2994 2994 1936 2097 292 97 194,500.00 South Salmara BPHC 9149 9149 4484 4133 145 145 145,000.00 Gazarikandi BPHC 7831 7721 4456 2977 192 192 192,000.00 Dhubri Civil Hospital 615 615 491 174 340 99 219,500.00 Dhubri Health & 1131 1131 877 787 210 190 200,000.00 Maternity Centre 44942 41881 24499 21304 2303 1040 1,671,500.00

Table 4.16: Status of ASHA Incentive for Full Immunization as on 31 st Jan’10

Target for Fully Infants fully Incentive of Rs. 250 SL No Name of BPHC Total Amount Imunization immunized received by ASHA 1 South Salmara BPHC 9002 6040 2963 740750.00

2 Halakura BPHC 6078 4575 1271 317750.00 3 Dharmasala BPHC 6832 6070 2487 621750.00

4 Golakgnaj BPHC 8378 6108 1227 306750.00 5 Gazarikandi BPHC 8200 8138 1458 364500.00 6 Raniganj BPHC 8792 6535 1761 440250.00 7 Chapor BPHC 4452 3238 2051 512750.00 Total 51734 40704 13218 3304500 .00

DHUBRI/DHAP/2010-11 62 Table: 4.17 Performance Report of National Disease Control Programme of Dhubri District

Table: 4.17.1: National Vector Borne Diseases Control Programme (NVBDCP) (Report from Jan 2004 to Dec 2008) of Dhubri District

Death Total No. of B/S Species R.T. due to Incidence Year Population given Malaria Coll. Eaxm Pos Pv Pf Conf. DigABERSPR SFR API AFI Pf%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

2004 1618945 93223 93223 1149 84 1065 1149 Nil Nil 5.75 1.23 1.14 0.71 0.65 92.30%

2005 1667208 94314 94314 1066 71 995 1066 Nil Nil 5.65 1.13 1.05 0.63 0.59 93.30%

2006 1692358 130833 130833 2432 321 2131 2432 6 Nil 7.73 1.85 1.62 1.43 1.25 87.60%

2007 1725283 121712 121712 1977 182 1795 1977 18 Nil 7.05 1.62 1.47 16.24 14.74 90.79%

2008 1729694 124334 124334 1411 98 1313 1411 Nil Nil 7.18 1.13 1.05 11.34 10.56 93.05% 2009 (Upto 1728860 113745 113745 1513 67 1446 1513 4 Nil 6.57 1.33 1.27 0.87 0.83 95.57% Nov’09)

Table: 4.17.2: National Leprosy Eradication Programme in Dhubri District (NLEP)

New cases detected Cases discharged Total No of Leprosy cases Year during the year during the year under treatment 2002 -03 81 76 76 2003-04 63 53 86 2004-05 70 88 68 2005-06 46 54 60 2006-07 32 16 76 2007-08 47 50 73 2008-09 51 54 70 2009-10 (Upto 37 20 87 Oct’09)

DHUBRI/DHAP/2010-11 63 Table: 4.17.3: National Programme for Control of Blindness (NBCP)

Table: 4.17.3.1 Cataract Performance of Dhubri District

YEAR IOL 2006-07 866 2007-08 768 2008-09 426 2009-10 (Upto 402 Nov’09)

Table: 4.17.3.2: School Eye Screening (SES) Performance of Dhubri District.

2009 10 Sl No Activity 200607 200708 200809 (upto Nov) No. of Teachers trained in Screening for Refractive 362 63 Nil Nil 1 Errors No of school going Children 5100 8273 4271 5199 2 Screened No of school going Children detected with Refractive 95 418 189 167 3 Errors No of school going Children 41 378 229 84 4 provided with free glass

Table: 4.17.4: Performance of RNTCP for the last 4 Quarters ie. July’08 to June’09

Annualized Cure rate for Annualized No of new Plan for the next Total number New smear cases detected total case smear positive year of patients put positive case in the last 4 Proportio detection rate cases put on on treatment detection rate corresponding n of TB TB (per lakh pop) treatment (per lakh p op) quarters patients Unit Annualize Cure tested for d NSP rate HIV CDR (85%) 3Q-08 3Q-08 4Q-08 1Q-09 2Q-09 3Q-08 4Q-08 1Q-09 2Q-09 3Q-08 4Q-08 1Q-09 2Q-09 3Q-08 4Q-08 1Q-09 2Q-09 3Q-08 4Q-08 1Q-09 2Q-09

Dhubr 70%

i DTC 74 47 71 94 92 37 53 58 67 27 69 75 85% 275 275 175 149 196 86.5 86.5 86.8 86.5 86.5 or more TU

Gauri 85% 70% ------pur 61 59 76 58 46 69 62 48 72 156 156 135 172 or more TU Figure not 85% available Bilasi 70% at present

para 50 49 47 68 61 60 53 74 61 60 63 88 86 91 134 134 133 107 154 87.8 87.8 87.7 or more TU

Gazari 85% 70%

kandi 91 96 60 31 47 44 55 29 31 42 52 27 38 52 173 173 104 78.2 78.2 89.2 88.3 85.2 or more TU

DHUBRI/DHAP/2010-11 64

Table4.18: PROGRESS OF BIRTH AND DEATH REGISTER Deptt.

PERFORMANCE YEAR TOTAL NO OF BIRTH TOTAL NO OF DEATH 2005 28357 3294 2006 30944 3451 2007 31544 3109 2008 33628 3057 2009 (Upto Oct’09) 24710 2903

PERFORMANCE YEAR INFANT DEATH MATERNAL DEATH STILL BIRTH 2005 5 0 131 2006 2 4 92 2007 32 19 234 2008 100 25 286 2009 (Upto Oct’09) 104 21 239

Table4.19 : PROGRESS OF HEALTH CHECKUP IN DHUBRI SCHOOL under School Health Deptt. TOTAL NO. OF SCHOOLS PERFORMANCE YEAR TOTAL NO. OF STUDENTS COVERED COVERED 2005 198 21295 2006 184 23319 2007 187 23166 2008 173 21211 2009(Upto Oct’09) 201 22837

Table 4.20 : Progress under AIDS control Programme

A. Performance of ICTC (Integrated Counseling and Testing Centre) – General in Dhubri

East : 28-05-03 Working : 03-12-03 Counseling Details/Positive Cases PRE POST POSITIVE CASES YEAR TEST TOTAL TEST TEST MALE FEMALE 2003 83 83 62 2 2 4 2004 195 195 195 2 3 5 2005 176 176 174 2 1 3 2006 409 409 397 3 4 7 2007 1608 1153 1153 5 0 5 2008 1660 1620 1620 2 8 10 2009 (Upto Nov’09) 1873 1869 1851 4 2 1 G. Total 6004 5505 5452 20 15 35 B. Performance of ICTC –PPTCT in Dhubri District East/Working : 010107 Counciling Details/Positive Cases PRE POST POSITIVE CASES YEAR TEST TOTAL TEST TEST MALE FEMALE 2007 1640 1576 1576 0 1 1 2008 1718 1749 1593 0 2 2 2009 (upto Nov’09) 3556 3548 3538 0 2 2 G.Total 6914 6873 6707 0 5 5 Positive Casese in the District : 40 (Male =20 & Female = 20) AIDS Cases = 7 (till Nov’09) Death = 7 (till Nov’09)

DHUBRI/DHAP/2010-11 65 Table: 4.21 .Progress of IEC activity in Dhubri District:

Progress during 200910.

A). Under Emergency management fund: Name of the IEC/BCC activity Languages Qu antit Remarks Sl.No y 1/8 Size Leaflets on Malaria Assamese 25000 Distributed to Malaria 1. copies Prone area and to DMO Poster Assamese 6000 Do 2 copies Flex Banner on Swine Flu Assamese 200 nos Installed in BPHC wise 3 prominent places Leaflets on Swine Flu Assamese 50000 Distributed in BPHC 4 copies wise Leaflets on Diabetes Assamese 3000 Distributed during 5 copies World Diabetes day

B). Workshop & Meeting Name of the IEC/BCC Conducted by Quantity Remarks Sl.No activity 1 Focus Group Discussion BEE 480 2 Focus Group Discussion HE 660 3 Focus Group Discussion LHV 840 Awareness meeting on DPMU 1 no DC attend the 4 breastfeeding at Dist HQ meeting on 3 rd August 09 Awareness meeting on BPMU 7 nos Local MLA, BDO, 5 Breastfeeding at BPHC etc attende d. Awareness meeting on DPMU 1 no In connection world 6 Diabetes diabetes Day.

C). Miking • Weekly Miking in all session day is going on. • BPHC wise Cassette on Immunization, malaria prepared. • Centrally a Cassette is prepared on Diabetes. • During Observation of world breastfeeding week mike is done round the District • During Health Mela 2009 Miking was done in all 3 places of health mela by respective BPHC D). Screening of Films • For adolescent Health Clinic a Hind Film Hari Bari is provided to all the BPHC for screening and accordingly they have screened. • On 22 nd November 2009 Some Diabetes awareness videos screened at The Town Club Dhubri premises during the Diabetes Awareness cum Free Blood Sugar Estimation Camp. • Screening of Film on Breastfeeding on 3 rd August 2009 at Jt. DHS Conference Hall Dhubri during observation of World Breast feeding Week.

DHUBRI/DHAP/2010-11 66 E). General IEC

Name of the IEC/BCC activity Languages Quantit Remarks Sl.No y Installation of Hoarding Boards Installed in the health institution 1 Assamese 7 nos on EOPD where EOPD is launched Supply of Digital Still Camera to Out of IEC fund the camera 2 10 nos BPMU were procured Subject are JSY, Immunization, 3 Information Board for SC on Flex Assamese 492 nos FP, ASHA, MMU, Majoni etc Installed in all BPHC areas, 4 Hoarding Boards Assamese 35 nos JSY, FP 4000 5 Newsletter Bi lingual copies 4000 6 Annual Report English copies Covering all the district street 7 Street Play 84 nos plays are organized on Malaria, JSY, FP, and Immunization. 8 Rallies on Breastfeeding 7 nos BPHC wise really organized. 6000 9 Poster on Health Meal 2009 Assamese Hanged in prominent places copies Cloth Banner for Health Mela 10. Assamese 45 nos Displayed at prominent places. 2009 Leaflets on malaria, JSTY, 21000 11. Assamese Distributed to the audiences ASHA etc copies 10000 12. Hand Bill on EOPD Assamese Distributed during Health Mela copies

F). Other Activity: Yoga: • 20 nos of School has been selected and MoU singed among Deputy Commissioner, Head Master and NGO. • 40 % of the total approved budget has been released to NGO as per MoU . • NGO- North East Apex Body has already engaged physical instructor to the 20 ns of selected school and Yoga programme already started School Health Awareness Programme:. • District level convergence meeting held with SSA on 30 th October 2009 at SSA office Dhubri and finalized the programme. • Initially 100 nos of Schools were selected for the programme. • Block level Convergence meeting with SSA officials has been organized and strategy is prepared. Now as per action plan School Health Awareness Programme in 100nos of School is going on successfully.

DHUBRI/DHAP/2010-11 67

CHAPTER 5 INDICATIVE FORMAT FOR CURRENT STATUS AND TARGETS

RCH II GOAL STATE: ASSAM

Current status Target (specify year & source ) 1011 1112

MMR 480 (SRS 2004-06) <350

IMR 64 (SRS 2008) <58

TFR 2.7 (SRS 2007) <2.4

RCH OUTCOMES Current Status TARGET (year & source ) 1011 1112

Maternal Health

1. % of pregnant women receiving full ANC coverage (3 ANC checks, 2 TT injections & 100 IFA Tablets)

Overall 21.9% (DLHS 3) 35% 55% 2007-08

2. % of pregnant women age 15-49 who are anaemic

Overall 72.0% (NFHS3 2005-06)

3. % of births assisted by a doctor/nurse/LHV/ANM/other health personnel

Overall 19% 30% 45% (HMIS web portal)

4. % of institutional births

Overall 15.8% (DLHS 3) 40% 50% 2007-08

5. % of mothers who received post partum care from a doctor/ nurse/ LHV/ ANM/ other health personnel within 2 days of delivery for their last birth Overall 14.8% (DLHS 3) 35% 2007-08

Child Health

DHUBRI/DHAP/2010-11 68 RCH OUTCOMES Current Status TARGET (year & source ) 1011 1112

6. % of neonates who were breastfed within one hour of life

Overall 70.0% (DLHS 3) 80% 90% 2007-08

7. % of infants who were breastfed exclusively till 6 months of age

Overall 38.1% (DLHS 3) 50% 60% 2007-08

8. Children (6-24 months) who received solid or semisolid food and still being breastfed (%)

Overall 97.7 % (DLHS 3) 100% 100% 2007-08

9. % of children 12-23 months of age fully immunized

Overall 23.2% (DLHS 3) 80% 90% 2007-08

10. % of children 6-35 months of age who are anaemic

Overall 76.7% 60% 40% (NFHS3 2005-06)

11. Children (above 21 months) who have received three doses of Vitamin A (%)

Overall 10.3% (DLHS 3) 30% 50% 2007-08

12. % of children under 3 years age with diarrhoea in the last 2 weeks who received ORS

Overall 39.1% (DLHS 3) 60% 75% 2007-08

13. % of children under 3 years age who are underweight

Overall 17.81% 10% 5% (HMIS web portal)

Family Planning

14. Knowledge of all modern family planning method

Overall 23.6% (DLHS 3) 45% 60% 2007-08

15. Contraceptive prevalence rate (limiting methods) Male Sterilization 6.65% 20% 30% (HMIS Report) Female Sterilization 5.54% 40% 50% (HMIS Report) 16. Contraceptive prevalence rate (spacing methods) Oral Pills 48.13% 60% 80% (HMIS Report)

DHUBRI/DHAP/2010-11 69 RCH OUTCOMES Current Status TARGET (year & source ) 1011 1112

IUDs 14.76% 30% 50% (HMIS Report) Condoms 43.96% 60% 80% (HMIS Report) 17. Unmet need for spacing methods among eligible couples

Overall 10.1% (DLHS 3) 8% 5% 2007-08

18. Unmet need for terminal methods among eligible couples

Overall 27.1% (DLHS 3) 20% 10% 2007-08

DHUBRI/DHAP/2010-11 70

CURRENT TARGET (cumulative) b STATUS a RCH INTERMEDIATE INDICATORS 10–11 (quarterwise) (year, 1112 source) Q1 Q2 Q3 Q4

Infrastructure

1. No. and % of PHCs upgraded to Out of 29 6 2 3 - provide 24X7 RCH services (as per nos. 18 GOI guidelines) nos. Inst completed and Handed over

2. No. and % of health facilities upgraded to FRUs, fulfilling the minimal criteria per the FRU guidelines (at least 3 critical criteria)

a. District Hospitals

b. Sub-district/ Civil Hospitals

c. CHCs

d. Block PHCs

3. No. and % of functional Sub-Centres c 246 nos.

4. No. and % of health facilities that have operationalised IMEP guidelines

Human Resources

5. No. and % of ANM positions filled d 230 29 29 29 29 (NRHM) 180 (FW) 46 (jt DHS), Total= 456 nos. of ANM posted at SC and Other inst ie 93% filled up

DHUBRI/DHAP/2010-11 71 CURRENT TARGET (cumulative) b STATUS a RCH INTERMEDIATE INDICATORS 10–11 (quarterwise) (year, 1112 source) Q1 Q2 Q3 Q4

6. No. and % of specialist positions filled O&G -2 O&G-1, Ped-1, Anaes-2, Med -2 d at FRUs Ananes- Dental-1, Eye –2, Surgeo –2 should 1(trained) be posted at Chapor and Mankachar Dental -1 FRU Paed-1 all are posted at Chapor FRU Programme Management

7. % of district action plans ready Yes

Financial Management

8. % of districts reporting quarterly Yes financial performance in time

Logistics / Procurement

9. % of district not having at least one 0% month stock of a. Measles vaccine b. OCP c. EC Pills d. Surgical Gloves

10. % of sub-centres supplied Kit A and 246 nos. of 246 (Kit A & B) 246 (Kit A & B) Kit B in the last 6 months SC supplied with Kit A and Kit B ie 100%

Training

11. No. and % of Medical Officers trained in

a. Management of Common Obstetric Complications

b. Life-saving anaesthesia skills 1 4

c. EmOC 1 4 4. 4 4.

d. RTI/STI 12 3 3 2 2

e. Safe Abortion Services 4 4 4 2

f. MTP using other methods 6 5 5 5 -

DHUBRI/DHAP/2010-11 72 CURRENT TARGET (cumulative) b STATUS a RCH INTERMEDIATE INDICATORS 10–11 (quarterwise) (year, 1112 source) Q1 Q2 Q3 Q4

g. IMNCI 13

h. Facility Based Newborn care

i. Care of sick children and severe malnutrition

j. NSV 2 1 1 1 1

k. Laparoscopic sterilisation 6 - - - -

l. Minilap (Abdominal Tubectomy) 4 (MO- MO-1 MO-1 - - 2,OT-2 OT-1 OT-1

m. IUD insertion 13 8 8 8 4

n. ARSH

o. IMEP 12. No. and % Staff trained in SBA

a. ANM 53 3 3 3 3 b. LHV 10 - - -

c. Staff nurse 57 6 6 6 6 13. No. and % Staff trained in RTI/ STI

a. ANM - 4 4 4 2

b. LHV - 2 2 2 1 nos.

c. Staff nurse - 4 4 4 2

d. Lab Technician - 2 2 2 - 14. No. and % Staff trained in IMNCI

a. ANM 455

b. LHV

c. AWW 1791

d. Staff nurse 15. No. and % of staff nurses trained in Facility Based Newborn Care

16. No. and % of ASHAs trained in Home Based Newborn Care

17. No. and % Staff trained in IUD insertion a. ANM 29 30 30 30 30

DHUBRI/DHAP/2010-11 73 CURRENT TARGET (cumulative) b STATUS a RCH INTERMEDIATE INDICATORS 10–11 (quarterwise) (year, 1112 source) Q1 Q2 Q3 Q4

b. LHV 9 - - - -

c. Staff nurse 17 10 10 10 10 18. No. and % of staff trained in ARSH

a. ANM

b. LHV

c. Staff nurse

d. Programme Managers 19. No. and % of state and district program managers trained on IMEP

20. No. and % of health personnel who have taken Contraceptive Updates

Maternal Health

21. % of ANC registrations in 3 ANC 49.68% 10% 15% 15% 20% Checkup (Upto Jan’10 report of HMIS)

22. % of 24 hrs PHCs conducting 14 nos. minimum of 10 deliveries/month PHC

23. No. and % of health facilities providing RTI/STI services

a. SDHs Nil

b. CHCs Nil

c. PHCs Nil 24. No. and % of health facilities providing Safe Abortion services (including MVA/ EVA and medical abortion)

a. DHs

b. SDHs 40 nos c. CHCs MVA kit d. PHCs

25. No. and % of planned Monthly Village 12070 25% 25% 25% 25% Health and Nutrition Days held (even if (86%) budgeted under NRHM Part B) (Monthly Report upto Jan’10)

DHUBRI/DHAP/2010-11 74 CURRENT TARGET (cumulative) b STATUS a RCH INTERMEDIATE INDICATORS 10–11 (quarterwise) (year, 1112 source) Q1 Q2 Q3 Q4

Child Health

26. No. of districts where IMNCI logistics are supplied regularly

27. No. and % of health facilities with at least one provider trained in Facility Based Newborn Care

Family Planning

28. No. and % of health facilities providing Female Sterilization services

a. DHs 7.24% (upto Jan’10)

b. SDHs 0

c. CHCs 0

d. PHCs 0 29. No. and % of health facilities providing Male Sterilization services

a. DHs 0

b. SDHs 0

c. CHCs 0

d. PHCs 10.6% (upto Jan’10)

30. No. and % of health facilities providing IUD insertion services

a. CHCs 19.82% b. PHCs (upto 5900 nos. of Beneciciary Jan’10) c. Sub centres 31. No. of accredited private institutions providing:

a. Female sterilisation services

b. Male sterilisation services

c. IUD insertion services 32. % of districts with Quality Assurance Committees (QACs)

33. % of district QACs having quarterly meetings

DHUBRI/DHAP/2010-11 75 CURRENT TARGET (cumulative) b STATUS a RCH INTERMEDIATE INDICATORS 10–11 (quarterwise) (year, 1112 source) Q1 Q2 Q3 Q4

34. % of planned Female Sterilisation camps held in the quarter Nil 12 12 12 12

35. % of planned NSV camps held in the 4 21 21 21 21 quarter Adolescent Reproductive and Sexual Health

36. % of ANC registrations in first trimester of pregnancy for women < 19 years of age

37. No. and % of health facilities providing ARSH services

a. FRUs

b. CHCs 6 4 c. PHCs

38. No. and % of health facilities with at least one provider trained in ARSH

Innovations/PPP/NGO

39. No. of districts covered under MNGO scheme

40. No. of MNGO proposals under 1 nos. implementation (received funding for MNGO planned activities)

Monitoring and Evaluation

41. % of districts reporting on the new yes MIES format on time

BCC/ IEC

42. No. and % of districts with Yes decentralised BCC/IEC strategy/ plans

DHUBRI/DHAP/2010-11 76

CHAPTER 6 GOALS, OBJECTIVE, STRATEGY AND ACTIVITIES UNDER DIFFERENT COMPONENTS OF NRHM

DHUBRI/DHAP/2010-11 77 National Rural Health Mission Recognizing the importance of Health in the process of economic and social development and improving the quality of life of our citizens, the Government of India has resolved to launch the National Rural Health Mission to carry out necessary architectural correction in the basic health care delivery system. The Mission adopts a synergistic approach by relating health to determinants of good health viz. segments of nutrition, sanitation, hygiene and safe drinking water. It also aims at mainstreaming the Indian systems of medicine to facilitate health care. The Plan of Action includes increasing public expenditure on health, reducing regional imbalance in health infrastructure, pooling resources, integration of organizational structures, programmes of health manpower, decentralization and district management of health programmes, community participation and ownership of assets, induction of management and financial personnel into district health system, and operationalizing community health centers into functional hospitals meeting Indian Public Health Standards in each Block of the Country.

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

The National Rural Health Mission (2005-12) seeks to provide effective healthcare to rural population throughout the country with special focus on 18 states, which have weak public health indicators and/or weak infrastructure. It also seeks to reduce the Maternal Mortality Rate (MMR) in the country from 407 to 100 per 1,00,000 live births, Infant Mortality Rate (IMR) from 60 to 30 per 1000 live births and the Total Fertility Rate (TFR) from 3.0 to 2.1 within the 7 year period of the Mission.

These 18 States are Arunachal Pradesh, Assam, Bihar, Chhattisgarh, Himachal Pradesh, Jharkhand, Jammu & Kashmir, Manipur, Mizoram, Meghalaya, Madhya Pradesh, Nagaland, Orissa, Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar Pradesh.

6.1 Goals of the Mission:

Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio(MMR) Universal access to public health services such as women’s health, child health, water, sanitation & hygiene, immunization and nutrition Prevention and control of communicable and non-communicable diseases, including locally endemic diseases Access to integrated comprehensive primary health care Population stabilization, gender and demographic balance Revitalize local health traditions and mainstream AYUSH Promotion of healthy life styles

DHUBRI/DHAP/2010-11 78 The overall objectives is to increase coverage and quality of services as envisaged under the National Rural Health Mission is to bring about outcomes in the Millennium Development Goals, the National Population Policy, National Health Policy, minimizing the regional variations in the areas of maternal and child health, communicable diseases and primary health and the health sector strategies.

Thus the broad objectives are as follows:

To improve the accessibility of poor and un reached groups to curative, preventive, promotive and rehabilitative health services To reduce maternal and child mortality, and the burden of communicable, non communicable and nutrition-related diseases and disorders To ensure quality at all levels of health and medical care services To maintain excellence in education and research in medicine and all allied professions (including management) In order to achieve the above broad objectives there is a need further focus on the following objectives:

Ensure that the whole population has access to a range of evidence based and affordable health promotion and prevention services Promote appropriate health seeking behaviour by all citizens Ensure universal equity of access to simple curative and emergency services Ensure that quality primary Health Care remains pre-eminent as the central strategic health priority for the district Ensure that the health systems necessary to provide such services, which are accountable to clients and are effective, are developed and strengthened in line with international best practices Actively engage in partnerships with PRI, civil society groups, NGOs, the private sectors and other development partners

DHUBRI/DHAP/2010-11 79

6.2 Outcomes of the Mission

Infant Mortality Rate reduced to 30/1000 live births Maternal Mortality Ratio reduced to 100/100,000 Total Fertility Rate Reduced to 2.1 Malaria Mortality Reduction Rate- 50% upto 2010, additional 10% by 2012 Kala Azar Mortality Reduction Rate – 100% by 2010 and sustaining elimination until 2012 Filaria/Microfilaria Reduction Rate: 70% by 2010, 80% by 2012 and elimination by 2015 Dengue Mortality Reduction Rate: 50% by 2010 and sustaining at that level until 2012 Japanese Encephalitis Mortality Reduction Rate: 50% by 2010 and sustaining at that level until 2012 Cataract Operation: increasing to 46 lakhs per year until 2012 Leprosy Prevalence Rate: reduce from 1.8/10,000 in 2005 to less than 1/10,000 thereafter Tuberculosis DOTS Services: Maintain 85% cure rate through entire Mission period Upgrading Community Health Centres to Indian Public Health Standards Increase utilization of First Referral Units from less than 20% to 75% Engaging female Accredited Social Health Activits (ASHA)

Community level

Availability of trained Community level worker at village level, with a drug kit for generic ailments Health Day at Anganwadi level on a fixed day/month for provision of immunization, ANC and PNC checkups and services related to mother & child health care, including nutrition Availability of generic drugs for common ailments at Sub Centre and hospital level Good hospital care through assured availability of doctors, drugs and quality services at PHC/CHC level Improved access to Universal Immunization through induction of Auto Disabled Syringes, alternate vaccine delivery and improved mobilization services under the programme Improved facilities for institutional delivery through provision of referral, transport, escort and improved hospital care subsidised under the Janani Suraksha Yojana (JSY) for the Below Poverty Line families. Availability of assured health care at reduced financial risk through pilots of Community Health Insurance under the Mission Provision of household toilets Improved outreach services through mobile medical unit

6.3 Mission Targets to be achieved

IMR reduced to 30/1000 live births by 2012 MMR reduced to 100/100,000 live births by 1012 TFR reduced to 2.1 by 2012 Malaria Mortality Reduction Rate- 50% up to 2010, additional 10% by 2012 Cataract operations-increasing to 46 lakhs until 2012 Leprosy Prevalence Rate- reduce from 1.8 per 10,000 in 2005 to less than 1 per 10,000 thereafter Tuberculosis DOTS series- maintain 85% cure rate through entire Mission period and also sustain planned case detection rate. Upgrading all Community Health Centres to Indian Public Health Standards. Increase utilization of First Referral Units from bed occupancy by referred cases of less than 20% to over 75% Engaging female Accredited Social Health Activists (ASHA) in every village.

DHUBRI/DHAP/2010-11 80 6.4 PART A: RCH PROGRAMME 6.4.1 : MATERNAL HEALTH Goal: To reduce maternal mortality rate from 480 (SRS 0406) to less than 350 by 201011.

O1. To increase the 3 ANC from 21.9% (DLHS-3) and 49.68% (HMIS report up Jan’10) to 70% by 2010-11 and also to reduce the proportion of pregnant women with anemia. Strategies:

S1. Early registration of Pregnancy Proposed Activities a. Training of 1726 nos of ASHA on early detection and registration of Pregnancy in the Sub Centre area. b. Identification of Pregnant Women and registration will be ensured by ASHA as early as possible taking help of urine examination for Pregnancy test by using of NISHYA KIT. c. Regular supply of Pregnancy Test Kit will be ensured to all 1726 nos. of ASHAs and 456 nos. of ANM d. Village Health & Nutrition Day in 1500 villages of the District will be used as a platform for motivating and mobilizing the women for early registration of pregnancy. e. The District under “Assam Bikash Yojana” has implemented “Mamoni”-Nutrional food for pregnant women where a pregnant woman after her first registration receives a hand book on nutrional food and MCH card. On her 2 nd checkup, a cheque of Rs. 500/- is given as monetory support for nutrional food and on her 3 rd checkup, another cheque of Rs. 500/- is given and a voucher for referral transport.

S2. To provide quality antenatal care to all pregnant woman by increasing the access through existing Govt. facilities.

Proposed Activities: a. It will be ensured that all the existing 246 Sub-Centres will be procured requisite equipments from the SC untited fund and it wil be equipped with BP instruments, weighting mahine and examination table. b. Regular supply of IFA tablet, TT injection and Hb Kit wil be ensured in all 246 Sc & 41 Health Institutions. (SD/MPHC/SHC/CHC/FRU/BPHC/UHC/SDCH/DH) c. In all the SC it will mandatory that ANM will perform regular checkup of BP, weight and Hb test of all the registrated pregnant women and will keep a upto date record in the MCH register and tickler chart for follow up with the help of ASHA

DHUBRI/DHAP/2010-11 81 d. Re Orientation Training of 456 nos. of ANM Block PHCwise in a batch of 30 on physical examination of pregnant women, Hb estimation and record keeping. e. Out of 246 SC functioning in rented building & Govt. dilapidated building, 58 nos SCs already taken up for construction during 2007-08, again another 45 SCs have been approved for new construction during 08-09 & 09-10 @ Rs. 7.5 lakhs and during current year 32 nos of SC will be proposed for construction for increase provision of quality antenatal care during 2010-11. (Annexure -A) f. The sanctioned vacant posts of ANM will be filled up through regular appointment by the State Govt. Total sanctioned post vacant under Addl CM & HO(FW) establishment =87 and JDHS establish=11 g. As per the report there are total 376 nos.of ANM in the district in the SC. The total requirement for the district @ 2 ANMs per SC (excluding outreach area) is 116. Therefore during 2010-11 atleast 50 ANM’s may be posted.

S.3. To provide quality antenatal care to all pregnant woman in inaccessible and uncovered areas.

Proposed Activities: a. The uncovered and inaccessible areas under South Salmara, Gazarikandi, Raniganj and Dharmasala BPHC (Total No of Char Village=124, & Char Population=1,39,801) have been identified where there is no other Health facilities to provide ANC coverage regularly. A total 26 nos. of Sub Center is proposed for @ Rs. 7.5 lakhs in the identified permanent Char areas to increase provision of quality antenatal care. b. The contractual ANM may be posted under NRHM @ 2 ANMs per SC. Therefore total requirent will be 52 nos. c. Logistic supply will also be regularized d. Special camp to be organized to cover uncovered inaccessible areas by mobile medical team & Boat Clinic.

S4. To increase awareness amongst the mothers and communities about the need of ANC.

Proposed Activities:

Communication strategies like street play, FGD, awareness meeting will be done laying emphasis on marriage after 18 years, first child after 20 years, need of ANC, birth preparedness and importance of hospital delivery to increase awareness amongst the mothers and communities about the need of ANC and exclusive breast feeding.

DHUBRI/DHAP/2010-11 82 O2. : To strengthen the basic obstetric care (institutional deliveries) from 30.3% (Coverage Evaluation Survey, RRC-NE) to 50% by 2010-11 Strategies:

S1. Increasing the access through facility strengthening.

Proposed Activities:

a. To strengthen the institutional delivery, the district has upgraded and taken up to 3 no.s BPHC , 1 nos. CHC, 1 nos. Maternity Centre, 6 nos. MPHC, 4 nos. SHC and 11 nos. SD to 24x7 hr delivery services during 05-06 to 09-10, Out of which the construction work has completed in 18 nos. Health Institutions and providing 24x7 hr delivery services and the construction work is going on in 8 nos. of health institutions.

b. Again during 2009-10, fund has been received for 3 nos. Health Institutions for upgradtion of 24x7 hr delivery services with maternity wards and the construction work is in process.

c. As per facility survey there is a requirement of 21 nos. labour table, 21 nos. of Stand light, 10 nos. Radiant warmer, 13 nos. Auto clave, 19 nos. Electric Sterilizer, 19 nos. backup Generator set including other logistics for 24x7 hr delivery services for quality services. The institutionwise detailed requirement is enclosed herewith as Annexure B d. Contractual engagement of 2 MO (MBBS), 3 MO (Ayur) and 55 GNM will be done in 24x7 PHCs deficient in manpower. The institutionwise detailed requirement is enclosed herewith as Annexure C e. The repairing and renovation of PHC Quarter of Jhowdanga SD, Bherbhangi SD, Dumardaha MPHC, Moterjhar SD & Kachokhana SD will be taken up during 2010-11 so as to ensure that MO stays in Quarters. f. During 10-11, 15 nos. SC has been proposed for taking up the Institutional Delivery at Folimari, Islamari, Barunitara, Simlabari, Silairpar, Gharialdanga, Ranpagli, Jhaskal III Borkanda, Kazaikata Pt-V, Rakhalpat, South Raipur, Paglahat, Fekamari and Baghapara SC. As per facility survey the gaps interms of infrasture and equipments/furniture have to be full filled during 2010-11. g. 57 nos. GNM. 10 nos. LHV and 53 nos. ANM has already trainined on Skilled Birth Attendent (SBA) at Civil Hospital, Dhubri till Nov, 2009-10, During 2010-11, another 24 nos. of GNM, and 12 nos. of ANM will be trained on SBA on priority basis to improve the quality of services.

DHUBRI/DHAP/2010-11 83 S2. Delivery by Trained Birth Attendant

Proposed Activities:

Even after implementation of JSY, there are pregnant women who cant reached Health Facilities for Institutional Delivery, these are the women from far flanged char areas/ riverine island even after creating awareness through ASHA and various IEC activities, the District is unable to bring these women specially from Char area where a sub-centre cannot be constructed not transport could be made available

Hence it is proposed in these difficult areas, women such as DHAI who any how is conducting delivery will be trained and provided with Disposable delivery Kit. , So that at least clean delivery practices could be ensured in these areas. An amount of Rs. 100 is proposed for DHAI as incentive for conducting delivery. Total budget is as follows - Estimated Incentive Total Budget PW 50% of 46935 100 23,46,750.00

S3. Social mobilization for institutional deliveries (Janani Suraksha Yojana) Proposed Activities:

a. The district will continue with Janani Suraksha Yojana, wherein all the pregnant woman will be given incentives for institutional deliveries till Nov, 09, the JSY beneficiaries in the District are 10485, out of 11366 Institution deliveries.

The payment structure will be in line to GoI guidelines, which is as follows:

Location Rural Amount (in Rs.) Urban Amount (in Rs.) Institutional Delivery 1400 1000 Home Delivery 500 500 ASHA (only for ID) 600 -

b. For the Year 2010-11, the total Pregnant Women estimated are 46935, this year the district proposed to increase the institution delivery from existing level to least 50%. Thefore based on this a detail calculation has been worked out for JSy beneficiaries and shown as below -

JSY CALCULATION FOR 201011 (Rs. In lakhs)

PW PW lakhs) District (in lakhs) (in lakhs) (in Live Birth Birth Live Rs.1400 (in lakhs) lakhs) Rs.1400 (in @Rs.500 (in lakhs) lakhs) @Rs.500(in @Rs.1000 (in lakhs) lakhs) @Rs.1000 (in JSY benefit urban IDurban benefit JSY Projected Population Population Projected 2010(Growth Rate 1.6) Rate 1.6) 2010(Growth JSY for Home delivery delivery JSYHome for JSY benefit (ID) Rural @Rural JSY benefit (ID) Population Census 2001 Census 2001 Population ASHA @Rs.600 for rural ID rural @Rs.600 ID ASHA for Projected ID (50%) 201011 201011 Projected ID (50%) ASHA @Rs.200 for urban ID @Rs.200 ID urban ASHA for Total JSY fund proposed (in proposed fund Total JSY Projected rural ID (87%) 2010 rural (87%) Projected ID Projected urban ID(13%) 2010 ID(13%) urban Projected Dhubri 1637344 1923153 47310 52041 26020 3383 22638 33.83 316.93 135.83 6.77 130.10 623.45

DHUBRI/DHAP/2010-11 84 c. The ASHA accompanying the pregnant woman for hospital delivery will also be given monetary incentive under this Scheme as per GoI guidelines. d. For developing the practice of institutional delivery age bar and order of pregnancy will not consider any more.

S4. Referral of obstetric emergencies

Proposed Activities: a. Village to Health facilities Most of the parts of the district is backward and covered by char area and most of the Pregnant women donot come to health facilties for delivery because of of non availitbility of transportation facility from village to health institution. In these areas the means of communication are bullock carts, hand pull carts, private vehicles and boats which are available on hire. So the district proposed for providing transportation facility to the pregnant women from village to Health Institution including char areas. The Projected Institutional Delivery for 2010-11 is 18744, In these backward, referral transport money will be provided to Prgenant women (expected Pregnant women living in this backward area =7497 (40% of ID) and Char areas 3748(20% of ID) coming for Institutional Delivery under following categories Distance Referal Money (in Rs.) Expected PW Estimated Budget Less than 5 KM Rs. 60/- 1874 1.12 lakh 5 to 10 KM Rs. 100/- 1874 1.87 lakh Above 10 KM Rs. 250/- 3749 9.37 lakh Hiring of Boat in Char area Rs. 350/- 3749 9.37 lakh Total 21.73 lakh b. Health Institution to Health Institution The Pregnant women and Sick New Born requiring referral to higher institutions will be transported from one Health Institutions to another using ambulance available in the health facility. Sl No Detail Unit Total (Rs. In Lakh) Rs. 4000/- pm per 1 PoL for 30 nos. Ambulance 14.40 lakh ambulance

DHUBRI/DHAP/2010-11 85 O-3. To Strengthen the Comprehensive Obstetric Care

Strategies:

S1. To improve the comprehensive EmOC in the CHCs and FRU.

Proposed Activities:

a. Construction of CHC to IPHS Standard has been completed for Chapor, Mankachar Halakura and Gauripur CHC in Dhubri district and required manpower will be provided during 2010-11 as per IPHS for comprehensive EmOC.

b. It will also be ensured to fill up all gaps in terms of logistics and equipments during 2010- 11 for operationalizing these health facilities

c. 2 nos. of Specialist in each discipline of O&G, Pae, Anae, Surgeon, and Radiologist etc will be reqcruited on contract basis for atleast 2 nos. IPHS institution i.e Halakura and Mankachar CHC. d. 4 nos. MBBS doctors will be trained at SIHFW for EmOC to make 4 nos. of CHC functional for comprehensive EmOC. O-4. Strategy: Increasing coverage of post partum care from 14.8% (DLHS3) to 35% by 2010-11

S-1: Ensure post partum care at Village level by ASHA/AWW/ANM

Proposed Activities: a. The AWW/ANM/AHSA of 246 SCs of Dhubri district will pay 3 post partum visit (1 st within 2 days, 2 nd within 14 days and 3 rd within 42 days) in respetive sub-centre areas and the activity will monitor by BPM/BAM/Asstt BPM. b. During Village Health and Nutrition Day, the mothers will be motivated on essential newborn care, early and exclusive breast-feeding and adopting family planning practices by ASHA/ANM S-2: Ensure post partum care at PHCs and Higher Health Institution Proposed Activities: a. It will ensure that the mother stays for 48 hrs after delivery in the Health Institutions so that necessary care can be taken if any complication arises and maternal mortality can be reduced. b. During their stay they will be counseled about essitential New Born care, Early & Exclusive Breast feeding and Adopting Family Planning practices.

DHUBRI/DHAP/2010-11 86 O-5. To improve safe abortion facilities and reduce unsafe abortion

S1. Increase the access to safe abortion in Govt. facilities.

Proposed Activities: a. DH/5 CHC/6 BPHC/ 2 SHC/ 1 MPHC/ 1 MC will be provided with requisite Kits to provide safe MTP. b. 40 MVA kit reveied by the District will supplied to all the above health centers (2 each for DH/CHC/PHC/SHC/MPHC) after training c. 15 nos. of Doctors from PHC/CHC/SHC will be trained in phased manner at District Civil Hospital, Dhubri for MTP d. Proper maintenance of records will be ensured. O-6: To promote RTI/STI Facilities S1: Operatonalize services for diagnosis & Treatment at CHC/DH Proposed Activities: a. District Civil Hospital and CHC will be strengthened to provide facilities for diagnosis and treatment of RTI/STI. The PHC however will focus on syndromic approach and drugs will be provided for the same. However, complicated cases will be referred to higher institutions. b. RTI/STI Kit will be provided to DHs and 5 nos. of CHCs of Dhubri District c. The Laboratory in the DHs, and CHCs will be provided with requisite logistics (drugs and kits) twice a year.

S2 Capacity building ANM/SN and Medical Officer & Lab Tech for managing RTI/STI

Proposed Activities:

ANMs (14)/ LHV(7), GNM (14) and Doctors (10) & Lab Tech (6) will be trained in the SIHFW, Guwahati in phase manner.

S3. Promote communication activities for prevention and early care seeking for RTI/STI.

Proposed Activities: a. Communication activities will be developed laying emphasis on symptoms of RTI, STI, and facilities available in the block area of diagnosis & treatment. The activity is budgeted under BCC/ IEC.

DHUBRI/DHAP/2010-11 87 6.4.2 : CHILD HEALTH

Indicator Status

IMR (SRS, 2008) 64 per 1000 live birth

Goal (Overall) 30 per 1000 live birth

Goal (Annual) < 58 per 1000 live birth by 201011

Situation Analysis

District : Dhubri Indicators DLHS 3 DLHS 2

Child feeding practices (Children under 3 years)

Children breastfed within one hour of birth (%) 70.0 - Children (age 6 months above) exclusively 38.1 - breastfed (%) Children (6-24 months) who received solid or 97.7 - semisolid food and still being breastfed (%). Treatment of childhood diseases (children under 3 years based on last two surviving children) Children with Diarrhoea in the last two weeks who 39.1 49.0 received ORS (%) Children with Diarrhoea in the last two weeks who 61.2 71.0 were given treatment (%) Children with acute respiratory infection/fever in the 62.4 - last two weeks who were given treatment (%) Children had check-up within 24 hours after 15.7 - delivery (based on last live birth)(%)

Children had check-up within 10 days after delivery 15.3 - (based on last live birth) (%)

DHUBRI/DHAP/2010-11 88 Goal: To reduce Infant mortality rate from 64 (SRS, 2008) to less than 58 by 201011.

O-1. Objectives: To improve new born care by 2010-11

S-1 ; Implementing Integrated Management of Neonatal & Childhood Illeness

To standardize case management of sick newborns and children under IMNCI. a. To focus on the most common causes of mortality. b. Nutrition assessment and counseling for all sick infants and children. c. Care of Newborns and Young Infants (infants under 2 months) including keeping the child warm; initiation of breastfeeding immediately after birth and counseling for exclusive breastfeeding and non-use of pre lacteal feeds; cord, skin and eye care; recognition of illness in newborn and management and/or referral; immunization and home visits in the postnatal period. d. Care of Infants (2 months to 5 years) including management of diarrhoea, acute respiratory infections (pneumonia) malaria, measles, acute ear infection, malnutrition and anemia; recognition of illness and at risk conditions and management/referral; prevention and management of Iron and Vitamin A deficiency; counseling on feeding for all children below 2 years; counseling on feeding for malnourished children between 2 to 5 years and immunization.

Proposed Activities a. 13 nos. Medical Officer, 3 nos. Nursing Staff and 2 CDPO has completed the ToT on IMNCI at SIHFW, Guwahati b. The district will organize 8 days training on IMNCI for 1791 nos. of AWW workers and 455 nos. of ANM in batchwise (24 partcipant per batch) as per training plan and providing IMNCI Kits and followup.

S-2: Strengthening of the Govt facilities to provide newborn care.

Proposed Activities : a. During 2008-09, fund has been received @ Rs.4.2 lakhs for establishment of 4 Bedded Neonatal Stabilization Unit at Dharmasal BPHC, Golokganj BPHC, Raniganj BPHC, Gazarikandi BPHC, Chapor CHC, Gauripur CHC, Halakura CHC, Agomani CHC, Mankachar CHC, 20 Bedded MC, Sapatgram SHC and Bilashipara SHC and the work is in progress. b. Again during 2009-10, fund has been received @ Rs.4.2 lakhs for establishment of 4 Bedded Neonatal Stabilization Unit at Salokcha SHC, Dhepdhep MPHC, Satrasal MPHC, Tamarhat MPHC and Lakhiganj SD and the work is in process. c. During 2010-11, the Neonatal Stabilization Unit of Dhubri districts have to make functional by providing logistics and manpower.

DHUBRI/DHAP/2010-11 89 S3. Capacity building of Doctors and Nurses on Basic Neo Natal Resuscitation training

Proposed Activites : a. The District TOT on Basic Neonatal Resuscitation technique has completed for 24 nos. Medical Officer, 2 nos. Sister Tutor, 2 nos Staff Nurse and 4 nos LHV at Dhubri b. Block level training of 48 nos of Doctors and 74 nos. of GNM’s of 24 x 7 PHC’s will be done on Basic Neo Natal Resuscitation techique batchwise (30 nos. participant per batch) as per training plan .

O-2. Promote early breast feeding and exclusive breast feeding till 6 months and above from 38.1% (DLHS 3) to 50% by 201011 Strategies:

S1. To increase awareness amongst mothers on benefits of breastfeeding upto 6 months and need of complementary feeding from 6 month onwards. Proposed Activities: a. IEC/BCC activities will be developed laying emphasis on early feeding of colostrums, exclusive breast-feeding of 6 months and importance and preparation of complementary feeding from 6 months onwards. b. Village Health and Sanitation Committees, SHG may also be involved for motivating pregnant women and lactating mothers to promote exclusive breast feeding c. ASHA will counsel the mothers on the importance of exclusive breastfeeding and complementory feeding. d. During VHND, pregnant women and lactating mothers are to be motivated for exclusive breast feeding.

O3. Objectives: To increase awareness of Diarrhea and ARI from 61.2% (DLHS 3) to 70% and increase the use of ORS from 39.1% (DLHS3) to 50% by 2010-11 and treatment of ARI

S1. To raise awareness amongst mothers and communities on diarrhea ARI.

Proposed Activities:

BCC/ IEC activities will be developed laying emphasis on use of HAF, continuing breastfeeding, solid feeds, ORS usage, and identification of danger signs of diarrhea and ARI. (To be included under BCC/ IEC).

DHUBRI/DHAP/2010-11 90 S2. Making ORS and zinc tablets available in remote/rural/tribal areas and difficult to reach areas through depot holders.

Proposed Activities : a. The refresher training of ASHA and AWW will be done on usage of ORS and Zinc tablets. b. ASHA/AWW will made depot holder for distributing ORS packates. The ASHA kit and SC Kit-A have ORS packats. The supply of AHSA Kit and SC Kit-A twince in a year will be ensured. The AWW will also be provided ORS packats. c. Performance of the depot holders and replenishment of the stock shall be reviewed by the PHC MOs/ BPM quarterly and arrangement for readily available stock of ORS to the depot holders shall be ensured from the BPHC

S3. Strengthen facilities at PHC, CHC, SDH and DH.

Proposed Activities: a. Fund @ Rs. 25000/- has been received for establishment of 13 nos ORT corner in DH, PHCs, CHCs, SDH and SHCs of Dhubri District. Out of which fund has been utilized for establishment of 10 nos of ORT Corner in the District. b. During 2010-11, the remaining fund has to be utilized for establishment of ORT coner in different identified Health institutions of the district. c. The health facilities will be provided with required drugs and kits

S-4. Promote referral services of severe cases of ARI and diarrhoea.

Proposed Activities: a. The VHND will be used as platform to bring awareness amongs the mothers and communities about warning signs of diarrhoea and ARI. b. The health functionaries will be given reorientation training for detection of ARI and Diarrhoea cases requiring referral.

O4. : To reduce prevalence of anemia (635 months)

S1. To prevent and treat anemia in children.

Proposed Activities: a. The pregnant women and mothers will be counseled by ASHA/AWW/ANM about importance of exclusive breast-feeding upto 6 months, importance of complementary feeding from 6 months onwards and preparation of iron rich food. b. Regular supply of IFA (s) tablets will be ensured to treat anemia.

DHUBRI/DHAP/2010-11 91 c. Children below 6 months to 60 months will be given 20 mg. elemental iron and 100 gm of folic acid in liquid formulation. d. Under School Health Programme weekly distribution of IFA tablets to Girls and Six monthly distribution of Albendazole for de-worming by the the Nodal School Teacher. The School teacher will ensure that the girls will consume IFA tablets infront of her. e. It will be ensure that each school should have one fix day for IFA distribution with minimum absenteeism.

O-5-: To reduce the prevalence of underweight among children under 3 years of age.

S1. To work closely with ICDS functionaries to reduce malnutrition.

Proposed Activities: a. Emphasis will be laid to reduce malnutrition amongst the children (3 – 6 years) by working with ICDS functionaries and augmenting the mid day meal programme

O-6-: To reduce Vitamin A deficiency.

S1. To prevent and treat VitaminA deficiency and deworming campaign among children .

Proposed Activities: a. Vit-A will be made available in all the institutions till the Sub-Centre level and administration of Vitamin-A upto 5 years of age will be ensured. b. VHND held every month in the village will also be used as a platform for Vit-A administration. c. In 2010-11, 2 rounds of Vitamin –A week campaign alongwith de-worming March, 2010 and Sept, 2011.

DHUBRI/DHAP/2010-11 92 6.4.3 : FAMILY PLANNING

Goal : To reduce TFR from 2.7 to less than 2.4 by 2010-11 O1- Objective: To meet the unmet need of contraception from 37.2% (DLHS3) to 28% and increase Contraceptive prevalence rate 23.6% (DLHS3) to 45% by 2010-11

S1. To raise awareness amongst the couples and communities about the advantage of contraceptives and small family. Proposed Activities:

a. Communication messages will be printed about importance of FP and availablity of FP services alongwith incentive offered and distibuted to ASHA/ANM/AWW (Details in IEC/BCC plan) b. IEC materials will be dirtributed to the community by ASHA/AWW/ANM in VHND alongwith Family Planning counseling for eligible couple for adopting family planning methods. c. During Home visit on Moday and Thursday ANM & ASHA will update eligible couple register and motivate the couple to adopt FP methods as per choice of the couple d. BCC/IEC activities will be done with help of AWW, ASHA, Woman’s SHGs, FNGOs as per need of the locality to raise awareness amongst the couples and communities about the advantage of contraceptives and small family.

e. During Health Day disadvantages of early marriage (too early, too many and too frequently) are to be explained especially to adolescent girls with the help of opinion and religious leaders of the village. h. One separate room will be allotted where ANM/GM will conduct counseling session’s alongwith distribution of contraceptive/IEC materials etc. in District Hospital, CHCs and BPHCs, MPHCs. SHCs, SDs during OPD hours.

S2. Increase the number of service delivery points.

Proposed Activities:

a. ASHA will act as a depot holder for Condom, Oral Pill and E-Pill and regular replenishment of the contraceptives on exhaustion is to be ensured during 2010-11.

b. 13 nos. of Doctor, 17 nos. of GNM, 29 nos. of ANM and 9 nos. of LHV has completed the TOT on inerstion of Copper-T 380A at Dhubri.

c. Training of 30 MO/ 120 ANM/ 40 GNM on IUD Insertion will be done as per training Plan during 2010-11.

d. The IUCD Kit received during 2009-10 alredy distributed where training imparted another 100 nos of IUCD kit will be required during 2010-11.

e. On Tuesday and Friday of every week Family planning services including IUD Insertion (after training of 120 nos ANM in Govt.Building) are to be provided in all the Govt. Building Sub Center of the District under the supervision of LHV/Doctor will be ensured. Family planning counseling will also be done alongwith.

f. Fixed day family IUD insertuion along with family planning counseling will be ensured at DH/FRU/CHC/BPHC/PHC.

DHUBRI/DHAP/2010-11 93

g. The women will be provided Rs. 20/- as per GoI guidline under RCH progrogramme for each IUD insertion, Budget under RCH flexipool.

No. of Expected Beneficiary Amount (in Rs.) Total Budget Budget under RCH 5900 20/- 1.18 Lakh Flexipool

S3. Improve the service delivery to provide quality female sterilization.

Proposed Activities: a. The District Hospital, CHC/FRU will be equipped with requisite infrastructure and logistics are to be provided Laparoscopic sterilization. (Annexure E) b. Fixed day sterilization (Lap. Camp) in the facilities twice in every week in the District Hospitals and once in Chapor CHC/FRUs will be ensured. c. Female sterilization in every 2 months in 4 CHCs, 3 BPHCs and 1 SDCH by camp approach will be ensured. c. 1nos. of SDCH, 4nos. of CHC and 3 nos. of BPHC will be provided with OT table and Boyles Appeartus for Laprascopic Sterilization. d. DH/FRU/4nos. of CHC/1nos SDCH/3 BPHCs will provided with Co 2 Gas Cylinder for Laprascopic sterilization. e. Training of 4nos. Medical Officers, 4nos. of OT boys on Co 2 gas technique as per training Plan. f. Medical Termination of Pregnancy, MTP will be ensured at DH/CHC/FRU/BPMC/MPHC/SHC after imparting training to 15 MOs and after providing MVA Kits received during 09-10 g. PPS will be ensured at District Hospital, Chapor FRU and Gauripur CHC where PPS surgeon & Mini Lap Kits available. h. The beneficiaries will be given incentive for Female sterilization as per GoI guidline.

No. of Expected Beneficiares Compensation Amount Total Budget

9800 1000.00 98.0 Lakh

Budget for Organizing Laprascopic Camp

Details Rate Total Amount

Laprascopic camp at 8 nos. Health Institutions 17000x8x6 8.16 Lakh

DHUBRI/DHAP/2010-11 94 S4. Encouraging Post partum Sterilisation scheme.

Proposed Activities: a. JSY Beneficiaries are to be motivated for accepting Post Partum Sterilization and refer the acceptor to FRU/CHC/DH where PPS can be done at every level.

b. The JSY beneficiary adopting female sterilsation will get compensation money of Rs. 600.00. Moreover the scheme also provides for Rs. 150.00 motivation fee for ASHA and AWW respectively.

O 2 : To increase the male sterilization from the existing level of 10.6% (HMIS report upto Jan’10) to 20% by 2010-11. S1 To raise awareness among the community regarding Non Scalpel Vasectomy.

Proposed Activities:

a. One day District level workshop will be organized by the Addl CM & HO (FW) incordination with District Administration. Zila Parishad (PRI) members, DIPRO, Teachers, Opinion leaders, Social activist, NGO of NYK etc.to sensitize them on the importance and promotion of NSV.

b. Similar workshop will be organize at Block PHC Level involving chaired by BDO for teachers, Openion leaders, religious leaers, PRI members etc to sensitize them on on the importance and promotion of NSV.

c. IEC material like Hand bill, Brochure, Leaf lets etc on NSV will be developed

d. BPHC wise outdoor publicity material on NSV like Hoarding, Bill Board, Flex Banner etc will be install in Public gathering areas

S2 To improve the service delivery to provide Non Scalpel Vasectomy

Proposed Activities:

a. At the BPHC level one NSV camps cum training for MOs will be organized registering at least 20 acceptors of NSV. One trainer from the Medical College or two trainers from District will attend the workshop. This camp will be organizded in each 7 Block PHCs of Dhubri District monthly. In the workshop MOs from PHC wil be trained.

b. The train MO of the Block and Master trainer of the District will attend to perform NSV sterilization in each Block and compensation money will be paid as per GoI guidelines.

Budget for Organizing NSV Camp

Details Rate Total Amount

NSV camp cum training at 7 Block PHCs monthly 15000x7x12 12.60 Lakh

DHUBRI/DHAP/2010-11 95 Budget for Compensation Package

No. of Expected Beneficiares Compensation Amount Total Amount

2000 1500.00 30.00 Lakh

6.4.4 : ADOLESCENT HEALTH

Objective: O1. To introduce a comprehensive health initiative for adolescent. O2. To ensure the reproductive health and nutrition needs are met. O3. To reduce prevalence of anemia in adolescents . Strategies: 1. School Health Programme (Details under Intersectoral Convergence)

2. Adolcent Clinic in the Health Institutions

Proposed Activities:

a. Fund has been received for establishment of Adolescent Health Clinic in 10 nos. of BPHCs/CHCs of Dhubri district and Out of which 6 nos. of Adolcent Health Clinic has been established.

b. During 2010-11, the remaining 4 nos. of Adolescent Health Clinic has to be established and to make functional already established Adolcent Health Clinic in true sense.

c. IEC & BCC activities will be developed laying emphasis on normal physiology, menstrual hygiene, use of CC, OC, EC, unwanted pregnancy, safe abortion, child marriage, various risk of teenage pregnancy etc.

d. Identification of adolescent groups and numbers of organized and drop out sectors through school health programmes and at the village level during regular home visit by ANMs by maintaining a register.

e. Counseling sessions will be held at regular intervals at fixed sites for both adolescent boys and girls separately. Counseling will be provided on the health days.

f. Alolescents will be supplemented with 30 mg elemental iron and 250 mcg folic acid per day for 100 days in a year

g. Special counseling and on the spot provision of IFA tablets to adolescent girls in order to prevent anaemia.

h. District will arrange training of School teachers on the basic knowledge of adolescent health.

DHUBRI/DHAP/2010-11 96 6.4.5 URBAN RCH

Urban population comprises of 12.16 % of the entire population of District. There are limited health care facilities for poor section of people or the urban slum dwellers. Goal: To improve the Health status of urban poor community by provision of quality integrated primary health care services.

Objectives: • Integrated and sustainable system for primary health care service delivery with focus on urban poor/slums. • Outreach services to be delivered at community level. • Referral services for the risk cases. • To create demand for services in slum population. Strategies S1 Instiitutiion strengtheniing through creatiion of Urban Heallth Centres

Proposed Activities:

During 200910, the District has started the Urban Health Centre, Rail Gumti area covering 30,000 population of the District and is providing following services.

• OPD services, 4 hrs in the morning and 2hrs in the evening

• Provding services like counseling services basic laboratory services, collection and reporting of vital events and IDSP and services for non Communicable diseases. • It will conduct health camps in the areas under the UHC to generate awareness in the community. a. During 2010-11, 2 nos of Urban Health Center is to be established in the urban slums of Dhubri namely, at 1) Bahdur Tari, 2) Dabry c. During 2010-11 the Urban Health Centers have to make functional by providing manpower and logistics.

Budget under UHC Unit cost of 1 Urban Health Centre = Rs. 99,, 82,000.00 per Year Total fund proposed for 333 nos. UHC during 20102010----1111 = 333x93x9x9x9,, 82,000.0082,000.00== Rs. 2229,29,9,9,46464646,0000,0000,0000.00.00.00.00

DHUBRI/DHAP/2010-11 97 6.4.6 VULNERABLE GROUP

The uncovered and inaccessible areas under South Salmara PHC, Gazarikandi PHC and Dharmasala PHC (Total No of Char Village=50, & Char Population= 69,945 ) has been identified which do not have any Health Care facilities. The Centre for North East Studies & Policy Research(C-NES) had signed a MoU with the National Rural Health Mission of the Government of Assam in February 2008 to extend health services to the people of char/sapories in ten districts of Assam including Dhubri district. The focus of the boat clinic initiative is Routine immunization, Ante natal care (ANC), and Post natal care (PNC), health checkups, awareness, and Water and sanitation in association partnership with NRHM, Assam, and District Health Society of Dhubri.

The C-NES team in Dhubri comprise of one District Programme Officer, Two Doctors, Three nurses, one laboratory technician, one pharmacist, three Community Workers and four boat crew members.

Objective: To Provide Primary Health care for inaccessible Char people S1: Promoting Boat Clinic for char areas of Dhubri, District

Proposed Activities: a. Antenatal Care services by Boat Clinic b. Postnatal care services by Boat Clinic c. Family Planning services d. Routine Immunization e. Curative care f. Basic Laboratory Services.

DHUBRI/DHAP/2010-11 98 The tentative annual action plan has been proposed keeping in view the immunization schedule as well antenatal check up providing minimum three checkup & two doses of TT for every pregnant women. A tentative plan of boat clinic camp is given below. Nos. of Target Target Char Quarter Month camp Char Infant Pregnant days population(Approx) (Approx) woman(Approx) 1st April 2010 to 48 16 Different 20399 504 596 June 2010 (16 days char per month) 2nd July 2010 to 48 16 Different 17628 434 507 September (16 days char 2010 per month) 3rd October 48 16 Different Same population Same Same 2010 (16 days char of quarter 1 st population population of to per of quarter quarter 1st December month) 1st 2010 4th January 48 16 Different Same population Same Same 2011 (16 days char of quarter 2 nd population population of to March per of quarter quarter 2nd 2011 month) 2nd Total 12 months 192 32 different 38027 938 1103 camps char

Details of char targeted for the year 20102011

SL. Name of Char/ Name of PHC Populatio Target NO. River Island n Infant for ANC PNC RI (Pregnant Woman) 1 Majer Char NC South Salmara 1950 48 57 57 2 Hatirchar Gajarikandi 1300 32 28 28 3 Moslabari South Salmara 1150 28 34 34 4 Katiaralga South Salmara 1450 36 42 42 5 Majer char Chalakura South Salmara 2100 52 61 61 6 Char Bhasani Dharmasala 1510 37 44 44 Aironjongla 7 Majerchar Pt -I South Salmara 1250 31 37 37 8 Bamundanga South Salmara 1450 36 42 42 9 Bylarchar Dharmasala 1250 31 37 37 10 Boldiaralga NC Dharmasala 1120 28 33 33 11 Dangirchar-Bagmara Dharmasala 1050 26 31 31 12 PoyestiMajercharPt-X South Salmara 1150 28 34 34 13 MohorircharBerabhana South Salmara 950 24 28 28 14 AironjonglaPtI(Namap Dharmasala 1100 27 32 32 ara) 15 Kalaikhowa South Salmara 1200 30 35 35 16 Piazbari South Salmara 850 21 25 25

DHUBRI/DHAP/2010-11 99 17 Sutlamari South Salmara 1100 27 32 32 18 Porarchar South Salmara 926 23 27 27 19 Poraporirchar Dharmasala 1150 28 34 34 20 NatinerAlga South Salmara 925 23 27 27 21 Dhedaimari South Salmara 1350 33 40 40 22 Ayermari South Salmara 1369 34 40 40 23 ChalakuraRiverblock South Salmara 1080 27 32 32 24 Bhasanirchar-Pt-II Dharmasala 1143 28 33 33 25 BoldiarAlga West South Salmara 1050 26 31 31 26 Kadamtola South Salmara 1020 25 30 30 27 Kaziarchar South Salmara 825 20 24 24 28 Mahamayarchar South Salmara 1225 30 36 36 29 Riverblock No.10 South Salmara 860 21 25 25 30 Haddirchar South Salmara 1040 26 30 30 31 Sialmari South Salmara 1025 25 30 30 32 Aminerchar South Salmara 1109 27 32 32 Total 38027 938 1103 1103

Details of char targeted in 1st & 3rd quarter

SL. Name of Char/ Name of PHC Populatio Target NO. River Island n Infant for ANC PNC RI (Pregnant Woman) 1 Majer Char NC South Salmara 1950 48 57 57 2 Moslabari South Salmara 1150 28 34 34 3 Katiaralga South Salmara 1450 36 42 42 4 Majerchar Chalakura South Salmara 2100 52 61 61 5 Char Bhasani Dharmasala 1510 37 44 44 Aironjongla 6 Bamundanga South Salmara 1450 36 42 42 7 Bylarchar Dharmasala 1250 31 37 37 8 Dangirchar-Bagmara Dharmasala 1050 26 31 31 9 MohorircharBerabhana South Salmara 950 24 28 28 10 AironjonglaPtI(Namap Dharmasala 1100 27 32 32 ara) 11 Kalaikhowa South Salmara 1200 30 35 35 12 Poraporirchar Dharmasala 1150 28 34 34 13 ChalakuraRiverblock South Salmara 1080 27 32 32 14 Riverblock No.10 South Salmara 860 21 25 25 15 Haddirchar South Salmara 1040 26 30 30 16 Aminerchar South Salmara 1109 27 32 32 Total 20399 504 596 596

DHUBRI/DHAP/2010-11 100 Details of char targeted in 2nd & 4th quarter SL. Name of Char/ Name of PHC Populatio Target NO. River Island n Infant for ANC PNC RI (Pregnant Woman) 1 Hatirchar Gajarikandi 1300 32 28 28 2 Majerchar Pt-I South Salmara 1250 31 37 37 3 Boldiaralga NC Dharmasala 1120 28 33 33 4 PoyestiMajercharPt-X South Salmara 1150 28 34 34 5 Piazbari South Salmara 850 21 25 25 6 Sutlamari South Salmara 1100 27 32 32 7 Porarchar South Salmara 926 23 27 27 8 NatinerAlga South Salmara 925 23 27 27 9 Dhedaimari South Salmara 1350 33 40 40 10 Ayermari South Salmara 1369 34 40 40 11 Bhasanirchar -Pt -II Dharmasala 1143 28 33 33 12 BoldiarAlga West South Salmara 1050 26 31 31 13 Kadamtola South Salmara 1020 25 30 30 14 Kaziarchar South Salmara 825 20 24 24 15 Mahamayarchar South Salmara 1225 30 36 36 16 Sialmari South Salmara 1025 25 30 30 Total 17628 434 507 507

DHUBRI/DHAP/2010-11 101 6.4.7 PUBLIC PRIVATE PARTNERSHIP (PPP). In Dhubri district there are 3 nos of Tea Garden namely Choibari Tea Estate, Chapor Tea Estate and Krishna Kali Tea Estate covering around 22,800 Population. During 2008-09 Choibari Tea Estate Hospital has been identified and selected for Public Private Partnership.The facility sarvey of Choibari Tea Estate has been completed and MOU has also signed accordingly. During 2009-10, Krishnakoli Tea Estate has been identied an selected for PPP. The facility survey and MMU will be signed shortly. The hospitals under PPP will mainly focus on RCH II activities like promoting JSY, Institutional delivery, new born care services, sterilization programmes, counselling on adolescent health etc. The targeted population will mainly be the mother and child, which will result in bringing down the MMR and IMR. Detials Budget as follows –

Sl No Detail Total

1 Manpower Rs. 4,80,000.00 2 Operation cost @30,000/- pm Rs. 3,60,000.00 3 Referral transport Rs. 60,000.00 4 Ambulance Rs. 5,50,000.00 5 Repair & Renovation Rs. 50,000.00 6 Drugs will be provided by the District Rs. 0.00 Total for one hospital Rs. 15,00,000.00

During 2001011, the total fund proposed for 2 nos. PPP Hospital = Rs. 30,00,000.00 `

DHUBRI/DHAP/2010-11 102 Comprehensive Training Plan of Dhubri District for the 201011 Sl Category of No Type of Training Current Status Duration Venue No partcipant Batch Maternal Health 40 Batch (GNM=17 GNM=24 Dhubri Civil 1 SBA 3 weeks 12 LHV=10, ANM=12 Hospital ANM=53) 16 Guwahati 2 EmOC 1 MO MO MBBS=4 nos 1 weeks Medical College MO MBBS=10 MO=12 nos Guwahati 3 RTI/STI Lab Tech=3 Lab Tech =6 nos 2 days 10 Medical College GNM=4 GNM=14 nos. ANM = 14 nos Child Health MO=13 ANM=456 4 IMNCI Nursing Staff=3 8 days 93 District HQ AWW=1791 CDPO=2 MO=24 Sister Tutor=2 MO=48 5 NRT 2 days 4 District HQ SN=2 GNM=74 LHV=4 Family Planning MO=13 MO=30 GNM=17 6 IUCD (CopperT380A) ANM=120 5 days 19 District HQ ANM=29 GNM=40 LHV=9 District Civil 7 MTP including MVA Specialist(O&G)=6 MO=15 15 days 3 Hospital MO=2 MO=1 Dubri Civil 8 Mini Lap 12 days 1 OT=2 OT=1 Hospital 9 Laprascopic Sterlization MO=6 - - - - 10 NSV MO=2 MO=4 1 At camp Site Guwahati MO=4 Medical 11 Co Gas Technique - 1 2 OT=4 College/SIHFW, Guwahati Immunization ANM=456 ANM=406 12 Refresher training on Immunization GNM=50 2 days 17-18 At District HQ LHV=6 LHV=17 Cold Chain Cold Chain 13 Vaccine Handler Training 1 days 2 At District HQ Handler=64 Handler=64 14 Blcok Level data Handler training Data Handler=28 Data Handler=28 1 days 1 At District HQ ANM=456 AHSA 15 Micro Planing - 1 days 78 At District HQ facilitator=176 ASHA=1726 NVBDCP Medical Officers Medical Officers 16 =4 =100 Laboratory Laboratory 17 Technicians Technicians (reorientation)=0 (reorientation)=48 Health As per Training Health 18 NVBDCP Supervisors Plan of Supervisors (M)=0 (M)=58 NVBDCP Health Health 19 Supervisors Supervisors (F)=0 (F)=7 Health Workers Health Workers 20 (F)=0 (F)=348

DHUBRI/DHAP/2010-11 103 Sl Category of No Type of Training Current Status Duration Venue No partcipant Batch

21 ASHAs=70 ASHAs=992 Community Community 22 Volunteers other Volunteers other than ASHA=0 than ASHA=200 Others specify: Others specify: MPW MPW (Contractual 23 (Contractual & & Spray Spray Workers=21 Workers=12 RNTCP 24 Training of MOs 100 MO=50 25 Training of LTs of DMCs- 17 LT=8 26 Training of Comm Volunteers 275 Volunter=100 27 Re- training of MOs - MO=50 28 Re- Training of LTs of DMCs 17 LT=25 As per Training 29 Re-training of Pvt Practitioners 20 MO(Pvt)=20 Plan of RNTCP 30 TB/HIV Training of MOs - MO=50 TB/HIV Training of STLS, LTs , STLS, MPW, 31 MPWs, MPHS, Nursing Staff, - Nursing staff, Community Volunteers etc Volunter=50 NLEP 4 days training of newly appointed 32 - MO=30 4 days MO’s (rural & urban) 30 nos 3 days training of newly appointed Health 33 - 3 days Health Supervisor 30 nos. Supvisor=30 3 days training of newly appointed Health Worker 34 - 3 days Health Worker (M) 30 nos (M) =30 3 days training of newly appointed Health Worker 35 - 3 days Health Worker (F) 30 nos (F) =30 As per Training 2 days training of newly appointed Plan of NLEP 36 - New MO= 30 2 days MO’s 30 nos

5 days training of newly appointed 37 - Lab Tech = 15 5 days Lab. Technician 15 nos.

NBCP School Teacher = Training of Manpower for Skill As per Training 38 - 100ANM/Health 1 days Upgradation Plan of NBCP Workers=600 IDSP 3 days training for MO( newly 39 inducted officers ) for a batch of 20 - MO= 40 3 days 2 At DSU trainees. 2 days training for Health Workers Health 40 - 2 days 20 Block PHCs for a batch of 20 trainees Workers=400 3 days training for Laboratory At District Civil 41 Technicians/ Microscopist for a batch - Lab Tech=40 3 days 2 Hospital of 20 trainees NRHM Additionaities Sensitization workshop to Medical 42 - MO (New)=37 2 days 1 At District HQ officers(Newly Appointed) 43 Sensitization workshop to PRIs - PRI member=196 1 days 4 At District HQ Capacity Building workshop for 44 - BPMU = 33 2 days 1 At District HQ BPMU

DHUBRI/DHAP/2010-11 104 6.5 PART B: NRHM ADDITIONALITIES

Village Level activity:

O1: Efective implementation of NRHM Programme at village levl.

S1: Strengthening Village Health and Sanitation Committees (VHSC).

Proposed Activities a. For the development of the villages of Dhubri district wherever there is an ASHA Village Health & Sanitation Committee has been formed as per NRHM guideline. In Dhubri district 1310 nos of VHSC has formed and open bank account and out of which 1300 nos of VHSC has received an amount of Rs.10,000 as Untied Grant. b. During 2010-11, additional 380 nos of VHSC has to be formed in the left out villages of the district where additional ASHA has been selected and have to open the bank account for Untited Grant c. Capacity building of the 1690 VHSC members is proposed during 2010-11 through MNGO/NGO including importance and preparation of Village Health Plan. d. During 2010-11, the Village Health Action Plan of each VHSC will be ensured. e. The VHSC will be responsible for the overall health of the village. It will take into consideration of the problems of the community and the health and nutrition care providers and suggest mechanism to solve it f. The committee will monitor all the health activities that are conducted in the village such as Village Health & Nutrition Day, Mothers Meeting etc. g. VHSC along with the ANM will be responsible to conduct household survey in the village. h. It will discuss every maternal or neonatal death that occurs in their village, analyze it and suggest necessary action to prevent such deaths. Get these deaths registered in the Panchayat. i. During emergency like flood or any epidemic the committee will utilize the fund for the relief camps or supplies such as in case of flood it can supply Halogen tablet for purification of water, ORS, Bleaching powder etc.

DHUBRI/DHAP/2010-11 105 S2: Observing Village Health & Nutrition Day

Proposed Activities a. During 2010-11, Observation of VHND will be ensured every month in each villages of Dhubri District by ASHA/AWW/ANM in the Awganwadi Centre where services like ANC, PNC, Immunization by ANM and Health Education and awareness will be provided by ASHA/AWW/BEE/LHV/ANM etc.

b. Procurement of Examination table, BP Instrument, Weighing machine etc will be ensured in the newly formed VHSCs out of VHSC fund for successful observation of VHND. c. Involvement of VHSCs members will be ensured during 2010-11 in each VHND. d. The Contigency fund of Rs. 100 for observing VHND will be provided out of VHSC fund. S3: Organizing Health Melas. Proposed Activities: a. 3 nos. of Health Melas has been organized during 2009-10 with objective to provide an easy to accesss platform for health services for all segments of population of the District. During this Health Melas extensive IEC on Malaria, Family Planning, TB, Blindness, AIDS, Leprosy, Water & Sanitation etc. was done. b. During 2010-11, similar Health Mela will be organized in Malaria prone area of the District. c. Rs 5 lakhs for is proposed for organzing Health Mela during 2010-11.

O2 : To Provide support to ASHAs of Dhubri District

S1 . Selection, Training and support to ASHAs

Proposed Activities: a. The selection and training of 1340 nos of ASHAs of Dhubri has completed 5th Module Training. b. The selection of Additional 380 nos of ASHA has also completed in the left out villages of the District. c. During 2010-11, 1 st , (Induction Training), 2 nd , 3 rd , 4 th & 5 th Module training of 380 nos ASHAs will be ensured. (No fund is proposed as fund already received) d. Also refresher training is to be imparted to 1340 nos. of ASHAs who have completed 4 th module training for 12 days in a year e. 380 nos of Radio Set, Umbrella and Bag is proposed during 2010-11 for 380 nos of additional ASHA.

DHUBRI/DHAP/2010-11 106 S2 : Providig ASHA Drug Kits Proposed Activities: a. Durig 2010-11, 1726 nos of ASHA Drug Kits is proposed for 1726 nos. of ASHA of Dhubri District b. Proper utilization of Drug Kit will be enusred during 2010-11 under the supervision of ANM and Sectoral MO. S3 : ASHA Facilitator Proposed Activities: a. During 2009-10, 176 nos. of ASHA Supervisor has been selected for 7 BPHC of Dhubri District ie. 1 supervisor for 10 ASHAs to handhold and monitor the ASHA activities. b. During 2010-11, these facilitators has to be trained on ASHA programme under NRHM and also on field level monitoring to be done so that they have an overview of various on going programmes under NRHM. The proposed training will be conducted through District ToT ASHA Facilitator. c. Honorarium including TA/DA of ASHA facilitator will be provided as per norms. Budget Details Unit (No) Rate (in Rs.) Total (in Lakh) Honorarium including TA/DA of 176 3500.00 73.92 lakh ASHA facilitator

S4: Incentive to ASHAs for Full Immunization Proposed Activities: a. The District will continue for providing incetive of Rs. 250/- to ASHAs for each fully immunized child as this increases the full immunization coverage rate of the District as the ASHAs after BCG will keep a track of the infants in her village as she is from the same village and will accompany the mother to the sub-centre to vaccinate the infant.This will also help the ANM in tracking/vaccinate the infants as there are instances where the ANM fails to vaccinate the infant as mothers are not willing or forgotten about the date of Immunization of their child but with the help of ASHAsi it will be easier for the ANM to conveience the mothers and also kepeping a track of the Infants. Budget proposed for the same as follows – Details Unit (No) Rate (in Rs.) Total (in Lakh) Infant Target=44617 80% of target Infants will be Incentive to 1726 ASHA immunized=35693 and out 250.00 66.92 lakh of which 60% will be mobilze by ASHA

DHUBRI/DHAP/2010-11 107 O3 : To strengthen the Health Institutions in terms of physical infrastructure and manpower.

S1. Providing Untited and Annual Maintenance fund to SC, PHC, CHC, SDCH

Proposed Activities:

a. As part of the National Rural Health Mission, it is proposed to provide each Health Institutions ie. SC, PHC, CHC, SDCH will be provided with Unitied and Annual Maintenance Fund. Th Untited funds will be utlize for the following purposes- Minor repair, whitewash of the hospital building Display of logo of NRHM Cleanliness & maintenance of toilets. Water supply etc. consumables of the hospital like gloves, regents, disinfectants etc. In addition an Annual Maintenance Fund is proposed for Govt. Building Sub-Centre, PHCs, CHCs and SDCH and the fund will be utilized for the following purposes-

Facelift of the hospital building Minor repairing whereever required with approval pf the management committee. Hospital consumables like gloves, regents, disinfectants. Chemicals for laboratory etc. The society engaged 1 (one) sweeper @ Rs 1000.00 for the cleanliness of labour room and hospital premises. Maintenance of running water supply and toilets. Maintenance of the generator and its POL. b. During 2010-11, it will be ensured that each health Institutions will have the clear action plan for utilizing the Unitied and Annual Maintenance Fund Budget A. Untited Fund

`Sl Total Health facility Target Unit Cost No (Rs. In Lakh) 1 SC 246 10000 24.60 2 PHC 32 25000 8.00 (5BPHC+4SHC+11 MPHC+11SD+1 MC) 3 CHC 6 50000 30.00 4 SDCH 1 50000 0.50 Total 63.10 Lakh

DHUBRI/DHAP/2010-11 108 B. Annual Maintenance Fund

`Sl Total Health facility Target Unit Cost No (Rs. In Lakh) 1 SC (Govt Building) 120 10000 12.00 PHC 2 32 50000 16.00 (5BPHC+4SHC+11 MPHC+11SD+1 MC) 3 CHC 6 100000 6.00 4 SDCH 1 100000 1.00 Total 35.00 Lakh

S2. Strengthening Rogi Kalyan Fund/Hospital Mamangement Committee

Proposed Activities:

a. The Rogi Kalyan Samitee/Hospital Management Committees has been formed in District Hospital, SDCH, 5 BPHCs, 6 CHCs, 4 SHCs, 11 MPHCs, 11 SDs, 1 Maternity Cnetre, with an objectives to have facility based planning and community involvement and ownership of the Health facilties by the respective RKS Committee/HMC b. During 2010-11, It is proposed to provide RKS fund to all the Health Institutions as detail below Budget Rogi Kalyan Samittee Fund

`Sl Total Health facility Target Unit Cost No (Rs. In Lakh) 1 DH 1 500000 5.00 2 SDCH 1 100000 1.00 3 CHC 6 100000 6.00 4 PHC 32 100000 32.00 (5BPHC+4SHC+11 MPHC+11SD+1 MC) Total 44.00

c. During 2010-11, all the RKS are to be registered under Societies Act. d. During 2010-11, it will be ensured that each health Institutions will have the clear action plan for utilizing the RKS Fund e. For the assessment of the RKS fund utilization by DH/SDCH/PHC/CHC/SHC/SD during 2009-10 an evaluation (Audit) will be done in the year 2010-11

DHUBRI/DHAP/2010-11 109 S3. Strengthening physical infrastructure of SCs/PHCs/CHCs, Proposed Activities (SubCentre) a. Out of 246 SC functioning in rented building & Govt. dilapidated building, 58 nos SCs already taken up for construction during 2007-08, another 45 SCs have been approved during 2008-09 & 09-10 for construction @ Rs. 7.5 lakhs and 32 nos. new SC will be proposed for construction for increase provision of quality antenatal care during 2010-11. (Annexure -A) b. During 2010-11, Upgradtion of Paglahat SC and Nayeralga SC to PHC is proposed Proposed Activities (PHCs) a. During 2006-07 and 08-09, Construction of Doctors (1 unit) and Nurse Quarter (3 unit) has been taken up in Golokganj PHC, Bilashipara SHC, Gauripur CHC, South Salmara CHC, Bogribari SD and Dhepdhepi MPHC and construction has been completed in all institution. b. During 2010-11 Construction of Doctors (1 unit) and Nurse Quarter (3 unit) has to be taken up at Hatsingimari SDCH, Sadullabari SHC and Kachokhana SD @ Rs.28.80 lakhs. c. During 2010-11, the following health institution has to be taken up for Quarter repairing JhowdangaSD, Bherbhangi SD, Dumardaha MPHC, Moterjhar SD & Santipur MPHC @10.00 lakhs per institution. d. During 2010-11, the following health institutions have been taken up for construction of Boundary wall (Goat proof fencing) at Hatsingimari Sub-Divisional Civil Hospital, Dharmasala BPHC, Tumni CHC, Bherbhangi SD and Kachokhana SD. S4. Providing Additional manpower at SCs/PHCs/CHCs/ SDCH Proposed Activities (SubCentre) a. As per the report there are total 376 nos.of ANM in the district in the SC. The total requirement for the district @ 2 ANMs per SC (excluding outreach area) is 116. Therefore during 2010-11 atleast 50 ANM’s may be posted. b. The contractual ANM may be posted under NRHM @ 2 ANMs in 26 nos of SC constructed in Permanent Chars of Dhubri District. Total requirement is 52 ANM. Proposed Activities (PHCs) a. Contractual engagement of 4 MO (MBBS) and 4 MO (Ayur) will be done in 24x7 PHCs deficient in manpower. The institutionwise detailed requirement is as follows-

SL NAME OF THE HEALTH INSTITUTION Type of Institution MO (MBBS) AYUR

1 Tamahat MPHC 24 x7 PHCs 1 0 2 Moterjhar SD 24 x7 PHCs 0 1 5 Dumardaha MPHC 24 x7 PHCs 0 1 6 BATERHAT SD 24 x7 PHCs 1 0 8 Jhowdanga SD 24 x7 PHCs 0 1 Total 2 3

DHUBRI/DHAP/2010-11 110 Proposed Activities ( For CHCs & SDCH)

a. Specialist Doctors on contract basis to be placed at 2 nos. IPHS institutions and SDCH Hatsingimari as follows –

Name of Health Category of speciailst Total Institution O&G Paedratic Anaesthesist Surgeon Mankachar CHC 1 1 1 1 4 Halakura CHC 1 1 1 1 4 SDCH (Hatsingimari) 1 1 1 1 4 Total 12

Proposed Activities ( For GNM at BPHC/CHC/24x7 PHCs) a. At Present, thereare 122 nos. of GNM have been posted at various Health Institutions of Dhubri District, Out of which 53 nos. are Reqular GNM and 69 nos. are Contractual GNM. To make the Health facility functional as IPHS norms, 192 nos. GNM is proposed during 2010-11. Requirement of Institutionwise as follows-

Present No. of GNM Sl No. of Health Total Health Institutions status of reuired (as Gap No Institutions reuirement GNM per IPHS)

1 CHC 4 26 9 10 10 2 BPHC 4 10 3 2 2 24x7 PHCs (inlucding Health 3 25 22 3 53 53 Institution under construction) 4 SDCH 1 1 9 8 8 Total 59 73 73

S5: Strengthening the District Hospitals by improving the physical infrastructure.

Proposed Activities: During 2008-09, Construction of 200 bedded Civil Hospital under NRHM has been taken up and the progress of work till Nov, 09 is around 60 %. Total project cost is Rs.7.14 Cr and after completion necessary logistics will have to be supplied during 2010-11 S6: Strengthening the Nursing Schools by improving the physical infrastructure. Proposed Activities: Construction of RCC GNM School cum Hostel Building for 100 nursing students at Dhubri Civil Hospital is in progress (42%). Total project cost is 2 Cr. So, no fund proposed in the current year.

DHUBRI/DHAP/2010-11 111 S 7.Ambulance for all PHC’s/CHCs/District Hospitals: Proposed Activities: a. 37 nos ambulances were already supplied by Govt., NRHM and MLA fund to 28 nos of different medicinal institutions of Dhubri District. (Annexure C) b. During 2010-11, new ambulance for Dumardaha MPHC is proposed @ Rs.5 Lakhs.

O4: To strengthen the health institutions in terms of necessary materials support in terms of equipments and drugs.

S1: Ensure proper functioning of the health centres by providing necessary equipments and drugs .

Proposed Activities : (Supply of Drugs) a. As per the IPHS norms the District propose to supply the Drugs for all the Health Instution as mentioned below Sl No Health Institutions No. of Health Institutions 1 SC 246 2 BPHC/MPHC/SHC/SD/MC 32 3 CHC 6 4 SDCH 1 5 Civil Hospital 1 6 Urban Health Centre 1 7 PPP Hospital 2 8 MMU 1 9 Boat Clinic 1

Proposed Activities : (Supply of Equipments) a. As per facility survey there is a requirement of 21 nos. labour table, 21 nos. of Stand light, 10 nos. Radiant warmer, 13 nos. Auto clave, 19 nos. Electric Sterilizer, 19 nos. backup Generator set including other logistics for 24x7 hr delivery services for quality services. The institutionwise detailed requirement is enclosed herewith as Annexure B b. The IUCD Kit received during 2009-10 alredy distributed where training imparted another 100 nos of IUCD kit will be required during 2010-11.

O5: To ensure effective implementation of the programme at the block level S1: Strengthening the block for effective implementation of the programme Proposed Activities : Support to district and Block level Resource Groups. At the district level, DPMU already exists. At the Block level Block Programme Manager, Block Accounts manager and Assist. Block Programme has also appointed during 2007-08 and 2008-09.

DHUBRI/DHAP/2010-11 112 During 2010-11, to support the Block Programme Management Unit the following manpower is proposed as follows-

SL No NAME OF POST UNDER NRHM NAME OF HEALTH INSTITUTION WHERE VACANT

1 Futkibari SD 2 Gauripur CHC PHC ACCTT. 3 Dhubri Health & maternity Centre 4 Tamarhat MPHC 1 Golakganj BPHC 2 Tamarthat MPHC LAB TECH 3 Dharmasala BPHC 4 Moterjhar SD

O6: To provide supportive measures to the districts for performance analysis and for preparation of health action plans. S1: Strengthening the planning activities. Propsoed Activities: a. Resource mapping in every village done by Village Health & Sanitation Committee will help to assess the need of the community. Therefore, by undertaking household and facility survey, the actual need of the community can be assessed which is also the essential requirements for developing District Health/Block Health Action Plans-annual & perspective. b. Orientation of VHSC of each BPHC.

O7: To provide health care services to the unserved, underserved and remote areas.

S 1.: Support to Mobile Medical Units (MMU) Proposed Activities: a. With the objective to take health care to the door step of the public in the rural far flung areas, especially in under served areas, the district has received the Mobile Medical Unit with specialized facilities like USG, X-ray etc and will continue the service. b. During 2009-10, training of GNM, Pharmacist, Radiographer and lab Tech. of MMU is proposed for skill upgradation. c. For Implmenting the Mobile Medicla Unit, Total fund proposed 21.66 lakh for 2010-11 for recurring expenditure of MMU, Dhubri. Details budget enclosed.

DHUBRI/DHAP/2010-11 113 d. 1. Recurring Costs: a. Manpower…………………………………… Rs12.36lakhs/ annum i. Medical Officer 2 Nos. General Practitioner -2 nos. (Rs 20,000.00 X 2 =Rs.40, 000.00/month) ii. GMN 2 Nos. (Rs. 7000.00 X 2= Rs.14,000.00/month) iii. Radiographer-1 no. (Rs 8,000.00/month) iv. Pharmacist-1 no. (Rs. 8000.00/month) v. Laboratory Technician-1no. (Rs. 8000.00/month) vi. 4th Grade cum handyman-2 nos. (Rs. 5000.00 X 2= Rs 10,000.00) vii. Driver-3 nos. Rs. 5000.00 X 3= Rs.15,000.00 (Total: Rs. 103,000.00 per month X 12 = Rs 12, 36,000.00 per year) b. Medicines………………… Rs. 5 lakhs / annum c. Training of manpower… Rs. 30,000.00 /annum d. Maintenance & repair of vehicle… Rs. 2 lakhs /annum e. POL Rs. 2 lakhs /annum

Grand Total Recurring Fund Required For Medical Mobile Unit , Dhubri i s. Rs.21.66 lakhs.

S2: Promoting Boat Clinic in char areas of Dhubri district. a. The uncovered and inaccessible areas under South Salmara PHC, Gazarikandi PHC and Dharmasala PHC (Total No of Char Village=50, & Char Population= 69,945 ) has been identified which do not have any Health Care facilities. The Centre for North East Studies & Policy Research(C-NES) had signed a MoU with the National Rural Health Mission of the Government of Assam in February 2008 to extend health services to the people of char/Chapories in five districts of Assam including Dhubri district. The focus of the boat clinic initiative is Routine immunization, Ante natal care (ANC), and Post natal care (PNC), health checkups, awareness, and Water and sanitation in association partnership with NRHM, Assam, and District Health Society of Dhubri.

DHUBRI/DHAP/2010-11 114 The tentative annual action plan has been proposed keeping in view the immunization schedule as well antenatal check up providing minimum three checkup & two doses of TT for every pregnant women. A tentative plan of boat clinic camp is given below. Nos. of Target Target Char Quarter Month camp Char Infant Pregnant days population(Approx) (Approx) woman(Approx) 1st April 2010 to 48 16 Different 20399 504 596 June 2010 (16 days char per month) 2nd July 2010 to 48 16 Different 17628 434 507 September (16 days char 2010 per month) 3rd October 48 16 Different Same population Same Same 2010 (16 days char of quarter 1 st population population of to per of quarter quarter 1st December month) 1st 2010 4th January 48 16 Different Same population Same Same 2011 (16 days char of quarter 2 nd population population of to March per of quarter quarter 2nd 2011 month) 2nd Total 12 months 192 32 different 38027 938 1103 camps char b. During 2009-10, a Speed Boat Ambulance has been received from Zilla Parishad Dhubri. In order to make functional of the speed boat ambulance and to extend health services to the people of char/Chapories in the districts. The following manpower including PoL is proposed during 2010-11 Sl No Detail Numbers Unit Cost Total Amount 1 Doctor 1 30,000.00 3,60,000.00 2 GNM 1 7000.00 84,000.00 3 ANM 2 5000.00 1,20,000.00 4 Lab Tech 1 8000.00 96,000.00 5 Pharmacist 1 7000.00 84,000.00 6 Pilot/Driver 1 5000.00 60,000.00 7 Handiman 2 3000.00 72,000.00 Pol & 1,00,000.00 8 12,00,000.00 Maintenance per month Total 20,76,000.00

DHUBRI/DHAP/2010-11 115 O8: Skill up gradation/Capacity Building at all levels. S1: Train and enhance capacity BPMU, PRIs & Medical offcers S2 : Stregthening Infrastructure of District Training Hall Proposed Activities: a. In order to organize the different trainings for the officials/health workers under the establishment of JDHS, Addl CM & HO(FW), Dhubri, it is required to repair and renovate the existence Training Hall, during 2010-11. A total Rs. 300000.00 lakh is proposed for carrying out the same activity. b. In order to implement the NRHM programme successfully, it is required to organize sentitization workshops on NRHM for the PRIs (ZP Member-28, GP President=168) and the medical offcers (37) and capacity building workshop for BPMU (BPM-7, BAM-9 & Assist.BPM-17) c. Sensitization workshop to Medical officers(Newly Appointed): A total of 37 medical officers newly appointed will be sensitized in 2010-11. Per batch 37 MOs will be there. There will be 2 days workshop. Altogether there will be 1 batches. Therefore budget is as follows: • DA @ Rs 200.00 for 2 days for 37 participants= Rs 14,800.000 • TA @ Rs 500.00 for 37 participants= Rs 18,500.00 • Honorarium to trainers @ Rs 200.00 for 3 trainers for 2 days = Rs 1200.00. • Tea, Snacks etc @ Rs.100.00 for 37 participants for 2 days= Rs 7400.00 Total= Rs 14800.00+ 18500.00+1200.00+7400.00 = Rs 41,900.00. Therefore total = Rs 41,900.00 d. Sensitization workshop to PRIs: A total of 196 PRIs (ZP Member-28, GP President=168) will be sensitized in 2010-11. A total of 4 batch PRIs will be sensitized. Per batch 50 PRIs will be there. There will be 1 days workshop.. Therefore budget for 1 batch is as follows: • DA @ Rs 125.00 for 1 days for 50 participants= Rs 6250.00 • TA @ Rs 300.00 for 50 participants= Rs 15,000.00 • Honorarium to trainers @ Rs 200.00 for 3 trainers per batch for 1 days = Rs 600.00. • Tea, Snacks etc @ Rs.100.00 for 50 participants for 1 days= Rs 5000.00 Total= Rs 6250.00+ 15,000.00+600.00+5000.00 = Rs 26,850.00. Therefore total = Rs 26,850 Therfore total Budget for 4 batch= 1,07,400.00 e. Capacity Building workshop for BPMU: A total of 33 BPMU (BPM-7, BAM-9 & Assist.BPM-17) will be sensitized in 2010-11 in 1 batch. There will be 2 days workshop.. Therefore budget is as follows: • DA @ Rs 125.00 for 2 days for 33 participants= Rs 8,250.00 • TA @ Rs 200.00 for 33 participants= Rs 6,600.00 • Honorarium to trainers @ Rs 200.00 for 3 trainers per batch for 2 days = Rs 1200.00. • Tea, Snacks etc @ Rs.100.00 for 33 participants for 2 days= Rs 6,600.00 Total= Rs 8,250.00+ 6600.00+1200.00+6600.00 = Rs 22,650.00. Therefore total = Rs 22,650.00

DHUBRI/DHAP/2010-11 116 IEC/BCC Strategy

Objectives:

1. To refute the myths and misunderstandings prevalent in the society 2. To create a demand for various health services being provided under NRHM . 3. Bringing about a behavioural change among individuals and community at a large.

Proposed Activities:

A.) Setting up and development of IEC/BCC unit at the district level:

1. One District Media Expert under NRHM is already placed at District, one District Extension & Media Officer and two nos of Dy Ext & Media officer is placed under Addl. CM & HO (FW), Dhubri 2. One Digital Video Camera, one still camera with Tripod is already available at District. 3. One Public Addressing System set; LCD Projector with Screen is available at District. 4. One laptop may be provided to the IEC/BCC cell of the district in Q1, which may cost around Rs. 35,000/-. 5. One LCD projector may be provided to each BPHC @Rs.50,000 X 7 nos of BPHC in Q2 6. One Grade IV staff may be deputed from regular set up to the IEC/BCC cell for assist the day-to-day activity.

B). Meeting Manpower requirements at District level

1. At Present no further manpower is required at District in IEC/BCC Cell.

C). Formative research/situational analysis/baseline study to identify focus areas

1. To find out the perception of the villagers and to do a study on the level of Knowledge of Family Planning, Immunization and Institutional Delivery an independent agency will be engaged. 2. In the first two-quarter they will visit the Char areas of Dhubri only. They will assist by ASHA and AWW. 3. Students of M. Phil & Phd will be encouraged to do research on the health status of tea garden population and finding will be used to prepare specific plan. 4. The process will be continued up to Q4 and total Budget requirement for per quarter is Rs. 15,000 X 7 nos BOHC X per quarter.

D). Develop IEC/BCC Strategy : Streamline objectives/identify Communication tools/identify media mix as per target audience/frame monitoring evaluation indicators Identify external agency/Advertising agency for the task (if needed)

DHUBRI/DHAP/2010-11 117 1. A comprehensive IEC/BCC action plan will be prepared in the Q2.

E). Media Mix : Develop a strategic media mix as per the target population and issues (Child Health, Maternal Health/Family Planning) a). Interpersonal Communications

1. On every Wednesday a Counselling session will be organised at 4 nos of FRUs and 7 nos of PHCs by BEE & LHV for the mother and eligible couple. 2. ICTC will be intimated and engaged in the counselling session. 3. ASHA, ANM, & AWWs will be instructed to do IPC whenever they do home visited. 4. Group Discussion will be organized by BEE, LHV, HE, they will get @ Rs.300/- for per GD X 5 GD in a month X 12 months 5. The GD will be organized at village level, SC level, AWW centre wise 6. Instruction will be given to VHSC to conduct community meetings out of their own funds. 7. Workshop at Block level will be organized, one workshop will be organised in each quarter, @Rs.5000 X 7 nos BPHC X per Quarter b). Community Media:

1. A audio cassette will be developed using folk tune on JSY, FP, immunization, ID etc and will be broadcast through slow moving vehicle, cost @ Rs1000/- X 52 Weeks X 7 nos BPHC 2. Street Play on Malaria, Immunization, JSY, FP etc will be organized in village area in per months, @Rs. 3000 per Street Play X 12 months X 7 nos BPHC 3. During Health Mela IEC exhibition and Drama will be organized. Cost will be Rs. 25,000/- 4. BPHC wise rally will be organized to make sensitise. One rally in each BPHC in each Quarter will be organised. Cost @ 2500 X 4 quarter X 7 BPHC c). Outdoor Media :

1. Street Banner on JSY, Immunization, family planning, ASHA, malaria etc will be developed centrally and installed in the prominent places. In each quarter 1000 nos of Street banner will prepared. @ Rs 150 X 1000 nos X 4Q. 2. For popularised the NRHM schemes among the general people IEC message will be displayed in the backside of the Buses. Cost @ Rs. 250 X 100 buses, will be done in Q2 3. During Q1 and Q3 Information Boards on Family Planning will be developed and installed in SC wise. Per SC will be provided 2 nos of Information Boards. Cost @ Rs 2000 X 246 nos of SC centre X 2nos of Information Board. 4. During Q2, Hoarding on JSY, ASHA, Immunization, ANC, PNC etc will installed in BPHC wise. 5 nos of Hoarding will be provided in each BPHC. Cost @ Rs, 10,000 X 5 nos of Hoarding X 7 nos of BPHC

DHUBRI/DHAP/2010-11 118 d). Print materials:

1. Pamphlets on health related issues would be developed for ASHA, AWW and PRI members; the same will be distributed during VHND. In per quarter 20000 copies will be brought out. Cost of per pamphlets will be Rs. 1 /- 2. In every quarter poster on related subject will be developed and distributed to BPHC. Quantity required 8000 per quarter and cost would be Rs.5/- per copy. 3. Newsletter will be published in each quarter, which will highlight all the major achievement of NRHM and other National Programme. 4000 copies will be published and will be distributed to ASHA, AWW PRI etc. Cost @ Rs. 25 X 4000 copies. 4. In the Q3 annual report will be published which will reselect the whole activity of the financial year. Cost @ Rs. 25 X 4000 copies will be distributed to all concern departments, officials. 5. A table calendar will be prepared which will contained IEC message and distributed to all Govt & Private office. The activity will be done in Q3 and 300 nos will be brought out. Cost @ Rs. 50 X 300 nos.

F) BCC implementation Components : Capacity Building and training of manpower Designate responsibilities as per task/identify coordinator and design activity chart 1. A District level Workshop on BCC capacity building will be organized for BPM, BEE, HE, LHV during Q1, appox cost of the workshop will be Rs. 10,000/- Special Training on BCC will be organized at BPHC level for ASHA facilitator and ANMs. The training will be organized round the year in all four quarters in phase wise. Cost for per Training will be Rs. 5000/-. In each BPHC 4 nos of training will be organized.

DHUBRI/DHAP/2010-11 119 Budget under IEC/BCC Plan

AnnexureIII Sl. Quarterly Budget Allocations Detailed Activities Remarks No Q1 Q2 Q3 Q4 Details activities Setting up and development of may be seen at 1 IEC/BCC unit at the district level IEC/BCC (Procurement of Laptop) Strategy for RCH, 35000 350000 0 0 Sl No. A Meeting Manpower requirements at 2 District level 0 0 0 0 Details activities Formative research/situational may be seen 3 analysis/baseline study to identify IEC/BCC focus areas Strategy for 105000 105000 105000 105000 RCH,Sl No. C Develop IEC/BCC Strategy Streamline objectives/identify Communication tools/identify media 4 mix as per target audience/frame monitoring evaluation indicators Identify external agency/Advertising agency for the task (if needed) 0 0 0 0 Media Mix Develop a strategic media mix as per the target population and issues( Child Health, Maternal Health/Family Planning) 0 0 0 0 a). Interpersonal Communications 0 0 0 0 Counselling at FRUs, PHCs I etc 0 0 0 0 One to one interaction by ii ASHAs/ANMs/AWWs 0 0 0 0 Details activities may Group discussions at be seen Village/Block iii IEC/BCC /Panchayat level ( by BEE, Strategy for Sl HE, LHV) 148500 148500 148500 148500 No. E (a) Community Meetings ( Will be iv conducted by VHSC) 0 0 0 0 5 Workshops at Panchayath/ v Block District level 35000 35000 35000 35000 b). Community Media 0 0 0 0 Folk arts ( preparation of I Audio Cassette & miking) 91000 91000 91000 91000 Details Street plays ( Rs.3000 X 12 activities may ii months X 7 BPHC) 63000 63000 63000 63000 be seen at iii Health Melas 25000 0 0 0 Annexure III, Sl No. E (b) iv Rallies 17500 17500 17500 17500 Social Mobilisation v Programmes 0 0 0 0 c). Outdoor Media 0 0 0 0 Details I Banners 150000 150000 150000 150000 activities may ii Bus Boards 0 25000 0 0 be seen Bulletin Boards ( information IEC/BCC iii Boards 2 nos for per SC wise) 492000 0 492000 0 Strategy for Sl

DHUBRI/DHAP/2010-11 120 Sign ages (Hoardings 5 nos No. E (c) iv for per BPHC) 0 350000 0 0 d). Television Spots 0 0 0 0 e). Radio Programmes 0 0 0 0 f). Newspaper advertisements 0 0 0 0 g). Print materials 0 0 0 0 Pamphlets @ Rs.1/- X 20,000 I X 4Q 20000 20000 20000 20000 ii Poster @ Rs.5 X 8000 X 4Q 40000 40000 40000 40000 Details activities may iii Flip Charts 0 0 0 0 be seen Newsletter @ Rs.25 X 4000 X iv IEC/BCC 4Q 100000 100000 100000 100000 Strategy for Annual Report @ Rs. 25 X v RCH,Sl No. E 4000 0 0 100000 0 (d) vi Flash cards 0 0 0 0 Calendars and danglers@ Rs vii 50 X 300 nos 0 0 15000 0 BCC implementation Components 0 0 0 0 Capacity Building and training of manpower Designate responsibilities Details as per task/identify coordinator and activities may design activity chart be seen 6 0 0 0 0 I Capacity building of Staff 10000 0 0 0 IEC/BCC Strategy for ii Internal Workshops 0 0 0 0 RCH,, Sl No.F Specialised training for Staff iii members 35000 35000 35000 35000 Monitoring and evaluation 7 Midterm monitoring Evaluation of the Programme 0 0 0 0 Total Quarterly Budget 1367000 1530000 1412000 805000

Total BCC/IEC Budget 51,14,000/

DHUBRI/DHAP/2010-11 121 6.6. PART C: UNIVERSAL IMMUNIZATION

PROGRAMME (UIP)

Situational Analysis Of Immunization Programme

Current Situation of implementation of Immunization Programme

District Profile

Total Population (2001) 16,34,589 As per Census 2001

Projected Population (2010) 19,07,814

Rural (%) 88.3% As per Censu s 2001

Urban (%) 11.7 As per Census 2001

Infant Mortality Rate (IMR) 64/1000 SRS 2008

Below Poverty Line (BPL) (%) 36.09% NFHS -3

Crude Birth Rate ( CBR) 26.9

Infants/Year (2010) 44261

Pregnancies /Year 52656

Sub-Divisions 3

District 1

Blocks 14

Gram Panchayat 172

Villages 1359

Towns/Urban Areas 3

DHUBRI/DHAP/2010-11 122

INFRASTRUCTURE AND STAFFING LEVELS:

Health Staff

Position Sanctioned In Position Proposed Trained In Posts Addition Last 3 Years Medical Officer 139 80 59 80

LHV 17 15 To be trained (Female Multi- for 2 days re- Purpose Health orientation Supervisor) Male Multi –purpose 54 47 7 47 Health Supervisor ANM F.W. -18 0 F.W. – 87 267 (Female F.W. – 267 (F.W & Multipurpose Health Med - 62 Contractual) worker) Male Multipurpose 203 161 42 Health worker Contractual ANM 230 Contractual GNM 69

Dedicated Immunization staffs

Position Sanctioned Post In position Proposed Trained In last 3 addition Years Dist. 1 1 Trained Immunization Officer District 2 2 Statistical investigator Cold Chain 1 1 To be trained Mechanic Non CFC Driver (UIP 1 1 1 Vehicle)

Public Health Infrastructure Building Sanctioned Functioning With Functional Proposed Cold Chain Expansion (No. Equipment of Facilities) Sub -centre 246 246 0 5 PHC /MPHC/SHC/SD 16 13 11 2 PHC Block PHC 7 7 7 3 CHC 6 5 5 0

DHUBRI/DHAP/2010-11 123 COLD CHAIN STATUS OF DHUBRI DISTRICT

No. of Name of the Sl Sl. Name of the Cold Cold Location/PHC of the Solar Remarks No. No. Chain Point Chain Cold Chain Point 1 Dist. F.W.Bureau 2 1 Dist Head Quarter 2 Dist Ware House 5 1 Civil Hospital 2 2 Dhubri Urban Unit 2 Urban Unit, Dhubri 1 Kazigaon SD & Tipkai MPHC 1 Dharmasala PHC 3 is now under BTAD area 3 Dharmasala BPHC and from B.S.F. Hospital 2 Gauripur CHC 1 is now withdrawn 1 Golakganj PHC 3 1 Rupsi is now 2 Dhepdhepi 1 in BTAD 3 Dumurdaha 1 area,Tamarhat 4 Kachakhana 1 is included to 4 Golakganj BPHC Dhubri District Moterjhar 5 1 from BTAD (Newly installed) and from Berbhangi 6 1 Kedar is (Newly installed) withdrawn 7 Tamarhat 1 1 Halakura PHC 1 2 Agomoni CHC 1 5 Halakura BPHC 3 Satrasal SD 1 4 Baterhat SD 1 1 Raniganj PHC 1 2 Bilasipara 2 6 Raniganj BPHC 3 Lakhiganj 1 4 Sapatgram 1 5 Bagribari 1 1 Chapar PHC 2 2 Bahalpur 1 7 Chapar BPHC 3 Salkocha 1 4 Rangamati 1 1 1 Gazarikandi PHC 2 (But not working) 2 Sukchar 1 3 Mankachar 1 8 Gazarikandi BPHC Hatsigimari 4 1 ( Newly installed) Kalapani 5 1 (Newly installed) 9 S Salmara BPHC 1 South Salmara PHC 1 Total Cold Chain Point 45 (In 32 Locations)

DHUBRI/DHAP/2010-11 124 Additional Requirement Of Cold Chain Equipment, 201011.

Cold Storage Point Total Number Proposed Propo sed Expansion Replacement ILR Storage Point 32 6 2

Total Deep Freezer 5 6 2

Solar Refrigerator 1 1 5

Stock Requirement (Functional) Sl No. Item as on 31st De'09 2009-10 2010-11 2011-12 1 Cold Chain Equipments a) WIC 1 b) WIF 1 c) ILR 38 8 d) DF 29 8 e) Cold Boxes 48 25 f) Vaccine Carrier 2352 150 150 g) Ice Pack 18726 5000 3500 3500 h) Vaccine Van 1 1

ILR Required :

1. B.S.F. Hospital - 1 No.(Replacement) 2. Raniganj PHC - 1 No. (Replacement) 3. Kalapani - 1 No. 4. Sadullabari - 1 No. 5. D.F.W.B. - 1 No. 6. Chapor PHC - 1 No 7. Moterjahr MPHC - 1 No 8. Halakuara PHC - 1 No Deep Freezer :

1. Dhepdhepi S.D. - 1 No. 2. Dumurdaha S.D. - 1 No. 3. Tamarhat PHC - 1 No. (Replacement) 4. B.S.F. Hospiital - 1 No. 5. Kalapani S.D. - 1 No. 6. Sadullabari S.D. - 1 No. 7. Halakura PHC - 1 No. 8. D.F.W.B. - 1 No.(300 lts Replacement)

DHUBRI/DHAP/2010-11 125 U.I.P. Related Training conducted during 09-10:

Position Numbers (Trained up to Dec’09) D.I.O. (Mid Level Manager) 1 M.O.s LHVs 6 ANMs 406 Cold Chain handler 64 Data Handler 28

Recent Performance

OPV-1st Dose OPV-3rd Dose DPT-1st Dose DPT-3rd Dose Yearly Target Yearly Target BCG Coverage Coverage Coverage Coverage Coverage (2008-09) (2009-10) (in numbers) (in numbers) (in numbers) (in numbers) (in numbers) Name of the PHC Inf PW Inf PW 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10

Dharmasala 5860 6972 5860 6972 6111 4328 6385 4298 5320 4378 6385 4298 5320 4378 Golakganj 5857 6968 7117 7826 5464 3822 5708 3667 4966 3469 5708 3667 4966 3469 Halakura 4390 4878 4481 5079 3497 2257 3726 2339 3797 2539 3726 2339 3797 2539 Raniganj 6803 8093 7539 7590 8973 3982 8992 4209 7230 4135 8992 4209 7230 4135 Chapor 3216 3823 2606 3100 3218 1989 3162 2760 2750 2143 3162 2760 2750 2143 S.Salmara 7717 9181 7717 9181 7979 5335 8417 5396 6277 4571 8417 5396 6277 4571 Gazarikandi 6957 8277 7079 8421 7555 4758 8380 4356 7322 4235 8380 4356 7322 4235 Dhubri Urban 1679 1992 1679 1992 1359 695 1386 721 908 524 1386 721 908 524 Boat Clinic 486 446 519 514 298 353 519 514 298 353 3886 2634 Total 42479 50184 44078 50161 44642 27612 46675 28260 38868 26347 46675 28260 8 7

Hep -B Hep-B Hep-B Birth 1st Dose 3rd Dose Measles TT2 + Booster Dose JE Vit-A 1st Dose Coverage Coverage Coverage Coverage Coverage Routine Coverage (in (in (in numbers) (in numbers) Name of (in numbers) numbers) the PHC numbers) 2008-09 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10 2008-09 2009-10

Dharmasala 0 0 0 0 0 0 4763 4346 5110 4735 0 0 2662 3990 Golakganj 0 0 0 0 0 0 4087 3301 5601 4073 0 0 3466 3178 Halakura 0 0 0 0 0 0 3282 2393 3378 2582 0 0 2858 2329

DHUBRI/DHAP/2010-11 126 Raniganj 0 0 0 0 0 0 5684 3525 7599 5019 0 0 3534 2087 Chapor 0 0 0 0 0 0 2144 2018 2490 2050 0 0 975 1526 S.Salmara 0 0 0 0 0 0 6250 4391 6993 5903 0 0 2591 3751 Gazarikandi 0 0 0 0 0 0 6083 3875 7092 5562 0 0 2967 3958 Dhubri Urban 0 0 0 0 0 0 852 476 2028 1704 0 0 704 476 Boat Clinic 0 0 0 0 0 0 354 223 162 187 0 0 0 59 Total 0 0 0 0 0 0 33499 24548 40453 31815 0 0 19757 21354

Vaccine preventable Diseases: Whooping Neonatal Tetanus Diptheria Measles Polio AES Cough Tetanus (Other) Name of the PHC Case Case Case Case Case Case Case Case Death Death Death Death Death Death Death Death

Dharmasala 0 0 0 0 0 0 0 0 90 0 0 0 0 0 Golakganj 0 0 0 0 0 0 0 0 0 0 0 0 0 Halakura 0 0 0 0 0 0 0 0 60 0 0 0 0 0 Raniganj 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Chapor 0 0 0 0 0 0 0 0 0 0 0 0 0 0 S.Salmara 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Gazarikandi 0 0 0 0 0 0 0 0 37 0 0 0 0 0 Dhubri Urban 0 0 0 0 2 0 1 0 13 0 0 0 0 0 Boat Clinic 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Total 0 0 0 0 2 0 1 0 200 0 0 0 0 0

DHUBRI/DHAP/2010-11 127 Objective

The Overall goal is to measure to increase immunization coverage rtes. Based on review of past performance, assessment of critical bottlenecks and planned activities Immunization Coverage Targets: INDICATORS Current 2009-10 Planned 2010-11 (upto Jan’10) BCG coverage (%) 70.05% 90% DPT-1 coverage (%) 71.59% 90% DPT-3 coverage (%) 64.13% 90% Measles coverage (%) 61.82% 90% Vit- A coverage (%2+ doses) 42.55% 60% Dropout rate BCG-Measles(%) 11.75% - Children fully vaccinated by 12 53.49% 70% months of age (%) from HMIS report

Key performance indicatrs:

INDICATORS Current 2009-10 Planned 2010-11 % Blocks with routine 100 100 immunization micro plan available

Key performance indicators:

INDICATORS Current 2009-10 Planned 2010-11 (upto Nov’09) ANM having received refresher 90% 100% training in Immunization within the last 3 years (%) DIO having participated in - 1 mid-level managers (MLM) training within the last 3 years(%)

DHUBRI/DHAP/2010-11 128 ACTION PLAN ON UIP PART –C , ASSAM,201011 :

As per guidelines laid down, outline action points for implementing delivery scheme at State / Block level, justifying state or State specific deviation from the establishment norms.

Total Projected Population : 1907814 Pregnant Woman target : 52656 Infant Target : 44261 Vaccination Sites : 17288 Sub Centres : 246 Villages : 1359 ANM/MPHW : 180 Addl. ANM : 230

1-2 Years Children = 43880 (2.30% of the projected population) 5 years Children = 46169 (2.42% of the projected population)

PROPOSED MONTHLY ACTION PLAN FOR ROUTINE IMMUNIZATION : 201011

Yearly Target

Name of M.O. M.O. Block PHC M.O. No. of No. of No.Of Session Planned Planned P.W. P.W. No.of S.C. No.ofS.C. Institution Institution No. BEE of No. of LHV No. of Population Population Chain Point Point Chain No. No. Cold Of No. Of Block No. Block Of Underserved Underserved No. No. Sector Of No. Of Session No. Of Session 0-1yr 0-1yr Infant South 1 47 6 4 1 1 0 2796 372 290537 8019 6740 Salmara Gazarikandi 1 44 3 7 3 1 1 2640 276 303650 8381 7045 Raniganj 1 48 7 7 9 1 3 3012 156 329098 9083 7635 Dharmasala 1 34 3 3 4 1 2 2532 240 327505 9039 7598 Golakganj 1 34 7 7 8 1 1 2388 24 271660 7498 6303

Halakura 1 22 4 4 4 1 2 1548 96 173330 4784 4021

Chapar 1 17 4 4 3 1 4 1500 132 138461 3822 3212 Dhubri 1 1 1 1 756 96 73572 2031 1707 Urban Total 8 246 34 37 33 8 13 17172 1392 1907814 52656 44261

DHUBRI/DHAP/2010-11 129 Requirement of Vaccine and Syringe during the year 201011

Requirement of Vaccine Dose Requirement of Syringe Name of Immunization Block PHC T.T. B.C.G. D.P.T. O.P.V. Measles 0.1 ml 0.5 ml 5 ml Card

South 24056 10111 40443 40443 10111 10111 74610 8481 8019 Salmara Gazarikandi 25142 10567 42268 42268 10567 10567 77977 7989 8381 Raniganj 27249 11453 45810 45810 11453 11453 84512 9075 9083 Dharmasala 27117 11397 45589 45589 11397 11397 84103 7656 9039 Golakganj 22493 9454 37815 37815 9454 9454 69762 7170 7498 Halakura 14352 6032 24128 24128 6032 6032 44511 4668 4784 Chapar 11465 4818 19274 19274 4818 4818 35557 4533 3822 Dhubri 6092 2560 10241 10241 2560 2560 18893 2292 2031 Urban Total 157967 66392 265568 265568 66392 66392 489927 51864 52656

Proposed Activity: Service Delivery Improvement: a. Mobilization of Children by ASHA : For every 1431 sites we have got one ASHA per site. Invitation card (IPC Slip) to be printed and distributed to ASHA . Missed/Dropout children are to be mobilize or Invited by ASHA to reduce the drop Out. The District will continue for providing incetive of Rs. 250/- to ASHAs for each fully immunized child as this increases the full immunization coverage rate of the District as the ASHAs after BCG will keep a track of the infants in her village as she is from the same village and will accompany the mother to the sub-centre to vaccinate the infant.This will also help the ANM in tracking/vaccinate the infants as there are instances where the ANM fails to vaccinate the infant as mothers are not willing or forgotten about the date of Immunization of their child but with the help of ASHAsi it will be easier for the ANM to conveience the mothers and also kepeping a track of the Infants. b. Hard to Reach area/Unreached Area : 116 nos of sites per month has been identified as difficult to reach areas/Char areas/Urban Slums. For Holding the sessions in Underserved and Slum areas ANM will be deputed and Rs. 300/- will be paid as honorarium and Rs. 50/- as contingency to ANM for holding the session. c. Vaccine Delivery (State Dist. To Cold Chain Pt.) :: Vaccine distribution plans are prepared to distributes vaccine from Dist. to 8 PHC by maintaining proper cold chain. Dist. To PHC :: As per vaccine distribution route map, Vaccine will distribute from Dist. To 8 PHC level cold chain pt. by insulated vaccine Van covering 3 PHCs per trip for one month quota. Per trip POL cost of Rs . 800/-, DA of driver is Rs. 90/-, loading/unloading of Vacc. And syringes is Rs. 100/- and maintenance of Vehicle Rs. 800/- PM is planned.

DHUBRI/DHAP/2010-11 130

d. ALTERNATE DELIVERY OF VACCINE : For 1431 normal sites Alternate arrangement is planned for vaccine delivery so that ANM can attend the session site in time. In 2009-10, 85% sites were covered, but in next year it will be arranged for 100% Rs. 50/- per normal site. In underserved slum area /Char area of 116 nos. it is planned to provide Rs. 100/- per site for alternate vaccine carrying. e. Cold Chain Maintenance Proper Functioning of Cold Chain Equipments (ILR/Deep Frezer/Col-Box/vaccine carrier etc.) and maintain temperature record of ILD/DF (daily twice), stock of vaccine and syringes at District and PHC level will be ensure during 2010-11. It will also be ensured that the quality of vaccine by maintaining proper Cold Chain System at storage and transportation. f. Computer Assistant under DIO: One Computer Assistant @ Rs.10,000 PM is provided to assist DIO in keeping up to data record on immunization and submit the performance report on physical and financial as per HIMS/UIP format. g. Supervision and Monitoring : : Rs.4,200/-PM is provided to utilize for POL expenses on supervision and monitoring purpose by Addl. CM&HO (FW)/ DIO to ensure satisfactory performance of immunization programme covering all sites. At Block PHC leve I.c of BPHC will look after the Immunization Programme and supervise the activity. In addition Sector MO, BEE, LHV will supervise the activity. h. TRAININGS : (i) 2 Days Training for ANM, LHV & GNM To improve the quality services of Immunization 2 days refresher training of Health workers (ANMs, LHV, GNM etc) along site visits related to immunization will be organized. The batch size should be 25-30 persons in each batch. Priority will be given to those ANMs who have hired drop out rates. 456 ANM/ 50 GNM/ 17 LHV will be trained during 2010-11. ii) Vaccine Handlers Training :: One day cold chain handlers training will be organized for 64 nos of Vaccine Handlers against 32 Cold Chain storage during 2010-11 by District cold chain officers and DIO in a batch of 15-20 trainees. At PHC level Contractual Pharmacist will be involved for computerized record keeping of Vaccine stock position. iii) Block level Data Handlers Training : For streamlining the reporting system of immunization ,the team of block level data handlers to be trained on reporting system at Dist. H.Q. by D.I.O , DDM, and S.I. The participants will be BEE, BPM, LHV and BAM .

DHUBRI/DHAP/2010-11 131

iv) Training on Micro Planning :: Block level Meeting/Training will be organized for all sub centres for all ANM, AWW, ASHA, ASHA Facilitator for finalization of Sub centre micro plan. i. Conduct Regular Monthly District and PHC Level Review Meetings: To identify sub center/ institutions lagging behind in performance and therby to take remedial measure, to avail opportunity for on site training and to solve the problems, to solve the problems identified by the participants and to provide feed back monthly review meeting will be ensured at District and Block Level. j. Injection Safty : Red Bag, Black Bag, Hub Cutter, Twine bucket, Injection pits etc will be ensured during 2010-11 for ensuring Injection safty.

DHUBRI/DHAP/2010-11 132

Budget under UIP Expenditure & Ahievement

2005-06 2006-07 2007-08 2008-09 2009-10 (till Nov'09) 2010-11 Service Delivery Norms

Funds Target requirement Remarks Expenditure Expenditure Expenditure Expenditure Expenditure Achievement Achievement

No. of No. of Sessions No. of Sessions Sessions Mobility support Supervised Supervised for Supervision at Rs.50,000 per Supervised district for Supervisory visits Districtlevel officers 12600 25162 74400 29457 11938 120000 by District level (this includes POL officers for and Maintenance) monitoring and per year 384 256 408 supervision of RI

Rs.500 per PHC/CHC % funds Cold Chain % funds used % funds used per year District 0 36433 1530 25466 used 51400 98400 maintenance Rs.10000 per year 99% 52% Hiring an ANM Focus on slum & @rs.300/ session for No. of No. of Sessions No. of Sessions underserved four Sessions 68600 171500 0 with hired 134400 with hired areas in urban sessions/month/slum with hired vaccinators vaccinators areas of 10000 population vaccinators and Rs.200/- per

DHUBRI/DHAP/2010-11 133 month as contingency per slum of i.e total expense 490 0 96 of Rs. 1400/- per month per slum of 10000 population

No. of No. of Sessions No. of Sessions Mobilization of Sessions Rs.150/session (for with ASHA with ASHA Children through 284000 939400 with ASHA 0 2813400 District) ASHA/mobilizers 9394 18756 18756

Geographically Hard to reach areas (session site>30 k.m. No. of No. of Sessions No. of Sessions from vaccine delivery 0 0 0 Sessions 0 385200 with AVD with AVD point, river crossing with AVD Alternate etc) @rs. 100 per RI Vaccine Delivery Session Hilly terrain @Rs.100 3852 per RI session For RI session in other areas @ Rs.50 215800 490000 15624 1046600 16104 937800 18756 per session

Support for Computer No. of C.A. No. of C.A. in No. of C.A. in

Assistant for RI in position position position Reporting (with District @ Rs. 8000- annual 10000 p.m. increment of 10% w.e.f. from 2010-11) 84000 Yes 77000 Yes 120000 Yes

DHUBRI/DHAP/2010-11 134 Printing and dissemination of immunization 50161 cards, tally Rs. 5 per beneficiary 0 0 0 0 250805 benefici sheets, aries monitoring forms etc

Quaterly Review & feedback meeting for No of No of persons No of persons exclusive for RI at persons trained. trained. District level with trained. one Block Mos, ICDS Review CDPO and other 0 0 0 60000 Meetings Shakeholders@ Rs 100/- per participant for meeting expences (launch, Organizational expences)

DHUBRI/DHAP/2010-11 135 Trainings: District Level orientation training for 2 No of days ANM, Multi No of persons No of persons Purpose Health persons As per revised norms trained trained Worker (Male), trained for trainings under 161723 344678 601301 LHV, Health RCH Assistant (Male/Female), Nurse Midwives, BEEs & other specialist (as per 267 412 523 RCH norms)

Three days training of As per revised norms No of Medical Officer No of person No of person for trainings under person on RI using trained trained RCH trained revised MO traing module

one day refresher training of District RI As per revised norms Computer for trainings under Assistants on RCH RIMs/HMIS and Immunization formats under NRHM

DHUBRI/DHAP/2010-11 136 One day Cold Chain handlers traing for block level cold chain handlers by state As per revised norms No of person No of person and District cold for trainings under 0 10870 0 9040 30 40585 31100 trained120 trained60 chain officers RCH and DIO for a batch of 15-20 trainees and three trainers.

One day training of block level No of No of person No of person data handler by person trained trained DIO and Dist trained

Cold Chain As per revised norms

officer to train for trainings under 18500 18450

about the RCH

reporting

formats of 28 30 Immunization and NRHM Microplanning to % of develop sub- SC/PHC/CHC/Dist % of center and PHC have updated at Rs 100/- per SC SC/PHC/CHC/Dist microplans using microplan this (meeting at 24600 24600 have updated bottom up year bolcklevel, logistic) microplan this planning with year participation of 100% ANM, ASHA,

DHUBRI/DHAP/2010-11 137 AWW For consolidation of microplan at PHC/CHC level @ Rs 9345 8000 0 8613 13000 24000 1000/- block & dist level @ 2000/- per dist.

% of fund POL for vaccine % of fund used % of fund used delivery from used Rs 100,000/dist/year 20724 50573 15757 45134 77509 201600 dist. To PHC/CHCs 73% 38%

Consumables for computer including At Rs 400/- 4800 provision for /month/dist internet access for RIMs

% funds Injection Safety % funds used % funds used used

Red/Black/Plastic at Rs 2/bag/session 37512 bags etc

Bleach/Hypo at Rs 500/ 4800 chlorite solution PHC/CHC/year

at Rs Twine bucket 3200 400/PHC/CHC/year

DHUBRI/DHAP/2010-11 138 Any District Specific Need % funds % funds used % funds used with Justification used ( please provide a separate write- 10% of total amount up on objective, of approved PIP stretegy, expected output and outcomes, basis for cost estimates etc. Total 42669 131038 660087 1964333 1705810 6018968

DHUBRI/DHAP/2010-11 139 6.7. PART D: NATIONAL DISEASE CONTROL PROGRAMME 6.7.1 National Vector Borne Disease Control Programme ( NVBDCP)

GOAL: To reduce morbidity and mortality due to malaria OBJECTIVE a. To bring down API from 4.27 to 2 b. To bring down PF% from 65.12% to 30% Strategies: 1. Early detection and prompt treatment 2. Case management & referral 3. Integrated Vector control 4. BCC & Social Mobilization 5. Intersectoral Convergence 6. Capacity building (Training) 7. Monitoring & Evaluation

DISTRICT PROFILE

THE DISTRICT IS SITUATED IN THE WESTERN CORNER OF THE STATE OF ASSAM BETWEEN

LATITUDE 25˚ 28' AND 26˚01'N ORTH AND LONGITUDE 89˚59' AND 90˚28' EAST .

IT IS SITUATED 35 METER ABOVE THE SEA LEVEL . IT HAS A TOTAL GEOGRAPHICAL AREA OF 2838 SQ .KMS .

IT IS BORDER BY KOKRAJHAR DISTRICT ON THE NORTH , MEGHALAYA AND BANGLADESH IN

SOUTH BOGAIGAON AND GOALPARA DISTRICT IN THE EAST AND WEST BENGAL AND

BANGLADESH IN THE WEST .

RIVER BRAHMAPUTRA FLOWS THROUGH THIS DISTRICT AND BESIDE THE DISTRICT INTO TWO PARTS VIZ SOUTH BANK AND NORTH BANK .

BILASIPARA , SOUTH SALMARA -MANKACHAR AND DHUBRI ARE THREE SUB -DIVISION OF THE

DISTRICT WITH H.Q. AT DHUBRI .

THE CLIMATE OF THE DISTRICT IS MAINLY HUMID . THUNDER STORMS OCCUR DURING THE PERIOD FROM MARCH TO MAY AND MAY TO OCTOBER IS CONSIDERED AS FLOOD SEASON .

Vital Statistics of the Distict at a Glance General:

1. Population - :: 17,28,860 (as per NVBDCP 2009 census) 2. Tea estate population - :: 9,581 No.s 3. BPL population - :: 11,71,392(as per 2001 census)

DHUBRI/DHAP/2010-11 140 4. Schedule caste - :: 63208(4.8%) (as per 2001 census) 5. Schedule tribe - :: 10223 (as per 2007 NVBDCP census)

Administrative details 1. Area - :: 2797.78 sq.km. 2. Sub-division - :: 3 nos 2. Development Block - :: 12 nos. 3 Village - :: 1302 4. Panchayat - :: 162 nos 5. Municipality - :: 1 6. Town - :: 3 7. ICDS - :: 12 8. Tea garden - :: 3 Border area

1. Development block - :: 6(Agomani,Golakganj, Dharmasala,South Salmara, Fekamari,Mankachar) 2. Village - :: 462

Health care Delivery Infrastructure

Government

1. Civil Hospital - :: 1 2. Sub-Divisional Hospital - :; 2 3. Chest Hospital - :: 1 4. 20 Bedded Maternity Hospital - :: 1 5. Block PHC - :: 7 6. CHC - :: 6 7. Mini PHC - :: 10 8. SHC - :: 6 9. State Dispensary - :: 14 10. FRU - :: 2 11. ESI Hospital - :: 1 12. Police Hospital - :: 1 13. Railway Hospital - :: 1 14. Malaria Clinic - :: 28 15. Sub-centre - :: 246

Private 1. Tea Garden Hospital - :: 1

DHUBRI/DHAP/2010-11 141

Status of Health facilities S. No Health facility No 1 District Hospital 1 2 Block PHC 7 3 Add PHC/ Mini PHC 10 4 Sub centre 246 5 Villages 1302 6 FTD 106 7 ASHA 1397 8 Rapid response team formed (yes/no) Yes

Human Resource S. No Health facility Sanctioned In Place Trained 1 DMO (Full Time) 1 1 Yes 2 AMO 1 1 No 3 MO 178 130 30 4 Lab Technician 35 35 33 5 Lab Technician 13 13 13 (contractual)* 6 Health Supervisors (M) 78 70 12 7 Health Supervisors (F) 21 8 1 8 MPW (M) 194 182 182 9 MPW (M) (contractual)# 10 9 9 10 MPW (F) 324 400 52 11 Malaria Technical 1 1 Yes Supervisor (contractual)* 12 ASHA 1397 1397 407

PHC wise epidemiological information 2005 to 2008 Total Pf. Deaths PHC BSC/B Year Population ABER Malaria Cas API SPR SFR due to Name SE Cases es malaria 2005 359107 21440 5.97 48 44 0.13 0.22 0.2 Nil Dharma 2006 368050 30762 8.35 467 432 1.26 1.51 1.4 2 sala 2007 370801 27426 7.39 281 238 0.75 1.02 0.86 6 2008 339070 18181 5.36 76 65 0.22 0.41 0.35 Nil 2005 132916 11947 8.98 18 12 0.13 0.15 0.1 Nil Halakur 2006 134892 14429 10.6 39 32 0.28 0.27 0.22 Nil a 2007 138420 12585 9.09 18 16 0.13 0.14 0.12 Nil 2008 147552 13203 8.94 13 12 0.08 0.09 0.09 Nil 2005 231367 13009 5.62 22 19 0.09 0.16 0.14 Nil Golokg 2006 229638 18668 8.12 68 41 0.29 0.36 0.21 Nil anj 2007 231698 16065 6.93 66 36 0.28 0.41 0.22 1

DHUBRI/DHAP/2010-11 142 2008 261312 16468 6.30 34 20 0.13 0.20 0.12 Nil 2005 314238 11083 3.52 107 70 0.34 0.96 0.63 Nil Raniga 2006 318167 16050 5.04 106 28 0.33 0.66 0.17 2 nj 2007 322311 13108 4.06 98 67 0.30 0.74 0.51 5 2008 318221 17590 5.52 113 92 0.35 0.64 0.52 Nil 2005 126952 8733 6.87 108 95 0.85 1.23 1.08 Nil 2006 127953 15630 12.2 498 405 3.89 3.18 2.59 1 Chapar 2007 130173 12709 9.76 248 217 1.90 1.95 1.70 3 2008 130560 14436 11.05 65 35 0.49 0.45 0.24 Nil 2005 238562 68854 2.87 47 47 0.19 0.68 0.68 Nil South 2006 243875 8881 3.64 85 71 0.34 0.95 0.79 Nil Salmar 2007 257390 10811 3.93 110 95 0.42 1.01 0.87 3 a 2008 247233 13133 5.31 127 124 0.51 0.96 0.94 Nil 2005 264066 21248 8.04 716 708 2.71 3.36 3.33 Nil 112 2006 267783 26413 9.79 1169 4.36 4.42 4.24 1 Gazarik 2 andi 112 2007 274790 29011 10.55 1154 4.19 3.97 3.86 Nil 1 2008 285746 31323 10.96 983 965 3.44 3.13 3.08 Nil 2005 1667208 94314 5.65 1066 995 0.63 1.13 1.05 Nil 213 2006 1692358 130833 7.73 2432 1.43 1.85 1.62 6 1 TOTAL 177 2007 1725283 121712 7.05 1975 1.14 0.11 1.47 18 0 131 2008 1728860 124334 7.18 1411 0.81 1.13 1.05 Nil 3

Subcentre wise epidemiological information 20072008 PHC Sub Centre Year Population BSC/BSE ABER Total Pf API SPR SFR Death Name Name Malaria cases due to cases malaria Dhubri Town 2007 28495 287 1.00 0 0 0 0 0 0 AA1 2008 28495 456 1.60 0 0 0 0 0 0 Dhubri Town 2007 17373 193 1.11 0 0 0 0 0 0 AA2 2008 17373 454 2.61 0 0 0 0 0 0 Aironjongla 2007 4590 203 4.42 3 3 0.65 1.47 1.47 0 2008 4590 455 9.91 1 1 0.21 0.21 0.21 0 Charbhasani 2007 4700 200 4.25 0 0 0 0 0 0 2008 4700 452 9.61 0 0 0 0 0 0 Bidyapara 2007 4905 200 4.07 0 0 0 0 0 0 Bhatigaon 2008 4905 454 9.25 1 1 0.20 0.22 0.22 0 DharmasalaPHC Bidyapara I 2007 4875 3850 78.97 76 66 15.5 1.97 1.71 1 2008 5075 1972 38.91 10 10 1.97 0.50 0.50 0 Madhusoulmari 2007 14550 3780 25.97 70 60 4.81 1.85 1.58 0 I 2008 14650 675 4.60 2 2 0.13 0.29 0.29 0 Tiamari II 2007 10996 2220 20.18 52 42 4.72 2.34 1.89 0

DHUBRI/DHAP/2010-11 143 2008 10996 380 3.45 2 2 0.18 0.52 0.52 0 Patamari 2007 5220 20 0.38 0 0 0 0 0 0 2008 5320 232 4.36 0 0 0 0 0 0 Bhogdahar 2007 5402 18 0.33 0 0 0 0 0 0 2008 5902 238 4.03 0 0 0 0 0 0 Reserverchar 2007 4910 9 0.18 0 0 0 0 0 0 2008 5010 235 4.69 0 0 0 0 0 0 Kachuarkhash 2007 6120 1215 19.85 8 7 1.30 0.65 0.57 1 0 2008 6320 670 10.60 2 2 0.31 0.29 0.29

2007 5108 848 4.33 4 4 0.78 0.47 0.47 0 Durahati 2008 5416 680 12.55 0 0 0 0 0 0 Singimari II 2007 4896 704 14.37 3 3 0.61 0.42 0.42 0 2008 5010 675 13.47 0 0 0 0 0 0 Tistarpar 2007 4698 650 13.83 3 3 0.63 0.46 0.46 0 2008 4898 670 13.67 0 0 0 0 0 0 Adabari 2007 15530 1556 10.01 6 5 0.38 0.38 0.32 0 2008 15830 380 2.40 2 2 0.12 0.52 0.52 0 Gaspara 2007 7126 62 0.87 3 2 0.42 4.83 3.22 0 2008 7650 375 4.90 2 2 0.26 0.53 0.53 0 Dubirpar 2007 6311 38 0.60 2 1 0.31 5.26 2.63 0 2008 6512 360 5.52 1 1 0.15 0.27 0.27 0 Binnachara 2007 6180 12 0.19 0 0 0 0 0 0 2008 6518 355 5.44 1 1 0.15 0.28 0.28 0 Silghag ri 2007 4135 250 6.04 1 0 0.24 0.40 0 0 2008 4515 270 5.98 1 1 0.22 0.37 0.37 0

DharmasalaPHC Howrarpar 2007 3717 262 7.04 0 0 0 0 0 0 2008 4018 280 5.91 1 1 0.24 0.41 0.41 0 Motirchar 2007 3592 291 8.10 0 0 0 0 0 0 2008 4092 242 5.91 1 1 0.24 0.41 0.41 0 Soulmari 2007 5320 170 3.19 0 0 0 0 0 0 2008 5620 245 4.35 0 0 0 0 0 0 Pyestirpar 2007 5812 198 3.40 0 0 0 0 0 2008 6012 252 4.19 1 1 0.16 0.39 0.39 0 Kacharihat 2007 6358 200 3.14 2 0 0.31 1.00 0 0 2008 6658 252 3.78 1 1 0.15 0.39 0.39 0 Gouripur Town 2007 14898 2771 18.59 12 11 0.82 0.43 0.39 0 AC1 2008 15098 700 4.63 4 4 0.26 0.57 0.57 0

Gauripur Town 2007 11955 760 6.35 4 4 0.35 0.52 0.52 1 AC2 2008 12055 680 5.64 3 3 0.24 0.44 0.44 0 sala sala PHC

Dharma Silairpar 2007 3298 305 9.24 1 1 0.31 0.32 0.32 0

DHUBRI/DHAP/2010-11 144 2008 4028 140 5.95 2 2 0.49 0.83 0.83 0 2007 4490 195 4.34 1 1 0.22 0.51 0.51 0 Darchuka 2008 2020 100 4.95 0 0 0 0 0 0 2007 4297 200 4.65 2 2 0.46 1.00 1.00 0 Baladmara 2008 5097 245 4.80 2 2 0.39 0.81 0.81 0 2007 4399 98 2.22 0 0 0 0 0 0 Nawarchar 2008 5038 242 4.80 1 1 0.19 0.41 0.41 0 2007 16898 407 2.40 0 0 0 0 0 0 Falimari 2008 16998 680 4.0 1 1 0.05 0.14 0.14 0

Dhubri Town 2007 17299 311 1.79 0 0 0 0 0 0 AD1 2008 17398 675 3.88 0 0 0 0 0 0 Dhubri Town 2007 20930 283 1.35 0 0 0 0 0 0 AD2 2008 21030 272 1.29 0 0 0 0 0 0 2007 5319 520 9.77 1 1 0.18 0.19 0.19 0 GeramariIV 2008 5619 262 4.66 1 1 0.17 0.38 0.39 0 2007 5380 409 7.60 0 0 0 0 0 0 Jhaleralga 2008 5680 255 4.48 0 0 0 0 0 0 2007 8530 180 2.11 3 3 0.35 1.66 1.66 1 Alomganj 2008 8730 362 4.14 1 1 0.11 0.27 0.27 0 2007 7038 180 2.55 0 0 0 0 0 0 Rangamati 2008 7538 360 4.77 2 2 0.26 0.55 0.55 0 2007 5060 322 6.36 0 0 0 0 0 0 Madaikhali 2008 5560 375 4.94 1 1 0.17 0.36 0.36 0 2007 4619 280 6.06 0 0 0 0 0 0 Ghageralga 2008 5019 258 5.14 1 1 0.19 0.38 0.38 0 2007 5779 300 5.19 0 0 0 0 0 Boraibari 2008 6012 255 4.24 1 1 0.16 0.39 0.39 0

2007 4561 370 8.11 1 0 0.21 0.27 0 0 KherbariIII 2008 4572 556 12.16 0 0 0 0 0 0 2007 5152 402 7.87 0 0 0 0 0 0 Pokalagi 2008 5156 560 10.84 0 0 0 0 0 0 2007 3781 350 9.25 0 0 0 0 0 0 Atgharitari 2008 3791 550 14.50 0 0 0 0 0 0 2007 4809 360 7.48 0 0 0 0 0 0 Gharialdanga 2008 4821 575 11.92 0 0 0 0 0 0 Halakura PHC 2007 10783 571 5.29 0 0 0 0 0 0 Chagolia 2008 10793 698 6.46 0 0 0 0 0 0 2007 6168 566 9.17 1 1 0.16 0.17 0.17 0 Koimari 2008 6168 550 8.91 0 0 0 0 0 0

DHUBRI/DHAP/2010-11 145 2007 5884 506 8.59 1 1 0.16 0.19 0.19 0 Kathaltoli 2008 5884 556 9.44 1 1 0.16 0.17 0.17 0 2007 12293 1338 10.88 2 1 0.16 0.14 0.07 0 BidyardabriI 2008 12293 542 4.40 3 3 0.24 0.55 0.55 0 2007 3337 159 4.76 0 0 0 0 0 0 KherbariI 2008 3337 232 6.95 0 0 0 0 0 0 2007 3687 150 4.06 0 0 0 0 0 0 PokalagiII 2008 3687 225 6.10 0 0 0 0 0 0 2007 3491 100 2.86 0 0 0 0 0 0 Basirkuti 2008 3491 202 5.78 0 0 0 0 0 0 2007 20833 2724 10.88 4 2 0.19 0.14 0.07 0 KaldobaIII 2008 20833 3181 15.26 0 0 0 0 0 0 2007 5476 624 11.39 2 2 0.36 0.32 0.32 0 Jhaskal 2008 5476 546 9.97 0 0 0 0 0 0 2007 5162 614 11.89 2 2 0.38 0.32 0.32 0 Pabarchara 2008 5162 540 16.46 3 2 0.58 0.55 0.37 0 2007 5597 634 11.32 1 1 0.17 0.15 0.15 0 TalliII 2008 5597 552 9.86 2 2 0.35 0.36 0.36 0 2007 5595 624 11.15 1 1 0.17 0.16 0.16 0 MoisaII 2008 5594 546 9.75 3 3 0.53 0.54 0.54 0 2007 7468 427 5.71 0 0 0 0 0 0 Halakura PHC Bhamundanga 2008 7468 445 5.95 0 0 0 0 0 0 2007 8855 452 5.10 1 1 0.11 0.22 0.22 0 KherbariIV 2008 8855 438 4.92 0 0 0 0 0 0 2007 6298 402 4.38 1 1 0.15 0.24 0.24 0 Rangpagli 2008 6298 452 7.17 1 1 0.15 0.22 0.22 0 2007 4791 575 12.00 1 1 0.20 0.17 0.17 0 Lohajani 2008 4791 587 12.25 0 0 0 0 0 0 2007 4400 572 13.00 0 0 0 0 0 0 Simlabari 2008 4400 570 12.95 0 0 0 0 0 0

Total Death PHC SubCentre Pf Year Population BSC/BSE ABER Malaria API SPR SFR due to Name Name cases cases malaria Golokganj 2007 21030 3336 15.14 26 12 1.18 0.77 0.35 0 BA1 2008 21934 3174 14.47 5 3 0.22 0.15 0.09 0 2007 4021 238 5.91 0 0 0 0 0 0 Ratiadaha 2008 4021 215 5.34 0 0 0 0 0 0 2007 3516 215 6.11 0 0 0 0 0 0 Kanori

GolokganjPHC 2008 3516 238 6.76 0 0 0 0 0 0 Bishkhowa 2007 3783 208 5.49 0 0 0 0 0 0

DHUBRI/DHAP/2010-11 146 2008 3783 195 5.15 0 0 0 0 0 0

Bishkhowa 2007 3550 220 6.20 0 0 0 0 0 0 IV 2008 3550 226 6.36 0 0 0 0 0 0 2007 3358 215 6.40 1 1 0.29 0.46 0.46 0 Gaikhowa 2008 3303 313 9.47 3 2 0.90 0.95 0.60 0 2007 2861 180 6.29 0 0 0 0 0 1 Majerchar 2008 2811 227 8.07 1 1 0.35 0.44 0.44 0 2007 3549 205 5.77 0 0 0 0 0 0 Rakhalpath 2008 3499 285 8.16 0 0 0 0 0 0 2007 3511 200 5.69 0 0 0 0 0 0 Sonahat 2008 3411 125 3.66 0 0 0 0 0 0 Berbhangi 2007 14558 946 6.08 3 2 0.19 0.31 0.21 0 BA4 2008 13743 1112 8.09 2 2 0.14 0.17 0.17 0 2007 15135 1675 10.38 1 0 0.06 0.05 0 0 Pratapganj 2008 16049 1569 9.77 2 0 0.12 0.12 0 0 2007 8642 485 5.48 0 0 0 0 0 0 Bisandoi 2008 8807 721 8.18 5 2 0.56 0.69 0.41 0 2007 8559 482 5.56 0 0 0 0 0 0 B.N. Chariali 2008 8559 636 7.43 1 1 0.11 0.15 0.15 0 2007 9147 605 6.61 0 0 0 0 0 0 Dafarpur 2008 9095 753 8.27 2 2 0.21 0.26 0.26 0

Baro 2007 7502 580 7.64 0 0 0 0 0 0 Charaikhola 2008 7541 530 7.02 1 1 0.13 0.18 0.18 0 2007 4621 425 9.19 1 0 0.21 0.23 0 0 South Raipur 2008 4601 518 11.25 7 5 1.52 1.35 0.96 0 2007 5041 438 8.68 0 0 0 0 0 0 Dhepdhapi 2008 5021 823 16.39 0 0 0 0 0 0 2007 4255 400 9.40 0 0 0 0 0 0 Batuatoli 2008 4254 222 5.21 3 1 0.70 1.35 0.45 0 2007 4689 38 0.81 0 0 0 0 0 0 Sukatikhata

Golokganj PHC 2008 4688 137 2.92 0 0 0 0 0 0 2007 5685 40 0.70 0 0 0 0 0 0 Lalkura 2008 5665 119 2.10 0 0 0 0 0 0 2007 4997 296 5.92 1 0 0.20 0.33 0 0 Dumardaha 2008 4947 310 6.26 0 0 0 0 0 0 2007 4888 278 5.68 1 1 0.20 0.35 0.35 0 Balajan 2008 4830 226 4.67 0 0 0 0 0 0 2007 5083 316 6.21 1 1 0.19 0.31 0.31 0 Sahebganj 2008 4033 319 7.90 0 0 0 0 0 0 Khudimari 2007 6035 327 5.16 3 0 0.47 0.91 0 0

DHUBRI/DHAP/2010-11 147 2008 6315 417 6.60 0 0 0 0 0 0 2007 7051 327 4.57 0 0 0 0 0 0 Chapghar 2008 7122 375 5.26 0 0 0 0 0 0 2007 5440 325 5.76 0 0 0 0 0 0 Hariharkuti 2008 5620 301 5.35 0 0 0 0 0 0

Uttar 2007 11998 991 7.31 0 0 0 0 0 0 Gadadhar 2008 12882 730 5.66 0 0 0 0 0 0 2007 5413 181 3.34 0 0 0 0 0 0 Bhatipatla 2008 3583 274 5.09 0 0 0 0 0 0 2007 5306 178 3.35 2 1 0.38 1.12 0.56 0 Paglahat 2008 5276 103 1.95 0 0 0 0 0 0 2007 4592 263 5.72 0 0 0 0 0 0 Ujanpatla 2008 4540 337 7.42 5 2 1.10 1.48 0.59 0 2007 3890 258 5.72 0 0 0 0 0 0 Madhyapatla 2008 3838 285 7.42 3 3 0.78 1.05 1.05 0 2007 0 0 0 0 0 0 0 0 0 Tamarhat 2008 18658 79 0.42 0 0 0 0 0 0 2007 0 0 0 0 0 0 0 0 0

Golokganj PHC Kamandanga 2008 8090 0 0 0 0 0 0 0 0 2007 0 0 0 0 0 0 0 0 0 Pokalagi 2008 5538 57 1.02 0 0 0 0 0 0 2007 0 0 0 0 0 0 0 0 0 Chotoguma 2008 5553 61 1.09 0 0 0 0 0 0 2007 0 0 0 0 0 0 0 0 0 Kaimmati 2008 3711 38 1.20 0 0 0 0 0 0 2007 0 0 0 0 0 0 0 0 0 Bainnaguri 2008 900 49 5.44 0 0 0 0 0 0

PHC Sub Centre Year Population BSC/BSE ABER Total Pf API SPR SFR Death Name Name Malaria cases due to cases malaria

Chapar 2007 15030 5070 33.73 84 72 5.58 1.65 1.42 0 Town 2008 15127 5106 33.75 20 16 1.32 0.39 0.31 0

2007 3803 804 21.14 20 19 5.25 2.48 2.36 0 Ariarjhar 2008 3120 630 20.19 6 5 1.92 0.95 0.79 0

2007 6148 329 5.35 2 2 0.32 0.60 0.60 0 Falimari 2008 6098 374 6.13 3 2 0.49 0.97 0.53 0

2007 4773 320 6.70 2 2 0.41 0.62 0.62 0 Chapar PHC Chapar PHC Baterdal 2008 4723 250 5.29 0 0 0 0 0 0

2007 4799 340 7.08 2 2 0.42 0.59 0.59 2 Barnitara 2008 4754 165 3.47 0 0 0 0 0 0

Dhirghat 2007 6083 130 2.13 1 1 0.16 0.76 0.76 0

DHUBRI/DHAP/2010-11 148 2008 5883 290 4.92 1 0 0.16 0.34 0 0

2007 5579 104 1.86 0 0 0 0 0 0 Soulmari 2008 5179 150 2.89 0 0 0 0 0 0

2007 5053 100 1.97 0 0 0 0 0 0 Simlabari 2008 4853 165 3.19 0 0 0 0 0 0

Islamari 2007 13335 4218 31.63 181 156 13.57 4.29 3.69 1 Bazar 2008 13279 3681 27.72 25 10 1.88 0.67 0.27 0

2007 3995 200 5.00 1 1 0.25 0.50 0.50 0 Kaljani 2008 2900 94 3.24 0 0 0 0 0 0

2007 8580 92 1.07 1 1 0.11 0.20 0.20 0 Noonmati 2008 8883 497 5.59 1 1 0.11 0.20 0.20 0

2007 6435 260 4.04 0 0 0 0 0 0 Santospur 2008 6406 290 4.52 0 0 0 0 0 0

2007 3952 0 0 0 0 0 0 0 0 Haridol 2008 3902 132 3.31 1 1 0.25 0.75 0.75 0

2007 4082 270 6.61 2 2 0.48 0.74 0.74 0 Jalikura 2008 3982 245 6.15 0 0 0 0 0 0

2007 4628 310 6.69 3 3 0.64 0.96 0.96 0 Bahalpur 2008 4528 660 14.57 3 1 0.66 0.45 0.15 0

2007 4295 260 6.05 1 1 0.23 0.38 0.38 0 Hardemara Chapar PHC PHC Chapar 2008 4280 255 5.95 0 0 0 0 0 0

2007 6827 810 11.86 5 5 0.73 0.61 0.61 0 Kursamari 2008 6727 640 9.51 2 2 0.29 0.31 0.31 0

2007 6988 820 11.74 6 5 0.85 0.73 0.60 0 Champabati 2008 6955 707 10.16 2 1 0.28 0.28 0.14 0

PHC Sub Centre Year Population BSC/BSE ABER Total Pf API SPR SFR Death Name Name Malaria cases due to cases malaria Fasatpur 2007 2221 38 1.71 1 0 0.45 2.63 0 0 Panbari 2008 1973 93 4.7 0 0 0 0 0 0 2007 2762 30 1.08 0 0 0 0 0 0 Chowtara 2008 2005 101 4.90 0 0 0 0 0 0 2007 3088 46 1.48 0 0 0 0 0 0 Ambari 2008 2086 94 4.50 0 0 0 0 0 0 2007 3260 20 0.61 1 1 0.30 5.00 5.00 1 Piyazbari 2008 1856 88 4.70 2 2 1.0 2.2 1.13 0 Raniganj PHC Pub 2007 3826 38 1.21 0 0 0 0 0 0 Sadhubhasa 2008 1945 91 4.60 0 0 0 0 0 0 2007 11141 803 7.20 10 10 0.89 1.24 1.24 0 Bagribari 2008 11996 710 5.90 2 2 0.10 0.20 0.14 0

DHUBRI/DHAP/2010-11 149 2007 9399 49 4.25 3 1 0.31 0.75 0.25 0 Pathakata 2008 7949 409 5.10 2 2 0.20 0.48 0.48 0 2007 3210 38 1.18 0 0 0 0 0 0 Barogirair 2008 7225 102 1.40 0 0 0 0 0 0

Jogirmahal 2007 2878 30 1.04 0 0 0 0 0 0 (Chotogirair) 2008 9225 168 1.80 0 0 0 0 0 0 2007 3781 46 1.21 0 0 0 0 0 1 Gutipara 2008 4104 48 1.10 0 0 0 0 0 0 2007 3230 30 0.92 0 0 0 0 0 0 Murabari 2008 3946 40 1.0 0 0 0 0 0 0 2007 9183 60 0.65 0 0 0 0 0 0 Borkanda 2008 5679 117 2.0 0 0 0 0 0 0 2007 7908 25 0.31 0 0 0 0 0 0 Tamakubari 2008 6800 0 0 0 0 0 0 0 0 2007 3602 46 1.27 0 0 0 0 0 0 Andamari 2008 3937 120 3.0 0 0 0 0 0 0 2007 3718 38 1.02 0 0 0 0 0 0 Kalairchar 2008 4021 127 3.10 0 0 0 0 0 0 2007 4389 30 0.68 1 0 0.22 3.33 0 0 Choudhurychar 2008 3853 131 3.30 0 0 0 0 0 0 2007 8002 38 0.47 0 0 0 0 0 0 Jharnarchar 2008 3415 318 3.70 0 0 0 0 0 0 2007 12590 570 4.52 1 1 0.07 0.17 0.17 1 Nayeralga 2008 14102 528 3.70 4 4 0.20 0.70 0.70 0 2007 12370 509 4.11 0 0 0 0 0 0 Pub Nayeralga 2008 12603 377 2.90 0 0 0 0 0 0 2007 6893 228 3.30 0 0 0 0 0 0 Thakuraralga 2008 6776 278 4.10 3 3 0.40 1.0 1.0 0 Raniganj PHC 2007 6357 220 3.46 0 0 0 0 0 0 Mayarchar 2008 6554 249 3.70 0 0 0 0 0 0 2007 4153 240 4.77 0 0 0 0 0 0 Buchirchar 2008 5436 237 4.30 0 0 0 0 0 0 2007 6241 256 4.10 0 0 0 0 0 0 Kazaikata 2008 5540 228 4.10 0 0 0 0 0 0 2007 4969 235 4.72 0 0 0 0 0 0 KazaikataIV 2008 5333 201 3.70 0 0 0 0 0 0 2007 12350 1202 9.73 26 23 2.10 2.16 1.91 0 Raniganj 2008 6623 1228 81.5 15 13 2.26 1.20 1.0 0 2007 6624 0 0 0 0 0 0 0 0 Lutapara 2008 6624 394 5.90 7 5 1.0 1.7 1.20 0

DHUBRI/DHAP/2010-11 150 2007 14350 759 5.28 13 13 0.90 1.71 1.71 0 Koimari 2008 14392 521 8.10 8 6 1.20 1.50 1.10 0 2007 12153 296 2.43 3 3 0.24 1.01 1.01 0 Futkibari 2008 12205 1479 12.10 11 10 0.90 0.70 0.70 0 2007 4305 38 0.88 0 0 0 0 0 0 Khudigaon 2008 11005 304 2.70 0 0 0 0 0 0 2007 6024 95 1.57 0 0 0 0 0 0 Dhemdhama 2008 6119 369 6.0 0 0 0 0 0 0 2007 19072 2534 13.28 16 6 0.83 0.63 0.23 1 Bilasipara 2008 19791 2426 12.20 11 11 0.50 0.40 0.40 0 2007 3021 145 4.79 0 0 0 0 0 0 Hatipota 2008 6807 213 3.01 0 0 0 0 0 0 2007 2819 140 4.96 0 0 0 0 0 0 Masaneralga 2008 7307 197 2.60 0 0 0 0 0 0 2007 1726 98 5.67 0 0 0 0 0 0 Hawdertari 2008 1900 84 4.40 0 0 0 0 0 0 Raniganj PHC 2007 2473 93 3.76 0 0 0 0 0 0 Gobordhanpara 2008 1865 75 4.0 0 0 0 0 0 0 2007 2127 80 3.76 0 0 0 0 0 0 Sutapara 2008 2003 95 4.70 0 0 0 0 0 0 2007 1748 90 5.14 0 0 0 0 0 0 Kalipara 2008 1795 104 5.70 0 0 0 0 0 0 2007 1667 106 6.35 0 0 0 0 0 0 Kachuagaon 2008 1902 104 5.40 0 0 0 0 0 0 2007 1514 96 6.34 0 0 0 0 0 0 Bhoterkanda 2008 1936 77 3.90 0 0 0 0 0 0 2007 6820 441 6.46 0 0 0 0 0 0 Maspara 2008 4510 267 5.90 0 0 0 0 0 0 2007 6704 440 4.56 0 0 0 0 0 0 Sagunmari 2008 4630 284 6.0 0 0 0 0 0 0 2007 7004 440 6.28 0 0 0 0 0 0 Rokakhata 2008 3803 384 4.30 0 0 0 0 0 0 2007 4126 406 9.84 0 0 0 0 0 0 Kathulipara 2008 3990 294 3.20 0 0 0 0 0 0 2007 4919 76 1.54 4 0 0.81 5.26 0 0 Sechapani 2008 4393 162 3.60 6 2 1.30 3.70 1.20 0 Raniganj PHC 2007 4242 84 1.98 2 2 0.47 2.38 2.38 0 Dhanpur 2008 4721 147 3.40 6 4 1.20 4.0 2.72 0 2007 4471 68 1.52 4 0 0.89 5.88 0 0 Pukhuripara 2008 4896 175 3.50 3 3 0.60 1.70 1.70 0

DHUBRI/DHAP/2010-11 151 2007 4023 88 2.18 3 0 0.74 3.4 0 0 Ayshakuti 2008 4429 200 4.50 0 0 0 0 0 0 2007 9061 298 3.28 8 6 0.88 2.68 2.01 0 Sapatgram 2008 9486 382 4.0 6 4 0.60 1.50 1.0 0 2007 3695 84 2.27 2 0 0.54 2.38 0 0 Kadamtola 2008 4019 230 5.70 2 1 0.40 0.80 0.40 0 2007 4493 68 1.51 0 0 0 0 0 0 Rabantari 2008 5548 41 0.70 2 2 0.30 0.80 0.80 0 2007 4012 66 1.64 0 0 0 0 0 0 Suripara 2008 4335 44 1.0 0 0 0 0 0 0

2007 7116 776 10.90 58 55 8.15 7.47 7.08 0 Kakripara 2008 9744 1196 12.2 64 64 6.5 5.4 5.4 0 2007 6289 322 5.12 11 11 1.74 3.41 3.41 0 Jhagrarchar 2008 4675 330 7.0 16 16 3.4 4.8 4.8 0 2007 6076 256 4.21 10 8 1.64 3.90 3.12 0 Dakergram 2008 4959 324 6.50 27 27 5.4 8.3 8.3 0 2007 6890 633 9.18 40 38 5.80 6.31 6.0 0 Thakuranbari 2008 8435 506 5.9 26 25 3.0 5.1 4.9 0 2007 7157 2880 40.24 27 27 3.77 0.93 0.93 0 Mankachar 2008 10946 3378 30.8 35 35 3.1 1.0 1.0 0 2007 7284 641 8.80 18 17 2.47 2.80 2.65 0 Sonarpara 2008 6937 733 10.5 27 26 3.8 3.6 3.5 0 2007 7164 297 4.14 6 6 0.83 2.02 2.02 0 Barmanpara 2008 4203 385 9.1 4 4 0.90 1.0 1.0 0

Gazarikandi PHC 2007 5264 542 10.29 14 14 2.65 2.58 2.58 0 Jordanga 2008 4563 451 9.8 26 26 5.6 5.7 5.7 0 2007 5481 422 7.69 17 17 3.10 4.02 4.02 0 Kuchnimara 2008 6404 415 6.4 20 20 3.10 4.80 4.80 0 2007 5809 1085 18.67 29 28 4.99 2.67 2.58 0 Jhaudanga 2008 7336 1491 20.30 38 38 5.1 2.5 2.5 0 2007 5753 449 7.80 6 6 1.04 1.33 1.33 0 Pubergram 2008 5044 502 9.9 16 16 3.17 3.18 3.18 0 2007 7199 586 8.14 38 35 5.0 6.14 5.97 0 Jhalorchar 2008 6406 516 8.10 21 21 3.2 4.0 4.0 0 2007 7141 912 12.77 45 42 6.3 4.93 4.6 0 Diarabazar 2008 6947 1193 17.10 26 26 3.70 2.10 2.10 0 2007 3960 616 15.55 56 55 14.14 9.09 8.89 0

PHC Kukurmara 2008 4592 544 11.80 33 33 7.10 6.0 6.0 0 Gazarikandi Dharakoba 2007 3907 325 8.31 18 15 4.60 5.53 4.61 0

DHUBRI/DHAP/2010-11 152 2008 3754 529 41.0 23 22 6.10 4.30 4.10 0 2007 3896 693 17.78 22 22 5.64 3.17 3.17 0 Bhurakata 2008 6211 509 8.10 22 22 3.50 4.30 4.30 0 2007 4288 161 3.75 21 21 4.89 13.0 13.0 0 Pipulbari 2008 3847 315 8.10 14 13 3.60 4.40 4.10 0 2007 7385 4491 60.18 122 106 16.51 2.71 2.36 0 Gazarikandi 2008 9315 6111 65.60 125 115 13.30 2.0 1.8 0 2007 7339 1819 24.78 79 75 10.76 4.34 4.12 0 Purandiara 2008 6990 1506 20.5 73 72 10.40 4.80 4.70 0 2007 10239 312 3.04 47 45 4.59 15.06 13.46 0 Fekamari 2008 17930 588 3.20 15 15 0.80 2.50 2.50 0 2007 9987 174 1.74 16 13 1.60 9.19 7.47 0 Manullahpara 2008 7820 202 2.50 4 4 0.50 1.90 1.90 0 2007 10006 217 2.16 21 20 2.09 9.67 9.32 0 Bamunpara 2008 4635 367 7.90 32 30 6.90 8.70 8.10 0 2007 12521 498 3.97 20 20 1.59 4.01 4.01 0 Fulerchar 2008 9425 572 6.0 9 9 0.90 1.50 1.50 0 2007 11982 434 3.06 18 18 1.50 4.14 4.14 0 Bangirchar 2008 6175 244 3.90 3 3 0.40 1.20 1.20 0 2007 3907 2283 58.43 28 28 7.16 1.22 1.22 0 Sukhchar 2008 3542 417 11.70 17 17 4.70 4.0 4.0 0 2007 3884 203 5.22 37 37 9.52 18.22 18.22 0 Bamuneralga 2008 5393 499 9.20 21 20 3.80 4.20 4.0 0 2007 3861 485 12.56 51 51 13.20 10.50 10.50 0 Berabhanga 2008 5077 429 8.40 29 29 5.70 6.70 6.70 0 2007 3831 350 9.13 63 60 16.44 18.0 17.14 0 Molakhowa 2008 3637 475 13.0 29 29 7.90 6.10 6.10 0 2007 3909 169 4.32 29 29 7.41 17.10 17.10 0 Gokulpur 2008 6393 473 7.30 28 28 4.30 5.90 5.90 0 2007 3755 29 0.77 4 4 1.06 13.70 13.70 0 Firingirchar 2008 3532 189 5.30 9 9 2.50 4.70 4.70 0

2007 1908 352 18.44 13 1 6.81 3.69 0.28 0 Kanaimara 2008 2963 338 11.40 11 10 3.70 3.20 2.90 0 2007 1861 168 9.02 9 9 4.83 5.35 5.35 0 Kokradanga 2008 3546 137 3.80 0 0 0 0 0 0 2007 1939 198 10.21 2 2 1.03 1.01 1.01 0 Boreralga 2008 6526 56 0.80 0 0 0 0 0 0 2007 1856 37 1.99 3 3 1.61 8.10 8.10 0 Bheramara 2008 3400 32 0.9 1 1 0.20 3.10 3.10 0 Khopatia 2007 3248 472 14.53 18 18 5.54 3.81 3.81 0

DHUBRI/DHAP/2010-11 153 2008 6107 528 8.60 29 29 4.7 5.4 5.4 0 2007 3315 128 3.86 1 1 0.3 0.78 0.78 0 K.K. M Para 2008 5951 80 1.30 6 6 1.0 7.5 7.5 0 2007 3270 71 2.17 2 2 0.61 2.81 2.81 0 Hazirhat 2008 5415 25 0.40 3 3 0.5 12.0 12.0 0 2007 3343 0 0 0 0 0 0 0 0 Takimari 2008 5663 0 0 0 0 0 0 0 0 2007 3065 220 7.17 5 5 1.63 2.27 2.27 0 Charbatbari 2008 5232 215 4.10 1 1 0.10 0.40 0.40 0 2007 4245 51 1.20 3 3 0.70 5.88 5.88 0 Tapalpara 2008 4701 214 4.50 1 1 0.20 0.4 0.4 0 2007 4082 40 0.97 5 5 2.44 12.0 12.0 0 Pankata 2008 2185 232 10.60 6 6 3.0 2.5 2.50 0 2007 7803 255 3.26 24 24 3.07 9.41 9.41 0 Baghapara 2008 6658 518 7.70 6 6 0.90 1.10 1.10 0 2007 7467 176 2.35 19 18 2.54 10.7 10.2 0 Borkona 2008 10032 342 3.40 19 19 1.80 5.50 5.50 0 2007 10395 735 7.07 18 18 1.73 2.44 2.44 0 Sadullahbari 2008 10206 1203 11.70 23 23 2.20 1.90 1.90 0

2007 9998 262 2.62 8 8 0.80 3.05 3.05 0 Bengervita 2008 7064 364 5.10 11 11 1.50 3.0 3.0 0 2007 4505 228 5.06 11 10 2.44 4.82 4.82 0 Tangaon 2008 5307 240 4.50 17 17 3.20 7.10 7.10 0 Pipulbari 2007 4380 270 6.16 14 13 3.19 5.18 4.81 0 Bazar 2008 4857 250 5.10 15 15 3.10 6.10 6.10 0 2007 4632 271 5.85 24 24 5.18 8.85 8.85 0 Jewali 2008 3630 275 7.50 10 10 2.70 3.60 3.60 0

2007 7204 950 13.18 14 10 1.94 1.47 1.05 0 Madertari 2008 6334 932 14.70 8 8 1.26 0.85 0.85 0

2007 6372 905 14.20 7 5 1.09 0.77 0.55 0 Choto Nisampur 2008 5602 385 6.87 0 0 0 0 0 0

2007 8027 250 3.11 1 1 0.12 0.4 0.4 0 Gossaindubi 2008 5140 152 2.95 1 1 0.19 0.65 0.65 0

Majerchar 2007 7014 186 2.65 1 1 0.12 0.4 0.4 1 Chalakura 2008 6736 170 2.52 0 0 0 0 0 0 South Salmara PHC PHC South Salmara 2007 5563 76 1.36 0 0 0 0 0 0 Chirakuti 2008 6706 250 3.72 2 2 0.29 0.80 0.80 0

2007 5830 87 1.49 0 0 0 0 0 0 Nayaparwa 2008 4673 194 4.15 0 0 0 0 0 0

DHUBRI/DHAP/2010-11 154 2007 5046 65 1.28 0 0 0 0 0 0 Feskamari 2008 5484 205 3.73 0 0 0 0 0 0

2007 5013 300 5.98 0 0 0 0 0 0 Jamdarhat 2008 3530 239 6.71 1 1 0.28 0.42 0.42 0

2007 4219 268 6.35 0 0 0 0 0 0 Falimari 2008 5212 233 4.47 0 0 0 0 0 0

2007 4507 310 6.87 0 0 0 0 0 0 Satsia 2008 6634 257 3.87 1 1 1.15 0.38 0.38 0

2007 11370 285 2.50 0 0 0 0 0 0 Jaruarchar 2008 10885 303 5.53 0 0 0 0 0 0

2007 3548 125 3.52 0 0 0 0 0 0 PadmaralgaI 2008 6976 105 1.50 0 0 0 0 0 0

2007 3819 117 3.06 0 0 0 0 0 0 PadmaralgaII 2008 5723 184 3.21 0 0 0 0 0 0

2007 3799 131 3.44 0 0 0 0 0 0 Payestidimatola 2008 6671 98 1.46 0 0 0 0 0 0

2007 3520 118 3.35 0 0 0 0 0 0 RiverblockIII 2008 4689 302 6.30 0 0 0 0 0 0

2007 13277 1090 8.20 0 0 0 0 0 0 Baladmara 2008 7412 712 9.60 0 0 0 0 0 0

2007 4517 205 4.53 0 0 0 0 0 0 Airkata 2008 5054 214 4.23 0 0 0 0 0 0

2007 3793 200 5.27 0 0 0 0 0 0 Riverchala 2008 4126 195 4.72 0 0 0 0 0 0

2007 3911 252 6.44 0 0 0 0 0 0 Kushbari 2008 5287 227 4.29 0 0 0 0 0 0

2007 3360 202 6.01 0 0 0 0 0 0 Sundarpara 2008 4278 136 3.17 0 0 0 0 0 0 South Salmara PHC PHC South Salmara 2007 4158 250 6.01 1 1 0.24 0.40 0.40 0 Salkata 2008 8999 325 3.61 0 0 0 0 0 0

Borkalia (Chatla 2007 4119 265 6.43 0 0 0 0 0 1 bilpara) 2008 6509 250 4.62 0 0 0 0 0 0

2007 4625 275 5.94 0 0 0 0 0 0 Namaserchow 2008 7074 196 2.77 0 0 0 0 0 0

2007 3593 215 5.98 0 0 0 0 0 0 Radhuramchala 2008 8208 250 3.04 0 0 0 0 0 0

2007 5680 243 4.27 0 0 0 0 0 0 Ambari 2008 3747 105 2.80 0 0 0 0 0 0

2007 6014 263 4.37 0 0 0 0 0 0 Ravatari 2008 6962 311 4.46 0 0 0 0 0 0

DHUBRI/DHAP/2010-11 155 2007 5502 225 4.08 0 0 0 0 0 0 Bauskata 2008 5360 264 4.92 0 0 0 0 0 0

2007 6254 892 14.26 26 18 4.15 2.91 2.69 0 Dhenerkuti 2008 8891 209 2.35 5 5 0.56 2.39 2.39 0

2007 7358 893 12.13 44 24 5.97 4.92 2.68 0 S. Salmara Bazar 2008 4590 899 19.50 19 19 4.13 2.11 2.11 0

2007 4848 83 1.71 3 1 0.61 3.61 1.30 0 Simlakandi 2008 5637 897 15.90 21 21 3.72 2.34 2.34 0

Tumni 2007 4780 82 1.71 3 1 0.62 3.65 2.43 0 Dawakandi 2008 5764 107 1.85 7 7 1.21 6.54 6.54 0

2007 4798 166 3.45 4 2 0.83 2.40 1.20 1 Bhalukkandi 2008 5439 252 0.20 11 11 2.02 4.36 4.36 0

2007 4008 57 1.42 0 0 0 0 0 0 Patakata 2008 5393 138 2.55 5 5 0.92 3.62 6.62

2007 3550 42 1.18 0 0 0 0 0 0 Satdubi 2008 4424 122 2.75 1 1 0.22 0.81 0.81 0

2007 4180 59 1.41 0 0 0 0 0 0 Katdanga 2008 6856 97 1.41 2 2 0.29 2.06 2.06 0

2007 4365 62 1.42 0 0 0 0 0 0 Monirchar 2008 5764 205 3.55 17 17 2.94 8.29 8.29 0

2007 3605 10 0.27 0 0 0 0 0 0 MuthakhowaI 2008 4916 102 2.07 0 0 0 0 0 0

2007 3550 8 0.22 0 0 0 0 0 0 MuthakhowaII 2008 5604 106 1.89 0 0 0 0 0 0

2007 3677 10 0.27 0 0 0 0 0 0 Katiaralga 2008 6647 89 1.30 0 0 0 0 0 0

2007 6067 275 4.53 0 0 0 0 0 0 Natineralga 2008 5142 402 7.81 0 0 0 0 0 0

2007 5562 250 4.49 0 0 0 0 0 0 Golaperalga 2008 7726 325 4.20 0 0 0 0 0 0

2007 5625 256 4.50 0 0 0 0 0 0 Muhurirchar 2008 4406 82 1.86 0 0 0 0 0 0

2007 0 0 0 0 0 0 0 0 0 Fakirganj 2008 4278 446 10.40 0 0 0 0 0 0

2007 0 0 0 0 0 0 0 0 0 Salapara 2008 3151 122 3.87 0 0 0 0 0 0

2007 0 0 0 0 0 0 0 0 0 Chalbandharchar 2008 3631 270 7.43 0 0 0 0 0 0

2007 0 0 0 0 0 0 0 0 0 Choudhury Char 2008 6482 108 1.66 0 0 0 0 0 0

DHUBRI/DHAP/2010-11 156

MONTHWISE EPIDEMIOLOGICAL REPORT FOR THE YEAR 2009 Population of the district :: 17,28,860 No.s No. of BSC/ No. No. RT Death (if Month Total SPR SFR MBER BSE of Pf of PV Given any) positive January 5532 36 33 3 0.65 0.60 0.32 36 Nil

February 6621 46 40 6 0.69 0.60 0.38 46 Nil

March 8074 59 51 8 0.73 0.63 0.47 59 Nil

April 8726 130 125 5 1.49 1.43 0.50 130 Nil

May 12605 262 251 11 2.08 1.99 0.73 262 1

June 19903 314 304 10 1.58 1.53 1.15 314 2

July 23831 294 282 12 1.23 1.18 1.38 294 Nil

August 14061 121 118 3 0.86 0.84 0.81 121 1

September 10865 86 82 4 0.79 0.75 0.62 76 Nil

October 13478 105 100 5 0.77 0.74 0.77 105 Nil

SURVEILLANCE

Active :- Active surveillance done by 103 numbers of surveillance worker . For proper surveillance each sub centre is to be manned by MPW(M).

Total sub-centre = 246 Existing SW = 103 No.s NMA = 17 Vaccinator = 43 BCG Tech. = 6 Health Asstt. = 10 MPW =10 Total =189 No.s

We need additional 57 (Fifty seven) MPW (M). Surveillance worker already mobilized to the priority areas for proper active surveillance . Supervision of surveillance activity

Village Level /Sub-Centre Level PHC Level District Level C.M & H.O ( CD ) / DMO / S.I M.I./ S.M.I. AMO / MTS

DHUBRI/DHAP/2010-11 157

Passive Surveillance Passive surveillance done by ASHA , FTD , and ANM in this Sub-centre .

Total 1397 number of ASHA have already been selected and they will be trained on Malaria . Training Programme of ASHA on Malaria. Total Total Training Date Venue Resource Supervision No. of ASHA Session person ASHA trained on Malaria 1397 407 16 Batch ( 50 Within PHC CM & HO(CD) From no.s participants April/20 Headquarter /DMO. State Hq. in each batch ) 10 s Officer.

• 407 no. ASHA of the priority villages already trained.

High Risk Areas: S. No Name of P HC High risk Sub High risk High risk Tribal Population (no) centre (no) Village (no) Population (no) Dharmasala 1 6 21 46,297 Nil Raniganj 2. 7 47 51,881 Nil Chapar 3 6 55 52,242 5,240 South Salmara 4 8 31 42,836 Nil Gazarikandi 5 45 236 2,85,746 5,580

District Total 72 390 4,79,002 10,820 Classify the areas as per following API ranges

Sub centre Villages Population @ % population of S. No API PHCs (No) (No) (No) Village (No) District 1 <1 7 178 950 12,79,013 73.99 2 1 – 2 7 30 142 2,25,302 13.02 3 2 – 5 3 27 150 1,52,434 8.81 4 5 – 10 1 9 47 55,806 3.22 5 > 10 1 2 13 16,305 0.94 Total 7 246 1302 17,28,860

Outbreak: Yes/ no if yes; Yes. • No of outbreaks : 1 • Area affected : Fakirganj area under South Salmara PHC. • Period of outbreak: 23-05-09 TO 29-06-09. • No of deaths reported during outbreak : 3 (Three) no.s.

DHUBRI/DHAP/2010-11 158 • Reasons for outbreak : Lack of regular surveillance, migration of people to neighboring State Meghalaya where Malaria is endemic. • Containment measures taken : Mass survey, DDT Spray, Bed-Net impregnation, Health Check-up & awareness Camps done in the effected Areas. RD Kits (for use in pf endemic subcentre from where reports of blood slide not received within 24hrs.)

(i) Planning for distribution of Rapid Diagnostic Kits during 2010 11

Sub Population Blood Villages in centre in at Villages Collection in RDTs to be S. inaccessibl PHC Name inaccessi in inaccessible distributed No e areas ble areas inaccessible areas (as per in 201011 (No) (No) areas (No) ABER) No. 1 Dharmasala 8 28 36,774 2,308 2,400

2 Golokganj 7 34 55,280 1,014 1,100

3 Raniganj 10 48 71,525 2,553 2,600

4 S. Salmara 14 54 90,404 2,059 2,100

Total 39 164 2,53,483 7,934 8,200

(ii) Requirement of Rapid Diagnostic Kits based on epidemiological data of 2008 for 2011 12 in the District. Slide Sub S. Village Total Tribal Collection Details centre No. (no) Population Population (as per (no) ABER) 1 Total areas with high Pf % 38 210 2,21,036 Nil 4929 2 Of the above prioritized (inaccessible areas) to be 39 164 2,53,983 Nil 7934 equipped with RDT during the year TOTAL 12863 3 No of RDTs Required for Inaccessible areas + High Pf % areas=13,000 No.s 2010-11 For Institutional use = 7,000 ASHA use = 10,000 Total = 30,000

DHUBRI/DHAP/2010-11 159 Areas for supply of ACT A. Planning for distribution of ACT in the District 2010 11

Pf cases S. Total ACT AS SP Name of PHC Nos reported in No. Population Blisters Tabs Tabs previous year 1 Dharmasala 3,39,070 65 2 Halakura 1,47,552 12 3 Golokganj 2,61,312 20 4 Raniganj 3,18,221 92

5 Chapar 1,30,560 35

6 South Salmara 2,47,233 124

7 Gazarikandi 2,85,746 965

TOTAL 17,29,694 1313 1298 6943 1735 Requirement of ACT for distribution 2011 2012 Pf cases reported AS Tabs SP Tabs S. Total ACT Blisters Name of PHC in previous year for for No. Population for adults Adults Children children children 1 Dharmasala 3,39,070 39 26 2 Halakura 1,47,552 7 5 3 Golokganj 2,61,312 12 8 4 Raniganj 3,18,221 56 36 5 Chapar 1,30,560 21 14 6 South Salmara 2,47,233 75 49 7 Gazarikandi 2,85,746 579 386 TOTAL 17,29,694 789 524 1298 6943 1735

Bed nets

Planning for distribution of Bednets

No of Househ No of Eligi Total olds Total Eligi House Total Total ble Tribal Hous with at distributed Total Planned to ble Hold to Bednet planned S Eligibl Popu popul ehold least 2 during be distributed in Sub be require to be . PHC e latio ation s effectiv (200910) 201011 (no cent impreg d (no) treated N Name village n (no) ebedne (no) re nated o. s (no) ts (no) (nos

.) E D ITNs LLINs A B C H D=C X 2 ITN LLIN F G 1 Dharmasa la 2 Halakura 3 Golokganj 4 Raniganj

DHUBRI/DHAP/2010-11 160 5 Chapar

6 South Salmara 7 Gazarikan di Total=7 72 390 17 10820 3234 50909 116897 233794 0 1990 20000 30000 167806 55 0

MICRO ACTION PLAN 2010 Identification of Village according to GIS Data in the District on Priority Basis Name of Total Priority –I Priority-II Priority-III Priority-IV PHC No. of API>5 & PF 50% API>5 & PF>30% - API>3 to <5 & PF <50% API>3 to <5 & PF>30% Sub- 50% to 50% Centre No. of No. No. of No. of No. No. No. of No. No. of No. of No. No. of S/C of Popu. S/C of of S/C of Popu. S/C of Popu. involved Vill. involved Vill. Popu. involved Vill. involved Vill. Dharmasala 34 Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Halakura 22 Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Golokganj 34 Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Raniganj 48 Nil Nil Nil Nil Nil Nil Nil Nil Nil 2 15 15015 Chapar 17 Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil Nil S. Salmara 46 Nil Nil Nil Nil Nil Nil 2 9 10,227 2 8 11203 Gazarikandi 45 11 57 64,602 Nil Nil Nil 18 103 1,02,617 3 18 17368 Total 246 11 57 64,602 Nil Nil Nil 20 112 1,12,844 7 41 43590

Total Village Total Population Sub center Priority-I 57 64,602 11 Priority-II Nil Nil Nil Priority-III 112 1,12,844 20 Priority-IV 41 43,590 7 Total 210 2,21,074 38

(Planning for IRS) Name of Trainings Total Population Spray Equipm PHCs Sub batches S. Village selected Tribal squads ent Requirem Selected centre of spray N selecte Populati required require ent of for IRS selected squads o d (no) on (no) d DDT (no) (no) P.I P. II (*) (no) (*) 1 Gazarikandi 11 57 64602 Nil Nil 3 2

SUPERVISION OF SPRAY WORK FOR THE YEAR 2010

Sl Name of No. of No. of Date of spray Supervisor Supervisor Supervisor at District No PHC Sub- Village at S.C. & at PHC centre Selected Village 1st 2nd selected Priority round round Priority basis basis. 1 Gazarikandi 11 57 15.2.10 15.5.10 SW,SI(M) MI,SMI i/c AMO,DMO, PHC CM&HO(CD),Jt.DHS

DHUBRI/DHAP/2010-11 161 TRAINING OF SUPERVISORS AND SPRAY SQUARDS, 2010.

No. of Total MPW & No. of Sl Name of No. of Training Resource Other spray Date Venue No PHC Man sessions persons supervisor squads power staffs 3 X 6 = 1st week of PHC CM&HO(CD) 1 Gazarikandi 11 29 1 18 February”10 H.Q. & DMO/AMO

ROAD MAP OF DDT DUMPING 2010. From No.of To PHC From PHC To Sub-Centre District km 1. Kakripara S/C, 2. Dakergram, 3. Jordanga 4. Jhawdanga , 5. Kukurmara, 6. Gajarikandi Dharakoba, Gazarikandi 110 to 11 No. 7. Gazarikandi, 8. Puran diara, 9.

Dhubri of S/C Bamunpara 10. Berabhanga, 11. Molakhowa

** IEC ACTIVITY FOR SENSITIZATION AND MOBILIZATION OF COMMUNITY FOR SPRAY OPERATION : -

1) Awareness meeting to be organized with involvement of local NGO, ASHA, AWW, local prominent bodies, teachers, SHG and miking to be done well before two days of spray operation. 2) Prior information regarding DDT Spray Operation in the community to be given by ASHA in this village Health Day, SFW, SW, SI, ANM, community volunteers PRI.

** Time of Reporting of 1 st round DDT spray After 15 days of completion of DDT spray operation.

** Analysis of 1 st round DDT Spray Analysis done by Joint Director of Health Services/ CM & HO ( CD) / DMO/ I/C PHC.

DHUBRI/DHAP/2010-11 162 Innovations

Commodity Requirement S. No. Innovations Describe details & Procedure adopted Patient referral e.g. Like use of NRHM/ RKS flexi Fund provided by District Health Society to the 1 funds for transport of PHC for referral of Severe Malaria Cases. severe cases

Transportation of slides 2 E g. Use of Public Nil transport system NGO/ CBO involvement 3 Refer to PPP guidelines on Nil www.nvbdcp.gov.in Community mobilization eg. Mobilizing using street Street plays on Malaria from NRHM side. 4 plays, puppet plays, self help groups

Previous Requirement for Balance Net requirement year’s current year Available (23) Item utilization (no) (no) (no) 1 2 3 4 Insecticide For IRS (Kg) 45,923 Kgs 9690 Kgs 27,679 Kgs Nil Insecticide For ITMN (Lts) 4843 Lts 4200 Lts Nil 4,200 Lts ITNs 30,300 50,000 Nil 50,000 Chloroquine (No.) 10,75,000 15,00,000 17,000 14,83,000 Primaquine 2.5 (No.) 41,400 50,000 8,000 42,000 Primaquine 7.5 (No.) 1,36,200 1,80,000 11,500 1,68,500 ACT ( Artesunate +SP) Blister (No.) 400 2,000 50 1,950 Artesunate tabs (No.) 7,800 6,943 1,704 5,239 S+P Combination (No.) 3,600 1,735 100 1,635 Quinine Injection (No.) 1,770 900 Nil 900 Quinine Sulphate (No.) 32,200 10,000 1,000 9,000 Arteether Inj (No.) 1,188 78 274 Nil RDK (No.) 41,050 30,000 375 29,625 Micro Slides (No.) 1,41,200 1,50,000 850 1,49,150 Pumps (No.) 16 No.s 6 16 Nil

DHUBRI/DHAP/2010-11 163 Training:

S. Training during Proposed Estimated Trainings No 200910 during 201011 Cost (Rs) 1 Medical specialists at District Hospital Nil 2 Medical Officers 4 100 1,60,000.00 3 Laboratory Technicians (induction) Nil 4 Laboratory Technicians (reorientation) Nil 48 80,000.00 5 Health Supervisors (M ) Nil 58 6 Health Supervisors (F) Nil 7 1,05,000.00 7 Health Workers (M) Nil 8 Health Workers (F) Nil 348 9 ASHAz 70 992 2,90,000.00 Community Volunteers other than 10 Nil 200 40,000.00 ASHA Others specify: MPW (Contractual & 11 21 (9+12) 12 10,000.00 Spray Workers Total 6,85,000.00

BCC/ IEC:

IEC Unit Cost during Estimated S. No Activities Proposed during 2010-11 (Rs) 200910 Cost (Rs) (No) A. Print Media 1 Posters 10.00 15,000 1,50,000.00 2 Hoardings 20,000.00 40 8,00,000.00 3 Newspaper 1,000.00 10 10,000.00 advertisement B. Community level 6 Health camps 1500.00 50 70 1,40,000.00 7 Village level awareness 500.00 700 3,50,000.00 camps for IRS/ ITBN 8 Others (specify) Street 2,000.00 10 20,000.00 Plays, Local advertisement. 1,000.00 10 10,000.00 Total 14,70,000.00

DHUBRI/DHAP/2010-11 164 PPP involvement Previous year Planned in Current Schemes Cost 200910 (no) year 201011(no) Scheme I EDPT 2 (Malaria Scheme II Microscopy & treatment Health Checkup 10 15,000.00 Camp) Scheme III Hospital based treatment - - - Scheme IV ITBN 2 50 25,000.00 Scheme V Larvivorous Fish - - - Total 4 60 40,000.00

Do a SWOT analysis of the district as below. Strengths In position manpower of NVBDCP Actions to be Taken :- DDT Spray for vector control. Rational utilization. Govt. supply Bed-Net to endemic villages. Community owned & Govt. supplied Bed-Net impregnation. Anti-Malarial drugs and equipments. Use of RDK for EDPT. Weakness Shortage of manpower. Filling up vacant posts. Shortage of accessories. Vehicle to be sanctioned & required accessories to be supplied. Opportunities Involvement of ASHA, AWW Regular communication with these selected MNGO from NRHM, PRI, groups. other local NGO and SHG. Threats Migration of people to and from Mobile teams and Boat Clinic to Meghalaya cover these areas. Char area and inaccessible area.

BUDGET & ESTIMATE ITEM ACTIVITY Amount Rs. Surveillance 57 No.s MPW X @ Rs.6000.00/ p.m X12 41,04,000.00 Vector Control-IRS Wages for 2 rounds DDT Spray for 3 Squads 1,56,240.00 DDT Dumping (Road & Boat) 50,000.00 Fogging Fogging Operation in 5 town areas 1,00,000.00 ITBN 350 Camps X @ Rs.500/ X 2 Rounds 3,50,000.00 Protective Equipments Purchase of hand gloves, Goggles, Apron, mask for 3 Spray 5,000.00 for spray Squads Training M.O, Lab-Tech, Health Supervisors, Health workers, ASHA, 6,85,000.00 Spray workers and spray Super visors BCC / IEC 14,70,000.00 M & E Jt. DHS/ CM& HO(CD) @ Rs. 10,000.00/ p.mX 12 = 1,20.000.00 DMO. @ Rs. 10,000/ p.m X 12 = 1,20,000.00 AMO/ MI Hq. @ Rs.5000/ p.m X12 = 60,000.00 MI PHC @Rs.1000/ p.m X12X7 PHC = 84,000.00 Miscellaneous For cross checking of B/S @ Rs.400 per PHC X 7 PHC X 12 33,600.00 Stationary Article for Office use 60,000.00 Telephone Bill @ Rs.1000/ p.m X 12 12,000.00 Collection of Anti-Malarial Drugs and Equipments from State 60,000.00 H.Q Total 74, 69,840.00

Total Budget & Estimated Cost is Rupees Seventy Four Lakhs Sixty Nine Thousand Eight Hundred Forty Only only

DHUBRI/DHAP/2010-11 165 6.7.2 REVISED NATIONAL TUBERCULOSIS PROGRAMME (RNTCP)

Objectives: 1. To achieve and maintain a cure rate of at least 85% among newly detected infectious (new sputum smear positive) cases, and 2. To achieve and maintain detection of at least 70% of such cases in the population

ANNUAL PLAN FOR PROGRAMME PERFORMANCE & BUDGET FOR THE YEAR 1ST APRIL 2010 TO 31 ST MARCH 2011 This action plan and budget have been approved by the DTCS.

Signature of the DTO______

Name_ Dr. Jogodindu Bikash Roy, Designation – DTO, Dhubri

Section-A – General Information about the District

1 Population (in lakh) please give projected population 2010 1850508 2 Urban population 224196 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. No. Name of the TU Population (in Please indicate if the TU is - No. of MCs Lakhs) Govt NGO Govt NGO Private

1 Dhubri DTC TU 444379 - - - 2 Gauripur TU 524644 - - - 3 Bilasipara TU 459441 - - - 4 Gazarikandi TU 422044 - - - DISTRICT 1850508 - - - - -

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

Dhubr 70%

i DTC 74 47 71 94 92 37 53 58 67 27 69 75 85% 275 275 175 149 196 86.5 86.5 86.8 86.5 86.5 or more TU

Gauri 85% 70% ------pur 61 59 76 58 46 69 62 48 72 156 156 135 172 or more TU Figure not 85% available Bilasi 70% at present

para 50 49 47 68 61 60 53 74 61 60 63 88 86 91 134 134 133 107 154 87.8 87.8 87.7 or more TU

Gazari 85% 70%

kandi 91 96 60 31 47 44 55 29 31 42 52 27 38 52 173 173 104 78.2 78.2 89.2 88.3 85.2 or more TU

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

S.No. Priority areas Activity planned under each priority area - Increased Meeting, Street Play, Interaction Meeting, Sensitization. 1 ACMS - Increased Publicity Materials. - Increased Wall Paintings Bus Board etc.

2 Training / Re-Training Particularly MOs, Dot Providers & LTs.

3 Supervision Increased Boat hiring.

4 Contractual staffs Particularly LTs 4 nos.

With NRHM in respect of ACMS, Supervision, Dot decentralization, 5 Coordination Finance and Sputum collection centres

NGO involvement in selected areas by small NGOs under new NGO 6 NGO Involvement scheme.

7. TB-HIV Coordination As per Action Plan.

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

Civil Works

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

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

DTC 1 1 0 - - -

TUs 4 4 0 - - -

DMC 20 20 1 Out of the 20 DMCs one DMC 30000 is performing poor. So it is rd planned that works of the 3 Quarter- DMC should be shifted to the 2010 near by sub-divisional hospital which has been functioning recently and with much OPD attendance. All Quarter during the Maintenance of financial year – Civil A separate sheet enclosed herewith in details ( last page) 30700 2010-11.

works

Total 60700 -

Civil Works under NRHM Additionalties Sl. Health Centres Item Numbers required. No. involved 1 Treatment (DOTS) Room For 45 PHIs ( Health Centres). Rs.50000X20= 1000000 One sitting room for Proposal for 20 DMCs during patients to take treatment the financial year 2010-11 under DOTS. 2 Observation room For 45 PHIs ( Health Centres). Rs.50000X20= 10000 00 ( for observation & work by DOT Providers) Proposal for 20 DMCs during the financial year 2010-11 One room attached to treatment room & one window to observe 3 Laboratory Room at Sukchar It is specially needed for Rs. 50000 DMC to be constructed with Sukchar DMC. laboratory outlet connection and a pit for waste matter disposal from the laboratory and Dot centre 4 Renovation of DTC building For DTc Office Rs.20000 -

168 a) One partition wall with At DTC Rs. 100000 one door & one window. b) Tiles fitting in DTO’s room, Laboratory & Computer room.

Total Rs. 2170000

Laboratory Materials

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

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

Purchase of Lab 396825 207090 180000 400000 As per norms Materials

Honorarium

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

(a) (b) (c) (d) (e) 226000 300000 Honorarium for 103250 200000 More expenditure DOT providers planned for current

(both tribal and financial year due to non tribal districts) outstanding expenditures. - Honorarium for - - - - DOT providers of Cat IV patients

Honorarium under NRHM Additionalties

• As seen in the column (c) above there is a need of Rs. 200000 for current financial year, but at present we have only Rs.50000. So it is requested that a sum of Rs. 150000 may be granted for this head from NRHM flexi pool for disposal of outstanding bills.

Total requirement Rs. 150000.

169 RNTCP-Dhubri District Annual Action Plan Format Advocacy, Communication and Social Mobilization (ACSM) for RNTCP – 2010-11

1) Information on previous year’s Annual Action Plan a) Budget proposed in last Annual Action Plan: 321800 b) Amount released by the state: 166730 c) Amount Spent by the district- 104310 ( Last 4 Quarter) 2) Permissible budget as per norm : 196500 3) Budget for next financial year for the district as per action plan detailed below: 299000 A. CHALLENGE 1 – LOW ACDR, NSP-CDR, LOW SUSPECT EXAMINED. I – Advocacy Activities.

Program WHY For WHOM WHAT When Challenges By Monitoring and Budg to be ACSM Target ACSM Activities Time Frame WHO Evaluation et for tackled by Objective Audience M the ACSM finan during the cial year Year 2010- Activities Materials/Me Q1 Q2 Q3 Q4 Output Outcome 11 dia Required. Low Gaini from DC, Regular Power point 3 3 3 3 DTO/W Meeting/Mi Incre No ACDR, ng Jt.DHS monthly Presentation HO nutes ase cost NSP-CDR, admin etc. meetings Consult referr Low istrati ant al of Suspect ve Involve Sensiti Power 1 1 1 1 DTO,M Report chest Cost Examined suppo ment of zation Point OTCs, s supm of rt for Educatio Briefi STS/ST Photog tomat meeti increa n Deptt. , ng presentation. LS raph ic ngs – se Social Booklet. Mutual Incre 500 X referr Welfare Meeting. Brouchers. Agree ase 12= al Deptt Factsh Factsheets. ment ACD 6000 from eets. Success R & OPD. Private Stories. 1 1 1 1 NSP- Cost Practition CDR of ers comm Tradition unicat ion al 1 1 1 1 Healers, materi Pharmacy als Owners. 20000

World 1 - - - TB Day 40000

II. Communication Activities Program When Challenges WHAT to be For WHOM WHY Time Frame Monitoring and tackled by Budget ACSM Activities By Evaluation ACSM Target for the ACSM WHO during the Audience financi Objective M Materials/ al year Year Activities Media Q1 Q2 Q3 Q4 Output Outcome 2010-11 Required. Low Publicity To inform DTO, MIncr 2000X4 ACDR, General through Cable communiti 1 1 1 1 MTO Vouchers ease in = NSP-CDR, public. cable Channels es and care Cs Case 8000 Low TV. providers Referral Suspect Flip MOT 1000 about the KAP Examined Chart. Cs, Minutes X16= DOT School Study Schools. Brouchers STS/S Photograph 16000 services Health 4 4 4 4 after . TLS, Office For for early Programme one Factsheet. Local Register Filip detection. year. Posters. PHI Chart

170 I/c, etc. Head 15000 Maste r of the Schoo l. I/c of the Care Patient PHI, 200X96 Minutes Providers Provider Dot =19200 24 24 24 24 Office Interactionn Provi , say Register Meeting. der 20000 and STLS. Walls of 400X80 Wall painting Health 20 20 20 20 DTO = Institutions 32000 Script and Street Man power DTO, 4000X4 Play/Dramma of 1 1 1 1 CF, =16000 professional STS/S groups. TLS Awareness General 10 General Public, Bus Board On hiring 200X40 10 10 10 DTO Photograph, Public Schools (inside) basis =8000 Office Record

Postering in On hiring 250X40 10 10 10 10 DTO Auto Rickswas basis =10000

Drum Beating DTO, On contract in Rural 4 4 4 4 OTCs basis 500X20 Markets , CF =10000

III. Social Mobilization Program When Challenges For WHOM WHAT to be WHY Time Frame Monitoring and Budget tackled by By Target ACSM Activities Evaluation for the ACSM ACSM WHO Audience financi during the Objective M al year Year Materials/Me Outco Activities Q1 Q2 Q3 Q4 Output 2010-11 dia Required. me Low General Community Flip Charts, 36 36 36 36 500 ACDR, awareness in General Level Meetings Posters, DTO, Minutes, Increa X144= NSP-CDR, public Community, Broachers, MOTC Photograph in self 72000 Low Increase Patients and Handbills. s, CF, , Office reportin Suspect Rate of self Dot Exhibition, Posters, 1 1 1 1 I/c MO Records g of 2000X4 Examined reporting Providers etc. Melas, Banners PHC, cases. =8000 To create STS/ST KEP a sense of LS study intrigration World TB Already given. 1 - - - after Alread day one y given. year. Other analysis and School Quiz Prize 2 2 2 2 1000X8 Motnito Children Competition & Materials =8000 ring Short Printing Sensitization Meeting. Materials(IEC) Quiz Materials. Local Small Sensitization Leaflets 4 4 4 4 500X16 NGO Groups and Posters =8000 Onteraction Brokers etc. For Meeting Printing material s 10000

Grand Total 299000

171 Comments, if any:- i) Due to constant low ACDR-NSP-CDR and Low Case Referrals stress has been given for increase of this crtteria. ii) It is presume that ACMS Activities for the above will also boost the other criteria’s like lowering of default rates etc.

Prepared by:- i. Dr. J.B. Roy, DTO, Dhubri Sign. of DTO, Dhubri ii. Sri Patal Ch. Paul, Accountant, RNTCP, Dhubri . iii. Sri Biswajit Mazumder, DEO Dhubri.

Equipment Maintenance:

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

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

Office Equipment One each 5900 25000 50000 Ageing of the of equipments need (Maintenance includes computer Computer, frequent software and hardware upgrades, Photocopier maintenance. repairs of photocopier, fax, OHP etc) and OHP

Binocular Microscopes ( RNTCP) 21 State TB - 90000 Accurate cost can be Cell ascertain from State TB Cell.

140000

Training:

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

(Rs.)

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

Training of MOs 150 100 25 - 25 - 90000 90000 As ACDR, 25 NSP-CDR and Training of LTs of DMCs- 17 8 - - - 14000 14000 case referral is low so intensive Govt + Non Govt training, re- training has Training of MPWs ------been planned

172 - - - Training of MPHS, pharmacists, - - - - -

nursing staff, BEO etc

Training of Comm Volunteers - 275 25 25 25 25 - 60000

Training of Pvt Practitioners ------

Other trainings # ------

Re- training of MOs - - 25 - 25 - - 23000

Re- Training of LTs of DMCs 25 17 25 - - - - 14000

Re- Training of MPWs ------

Re- Training of MPHS ------

Re- Training of Pharmacists ------

Re- Training of nursing staff, ------BEO

Re- Training of CVs ------

Re-training of Pvt Practitioners 20 20 - 20 - - - 20000

TB/HIV Training of MOs 150 - - 25 - 25 - 42000 - - 25 - 25 - TB/HIV Training of STLS, LTs , - 30000 MPWs, MPHS, Nursing Staff, Community Volunteers etc

TB/HIV Training of STS ------

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

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

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

Total :Rs. 293000 # Please specify --

Vehicle Maintenance:

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

173 (Rs.)

(a) (b) (c) (d) (e) (f) 1. Supervision Four Wheelers 1 1 196500 100000 300000 intensified. 2. Ageing of the vehicle Two Wheelers 4 4 need frequent repairing / parts replacement etc.

Vehicle Hiring:

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

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

For DTO 1 1 Slightly more fund is required due to 68000 200000 320000 boat hiring and For MO-TC 4 4 vehicle hiring in South Bank bi DTO.

320000

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

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

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

ACSM Scheme: TB advocacy, Four NGOs in communication, and social separate areas mobilization covering 1 laqc population Nil 4 Nil Nil 37500 each. The areas are having low case detection problem.

SC Scheme: Sputum Three identified Collection Centre/s health institution are Nil 3 Nil Nil 180000 stuffed with patients, but difficult in communication.

Transport Scheme: Sputum Three identified Pick-Up and Transport Service health institution are Nil 5 Nil Nil 24000 stuffed with patients, but difficult in communication.

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

LT Scheme: Strengthening Two DMCs are RNTCP diagnostic services having no post Nil 2 Nil Nil 100000 of LT, suffering sue to shortage of LT.

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

Adherence scheme: Some areas are Promoting treatment identified as adherence high default Nil 3 Nil Nil 60000. areas despite regular supervision.

Slum Scheme: Improving TB District control in Urban Slums headquarter has many slum Nil 1 Nil Nil 50000 areas & high rate of incidence & prevalence of

175 TB Nil Nil Nil Nil Tuberculosis Unit Model Nil - Nil Nil Nil Nil TB-HIV Scheme: Delivering TB-HIV interventions to high Nil HIV Risk groups (HRGs) - 451500 TOTAL

Miscellaneous:

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

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

TA/DA 150000 400000 Stationeries / The 360750 257000 - expenditure which does not fall in any other heads of account

- 400000 * Please mention the main activities proposed to be met out through this head Miscellaneous under NRHM additionalities

Item No. requires Budget in Rs.

Plastic Handled Chairs for patients to sit at the 45 PHI DOT Centres. 6 chairs for 45X6=270 270XRs.500=135000 each PHI DOT Centre

Water Filter for patients at the 45 PHI DOT Centres 45X1+5 50XRs.500=25000 extra=50

Weight Machine for patients at the 45 PHI DOT Centres 45X1+5 50XRs.500=25000 extra=50

Steel Almirah 7 ft. height for each of the 45 PHI DOT Centre 45X1=45 45X8000=360000

One Steel Table (non secretariat) for each of the 45 PHI DOT Centre 45X1=45 45XRs.2000=90000

One Steel rack for each of the 45 PHI DOT Centre 45X1=45 45XRs.1000=45000

One Iron safe for keeping cash amounts, used and unused check books and 1 20000 other very important documents – only for DTC, Dhubri office. Total Rs. 700000

176

Contractual Services:

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

(Rs.)

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

Medical Officer- Not to be filled - - DTC

STS 4 4 - As per norms. STLS 4 4 - 1365000 640000 1285000

TBHV 1 1 -

DEO 1 1 -

Accountant – part 1 1 - time

Contractual LT 2 4

Driver 1 1 -

Printing:

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

(Rs.)

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

Printing* 360750 17000 60000 365000 As per Printing of Forms, population Patients Cards etc. norms.

* Please specify items to be printed Research and Studies:

Any Operational Research project planned (Yes) No. (Post Graduate grant for one research paper from each Medical College)

Estimated Budget (to be approved by STCS).______

177 Medical Colleges

Activity Amount permissible Estimated Expenditure for the Justification/ remarks as 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 - - -

- - -

Procurement of Vehicles:

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

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

4-wheeler ** 1 - - -

2-wheeler 4 3 150000 3 motorcycles will cross 6 years in the first Qtr.-2010.

The motorcycles are requiring frequent major repairing.

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

178 Procurement of Equipment:

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

(a) (b) (c) (d) 1 TF T Office Equipment 1 Computer Monitor 10000 For upgradation and (computer, modem, replacement of the scanner, printer, UPS 2 Printer 1 UPS 2500 existing system. etc) 1 UPS 1 Scanner 3500 1 Modem 1 Scanner

Any Other - One 50000 Due to frequent Generator Set. loadsheding District Society has already approved. One LCD 80000 projector The old projector is not working well and training and its programms are increasing accessories day by day. and Laptop 5 Digital 45000 cameras IEC awareness demands more photographs with quality pictures.

One for each TU , One for DTO

Procurement of Equipment under NRHM Additionalities

Note :- From the above procurement of equipment section, the column for “Any other” is sought from NRHM additionalities. So a total sum of Rs. 175000 has been requested in the NRHM Additionalities budget.

* Maintenance of Civil Work (Worksheet)

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

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

DMC - 20 - - 1000 X 20=21000 -

Drug Stores - 4 - - 1300X4=5200 -

DTC - 1 - - 4500 - Total 30700 -

179

Section D: Summary of proposed budget for the district – Budge t estimate for the coming Budget sought from Category of FY 2010- 11 NRHM additionalities S.No. (To be based on the planned 2010-11 Expenditure activities and expenditure in In Rs. Section C) in. Rs. 1 Civil works 61000 2170000 2 Laboratory materials 400000 3 Honorarium 300000 150000 4 IEC/ Publicity 299000 Equipment 5 maintenance 140000 6 Training 293000 7 Vehicle maintenance 300000 8 Vehicle hiring 320000 9 NGO/PP support 450000 10 Miscellaneous 400000 700000 11 Contractual services 1285000 12 Printing 365000 13 Research and studies 0 14 Medical Colleges 0 Procurement – 15 vehicles 150000 Procurement – 175000 16 equipment 191000 TOTAL 4954000 3195000 ** Only if authorized in writing by the Central TB Division

Grand Total :- Rs.( 4954000+ 3195000 ) - Rs.175000=Rs. 7974000

Please note :- if Rs,. 175000 is sanctioned from NRHM additionalities head- procurement of equipment, then this amount should be deducted from the procurement head of RNTCP budget which has been shown as Rs. 191000.

180 6.7.3 N.L.E.P.

Introduction District Dhubri is situated in the Western Part of Assam. It is the boarder District of Assam. It has 7 Block PHCs & having population of 18,43,113

Situation Analysis

As NELP has been integrated with GHC, drugs are available at CH/PHC/CHC/SDs, MO’s are diagnosing cases who have come voluntarily & NLEP staff is assisting GHC staff at every level as per need. Now, NLEP also integrated with NRHM & involvement & ASHA’s to be ensured for regular treatment. In addition, monitoring & supervision will become more effective. It is supposed that at each & every level, regular & repeated orientations of staff (both NLEP & GHC) are needed to provide quality services. As there are no survey activities, we have to initiate regular IEC activities in the community to decreases stigma & discrimination & to increase awareness. Strength :- 1. Trained District Nuclens staff.

2. Trained & motivated GHC staff.

3. Availability of Guidelines from State from time to time.

4. Availability of MDT.

5. Review & monitoring is being done regularly.

6. Fund stored be regular in time.

Weaknesses :- 1. NLEP & GHC staff at PHC/CHC/SHC/SD level are engaged more in other activities.

2. Inadequate mobility at PHC level & as well as non-availability of TA/DA.

Opportunity :- 1. Integration of NLEP with GHC staff

2. Integration with NRHM leading to better monitoring & supervision.

3. Valuable support of RCS by the GMCH/AMCH & SMCH.

181 Threats :- 1. Involvement of leprosy staff in other programmes.

2. NLEP staff posted improperly.

3. Frequently transfer of staff.

4. Low priority to NLEP staff at all level.

5. Priority to other programme Suggestion :- 1. Physical : The School Teacher of char areas (difficult area) to be trained in leprosy to facilitate detection of leprosy cases.

2. Financial : Easy & regular fund flow for the time bound activities.

Performance under NLEP : Indicator 2006-07 2007-08 2008-09 2009-2010 No. of new cases detected 32 47 51 37 up to Oct’09 (ANCDR) No. of cases on record at 76 73 70 87 the yearend (PR) No. of Gr.II disability X Nil Gr-8 1 among non cases (%) Gr-1 Treatment Completion 73% 55% 80% - Rate Re-construction Surgery X X X X conducted (Cumulative number to be mentioned & rate/percentage to be given on bracket).

Infrastructure : District HQ : District Nucleus Cell is in position & providing supervision & monitoring. Man power of District Nucleus Cell are 1. Medical Officer-1

2. Non-Medical Supervisor-1

3. Non-Medical Assitant-1

4. Contractual Driver-1

182 Training Plan : A. 4 days training of newly appointed MO’s (rural & urban) 30 nos.

Expenditures Details : Stationary 30 x 50 = 1,500 /- Lunch & Tea 35 x 100 x 4= 14,000 /- Total Cost TA & DA 30 x 300 x 4 = 36,000 /- 53,900 /- Trainer’s 2 x 300 x 4 = 2,400 /-

B. 3 days training of newly appointed Health Supervisor 30 nos.

Expenditures Details : Stationary 30 x 50 = 1,500 /- Lunch & Tea 35 x 75 x 3= 7,875 /- Total Cost TA & DA 30 x 160 x 3 = 14,400 /- 25,575 /- Trainer’s 2 x 300 x 3 = 1,800 /-

C. 3 days training of newly appointed Health Worker (M) 30 nos. Expenditures Details : Stationary 30 x 50 = 1,500 /- Lunch & Tea 35 x 75 x 3= 7,875 /- Total Cost TA & DA 30 x 120 x 3 = 10,800 /- 21,975 /- Trainer’s 2 x 300 x 3 = 1,800 /-

D. 3 days training of newly appointed Health Worker (F) 30 nos. Expenditures Details : Stationary 30 x 50 = 1,500 /- Lunch & Tea 35 x 75 x 3 = 7,875 /- Total Cost TA & DA 30 x 120 x 3 = 10,800 /- 21,975 /- Trainer’s 2 x 300 x 3 = 1,800 /- E. 2 days training of newly appointed MO’s 30 nos. Expenditures Details : Stationary 30 x 50 = 1,500 /- Lunch & Tea 35 x 100 x 2 = 7,000 /- Total Cost TA & DA 30 x 300 x 2 = 18,000 /- 27,700 /- Trainer’s 2 x 300 x 2 = 1,200 /-

F. 5 days training of newly appointed Lab. Technician 15 nos. Expenditures Details : Stationary 15 x 50 = 750 /- Lunch & Tea 15 x 75 x 5 = 5,625 /- Total Cost TA & DA 15 x 120 x 5 = 9,000 /- 18,375 /- Trainer’s 2 x 300 x 5 = 3,000 /-

183 IEC Plan : a. Inter Personal Workshop Communication @ 6,000 /- x 2 nos = 12,000 /- b. Folk Show @ 3,000 /- x 7 Nos = 21,000/- c. Wall painting @500/- x 50 Nos = 25,000 /- d. Advocacy meeting @500/- x 30 Nos = 15,000 /- e. Publicity through TV, Radio, Newspaper etc = 10,000 /- Total Cost f. Rallies @ 5,000/- x 1 No. = 5,000/- 1,25,000 /- g. Health Mela @ 3,000/- X 50 Nos = 9,000/- h. I.P.C. meeting @ 500/- x 50 Nos = 25,000/- i. Meeting with Zila Parisad @ 3,000/- x 1 No. = 3,000 /-

DPMR : a. Procurement of M.C.R. @200/- x 120 Pairs = 24,000/- b. Patients welfare Blanket @300/- Total Cost x 100 Nos = 30,000/- 79,000 /- c. For R.C.S. of BPL cases incentive for 5 cases @ 25,000/- each = 25,000 /-

Urban Leprosy Control : Nil Leprosy colonies : Nil Procurement Plan : a. Purchase to be made as per drug list (guideline)

b. Need base purchase to be done.

c. Equipments - Not necessary.

d. Printing Register/Forms etc. to be printed as per need.

e. No such specific NGO is existing in the District.

Incentive for ASHA : a. Number of ASHA trained & involved in NLEP – 1327 nos.

b. Number of Neno PB & MB cases likely to be detected during the year by ASHA based on the trend of New case detection – 50 Nos.

NLEP Monitoring & Review Plan : a. Review meeting has been conducted montly.

b. Monitoring & supervision works has been done regularly.

184 Vehicle operation & hiring : 2 (two) vehicles are operating Office expenditure & consumable : Stationeries & other Misc. Expenditure which does not fall in any other Head of Acctt. Format for submitting budget Proposal : Sl. Activity Proposal Amount Proposed No. 1. Contractual Services 54,000 /- District one Driver @ 4,500/-PM x 12 months 2. Services through ASHA/USHA 25,000 /- Sensitization of ASHA/incentive to ASHA 3. Office expenses & consumables 40,000 /- 4. Capacity Building (Training) 4 days training of newly appointed MO (rural & urban 53,000 /- ) 3 days training of newly appointed Health worker & 69,525 /- Health Supervisor 2 days refresher training og MO 27,700 /- 5 days training of newly appointed Lab. Technician 18,375 /- 5. Behaviours change communication (IEC) 1,25,000 /- Mass media, outdoor media, Rural media & Advocacy 6. POL/Vehicle operation & hiring 80,000 /- & vehicle at state level & vehicle at district level 7. DPMR 30,000 /- MCR footwear, Aids and appliances, welfare 12,500 /- allowances to BPL patients for RCS support to Govt. 2,50,000 /- Institution for RCS 8. Materials & supplies 52, 000 /- Supportive drugs, Lab reagent & equipment & printing forms. 9. Urban leprosy control Do not arises Township, Medium cities-I, Medium cities-II & Mega cities 10. NGO-SET scheme 50,000 /- 11. Supervision, Monitoring & Review 50,000 /- Review Meeting & Travel expenses Cash Assistance 6,000 /- Total = 9,43,100 /-

185 6.7.4 N.P.C.B.

Goal : Reduce prevallence of preventablle Bllindness

ACTION PLAN 2010-11

STRATEGY ACTIVITY Sub -Activity TIME Responsible PERIOD Persons Weekly Cataract Procurement of Drugs, Weekly Superintendent Cataract Surgery Eye Operation at Sharp Instruments, IOL, Two days D.O.S. at base Hospital Civil Hospital, Consumables etc. operation D.P.M. Approach Arrangement of Beds etc. Development of Development of O.T. Fortnightly Jt.D.H.S., Eye Operation Placement of Instruments Eye Camp D.O.S. & Facility at CHCs Deployment of Staffs D.P.M. Intensive IEC Eye Screening at Sub-centers PMOA & Eye Screening and Activities and by the PMOA on fixed day April-March D.P.M. Detection of Cataract Blindness Survey every week 20010-11 Cases at Sub-Canters Inform the targeted Population by ASHA through Health Day Door to Door Survey at 30nos Apr-May-June D.P.M. Blindness Survey Villages/Towns / 2010 D.O.S. 6000 houses Development of Make Provision for Room in Development of Infra- Vision Centres at consultation with the i/c M.O. April-May D.P.M. -structural facility for 2010 Vision Screening at Mankachar CHC Procurement & Placement of PHC/CHC where S.Salmara CHC Equipments & Furnitures Ophth. Asstt. posted Orientation Training July D.P.M. Training & Vision of School Teachers 2010 Screening at Schools Popularization of Screening & detection School Eye Screening of RE to the remote Programme area with Mobile May –Nov/10 D.P.M. Vision Testing Van Feb – Mar/11 Distribution of free Spectacles to the School Children Orientation Meeting Sensitization Meeting Aug /2010 D.P.M. Popularization of Eye at all 7 BPHCs With all M.O./ ANMs etc Donation & Eye Care Awarness Meeting & IEC Activity & organisa Aug–Sept D.P.M. Eye Screening Camps -tion of Eye Checkup 2010 at 14 Development camps Blocks

186 Budget Under NPCB for 201011 STRATEGY ACTIVITY Sub-Activity Cost per Unit Total Cost Weekly Cataract Procurement of Drugs, @ Rs. 750/- Eye Operation at Consumables, Sutures, etc. For 800 oprns. 6,00,000.00 1. Cataract Surgery Civil Hospital @ 9 at base Hospital Oprn. Per day for 2 Procurement of Sharp Lump-sum 40,000.00 Approach O.T. day for 45 weeks , Instruments etc. Vision Screening at 100 Training of 100 School 2. School Eye Schools @ 200 students Teachers Details 25,000.00 Screening Programme each 7% defective Refraction of 20000School Visit by PMOAs @ Rs.20/- each Students i.e. 1400 students for confirWith Vision Testing Van for 1400 students 28,000.00 -matory camps 30% Refrective Error of 1400 Nos. i.e. @ 200/- each for 420 nos. students for distribu- 420 students 84,000.00 tion of Free Spectacles 3. Procurement of Development of Eye Development of O.T. Equipmernts Operation Facility at Placement of Instruments Lump-sum 5,00,000.00 Dhubri Town Health Instt. Deployment of Staffs 4. Development of Development of Vision Make Provision for Room in Vision Centre: Cerntre where O.A. posted consultation with the in- 50,000/- each 1,00,000.00 1. Mankachar CHC charge M.O. 2. South Salmara CHC Procurement & Placement of Equipments & Furnitures Printing of Forms, Blind @ Rs.50/-each 5. Eye Screening and IEC Activities Register, Leaflets, For IEC and 15,000.00 Detection of Cataract Stationeries Cases at Sub-Canters Eye Screening at Sub-centers by the Organisation & Rs. 200/- for 58,000.00 PMOA on fixed day Contingencies Organization Every week Exp. of at 290 Health Instt. Door to Door Survey at 30nos 15/- Blindness Survey Villages/Towns per house 90,000.00 6000 houses Orientation Meeting Sensitization Meeting at all 7 BPHCs With all M.O.s/ BPMU/ @ Rs. 3000/- 21,000.00 6. Popularization of BEEs/ ANMs Eye Donation & Eye Awarness Meeting & IEC Activity at 20 nos @ Rs. 1,500/- Care Eye Screening Camps Of Health Institutions Each for 20 30,000.00 at 14 Development With Flaxo banners H.Institutions Blocks Salary Support of DPM=1 96,000/- 7. District Health Dealing MANAGEMENT Society Asstt.= 1 18,000/- 114,000.00 OF District Health 20,000.00 Society TA/DA of the Staff Lump-sum

Maintenance of Ophth. Equipments Lump-sum 16,000.00 Contingency & Other Activities 30,000.00 Total 17,71,000.00

187

6.7.5 INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP)

Proposed activities schedule for DSU/ IDSP/ Dhubri DHAP:: 2010 11

1. 3 days training for newly inducted Medical Officers on IDSP. 2. 2 days training for Health Workers. 3. 3 days training for Laboratory Technicians/ Microscopist at District Laboratory. 4. Weekly online transmission of S, P & L Forms. 5. Dissimilation of Early Warning Out Break Responses. 6. Supervision and Monitoring of Peripheral Surveillance Units. 7. Activities on International Health Regulation ( IHR ) Focal Point (daily basis online reporting of H1N1 Influenza Status).

Working plan for above proposal:

Sl No Initiatives Number of batches to be trained Venue

I Qtr II Qtr III QTR IV QTR

1 3 days training for 1 batch 1 batch MO( newly inducted officers ) for a batch at DSU of 20 trainees. 2 2 days training for 5 5 5 5 batches Block PHC Health Workers for a batches batches batches Premises batch of 20 trainees.

3 days training for 1 batch 1 batch at District 3 Laboratory Laboratory. Technicians/ Microscopist for a batch of 20 trainees. 4 Supervision and 6 Nos of 6 Nos of 6 Nos of 6 Nos of at PSU Monitoring of visits at visits at visits at visits at Peripheral PSU PSU PSU PSU Surveillance Units

188 INTEGRATED DISEASE SURVEILLANCE PROJECT. BUDGET BREAK UP OF VARIOUS HEAD, DHUBRI DISTRICT.

( RS IN LAKHS )

Sub - Tasks Unit Cost No of 2010-11 Remarks activity Units 1. Staff 1.1 Epidemiologists 30000 Salary 1.2 Microbiologists 20000 1.3 Entomologist 20000 1.4 Consultant ( Finance ) 14000 1.5 Consultant ( Training ) 28000 1.6 State Data Manager 14000 1.7 District Data Manager 13500 12 162000 1.8 Data Entry Operator 8500 12 102000 1.9 Accountant 9500 12 114000 already appointed & 1.10 Administrative Assistant 7000 12 84000 working as per Govt. guidelines the said post may be continued with IDSP. Sub Total 462000 2.Training 2.1 Training of Hospital 36500 2 73000 Doctors 2.2 Training of Hospital 15500 20 310000 Pharmacist/ Nurses 2.3 Training of Laboratory 23500 2 47000 Technicians/ Microscopist Sub Total 430000 3. 3.1 Mobility Support, 5800 12 69600 Operational 3.2 Office Expenses 5000 12 60000 Cost 3.3 ASHA incentives for 100 120 12000 Outbreak reporting 3.4 Collection and 3000 12 36000 transportation of samples 3.5 IDSP reports including 500 12 6000 alerts 3.6 Printing of IDSP Forms 2000 12 24000 3.7 Broadband Expenses 1000 12 12000 Sub Total 219600 4. New 4.1 Review Meeting District 5000 2 10000 Innovations Committee Grand Total 1121600

( Rupees eleven lakhs twenty one thousand six hundred only)

189 6.7.6 National tobacco Control Programme (NTCP)

National Tobacco Control Programme (NTCP) was launched in the year 2007-08 as pilot programme in 18 districts covering 9 states of India and Assam is one of the Sate. At present the programme is running in 42 districts covering 21 states of the country.

The Basic Objective of the NTCP: 1. To Build up Capacity of the District to effective implementation the Anti Tobacco Initiatives 2. Skill development of the Health and Social Workers 3. To take up appropriate IEC/BCC and mass awareness campaign 4. Introducing NTCP agendas in School Health Programme 5. To set up a regulatory mechanism to monitor 6. Implement the Anti Tobacco laws farmed by Government 7. To establish Tobacco Cessation Centres 8. To conduct Global Adult tobacco survey for surveillance

Proposed Activities: 1. District Tobacco Control Cell will be set up, one Psychologist and One Social Worker will be appointed on the Contractual basis. All the activities will be carried under the supervision of DPMU NRHM 2. Phase wise training will be conducted for BPM, BEE, HE & LHV and MNGO members. 3. Awareness cum sensitisation meeting with Civil Society group such as Women SHG, NGOs, ULB’s and PRI’s, School teachers, health workers, law enforcers etc. IEC materials will be developed. 4. Special Talk show on Anti Tobacco, awareness rally, quiz etc will be arranged with School Health Progarmme. 5. For effective implementation of NTCP at grass root level frequent monitoring is required, hence monitoring plan will be developed. 6. For enforcement of anti-tobacco law awareness regarding the following specification provision will be increased: a. Ban on Smoking in public in public places b. Ban on sale of tobacco products to children bellow 18 years c. Ban on direct/indirect advertisement promotion and sponsorship of tobacco products d. Ban on sale of tobacco products within 100 yards of the educational institutions e. Mandatory depicition of Specified health warning on all tobacco products f. Testing of tobacco products for tar and nicotine.

190 7. Under the supervision of the Psychologist and Social Worker a Tobacco Cessation Centres will be established at Dhubri Civil Hospital, Dhubri. 8. For find out the actual status of the district Global l Adult tobacco survey will be conducted.

Proposed Budget for District Tobacco Control Programme (NTCP)

Sl.No Components Calculation (Rs) Total (Rs) Salaries: 10000 X 12 months 1 I). Psychologist: Rs.10, 000/- per month 216,000 8000 X 12 months ii). Social Worker: Rs. 8,000/- per month

2 Training 200,000 200,000

3 IEC Activity 200,000 200,000

4 School Activity 400,000 400,000

Monitoring of Tobacco Control Laws & 5 100,000 100,000 Reporting

6 Contingency 100,000 100,000

Total 12,16,000/

191 6.7.7 National Mental Health Programme

It is estimated that 6-7% of population suffers from mental disorders. Together these disorders account for 12% of the global burden of diseases (GBD) and an analysis of trends indicates this will increase to 15% by 2020 (World Health Report, 2001). Most of them (>90%) remain un-treated. Poor awareness about symptoms of mental illness, myths & stigma related to it, lack of knowledge on the treatment availability & potential benefits of seeking treatment are important causes for the high treatment gap. As present there 123 nof of district has been covered under District Metal Health Programme.

Strategy: 1. Enhancing the capacity of the mental health infrastructure to serve a greater number of Service seekers. 2. Improving the quality of services in custodial institutions and developing innovative approaches in non-custodial settings. 3. Initiating research that would provide information on planning and implementing appropriate services. 4. Manpower development.

Proposed Activities: 1. Enhancing the Capacity of the Mental Health Infrastructure

a. Increasing the number of mental institutions b. Increasing the service capacity of individual institutions c. Integrating mental health with general health

1. One district Counselling Centre will be established 2. Crisis Helpline will be set up 3. Regular Counselling session will be organized in Colleges, Work Place, necessary arrangement will be made for stress management. 4. Thought DHMP it to be ensured that basic mental health services are being provided at the community level. 5. Necessary support staff (Clinical Psychologist, PSWs, Psychiatric Nurses etc )will be engaged on purely contractual basis. 6. Required medicines will be supplied to all health institutions. 7. IEC materials like handbook, Leaflets, Picture Chart etc will be developed. 8. Contingency for running the DMHP will be released to BPHC wise.

Total Budget proposed under Mental Health Programem during 201011 is Rs. 5,00,000.00

192 6.8 PART E: CONVERGENCE

Intersectoral Convergence

Intersectoral Convergence is a vital component of National Rural Health Mission. The main aim of convergence is to facilitate integration of various services to meet simultaneously the various felt needs in diversified areas of the targeted groups. One of the main objectives of convergence is the coordinated delivery of some or all services in view of the complementarily of their objectives.

Inter Sectoral Convergence with PHE:

Proposed Activities: • A district level convergence Meeting with PHE department will be organized to streamline the TSC (Total Sanitation Camping). • After the district level meeting similar Block level meeting with block officials will be organized at Block level. • Under VHSC fund an amount of Rs. 3000/- is meant for construction of sanitary toilet. The fund will be handed over to PHE department by respective VHSC for further course of action. • Flex Hoarding Board BPHC wise 10 nos will be developed and installed • IEC materials like Poster, leaflets etc will be developed and distributed . Inter Sectoral Convergence with Education Department: Activity already done: • District level convergence meeting held with SSA on 30 th October 2009 at SSA office Dhubri and finalized the programme. • Initially 100 nos of Schools were selected for the programme. • Block level Convergence meeting with SSA officials has been organized and strategy is prepared. • Now as per action plan School Health Awareness Programme in 100nos of School is going on successfully.

Proposed Activity: • In the next financial year another 100 nos of School will be selected for School Health Programme. • School Teacher of the Selected School will be trained in phase wise. • Health Awareness video will be screen in all the selected schools. • IEC materials life Picture Chart will be developed for School students. • Quiz, Essay writing & Art computations etc will on Health related subject will be organized.

Total Budget proposed under Convergence during 201011 is Rs. 2,00,000.00

193 Chapter – 7 HMIS & Monitoring and Evaluation

As per letter of MD, NRHM, Assam vide no. NRHM/MIS/DO/121/09-10/19833-59 dt. 13 th Nov’09, the District Health Socety, NRHM, Dhubri has designated the following officiares as Nodal Monitoring and Evaluation Officer in addtiona to their noram responsibilities for strengthening monitoring and evaluation activities and to serve single point of contact for all health related M&E information. The following officer is as follows –

Present Designation New Designation District Data manager and District Nodal M & E District Data Manager Officer Block Programme Manager and Block Nodal Block Programme Manager M & E Officer

It has also ensured that District Programme Officers (RCH, RNTCP, NVBDCP, NLEP, UIP, IDSP etc) should endorse a copy of the compiled data to the Nodal M&E Officer at each level i.e District & Block level and should cooperate with newly designated Nodal M&E Officer at each level for builing up the integrated health database.

Data Uploading in the Web Portal District Nodal M&E officer is responsible for uploading regaular HMIs data in the HMIS portal. All programme officers are cooperating with the District Nodal M&E Officer to upload data correctly, completely and regularly.

Data quality It has also ensured that the data before uploading in the HMIS webportal should be verified properly.

Monitoring & Evaluation Monitoring and Evaluation is the backbone of any programme. Monitoring may be done for ongoing activities for effective implementation of any programme and the impact should be assessed through proper evaluation of the activities initiated under NRHM . To achieve the desired outcome it is mandatory to conduct review at all level; i.e. from District level to Block level at regular intervals in a systemic manner. The required Mobility Supports for the officers who will be entrusted with the job of monitoring and supervision would also be under this component of the programme. As new reporting formats would be introduced, it has been decided that all the officers and staff who will be involved in the programme would be adequately trained and assigned so that there will be no communication gaps and the desired out come would be reach at the District in due time.

194 Monitoring 1. District Health Mission (DHM)

District Health Society (DHS) At District Level

DHS Secretariat (District Programme Committee for Programme Management Support various health programmes Unit (DPMSU)

DISTRICT MONITORING TEAM

Block Health Committee

At Block Level Hospital Management Society of Block PHC/CHC

Village Health Committee

Impact evaluation will be conducted with the help of internal/external agencies as per the need of the programme. The main aim of NRHM is to provide accessible, affordable and quality health care to the

rura population to reduce Maternal Mortlity Rate(MMR), Infant Mortality Rate(IMR), Total

Fertality Rate(TFR) and minimize disease burden (viz- Gastroenterities/Malaria/TB etc). This will

be possible only when all Institutions from Sub-Centre upto District Hospital can be made

functional in true sense. Monitoring is the only way to know whether the institutions are functioning

or not and also to identify the gaps in Infrastructure, Manpower, Equipments, Instruments and

other Logistics. Monitoring can be done by four ways

1. Direct Observations using checklists (Different Checklist for different Institutions) 2. Reviewing and analyzing HMIS reports 3. Taking to the Community (interaction) 4. Conducting PHC level review meeting

195 Approaches of Monitoring

1. Monitoring from District level

As per the letter of MD, NRHM, Assam vide no. NRHM/DOC/557/07-08/6685-6711 dated

26.6.08, A District Monitoring Team has been constituted with the following members : -

1. Joint Diretcor of Health Services cum Member Secretary, DHS, Dhubri

2. Addl CM & HO (FW), Dhubri

3. DIO, Dhubri

4. SDM & HO (HQ), Dhubri

5. DPM, DME, DAM, DDM, Dhubri

6. SDM & HO (PH)/JSY Nodal Officer, Dhubri

The Institution to be monitored by District team: District Hospital, SDCH, FRU, CHC, 24x7

PHC, Block PHC and Cross monitoring of the institutions monitored by Block PHC

Sources of Information to be taken during monitoring: Reports, OPD/Indoor Register,

Attendance Registers, Drugs Stock Regsiter and Other registers maintained by the concerned institutions, FMR, Minutes of the meeting etc and Special tools like case studies/diary. Recorded

Observations, One-on-One Interview, Focus Group Discussion, Sample Survey Recording etc.

Through Monitoring we can

- Review Progress - Identifying Problems in Planning and/or Implementation - Make adjustments to make a difference. The District Monitors will do monitoring and supervision as per allotted BPHC and as per quarterly plan and submit the monitoring report to the Joint Director of Health Services cum member secretary, DHS, Dhubri in 1 st week of every month on the basis of Check list so that remedial measures can be taken.

196 2. Monitoring from Block level A block level monitoring team has also constituted to monitor vaious health programmes under NRHM in their respective Blcok PHC area. The Team consist of SDM& HO/In-Charge of BPHC, Sectoral MO, BPM, BAM, Asst BPM, BEE etc. During 2010-11, it will be ensured that the team will carry prescribe checklist of monitoring and submit the detail report to the in-Charge of Block PHC with a copy to Dist. HQ. The copy of the monitoring report will be send to each MPHC/SHC/SD/SC with feedback and suggestion for improvement . 3. Monitoring Micro Plan In order to stream line of monitoring system it will be ensured during 2010-11, that each BPHC will prepare a micro monitoring plan and submit to the District and also stick to the monitoring Micro Plan and submit report to the District HQ. It will be ensured that the District monitoring team will do the monitoring and supervision as per quarterly micro monitoring plan as enclosed herewith. Quarterly Micro Monitoring Plan of District Monitoring Team

Jan’10 Feb’10 Mar’10 Designation Sl No of Official Name of Institution Name of Institution Name of Institution to be visited to be visited to be visited Mankachar CHC, Chapor FRU, Halakura CHC, Sukchar MPHC, Salokocha SHC, 1 JDHS, Dhubri Agmoni CHC, Satrasal Sadullabari SHC, Bahalpur SD, MPHC, Boterhat SD Kakripara SD, Champabati MPHC Jhawdanga SD Mankachar CHC, Chapor FRU, Halakura CHC, Addl. CM & Sukchar MPHC, Salokocha SHC, Agmoni CHC, 2 HO (FW), Sadullabari SHC, Bahalpur SD, Satrasal MPHC, Dhubri Kakripara SD, Champabati MPHC Boterhat SD Jhawdanga SD

Dumurdaha MPHC, Jaruwa MPHC, Dhepdhepi MPHC, Gauripur CHC, Chirakuti MPHC, 3 DIO, Dhubri Moterjhar MPHC, Geramari MPHC Fakirganj MPHC, Bherbhangi SD, Medartari SD Kachokhana SD,

Bilasipara SHC, Dumurdaha MPHC, Sapatgram SHC, Chapor FRU, Dhepdhepi MPHC, SDM & HO Santipur MPHC Salokocha SHC, 4 Moterjhar MPHC, (HQ), Dhubri Lakhiganj SD, Bahalpur SD, Bherbhangi SD, Futkibari SD, Champabati MPHC Kachokhana SD, Bogribari SD

197 Dumurdaha MPHC, Halakura CHC, Jaruwa MPHC, Dhepdhepi MPHC, SDM & HO Agmoni CHC, Chirakuti MPHC, 5 Moterjhar MPHC, (PH), Dhubri Satrasal MPHC, Fakirganj MPHC, Bherbhangi SD, Boterhat SD Medartari SD Kachokhana SD,

Bilasipara SHC, Mankachar CHC, Sapatgram SHC, Sukchar MPHC, DPM/DDM, Gauripur CHC, Santipur MPHC 6 Sadullabari SHC, NRHM, Dhubri Geramari MPHC Lakhiganj SD, Kakripara SD, Futkibari SD, Jhawdanga SD Bogribari SD Bilasipara SHC, Jaruwa MPHC, Sapatgram SHC, DME/DAM, Chirakuti MPHC, Santipur MPHC Gauripur CHC, 7 NRHM, Fakirganj MPHC, Lakhiganj SD, Geramari MPHC Dhubri Medartari SD Futkibari SD, Bogribari SD

198

Apil’10 May10 June’10 Designation Sl No of Official Name of Institution Name of Institution Name of Institution to be visited to be visited to be visited Bilasipara SHC, Dumurdaha MPHC, Sapatgram SHC, Chapor FRU, Dhepdhepi MPHC, Santipur MPHC Salokocha SHC, 1 JDHS, Dhubri Moterjhar MPHC, Lakhiganj SD, Bahalpur SD, Bherbhangi SD, Futkibari SD, Champabati MPHC Kachokhana SD, Bogribari SD Bilasipara SHC, Dumurdaha MPHC, Chapor FRU, Sapatgram SHC, Addl. CM & Dhepdhepi MPHC, Salokocha SHC, Santipur MPHC 2 HO (FW), Moterjhar MPHC, Bahalpur SD, Lakhiganj SD, Dhubri Bherbhangi SD, Champabati MPHC Futkibari SD, Kachokhana SD, Bogribari SD Mankachar CHC, Chapor FRU, Halakura CHC, Sukchar MPHC, Salokocha SHC, Agmoni CHC, 3 DIO, Dhubri Sadullabari SHC, Bahalpur SD, Satrasal MPHC, Kakripara SD, Champabati MPHC Boterhat SD Jhawdanga SD Dumurdaha MPHC, Mankachar CHC, Halakura CHC, Dhepdhepi MPHC, Sukchar MPHC, SDM & HO Agmoni CHC, 4 Moterjhar MPHC, Sadullabari SHC, (HQ), Dhubri Satrasal MPHC, Bherbhangi SD, Kakripara SD, Boterhat SD Kachokhana SD, Jhawdanga SD

Halakura CHC, Jaruwa MPHC, SDM & HO Agmoni CHC, Gauripur CHC, Chirakuti MPHC, 5 (PH), Dhubri Satrasal MPHC, Geramari MPHC Fakirganj MPHC, Boterhat SD Medartari SD

Jaruwa MPHC, Mankachar CHC, Sukchar MPHC, DPM/DDM, Chirakuti MPHC, Gauripur CHC, 6 Sadullabari SHC, NRHM, Dhubri Geramari MPHC Fakirganj MPHC, Kakripara SD, Medartari SD Jhawdanga SD

Bilasipara SHC, Jaruwa MPHC, DME/DAM, Sapatgram SHC, Gauripur CHC, Chirakuti MPHC, Santipur MPHC 7 NRHM, Geramari MPHC Fakirganj MPHC, Lakhiganj SD, Dhubri Medartari SD Futkibari SD, Bogribari SD

199

July’10 Aug10 Sept’10 Designation Sl No of Official Name of Institution Name of Institution Name of Institution to be visited to be visited to be visited Bilasipara SHC, Jaruwa MPHC, Sapatgram SHC, Gauripur CHC, Chirakuti MPHC, Santipur MPHC 1 JDHS, Dhubri Geramari MPHC Fakirganj MPHC, Lakhiganj SD, Medartari SD Futkibari SD, Bogribari SD

Jaruwa MPHC, Mankachar CHC, Addl. CM & Sukchar MPHC, Chirakuti MPHC, Gauripur CHC, 2 HO (FW), Sadullabari SHC, Geramari MPHC Dhubri Fakirganj MPHC, Kakripara SD, Medartari SD Jhawdanga SD

Halakura CHC, Jaruwa MPHC, Agmoni CHC, Gauripur CHC, Chirakuti MPHC, 3 DIO, Dhubri Satrasal MPHC, Geramari MPHC Fakirganj MPHC, Boterhat SD Medartari SD

Dumurdaha MPHC, Mankachar CHC, Halakura CHC, Dhepdhepi MPHC, Sukchar MPHC, SDM & HO Agmoni CHC, 4 Moterjhar MPHC, Sadullabari SHC, (HQ), Dhubri Satrasal MPHC, Bherbhangi SD, Kakripara SD, Boterhat SD Kachokhana SD, Jhawdanga SD Mankachar CHC, Chapor FRU, Halakura CHC, Sukchar MPHC, SDM & HO Salokocha SHC, Agmoni CHC, 5 Sadullabari SHC, (PH), Dhubri Bahalpur SD, Satrasal MPHC, Kakripara SD, Champabati MPHC Boterhat SD Jhawdanga SD Bilasipara SHC, Dumurdaha MPHC, Chapor FRU, Sapatgram SHC, Dhepdhepi MPHC, DPM/DDM, Salokocha SHC, Santipur MPHC 6 Moterjhar MPHC, NRHM, Dhubri Bahalpur SD, Lakhiganj SD, Bherbhangi SD, Champabati MPHC Futkibari SD, Kachokhana SD, Bogribari SD Bilasipara SHC, Dumurdaha MPHC, Sapatgram SHC, Chapor FRU, DME/DAM, Dhepdhepi MPHC, Santipur MPHC Salokocha SHC, 7 NRHM, Moterjhar MPHC, Lakhiganj SD, Bahalpur SD, Bherbhangi SD, Dhubri Futkibari SD, Champabati MPHC Kachokhana SD, Bogribari SD

200

Oct’10 Nov’10 Dec10 Designation Sl No of Official Name of Institution Name of Institution Name of Institution to be visited to be visited to be visited

Dumurdaha MPHC, Mankachar CHC, Halakura CHC, Dhepdhepi MPHC, Sukchar MPHC, Agmoni CHC, 1 JDHS, Dhubri Moterjhar MPHC, Sadullabari SHC, Satrasal MPHC, Bherbhangi SD, Kakripara SD, Boterhat SD Kachokhana SD, Jhawdanga SD

Mankachar CHC, Chapor FRU, Halakura CHC, Addl. CM & Sukchar MPHC, Salokocha SHC, Agmoni CHC, 2 HO (FW), Sadullabari SHC, Bahalpur SD, Satrasal MPHC, Dhubri Kakripara SD, Champabati MPHC Boterhat SD Jhawdanga SD Bilasipara SHC, Dumurdaha MPHC, Chapor FRU, Sapatgram SHC, Dhepdhepi MPHC, Salokocha SHC, Santipur MPHC 3 DIO, Dhubri Moterjhar MPHC, Bahalpur SD, Lakhiganj SD, Bherbhangi SD, Champabati MPHC Futkibari SD, Kachokhana SD, Bogribari SD Bilasipara SHC, Jaruwa MPHC, Sapatgram SHC, SDM & HO Gauripur CHC, Chirakuti MPHC, Santipur MPHC 4 (HQ), Dhubri Geramari MPHC Fakirganj MPHC, Lakhiganj SD, Medartari SD Futkibari SD, Bogribari SD Jaruwa MPHC, Mankachar CHC, Sukchar MPHC, SDM & HO Chirakuti MPHC, Gauripur CHC, 5 Sadullabari SHC, (PH), Dhubri Geramari MPHC Fakirganj MPHC, Kakripara SD, Medartari SD Jhawdanga SD

Halakura CHC, Jaruwa MPHC, DPM/DDM, Agmoni CHC, Gauripur CHC, Chirakuti MPHC, 6 NRHM, Dhubri Satrasal MPHC, Geramari MPHC Fakirganj MPHC, Boterhat SD Medartari SD

Bilasipara SHC, Dumurdaha MPHC, Sapatgram SHC, Chapor FRU, DME/DAM, Dhepdhepi MPHC, Santipur MPHC Salokocha SHC, 7 NRHM, Moterjhar MPHC, Lakhiganj SD, Bahalpur SD, Bherbhangi SD, Dhubri Futkibari SD, Champabati MPHC Kachokhana SD, Bogribari SD

4. Reports and Returns It will be ensured during 2010-11 that DH/BPHC/CHC/PHC/Sc will submit the report as per New HMIS format.

201 5. Review meetings a.District Review Meeting : It will be ensure that District Review meeting on 6 th to 7 th Day of the month after receiving HMIS report from all Block PHC/SDCH/DH.

The DPM will collect all the minutes of BPHC Level review meeting and prepare asummary note. The agenda and agenda note will be prepared by DEMO/Dy. DEMO & DPM inconsultation with Addl. CM&HO(FW) and Joint DHS.

All Program Officers of the District/ DMO/ All SDM& HO I/C BPHC/ Superintendent Civil Hospital & SDCH/ Medical Officers from MMU & Boat Clinic/ DIO/Addl. CM & HO(FW) / CM & HO (CD)/ Principal ANM/GNM School/ District Programme Manager/ District Accounts Manager/ District Media Expert/ District Data Manager/ i/c MO District Drugs Store/District Drugs Store Manager/ AE/Junior Engineer (Construction)/ District CommunityMobilizer/ Computer Assistant / Data Entry Operator cum Office Assistant, District Drugs Store,etc will attend the meeting.

The minutes of the meeting will be recorded by the person entrusted by Joint DHS. Minutes must be submitted to Mission Director, NRHM, Assam along with presentation of the report analysis and monthly reporting format for review meeting (Annexure I).

The attendance registered is to be maintained regularly by obtaining signature Institution wise so that absentees can be identified to take necessary action.

Routinely the following are the points of discussion:- 1. At the Onset of the meeting - The Chairperson (Joint DHS) will read out the minutes of the last review meeting along with the action taken report. He will also discuss the salient points of last District Health Society meeting

2. HMIS Report – DEMO/DPM will present analyzed HMIS Report and will announce the names of the reporting units from where reports were not received. Reporting month means from 1 st day to last day of the month (i.e., 1 st to 30 th / 31 st / 28 th / 29 th ) as the case may be.

They will also point out the Reporting Units submitting incorrect HMIS Report, so that reports are received Timely, Regularly, & Correctly. Performance of all health institutions of the Districts must be analyzed for all health indicators including ANC, Institutional Delivery, JSY, PNC, Immunization, Family Planning, VHND, Majoni, Mamoni, etc. District will identify the low performing areas for various Programmes like ANC,Institutional Delivery, JSY, PNC, Immunization, Family Planning, VHND, Majoni, Mamoni, etc to find out the cause of low performance and action to be taken.High performing Block PHC/ Health Institutions should be appreciated at the meeting. Soft copy and hard copy of the presentation of report analysis should be submitted to Mission Director, NRHM, Assam along with the minutes and Monthly Reporting Format for Review Meetings (AnnexureI).

202 3. Internal Monitoring Report – Joint DHS will discuss Institution wise gaps identified during monitoring by the District Monitoring Team and Action Plan is to be prepared in the meeting itself to minimize the gaps. Monitoring Report should be submitted to Mission Director, NRHM, Assam. Commonly identified gaps in respect to performance are as follows :-

Activities Target Performance during Cumulative since the reporting month April No. of PW receiving 3 ANC No. of High risk PW/PW with Complication in Antenatal Period referred No. of Institution Delivery conducted No. of JSY Beneficiaries No. of Health and Nutrition Day Organized No. of fully Immunized Infants No of ASHA incentive given for full immunization DPT 1 to DPT3 No. of Dropout Infants from DPT 1 to Measles No. of Dropout Infants from Contraceptive Distributed a) Nirodh b) Oral Pill c) E Pill No. of IUCD inserted No. of Mini lap performed No. of Laparoscopic Sterilization performed No. of NSV performed No. of MTP performed

203 4. Status of Medicine/Contraceptive/Logistic – District Drug Store Manager (NRHM) will present his/her monitoring report and will discuss how uninterrupted supply of Medicine/Contraceptive/Logistic to all the Institutions can be ensured.

5. Status of Manpower – Health Institution wise status of Manpower (Doctor/ GNM/ ANM/ Lab Tech/ Pharmacist / etc) will be reviewed in the review meeting and gap analysis with action taken proposed will be recorded in the minutes.

6. Fund utilization - DAM will present Institution wise utilization of Fund bearing in mind that there should not be any backlog for payment of JSY incentive to Mother & ASHA. Guideline for utilization of untied, maintenance and RKS Fund is to be discussed thoroughly.

7. Civil work - Junior Engineer/ Asst. Engineer allotted for the District is also to be invited to the meeting to present status of Civil Works in entire District.

8. Feed back from the participants - The participants need to express their problems in implementing activities under NRHM and also to share their success stories.

9. UIP DIO will present the Routine Immunization Report PHC wise and will announce the name of the PHCs lagging behind in performance and action to be taken to improve the performance. He/She will also discuss about Immunization week/ Pulse Polio/ Cold Chain Status whenever it is necessary.

10. NVBDCP/RNTCP/NLEP/NBCP/IDSP/IDDCP - The Program Officer of the concern Program will present the performance report along with action taken report to improve the performance.

11. Discussion on implementation of DHAP (District Health Action Plan) - The DPM will highlight the quarterly activities to be performed by District as ear marked in the work plan of DHAP.

12. Status of in service training – DPM will collect the status of in service training imparted in the District at various sites of the District. At present the trainings are as follows :-

Training Name Load Achievement Cumulative (Since April) SBA at District Hospital IMNCI by a Nodal Officer IUCD by Expert Master Trainer Mini lap Training at District Hospital Laparoscopic Sterilization Training at District Hospital MTP Training at

204 District Hospital 3 days Routine Immunization Training by DIO/ Addl. CM & HO (FW) Neonatal Restabilization Training

13. Functioning of District Hospital/SDCH/FRU/ 24 x 7 PHC – In charge of these Institution will present there Functional Status and Action Plan is to be prepared to minimize the gaps

14. Orientation Hour - All circulars, guidelines received from the State (MD, NRHM/ DHS/GoA) during the reporting month are to be discussed thoroughly by Chairman and responsibility is to be fixed for implementation. New Programmes introduced should also be discussed in the meeting.

15. Miscellaneous - Any other issues which are considered as important are to be discussedin the meeting.

The District review meeting will have impact over implementation of NRHM only when follow up actions are taken by the Joint DHS & Addl. CM & HO(FW) & All Program Officers. b. Block Level Review Meeing :

The Block PHC Review meeting is to be organized monthly by all Block PHC on 2 nd to 4 th Day of every month after receiving HMIS Report from SC/SD/MPHC/SHC/CHC/FRU.

The agenda and agenda note will be prepared by BEE & BPM in consultation with MO i/c Block PHC.

All Sr MO from each institution, BPM/ BAM/ BEE/ Computor/ HE/ LHV/ Store In charge/ ANM, Male worker, under the Block PHC will attend the meeting.

One representative from District Level will also attend the meeting.

The minutes of the meeting will be recorded by the person entrusted by (MO I/C Block PHC). Minutes must be submitted to Jt. DHS of the district with a copy mark to Mission Director, NRHM, Assam.

The attendance registered is to be maintained regularly by obtaining signature Institution wise so that absentees can be identified to take necessary action.

Routinely the following are the points of discussion:-

1) At the Onset of the meeting - The Chairperson ( MO I/C BPHC) will read out the minutes of the last review meeting along with the action taken report.

205

2) HMIS Report - BEE & BPM will present analyzed HMIS Report and will announce the names of the reporting units from where reports were not received. They will also point out the Health Institution submitting incorrect HMIS Report, so that reports are received Timely, Regularly, & Correctly.

Performance of all health institutions (CHC/MPHC/SHC/SD/SC) under the jurisdiction of the Block PHC must be analyzed for all health indicators including ANC, Institutional Delivery, JSY, PNC, Immunization, Family Planning, VHND, Majoni, Mamoni, etc.

BPHC will identify the low performing areas for various Programmes like ANC, Institutional Delivery, JSY, PNC, Immunization, Family Planning, VHND, Majoni, Mamoni, etc to find out the cause of low performance and action to be taken. High performing Block PHC/ Health Institutions should be appreciated at the meeting.

3) Internal Monitoring Report - MO I/C Block PHC will discuss Institution wise gaps identified during monitoring by Block & District Monitoring Team and Action Plan is to be prepare in the meeting itself to minimize the gaps. Commonly identified gaps in respect to performance are as follows :-

Activities Target Performance during Cumulative since the reporting month April No. of PW receiving 3 ANC No. of High risk PW/PW with Complication in Antenatal Period referred No. of Institution Delivery conducted No. of JSY Beneficiaries No. of Health and Nutrition Day Organized No. of fully Immunized Infants No of ASHA incentive given for full immunization DPT 1 to DPT3 No. of Dropout Infants from DPT 1 to Measles No. of Dropout Infants from Contraceptive Distributed d) Nirodh e) Oral Pill f) E Pill No. of IUCD inserted No. of Mini lap performed No. of Laparoscopic Sterilization performed No. of NSV performed No. of MTP performed

206

4) Status of Medicine/Contraceptive/Logistic - The Pharmacist (NRHM) will present his/her monitoring report and will discuss how uninterrupted supply of Medicine/Contraceptive/Logistic to all the Institutions can be ensured.

5) Fund utilization - BAM will present Institution wise utilization of Fund bearing in mind that there should not be any backlog for payment of JSY incentive to Mother & ASHA. Guideline for utilization of untied, maintenance and RKS Fund is to be discussed thoroughly.

6) Civil work - Junior Engineer/ Asst. Engineer allotted for the District is also to be invited to the meeting to present status of Civil Works in entire Block PHC Area.

7) Feed back from the participants - The participants need to express their problems in implementing activities under NRHM and also to share their success stories.

8) UIP/NVDCP/RNTCP/NLEP/NBCP/IDSP/IDDCP - SMO other than In- charge Block PHC is to be given responsibilities to implement these National programmes. He/She will present the performance report of these program in the meeting.

9) Discussion on implementation of Block Health Action Plan - The BPM will highlight the quarterly activities to be performed by BPHC as ear marked in the work plan of BHAP.

10) Status of in service training – DPM will collect the status of in service training imparted in the District at various sites of the District. At present the trainings are as follows :- No of persons trained Training Name Others Docotr GNM ANM LHV (Pleasespecify

11) Orientation Hour - All circulars, guidelines received from the District during the reporting month are to be discussed thoroughly by Chairman and responsibility is to be fixed for implementation. New Programmes introduced must be discussed in the meeting. Subject of orientation will depend upon the findings of monitoring. It may be regarding functioning of Sub-Centre/ 24x7 PHCs/ORT corner /Adolescent Clinic/ MMU/Boat Clinic/ Innovative Scheme.

12) Miscellaneous - Any other issues which are considered as important are to bediscussed in the meeting.

The Block PHC review meeting will have impact over implementation of NRHM only when follow up actions are taken by the MO I/C Block PHC.

207 6. Capacity Building on New HMIS format and Registers for Block Official During 2010-11, One day capacity building workshop will be done at District Level to BPM/BEE/LHV/UE/Computor etc on New HMIS format and Regsiters. 7. Internet connectivity at Blcok Level: During 2010-11, 7 nos. Block PHC, 1 CHC, 1 DH and 1 MC will be ensured that the establsiment of Internet connection at Block PHC so that the sub-district level data can be uploaded to the Ministry Web Portal.. It will also help to establish better communication between District and Block PHC and save time, money and energy spend for communication and report submission. 8. Procurement of HW/SW and Other equipments. During 2010-11, As the electricity is available in Bherbhangi SD, (PHC Acct =1), Bogribari SD (PHC Acct Proposed=1) and Dhubri Health & Maternity Centre (PHC Acct Proposed=1), 3 nos. computers will be proposed for 2010-11 at Bherbhangi SD, BogribariSd and Dhubri Health & maternity Centre.

Budget Allocation Sl Major Head Minor Head Budget in Rs. Details Remarks No Salaries of M&E, MIS & Data Budgeted under RCH and 1 - - Entry Operator NRHM additionalities Stregtening of 2 M&E/HMIS Mobility for M&E Officers 2460000 3 M&E studies - - Hardware & Software 4 200000 - Procurment of Procurement 5 HW/SW and Internet connectivity 100000 - 6 other Annual maintenance 300000 Equipments Printing and Computer 7 150000 Stationary Review of Existance Register 8 to make them compatibe with 50000 - National HMIS Operationalising Printing of New 9 - - HMIS at Sub- Resgiters/Forms District Level Capacity Building on New 10 HMIS format and Registers 50000 for Block Official Total 3310000

208 Chapter – 8 Work Plan

Sl. 1st 2nd 3rd 4th Responsible WORK PLAN No. Qr Qr Qr Qr Person

A RCH PROGRAMME

MATERNAL HEALTH

S-1. Early registration of Pregnancy Proposed Activities:-

a.Training of 1726 nos of ASHA on early detection and registration of Pregnancy in the Sub Centre area.

b. Identification of Pregnant Women and registration will be ensured by ASHA as early as possible taking help of urine examination for Pregnancy test by using of NISHYA KIT.

c. Regular supply of Pregnancy Test Kit will be ensured to all 1726 nos. of ASHAs and 456 nos. of ANM

d. Village Health & Nutrition Day in 1500 villages of the District will be used as a platform for motivating and mobilizing the women for early registration of pregnancy.

A1 e. The District under “Assam Bikash Yojana” has implemented “Mamoni”-Nutrional food for pregnant women where a pregnant women after her first registration receives a hand book on nutrional food and MCH card. On her 2 nd checkup, a cheque of Rs. 500/- is given as monetory support for nutrional food and on her 3 rd checkup, another cheque of Rs. 500/- is given & Jt.DHS/Addl. HO/DPMU/DIO CM and a voucher for referral transport.

S2. To provide quality antenatal care to all pregnant woman by increasing the access through existing Govt. facilities.

Proposed Activities :

a. It will be ensured that all the existing 246 Sub- Centres will be procure requisite equipments from the SC untited fund and it wil be equipped BP instruments, weighting mahine and examination table.

209 b. Regular supply of IFA tablet, TT injection and Hb Kit wil be ensured in all 246 Sc & 41 Health Inst (SD/MPHC/SHC/CHC/FRU/BPHC/UHC/SDCH/DH) c. In all the SC it will mandatory that ANM will perform regular checkup of BP, weight and Hb test of all the registrated pregnant women and will keep a upto date record in the MCH register and tickler chart for follow up with the help of ASHA d. Re Orientation Training of 456 nos. of ANM Block PHCwise in a batch of 30 on physical examination of pregnant women, Hb estimation and record keeping. e. Out of 246 SC functioning in rented building & Govt. dilapidated building, 58 nos SCs already taken up for construction during 2007-08, another 20 new SCs has been approved during 09-10 @ Rs. 7.5 lakhs and 70 nos. new SC will be proposed for construction for increase provision of quality antenatal care. (Annexure -A) f. The sanctioned vacant posts of ANM will be filled up through regular appointment by the State Govt. Total sanctioned post vacant under Addl CM & HO(FW) establishment =87 and JDHS establish=11 g. As per the report there are total 376 nos.of ANM in the district in the SC. The total requirement for the district @ 2 ANMs per SC (excluding outreach area) is 116. Therefore the total contractual ANMs for the year 2010-11 will be 116

S.3. To provide quality antenatal care to all pregnant woman in inaccessible and uncovered areas.

Proposed Activities: a. The uncovered and inaccessible areas under South Salmara, Birsing Jurwa, Fekamri, Jamadarhat and Mankachar Development block (Total No of Char Village=325, & Char Population=4,35,063) has been identified to provide ANC coverage regularly. A total 50 nos. of out reach post will be constructed @ Rs. 0.75 lakhs in Char areas to increase provision of quality antenatal care. The Out reaches post are deigned for the flood prone and reverine areas as these can be relocated and dismantled as per the requirement of the environment.

210 b. The contractual ANM may be posted under NRHM @ 2 ANMs per Out reach post (in 325 outreach area- Char). Total requirement is 100 ANM. c.Logistic supply will also be regularized d. Special camp to be organized to cover uncovered inaccessible areas by mobile medical team & Boat Clinic. S4. To increase awareness amongst the mothers and communities about the need of ANC. Proposed Activities: Communication strategies like street play, FGD, awareness meeting will be done laying emphasis on marriage after 18 years, first child after 20 years, need of ANC, birth preparedness and importance of hospital delivery to increase awareness amongst the mothers and communities about the need of ANC and exclusive breast feeding.

S1. Increasing the access through facility strengthening. Proposed Activities: a. To strengthen the institutional delivery, the district has upgraded and taken up to 3 no.s BPHC , 1 nos. CHC, 1 nos. Maternity Centre, 6 nos. MPHC, 4 nos. SHC and 11 nos. SD to 24x7 hr delivery services during 05-06 to 09-10, Out of which the construction work has completed in 18 nos. Health Institutions and providing 24x7 hr delivery services and the construction work is going on in 8 nos. of health institutions. b. Again during 2009-10, fund has been received for 3 nos. Health Institutions for upgradtion of 24x7 hr delivery services with maternity wards and are in process. c. As per facility survey there is a requirement of 21 nos. labour table, 21 nos. of Stand light, 10 nos. Radiant warmer, 13 nos. Auto clave, 19 nos. Electric Sterilizer, 19 nos. backup

Generator set including other logistics for 24x7 hr delivery services for quality services. The institutionwise detailed requirement is enclosed herewith as Annexure B d. Contractual engagement of 4 MO (MBBS), 4 MO (Ayur) and 49 GNM will be done in 24x7 PHCs deficient in manpower. The institutionwise detailed requirement is enclosed herewith as Annexure C

211 e. The repairing and renovation of PHC Quarter of Jhowdanga SD, Bherbhangi SD, Dumardaha MPHC,

Moterjhar SD & Kachokhana SD will be taken up during 2009-10 so as to ensure that MO stays in Quarters. f. During 10-11, 15 nos. SC has been proposed for taking up the Institutional Delivery at Folimari, Islamari, Barunitara, Simlabari, Adabari, Silairpar, Gharialdanga, Ranpagli, Borkanda, Chotogiraipar, Ratidaha, Rakhalpat, Kanuri, Fekamari and Baghapara SC. As per facility survey the gaps interms of infrastrucre and equipments/furniture have to be full filled during 2010-11. g. 57 nos. GNM. 10 nos. LHV and 53 nos. ANM has already trainined on Skilled Birth Attendent (SBA) at Civil Hospital, Dhubri till Nov, 2009-10 another 24 nos. of GNM, and 12 nos. of ANM will be trained on SBA on priority basis to improve the quality of services.

S-3. Social mobilization for institutional deliveries (Janani

Suraksha Yojana) Proposed Activities: a. The district will continue with Janani Suraksha Yojana, wherein all the pregnant woman will be given incentives for institutional deliveries till Nov, 09, the JSY beneficiaries in the District are 10485, out of 11366 Institution deliveries.

b. For the Year 2010-11, the total Pregnant Women estimated are 52041, this year the district proposed to increase the institution delivery from existing level to least 50%. c. The ASHA accompanying the pregnant woman for hospital delivery will also be given monetary incentive under this Scheme as per GoI guidelines. d. For developing the practice of institutional delivery age bar and order of pregnancy will not consider any more.

S-4. Referral of obstetric emergencies Proposed Activities:

212 a. Village to Health facilities Most of the parts of the district is backward and covered by char area and most of the Pregnant women donot come to health facilties for delivery because of of non availitbility of transportation facility from village to health institution. In this areas the means of communication are bullock carts, hand pull carts, private vehicles and boats which are available on hire. So the district proposed for providing transportation facility to the pregnant women from village to Health Institution including char areas. The Projected Institutional Delivery for 2010-11 is 26020, In these backward, referral transport money will be provided to Prgenant women (expected Pregnant women living in this backward area =10408 and Char areas 5204) coming for Institutional Delivery under following categories

b. Health Institution to Health Institution The Pregnant women and Sick New Born requiring referral to higher institutions will be transported from one Health Institutions to another using ambulance available in the health facility.

S-1. To improve the comprehensive EmOC in the CHCs and

FRU. Proposed Activities: a. Construction of CHC to IPHS Standard has been completed for Chapor, Mankachar Halakura and Gauripur CHC in Dhubri district and required manpower will be provided during 2010-11 as per IPHS for comprehensive EmOC. b. It will also be ensured to fill up all gaps in terms of logistics and equipments during 2010-11 for operationalizing these health facilities c. 4 nos. of Specialist in each discipline of O&G, Pae, Anae, Surgeon, and Radlogist etc will be reqcruited on contract basis for 4 nos. IPHS institution

Multi skilling training- 4 nos. MO (MBBS) will be trainined at GMC for Anesthesia & 4 nos. MBBS doctors will be trained at SIHFW for EmOC to make 4 nos. of CHC functional for comprehensive EmOC. d. Ensure post partum care at Village level by

ASHA/AWW/ANM S-1: Ensure post partum care at Village level by

ASHA/AWW/ANM Proposed Activities:

213 a. The AWW/ANM/AHSA of 246 SCs of Dhubri district will pay 3 post partum visit (1st within 2 days, 2nd within 14 days and 3rd within 42 days) in respetive sub-centre areas and the activity will monitor by BPM/BAM/Asstt BPM. b. During Village Health and Nutrition Day, the mothers will be motivated on essential newborn care, early and exclusive breast-feeding and adopting family planning practices by ASHA/ANM S-2: Ensure post partum care at PHCs and Higher Health

Institution Proposed Activities: a. It will ensure that the mother stays for 48 hrs after delivery in the Health Institutions so that necessary care can be taken if any complication arises and maternal mortality can be reduced. b. During their stay they will be counseled about essitential New Born care, Early & Exclusive Breast feeding and Adopting Family Planning practices.

S-1. Increase the access to safe abortion in Govt. facilities.

CHC/DH Proposed Activities: a. District Civil Hospital and CHC will be strengthened to provide facilities for diagnosis and treatment of RTI/STI. The PHC however will focus on syndromic approach and drugs will be provided for the same. However, complicated cases will be referred to higher institutions. b. RTI/STI Kit will be provided to DHs and 5 nos. of CHCs of

Dhubri District c. The Laboratory in the DHs, and CHCs will be provided with requisite logistics (drugs and kits) twice a year.

214 S-2 Capacity building ANM/SN and Medical Officer & Lab

Tech for managing RTI/STI Proposed Activities: a. ANMs (14)/ LHV(7), GNM (14) and Doctors (10) & Lab Tech (6) will be trained in the SIHFW, Guwahati in phase manner. S-3. Promote communication activities for prevention and

early care seeking for RTI/STI Proposed Activities: a. Communication activities will be developed laying emphasis on symptoms of RTI, STI, and facilities available in

the block area of diagnosis & treatment. The activity is budgeted under BCC/ IEC.

6.4.2 : CHILD HEALTH

S-1 ; Implementing Integrated Management of Neonatal &

Childhood Illeness Proposed Activities

a. 13 nos. Medical Officer, 3 nos. Nursing Staff and 2 CDPO

has completed the ToT on IMNCI at SIHFW, Guwahati

b. The district will organize 8 days training on IMNCI for 1791 nos. of AWW workers and 455 nos. of ANM in

batchwise (24 partcipant per batch) as per training plan and providing IMNCI Kits and followup. S-2: Strengthening of the Govt facilities to provide

newborn care. Proposed Activities : A2 a. During 2008-09, fund has been received @ Rs.4.2 lakhs for establishment of 4 Bedded Neonatal Stabilization Unit at Dharmasal BPHC, Golokganj BPHC, Raniganj BPHC, Gazarikandi BPHC, Chapor CHC, Gauripur CHC, Halakura CHC, Agomani CHC, Mankachar CHC, 20 Bedded MC, Sapatgram SHC and Bilashipara SHC and the work is in progress. Jt.DHS/Addl. CM & HO/DPMU/DIO/DME & Jt.DHS/Addl. HO/DPMU/DIO/DME CM b. Again during 2009-10, fund has been received @ Rs.4.2 lakhs for establishment of 4 Bedded Neonatal Stabilization Unit at Salokcha SHC, Dhepdhep MPHC, Satrasal MPHC, Tamarhat MPHC and Lakhiganj Sd and the work yet not started c. During 2010-11, the Neonatal Stabilization Unit of Dhubri districts have to make functional by providing logistics and manpower.

215 S-3. Capacity building of Doctors and Nurses on Basic Neo

Natal Resuscitation training Proposed Activites : a. The District TOT on Basic Neonatal Resuscitation technique has completed for 24 nos. Medical Officer, 2 nos. Sister Tutor, 2 nos Staff Nurse and 4 nos LHV at Dhubri b. Block level training of 48 nos of Doctors and 74 nos. of GNM’s of 24 x 7 PHC’s will be done on Basic Neo Natal

Resuscitation techique batchwise (30 nos. participant per batch) as per training plan. S-1. To increase awareness amongst mothers on benefits of breast-feeding upto 6 months and need of complementary feeding from 6 month onwards. Proposed Activities: a. IEC/BCC activities will be developed laying emphasis on early feeding of colostrums, exclusive breast-feeding of 6 months and importance and preparation of complementary feeding from 6 months onwards. b. Village Health and Sanitation Committees, SHG may also be involved for motivating pregnant women and lactating mothers to promote exclusive breast feeding c. ASHA will counsel the mothers on the importance of exclusive breastfeeding and complementory feeding. d. During VHND, pregnant women and lactating mothers are to be motivated for exclusive breast feeding.

S-1. To raise awareness amongst mothers and communities on diarrhea ARI. Proposed Activities: BCC/ IEC activities will be developed laying emphasis on use of HAF, continuing breast-feeding, solid feeds, ORS usage, and identification of danger signs of diarrhea and ARI. (To be included under BCC/ IEC). S-2. Making ORS and zinc tablets available in remote/rural/tribal areas and difficult to reach areas through depot holders. Proposed Activities: a. The refresher training of ASHA and AWW will be done on usage of ORS and Zinc tablets. b. ASHA/AWW will made depot holder for distributing ORS packates. The ASHA kit and SC Kit-A have ORS packats. The supply of AHSA Kit and SC Kit-A twince in a year will be ensured. The AWW will also be provided ORS packats.

216 c. Performance of the depot holders and replenishment of the stock shall be reviewed by the PHC MOs/ BPM quarterly and arrangement for readily available stock of ORS to the depot holders shall be ensured from the BPHC

S-3. Strengthen facilities at PHC, CHC, SDH and DH. Proposed Activities: a. Fund @ Rs. 25000/- has been received for establishment of 13 nos ORT corner in DH, PHCs, CHCs, SDH and SHCs of

Dhubri District. Out of which fund has been utilized for establishment of 10 nos of ORT Corner in the District. b. During 2010-11, the remaining fund has to be utilized for establishment of ORT coner in different identified Health institutions of the district. c. The health facilities will be provided with required drugs and kits S-4. Promote referral services of severe cases of ARI and diarrhoea. Proposed Activities: a. The VHND will be used as platform to bring awareness amongs the mothers and communities about warning signs of diarrhoea and ARI. b. The health functionaries will be given reorientation training for detection of ARI and Diarrhoea cases requiring referral. S-1. To prevent and treat anemia in children. Proposed Activities: a. The pregnant women and mothers will be counseled by ASHA/AWW/ANM about importance of exclusive breastfeeding upto 6 months, importance of complementary feeding from 6 months onwards and preparation of iron rich food. b. Regular supply of IFA (s) tablets will be ensured to treat anemia. c. Children below 6 months to 60 months will be given 20 mg. elemental iron and 100 gm of folic acid in liquid formulation. d. Under School Health Programme weekly distribution of IFA tablets to Girls and Six monthly distribution of Albendazole for de-worming by the the Nodal School Teacher. The School teacher will ensure that the girls will consume IFA tablets infront of her. e. It will be ensure that each school should have one fix day for IFA distribution with minimum absenteeism.

217 S-1. To work closely with ICDS functionaries to reduce

malnutrition. Proposed Activities: a. Emphasis will be laid to reduce malnutrition amongst the children (3 – 6 years) by working with ICDS functionaries and augmenting the mid day meal programme S-1. To prevent and treat Vitamin-A deficiency and de-

worming campaign among children . Proposed Activities: a. Vit-A will be made available in all the institutions till the Sub-Centre level and administration of Vitamin-A upto 5 years of age will be ensured. b. VHND held every month in the village will also be used as

a platform for Vit-A administration. c. In 2010-11, 2 rounds of Vitamin –A week campaign

alongwith de-worming May, 2010 and December, 2011.

FAMILY PLANNING

S1. To raise awareness amongst the couples and communities about the advantage of contraceptives and small family. Proposed Activities: a. Communication messages will be printed about importance of FP and availablity of FP services alongwith

incentive offered and distibuted to ASHA/ANM/AWW (Details in IEC/BCC plan) b. IEC materials will be dirtributed to the community by ASHA/AWW/ANM in VHND alongwith Family Planning

counseling for eligible couple for adopting family planning methods. A3 c. During Home visit on Moday and Thursday ANM & ASHA will update eligible couple register and motivate the couple to adopt FP methods as per choice of the couple

d. BCC/IEC activities will be done with help of AWW, ASHA, Woman’s SHGs, FNGOs as per need of the locality to raise

awareness amongst the couples and communities about the advantage of contraceptives and small family. Jt.DHS/Addl. CM & HO/DPMU/DIO/DME/FP Cordinator Cordinator CM & Jt.DHS/Addl. HO/DPMU/DIO/DME/FP

e. During Health Day disadvantages of early marriage (too early, too many and too frequently) are to be explained

especially to adolescent girls with the help of opinion and religious leaders of the village.

218 f. One separate room will be allotted where ANM/GNM will conduct counseling session’s alongwith distribution of contraceptive/IEC materials etc. in District Hospital, CHCs and BPHCs, MPHCs. SHCs, SDs during OPD hours.

S2. Increase the number of service delivery points. Proposed Activities: a. ASHA will act as a depot holder for Condom, Oral Pill and E-Pill and regular replenishment of the contraceptives on exhaustion is to be ensured during 2010-11. b. 13 nos. of Doctor, 17 nos. of GNM, 29 nos. of ANM and 9 nos. of LHV has completed the TOT on inerstion of Copper-T 380A at Dhubri. c. Training of 30 MO/ 120 ANM/ 40GNM on IUD Insertion will be done as per training Plan during 2010- 11.(Annexure……..) d. The IUCD Kit received during 2009-10 alredy distributed where training imparted another 100 nos of IUCD kit will be required during 2010-11. e. On Tuesday and Friday of every week Family planning services including IUD Insertion (after training of 120 nos ANM in Govt.Building) are to be provided in all the Govt.

Building Sub Center of the District under the supervision of LHV/Doctor will be ensured. Family planning counseling will also be done alongwith. f. Fixed day family IUD insertuion along with family planning counseling will be ensured at DH/FRU/CHC/BPHC/PHC. g. The women will be provided Rs. 20/- as per GoI guidline under RCH progrogramme for each IUD insertion, Budget under RCH flexipool. S3. Improve the service delivery to provide quality female sterilization. Proposed Activities: a. The District Hospital, CHC/FRU will be equipped with requisite infrastructure and logistics are to be provided Laparoscopic sterilization. (Annexure E) b. Fixed day sterilization (Lap. Camp) in the facilities twice in every week in the District Hospitals and once in Chapor CHC/FRUs will be ensured. c. Female sterilization in every 2 months in 4 CHCs, 3 BPHCs and 1 SDCH by camp approach will be ensured.

219 d. 1nos. of SDCH, 4nos. of CHC and 3 nos. of BPHC will be provided with OT table and Boyles Appeartus for Laprascopic Sterilization. e. DH/FRU/4nos. of CHC/1nos SDCH/3 BPHCs will provided with Co2 Gas Cylinder for Laprascopic sterilization. f. Training of 4nos. Medical Officers, 4nos. of OT boys on

Co2 gas technique as per training Plan. g. Medical Termination of Pregnancy, MTP will be ensured at DH/CHC/FRU/BPMC/MPHC/SHC after imparting training to 15 MOs and after providing MVA Kits received during 09- 10 h. PPS will be ensured at District Hospital, Chapor FRU and

Gauripur CHC where PPS surgeon & Mini Lap Kits available. i. The beneficiaries will be given incentive for Female sterilization as per GoI guidline. S4. Encouraging Post partum Sterilisation scheme. Proposed Activities: a. JSY Beneficiaries are to be motivated for accepting Post Partum Sterilization and refer the acceptor to FRU/CHC/DH where PPS can be done at every level. b. The JSY beneficiary adopting female sterilsation will get compensation money of Rs. 600.00. Moreover the scheme also provides for Rs. 150.00 motivation fee for ASHA and AWW respectively.

S1- To raise awareness among the community regarding

Non Scalpel Vasectomy. Proposed Activities: a. One day District level workshop will be organized by the Addl CM & HO (FW) incordination with District Administration. Zila Parishad (PRI) members, DIPRO, Teachers, Opinion leaders, Social activist, NGO of NYK etc.to sensitize them on the importance and promotion of NSV. b. Similar workshop will be organize at Block PHC Level involving chaired by BDO for teachers, Openion leaders, religious leaers, PRI members etc to sensitize them on on the importance and promotion of NSV. c. IEC material like Hand bill, Brochure, Leaf lets etc on NSV will be developed d. BPHC wise outdoor publicity material on NSV like Hoarding, Bill Board, Flex Banner etc will be install in Public gathering areas

220 S2- To improve the service delivery to provide Non Scalpel

Vasectomy Proposed Activities:

a. At the BPHC level one NSV camps cum training for MOs will be organized registering at least 20 acceptors of NSV. One trainer from the Medical College or two trainers from

District will attend the workshop. This camp will be organizded in each 7 Block PHCs of Dhubri District monthly. In the workshop MOs from PHC wil be trained.

b. The train MO of the Block and Master trainer of the District will attend to perform NSV sterilization in each Block and compensation money will be paid as per GoI guidelines.

6.4.4 : ADOLESCENT HEALTH

1. School Health Programme (Details under Intersectoral Convergence) 1. Adolcent Clinic in the Health Institutions Proposed Activities: a. Fund has been received for establishment of Adolescent Health Clinic in 10 nos. of BPHCs/CHCs of Dhubri district and

Out of which 6 nos. of Adolcent Health Clinic has been established.

b. During 2010-11, the remaining 4 nos. of Adolescent Health Clinic has to be established and to make functional already established Adolcent Health Clinic in true sense.

c. IEC & BCC activities will be developed laying emphasis on A4 normal physiology, menstrual hygiene, use of CC, OC, EC,

unwanted pregnancy, safe abortion, child marriage, various risk of teenage pregnancy etc. Jt.DHS/ DPMU Jt.DHS/ d. Identification of adolescent groups and numbers of organized and drop out sectors through school health

programmes and at the village level during regular home visit by ANMs by maintaining a register.

e. Counseling sessions will be held at regular intervals at fixed sites for both adolescent boys and girls separately. Counseling will be provided on the health days.

f. Alolescents will be supplemented with 30 mg elemental

iron and 250 mcg folic acid per day for 100 days in a year

221 g. Special counseling and on the spot provision of IFA tablets

to adolescent girls in order to prevent anaemia.

h. District will arrange training of School teachers on the

basic knowledge of adolescent health.

6.4.5 URBAN RCH

S1 Institution strengthening through creation of Urban Health Centres Proposed Activities:

During 2009-10, the District has started the Urban Health Centre, Rail Gumti area covering 30,000 population of the District and is providing following services.

• OPD services, 4 hrs in the morning and 2hrs in the evening

A5 • Provding services like counseling services basic laboratory services, collection and reporting of vital events and IDSP and services for non Communicable diseases.

• It will conduct health camps in the areas under the UHC to generate awareness in the community.

During 2010-11, 3 nos of Urban Health Center is to be Officer Health & JDHS/SDM HO/Urban established in the urban slums of Dhubri namely, at 1) Bahdur Tari, 2) Dabry and 3) Choto Harishaba. During 2010-11 the Urban Health Centers have to make

functional by providing manpower and logistics.

6.4.6 VULNERABLE GROUP

S-1: Promoting Boat Clinic for char areas of Dhubri, District

Proposed Activities: a. Antenatal Care services by Boat Clinic A6 b. Postnatal care services by Boat Clinic c. Family Planning services d. Routine Immunization

e. Curative care Clinic/DPMU

f. Basic Laboratory Services. of In-Charge Boat

NRHM Additionalities S-1: Strengthening Village Health and Sanitation B Committees (VHSC).

Proposed Activities

222 a. For the development of the villages of Dhubri district wherever there is an ASHA Village Health & Sanitation Committee has been formed as per NRHM guideline. In

Dhubri district 1310 nos of VHSC has formed and open bank account and out of which 1300 nos of VHSC has received an amount of Rs.10,000 as Untied Grant. b. During 2010-11, additional 380 nos of VHSC has to be formed in the left out villages of the district where additional ASHA has been selected and have to open the bank account for Untited Grant c. Capacity building of the 1690 VHSC members is proposed during 2010-11 through MNGO/NGO including importance and preparation of Village Health Plan. d. During 2010-11, the Village Health Action Plan of each

VHSC will be ensured. e. The VHSC will be responsible for the overall health of the village. It will take into consideration of the problems of the community and the health and nutrition care providers and suggest mechanism to solve it f. The committee will monitor all the health activities that are conducted in the village such as Village Health & Nutrition Day, Mothers Meeting etc. g. VHSC along with the ANM will be responsible to conduct household survey in the village. h. It will discuss every maternal or neonatal death that occurs in their village, analyze it and suggest necessary action to prevent such deaths. Get these deaths registered

in the Panchayat. DPMU/SDM & School HO Health/Nodal Officer-JSY/ASHA i. During emergency like flood or any epidemic the committee will utilize the fund for the relief camps or supplies such as in case of flood it can supply Halogen tablet for purification of water, ORS, Bleaching powder etc.

S-2: Observing Village Health & Nutrition Day Proposed Activities During 2010-11, Observation of VHND will be ensured every month in each villages of Dhubri District by ASHA/AWW/ANM in the Awganwadi Centre where services like ANC, PNC, Immunization by ANM and Health Education and awareness will be provided by ASHA/AWW/BEE/LHV/ANM etc.

223 Procurement of Examination table, BP Instrument, Weighing machine etc will be ensured in the newly formed VHSCs out of VHSC fund for successful observation of VHND.

Involvement of VHSCs members will be ensured during

2010-11 in each VHND. The Contigency fund of Rs. 100 for observing VHND will be provided out of VHSC fund. Organizing Health Melas. Proposed Activities:

3 nos. of Health Melas has been organized during 2009-10 with objective to provide an easy to accesss platform for health services for all segments of population of the District.

During this Health Melas extensive IEC on Malaria, Family Planning, TB, Blindness, AIDS, Leprosy, Water & Sanitation etc. was done.

During 2010-11, similar Health Mela will be organized in

Malaria prone area of the District. Rs 5 lakhs for is proposed for organzing Health Mela during

2010-11. S-1 . Selection, Training and support to ASHAs Proposed Activities: a. The selection and training of 1340 nos of ASHAs of Dhubri has completed 5th Module Training. b. The selection of Additional 380 nos of ASHA has also completed in the left out villages of the District. c. During 2010-11, 1st, (Induction Training), 2nd, 3rd, 4th & 5th Module training of 380 nos ASHAs will be ensured. (No fund is proposed as fund already received) d. Also refresher training is to be imparted to 1340 nos. of

ASHAs who have completed 4th module training e. 380 nos of Radio Set, Umbrella and Bag is proposed during 2010-11 for 380 nos of additional ASHA. S-2 : Providig ASHA Drug Kits Proposed Activities: Durig 2010-11, 1726 nos of ASHA Drug Kits is proposed for

1726 nos. of ASHA of Dhubri District

Proper utilization of Drug Kit will be enusred during 2010-11 under the supervision of ANM and Sectoral MO.

S-3 : ASHA Facilitator Proposed Activities:

224 During 2009-10, 176 nos. of ASHA Supervisor has been selected for 7 BPHC of Dhubri District ie. 1 supervisor for 10 ASHAs to handhold and monitor the ASHA activities.

During 2010-11, these facilitators has to be trained on ASHA programme under NRHM and also on field level monitoring to be done so that they have an overview of various on going programmes under NRHM. The proposed training will be conducted through District ToT ASHA Facilitator.

Honorarium including TA/DA of ASHA facilitator will be provided as per norms S-4: Incentive to ASHAs for Full Immunization Proposed Activities:

The District will continue for providing incetive of Rs. 250/- to ASHAs for each fully immunized child as this increases the full immunization coverage rate of the District as the ASHAs after BCG will keep a track of the infants in her village as she is from the same village and will accompany the mother to the sub-centre to vaccinate the infant.This will also help the

ANM in tracking/vaccinate the infants as there are instances where the ANM fails to vaccinate the infant as mothers are not willing or forgotten about the date of Immunization of their child but with the help of ASHAsi it will be easier for the ANM to conveience the mothers and also kepeping a track of the Infants.

S-1. Providing Untited and Annual Maintenance fund to SC,

PHC, CHC, SDCH Proposed Activities: a. As part of the National Rural Health Mission, it is proposed to provide each Health Institutions ie. SC, PHC, CHC, SDCH will be provided with Unitied and Annual Maintenance Fund. Th Untited funds will be utlize for the following purposes- During 2010-11, it will be ensured that each health Institutions will have the clear action plan for utilizing the Unitied and Annual Maintenance Fund S-2. Strengthening Rogi Kalyan Fund/Hospital

Mamangement Committee Proposed Activities:

225 a. The Rogi Kalyan Samitee/Hospital Management Committees has been formed in District Hospital, SDCH, 5 BPHCs, 6 CHCs, 4 SHCs, 11 MPHCs, 11 SDs, 1 Maternity

Cnetre, with an objectives to have facility based planning and community involvement and ownership of the Health facilties by the respective RKS Committee/HMC b. During 2010-11, It is proposed to provide RKS fund to all the Health Institutions c. During 2010-11, all the RKS are to be registered under

Societies Act. d. During 2010-11, it will be ensured that each health Institutions will have the clear action plan for utilizing the RKS Fund e. For the assessment of the RKS fund utilization by DH/SDCH/PHC/CHC/SHC/SD during 2009-10 an evaluation (Audit) will be done in the year 2010-11 S-3. Strengthening physical infrastructure of

SCs/PHCs/CHCs, Proposed Activities (Sub-Centre) Out of 246 SC functioning in rented building & Govt. dilapidated building, 58 nos SCs already taken up for construction during 2007-08, another 20 new SCs has been approved during 09-10 @ Rs. 7.5 lakhs and 30 nos. new SC will be proposed for construction for increase provision of quality antenatal care. (Annexure -A) Proposed Activities (PHCs) During 2006-07 and 08-09, Construction of Doctors (1 unit) and Nurse Quarter (3 unit) has been taken up in Golokganj PHC, Bilashipara SHC, Gauripur CHC, South Salmara CHC, Bogribari SD and Dhepdhepi MPHC and construction has been completed in all institution. b. During 2010-11 Construction of Doctors (1 unit) and Nurse Quarter (3 unit) has to be taken up at Sadullabari SHC, Kachokhana @ Rs.28.80 lakhs c. During 2010-11, the following health institution has to be taken up for Quarter repairing JhowdangaSD, Bherbhangi

SD, Dumardaha MPHC, Moterjhar SD & Santipur MPHC @10.00 lakhs per institution. S-4. Providing Additional manpower at SCs/PHCs/CHCs/

SDCH Proposed Activities (Sub-Centre)

226 As per the report there are total 376 nos.of ANM in the district in the SC. The total requirement for the district @ 2

ANMs per SC (excluding outreach area) is 116. Therefore the total contractual ANMs for the year 2010-11 will be 116

The contractual ANM may be posted under NRHM @ 2 ANMs per Out reach post (50 nos. out reach post under South Salmara BPHC). Total requirement is 100 ANM.

Proposed Activities (PHCs)

Contractual engagement of 4 MO (MBBS) and 4 MO (Ayur) will be done in 24x7 PHCs deficient in manpower.

Proposed Activities ( For CHCs & SDCH) Specialist Doctors on contract basis to be placed at 4 nos.

IPHS institutions and SDCH Hatsingimari

Proposed Activities ( For GNM at BPHC/CHC/24x7 PHCs)

At Present, thereare 122 nos. of GNM have been posted at various Health Institutions of Dhubri District, Out of which 53 nos. are Reqular GNM and 69 nos. are Contractual GNM. To make the Health facility functional as IPHS norms, 192 nos. GNM is proposed during 2010-11.

S-5: Strengthening the District Hospitals by improving the physical infrastructure. Proposed Activities:

During 2008-09, Construction of 200 bedded Civil Hospital under NRHM has been taken up and the progress of work till Nov, 09 is around 60 %. Total project cost is Rs.7.14 Cr and after completion necessary logistics will have to be supplied during 2010-11

S-6: Strengthening the Nursing Schools by improving the physical infrastructure. Proposed Activities: Construction of RCC GNM School cum Hostel Building for 100 nursing students at Dhubri Civil Hospital is in progress

(42%). Total project cost is 2 Cr. So, no fund proposed in the current year. S- 7.Ambulance for all PHC’s/CHCs/District Hospitals: Proposed Activities: During 2010-11, new ambulance for Dumardaha MPHC is proposed @ Rs.5 Lakhs. S-1: Ensure proper functioning of the health centres by providing necessary equipments and drugs.

227 Proposed Activities : (Supply of Drugs) As per the IPHS norms the District propose to supply the Drugs for all the Health Instution as mentioned below

SC BPHC/MPHC/SHC/SD/MC CHC SDCH Civil Hospital Urban Health Centre PPP Hospital MMU Boat Clinic

Proposed Activities : (Supply of Equipments)

As per facility survey there is a requirement of 21 nos. labour table, 21 nos. of Stand light, 10 nos. Radiant warmer, 13 nos. Auto clave, 19 nos. Electric Sterilizer, 19 nos. backup

Generator set including other logistics for 24x7 hr delivery services for quality services. The institutionwise detailed requirement is enclosed herewith as Annexure B

The IUCD Kit received during 2009-10 alredy distributed where training imparted another 100 nos of IUCD kit will be required during 2010-11. S-1: Strengthening the block for effective implementation of the programme Proposed Activities : Support to district and Block level

Resource Groups.

During 2010-11, to support the Block Programme

Management Unit the following manpower is proposed .

S-1: Strengthening the planning activities. Propsoed Activities: 1. Resource mapping in every village done by Village Health & Sanitation Committee will help to assess the need of the community. Therefore, by undertaking household and facility survey, the actual need of the community can be assessed which is also the essential requirements for developing District Health/Block Health Action Plans-annual & perspective. 2. Orientation of VHSC of each BPHC. S 1.: Support to Mobile Medical Units (MMU) Proposed Activities:

228 a. With the objective to take health care to the door step of the public in the rural far flung areas, especially in under served areas, the district has received the Mobile Medical Unit with specialized facilities like USG, X-ray etc and will continue the service. b. During 2009-10, training of GNM, Pharmacist, Radiographer and lab Tech. of MMU is proposed for skill upgradation. c. For Implmenting the Mobile Medicla Unit, Total fund proposed 21.66 lakh for 2010-11 for recurring expenditure of MMU, Dhubri. Details budget enclosed.

S-2: Promoting Boat Clinic in char areas of Dhubri district.

Proposed Activities: Antenatal Care services by Boat Clinic Postnatal care services by Boat Clinic Family Planning services Routine Immunization Curative care Basic Laboratory Services. S-1: Train and enhance capacity BPMU, PRIs & Medical offcers

S-2 : Stregthening Infrastructure of of District Training Hall

Proposed Activities: In order to organize the different trainings for the officials/health workers under the establishment of JDHS, Addl CM & HO(FW), Dhubri, it is required to repair and renovate the existence Training Hall, during 2010-11. A total Rs. 300000.00 lakh is proposed for carrying out the same activity.

In order to implement the NRHM programme successfully, it is required to organize sentitization workshops on NRHM for the PRIs (ZP Member-28, GP President=168) and the medical offcers (37) and capacity building workshop for BPMU (BPM-7, BAM-9 & Assist.BPM-17)

IEC/BCC Strategy Proposed Activities: A.) Setting up and development of IEC/BCC unit at the district level:

229 1. One District Media Expert under NRHM is already placed at District, one District Extension & Media Officer and two nos of Dy Ext & Media officer is placed under Addl. CM & HO (FW), Dhubri 2. One Digital Video Camera, one still camera with Tripod is already available at District.

3. One Public Addressing System set; LCD Projector with

Screen is available at District.

4. One laptop may be provided to the IEC/BCC cell of the district in Q1, which may cost around Rs. 35,000/-.

5. One LCD projector may be provided to each BPHC

@Rs.50,000 X 7 nos of BPHC in Q2

6. One Grade IV staff may be deputed from regular set up to the IEC/BCC cell for assist the day-to-day activity.

B). Meeting Manpower requirements at District level

1. At Present no further manpower is required at District in

IEC/BCC Cell.

C). Formative research/situational analysis/baseline study to identify focus areas

1. To find out the perception of the villagers and to do a study on the level of Knowledge of Family Planning,

Immunization and Institutional Delivery an independent agency will be engaged.

2. In the first two-quarter they will visit the Char areas of

Dhubri only. They will assist by ASHA and AWW.

Students of M. Phil & Phd will be encouraged to do research on the health status of tea garden population and finding will be used to prepare specific plan.

4. The process will be continued up to Q4 and total Budget requirement for per quarter is Rs. 15,000 X 7 nos BOHC X per quarter.

Develop IEC/BCC Strategy : Streamline objectives/identify Communication tools/identify media mix as per target audience/frame monitoring evaluation indicators Identify external agency/Advertising agency for the task (if needed)

230 Part C: UNIVERSAL IMMUNIZATION PROGRAMME (UIP)

Proposed Activity:

Service Delivery Improvement:-

Mobilization of Children by ASHA : For every 1431 sites we have got one ASHA per site. Invitation card (IPC Slip) to be printed and distributed to ASHA . Missed/Dropout children are to be mobilize or Invited by ASHA to reduce the drop Out. The District will continue for providing incetive of Rs. 250/- to ASHAs for each fully immunized child as this increases the full immunization coverage rate of the District as the ASHAs after BCG will keep a track of the infants in her

village as she is from the same village and will accompany the mother to the sub-centre to vaccinate the infant.This will also help the ANM in tracking/vaccinate the infants as there are instances where the ANM fails to vaccinate the infant as mothers are not willing or forgotten about the date of Immunization of their child but with the help of ASHAsi it will be easier for the ANM to conveience the mothers and also kepeping a track of the Infants.

Hard to Reach area/Unreached Area : 116 nos of sites per month has been identified as difficult to reach areas/Char areas/Urban Slums. For Holding the sessions in Underserved

and Slum areas ANM will be deputed and Rs. 300/- will be paid as honorarium and Rs. 50/- as contingency to ANM for holding the session. JDHS/Addl CM&HO/DPMU/DIO/SDM&HO/BPMU CM&HO/DPMU/DIO/SDM&HO/BPMU JDHS/Addl

Vaccine Delivery (State- Dist. To Cold Chain Pt.) :: Vaccine distribution plans are prepared to distributes vaccine from Dist. to 8 PHC by maintaining proper cold chain.

Dist. To PHC :: As per vaccine distribution route map, Vaccine will distribute from Dist. To 8 PHC level cold chain pt. by insulated vaccine Van covering 3 PHCs per trip for one

month quota. Per trip POL cost of Rs. 800/-, DA of driver is Rs. 90/-, loading/unloading of Vacc. And syringes is Rs. 100/- and maintenance of Vehicle Rs. 800/- PM is planned.

ALTERNATE DELIVERY OF VACCINE :

231 For 1431 normal sites Alternate arrangement is planned for vaccine delivery so that ANM can attend the session site in time. In 2009-10, 85% sites were covered, but in next year it will be arranged for 100% Rs. 50/- per normal site. In underserved slum area /Char area of 116 nos. it is planned to provide Rs. 100/- per site for alternate vaccine carrying.

Cold Chain Maintenance Proper Functioning of Cold Chain Equipments (ILR/Deep Frezer/Col-Box/vaccine carrier etc.) and maintain temperature record of ILD/DF (daily twice), stock of vaccine and syringes at District and PHC level will be ensure during 2010-11. It will also be ensured that the quality of vaccine by maintaining proper Cold Chain System at storage and transportation.

Computer Assistant under DIO: One Computer Assistant @ Rs.10,000 PM is provided to assist DIO in keeping up to data record on immunization and submit the performance report on physical and financial as per HIMS/UIP format.

Supervision and Monitoring : : Rs.4,200/-PM is provided to utilize for POL expenses on supervision and monitoring purpose by Addl. CM&HO (FW)/

DIO to ensure satisfactory performance of immunization programme covering all sites. At Block PHC leve I.c of BPHC will look after the Immunization Programme and supervise the activity. In addition Sector MO, BEE, LHV will supervise the activity. TRAININGS : (i) 2 Days Training for ANM, LHV & GNM To improve the quality services of Immunization 2 days refresher training of Health workers (ANMs, LHV, GNM etc) along site visits related to immunization will be organized.

The batch size should be 25-30 persons in each batch. Priority will be given to those ANMs who have hired drop out rates.

456 ANM/ 50 GNM/ 17 LHV will be trained during 2010-11.

232 ii) Vaccine Handlers Training :: One day cold chain handlers training will be organized for 64 nos of Vaccine Handlers against 32 Cold Chain storage during 2010-11 by District

cold chain officers and DIO in a batch of 15-20 trainees. At PHC level Contractual Pharmacist will be involved for computerized record keeping of Vaccine stock position.

iii) Block level Data Handlers Training : For streamlining the reporting system of immunization ,the team of block level data handlers to be trained on reporting system at Dist. H.Q. by D.I.O , DDM, and S.I. The participants will be BEE, BPM, LHV and BAM. iv) Training on Micro Planning :: Block level Meeting/Training will be organized for all sub centres for all

ANM, AWW, ASHA, ASHA Facilitator for finalization of Sub centre micro plan. Conduct Regular Monthly District and PHC Level Review

Meetings: To identify sub center/ institutions lagging behind in performance and therby to take remedial measure, to avail opportunity for on site training and to solve the problems,

to solve the problems identified by the participants and to provide feed back monthly review meeting will be ensured at District and Block Level. Injection Safty : Red Bag, Black Bag, Hub Cutter, Twine bucket, Injection pits etc will be ensured during 2010-11 for ensuring Injection safty.

D 6.7. PART D: NATIONAL DISEASE CONTROL PROGRAMME

NVBDCP

SURVEILLANCE Active :- Active surveillance done by 103 numbers of

surveillance worker . For proper surveillance each sub D1 centre is to be manned by MPW(M).

Passive Surveillance Passive surveillance done by ASHA , FTD , and ANM in this

Sub-centre . JDHS/DMO

Training Programme of ASHA on Malaria. RD Kits (for use in pf endemic sub-centre from where

reports of blood slide not received within 24hrs.)

233 (Planning for IRS)

TRAINING OF SUPERVISORS AND SPRAY SQUARDS, 2010.

REVISED NATIONAL TUBERCULOSIS PROGRAMME (RNTCP)

Civil Works under NRHM Additionalties Treatment (DOTS) Room One sitting room for patients to take treatment under DOTS. Observation room ( for observation & work by DOT Providers)

One room attached to treatment room & one window to observe Laboratory Room at Sukchar DMC to be constructed with laboratory outlet connection and a pit for waste matter D2 disposal from the laboratory and Dot centre Renovation of DTC building

a) One partition wall with one door & one window.

b) Tiles fitting in DTO’s room, Laboratory & Computer room. JDHS/DTO

Laboratory materials Honorarium IEC/ Publicity Equipment maintenance Training Vehicle maintenance Vehicle hiring NGO/PP support Miscellaneous Contractual services N.L.E.P. Training Plan : A. 4 days training of newly appointed MO’s (rural & urban)

30 nos. B. 3 days training of newly appointed Health Supervisor 30

nos. D3 C. 3 days training of newly appointed Health Worker (M) 30

nos. D. 3 days training of newly appointed Health Worker (F) 30

nos.

E. 2 days training of newly appointed MO’s 30 nos. of JDHS/In-Charge NLEP/DME F. 5 days training of newly appointed Lab. Technician 15

nos.

234 IEC Plan : DPMR : Procurement Plan : a. Purchase to be made as per drug list (guideline) b. Need base purchase to be done. c. Equipments - Not necessary.

d. Printing Register/Forms etc. to be printed as per need.

e. No such specific NGO is existing in the District. 6.7.4 N.B.C.P. Proposed Activities: Weekly Cataract Eye Operation at Civil Hospital, Development of Eye Operation Facility at CHCs Intensive IEC Activities and Blindness Survey Door to Door

D4 Blindness Survey Development of Vision Centres at

Mankachar CHC JDHS/DPM,NBCP/DME JDHS/DPM,NBCP/DME S.Salmara CHC Training & Vision

Screening at Schools Orientation Meeting

at all 7 BPHCs Awarness Meeting & Eye Screening Camps

at 14 Development Blocks

INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP)

Proposed activities 1. 3 days training for newly inducted Medical Officers on

IDSP. D5 2. 2 days training for Health Workers. 3. 3 days training for Laboratory Technicians/ Microscopist JDHS/DSO at District Laboratory. 4. Weekly online transmission of S, P & L Forms.

5. Dissimilation of Early Warning Out Break Responses.

235 6. Supervision and Monitoring of Peripheral Surveillance

Units.

7. Activities on International Health Regulation ( IHR ) Focal

Point (daily basis online reporting of H1N1 Influenza Status).

National Mental Health Programme Proposed Activities: 1. Enhancing the Capacity of the Mental Health

Infrastructure a. Increasing the number of mental institutions

b. Increasing the service capacity of individual institutions

c. Integrating mental health with general health 1. One district Counselling Centre will be established 2. Crisis Hipline will be set up 3. Regular Counselling session will be organized in Colleges, Work Place, necessary arrangement will be made for stress D6 management.

4. Thought DHMP it to be ensured that basic mental health JDHS/DPMU

services are being provided at the community level.

5. Necessary support staff (Clinical Psychologist, PSWs, Psychiatric Nurses etc )will be engaged on purely contractual basis. 6. Required medicines will be supplied to all health

institutions. 7. IEC materials like handbook, Leaflets, Picture Chart etc

will be developed. 8. Contingency for running the DMHP will be released to

BPHC wise. National tobacco Control Programme (NTCP) Proposed Activities: 1. District Tobacco Control Cell will be set up, one Psychologist and One Social Worker will be appointed on

the Contractual basis. All the activities will be carried under the supervision of DPMU NRHM 2. Phase wise training will be conducted for BPM, BEE, HE &

D7 LHV and MNGO members. 3. Awareness cum sensitisation meeting with Civil Society group such as Women SHG, NGOs, ULB’s and PRI’s, School

teachers, health workers, law enforcers etc. IEC materials will be developed.

4. Special Talk show on Anti Tobacco, awareness rally, quiz of NTCP/DPM/DME JDHS/In-Charge

etc will be arranged with School Health Progarmme.

236 5. For effective implementation of NTCP at grass root level frequent monitoring is required, hence monitoring plan will be developed. 6. For enforcement of anti -tobacco law awareness regarding

the following specification provision will be increased: a. Ban on Smoking in public in public places b. Ban on sale of tobacco products to children bellow 18

years c. Ban on direct/indirect advertisement promotion and

sponsorship of tobacco products d. Ban on sale of tobacco products within 100 yards of the

educational institutions e. Mandatory depicition of Specified health warning on all

tobacco products f. Testing of tobacco products for tar and nicotine. 7. Under the supervision of the Psychologist and Social Worker a Tobacco Cessation Centres will be established at Dhubri Civil Hospital, Dhubri. 8. For find out the actual status of the district Global l Adult

tobacco survey will be conducted. Intersectoral Convergence Proposed Activities: • A district level convergence Meeting with PHE department will be organized to streamline the TSC (Total Sanitation Camping). • After the district level meeting similar Block level meeting

with block officials will be organized at Block level. • Under VHSC fund an amount of Rs. 3000/- is meant for construction of sanitary toilet. The fund will be handed over

to PHE department by respective VHSC for further course of action. • Flex Hoarding Board BPHC wise 10 nos will be developed

and installed E • IEC materials like Poster, leaflets etc will be developed and

distributed . Inter Sectoral Convergence with Education Department:

Proposed Activity: JDHS/In-/DPM/DME • In the next financial year another 100 nos of School will be

selected for School Health Programme. • School Teacher of the Selected School will be trained in

phase wise. • Health Awareness video will be screen in all the selected

schools. • IEC materials life Picture Chart will be developed for

School students. • Quiz, Essay writing & Art computations etc will on Health

related subject will be organized.

237 Chapter – 9

Summary of Budget

Programme Amount( In Rs.Cr)

RCHII Flexipool 32,345,665.23

NRHM Mission Flexipool 10,99,21,450.00

Immunization(UIP) 6,018,968.00

National Disease Control Programme 0.00

(i) NVBDCP 7,469,840.00

(ii) RNTCP 7,974,000.00

(iii) NPCB 1,771,000.00

(iv) NLEP 943,100.00

(v) IDSP 1,121,600.00

(vi) NTCP 1,216,000.00

(vii) NMHP 500,000.00

Total 16,92,81,623.23

238

A. BUDGET UNDER RCHII

Fund utilized Expected Fund Expenditure and will be balance on Fund approved in Unspent likely to be Actual Fund utilized till 01.04.10 S. proposed for 200910 balance as on made from proposed for Budget Head 31.03.10 (Rs. In (Rs. In lakhs) Remarks No. 201011 (Rs. In lakhs) 30.11.09 01.01.10. to 201011 lakhs)against against fund (Rs. In lakhs) (Fund (Rs. In lakhs) 31.03.10. (Rs. In lakhs) fund approved approved in Received) (Rs. In lakhs) in 200910 200910

1 Maternal Health 6,000,000.00 - 18,110,559.19 5,093,000.00 5,093,000.00 13,017,559.19 (7,017,559.19)

2 Child Health - - 173,033.00 147,035.00 147,035.00 25,998.00 (25,998.00)

3 Family Planning 118,000.00 - 2,000,000.00 1,500,000.00 1,500,000.00 500,000.00 (382,000.00)

4 Adolescent Health - 300,000.00 250,000.00 250,000.00 50,000.00 (50,000.00)

5 Urban Health 2,946,000.00 642,000.00 906,650.00 722,000.00 722,000.00 184,650.00 2,761,350.00 Vulnerable group and 6 tribal RCH 12,000,000.00 - - - - - 12,000,000.00

7 Innovations / PPP / NGO - - 797,822.00 650,000.00 650,000.00 147,822.00 (147,822.00) Institutional 8 Strengthening/ HMIS 3,310,000.00 1,932,250.00 2,715,210.48 - 2,715,210.48 594,789.52 Infrastructure & HR / 9 IMEP 19,980,000.00 14,052,048.00 11,967,598.00 11,967,598.00 2,084,450.00 (2,084,450.00)

10 Training 3,420,000.00 787,670.00 1,555,422.00 1,555,067.00 1,555,067.00 355.00 3,419,645.00

11 BCC / IEC 5,114,000.00 3,418,210.00 4,753,012.22 3,750,000.00 3,750,000.00 1,003,012.22 4,110,987.78

12 Procurement ------Dist.Prog.Management 13 Unit 908,000.00 2,670,793.00 2,007,606.03 569,902.00 569,902.00 1,437,704.03 (529,704.03)

Total Base Flexipool 33,816,000.00 29,430,923.00 47,371,362.92 26,204,602.00 26,204,602.00 21,166,760.92 12,649,239.08

14 JSY 62,345,000.00 50,000,000.00 66,774,658.85 14,000,000.00 14,000,000.00 52,774,658.85 9,570,341.15 Sterilization 15 compensation and camps 14,876,000.00 6,565,500.00 6,635,915.00 1,886,000.00 1,886,000.00 4,749,915.00 10,126,085.00

Total RCH Flexipool 111,037,000.00 85,996,423.00 120,781,936.77 42,090,602.00 42,090,602.00 78,691,334.77 32,345,665.23

239 B: BUDGET UNDER N.R.H.M ADDITIONALITIES:

Budget Format for NRHM Mission Flexible Pool Part B * and Part E Total Number Rate S.No. Initiative Amount Remarks Proposed Proposed (in lakhs) A ASHAs fund A1 Selection & Training of ASHA 380 0 0 already received A2 ASHA Kit 1726 0 0 A3 ASHA Incentives 26770 250 6692500 A4 Others 0 0 0 TOTAL(A) 6692500 B Infrastructure related matters B1 New Construction of DH 0 0 0 B2 Renovation / Upgradation of DH 0 0 0 B3 New Construction of CHCs 0 0 0 B4 Renovation / Upgradation of CHCs 0 0 0 B5 New Construction of CHCs 0 0 0 B6 New Construction of PHCs 0 0 0

B7 Construction of Doctors and Nurses Quarter 3 2880000 8640000

B8 New Construction of SCs 32 750000 24000000 B9 Upgradation of SC 2 2500000 5000000 Construction of Boundary wall(Goat prrof B10 5 1000000 5000000 fencing) B11 MMU 1 2166000

B12 Emergency & Referral Services 2173000 B13 Pol Money for Ambulance 1440000 B14 Repair/Renovation of Training Hall 1 300000 TOTAL(B) 48719000 C Human Resources related matters C1 Contractual Specialists 12 30000 4320000 C2 Contractual Doctors 2 25000 600000 C3 Contractual Paramedical(Lab Tech) 4 7000 336000 C4 Contractual ANM 102 5000 6120000 C5 Contractual MO (Ayur) 3 15000 540000 C6 Contractual GNM 73 7000 6132000 TOTAL(C) 18048000 D Programme Management related matters D1 State Programme Managemet 0 0 0 D2 Divisional PMSU 0 0 0 D3 Block PMSU 6 10000 720000 D4 District Health Action Plan 1 100000 100000

240 D5 Monitoring & Evaluation 3310000 3310000 D6 Others 0 0 0 TOTAL(D) 4130000 Untied Funds, Annual Maintainence E Grants and RKS fundsrelated matters E1 Rogi Kalyan Samiti-DH 1 500000 500000 E2 Rogi Kalyan Samiti-SDH 1 100000 100000 E3 Rogi Kalyan Samiti-CHC 6 100000 600000 E4 Rogi Kalyan Samiti-PHC/SDCH 33 100000 3300000 E5 Untied Fund for CHC 6 50000 300000 E6 Untied Fund for PHC 32 25000 800000 E7 Untied Fund for SC 246 10000 2460000 E8 Untied Fund for VHSC 1690 10000 16900000 E9 Annual Maintenance Grant-DH 0 0 0 E10 Annual Maintenance Grant-CHC 6 100000 600000 E11 Annual Maintenance Grant-BPHC 5 50000 250000 E12 Annual Maintenance Grant-SDCH 1 100000 100000 E13 Annual Maintenance Grant-PHC 27 50000 1350000 E14 Annual Maintenance Grant-SC(Govt) 120 10000 1200000 E15 Others 0 0 0 TOTAL(E) 28460000 Training & Capacity Building related F matters F1 Management Development Trainings 0 0 0 F2 Capacity Building/Orientation Workshops 171950 F3 Others 0 0 0 TOTAL(F) 171950 Innovations (No approval without G details) G1 Health Melas 1 500000 500000 G2 District Innovations 0 0 0 G3 Incentive Scheme 0 0 0 G4 PPP initiative 2 1500000 3000000 G5 Others 0 0 0 G6 Health Insurance scheme 0 0 0 G7 Others 0 0 0 TOTAL(G) 3500000

Intersectoral Convergence (Part E) (No H approval without details)

H1 Ayush 0 0 0 H2 Intersectoral Convergence Related 200000 200000 H3 Others 0 0 0 TOTAL(H) 200000 Grand Total (A+B+C+D+E+F+G+H) 109921450

241 C: BUDGET UNDER IMMUNIZATION:

Expenditure & Ahievement

2005-06 2006-07 2007-08 2008-09 2009-10 (till Nov'09) 2010-11 Service Delivery Norms

Funds Target requirement Remarks Expenditure Expenditure Expenditure Expenditure Expenditure Achievement Achievement

Mobility support No. of No. of Sessions No. of Sessions for Supervision at Rs.50,000 per Sessions Supervised Supervised district for Supervised Supervisory visits Districtlevel officers 12600 25162 74400 29457 11938 120000 by District level (this includes POL officers for and Maintenance) monitoring and per year 384 256 408 supervision of RI

243 month as contingency per slum of i.e total expense 490 0 96 of Rs. 1400/- per month per slum of 10000 population

No. of No. of Sessions No. of Sessions Mobilization of Sessions Rs.150/session (for with ASHA with ASHA Children through 284000 939400 with ASHA 0 2813400 District) ASHA/mobilizers 9394 18756 18756

Support for Computer No. of C.A. No. of C.A. in No. of C.A. in

Assistant for RI in position position position Reporting (with District @ Rs. 8000- annual 10000 p.m. increment of 10% w.e.f. from 2010-11) 84000 Yes 77000 Yes 120000 Yes

244 Printing and dissemination of immunization 50161 cards, tally Rs. 5 per beneficiary 0 0 0 0 250805 benefici sheets, aries monitoring forms etc

Quaterly review meeting exclusive for RI at Block level @ Rs 50/- pp as honorariam for ASHAs (travel) and Rs 147600 25 pp at the disposal of MO-I/C for meeting expences (refresments, stationary and misc. expences) Trainings: As per revised norms No of District Level No of persons No of persons for trainings under 161723 persons 344678 601301 orientation trained trained RCH trained training for 2 245 days ANM, Multi Purpose Health Worker (Male), LHV, Health Assistant (Male/Female), Nurse Midwives, 267 412 523 BEEs & other specialist (as per RCH norms)

Three days training of As per revised norms No of Medical Officer No of person No of person for trainings under person on RI using trained trained RCH trained revised MO traing module

one day refresher training of District RI As per revised norms Computer for trainings under Assistants on RCH RIMs/HMIS and Immunization formats under NRHM

246 One day Cold Chain handlers traing for block level cold chain handlers by state As per revised norms No of person No of person and District cold for trainings under 0 10870 0 9040 30 40585 31100 trained120 trained60 chain officers RCH and DIO for a batch of 15-20 trainees and three trainers.

One day training of block level No of No of person No of person data handler by person trained trained DIO and Dist trained

Cold Chain As per revised norms

officer to train for trainings under 18500 18450

about the RCH

reporting

247 AWW For consolidation of microplan at PHC/CHC level @ Rs 9345 8000 0 8613 13000 24000 1000/- block & dist level @ 2000/- per dist.

% of fund POL for vaccine % of fund used % of fund used delivery from used Rs 100,000/dist/year 20724 50573 15757 45134 77509 201600 dist. To PHC/CHCs 73% 38%

Consumables for computer including At Rs 400/- 4800 provision for /month/dist internet access for RIMs

% funds Injection Safety % funds used % funds used used

Red/Black/Plastic at Rs 2/bag/session 37512 bags etc

Bleach/Hypo at Rs 500/ 4800 chlorite solution PHC/CHC/year

at Rs Twine bucket 3200 400/PHC/CHC/year

248 Any District Specific Need % funds % funds used % funds used with Justification used ( please provide a separate write- 10% of total amount up on objective, of approved PIP stretegy, expected output and outcomes, basis for cost estimates etc. Total 42669 131038 660087 1964333 1705810 6018968

249

D1. BUDGET & ESTIMATE UNDER (NVBDCP)

ITEM ACTIVITY Amount Rs. Surveillance 57 No.s MPW X @ Rs.6000.00/ p.m X12 41,04,000.00 Vector Control-IRS Wages for 2 rounds DDT Spray for 3 Squads 1,56,240.00 DDT Dumping (Road & Boat) 50,000.00 Fogging Fogging Operation in 5 town areas 1,00,000.00 ITBN 350 Camps X @ Rs.500/ X 2 Rounds 3,50,000.00 Protective Equipments for Purchase of hand gloves, Goggles, Apron, mask 5,000.00 spray for 3 Spray Squads Training M.O, Lab-Tech, Health Supervisors, Health 6,85,000.00 workers, ASHA, Spray workers and spray Super visors BCC / IEC 14,70,000.00 M & E Jt. DHS/ CM& HO(CD) @ Rs. 10,000.00/ p.mX 12 1,20.000.00 = 1,20,000.00 DMO. @ Rs. 10,000/ p.m X 12 = 60,000.00 AMO/ MI Hq. @ Rs.5000/ p.m X12 84,000.00 = MI PHC @Rs.1000/ p.m X12X7 PHC = Miscellaneous For cross checking of B/S @ Rs.400 per PHC X 7 33,600.00 PHC X 12 60,000.00 Stationary Article for Office use 12,000.00 Telephone Bill @ Rs.1000/ p.m X 12 60,000.00 Collection of Anti-Malarial Drugs and Equipments from State H.Q Total 74,69,840.00

Total Budget & Estimated Cost is Rupees Seventy Four Lakhs Sixty Nine Thousand Eight Hundred Forty Only only

251 D2 : BUDGET UNDER RNTCP

Budge t estimate for the coming Budget sought from Category of FY 2010- 11 NRHM additionalities S.No. (To be based on the planned 2010-11 Expenditure activities and expenditure in In Rs. Section C) in. Rs. 1 Civil works 61000 2170000 2 Laboratory materials 400000 3 Honorarium 300000 150000 4 IEC/ Publicity 299000 Equipment 5 maintenance 140000 6 Training 293000 7 Vehicle maintenance 300000 8 Vehicle hiring 320000 9 NGO/PP support 450000 10 Miscellaneous 400000 700000 11 Contractual services 1285000 12 Printing 365000 13 Research and studies 0 14 Medical Colleges 0 Procurement – 15 vehicles 150000 Procurement – 175000 16 equipment 191000 TOTAL 4954000 3195000 ** Only if authorized in writing by the Central TB Division

Grand Total :- Rs.( 4954000+ 3195000 ) - Rs.175000=Rs. 7974000

252

Budget Uner NPCB

STRATEGY ACTIVITY Sub-Activity Cost per Unit Total Cost Weekly Cataract Procurement of Drugs, @ Rs. 750/- Eye Operation at Consumables, Sutures, etc. For 800 oprns. 6,00,000.00 1. Cataract Surgery Civil Hospital @ 9 at base Hospital Oprn. Per day for 2 Procurement of Sharp Lump-sum 40,000.00 Approach O.T. day for 45 weeks , Instruments etc. Vision Screening at 100 Training of 100 School 2. School Eye Schools @ 200 students Teachers Details 25,000.00 Screening Programme each 7% defective Refraction of 20000School Visit by PMOAs @ Rs.20/- each Students i.e. 1400 students for confirWith Vision Testing Van for 1400 students 28,000.00 -matory camps 30% Refrective Error of 1400 Nos. i.e. @ 200/- each for 420 nos. students for distribu- 420 students 84,000.00 tion of Free Spectacles 3. Procurement of Development of Eye Development of O.T. Equipmernts Operation Facility at Placement of Instruments Lump-sum 5,00,000.00 Dhubri Town Health Instt. Deployment of Staffs 4. Development of Development of Vision Make Provision for Room in Vision Centre: Cerntre where O.A. posted consultation with the in- 50,000/- each 1,00,000.00 1. Mankachar CHC charge M.O. 2. South Salmara CHC Procurement & Placement of Equipments & Furnitures Printing of Forms, Blind @ Rs.50/-each 5. Eye Screening and IEC Activities Register, Leaflets, For IEC and 15,000.00 Detection of Cataract Stationeries Cases at Sub-Canters Eye Screening at Sub-centers by the Organisation & Rs. 200/- for 58,000.00 PMOA on fixed day Contingencies Organization Every week Exp. of at 290 Health Instt. Door to Door Survey at 30nos 15/- Blindness Survey Villages/Towns per house 90,000.00 6000 houses Orientation Meeting Sensitization Meeting at all 7 BPHCs With all M.O.s/ BPMU/ @ Rs. 3000/- 21,000.00 6. Popularization of BEEs/ ANMs Eye Donation & Eye Awarness Meeting & IEC Activity at 20 nos @ Rs. 1,500/- Care Eye Screening Camps Of Health Institutions Each for 20 30,000.00 at 14 Development With Flaxo banners H.Institutions Blocks Salary Support of DPM=1 96,000/- 7. District Health Dealing MANAGEMENT Society Asstt.= 1 18,000/- 114,000.00 OF District Health 20,000.00 Society TA/DA of the Staff Lump-sum

Maintenance of Ophth. Equipments Lump-sum 16,000.00 Contingency & Other Activities 30,000.00 Total 17,71,000.00

253

D4. Budget under NLEP Sl. Activity Proposal Amount No. Proposed 1. Contractual Services 54,000 /- District one Driver @ 4,500/-PM x 12 months 2. Services through ASHA/USHA 25,000 /- Sensitization of ASHA/incentive to ASHA 3. Office expenses & consumables 40,000 /- 4. Capacity Building (Training) 4 days training of newly appointed MO (rural & 53,000 /- urban ) 3 days training of newly appointed Health worker & 69,525 /- Health Supervisor 2 days refresher training og MO 27,700 /- 5 days training of newly appointed Lab. Technician 18,375 /- 5. Behaviours change communication (IEC) 1,25,000 /- Mass media, outdoor media, Rural media & Advocacy 6. POL/Vehicle operation & hiring 80,000 /- & vehicle at state level & vehicle at district level 7. DPMR 30,000 /- MCR footwear, Aids and appliances, welfare 12,500 /- allowances to BPL patients for RCS support to Govt. 2,50,000 /- Institution for RCS 8. Materials & supplies 52, 000 /- Supportive drugs, Lab reagent & equipment & printing forms. 9. Urban leprosy control Do not arises Township, Medium cities-I, Medium cities-II & Mega cities 10. NGO-SET scheme 50,000 /- 11. Supervision, Monitoring & Review 50,000 /- Review Meeting & Travel expenses Cash Assistance 6,000 /- Total = 9,43,100 /-

254

D5. Budget Under IDSP

Sub - Tasks Unit No of 2010-11 Remarks activity Cost Units 1. Staff 1.1 Epidemiologists 30000 Salary 1.2 Microbiologists 20000 1.3 Entomologist 20000 1.4 Consultant ( Finance ) 14000 1.5 Consultant ( Training ) 28000 1.6 State Data Manager 14000 1.7 District Data Manager 13500 12 162000 1.8 Data Entry Operator 8500 12 102000 1.9 Accountant 9500 12 114000 already 1.10 Administrative 7000 12 84000 appointed & Assistant working as per Govt. guidelines the said post may be continued with IDSP. Sub Total 462000 2.Training 2.1 Training of Hospital 36500 2 73000 Doctors 2.2 Training of Hospital 15500 20 310000 Pharmacist/ Nurses 2.3 Training of Laboratory 23500 2 47000 Technicians/ Microscopist Sub Total 430000 3. 3.1 Mobility Support, 5800 12 69600 Operational 3.2 Office Expenses 5000 12 60000 Cost 3.3 ASHA incentives for 100 120 12000 Outbreak reporting 3.4 Collection and 3000 12 36000 transportation of samples 3.5 IDSP reports including 500 12 6000 alerts 3.6 Printing of IDSP 2000 12 24000 Forms 3.7 Broadband Expenses 1000 12 12000 Sub Total 219600 4. New 4.1 Review Meeting 5000 2 10000 Innovations District Committee Grand Total 1121600

255

D6 : Budget under NTCP

Proposed Budget for District Tobacco Control Programme (NTCP)

Sl.No Components Calculation (Rs) Total (Rs) Salaries: 10000 X 12 months 1 I). Psychologist: Rs.10, 000/- per month 216,000 8000 X 12 months ii). Social Worker: Rs. 8,000/- per month

2 Training 200,000 200,000

3 IEC Activity 200,000 200,000

4 School Activity 400,000 400,000

Monitoring of Tobacco Control Laws & 5 100,000 100,000 Reporting

6 Contingency 100,000 100,000

Total 12,16,000/

256

E: Budegt Under Convergence

Physical Total amount Sl. No Activity/ Subactivity Unit cost target (Rs.) E.1 Convergence meeting 5000 1,00,000 Meeting with representative 20 from PHE, Education Dept, Social Welfare dept, PRI members, vertical Health System RNTCP, NLEP, NVBDCP, DBCS etc

E.2 Convergence workshop 2 days Workshop with 7 25000 1,75,000 representative from PHE, Education Dept, Social Welfare dept, PRI members, vertical Health System RNTCP, NLEP, NVBDCP, DBCS etc E.3 Dist. Level Training of 4 7500 30,000 members from other dept and vertical health system

Grand Total 3,05,000/

257

DETAIL BUDGET (ANNEXURE 3 e )

Baseline Physical Target Rate Fund Proposed For 2010-11 (Rs. Lakhs) / Unspent Fund Current Unit of Balance proposed Sl Budget Head Remarks Status Measure Q Total (Rs./ Total on (Rs. Q I Q II Q IV Q I Q II Q III Q IV (31st III Annual Unit) Annual 31.03.10. Lakh) Jan, 10)

MATERNAL 1. HEALTH To increase the 3 ANC from 21.9% (DLHS-3) and 41.05% (HMIS report) to 60% by

2010-11 and also to reduce the proportion of pregnant women with anemia. Early S1 registration of pregnancy Training of 1726 nos of ASHA on early detection and registration 432 432 430 432 1726 of Pregnancy in the Sub Centre area. Regular supply of Pregnancy Test Kit will be ensured to Detail in

all 1726 nos. of procurement ASHAs and 456 nos. of ANM Village Health & Nutrition Day will be used as a platform for Fund avialbel motivating and 12068 5178 5178 5178 5178 20712 0 in VHSC mobilizing the women for early registration of pregnancy.

259

The District under “Assam Bikash Yojana” has implemented “Mamoni”-Nutrional food for pregnant women where a pregnant woman after her first registration receives a hand book on nutrional 19948 8643 8643 8643 8643 34572 8.64 8.64 8.64 8.64 34.56 95.00 0 food and MCH card. On her 2 nd checkup, a cheque of Rs. 500/- is given as monetory support for nutrional food and on her 3 rd checkup, another cheque of Rs. 500/- is given and a voucher for referral transport. Provide Quality Ante Natal S2 Care to all pregnant women Re Orientation Training of 456 nos. of ANM Block PHCwise in a batch of 30 on 114 114 114 114 456 physical examination of pregnant women, Hb estimation and record keeping To strengthen the basic obstetric care (institutional deliveries) S3 from 30.3% (Coverage Evaluation Survey, RRC- NE) to 50% by 2010-11

260

Sub Centre

Micro Birth Planning by the In Training 26020 ANM for all the Plan Pregnant women Referral of the complicated cases to the higher institutions

Labour Equipments for Under Table 24x7 facilities Procurement 21nos.

Shadow less Under

lamps 21 Procurement nos.

5 KVA generator Under NRHM 19 nos.

PHC/CHC

Enganagement of contracutal under HR of 5 doctots & NRHM Addl paramedics Strengthening referral in Referral

transport Transport mechanism SBA training of the doctors & 120 9 9 9 9 36 In training GNM Repair & Renovation of 5 NRHM Addl. doctors & nurses quarters Delivery by S4 TBA in the difficult areas

261

Training of 1000 in Training Dai

Procurement of Under NRHM DDK Rs. 100 Incentive to Dai 23467 per 11.73 11.73 23.46 0.00 23.46 per delivery delivery Home Delivery Janani S5 Suraksha 12283 6505 6505 6505 6505 26020 155.9 155.9 155.9 155.9 623.5 527.7 95.7 Yojana Referral S6 Transport Village to Health Under Intitution (60% 5.43 5.43 5.43 5.43 21.7 0.00 NRHM of ID) POL for ambulance for Under 3.60 3.60 3.60 3.60 14.4 0.00 transporting the NRHM women Objective: To strengthen the basic obstetric care (institutional deliveries)

from 30.3% (Coverage Evaluation Survey, RRC- NE) to 50% by 2010-11 Increasing the access through

facility strengthening

Labour room Budgeted Upgradation with under

wards for 24 X Infrastructure 7 PHCs. & HR

262

To strengthen the S1 Comprehensive obstetric care FRU OT Instruments & new born caer instruments OT & New born care corner

repair & renovation Back up power

(10 KVA)

Water Supply

repair

Blood Storage Facility upgradation Training of under doctors on 4 training CEmoC Training of

doctors on LSAS

Increasing coverage of post partum care from 14.8% (DLHS3) to 35% by 2010 -11 Ensure post partum care by S1 ASH/ AWW/ANM IEC Material for under the mothers on IEC/BCC PPC Post partum S2 care at Health facilities

263

Baby Kit for institutional delivery for mothers staying up to 48 hrs To increase awareness among the community on Maternal & Perinatal Death Maternal & Perinatal Death Autopsy To improve safe abortion facilities. Increase safe abortion S1 facilities in Govt. Hospitals

15 Mos will be under 15 trained in MTP training

Procurement of

MVA kit

Access to safe S2 abortion in Pvt. Facilities New Initiative

by the districts

Project Palna (Dibrugarh & Dhemaji

SUB TOTAL OF MATERNAL #### 173.54 185.27 185.27 717.62 527.74 189.88 HEALTH

264

2 CHILD HEALTH

To improve new born care

by 2009-10

S1 IMNCI

Training of health workers of under 274 274 274 274 1096 Dhubri districts Training

under Procurement of IMNCI Kit Procurement

Facility Based New Born S2 Care

under Training of MO Training Setting up of SNCU in S3 districts

Setting up of SNCU in

districts

Setting up of Stabilization S4 Centre

Under Infrastructure Stabilization centre for PHC & procurement

Objectives: Promote early breast feeding and exclusive breast feeding

till 6 months and above from 38.1% (DLHS 3) to 50% by 2010-11

265

Increases awareness amongst mothers about S1 importance of exclusive breast feeding and complementary feeding

Communication activities Under

(IEC/BCC) IEC/BCC

Health Institutions to be Under BCC made Baby Friendly hospital

Objective: To increase the percentage of 12 months of age fully immunized children from 53.49% to 70% by 2010-11.

To strengthen the present

immunization system.

Details of immunization given Details under

under UIP component UIP

Objectives: To increase

the use of ORS

Making ORS and zinc tablets available in all the districts as well as in S1 remote/rural/tribal areas and difficult to reach areas through depot holders.

Referral of diarrhoea S2 cases

Training of ASHA & AWW on under

ORS & Zinc as a depot holder IEC/BCC

266

Procurement of ORS packets

& Zinc Tablets

under IMNCI kit to be provided Procurement

Referral of sick children with under referral

diarrhoea transport

All the govt. health facilities will be strengthened to provide treatment of Diarrhoea. ORT Corner are created to rehydrate children Included in

suffering from dehydration IEC/BCC due to acute watery diarrhoea keeping the child for four hours and will be made functional

Increase awareness of ARI and improve referral of ARI cases

Reorientation treaining of S1 ANMs

S2 Prompt referral

ANMs to be given refresher training on ARI & diarrohea Details in

case detection and referral of training plan these cases

under referral Prompt referral of ARI cases transport

Reduce prevalance of

anemia

267

To prevent and treat anemia

Counselling and Included in communication activities IEC/BCC

Suplly of IFA(s) tablets

Reduce Vitamin A deficiency

Prevent and treat Vit-A deficiency in children

Vitamin A campaign

SUB TOTAL OF CHILD 0.00 0.00 0.00 0.00 HEALTH

268

3 FAMILY PLANNING

To meet the unmet need of contraception from 37.2% (DLHS3) to 28% and increase Contraceptive prevalence rate 23.6% (DLHS3) to 45% by 2010-11

To raise awareness amongst the couples and communities about the S1 advantage of contraceptives and small family. Communication activities will be developed with help of AWW, ASHA, Woman’s IEC/BCC SHGs, male workers, CBOs & FNGOs as per need of the locality.

Family planning counseling will be ensured by ASHA & ANMs during home visits and VHND and also at the sub center during visit of the NRHM Addl women for immunization, care of the children etc to meet the unmet need of contraception and also need of small family.

Increase the number of S2 service delivery points

ASHA and AWW will act as depot holders. All the depot Procurement holders will be provided with plan wider basket of choice (OCP, ECP, and Nirodh).

269

The ANMs will be trained for Training & IUCD. Necessary logistics for Procurement IUCD insertion at SC level Plan will be supplied (IUD kit).

Budgeted Incentive for IUCD 5900 Rs.20 0.3 0.3 0.3 0.3 1.2 0 1.2 under RCH Flexi-pool

Improve the service S3 delivery to provide quality female sterilization.

under 15 Mos will be trained in MTP training

Under Procurement of MVA kit Procurement

Budgeted Compensation package for 2450 2450 2450 2450 9800 Rs.1000 24.5 24.5 24.5 24.5 98.00 0.00 98.00 under RCH female strilization in Govt. Flexi-pool

Compensation package for Budgeted female sterilization in pvt under RCH hospitals Flexi-pool To increase the male sterilization from the existing level of 10.6%

(HMIS report upto Jan’10) to 20% by 2010- 11. Raising awareness for S1 NSV

Workshop at State Level

Workshop at District levek

Improve service delivery S2 for NSV

270

Budgeted NSV camps cum training 21 21 21 21 84 Rs. 15000 3.15 3.15 3.15 3.15 12.6 0.00 12.6 under RCH Flexi-pool

Budgeted Compensation package for 500 500 500 500 2000 Rs.1500 7.5 7.5 7.5 7.5 30.00 0.00 30.00 under RCH male sterilization in Govt. Flexi-pool

Compensation package for male sterilization in pvt hospitals Outreach camps in

uncovered areas

Sterilization camps in 11 S1 high focus districts

Special sterlization camps

for females for 3 months

Sterilization camps in S2 uncovered areas

Female Sterilization

Male Sterilization

Innovation under Family

Planning:

Samidhri Babe Kisu Hamai (Second Honeymoon Scheme )in 10 districts

SUB TOTAL OF FAMILY 35.45 35.45 35.45 35.45 141.80 5.00 136.80 PLANNING

271

4 ADOLESCENT HEALTH

Introduce a comprehensive health plan for adolescent

To ensure reproductive haelth and nutrition needs are met Under S1 School health programme intersectoral convergence

Outreach programmes for S2 out of school adolescents

Adolescent Clinic in Health S3 Institutions

Awareness generation activities related to under

adolescent health. (under IEC/BCC IEC/BCC).

T raining of counselors on

ARSH

Incentive to the counselors

Outreach Health Programme for Adolescents for 1 district, viz. Morigaon, pilot basis through FNGO & Peer Educator.

Low Cost Sanitary Napkins to

adolescent females .

SUB TOTAL OF 0 0 0 0 0.00 0.00 0.00 ADOLESCENT HEALTH

272

5 URBAN RCH

To provided integrated and sustainable system for primary health care service delivery with focus on urban poor/slums.

Increasing access to service

delivery point

UHC - Railgumti, Dhubri 1 no 1

Urban Health Centres 2 no 1 1 2 7.37 7.37 7.37 7.37 29.46 1.84 27.62

Acrredited Urban Health

Workers

SUB TOTAL OF URBAN RCH 7.37 7.37 7.37 7.37 29.46 1.84 27.62

VULNERABLE GROUP & 6 TRIBAL RCH

Health Camp for the refugees

in two districts

Health camps in the flood affected areas of two districts ( Lakhimpur & Dhemaji)

Mobility support to ANMs

working in char areas

Camps and procurement of inflatable boats in Karbianglong district

SUB TOTAL VULNERABLE 0 0.00 0.00 0.00 0.00 0.00 GROUP AND TRIBAL RCH

273

INNOVATIONS/ PPP/ NGO/ PNDT/ 7 QA

7 PPP Under A- PPP with old Tea Garden 1 1 NRHM 1 Addl Under PPP with new Tea Garden 1 1 NRHM Addl

PPP with Charitable/Private Hospital

Chiranjivi Yojna (in 5 districts, A- viz..Kamrup, Jorhat, Dibrugarh, Barpeta 2 and Silchar)

7 NGO SCHEME

A- Release of 2 nd installment 1

A- Release of 1st installment 2

Release of 2nd installment

Release of preparatory grant

External agency evaluation of 10

MNGOs

A- Quarterly review meetings 3

7 PNDT/GENDER ISSUE

A- Meetings 1

274 a State Supervisory Board meetings

Meetings of the Multi Member State b Appropriate Authority to be organized

A State level 1 (one) Day Public c Seminar cum workshop

District level Advisory Committee d Meetings

Quarterly Reports (printing of the A- format to be done if required, so fund is 2 required)

A- Contingency Fund 3

A- Mobility 4

7 QUALITY ASSURANCE

A- Quality Assurance in 6 districts 1

Development of software for QA

SUB TOTAL OF 0.00 0.00 0.00 0.00 0.00 0.00 0.00 INNOVATIONS/PPP/NGO/PNDT/QA

275

INSTITUTIONAL 8 STRENGTHENING / HMIS

8 Strengthening of M&E Cell 8 8 6.15 6.15 6.15 6.15 24.6

M&E consultant(s) recruited Included in 8 1 No and in position DPMU

Provision of equipment at 8 1.88 1.88 1.88 1.88 7.52 state and district levels Operationalising the new 8 MIES format Printing of all MCH registers 9 incorporating new MIS formats 9 Printing of new formats

a) Monthly format for SC's and equivalent facilities

(NRHM/HSC/3/M ). Bilangual Format - English & Assamese

b) Monthly format for PHC's and equivalent facilities (NRHM/PHC/3/M )

c) Monthly format for CHC's and equivalent hospitals (NRHM/CHC/3/M ) d) Monthly format for Sub- District Hospitals and

equivalent hospitals (NRHM/SDH/3/M ) e) Monthly format for District Hospitals and equivalent hospitals (NRHM/DH/3/M )

9 Training of staff

276

a) 2 days training on Reporting System and M&E for District Level Officers b) 2 days training on Reporting System and M&E for Block Level Officers c) 1 day training on Reporting System and M&E at Block 0.13 0.13 0.13 0.13 0.50 Level

Other M&E activities 9 (please specify)

a) BPHC level- monthly No 21 21 21 21 84 Rs.5,000.00 1.05 1.05 1.05 1.05 4.20 0.00 89.40 Review Meeting b) District Level Monthly No 3 3 3 3 12 Rs.25,000.00 0.75 0.75 0.75 0.75 3.00 0.00 81.00 Review Meeting c) State Level Quarterly

Review Meeting

SUB TOTAL OF INSTITUTIONAL 9.96 9.96 9.96 9.96 39.82 27.15 12.67 STRENGTHENING / HMIS

INFRASTRUCTURE AND 9 HR

INFECTION MANAGEMENT 9 & ENVIRONMENT PROTECTION

Training

CBWTF

BMW Consumables

277

9 Infrastructure

24 x 7 PHC Up-gradation & renovation of labour room

and maternity wards for 24 X 7 PHC FRU - OT & New born care corner repair & renovation for FRU FRU - Blood Storage Facility

upgradation for FRU

SNCU - Upgradation & repair

SNCU- Manpower

Stabilization Unit - Tiling,

reconstruction & wiring

Repair & Renovation of O/O

DHS SUB TOTAL OF IMEP INFRASTRUCTURE AND 0 0 0 0.00 0.00 0.00 HR

10 TRAINING

Carry out repairs/ renovations of the training institutions(LECTURE HALL 10.1.1 50+ HOSTEL 55 + ELECTRICITY REPAIRING 36 + SUPPORT SERVICE 15) Provide equipment and training aids to the training 10.1.2 institutions (AV equipments + Library books)

Contractual staff recruited 10.1.3 and in position

278

Other activities (pl. specify) 10.1.4 VEHICLES & CONTINGENCIES

Development of training 10 packages

Development/ translation and duplication of training materials (PRINTING OF 10.2.1 IMNCI CHARTS, MODULES & BOOKLETS ETC AND BCC, RTI/STI MODULES, ARSH MODULES, SBA MODULES)

Specialised training equipment (for skills 10.2.2 trainings) provided (IMNCI trg aids & ZOE Model)

10.2.3 Other activities (pl. specify) Monitoring of Training 10.2.4 programme Regional Training Co- 10.2.5 ordinating Unit SUB TOTAL OF 10.1 TO 0.00 0.00 0.00 0.00 0.00 0.00 0.00 10.2.5

10 Maternal Health Training

Skilled Attendance at Birth / 10.3.1 SBA

Setting up of SBA Training 10.3.1.1 Centres

10.3.1.2 TOT for SBA

Training of Medical Officers in 10.3.1.3 Management of Common Obstetric Complications

Training of Staff Nurses in 10.3.1.4 SBA

Training of ANMs / LHVs in 10.3.1.5 SBA

279

10.3.2 EmOC Training

Setting up of EmOC Training 10.3.2.1 Centres

10.3.2.2 TOT for EmOC

Training of Medical Officers in 10.3.2.3 EmOC

Life saving Anaesthesia 10.3.3 skills training Setting up of Life saving 10.3.3.1 Anaesthesia skills Training Centres

TOT for Anaesthesia skills 10.3.3.2 training

Training of Medical Officers in 10.3.3.3 life saving Anaesthesia skills

Safe abortion services 10.3.4 training (including MVA/ EVA and Medical abortion)

TOT on safe abortion 10.3.4.1 services

Training of Medical Officers 10.3.4.2 in safe abortion

10.3.5. RTI / STI Training

10.3.5.1 TOT for RTI/STI training

Training of laboratory 10.3.5.2 technicians in RTI/STI

280

Training of Medical Officers 10.3.5.3 in RTI/STI

Training of Staff Nurses in 10.3.5.4 RTI/STI

Training of ANMs / LHVs in 10.3.5.5 RTI/STI

Orientation of Dai / TBAs 10.3.6 on safe delivery Other maternal health 10.3.7 training (please specify) District Orientation Trg. For 10.3.7.1 Mos

Integrated MCH Services 10.3.7.2 Orientation

State level ToT Block level ToT

ANM Multi Skilling of Medical 10.3.8 Officers on Radiology Multi Skilling of Medical 10.3.9 Officers on Clinical Pathology 10 IMEP Training

10.4.1 TOT on IMEP

IMEP training for state and 10.4.2 district programme managers IMEP training for medical 10.4.3 officers

SUB TOTAL OF MATERNAL 0.00 0.00 0.00 0.00 0.00 0.00 0.00 HEALTH TRAINING

281

11 Child Health Training

IMNCI Training (pre- 10.5.1 service and in-service)

TOT on IMNCI (pre- 10.5.1.1 service and in-service)

IMNCI Training for 10.5.1.2 Medical Officers

IMNCI Training for staff 10.5.1.3 nurses

1096 ANMs/ IMNCI Training for ANMs / 10.5.1.4 AWWs 120 120 120 120 480 171370/batch 8.55 8.55 8.55 8.55 34.2 LHVs (20 batches) IMNCI Training for 10.5.1.5 Anganwadi Workers

Multi Skilling Training of 10.5.1.6 Mos of FRUs & CHCs

10.5.1.7 SNCU TRAINING

SUB TOTAL OF CHILD 8.55 8.55 132.1 192.8 34.2 0 34.2 HEALTH TRAINING Family Planning 11 Training Laparoscopic 10.6.1 Sterilisation Training

TOT on laparoscopic 10.6.1.1 sterilisation

Laparoscopic sterilisation 10.6.1.2 training for medical officers

10.6.2 Minilap Training

282

10.6.2.1 TOT on Minilap

Minilap training for 10.6.2.2 medical officers

Non-Scalpel Vasectomy 10.6.3 (NSV) Training

10.6.3.1 TOT on NSV

10.6.3.2 NSV

10.6.4 IUD Insertion

10.6.4.1 TOT for IUD insertion

Training of Medical officers 10.6.4.2 in IUD insertion (DTT Level)

Training of staff nurses in 10.6.4.3 IUD insertion

Training of ANMs / LHVs in 10.6.4.4 IUD insertion

Contraceptive update/ISD 10.6.5 Training

Other family planning 10.6.6 training (please specify)

SUB TOTAL OF FAMILY 0 0 0 0 0 0.00 0.00 PLANNING TRAINING Adolescent Reproductive and 11 Sexual Health/ARSH Training 10.7.1 TOT for ARSH training

283

Orientation training of 10.7.2 state and district programme managers ARSH training for medical 10.7.3 officers ARSH training for 10.7.4 ANMs/LHVs

10.7.5 ARSH training for AWWs

Training of ASACS 10.7.6 counselors SUB TOTAL OF ARSH 0 0 0 0 0 0 0.00 TRAINING

Other training

BCC Training for DTT BCC Training for ASHA SUB TOTAL OF OTHER 0 0 0 0 0.00 0 0.00 TRAINING SUB TOTAL OF 8.55 8.55 132.12 192.79 34.20 0.00 34.20 TRAINING

11 BCC/IEC

11.1 Setting up and development of IEC/BCC unit at the district level (Procurement of Laptop) 35000 350000 0 0

11.2 Meeting Manpower requirements at District level 0 0 0 0

11.3 Formative research/situational analysis/baseline study to identify focus areas 105000 105000 105000 105000

284

Develop IEC/BCC Strategy Streamline objectives/identify Communication tools/identify 11.4 media mix as per target audience/frame monitoring evaluation indicators Identify external agency/Advertising agency for the task (if needed) 0 0 0 0 Media Mix Develop a strategic media mix as 11.5 per the target population and issues( Child Health, Maternal Health/Family Planning) 0 0 0 0

a). Interpersonal

11.6 Communications

11.7 Counselling at FRUs, PHCs etc 0 0 0 0

One to one interaction by 11.8 ASHAs/ANMs/AWWs 0 0 0 0

Group discussions at Village/Block 11.9 /Panchayat level ( by BEE, HE, LHV) 148500 148500 148500 148500

Community Meetings ( Will be 11.10 conducted by VHSC) 0 0 0 0

Workshops at Panchayath/ Block 11.11 District level 35000 35000 35000 35000

11.12 b). Community Media

Folk arts ( preparation of Audio 11.13 Cassette & miking) 91000 91000 91000 91000

285

Street plays ( Rs.3000 X 12 months 11.14 X 7 BPHC) 63000 63000 63000 63000

11.15 Health Melas 25000 0 0 0

11.16 Rallies 17500 17500 17500 17500

11.17 Social Mobilisation Programmes 0 0 0 0

11.18 c). Outdoor Media

11.19 Banners 150000 150000 150000 150000

11.20 Bus Boards 0 25000 0 0

Bulletin Boards ( information Boards 11.21 2 nos for per SC wise) 492000 0 492000 0 Sign ages (Hoardings 5 nos for per 11.22 BPHC) 0 350000 0 0

11.23 d). Television Spots 0 0 0 0

11.24 e). Radio Programmes 0 0 0 0

11.25 f). Newspaper advertisements 0 0 0 0

11.26 g). Print materials 0 0 0 0

11.27 Pamphlets @ Rs.1/- X 20,000 X 4Q 20000 20000 20000 20000

11.28 Poster @ Rs.5 X 8000 X 4Q 40000 40000 40000 40000

11.29 Flip Charts 0 0 0 0

11.30 Newsletter @ Rs.25 X 4000 X 4Q 100000 100000 100000 100000

11.31 Annual Report @ Rs. 25 X 4000 0 0 100000 0

11.32 Flash cards 0 0 0 0

286

Calendars and danglers@ Rs 50 X 11.33 300 nos 0 0 15000 0

11.34 BCC implementation Components

Capacity Building and training of manpower Designate 11.35 responsibilities as per task/identify coordinator and design activity chart

0 0 0 0

11.36 Capacity building of Staff 10000 0 0 0

11.37 Internal Workshops 0 0 0 0

Specialised training for Staff 11.38 members 35000 35000 35000 35000

Monitoring and evaluation 11.39 Midterm monitoring Evaluation of the Programme 0 0 0 0 SUB TOTAL OF BCC 11.1 13.67 15.3 14.12 8.05 51.14 51.14 TO 11.39

SUB TOTAL OF BCC/IEC

287

12 PROCUREMENT

Maternal Health

Partograph

ANC Card

24 x 7 PHC - Equipments for 24x7 facilities for Maternal Health

FRU - OT Instruments & new born caer instruments for FRU

SNCU Equipments

Stabilization Centre - Bed

Stabilization Centre -

Equipments

Stabilization Centre -

Servo Satbilizer

Sub Total

Family Planning

288

IUD Insertion Kit

OCP

Nirodh

EC Pill

Laparoscopes with CO2/ Air

Insuflation

Minilap kit

MVA kit

NSV kit

OT Table for Lap operation

2 nos. CO cylinder for 24 DH 2 and 37 FRU SUB TOTAL

Child Health

IMNCI Kits

Tab Albendazole

Vitamin A solution

Sub Total

SUB TOTAL OF 0.00 0.00 0.00 PROCUREMENT

PROGRAMME 13 MANAGEMENT

289

A- State Programme

1 Management Unit (SPMU)

Salary of the SPMU 0.00

A- District Programme

2 Management Unit (DPMU)

Salary of the DPMU 2.27 2.27 2.27 2.27 9.08 14.38 -5.3

A- Strengthing of Financial

3 Management System

Training in accounting a procedures

Annual Audit of the b Programme c Concurrent Audit c1 District Level

c2 State Level

c3 Regional Workshop

SUB TOTAL OF PROGRAMME 0.00 0.00 0.00 9.08 0.00 9.08 MANAGEMENT

SUB TOTAL BASE FLEXI 1023.12 561.73 461.39 POOL

A- Janani Suraksha Yojana 1

Institutional Delivery

290

Rural

Urban

Home Delivery

SUB TOTAL OF JSY 0.00 0.00 0.00

Family Planning compensation (male and A2 0.00 Female), Sterlization camps and Mega camps GRAND TOTAL (RCH 1023.12 561.73 461.39 FLEXIPOOL)

291

ANNEXURE

Annex-I Status of FRU Operationalization S. Total No of FRUs Target for *FRUs operationalized till District NO Planned till 2010 2009-10 December, 2009 Dhubri 2 1 *Must fulfil GoI Minimum Criteria Status of 24x7 PHCs S. District Total No of 24x7 Target for 2009- *24x7 PHCs NO PHCs Planned till 10 operationalized 2010 till December, 2010 Dhubri 24 11 14 *Must fulfil GoI Minimum Criteria Status of Anaesthesia Training S. No of No of Total No Target No No of trained MOs N State Medical District of for trained posted at FRU till O Colleges Hospitals MBBS 2009- till December 2009 conducting conductin Doctors 10 Decem LSAS g LSAS to be ber Training Training trained in 2009 LSAS till 2010 1

Status of EmOC Training S. State No of No of Total No Target No No of NO Medical District of MBBS for 2009- trained trained Colleges Hospitals Doctors 10 till MOs conducting conducting to be December posted at EmOC EmOC trained in 2009 FRUs till Training Training EmOC December till 2010 2009 1 1 1 Nil Status of SBA Training S. No of No of district No of No of Target No NO State districts hospitals/training Master SNs/ANMs/LHVs for trained conducting institutes Trainers to be trained till 2009- till SBA practicing SBA trained 2010 10 December Training Protocols (Both 2009 particularly State and Partograph Districts) 1 GNM=24, GNM=17 ANM=12 LHV=10 ANM=53

293

Status of MTP Training S. State No of doctors planned to No. trained No. of 24x7 No. Of NO be trained in till PHCs DH/FRUs MA/MVA/EVA/ till 2010 December providing providing 2009 safe comprehensive Abortion safe abortion Services services Dhubri MO=15 O&G=6 Nil 2

S. District. Budget allocated under MH Budget Budget Budget NO (excluding JSY 2009-10) utilized allocated utilized under under MH under JSY JSY till (excluding 2009-10 December JSY till 2009 December 2009) Dhubri 6,000,000.00 5,093,000.00 5 Cr 2 cr 89 Lakhs

Table on Incentives No of Name of Level of Facility Amount Type of Performance worker Quantifiable the (CHCs/PHCs/Sub- of Worker Expected given Output Scheme Centres) Incentive incentive

294

Annexure B (PtI) Additiional requirment of Equiptment/Instrument with present status of Dhubri District:

Oxygen Cylinder B Oxygen Radiant Resuciation Electric Autoclave Type Cylinder B Warmer Kit Sterilizer Name of Health with Flow Type Sl.No. Institutions Meter

Add Add Add Add Add Add PS PS PS PS PS PS Req Req Req Req Req Req Dharmasala 1 1 1 1 1 1 1 PHC 2 Raniganj PHC 1 1 1 1 1 1 1 3 Golakganj PHC 1 1 1 1 1 1 1 Gazarikandi 4 1 1 0 1 1 1 1 PHC 5 Bilasipara SHC 1 1 0 1 1 3 3 Sapatgram 6 1 1 1 1 1 1 SHC Sadullabari 7 1 1 1 1 1 1 SHC 8 Salkocha SHC 1 1 1 1 1 1 South Salmara 9 0 1 0 1 0 1 1 1 1 CHC(Kowahagi)

10 Gauripur CHC 1 1 1 1 1 1 1 11 Halakura CHC 1 0 1 1 1 1 1 1 12 Agomoni CHC 1 0 1 1 1 1 1 1 Mankachar 13 1 1 0 1 1 1 1 CHC Geramari 14 0 1 0 1 0 1 1 1 1 MPHC 15 Santipur MPHC 0 1 0 1 0 1 1 1 1 16 Jarua MPHC 0 1 0 1 0 1 1 1 1 Dumordaha 17 0 1 0 1 0 1 1 1 1 MPHC Tamarhat 18 1 1 1 1 1 1 1 MPHC 19 Satrasal MPHC 1 1 1 1 1 1 20 Bagribari SD 0 1 0 1 0 1 1 1 1 21 Medortary SD 0 1 0 1 0 1 1 1 1 22 Futkibari SD 0 1 0 1 0 1 1 1 1 23 Berbhangi SD 0 1 0 1 0 1 1 1 1 24 Jhowdanga SD 0 1 0 1 0 1 1 1 1 20 Bedded Mat. 25 1 1 1 1 1 1 1 Centre, Dhubri 26 Bahalpur SD 1 1 0 1 1 1 1

295

27 Boterhat SD 1 1 0 1 1 1 1 28 Kakripara SD 1 0 1 0 1 1 1 1 29 Dhepdhepi SD 1 1 1 1 1 1 30 Moterjhar SD 1 1 1 1 1 1 Kachokhana 31 1 1 1 1 1 1 SD 32 Lakhiganj SD 1 1 1 1 1 1 Total 22 10 19 13 16 23 13 19 13 21 12 22

Trolley, Humidifier, Patient Instrument Wrench Foot Invalid trolley IV Dip Bed Side- Trolley and Step- Wheel with Stand Locker ( high Name of Health Neonatal Double Chair removable Sl.No. quality ) Institutions Mask & top Adult Mask

Add Add Add Add Add Add Add PS PS PS PS PS PS PS Req Req Req Req Req Req Req Dharmasala 1 1 1 2 6 1 1 1 PHC 2 Raniganj PHC 1 1 2 6 1 1 1

3 Golakganj PHC 1 4 4 1 1 1 1 Gazarikandi 4 1 1 2 6 1 1 1 PHC 5 Bilasipara SHC 1 3 15 10 1 1 1 Sapatgram 6 1 1 2 6 1 1 1 SHC Sadullabari 7 1 1 2 6 1 1 1 SHC 8 Salkocha SHC 1 1 2 6 1 1 1 South Salmara 9 1 1 2 6 1 1 1 CHC(Kowahagi)

10 Gauripur CHC 1 1 2 5 1 1 1 11 Halakura CHC 1 1 10 20 1 1 1 12 Agomoni CHC 1 1 2 6 1 1 1 Mankachar 13 1 1 2 6 1 1 1 CHC Geramari 14 1 1 2 6 1 1 1 MPHC 15 Santipur MPHC 1 1 2 6 1 1 1 16 Jarua MPHC 1 1 2 6 1 1 1 Dumordaha 17 1 1 2 6 1 1 1 MPHC Tamarhat 18 1 1 2 6 1 1 1 MPHC 19 Satrasal MPHC 1 1 2 6 1 1 1

296

20 Bagribari SD 1 1 2 6 1 1 1 21 Medortary SD 1 1 2 6 1 1 1

22 Futkibari SD 1 1 2 6 1 1 1 23 Berbhangi SD 1 1 2 6 1 1 1 24 Jhowdanga SD 1 1 2 6 1 1 1 20 Bedded Mat. 25 1 1 2 6 1 1 1 Centre, Dhubri 26 Bahalpur SD 1 1 2 6 1 1 1 27 Boterhat SD 1 1 2 6 1 1 1

28 Kakripara SD 1 1 2 6 1 1 1 29 Dhepdhepi SD 1 1 2 6 1 1 1 30 Moterjhar SD 1 1 2 6 1 1 1 Kachokhana 31 1 1 2 6 1 1 1 SD 32 Lakhiganj SD 1 1 2 6 1 1 1 Total 9 23 17 20 53 34 90 114 10 22 10 22 10 22

Labour Steel Toothed Instrument Table with Stand Tray Artery Cabinet foam Light Name of Health with lid Forcep Sl.No. mattress Institutions

Add Add Add Add Add PS PS PS PS PS Req Req Req Req Req Dharmasala 1 1 1 1 2 1 PHC 2 Raniganj PHC 1 1 1 1 2 1

3 Golakganj PHC 1 1 1 2 1 Gazarikandi 4 1 1 1 1 2 1 PHC 5 Bilasipara SHC 1 1 1 2 5 Sapatgram 6 1 1 1 2 1 SHC Sadullabari 7 1 1 1 2 1 SHC 8 Salkocha SHC 1 1 1 2 1 South Salmara 9 1 0 1 1 2 1 CHC(Kowahagi)

10 Gauripur CHC 1 1 1 1 2 1 11 Halakura CHC 1 1 1 1 2 1 12 Agomoni CHC 1 1 1 1 2 1 Mankachar 13 1 1 1 1 2 1 CHC

297

Geramari 14 1 0 1 1 2 1 MPHC 15 Santipur MPHC 1 0 1 1 2 1 16 Jarua MPHC 1 0 1 1 2 1 Dumordaha 17 1 0 1 1 2 1 MPHC Tamarhat 18 1 1 1 1 2 1 MPHC 19 Satrasal MPHC 1 1 1 2 1 20 Bagribari SD 1 0 1 1 2 1 21 Medortary SD 1 0 1 1 2 1

22 Futkibari SD 1 1 1 1 2 4 23 Berbhangi SD 1 0 1 1 2 1 24 Jhowdanga SD 1 0 1 1 2 1 20 Bedded Mat. 25 1 1 1 1 2 1 Centre, Dhubri 26 Bahalpur SD 1 0 1 1 2 1

27 Boterhat SD 1 1 1 1 2 1 28 Kakripara SD 1 0 1 1 2 1 29 Dhepdhepi SD 1 1 1 2 1 30 Moterjhar SD 1 1 1 2 1 Kachokhana 31 1 1 1 1 1 SD 32 Lakhiganj SD 1 1 1 1 1 Total 10 22 21 21 11 21 20 42 20 19

Needle Episiotomy Dressing Tissue Binocular Bowls Holder Scissor Drums Forceps Microscope Name of Health Sl.No. Institutions

Add Add Add Add Add Add PS PS PS PS PS PS Req Req Req Req Req Req Dharmasala 1 1 1 2 2 2 1 PHC 2 2 Raniganj PHC 1 2 2 2 2 1 3 Golakganj PHC 1 2 1 1 2 2 1 Gazarikandi 4 1 2 2 2 2 1 PHC 5 Bilasipara SHC 1 3 3 2 2 1 Sapatgram 6 1 1 2 2 2 1 SHC Sadullabari 7 1 1 2 2 2 1 SHC

298

8 Salkocha SHC 1 1 2 2 2 1 South Salmara 9 1 2 2 2 2 1 CHC(Kowahagi) 10 Gauripur CHC 1 1 1 1 1 2 1 1 11 Halakura CHC 1 2 2 2 2 1 12 Agomoni CHC 1 2 2 2 2 1 Mankachar 13 1 2 2 2 2 1 CHC Geramari 14 1 2 2 2 2 1 MPHC 15 Santipur MPHC 1 2 2 2 2 1 16 Jarua MPHC 1 2 2 2 2 1 Dumordaha 17 1 2 2 2 2 1 MPHC Tamarhat 18 1 2 2 2 2 1 MPHC 19 Satrasal MPHC 1 1 1 2 2 2 1 20 Bagribari SD 1 2 2 2 2 1

21 Medortary SD 1 2 2 2 2 1 22 Futkibari SD 1 2 1 1 1 1 1 23 Berbhangi SD 1 2 2 2 2 1 24 Jhowdanga SD 1 2 2 2 2 1 20 Bedded Mat. 25 1 2 2 2 2 1 Centre, Dhubri 26 Bahalpur SD 1 2 2 2 2 1 27 Boterhat SD 1 2 2 2 2 1 28 Kakripara SD 1 2 2 2 2 1 29 Dhepdhepi SD 1 1 1 2 2 2 1 30 Moterjhar SD 1 1 1 2 2 2 1 Kachokhana 31 1 1 1 2 2 2 1 SD 32 Lakhiganj SD 1 1 1 2 2 2 1 Total 9 23 15 48 24 41 39 24 22 40 12 20

299

DG Set Requirement Format for Dist. Hospital, SDCH, FRU, CHC, BPHC, 24X7 PHC Annexure B

PtII Name of the District: Dhubri

Whether Present Status of the DG No. of Capacity covered Set Present Name of the Delivery Make of Dt. of Source of Sl.No of DG under Requirement Remarkas Health Institution 0910(upto DG Set Installation Supply beyond Set AMC Need if any Sep'09) Working economic (Y/N) repair repair

Dhubri Civil 30 KV & 1 2223 Kirlosker NA Govt N Y 1 30 KV Hospital 14 KV

Within Dhubri Health & 2 143 NA 5 KW NA Govt. Supply N Y Y economic 1 Maternity Centre repair 1st Phase 3 Halakura CHC 1064 NA NA NA NA NA 1 distribuion

Govt. supply under NRHM Low HP 4 Agomoni CHC 348 Kirlosker 8 HP 27-2-09 scheme along Y Y Y Y 1 Generator with newly needed labour room

5 Boterhat SD 105 NA NA NA NA NA 1

6 Satrasala MPHC 61 NA NA NA NA NA 1

7 Golakganj PHC 631 USHA 5 KV NA Govt. Supply NO Y N

301

8 Kachokhana SD 76 NA NA NA NA NO 1

9 Dhepdhepi MPHC 37 NA NA NA NA NO 1

10 Moterjhar SD 97 NA NA NA NA NO 1

1st Phase 11 Tamahat PHC 363 NA NA NA NA NO 1 distribuion

NRHM RKS Recently 12 Raniganj PHC 68 Honda 2.5 KV NA Y Y N Fund Purchased

1st Phase 13 Bilasipara SHC 564 NA NA NA NA No 1 distribuion

14 Sapatgram SHC 118 NA NA NA NA No 1

15 Lakhiganj SD 78 NA NA NA NA No 1

16 Futkibari SD 34 NA NA NA NA No 1

17 Chapor FRU 358 Kirlosker 10 KV NA Govt No Y N

18 Salkocha SHC 45 NA NA NA NA NA 1

302

19 Bahalpur SD 17 NA NA NA NA NA 1

20 Gazarikandi BPHC 797 USHA 5 KV 23.7.07 Govt NA Y 1 10 KV

1st Phase 21 Mankachar CHC 388 NA NA NA NA NA 1 distribuion

22 Dharmasala BPHC 246 Birla 12 KV Oct, 2009 Govt Y Y N

5 KV (1st 23 Gauripur CHC 164 Kirlosker 2.5 KV May, 2006 Govt NA Y 1 Phase distribuion)

303

Instittionwise requirement of Contractual manpower AnnexureC NAME OF THE HEALTH MO SL Type of Institution AYUR GNM INSTITUTION MBBS 1 Tamahat MPHC 24 x7 PHCs 1 0 2 2 Moterjhar SD 24 x7 PHCs 0 1 1 3 Kachokhana SD 24 x7 PHCs 0 0 1 4 Dhepdhepi MPHC 24 x7 PHCs 0 0 1 5 Berbhangi SD 24 x7 PHCs 0 0 3 6 Dumardaha MPHC 24 x7 PHCs 0 1 3 7 BATERHAT SD 24 x7 PHCs 1 0 2 8 SATRASAL MPHC 24 x7 PHCs 0 0 2 9 Geramari MPHC 24 x7 PHCs 0 0 3 10 S.Salmara CHC(Tumni) 24 x7 PHCs 0 0 4 11 Medortari SD 24 x7 PHCs 0 0 3 12 Jarua MPHC 24 x7 PHCs 0 0 3 13 Jhowdanga SD 24 x7 PHCs 0 1 3 14 Kakripara SD 24 x7 PHCs 0 0 3 15 Sadullabari SHC 24 x7 PHCs 0 0 3 16 Lakhiganj SD 24 x7 PHCs 0 0 1 17 Futkibari SD 24 x7 PHCs 0 0 3 18 Bagribari SD 24 x7 PHCs 0 0 3 19 Santipur MPHC 24 x7 PHCs 0 0 3 20 Salkocha SHC 24 x7 PHCs 0 0 2 21 Champabati MPHC 24 x7 PHCs 0 0 0 Total 2 3 49

305

306

266