AROGYA KERALAM WAYANAD
PROGPROGRAMMERAMME IMPLEMENTATION PLAN 2011 --- 11121222
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INDEX
SL. Particulars Page No No
1 Chapter I - Executive Summery 3
2 Chapter II – Situation Analysis 6
3 Chapter III - Fund Details 2009-10 13
4 Budget ear marked for 2010-11 17
5 Fund Utlized till 30 th Nov 2010 26
6 Chapter IV - DHAP 34
7 Activity wise PIP – A - RCH 74
8 Activity wise PIP – B – Additionalties 127
9 Activity wise PIP – C – Immunization 172
10 Chapter V - Disease Control Programmes 173
11 Other Activities (D1-NVBDCP) 174
12 Other Activities (D2-NLEP) 179
13 Other Activities (D3-RNTCP) 183
14 Other Activities (D4-NPCB) 184
15 Other Activities (D5-IDSP) 185
16 Other Activities (D6-IDD) 186
17 Chapter VI – Intersectoral Convergence 187
18 AYUSH 188
19 Monitoring and Evaluation 189
20 Budget Summary 191
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Chapter 1 EXECUTIVE SUMMARY
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It is the 6th year of implementation of NRHM in this backward tribal high focus district of wayanad in non high focus state of Kerala. The program has led to an overall transformation of a majority of institutions in their structure, facility upgrading, resource availability, manpowering, and decentralization of finance management. Empowering of existing health system and introducing and integrating newer programs of non- communicable disease control program, palliative care program, sickle cell disease control program, district mental health program have infused new vigour into the health services of the district and gives us pride to declare as successful widely accepted and fruitful health interventions carried out with ASHAs.
Integration of HISP into statistical data collection and analysis, District planning using this data both for communicable, non-communicable diseases, planning for interventions in the field of maternal and child health, recognizing the vulnerable areas requiring additional inputs in the realm of tribal health have all been contributions of expertise provided in IDSP and HISP through NRHM.
These are the visible outcomes of NRHM:
• Out Patient increase from 166510 in2005 to 332878 in 2010 • Inpatient service increase from 15152 (2005) to 23596 (2010) • Operationalising 24/7 PHCs from 2 in2005 to 8 in 2010 • Operationalising delivery services from 3 in 2005 to 6 in 2010 • Bringing a shift in total deliveries conducted in private sector to the public sector. • Enhancement of immunization coverage • Reduction of home deliveries • Reduction of Maternal mortality rate • Reduction of tribal specific maternal mortality rate • Delivery of non communicable disease package through 204 fixed clinic day to beneficiaries • Delivery of sickle cell special clinics with nutrition augmentation at -15- centres. • Delivery of mobile mental health care services though fixed day clincs at 16 centres. • Delivery of Palliative care program through 6PRI home care initiatives
These being only an illustrative list, we are aware of our challenges also.
We also have a vision for Wayanad: POORNAYU: a convergence for total and positive health for the entire span of life addressing health issues at each stage of life.
Our utmost concerns are the following ;
Reducing home deliveries to prevent maternal mortality. Reducing adolescent anemia. Improve ante natal nutrition and thereby improve birth weight of newborns, currently the lowest in the state. Address high incidence of Hepatits B infection among tribals. Address socio- economic health impact of widespread alcoholism among tribes.
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Reducing incidence of vector borne disease Reduce high incidence and mortality of Leptospirosis in the district
Our strategies for the same are elaborated in succeeding chapters: however, in a nutshell they would be:
Call-taxi- reimburse-at-flexipool fund at facility level. Special supplementation .convergence program with ASHA and AWW for adolescents. Special cooked food incentive to antenatal women on clinic days converging with Kudumbasree to augment maternal check up at sub centre level Incorporating Hepatitis B screening in Tribal Mobile camps and immunize at risk contacts. Empowering vector control unit to facilitate reduction of increasing malaria Special migrant population programs to address import of communicable, VPDs. Support to existing special programs. Integrated , convergent program to combat Leptospirosis in the district. FRU upgradation at selected delivery servicing facilities Manpower augmentation to achieve the above. Providing of better technology at selected laboratories. Developing a technology equipped district level coordinating office to achieve our objectives These being our district picture, a brief budget summary is as follows.
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Chapter II SITUATION ANALYSIS
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District Profile
Area : 2132 sq. km Dt. HQ : KALPETTA Population : 7,80,619 Tribal Population : 1,36,062 Density : 369/sq. km Health Blocks : 5 Revenue Blocks : 4
Villages Wards Year Blocks SCs PHCs CHCs DH GH THQH (Wards) Panchayat Municipal Corporation
2005-06 3 25 1 0 204 21 9 1 0 2
2006-07 3 25 1 0 204 21 9 1 0 2
2007-08 3 25 1 0 204 23 4 1 0 2
2008-09 459 3 25 1 0 204 23 8 1 1 2
2009-10 459 3 25 1 0 204 23 8 1 1 2
2010-11 487 4 25 1 0 204 23 8 1 1 2
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Health services in wayanad District Hospital : 1 Taluk Hospital : 2 General Hospital : 1 Community Health Centre : 9 24 x 7 Primary Health Centre : 8 Primary Health Centre : 13 TMMU : 5 Sub Centres : 204 JHI (MPW) Sections : 126
Health Indices – Wayanad
Life Expectancy (Male) : 66 Life Expectancy (Female) : 72 Birth Rate : 17.8 Death Rate : 6.8 IMR : 13.8 MMR : 0.98 TFR : 2.6
Sex Ratio : 1005
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ACHIEVEMENTS IN NUT SHELL
Outpatient April 09- March 10 April 10-Nov10
OPD attendance (All) 1882428 1289593
INPATIENT ADMISSIONS April 09-March 10 April 10- Nov 10
Children 12601 10533
Adults 42867 30997
FAMILY PLANNING
Activity April 10- Nov 10 April 09- March 10 Number of NSV/Conventional Vasectomy conducted 168 141
Number of Laparoscopic sterilizations conducted 265 264
Number of Mini-lap sterilizations conducted 123 59
Number of Post-Partum sterilizations conducted 2630 1613
Number of IUD Insertions 1774 1170
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CHILD IMMUNIZATION
Number of Infants 0 to 11 months old who received the April 09- April 10-Nov following: March 10 10 Percentage
BCG 15587 9953 105.75%
DPT1 14797 9605 102.05%
DPT2 14611 9480 100.72%
DPT3 14662 9341 99.25%
OPV 0 (Birth Dose) 13218 9023 95.87%
OPV1 14494 9589 101.88%
OPV2 14495 9451 100.41%
OPV3 14830 9266 98.45%
Hepatitis-B1 14431 9449 100.39%
Hepatitis-B2 13859 9215 97.91%
Hepatitis-B3 14446 9179 97.52%
Measles 13315 8480 90.09%
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Major N.G.O’s in Wayanad District
There are many NGO’s working in Wayanad District. Swami Vivekananda Medical Mission is the Mother NGO selected for Wayanad District under the RCH programme. They have selected 4 field NGO’s working under them in the selected underserved areas of Wayanad
1. Rastha, Kambalakkad : Pakkom Area 2. Arshabharath, Meppadi : Meppadi 3. Wayanad Sarva Seva Mandalam : Noolpuzha 4. Swami Vivekananda Medical Mission : Tirunelly
Some of the other NGO’s working in the District include
1. Nehru Yuvak Kendra, Kalpetta 2. Wayanad Social Service Society, Mananthavady 3. World Vision, Mananthavady 4. HILDA, Sulthan Bathery 5. Red Cross Society, Pulpally 6. Rotary International 7. Lions Club 8. Y.M.C.A. 9. Sreyas, Sulthan Bathery 10. Wayanad Initiative in Palliative Care
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HEALTH BLOCK WISE INSTITUTIONS Porunnannur Thariode Meppady Meenangadi Pulpally CHC Porunna nnur CHC Thariode CHC Meppady CHC Meenangadi CHC Pulpallly CHC Perya PHC Kappukunnu GH Kalpetta CHC Ambalavayal THQH Bathery Dist.Hospital PHC Padinjarathara THQH Vythiri PHC Varadoor 24 X 7 PHC Mananthavady Mullankolly CHC Panamaram PHC Kappukunnu PHC Sugandagiri PHC Chulliode PHC Pakkom CHC Nallornadu PHC Pozhuthana 24 X 7 PHC Cheeral 24 X 7 PHC Poothadi PHC Begur PHC Vengapally 24 X 7 PHC 24 X 7 PHC Vazhavatta Noolpuzha 24 X 7 PHC Appapara PHC Chethalayam PHC Kurukkanmoola 24 X 7 PHC Eda vaka PHC Thondernadu 24 X 7 PHC Vellamunda
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CHAPTER III
FUNDS ALLOTTED AND UTILIZED TILL 2009-10 EACH CATEGORY
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CONSOLIDATED FUND RECEIVED AND UTILIZED TILL 2010-11(UP TO NOV 2010)
Year Opening Fund Total fund with Expenditure % of exp Balance Balance received the Society reported 2005-06 0 0.22 0.22 0 0% 0.22 2006-07 0.22 1.495 1.715 0.4822 28% 1.2328 2007-08 1.2328 5.0461 6.2789 3.7506 60% 2.5283
2008-09 2.5283 7.805 10.3333 6.074 59% 4.2593 2009-10 4.2593 6.392 10.6513 9.345 88% 1.3063 2010 11 1.3063 5.034 6.3403 3.38 53.3% 2.96 (tiilll Nov10) TOTAL - 24.8921 - 23.0518 93% 2.96
*Amounts Shown Above Are In Crores
CONSOLIDATED FUND RECEIVED AND UTILIZED TILL 2010-11(UP TO NOV 2010) UNDER A-RCH
Year Opening Fund Total fund with Expenditure % of exp Balance (carry Balance received the Society reported forward to next year) 2005 06 ….. 0.18 0.18 0 0% 0.18 2006 07 0.18 0.31 0.49 0.3 61% 0.19 2007 08 0.19 3.35 3.54 3.01 85% 0.53 2008 09 0.53 4.35 4.88 3.74 77% 1.14 2009 10 1.14 3.83 4.97 4.87 98% 0.1 2010 11 0.1 2.86 2.76 2.34 84% ( 0.42 (tiilll Nov10) TOTAL - 14.17 - 14.72 99% 0.42
*Amounts Shown Above Are In Crores
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CONSOLIDATED FUND RECEIVED AND UTILIZED TILL 2010-11(UP TO NOV 2010) Under B – NRHM FLEXI POOL
Year Opening Fund Total fund with Expenditure % of exp Balance (carry Balance received the Society reported forward to next year) 2005 06 0 0 0 0 0% 0 2006 07 0 1.091 1.091 0.088 8% 1.003 2007 08 1.003 1.632 2.635 0.67 25% 1.965 2008 09 1.965 3.228 5.193 2.259 44% 2.934 2009 10 2.934 2.348 5.282 4.235 80% 1.047 2010 11 1.047 2.184 3.231 1.79 55.4% 1.441 (tiillll Nov''10) TOTAL - 10.083 - 8.242 83% 1.441
*Amounts Shown Above Are In Crores
CONSOLIDATED FUND RECEIVED AND UTILIZED TILL 2010-11(UP TO NOV 2010) UNDER C - IMMUNISATION
Year Opening Fund Total fund Expenditure % of exp Balance (carry Balance received with the reported forward to next year) Society 2005 06 0 0.04 0.04 0 0% 0.04 2006 07 0.04 0.094 0.134 0.0942 70% 0.0398 2007 08 0.0398 0.0641 0.1039 0.0706 68% 0.0333 2008 09 0.0333 0.227 0.2603 0.075 29% 0.1853 2009 10 0.1853 0.214 0.3993 0.24 60% 0.1593 2010 11 0.1593 0 0.1593 0.0267 16% 0.1326 (tiilll Nov10) TOTAL - 0.6391 - 0.5065 78% 0.1326
*Amounts Shown Above Are In Crores
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CONSOLIDATED FUND RECEIVED AND UTILIZED TILL 2010 -11(UP TO NOV 2010) UNDER ADDITIONALITIES
FUND ALLOTED FUND UTILIZED SL FUND 2009-10 2009-10 NO. 2006-07 2007-08 2008-09 TOTAL 2006-07 2007-08 2008-09 TOTAL 1 UTF S/C 1670000 2130000 1940000 2040000 7780000 253396 2384727 1679078 1869735 6186936 2 HMC 2550000 3100000 4600000 10250000 329746 2311788 2810964 5452498 3 WHSC 4363550 3339550 4500000 12203100 1200786 3695078 4023576 8919440 UTF 925000 682936 4 CHC/PHC 125000 1325000 825000 3200000 50000 649794 782324 2165054 5 AMG S/C 2530000 1390000 2050000 5970000 637000 1538204 1341639 3516843 AMG 1700000 1078154 6 CHC/PHC 50000 2350000 1250000 5350000 909732 1459203 3447089 TOTAL 1845000 15248550 11844550 28938100 44753100 303396 6111785 11465675 46818956 29687860
CONSOLIDATED FUND RECEIVED AND UTILIZED TILL 2010-11(UP TO NOV 2010) UTF AMG FUND UTF S/C HMC WHSC CHC/PHC AMG S/C CHC/PHC TOTAL 2006 -07 1670000 125000 50000 1845000 2007-08 2130000 2550000 4363550 1325000 2530000 2350000 15248550 2008-09 1940000 3100000 3339550 825000 1390000 1250000 11844550 2009-10 2040000 4600000 4500000 925000 2050000 1700000 28938100 FUND 2010- 2040000 2950000 2295000 930000 1125000 ALLOTED 11(Nov) TOTAL 9820000 13200000 14498100 3200000 6900000 6475000 57876200 2006-07 253396 50000 303396
2007-08 2384727 329746 1200786 649794 637000 909732 6111785 2008 -09 1679078 2311788 3695078 782324 1538204 1459203 11465675 2009-10 1869735 2810964 4023576 682936 1341639 1078154 46818956 FUND 2010- 486503 724730 1365043 131372 87193 243487 UTILIZED 11(Nov) TOTAL 6673439 6177228 10284483 2296426 3604036 3690576 64699812
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BUDGET EARMARKED 2010-11
Head Activity Amounts in Lakhs A.1.1 Operationalise facilities (only dissemination, monitoring, and quality) A.1.1.1 Operationalise FRUs A.1.1.2 Operationalise 24x7 PHCs A.1.1.3 MTP services at health facilities A.1.1.4 RTI/STI services at health facilities A.1.1.5 Operationalise Sub-centres A.1.2 Referral Transport A.1.3 Integrated outreach RCH services A.1.3.1 RCH Outreach Camps 4 camps per month @ Rs.15000/camp 7.00 A.1.3.2 Monthly Village Health and Nutrition Days A.1.4 Janani Suraksha Yojana / JSY A.1.4.1 Home Deliveries 386 deliveries @ Rs.500/delivery 1.93 A.1.4.2 Institutional Deliveries 6180 Rural @ Rs.700/- deliveries, Rs.200/case for ASHA. Transport 55.62 Assistance of Rs.100/- fro RSBY funds from 1st July 2010 A.1.5 Other Strategies testing of 1272units of blood @ Rs.500/- 6.36
A.2 CHILD HEALTH A.2.1 IMNCI A.2.2 Facility Based Newborn Care/FBNC A.2.3 Home Based Newborn Care/HBNC A.2.4 School Health Programme detailed budget will be given separetely 4.04 A.2.5 Infant and Young Child Feeding/IYCF IYCF & IMNCI training for ANMs, Ward level orientation by ANMs
for ASHA, AWW & Community. Funds will be released from Hqrs directly A.2.6 Care of Sick Children and Severe Malnutrition A.2.7 Management of Diarrohea, ARI and Micronutrient ARI program - Malnutrition District training. 3 0.45 batches @Rs.15000/- A.2.8 Other strategies/activities-WHND
A.3 FAMILY PLANNING
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A.3.1 Terminal/Limiting Methods A.3.1.1 Dissemination of manuals on sterilisation standards & quality assurance of sterilisation services
A.3.1.2 Female Sterilisation camps A.3.1.3 NSV camps 4 camps @ 1.30 Rs.35,000/- A.3.1.4 Compensation for female sterilisation 812 cases @ 8.12 Rs.1000/case A.3.1.5 Compensation for male sterilisation 416 cases @ 6.24 Rs.1500/case A.3.1.6 Accreditation of private providers for sterilisation services A.3.2 Spacing Methods A.3.2.1 IUD camps A.3.2.2 IUD services at health facilities 2688cases @ 0.54 Rs.20/case A.3.2.3 Accreditation of private providers for IUD insertion services A.3.2.4 Social Marketing of contraceptives A.3.2.5 Contraceptive Update seminars 1 seminar 0.55 A.3.3 POL for Family Planning A.3.4 Repairs of Laparoscopes
A.4 ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH / ARSH A.4.1 Adolescent services at health facilities. Setting up of clinics
at THQH A.4.2 Other strategies/activities
A.5 URBAN RCH Salary of JPHN/MO and vehicle charges
A.6 TRIBAL RCH Medical Camp - TMU 100 camp @ Rs.1000 1 Medical Camp - PHC/CHC 33 camps @ 0.99 Rs.3000/- Special Medical Camp 5 camps @ 0.55 Rs.11,000/- Adolescent Health Edn camp 20 class @ Rs.1500/- 0.3 Adol.Health club -Tribal hostl 0.16 Valayapura Sickle Cell Anemia project 25 A.7 VULNERABLE GROUPS
A.8 INNOVATIONS/ PPP/ NGO A.8.1 PNDT and Sex Ratio A.8.2 Public Private Partnerships A.8.3 NGO Programme
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A.8.4 Other innovations( Gender Equity)
A.9 INFRASTRUCTURE & HUMAN RESOURCES A.9.1 Contractual Staff & Services salary and 179.00 allowance to A.9.1.1 ANMs doctors, Specialists, A.9.1.2 Laboratory Technicians ANMs, LT, Staff A.9.1.3 Staff Nurses Nurse, Pharmascist A.9.1.4 Specialists (Anesthetists, Pediatricians, Ob/Gyn, Surgeons, Physicians) A.9.1.5 Others - Computer Assistants/ BCC Co-ordinator/ ASHA Link Worker etc A.9.1.6 Incentive/ Awards etc. to Link worker/ SN/ Mos etc. (stipend to BSC interns) A.9.2 Major civil works (New constructions/ extensions/additions) A.9.2.1 Major civil works for operationalisation of FRUS
A.9.2.2 Major civil works for operationalisation of 24 hour services at PHCs A.9.3 Minor civil works A.9.3.1 Minor civil works for operationalisation of FRUs
A.9.3.2 Minor civil works for operationalisation of 24 hour services at PHCs A.9.4 Operationalise Infection Management & Environment Plan at health facilities A.9.5 Other Activities (RCH-I Civil Works)
A.10 INSTITUTIONAL STRENGTHENING A.10.1 Human Resources Development A.10.2 Logistics management/ improvement A.10.3 Monitoring & Evaluation / HMIS A.10.4 Sub Centre Rent and Contingencies 0.00 A.10.5 Other Activities (Monitoring and Evaluation) A.11 TRAINING A.11.1 Strengthening of Training Institutions A.11.2 Development of training packages A.11.3 Maternal Health Training A.11.3.1 Skilled Birth Attendance / SBA 6 batches 2.04 A.11.3.2 EmOC, Dai, Palliative care, IDRV, Anesth trg 10 batch 2.50 A.11.3.3 Life saving Anesthesia skills training A.11.3.4 MTP training 2 batch 0.48 A.11.3.5 RTI / STI Training A.11.3.6 Dai Training A.11.3.7 Other MH Training (ISD Refresher ) A.11.4 IMEP Training A.11.5 Child Health Training
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A.11.5.1 IMNCI A.11.5.2 Facility Based Newborn Care A.11.5.3 Home Based Newborn Care A.11.5.4 Care of Sick Children and severe malnutrition
A.11.5.5 Other CH Training (pl. specify) A.11.6 Family Planning Training A.11.6.1 Laparoscopic Sterilisation Training 2 batch 0.48 A.11.6.2 Minilap Training 2 batch 0.48 A.11.6.3 NSV Training 1 batch 0.22 A.11.6.4 IUD Insertion Training JPHN 4 batch 0.84 A.11.6.5 Contraceptive Update/ISD Training A.11.6.6 IUCD Providers 4 batch 1.48 A.11.7 ARSH Training A.11.8 Programme Management Training A.11.8.1 SPMU Training A.11.8.2 DPMU Training A.11.9 Other training (pl. specify) by KSIHFW Tvm & KKD
A.12 BCC / IEC A.12.1 Strengthening of BCC/IEC Bureaus (state and district levels) 2.00 A.12.2 Development of State BCC/IEC strategy A.12.3 Implementation of BCC/IEC strategy A.12.3.1 BCC/IEC activities for MH 0.50 A.12.3.2 BCC/IEC activities for CH 0.25 A.12.3.3 BCC/IEC activities for FP 0.25 A.12.3.4 BCC/IEC activities for ARSH 0.25 A.12.4 Other activities (please specify)
A.13 PROCUREMENT A.13.1 Procurement of Equipment A.13.1.1 Procurement of equipment: MH A.13.1.2 Procurement of equipment: CH A.13.1.3 Procurement of equipment: FP A.13.1.4 Procurement of equipment: IMEP A.13.2 Procurement of Drugs and supplies A.13.2.1 Drugs & supplies for MH A.13.2.2 Drugs & supplies for CH A.13.2.3 Drugs & supplies for FP A.13.2.4 Supplies for IMEP A.13.2.5 General drugs & supplies for health facilities
A.14 PROGRAMME MANAGEMENT
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A.14.1 Strengthening of State society/State Programme Management Support Unit A.14.2 Strengthening of District society/District Programme Salary of District Management Support Unit staff other than DPM 19.00 and BME and other management cost A.14.3 Strengthening of Financial Management systems Finance review meeting, printing of accounting registers 1.60 and con current Audit fees A.14.4 Other activities (Prog. Management Expenses, Mobilty support to state, district, block for all staff).
Total 331.52 B TIME LINE ACTIVITIES - Additinalities under NRHM (Mission Flexible Pool) B1 ASHA B1.1 Selection & Training of ASHA As per norms 19.37 B1.2 Procurement of ASHA Drug Kit B1.3 Performance related incentives to ASHAs As per norms 18.79 BCC Kit for ASHA B2 Untied Funds B2.1 Untied Fund for CHCs 16 inst 8.00 B2.2 Untied Fund for PHCs 13 inst 3.25 B2.3 Untied Fund for Sub Centers 204 inst 20.40 B2.4 Untied fund for VHSC 459 wards 45.90 B3 Hospital Strengthening B3.1 Upgradation of CHCs, PHCs, Dist. Hospitals to IPHS) B3.1.1 District /General Hospitals B3.1.2 CHCs B3.1.3 PHCs B3.1.4 Sub Centers B3.1.5 Others Strengthening of District and Su-divisional
B3.2 Hospitals THQH GOVT W&C B4 Annual Maintenance Grants B4.1 CHCs 16 inst 16.00 B4.2 PHCs 13 inst 6.50 B4.3 Sub Centers 186 inst 18.60 New Constructions/ Renovation and Settingup
B5 B5.1 CHCs B5.2 PHCs
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B5.3 SHCs/Sub Centers B5.4 Setting up Infrastructure wing for Civil works B5.5 Govt. Dispensaries/ others renovations Construction of BHO, Facility improvement, civil
B5.6 work, BemOC and CemOC centers B6 Corpus Grants to HMS/RKS B6.1 District Hospitals/Gen/THQH/Specialty 2 inst 10.00 B6.2 CHC/24x7 PHCs 16 inst 16.00 B6.3 PHCs 13 inst 13.00 B6.4 Other or if not bifurcated as above District Action Plans (Including Block, Village) lumpsum grant 1.00 B7 B8 Panchayti Raj Initiative Constitution and Orientation of Community leader &
B8.1 of VHSC,SHC,PHC,CHC etc Orientation Workshops, Trainings and capacity building of PRI at State/Dist. Health Societies, B8.2 CHC,PHC B8.3 Others Mainstreaming of AYUSH Salary and Vehicle 18.68 B9 for AYUSH B10 IEC-BCC NRHM B10.1 Health Mela Creating awareness on declining sex ratio issue
B10.2 B10.3 Other activities Mobile Medical Units (Including recurring B11 expenditures)-KEMP B12 Referral Transport B12.1 Ambulance B12.2 Operating Cost (POL) B13 School Health Programme Additional Contractual Staff (Selection, Training,
B14 Remuneration) Additional Staff/ Supervisory Nurses PHC,CHC
B14.1 (Including Ayush Stream) B14.2 Additional ANM, ,LHV, MPW B14.3 PHNs at PHC level Medical Officers at PHCs (Including AYUSH
B14.4 stream) B14.5 Additional Allowances to MOs PHC, CHC Lab technicians, Gynecologists, Anest hetists, Pedisterian, Specialist CHC, Radiologist, Sonologist, Pathologist, Dental Surgeons. B14.6 B15 PPP/ NGOs Non governmental providers of health care
B15.1 RMPs/TBAs
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B15.2 Grant in Aid to NGOs B16 Training Strengthening of Existing Training B16.1 Institutions/Nursing School B16.2 New Training Institutions/School
B16.3 Training and Capacity Building Under NRHM Promotional Trg of health workers females to lady
B16.3.1 health visitor etc. Training of AMNs,Staff nurses,AWW,Anganbadi
B16.3.2 Other training and capacity building programmes
B16.3.3 B17 Incentives Schemes B17.1 Incentives to Specialists (CHCs) B17.2 Incentives to Medical Officers (PHCs) B17.3 Other Incentives Schemes Pla nning, Implementation and Monitoring
B18 Community Monitoring (Visioning workshops at
B18.1 state, Dist, Block level) B18.1.1 State level B18.1.2 District level B18.1.3 Block level B18.1.4 Other B18.2 Quality Assurance B18. 3 Monitoring and Evaluation B18.3.1 Computerization HMIS and e-governance, e-health
B18.3.2 Other M & E B19 Procurements B19.1 Drugs B19.2 Equipments B19.3 Others B20 PNDT Activities B21 Regional drugs warehouses B22 New Initiatives/ Strategic Interventions (As per State health policy) / Innovation/ Projects (Telemedicine, Hepatitis, Mental Health, Nutition Programme for Pregnant Women, Neonatal) NRHM Helpline) as per need (Block/ District Action Plans)
Pai n and palliative care Salary of staff for Paliative care 6.65 Mental Health Telemedicine KEMP NCD
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Geriatric Care Hemophilia Snakebite Project B23 Health Insurance Scheme B24 Research, Studies, Analysis B25 State level health resources center(SHSRC)
B26 Support Services B26.1 Support Strengthening NPCB B26.2 Support Strengthening Midwifery Services under medical services B26.3 Support Strengthening RNTCP B26.4 Contingency support to Govt. dispensaries B26.5 Other Support Programmes B27 NRHM Management Costs/ Contingencies
B27.1 Block Level PMU Salary of Block cordinator and 16.40 PRO B27.2 District level Salary of DPM and Asst Biomedical 4.20 Officer B27.3 State level B27.4 Audit Fees B27.5 Concurrent Audit system B27.6 Other Management expenses B27.7 Telephone and Mobile phone, Contingencies expenses B27.8 Mobility Support to BMO/MO/Others Vehicle rent and 7.00 repairs B.28 Other Ex penditures (Power Backup, Convergence etc) Total 249.73 IMMUNISATION STRENGTHENING PROGRAMME 2010 -11
Sl. No Particulers
Number of Sub Centres 1 Funds for Cold Chain Maintenance 0.10 support for Computer Assistants at State and 2 0.96 District level 3 Quarterly review meeting of State level
4 Quarterly review meeting of District level 0.20
Mobility Support for Supervision and Monitoring at 5 0.50 districts and State level
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6 Alternate Vaccine Delivery to Session Sites 4.82
7 Focus on Urban Slums and under served areas 4.70
Incentive for Social Mobilisation by ASHA/Linked 8 0.95 workers District level orientation for 2 days ANMs, MPHW, 9 3.06 LHV Training Medical Oficers on RI usine the revised MO 10 1.00 Training module
11 Training Cold Chain Handlers - One day Training 0.17
AEFI workshop at State level for district programme 12 officers and members of committees and other stake holders
Support for Rims procurement of accessories 13 ongoing expenses, and related expenditure
Refresher Training for RIMS support staff state 14 level 15 Weste disposal activities 0.37 16 Printing and issue of folders & Posters
17 Printing of Mother Child Card/ Vaccination Card
18 Printing of MCH Register and Formats To develop micro plan at sub centre level and block 19 0.20 level TOTAL 17.03
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FUND UTILIZATION TILL 30 TH NOVEMBER 2010
Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Cumulative Expenditure tillExpenditure A RCH - TECHNICAL STRATEGIES & ACTIVITIES (RCH FLEXI POOL) 0 A.1 MATERNAL HEALTH 0 A.1.1 Operationalise facilities (only dissemination, monitoring, and quality) 0 A.1.1.1 Operationalise FRUs 0 A.1.1.2 Operationalise 24x7 PHCs 0 A.1.1.3 MTP services at health facilities 0 A.1.1.4 RTI/STI services at health facilities 0 A.1.1.5 Operationalise Sub -centres 0 A.1.2 Referral Transport 0 A.1.3 Integrated outreach RCH services 0 A.1.3.1 RCH Outreach Camps 27961 A.1.3.2 Monthly Village Health and Nutrition Days 0 A.1.4 Janani Suraksha Yojana / JSY 0 A.1.4.1 Home Deliveries 27500 A.1.4.2 Institutional Deliveries 2605010 Asha Incentives- JSY 269430 A.1.5 Other Strategies 75000 0 A.2 CHILD HEALTH 0 A.2.1 IMNCI 0 A.2.2 Facility Based Newborn Care/FBNC 0 A.2.3 Home Based Newborn Care/HBNC 0 A.2.4 School Health Programme 53778 A.2.5 Infant and Young Child Feeding/IYCF 0 A.2.6 Care of Sick Children and Severe Malnutrition 0 A.2.7 Management of Diarrohea, ARI and Micronutrient Malnutrition 5000 A.2.8 Other strategies/activities 0 0 A.3 FAMILY PLANNING 0 A.3.1 Terminal/Limiting Methods 0
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Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Expenditure till Expenditure A.3.1.1 Dissemination of manuals on ste rilisation standards & quality assurance of sterilisation services 0 A.3.1.2 Female Sterilisation camps 0 A.3.1.3 NSV camps 0 A.3.1.4 Compensation for female sterilisation 934194 Asha Incentives- Mobilisation for female sterilisation 70060 A.3.1.5 Compensation for male sterilisation 126247 Asha Incentives- Mobilisation for Male sterilisation- 6600 A.3.1.6 Accreditation of private providers for sterilisation services 0 A.3.2 Spacing Methods 0 A.3.2.1 IUD camps 0 A.3.2.2 IUD services at health facilities 0 A.3.2.3 Accreditation of private providers for IUD insertion services 0 A.3.2.4 Social Marketing of contraceptives 0 A.3.2.5 Contraceptive Update seminars 0 A.3.3 POL for Family Planning 0 A.3.4 Repairs of Laparoscopes 0 0 A.4 ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH / ARSH 0 A.4.1 Adolescent services at health facilities. 0 A.4.2 Other strategies/activities 0 Interventions on Geriatric Care 0 A.5 URBAN RCH 0 0 A.6 TRIBAL RCH 0 A.6.1 Tribal RCH Services 43300 A.6.2 Other Strategies/activities- Tribal RCH(Sickle Cell) 1613758 0 A.7 VULNERABLE GROUPS 0 0 A.8 INNOVATIONS/ PPP/ NGO 0 A.8.1 PNDT and Sex Ratio 0
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Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Expenditure till Expenditure A.8.2 Public Private Partnerships 0 A.8.3 NGO Programme 0 A.8.4 Sickle cell disease project 0 0 A.9 INFRASTRUCTURE & HUMAN RESOURCES 0 A.9.1 Contractual Staff & Services 0 A.9.1.1 ANMs 699347 A.9.1.2 Laboratory Technicians 1476702 A.9.1.3 Staff Nurses 4648291 A.9.1.4 Specialists (Anesthetists, Pediatricians, Ob/Gyn, Surgeons, Physicians) 10646708 A.9.1.5 Others - MBBS,Computer Assistants/ BCC Co-ordinator/ ASHA Link Worker etc 1065962 A.9.1.6 Incentive/ Awards etc. to Link worker/ SN/ Mos etc. 580101 A.9.2 Major civil works (New constructions/ extensions/additions) 0 A.9.2.1 Major civil works for operationalisation of FRUS 0 A.9.2.2 Major civil works for operationalisation of 24 hour services at PHCs 0 A.9.3 Minor civil works 0 A.9.3.1 Minor civil works for operationalisation of FRUs 0 A.9.3.2 Minor civil works for operationalisation of 24 hour services at PHCs 0 A.9.4 Operationalise Infection Management & Environment Plan at health facilities 0 A.9.5 Other Activities (RCH-I Civil Works) 0 A.9.99.1 Other (Family Poly Clinic- Kalpetta) 0 A.10 INSTITUTIONAL STRENGTHENING 0 A.10.1 Human Resources Development 0 A.10.2 Logistics management/ improvement 0 A.10.3 Monitoring & Evaluation / HMIS 26705 A.10.4 Sub Centre Rent and Contingencies 0 A.11 TRAINING 0 A.11.1 Strengthening of Training Institutions 0 A.11.2 Development of training packages 0 A.11.3 Maternal Health Training 0
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Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Expenditure till Expenditure A.11.3.1 Skilled Birth Attendance / SBA 0 A.11.3.2 EmOC Training 0 A.11.3.3 Life saving Anesthesia skills training 0 A.11.3.4 MTP training 0 A.11.3.5 RTI / STI Training 0 A.11.3.6 Dai Training 0 A.11.3.7 Other MH Training (ISD Refresher ) 0 A.11.4 IMEP Training 0 A.11.5 Child Health Training 0 A.11.5.1 IMNCI 0 A.11.5.2 Facility Based Newborn Care 0 A.11.5.3 Home Based Newborn Care 0 A.11.5.4 Care of Sick Children and severe mal nutrition 0 A.11.5.5 Other CH Training (pl. specify) 0 A.11.6 Family Planning Training 0 A.11.6.1 Laparoscopic Sterilisation Training 0 A.11.6.2 Minilap Training 0 A.11.6.3 NSV Training 0 A.11.6.4 IUD Insertion Training 57690 A.11.6.5 Contraceptive Update/ISD Training 0 A.11.6.6 Other FP Training (pl. specify) 0 A.11.7 ARSH Training 0 A.11.8 Programme Management Training 0 A.11.8.1 SPMU Training 0 A.11.8.2 DPMU Training 0 A.11.9 Other training (pl. specify) 10400 0 A.12 BCC / IEC 0 A.12.1 Strengthening of BCC/IEC Bureaus (state and district levels) 63313 A.12.2 Development of State BCC/IEC strategy 0 A.12.3 Implementation of BCC/IEC strategy 0 A.12.3.1 BCC/IEC activities for MH 10875 A.12.3.2 BCC/IEC activities for CH 0 A.12.3.3 BCC/IEC activities for FP 5000
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Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Expenditure till Expenditure A.12.3.4 BCC/IEC activities for ARSH 0 A.12.4 Other activities (world Health Population Day, house hold survey, catreet operation) 30872 0 A.13 PROCUREMENT 0 A.13.1 Procurement of Equipment 0 A.13.1.1 Proc urement of equipment: MH 0 A.13.1.2 Procurement of equipment: CH 0 A.13.1.3 Procurement of equipment: FP 0 A.13.1.4 Procurement of equipment: IMEP 0 A.13.2 Procurement of Drugs and supplies 0 A.13.2.1 Drugs & supplies for MH 0 A.13.2.2 Drugs & supplies for CH 0 A.13.2.3 Drugs & supplies for FP 0 A.13.2.4 Supplies for IMEP 0 A.13.2.5 General drugs & supplies for health facilities 0 0 A.14 PROGRAMME MANAGEMENT 0 A.14.1 Strengthening of State society/State Programme Management Support Unit 0 A.14.2 Strengthening of District society/District Programme Management Support Unit 1208118 A.14.3 Strengthening of Financial Management systems 108130 A.14.4 Other activities (Prog. Management Expenses, Mobilty support to state, district, block for all staff). 0 A.14.4 0 0 B TIME LINE ACTIVITIES - Additinalities under NRHM (Mission Flexible Pool) 0 B1 ASHA 0 B1.1 Selection & Training of ASHA 685074 B1.2 Procurement of ASHA Drug Kit 0 B1.3 Performance related incentives to ASHAs 2540151 B2 Untied Funds 0 B2.1 Untied Fund for CHCs 89437 B2.2 Untied Fund for PHCs 41935
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Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Expenditure till Expenditure B2.3 Untied Fund for Sub Centers 495941 Asha incentives - Review Meeting 67700 B2.4 Untied fund for VHSC 1373843 Asha incentives - Mobilisation for Nutrition Day 72070 B3 Hospital Strengthening 0 B3.1 Upgradation of CHCs, PHCs, Dist. Hospitals to IPHS) 0 B3.1.1 District Hospitals 0 B3.1.2 CHCs 0 B3.1.3 PHCs 0 B3.1.4 Sub Centers 0 B3.1.5 Others 0 B3.2 Strengthening of District and Su-divisional Hospitals 43730 B4 Annual Maintenance Grants 0 B4.1 CHCs 88206 B4.2 PHCs 155281 B4.3 Sub Centers 87193 B5 New Constructions/ Renovation and Settingup 0 B5.1 CHCs & THQH 0 B5.2 PHCs 0 B5.3 SHCs/Sub Centers 0 B5.4 Setting up Infrastructure wing for Civil works 0 B5.5 Govt. Dispensaries/ others renovations 0 Construction of BHO, Facility improvement, civil work, BemOC and CemOC centers B5.6 0 B6 Corpus Grants to HMS/RKS/HMC 447827 B7 District Action Plans (Including Block, Village) 0 B8 Panchayti Raj Initiative 0 Constitution and Orientation of Community leader & of VHSC,SHC,PHC,CHC etc B8.1 0 Orientation Workshops, Trainings and capacity building of PRI at State/Dist. Health Societies, CHC,PHC B8.2 0 B9 Mainstreaming of AYUSH 828870 B10 IEC-BCC NRHM 0 B10.1 Health Mela 0 B10.2 Creating awareness on declining sex ratio issue 0
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Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Expenditure till Expenditure B10.3 Other activities 0
B11 Mobile Medical Units (Including recurring expenditures) 0 B12 Referral Transport 0 B12.1 Ambulance 0 B12.2 Operating Cost (POL) 0 B13 School Health Programme 0 Additional Contractual Staff (Selection, Training, Remuneration) B14 0 Additional Staff/ Supervisory Nurses PHC,CHC (Including Ayush Stream) B14.1 0 B14.2 Additional ANM, ,LHV, MPW 0 B14.3 PHNs at PHC level 0 B14.4 Medical Officers at PHCs (Including AYUSH stream) 0 B14.5 Additional Allowances to MOs PHC, CHC 0 Lab technicians, Gynecologists, Anesthetists, Pedisterian, Specialist CHC, Radiologist, Sonologist, Pathologist, Dental Surgeons. B14.6 0 B15 PPP/ NGOs 0 Non governme ntal providers of health care RMPs/TBAs B15.1 0 B15.2 Grant in Aid to NGOs 0 B16 Training 0
B16.1 Strengthening of Existing Training Institutions/Nursing School 29980 B16.2 New Training Institutions/School 0 B16.3 Training and Capacity Building Under NRHM 0 Promotional Trg of health workers females to lady health visitor etc. B16.3.1 0 B16.3.2 Training of AMNs,Staff nurses,AWW,Anganbadi 0 B16.3.3 Other training and capacity building programmes 0 B17 Incentives Schemes 0 B17.1 Incentives to Specialists ( CHCs) 0 B17.2 Incentives to Medical Officers (PHCs) 0 B17.3 Other Incentives Schemes 0 B18 Planning, Implementation and Monitoring 0
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Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Expenditure till Expenditure Community Monitoring (Visioning workshops at state, Dist, Block level) B18.1 0 B18.1.1 State level 0 B18.1.2 District level 0 B18.1.3 Block level 0 B18.1.4 Other 0 B18.2 Quality Assurance(NABH) 6303 B18.3 Monitoring and Evaluation 0 B18.3.1 Computerization HMIS and e-governance, e-health 0 B18.3.2 Other M & E 0 B19 Procurements 0 B19.1 Drugs 0 B19.2 Equipments 0 B19.3 Others 0 B20 PNDT Activities 0 B21 Regional drugs warehouses 0 B22 Pain&Paliative Project/NCD 0 B.22.1 Pain & Paliative Project 532459 B.22.2 NCD programme 840418 Asha Incentives - NCD Follow up 157785 B23 Health Insurance Scheme 0 B24 Research, Studies, Analysis 0 B25 State level health resources center(SHSRC) 0 B26 Support Services 0 B26.1 Support Strengthening NPCB 0 B26.2 Support Strengthening Midwifery Services under medical services 0 B26.3 Support Strengthening RNTCP 0 B26.4 Contingency support to Govt. dispensaries 0 B26.5 Other Support Programmes 0 B27 NRHM Management Costs/ Contingencies 0 B27.1 Block Level PMU 1253028 B27.2 District level 68417 B27.3 State level 0 B27.4 Audit Fees 0
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Format of Financial Management Report to be submitted by the AROGYA KERALAM WAYANAD FINANCIAL REPORT TILL NOVEMBER '10 S. STRATEGY/ACTIVITIES NO Date Date Cumulative Expenditure till Expenditure B27.5 Concurrent Audit system 0 B27.6 Other Management expenses 0 B27.7 Telephone and Mobile phone, Contingencies expenses 0 B27.8 Mobility Support to BMO/MO/Others 818487 B.28 Other Expenditures (Power Backup, Convergence etc) 0 B.29 Fund Received under Mission Flexipool 0 0 C IMMUNISATION 0 C.1 RI strengthening project (Review meeting, Mobility support, Outreach services etc) 107912 Asha Incentives- Social Mobilisation for Immunisation 158010 C.2 Cold chain maintenance 0 C.3 Pulse Polio operating costs 0 Others ( Immunisation) 2300
TOTAL 37488409
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CHAPTER IV
DHAP
Chapter 4 (DHAP) ANNEXERS
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Number of facilities/HR Service utilization
Based on Projection S. Achievem Area Indicator Planned Achieve Plan for performance for No. ent Services 1 ment 2011-2012 during Apr-Nov 2011-12 2 2010
4 C-sections 84 74 6 4 MTPs 3 No. of FRUs 1 Operational 6 2 33.33% Male 8 ised 5 sterilisations Female 100 67 sterilisations Normal 0 0 0 deliveries MTPs 0 0 Male 0 No. of 24x7 sterilisatio 0 PHCs 2 8 8 100 ns Operational Female 0 ised sterilisatio 0 ns IUD 0 0 insertions No. of sub - 0 Normal 0 0 Facility Operationalisation Facility centres deliveries operationali 0 3 0 0 0 sed as IUD 0 delivery insertions points No. of 1 0 SNCUs Newborns 4 0 0 0 0 operationali treated sed No. of 1 0 NBSUs Newborns 5 0 0 0 0 operationali treated sed EmOC 1 0 14 0 0 0 C-sections 0 training LSAS 0 15 0 0 0 C-sections 0 training
Capacity Capacity Deliveries 0 16 SBA 0 0 0 0
Capacity Building Building Capacity conducted
1 (2005-11) 2 2005-11, till November 2010)
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17 MTP 2 batch 0 0 1 MTPs 222 444 18 RTI/STI 0 0 0 0 19 IMNCI 0 0 0 0 0 Children 20 F-IMNCI 0 0 0 and infants 0 0 treated 0 Newborns 21 NSSK 0 0 0 resuscitate 0 0 d 1 Sterilisatio 22 Minilap 1 batch 0 0 18 19 ns 1 Sterilisatio 23 NSV 1 batch 0 0 23 36 ns Laparoscopi 2 batch Sterilisatio 24 c 4 batch 0 0 623 789 ns sterilization 2batch IUD 449 25 IUD 4 0 0 426 insertions
- 38 - AROGYAKERALAM WAYANAD PIP 2011-12 ANNEXURE 3 bc
MONITORABLE INDICATORS
2010-11 2011-12 Baseline Q1 Q2 Q3 Q4 INDICATOR Target Target Target Target Annual Target 1. Maternal Health 1.1: Service Delivery 1.1.1: % Pregnant women 24 70 72 73 74 75 registered for ANC in the quarter 1.1.2: % PW registered for ANC in 74 60 63 65 68 70 the first trimester, in the quarter 1.1.3: Institutional deliveries (%) in 96.37 68 70 74 78 80 the quarter (Public) 1.2: Quality 1.2.1: % unreported deliveries in 0 0 0 0 0 0 the quarter 1.2.2: % high risk pregnancies 4% 4% 4% 4% 4% identified 3 (a) % women having hypertension (b) % women having low Hb level 41 1.2.3: % of Home Delivery by SBA 21 0 0 0 0 0 (i.e. assisted by doctor/ nurse/ ANM) 1.2.4: C-sections performed (%) 40% 40% 40% 40% (a) in Public facilities 23% 40%
(b) in private accredited facilities 27% 60% 60% 60% 60% 60%
1.2.5: % of deliveries discharged 0.9 40 42 44 48 50 after at least 48 hours of delivery (out of public institution deliveries)
1.2.6: % of still births 0.63 1% 1% 1% 1% 1%
1.2.7: %age of maternal deaths 100 100 100 100 100 100 audited 2010- 11 Baseline 2011-12 Q3 Q4 Annual INDICATOR Q1 Target Q2 Target Target Target Target 1.3: Outputs
1.3.1: % of 24x7 PHCs 100 85 87 88 89 90
arogyakeralam wayanad Page 39 AROGYAKERALAM WAYANAD PIP 2011-12 operationalised as per the GoI guidelines(cumulative) 1.3.2: % of FRUs operationalised as 33.33 100 100 100 100 per the GoI guidelines(cumulative) 1.3.3: % of Level 1 MCH centres operationalised 1.3.4: % of Level 2 MCH centres 0 53 55 57 58 60 operationalised 1.3.5: % of Level 3 MCH centres 0 0 1 1 operationalised 1.3.6: % ANMs/ LHVs/ SNs trained 0 0 as SBA 1.3.7: % doctors trained as EmOC 0 0 1.3.8: % doctors trained as LSAS 0 0 Facility utilization
1.3.9: % of FRUs conducting C- 100 100 100 100 100 section 1.3.10: Average no. of c- sections per 30 28 26 24 22 20 FRU 1.3.11: Average no. of MTPs 14 24 24 24 24 performed in FRUs 24
1.3.12: Average no. of deliveries per 0 24x7 PHCs 1.3.13: Average no. of MTPs 0 performed per 24x7 PHC 1.3.14: % of SC conducting at least 5 0 deliveries per month
arogyakeralam wayanad Page 40 AROGYAKERALAM WAYANAD PIP 2011-12
2010-11 2011-12 Baseline[ Q1 Q2 Q3 Q4 Annual INDICATOR Target Target Target Target Target 2. Child Health
2.1: Service Delivery
2.1.1: Children 9-11 months age fully 65% 70 71 73 74.5 75 immunized (%) 2.1.2: % children breastfed within 1 hour 82% 100 100 100 100 100 of birth 2.13: % of low birth weight babies 12.2% 10. 10 10 10 10
2.2: Quality
2.2.1: %age of women receiving PP 62% 100 100 100 100 check up to 48 hrs to 14 days 2.2.2: % drop out from BCG to 9% 1.5% 1.5% 1.5% 1.5% 1.5% measles 2.3: Outputs 2.3.1: % of SNCUs operationalised 2.3.2: % of stabilisation units operationalised 2.3.3: % of new born baby care corners operationalised 2.3: Facility utilization
2.3.4: Average no. of children treated in SNCUs 2.4.5: Average no. of children treated in NBSUs
arogyakeralam wayanad Page 41 AROGYAKERALAM WAYANAD PIP 2011-12
2010-11 2011-12 Baseline[ Q1 Q2 Q3 Q4 Annual INDICATOR Target Target Target Target Target 3.Family Planning
3.1: Service Delivery
3.1.1: % of total sterilisation against 54.2 ELA 3.1.2: % post partum sterilisation 69.01 3.1.3: % male sterilizations 50.25 3.1.4: % of IUD insertions against 72 planned 3.1.5: % Sterilization acceptors with 2 59 children 3.1.6: % Sterilisation acceptors with 3 or 48 more children
3.2: Quality
3.2.1: % of complications following 0.2 sterilisation 3.3: Outputs
3.3.1: % doctors trained as minilap 3 05 05 10 3.3.2: % doctors trained as NSV 2 5 5 3.3.3: % doctors trained as laparoscopic 1 05 07 12 sterilisation 3.3.4: % ANM/LHV/SN/MO trained in 45 90 IUD insertion
arogyakeralam wayanad Page 42 AROGYAKERALAM WAYANAD PIP 2011-12
2010-11 2011-12 Baseline[ Q1 Q2 Q3 Q4 Annual INDICATOR Target Target Target Target Target HR productivity
3.3.5: Average no. of NSVs conducted by 13/ month trained doctors 3.3.6: Average no. of minilap sterilisations 6/month conducted by minilap trained doctors
3.3.7: Average no. of laparoscopic 30/month sterilisations conducted by lap sterilisation trained doctors 3.3.8: Average no. of IUDs inserted by MO 25/month trained in IUD insertion
3.3.9: Average no. of IUDs inserted by SN/ 42/month LHV/ ANM trained in IUD insertion Facility utilization
3.3.10: Average no. of sterilizations 325/month 350 350 350 350 350 performed in FRUs
ANNEX 3d : WORK PLAN
Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
1. MATERNAL HEALTH 1.1. Operationalise facilities District 1.1.1. Operationalise FRUs 1.1.1.1. Organise dissemination workshops for FRU gu idelines 1.1.2. Operationalise 24x7 PHCs 1.1.2.1. Prepare plan for operationalisation across districts (cost of plan meeting should be kept) 1.1.2.2. Monitor progress and quality of service delivery
arogyakeralam wayanad Page 43 AROGYAKERALAM WAYANAD PIP 2011-12
1.1.3. Operationalise Safe abortion services (including MVA/ EVA and medical abortion)at health facilities 1.1.3.1. Prepare plan for operationalisation across districts (priortise facilities for safe abortion services; cost of plan meeting should be kept) 1.1.3.2. Monitor progress and quality of service delivery 1.1.4.1. Prepare plan for operationalisation across districts (priortise facilities for RTI/STI services; cost of plan meeting should be kept)
arogyakeralam wayanad Page 44 AROGYAKERALAM WAYANAD PIP 2011-12
Budget Head Qtr.1 Qtr. 2 Qtr.3 Qtr.4 Responsible
1.1.4.2. Monitor progress and quality of service delivery. 1.1.5. Operationalise sub -centres 1.3. Integrated outreach RCH services 1.3.1. RCH Outreach Camps in un-served/ under- served areas (state should focus on facility based services and outreach camps to be restricted to areas without functional health facilities) 1.3.2. Monthly Village Health and Nutrition Days District 1.3.2.1. Monitor quality of services and utilisation District
1.4. Janani Suraksha Yojana / JSY (details of District IEC/BCC in section 12) 1.4.1. Dissemination of JSY guidelines to districts District and sub -districts. 1.4.2. Implementation of JSY by districts. District
1.4.2.1. Home deliveries District
1.4.2.2. Institutional deliveries District
1.4.2.2.1. Rural District
1.4.2.2.2. Urban District
1.4.2.2.3. C-sections District
arogyakeralam wayanad Page 45 AROGYAKERALAM WAYANAD PIP 2011-12
Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
1.4.3. Other activities (JSY) District
1.4.3.1 ASHA Incentive District
1.4.3.2. Admin Cost (5%) District
1.5. Other strategies/activities (please specify) Blood Transfusion District
2. CHILD HEALTH 2.1. IMNCI (details of training, drugs and supplies, under sections 11 and 13) 2.2. Facility Based Newborn Care/FBNC (SNCU, NBSU, NBCC) Note: details of training, drugs and supplies, under sections 11 & 13 2.3. Home Based Newborn Care/HBNC (details of training, drugs and supplies, under sections 11 and 13) 2.4. School Health Programme District 2.4.1. Prepare and disseminate guidelines for School Health Programme. 2.4.2. Prepare detailed operational plan for School Health Programme across districts (cost of plan meeting should be kept)
arogyakeralam wayanad Page 46 AROGYAKERALAM WAYANAD PIP 2011-12
Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
2.4.3. Implementation of School Health Programme by districts. 2.4.4. Monitor progress and quality of services. 2.5. Infant and Young Child Feeding/IYCF (details of training, drugs & supplies, under sections 11 and 13) 3. FAMILY PLANNING 3.1. Terminal/Limiting Methods District 3.1.1. Dissemination of manuals on sterilisation District standards & quality assurance of sterilisation services 3.1.2. Prepare operational plan for provision of District sterilisation services at facilities (fixed day) as well as camps (including training, BCC/IEC, equipment, drugs and supplies, etc.; cost of plan meeting should be kept). 3.1.3. Implementation of sterilization services by District districts 3.1.3.1. Organise female sterilisation camps District
3.1.3.2. Organise NSV camps District
3.1.3.3. Compensation for female sterilisation District
3.1.3.4. Compensation for NSV Acceptance District
arogyakeralam wayanad Page 47 AROGYAKERALAM WAYANAD PIP 2011-12
Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
3.1.4. Accreditation of private providers to provide District sterilisation services 3.2. Spacing Methods 3.2.1. Implementation of IUD services by districts. 3.2.1.1. Provide IUD services at health facilities / District compensation 3.3. POL for Family Planning/ Others District 4. ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH / ARSH 4.1. Adolescent friendly services 4.1.1. Disseminate ARSH guidelines. District
4.1.2. Prepare operational plan for ARSH services District across districts (including training, BCC/IEC, equipment, drugs and supplies, etc.; cost of plan meeting should be kept). 4.1.3. Implement ARSH services in districts. 4.1.3.1. Setting up of Adolescent Clinics at health District facilities. 4.1.4. Monitor progress, quality and utilisation of District services. 4.2. Other strategies/activities (please specify)
arogyakeralam wayanad Page 48 AROGYAKERALAM WAYANAD PIP 2011-12
Budget Head Responsible Qtr.1 Qtr.2 Qtr.3 Qtr.4
Details of the Menstrual Hygiene project to be provided and budgeted under this head) 5. URBAN RCH 5.1. Urban RCH Services 5.1.1. Identification of urban areas / mapping of urban District slums 5.1.2. Prepare operational plan for urban RCH (including infrastructure and human resources, training, BCC/IEC, equipment, drugs and supplies, etc.; cost of plan meeting should be kept). 5.1.3. Implementation of Urban RCH plan/ activities 5.1.3.1. Recruitment and training of link workers for urban slums 5.1.3.2. Strengthening of urban health posts and urban health centres 5.1.3.3. Provide RCH services (please specify) 5.1.4. Monitor progress, quality and utilisation of services. 5.2. Other Urban RCH strategies/activities (please specify) 6.1.2. Prepare operational plan for tribal RCH District (including infrastructure and human resources, training, BCC/IEC, equipment, drugs and supplies, etc.; cost of plan meeting should be kept). 6.1.3. Implementation of Tribal RCH activities
arogyakeralam wayanad Page 49 AROGYAKERALAM WAYANAD PIP 2011-12
Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
6.1.4. Monitor progress, quality and utilisation of services. 6.2. Other Tribal RCH strategies/activities (please District specify) Note: PPP/ Innovations/NGO to be mentioned under section 8) 7. VULNERABLE GROUPS (Other vulnerable communities not covered by Urban District and Tribal RCH such as salt pan workers, migrants etc.) 7.1. Services for Vulnerable groups 7.1.1. Mapping of vulnerable groups 7.1.2. Prepare operational plan for vulnerable groups (including infrastructure and human resources, training, BCC/IEC, equipment, drugs and supplies, etc.; cost of plan meeting should be kept). 7.1.3. Implementation of RCH activities 7.2. Other strategies/activities (please specify) Note: PPP/ Innovations/NGO to be mentioned under section 8) 8. INNOVATIONS/ PPP/ NGO 8.3. NGO Programme 8.4. Other innovations (if any) 9. INFRASTRUCTURE AND HUMAN RESOURCES 9.1. Contractual Staff & Services District
arogyakeralam wayanad Page 50 AROGYAKERALAM WAYANAD PIP 2011-12
Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
9.1.1. ANMs 9. 1.2. Laboratory Technicians 9.1.3. Staff Nurses 9.1.4. Specialists (Anaesthetists, Paediatricians, Ob/Gyn, Surgeons, Physicians) and doctors 9.1.5. Others (specify): salary of all consultants, computer operators, assistants etc. to be booked under programme management 9.1.6. Incentive/ Awards etc. to ASHA Link worker/ SN/ MOs etc. 9.2. Major civil works (extensions/additions) 10. INSTITUTIONAL STRENGTHENING 10.1. Human Resources Sy stem Strengthening 10.4. Sub-centre rent 10.5. Other strategies / activities (please specify) 10.5.1. Strengthening Quality assurance systems for RCH 11. TRAINING District 11.1. Strengthening of Training Institutions (SIHFW, ANMTCs, etc.) 11.1.2. Provide equipment and training aids to the training institutions 11.1.3. Developing systems for monitoring & evaluations of training programmes. 11.1.4. Other activities (pl. sp ecify) 11.2. Development of training packages
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Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
11.3. Maternal Health Training 11.3.3.2. TOT for Anaesthesia skills training 11.3.3.3. Training of Medical Officers in life saving Anaesthesia skills 11.3.5.2. Training of laboratory technicians in RTI/STI 11.3.5.3. Training of Medical Officers in RTI/STI 11.3.5.4. Training of Staff Nurses in RTI/STI 11.3.5.5. Training of ANMs / LHVs in RTI/STI 11.3.6. Orientation of Dai / TBAs on safe delivery 11.3.7. Other maternal health training (please specify) 11.4. IMEP Training 11.6. Family Planning Training District 11.6.1. Laparoscopic Sterilisation Training District
11.6.1.1. TOT on laparoscopic sterilisation District
11.6.1.2. Laparoscopic sterilisation training for medical District officers 11.6.2. Minilap Training District
11.6.2.1. TOT on Minilap District
11.6.2.2. Minilap training for medical officers District
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Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
11.6.3. Non-Scalpel Vasectomy (NSV) Training District
11.6.3.1. TOT on NSV District
11.6.3.2. NSV Training of medical officers District
11.6.4. IUD Insertion District
11.6.4.1. TOT for IUD insertion District
11.6.4.2. Training of Medical officers in IUD insertion District
11.6.4.3. Training of staff nurses in IUD insertion District
11.6.4.4. Training of ANMs / LHVs in IUD insertion District
11.6.5. Contraceptive update/ISD Training District
11.6.6. Other family planning training (please specify) District
11.7. Adolescent Reproductive and Sexual District Health/ARSH Training 12. BCC / IEC District
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Budget Head Qtr.1 Qtr.2 Qtr.3 Qtr.4 Responsible
13. PROCUREMENT 14.2. Strengthening of District society/District District Programme Management Support Unit 14.2.1. Contractual Staff for DPMSU recruited and in District position 14.3. Strengthening of Financial Management District systems
Annex 8: Planning
Status of Facility Operationalisation
Total No Total No. Target Achievement in Target operationalised S. No. Facility Planned till 2012 for 2010-11 (till for 2011- till 2010 (till Dec. (cumulative) 2010-11 December, 2010) 12 2010 cumulative)
1. FRUs 6 2 4 2 4
2. 24x7 PHCs 8 8 0 8 0
Status of MCH Centres Operationalisation *
Total No operationalised SL. Facility Total identified till December 2010 Target for 2011-12 No. (cumulative)
1. MCH Centre Level III 0 0 0
2. MCH Centre Level II 1 0 1
3. MCH Centre Level I 0 0 0
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Performance based incentives
Status of Anaesthesia Training Not being done
Status of EmOC Training : Not being done
Status of SBA Training –(condensed course of 2 days)
No. of Instituti ons (includi No. Of district Total No of Total No of ng hospitals/traini No of Master No. of SNs/ SNs/ANMs/L SNs/ANMs/L District ng institutes Trainers ANMs/ LHVs Target Target HVs trained HVs trained Hospital practicing SBA trained to be trained for for 2011- till 2010 (till in 2010-11 s) Protocols till 2012 2010-11 12 (Both State Dec. 2010 (till Dec. conduct particularly (cumulative) and Districts) cumulative 2010) ing SBA Partograph training in the state
NA 1 0 6 0 20
Status of MTP Training
No of No. of No. of 24x7 doctors Targets for No. of No. of Private PHCs planned Total No of 2010-11 No. of doctors DH/FRUs Govt. Health providing at to be doctors trained (No. of trained in health Facilities least 1 st Providing trained in till 2010 (till doctors 2010-11 (till facilities accredited Trimester, Comprehe MA/ Dec. 2010 planned to December conducti for Safe nsive Safe MVA/ cumulative be trained 2010) ng MTPs conducting Abortion Abortion EVA till in 10-11) MTPs Services services 2012
4 4 5 9 0 0 4
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B. Additional Support required
Expenditure & Achievement
2009-10 2010-11(till Dec) 2011-12
Service Norms* Delivery: - Funds Target requirement Expenditure Expenditure Achievement Achievement
No of Mobility @Rs.50,000 per No of No of sessions support for District for district sessions sessions level officers (this Supervise supervision Supervised 50000 Supervised 100000 includes POL and d maintenance) per year Supervisory visits by state No of No of No of and district districts districts districts level officers By state level visited for RI visited for RI visited for for monitoring officers @ review review RI review and supervision Rs.100,000 /year of RI
@ Rs 500 per % Funds % Funds % Funds Cold Chain PHC/CHC per year used used used 10000 70000 maintenance District Rs 10,000 per year
For organizing No of No of No of outreach sessions sessions sessions sessions Focus on slum with the help of with hired with hired with hired & underserved Urban RCH Team in vaccinator vaccinators vaccinators 400000 areas in urban ONE municipal s areas: area.. 0
Mobilization of No. of No. of No. of children @ Rs 150/session sessions 0 sessions 1000000 sessions through ASHA/ (for all states/UT.s) with ASHA with ASHA with ASHA mobilizers
Alternative Geographically No of 41000 No of 400000 No of Vaccine hard to reach areas sessions sessions sessions
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Expenditure & Achievement
2009-10 2010-11(till Dec) 2011-12
Service Norms* Delivery: - Funds Target requirement Expenditure Expenditure Achievement Achievement
Delivery: (eg. Session with AVD with AVD with AVD site>30 kms from vaccine delivery point, river crossing etc.) @ Rs 100 per RI session
NE States and Hilly terrains @100 per RI session
For RI session in other areas @ Rs.50 per session.
State @Rs 12,000- Support for Computer 15,000 p.m. Assistant for RI reporting (with No of C.A. in No of C.A. in No of C.A. annual position position in position Districts @ Rs increment of 56000 96600 10% w.e.f. from 8000- 10,000 p.m 1 2010-11) 1
Printing and dissemination of immunization @ Rs 5 per cards, tally beneficiary sheets, monitoring forms, etc.
Support for No of No of No of meetings meetings meetings Review Quarterly State held held held Meetings level Review Meetings of district
officers @ Rs
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Expenditure & Achievement
2009-10 2010-11(till Dec) 2011-12
Service Norms* Delivery: - Funds Target requirement Expenditure Expenditure Achievement Achievement
1250/participant/d ay for 3 persons (CMO/DIO/Dist Cold Chain Officer)
Quarterly Review & feedback meeting for exclusive for RI at district level with one Block MO.s, ICDS CDPO and other 100000 stakeholders@ Rs 100/- per participant for meeting expenses (lunch, organizational expenses)
Quarterly review meeting exclusive for RI at Block level @Rs 50/-pp as honorarium for ASHAs (travel) and Rs 25 per person at 0 the disposal of MO-I/C for meeting expenses(refreshm ents, stationery and misc. expenses)
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Expenditure & Achievement
2009-10 2010-11(till Dec) 2011-12
Service Norms* Delivery: - Funds Target requirement Expenditure Expenditure Achievement Achievement
No of No of No of Trainings persons persons persons trained trained trained
District level orientation training for 2 days ANM, Multi Purpose Health Worker (Male), LHV, As per revised Health norms for trainings 19 Assistant (Male under RCH 25000 / Female), Nurse Mid Wives, BEEs & other specialist (as per RCH norms)
Three day training of No of No of Medical As per revised No of persons persons Officers on RI norms for trainings 50000 50000 persons trained- trained-40 using revised under RCH trained Nos MO training 30 module
One day refresher training of District RI As per revised Computer norms for trainings 0 0 0 0 Assistants on under RCH RIMS/HMIS and Immunization formats under NRHM
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Expenditure & Achievement
2009-10 2010-11(till Dec) 2011-12
Service Norms* Delivery: - Funds Target requirement Expenditure Expenditure Achievement Achievement
One day Cold Chain handlers training for block level cold chain handlers No of No of As per revised No of by State and persons persons norms for trainings 35000 33000 persons District Cold trained- trained-75 under RCH trained Chain Officers 75 Nos and DIO for a batch of 15-20 trainees and three trainers
One day Training of block level data handlers by DIO and As per revised No of No of No of District Cold norms for trainings persons persons persons chain Officer to under RCH trained trained trained train about the reporting formats of Immunization and NRHM
Microplanning
To develop sub- @ Rs 100/- per center and PHC subcentre No.of 20400 No. of microplans (meeting at block Districts Districts using bottom level, logistic) have have up planning updated updated with For consolidation microplans microplan participation of of microplan at this year 8800 s this year ANM, ASHA, block PHC @ 500/- AWW & at district level @ Rs 1800/- per
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Expenditure & Achievement
2009-10 2010-11(till Dec) 2011-12
Service Norms* Delivery: - Funds Target requirement Expenditure Expenditure Achievement Achievement
district
% Funds % Funds % Funds used used used POL for vaccine delivery from State to District and from district to PHC/CHCs
Consumables for computer including @ 2000/ - month/ 25000 provision for district internet access for RIMS
% funds % Funds % Funds Injection Safety used used used
Red/Black @ Rs
Plastic bags etc 2/bags/session 5500 Bleach/Hypochl @ Rs 500 per orite solution PHC/CHC per year
@ Rs 400 per Twin bucket PHC/CHC per year
Any State % funds % Funds % Funds
Specific Need used used used with 10 % of total justification amount of (Please provide approved PIP a separate write-up on objective,
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Expenditure & Achievement
2009-10 2010-11(till Dec) 2011-12
Service Norms* Delivery: - Funds Target requirement Expenditure Expenditure Achievement Achievement strategy, expected output and outcomes, basis for cost estimates etc.)
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District –wise Coverage reports (in numbers)
OPV - 1st Dose OPV - 3rd Dose DPT - 1st Dose Yearly Target BCG Coverage DPT - 3rd Dose Coverage Coverage Coverage Coverage (in (2010-11) (in Numbers) S. Name of (in Numbers) (in Numbers) (in Numbers) Numbers) No District Pregnant 2010- 2010- 2011- 2011- 2011- 2010- 2011- Infants 2011-12* 2010-11 2010-11 Women 11 11 12* 12* 12* 11 12*
Wayanad 19325 21512 19325 20165 18985 20165 18512 20165 18416 20165 18512 20165
TOTAL 19325 21512 19325 20165 18985 20165 18512 20165 18416 20165 18512 20165
TT2+Booster Hep B - 1st Dose Hep B - 3rd Dose Hep B - Birth Dose JE-routine Name of Measles Coverage Coverage Coverage S. No Coverage (Wherever District Coverage (Wherever (Wherever (Wherever applicable) applicable) applicable) applicable)
2010- 2011- 2010-11 2011-12* 2010-11 2011-12* 2010-11 2011-12* 2010-11 2011-12* 2010-11 2011-12* 11 12*
Wayanad 68% 100% 80% 90% 34% 90% 88% 95% 86% 95% 0 0
TOTAL 68% 100% 80% 90% 34% 90% 88% 95% 86% 95% 0 0
# Coverage for 2010-11 till Dec’10
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District –wise VPD reports in 2010-11 (in numbers) 3
Neonatal Name of Diphtheria Whooping Cough Tetanus Tetanus(Other) Measles Polio S. the No Districts Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
Wayanad 0 0 3 0 0 0 0 0 112 0 0 0
TOTAL 0 0 3 0 0 0 0 0 112 0 0 0
3 No cases of AES and hence no deaths
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Annex 8c
FAMILY PLANNING FOR 2011-12
SCHE DULE BUDGET WORK STRATEGY / ACTIVITY Planned Achieved D/ PLAN (In Trg. lakhs) LOAD
2010-11 2011-12
1 FAMILY PLANNING MANAGEMENT
Review meetings on Family Planning 12 12 12 12 0 1.1 performance and initiatives at the state and district level (periodic)
Monitoring and supervisory visits to 85 85 85 85 1.2 districts/ facilities
Orien tation workshops on technical 5 3 3 3 1.3 manuals of FP viz. standards, QA, FDS approach, SOP for camps, Insurance etc.
2 TERMINAL/LIMITING METHODS (Providing sterilisation services in districts)
Plan for facilities providing FEMALE 4 4 5 5 2.1 sterilisation services on fixed days at health facilities in districts
Plan for facilities providing NSV services 3 3 4 4 2.2 on fixed days at health facilities in districts
Number of FEMALE Sterilisation camps in 50 33 60 60 A-3 2.3 districts.
2.4 Number of NSV camps in districts. 48 28 48 48 A-3
2.5 Compensation for sterilisation (female) 1029
2.6 Compensation for sterilisation NSV (male) 321 321 321 321
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SCHE DULE BUDGET WORK STRATEGY / ACTIVITY Planned Achieved D/ PLAN (In Trg. lakhs) LOAD
2010-11 2011-12
2.7 Mobility support to surgeon’s team 48 48 60 60
Accreditation of private centres/NGOs 85 73 100 100 2.8 for sterilization services
2.9 Plan for post partum sterilisation 6324 6324 7528 7528
3 SPACING METHOD (Providing of IUD services by districts)
Plan for providing IUD services at health 4500 3800 5600 5600 3.1 facilities in districts
3.2 No. of IUD camps in districts 0 0 0 0
3.3 Compensation for IUD
Compensation to ASHA for ensuring 0 0 0 0 3.4 retention of IUD by clients
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4 SOCIAL MARKETING OF CONTRACEPTIVES
4.1 Setting up CBD Outlets 0 0 0 0
5 FAMILY PLANNING TRAINING
5.1 Laparoscopic Sterilisation Training
5.1.1 TOT on laparoscopic sterilisation 0 0 0 0
Laparoscopic sterilisation training for D-NA 5.1.2 service providers (gynaecologists /surgeons)
5.2 Minilap Training for MOs/ MBBS
5.2.1 TOT on Minilap 0 0 0 0
Minilap training for service providers D-NA 5.2.2 (medical officers)
5.3 Non-Scalpel Vasectomy (NSV) Training
5.3.1 TOT on NSV 0
5.3.2 NSV training for medical officers 1 0 1 1
5.4 IUD Insertion training
5.4.1 TOT for IUD in sertion 0
5.4.2 Training of Medical officers in IUD insertion 1 0 1 1
5.4.3 Training of staff nurses in IUD insertion 0 0 1 1
5.4.4 Training of ANMs / LHVs in IUD insertion
No. of Contraceptive Update trainings for 1 0 1 1 5.5 health providers in the districts
5.7 Other FP trainings (please specify)
BCC/IEC activities/campaigns/melas for 12 12 12 12 family planning e.g. Funds earmarked for 6 district and block level activities during ‘World Population Day’ celebration week
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7 PROCUREMENT of DRUGS/MATERIALS
7.1 NSV Kits D-NA
7.2 IUD insertion Kits D-NA
7.3 Minilap Set D-NA
7.4 Procurement/ repair of laparoscopes D-NA
7.5 Procurement of drugs & supplies for FP D-NA
Innovatory schemes for promoting FP at 0 0 0 0 8 state or district level
Performance based rewards to institutions 9 and providers for FP performance at state and district level
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Annex 8e: ARSH FORMATS FOR PIPS 2011-12
Check-list for ARSH activities
S. No. Activity Status as on 01.04.2010 Planned for Achievement Planning Remarks 2010-11 against plan for 2011- till 31.12.2010 12
1. 1-day State 1 Orientation Workshop for ARSH
2. State level Training of 0 Trainers (3 days)
3. Printing of Training 0 Modules
4. IEC for ARSH Done in (6)CHC Areas 8 Units 100% where ARSH Clinic is more functioning.
5. Helpline for ARSH D-NA
6. Convergence with D-NA other programmes / departments (WCD, SACS, MoYAS, HRD)
7. Other activities (pls D-NA specify)
2. District level Formats:
2a. Data to be collected on an annual basis : PROGRAMME NOT IMPLEMENTED
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ANNEX 8f
URBAN HEALTH PROGRAMME
S.No. Name of cities identified Major urban health Urban health Brief on activities for implementing UHPs. In strategies/activities strategies/activities as being supported by the State PIPs. Under carried out under proposed now in the State external agencies Urban RCH, so far Urban RCH so far, PIP under Urban RCH, city- city-wise wise
1. Kalpetta Municipal Area Maternal and C hild 1. Strengthening None Health Outreach immunisation programmes. Outreach immunisation 2. BCC campaign on Programmes domestic violence prevention.
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Annex
Performance indicators
Parameters /processes Current Status
Yes/No Complete In process Not To be relevant done
I Strengthened Institutional Mechanisms for Social and Gender Equity
A The key entry points identified for Yes addressing social inclusion and gender equity - a nodal gender and equity person, plans to train ANMs, ASHS, district level
functionaries, use of MIS, BCC b Has the plan been built on systematic Yes * mapping of underserved districts and vulnerable social groups 4, including (but not limited to) the Tribal areas.
II Improved Services for Disadvantaged Social Groups and Women as Clients
a) Are specific strategies or mechanisms Yes proposed to reach at a scale including budget allocations for 1) Under Served Districts 2. Social Group - ANC, PNC, Nutrition and Health, Ambulance and Transport Facilities, Trained medical staff, hospitals, safe community friendly alternative systems
b Are there strategies specified to ensure Yes quality of services from a woman’s perspective (e.g. through expansion of district Quality of Care Protocols, district teams). Are issues such as adequate, clean and separate toilets for women, privacy with the help of screens/ partitions, sufficient water, clean linen etc included as an aspect of quality?
4 By vulnerable groups we mean SC, ST, minorities, urban Poor, women, adolescent girls and boys, occupation based groups, migrants, etc.
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Parameters /processes Current Status
Yes/No Complete In process Not To be relevant done
c Is there a plan for adolescent friendly Yes health services - anemia treatment, delay marriages, delay pregnancy, etc (inclusion of adolescent boys/girls, married and unmarried, out-of-school and in-school for SRH education and service provision). d Are there strategies for development of Yes capacity to provide counseling services at appropriate levels (e.g. for Family Planning, HIV prevention and testing, STI -partner management and Gender Based Violence) and integrate these in health services
III Improved Health Financing a Is there sufficient allocation of funds for Yes emergency transport, emergency obstetric care, MTP services, maternal complications b Is there adequate allocation of funds for Yes health delivery strategy made for women and BPL, SC, ST, migrants, urban poor, minorities and locally vulnerable groups
IV Training a Do training plans include a focus on No provision of MTP, management of RTI/STI, insertion of IUDs, vasectomies?
VI Improved Community Involvement - RCH - NRHM a Are there plans and funds for yes communication, networking and BCC activities through community and women’s groups for improved RCH outcomes (e.g. involvement of community volunteers, health messages through SHGs, strengthening of Mahila Swasthya Sanghs, health action groups and community health dialogues)
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Parameters /processes Current Status
Yes/No Complete In process Not To be relevant done
b Are there mechanism to ensure Yes participation of socially marginalized groups and 50% women’s participation in RKS and VHSCs c Are there mechanisms to involve Yes Panchayati Raj Institutions/Self Help Groups in needs assessment and planning ?
VII Innovative approaches to make services and service environment client friendly a Are there provision for innovative Yes approaches to making services client – centered (e.g. 24 hour help counters at district hospitals for assisted referrals, helplines for emergency transport) b Are putting up patients rights charters, rate Yes charts, timings, in local languages at all health centres, putting up complaints boxes and credible grievance redressal system being practiced? c Are plans for linking hospitals with NGOs, Yes Women’s groups, help lines to address gender based violence
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VIII Men as partners and clients a Are there innovative plans and allocation to Yes improve provision of STI services to men (e.g. through BCC, male health workers, partner notification and treatment) b Are their plans and allocations for BCC and No MPW training to improve men’s involvement in family planning including use of condoms and terminal methods
IX Women Health Care Providers q Are there mechanisms to report or address Yes sexual harassment at work-place at the district level? b Are field level functioning of ANMs/ No Frontline workers e.g. provision of mobile phones, provision of vehicles for easy transport
X Better implementation of PCPNDT Act a Are there plan and allocations for better Yes implementation of the PNDT act to stop sex-selection, specifically for
-support cells at district providing monitoring or legal help -
- capacity-building of Appropriate Authorities and other stakeholders including for monitoring visits
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ACTIVITY WISE PIP A - RCH
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Health Facilities in Wayanad
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Project No. WA – 1 Head of Account A.1.1.1
Name of Operatio nalise FRUs Project
Total Budget (In lakhs)
Current Staff Pattern
DH Mananthavady THQH Bathery SL. No. of NRHM No. of NRHM Particulars In In Regular Contract & Regular Contract & No Position Position Posts CRS Posts CRS 1 Specialist 33 22 0 14 6 2 Doctors 2 MBBS Doctors 8 6 8 5 3 7 3 Staff Nurses 73 54 11 10 10 6 4 Lab Tech 2 1 13 2 2 6 5 Pharmacist 3 3 2 2 2 1 6 Attender 45 45 0 5 5 0
7 Others (Specify) 63 2(Radiographer) 7 1(Radiographer)
Other Details
SL. DH THQH Particulars No Mananthavady Bathery 1 No. of deliveries (Avg. per Year) 2291 769 2 No. of IP patients (Avg. per Year) 24340 5651 3 No. of functioning OTs 5 2 4 No. of surgeries taking place. (Avg. per Year) 2114 63 5 No. of LSCS conducted. (Avg. per Year) 704 390
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Kerala - Wayanad- Complicated Pregnancies & Deliveries Treated - Apr'09 to Mar'10
Reported Deliveries Reported ANC Registration 15,113 15,460 Complicated Complicated Pregnancies C - Section PNC Maternal Pregnancies Abortions Still Births Rate Deliveries Complications attended 2,134 16% 3,167 134 1,065 157
Complicated Deliveries Treated with No Of No Of severe IV antihypertensive/Mag Blood Eclampsia anemia cases IV Antibiotics IV Oxytocis Sulph injection Transfusion cases Treated treated 565 160 3,169 517 1 409
Situation Analysis: D H Manathavady & THQH Sulthan Bathery are the two existing FRU‘s functioning in Wayanad District. The problems in fully operationalisating these institutions are:
1. Severe shortage of manpower 2. Lack of sufficient space for admissions 3. Poor lab facilities 4. Absence of sufficient OTs
Goal: Fully operationalise the existing two FRUs
Objective: To give quality medical care to all mothers and children referred from peripheral institution.
Strategy:
1. To filling up all the existing vacancies against sanctioned manpower 2. To provide additional manpower where needed 3. To construct sufficient additional wards and OTs attached to the existing buildings 4. Timely provision of sufficient equipments and reagents & replenishment as per need
Process:
1. Reporting all existing vacancies and request for filling of the posts against the sanctioned mainly , Specialists, Medical Officers and Staff Nurse 2. Provide additional manpower as per the sanctioned bed strength, according to which there is a need for MOs , SN and Lab Tech. In addition to these there is a need for Operation Technicians for fully functioning of OTs. 3. The medical officers post would be filled following the counseling of Compulsory Rural Service cadre who are posted for one year at these centers. 4. The available space in the vicinity of the wards will be used for additional wards in the FRUs for which budget under Civil works (minor) would be proposed. Refurbishment of existing labour room. 5. Additional rooms designate as SNCUs 6. Procurement of the minor laboratory equipments and reagents would be done through RKS and major equipments through government procurement procedure.
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Outcome:
• Well equipped operation Theater & Labour Room • Skilled man power will be available for quality patient care. • Diagnostics services including Laboratory services can improve. • The quality of New born care will be increased. • The facility of Blood Bank & Blood storage unit can provide.
Budget
Sl Remarks N o. Activities DH Mananthavady THQH Bathery ref
Particulars Amount Particulars Amount
Operationalising A.9.2.1 O.T and Labour 1 Room 1.0 1.0
Supply Of B16.1.1 2 Equipments Kit 1.0 1.00
Supply of obsteric B16.2.1 3 emergency drugs 0.50 0.50
Diagnostic B16.1.1 Services including Procurement of Procurement of 4 Lab Equipments 2.00 Equipments 1.00
Procurement of B16.1.1 Phototherapy Procurement of unit Phototherapy ,Transilluminator Newborne care unit,Transilluminator and Radient 5 unit and Radient Warmer 2.00 Warmer 1.00
6 1.00 1.00 NACO Blood Bank and
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Blood Storage unit
Training for staff NACO 2. Nurse,Lab Oper Technician,Blood 7 bank tech. 0.50 0.50 ation alisat ion of proposed FRU’s
Situation:
30% of home deliveries are from the Wayanad District and these are mainly from the CHC areas of Pulpally, Meengady, Porunnanore, Thariyode, and Mepady.
Goal: 100% institutional Delivery
Objective:
1. Strengthen the existing institutions to operationalize as FRUs 2. Increase referral transport system
Strategy:
1. Incentives for MOs and specialist 2. Infrastructure development 3. Referral transport 4. Trainings for all staff
Process:
1. Under the scheme of incentives of MOs working in the remote and rural areas, as proposed to state. 2. The available space in the vicinity of the wards will be used for additional wards in the FRUs for which budget under Civil works (minor) would be proposed. Refurbishment of existing labour room. 3. Additional rooms designate as SNCUs 4. Procurement of the minor laboratory equipments and reagents would be done through RKS and major equipments through government procurement procedure. 5. Training of all SNs in management of BEmOC 6. Call taxi system to pick-up mothers to these institutions from filed areas (please PPP/Referral).
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Current Staff Patern
THQH Vythiri GH Kalpetta CHC Meenangady CHC Pulpally No. No. No. No. SL. In In In In Particulars of NRHM of NRHM of NRHM of NRHM Posi Posi Posi Posi No Reg & CRS Reg & CRS Reg & CRS Reg & CRS tion tion tion tion Posts Posts Posts Posts 1 Specialist 12 8 0 7 3 0 0 0 0 0 0 0 Doctors 2 MBBS 7 5 3 3 3 2 4 4 3 5 4 2 Doctors 3 Staff 15 13 0 4 4 5 2 2 10 9 9 0 Nurses 4 Lab Tech 2 2 1 1 1 1 1 3 3 1 5 Pharmacist 4 4 1 1 1 2 1 1 1 2 2 1 6 Attender 13 13 0 4 4 0 5 5 0 4 4 0 7 Others 27 0 9 1 (Radio 22 1 19 0 (Specify) Grapher) (Ophthalmic)
Other Details
SL. THQH GH CHC CHC Particulars No Vythiri Kalpetta Meenangady Pulpally Distance from proposed centers to 1 the existing FRUs 45 35 35 26
No of deliveries and surgeries 2 taking place. 288 931 497 123
3 No. of LSCS conducted 258 420 310 18
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Budget:
Sl CHC CHC THQH GH Total Remarks No Activites Pulpally Meenangady Vythri Kalpatta
Operationalising O.T and 4 A.9.2.1 1 Labour Room: 1.00 1.00 1.00 1.00
2 Procurement of Equipment 2.00 2.00 2.00 2.00 8 B16.1.1
Diagnostic Services including 2 B16.1.1 3 Lab equipments 0.50 0.50 0.50 0.50
4 Newborn care unit 1.00 1.00 1.00 1.00 4 B5.7
Blood Bank and Blood Storage 4 NACO 5 unit 1.00 1.00 1.00 1.00
Training for staff Nurse, Lab 2 NACO 6 Technician, Blood bank tech. 0.5 0.5 0.5 0.5
GRAND TOTAL
Project No. WA-2 Head of Account A.1.1.2
Name of Operationalisation of 24 x7 PHCs Project
Total Budget (In lakhs)
Situation:
Currently eight 24x7 PHCs are functional in the district out of 21 PHCs. These PHCs are have been made functional through NRHM. These institutions are not equipped to conduct delivery procedures due to lack of infrastructure in the labour rooms and shortage of man power. Secondly these facilities need to be strengthened for providing the emergency medical care for NCD patients.
Goal: 100 % Operationalisation of 24x7 facilities to provide delivery and NCD services
Objective:
1. management of normal deliveries and level one complications 2. management and stabilization of NCD patients
STRATEGY:
1. Training of existiting staff in management of delivery cases and complications 2. Training of existing staff in NCD management in pregnant women
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3. Rationalization of trained specialists in NCD to these areas 4. Infrastructure development including lab facility
Process:
1. One staff to be trained at one given point of time in management of basic complicated delivery. SO that the services at the PHC are not affected 2. Following the training of all staff in the above, NCD training could be followed in the similar manner. 3. The availability of specialist in these areas are limited. Therefore, once a day visit of specialist clinic in these 24x7 PHCs. 4. Incentivize MOs and SNs for conducting delivery during night hours and also for management of NCDs. 5. Refurbishment of the existing labour rooms for maintaining sterilization and also ensuring 48 hrs stay at the place of delivery.
Outcome: Round the clock emergency obstetric and other medical care in remote and tribal areas
24 X7 PHCs Staff Details (Annexure 1)
PHC Appapara PHC Edavaka PHC Vellamunda PHC Cheeral No. No. No. No. SL. In In In In Particulars of NRHM of NRHM of NRHM of NRHM Posi Posi Posi Posi No Reg & CRS Reg & CRS Reg & CRS Reg & CRS tion tion tion tion Posts Posts Posts Posts 1 Specialist 0 0 0 0 Doctors 2 MBBS 3 2 3 3 3 1 1 1 2 3 3 1 Doctors 3 Staff 1 1 1 1 1 0 1 1 2 3 3 1 Nurses 4 Lab Tech 1 1 0 0 1 1 0 1 1 0 5 Pharmacist 1 1 0 1 1 0 1 1 0 1 1 1 6 Attender 2 2 0 1 1 0 2 2 0 3 3 0 7 Others 23 0 14 0 14 0 15 0 (Specify)
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24 X7 PHCs Staff Details (Annexure 2)
PHC Vazhavatta PHC Mullankolly PHC Poothady PHC Noolpuzha No. No. No. No. SL. In In In In Particulars of NRHM of NRHM of NRHM of NRHM Posi Posi Posi Posi No Reg & CRS Reg & CRS Reg & CRS Reg & CRS tion tion tion tion Posts Posts Posts Posts 1 Specialist 0 0 0 0 Doctors 2 MBBS 3 3 0 1 1 1 3 3 2 3 3 3 Doctors 3 Staff 4 4 1 1 1 1 0 1 1 1 Nurses 4 Lab Tech 1 1 0 0 1 1 0 1 1 0 5 Pharmacist 1 1 0 1 1 0 1 1 0 1 1 0 6 Attender 2 2 0 1 1 0 2 2 0 4 4 0 7 Others 20 0 17 0 19 0 15 0 (Specify)
CHC Staff Details (Annexure 1)
CHC Porunnannur CHC Perya CHC Nallornadu CHC Thariode No. No. No. No. SL. In In In In Particulars of NRHM of NRHM of NRHM of NRHM Posi Posi Posi Posi No Reg & CRS Reg & CRS Reg & CRS Reg & CRS tion tion tion tion Posts Posts Posts Posts 1 Specialist 0 0 2 1 0 0 Doctors 2 MBBS 3 2 4 5 5 1 3 2 1 4 2 2 Doctors 3 Staff 4 4 1 6 6 1 1 6 6 1 Nurses 4 Lab Tech 1 1 0 2 2 1 1 1 1 0 5 Pharmacist 1 1 1 2 2 1 1 6 Attender 2 2 0 4 4 3 3 7 Others 18 0 36 41 (Specify)
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CHC Staff Details (Annexure 2)
CHC Meppadi CHC Ambalavayal CHC Meenangadi CHC Pulpally No. No. No. No. SL. In In In In Particulars of NRHM of NRHM of NRHM of NRHM Posi Posi Posi Posi No Reg & CRS Reg & CRS Reg & CRS Reg & CRS tion tion tion tion Posts Posts Posts Posts 1 Specialist 0 0 0 0 Doctors 2 MBBS 3 2 2 2 2 3 3 2 Doctors 3 Staff 1 1 1 4 4 2 10 0 Nurses 4 Lab Tech 1 1 1 1 1 0 1 1 5 Pharmacist 1 1 0 1 1 0 1 1 6 Attender 1 1 0 5 5 0 0 0 7 Others 52 0 28 0 1( Ophth 0 (Specify) almic)
CHC Staff Details (Annexure 3)
CHC Panamaram No. SL. In Particulars of NRHM Posi No Reg & CRS tion Posts 1 Specialist
Doctors 2 MBBS 3 2 0 Doctors 3 Staff 1 7 7 Nurses 4 Lab Tech 1 1 0 5 Pharmacist 1 1 0 6 Attender 5 5 0
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7 Others 0 21 (Specify)
Other Details – 24 X7 PHC
SL. PHC PHC PHC PHC PHC PHC PHC PHC Particulars No Appapara Edavaka Vellamunda Cheeral Vazhavatta Mullankolly Poothady Noolpuzha No. of 1 deliveries taking place. No. of IP 2 181 156 593 649 441 0 54 390 patients 3 No. of beds 24 24 10 24 24 0 24 Distance to 4 25 4 16 10 6 25 16 10 nearest FRU Whether tribal 5 Yes Yes Yes area or not No. of LSCS 6 conducted
Other Details – CHCs
CHC CHC CHC CHC CHC CHC SL. CHC CHC CHC Particulars Porunnann Nallorna Thario Meppa Meenang Ambala No Perya Panamaram Pulpally ur du de di adi vayal No. of 1 deliveries ` 497 taking place. No. of IP 2 956 931 2332 490 3645 1408 3844 5364 1386 patients 3 No. of beds 30 30 42 40 24 16 34 36 Distance to 4 9 20 16 10 13 10 10 30 nearest FRU Whether tribal 5 Yes Yes Yes area or not No. of LSCS 6 conducted
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Budget:
Particulars Unit Amount in Total Remarks Lakhs
Refurbishment 8 1 8 A.9.2.2
Supply of 8 0.5 4 B.16.1.1 equipments and kits
Supply of 8 0.25 2 B.16.2.5 obstetrics emergency drugs
Manpower training 1 0.25 0.25 A.10.3.1 (SBA) (for 16 SN)
Strengthening of 8 0.5 4 B.16.1.1 Diagnostic services & Equipments
NCD management 8 0.1 0.8 D.9 in pregnant women
Grand Total in Lakhs
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Project No. WA-3 Head of Account A.1.1.3
Name of MTP services at Health Facilities Project
Total Budget (In lakhs)
Situation :
The need for MTP services are not understood in the community, mainly among the tribal population. The social –exploitation of women is also very high in the Traibal women. Even in the non-tribal population the awareness about the services are limited. 121 MTPs are performed up to November 2010 (HMIS Report). This is low number, compared to pregnancy among unwed women.
Goal: meet the unmet demand for MTP services
Objective:
1. Provide MTP services in all FRUs and 24x7 PHCs
Strategy:
1. BCC among community for social change and Incentive for health workers
Process:
1. Bring about behavior change among community to address the pre-aged pregnancy as a pre-disposed risk for maternal death. Through community based health workers (ASHA, ANM, AWW etc) 2. Training to Medical officers and staff Nurse for conducting safe abortion service. 3. Incentive for MOs and SNs for providing safe abortion services during odd hours. 4. Incentive for ASHA for mobilizing tribal women in the notified areas for undergoing safe abortions.
Budget
Sl no Particulars No. of Unit Total Remarks Unit cost
1 BCC Activities 34 2000 0.68 B.10.2.1
2 Training of Medical officers (10 1 35000 0.35 A.10.3.4 MOs)
3 Incentive to ASHA 839 50 0.42 B.1.6
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Project No. WA-4 Head of Account A.1.1.4
Name of RTI / STI CLINICS AT HEALTH FACILITIES Project
Total Budget (In lakhs) 6.60
Situation:
RTI/ STI services are available in FRUs and 8 CHCs. The services at the CHCs are currently not been provided as a result of non-availability of consumables. The consumables were adjusted from the CHC untied the fund for purchase of consumables. 773 women and 349 men were treated for RTI/STI up to November 2010 (HMIS Report November 2010).
Kerala - Wayanad- Apr'09 to Mar'10 Total OPD Total RTI/STI cases 1,882,448 3,584
Goal: Control of RTI/STI
Objective:
1. Reduction in incidence of RTI/STI 2. Increase Awareness about STDs and its complications 3. Reduction of complications of RTI/STI eg: Infertility, Genital Tract Malignancies etc
Process:
1. Conduct RTI/STI Screening Camps at block level monthly, target groups 2. Promote Condom Usage by motivating eligible couples through link workers 3. Conduct Cervical Cancer Screening Camps once in three months block wise along with RTI/STI Camp. 4. Collection and transportation of PAP smear for early detection of cases. 5. PPP with laboratories for laboratory analysis of PAP smears. 6. IEC / BCC activities esp. among adolescents
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Budget:
Sl Prticulars No.of Unit Total Remarks no Unit cost
1 RTI/STI Screening Camps at block level 20 2000 0.4
2 Promote Condom Usage NACO
3 Cervical Cancer Screening Camps 20 1000 0.20
4 Consumables, Collection and 1200 400 4.8 transportation of PAP smear (60 samples per camp)
5 laboratory analysis of PAP smears 1200 100 1.2
6 IEC / BCC activities 5 1000 0.05 B10.2.1
Grand Total 6.60
Project No. WA -5 Head of Account A.1.1.5
Name of Project OPERATIONALISE SUB - CENTRES
Total Budget (In lakhs)
Situation:
The Porunnannore CHC area and Pulapally PHC area have reported more number of home deliveries. The major reason for home was found to be lack of transportation and lack of awareness among tribal women about the services.
Prioritize the sub-centers where additional ANM under NRHM is required under the 2 nd ANM scheme. The subcenters have been priorities based on the number of home deliveries being reported (Refer to red dots in map).
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Home Delivery - April to November 2010 Sub-centre PHC Muthanga 13 Noolpuzha Chekady 9 Pakkam Marakkadavu 7 Mullankolly Panavally 6 Appapara
Goal: to provide safe home delivery
Objective:
1. To provide SBA at the time of delivery 2. To identify and refer high risk cases
Strategy:
1. Train JPHN in the identified sub-center area for providing safe home delivery 2. Rationalize appointment of JPHN in the selected sub-centers
Process:
1. The JPHNs of the selected Sub-centers are to be trained in providing SBA delivery. 2. Arrange meetings and social gathering to address the importance of institutional delivery and bring about behavior change among community. These are to be part of WHNDs
Budget: Additional JPHNs and SBA training
Sl Particulars No.of Unit Total Remarks no Unit cost
1 Salary to Additional JPHN 4 80160 3.21 A9.1.3
2 IEC/BCC (WHND) 4 2000 0.08 A.1.3.2
3 SBA training for JPHN(8 1 10000 0.10 A10.3.1 JPHNs)
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Project No. WA -6 Head of Account A.1.2
Name of Project REFERRAL TRANSPOR T
Total Budget (In lakhs) 1.50
Situation:
Tribal population is spatial distributed in remote and inaccessible areas where there are no public transport systems. The public transport facilities to these areas are also limited and quite often depend on the private transport facility. Due to resource constraint tribal population usually come to health facility by walk. This is common feature during ANC or even PNC. Therefore there is a need for early transportation facility and also a mechanism to reimburse the transportation cost.
Goal:
1. Prompt referral service
Objective:
1. Timely transportation of tribal women to nearest FRUs 2. To reduce the catastrophic burden due to event of delivery
Strategy:
1. Timely transportation of tribal women to nearest FRUs 2. To reduce the catastrophic burden due to event of delivery
Process:
1. Create pool of taxi drivers willing to provide the transport services round the clock from the tribal areas 2. Display the contact number of empanelled taxi drivers at the tribal colonies and also disseminate information to tribal colonies during the VHNDs
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3. Vouchers to be given to taxi driver once a patient is brought to FRUs from field. Some cases would also require referrals of higher order like transport to medical colleges. These cases would also receive a separate voucher from FRUs. All vouchers would be reimbursed by PHC MO of the respective area as and when produced.
Budget: The budget should address the empanelled tax drivers, minimum fare to cover up to 10 KMs is rupees 150/- and then additional to be Rs 10/KM.
Sl Particulars No.of Unit Total Remarks no Unit cost
Taxi Hiring Charge 5000/facility to be given as corpus grant to PHCs and 1 (An estimate of 500 1.5 CHCs 500 cases per year)
Project No. WA -7 Head of Account A.1.3.1
Name of RCH Outreach camps Project
Total Budget (In lakhs) 0.90
Situation:
The previous RCH camps were able to detect many of the issues related to women and child health, like alcoholism, drug abuse, substance abuse among schoolchildren.
Goal:
1. 100% ANC coverage to all beneficiaries.
Objective:
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1. To have camps regularly to increase ANC, Immunisation coverage in areas with low coverage 2. To detect and provide assistance to all anemic women 3. To address substance abuse, drug abuse, tobacco related and alcoholism
Strategy:
1. To increase awareness about health and sanitation 2. To increase case detection rate among anemic women 3. To increase awareness about harmful effects of substance abuse, drug abuse, tobacco related diseases and alcoholism
Process:
1. A team of five specialist would be formed who are locally from nearest health facility. The priority would be for having a Gynecologist and Pediatrician. 2. All identified high women would be screened by specialist at these camps for confirmation and with a referral card for prompt action at FRUs. 3. Preparation of detailed plan and adherence to the plan for RCH camps at each health block in every two months. 4. Sickle Cell anemia patient to be monitored at the RCH camp 5. ANC checkup by specialist and refer to nearest FRU to monitor the progress. 6. Immunisation status monitoring during the RCH camps with that of the immunization. 7. RTI/STI case detection in these camps and followed by counseling of women and couple 8. Unwed mothers to be counseled for abortion in case of need and promote for safe delivery at the health facility 9. Spacing methods promotion for couples and providing the services like IUD insertion for those needy. 10. Detection of malnutrition among children 11. Detection of developmental growth abnormalities among children.
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Budget:
Sl no Particulars No.of Unit Total Remarks Unit cost
1 Medical Officers @500 x 5 5 2500 0.125
2 Block coordinator 5 150 0.0075
3 Staff Nurse @150 x 1 5 150 0.0075
4 LHI/HI @ Rs. 150 x 2 5 300 0.015
5 JPHN / JHI @ 100 x 2 5 200 0.01
6 ASHA @ Rs 7 5 x 2 5 150 0.0075
7 Nursing assistant @ 100 x 1 5 100 0.005
8 Pharmacist @ 150 x 1 5 150 0.0075
9 H/ A Gr. II @ 75 x 1 5 75 0.00375
10 Clerk @ 100 x 1 5 100 0.005
11 Driver @ 100 x 1 5 100 0.005
12 Medicines 5 10000 0.50
13 Publicity POL & Organizational 5 4025 0.20 cost & light Refreshments
Grand Total 0.89875
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Project No. WA -8 Head of Account A.1.3.2
Name of Monthly Ward Health & Nutrition Days Project
Total Budget (In lakhs) 11.77
Total rural wards 459
Municipal Wards 28
Total Wards 487
Goal: to increase awareness about health among community members
Objective:
1. To mobilize villagers and encourage participation in Health Related activity 2. Provide Health care service in the remote areas of the ward so as to take health care delivery system to the door steps of people in the inaccessible areas of the ward. 3. Increase awareness about emerging new diseases and seasonal diseases 4. Create awareness about Health care facility 5. IEC/BCC activities conducted among the layman 6. Importance of early ANC registration and checkup ensured. 7. Immunization status improvisation can be done through IEC in WHND. 8. Improve nutrition status of children by using locally available food
Process:
1. ASHA and AWW to mobilize mother and children and young adolescent girls for WHNDs. To discuss the needs of women, child health and adolescent health during these meetings 2. Address followup of cases, women and adolescent girls, diagnosed of Sickel Cell Anemia 3. Addressing nutrition importance, communicable disease management, management of non-communibcale disease and also best health practices 4. Awarding women who have completed immunization of their children 5. Encourage breast feeding practices and discuss the problems of breast feeding
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6. Discussing importance of safe sexual practice among adolescent girls and addressing the issues related to pregnancy. 7. Description of facilities where MTP services are provided and its confidentiality and safety measures taken 8. Discussion of social causes like Alcoholism, and drug abuse and mobilize women for referral to de-addiction centers 9. Discussion with women about the violence and rape, and motivating them to report them to nearest police station. 10. Follow-up on the prompt actions and socitieal security for victims.
Budget:
There are 487 wards and Rs 100 to be paid to ASHA as incentive and Rs 200 is earmarked for conducting the programme.
Rs 100 + Rs 200 = Rs 300 x 12 months = Rs 3600/ward/year
Total for 487 wards = Rs 17,53,200
Sl no Particulars No.of Unit Unit cost Total Remarks
1 WHND 487 2400 11.69
2 ASHA Incentive 839 100 0.84 B.1.6
3 IEC/BCC (WHND) 4 2000 0.08 From A 1.1.5
Grand Total 11.77
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Project No. WA -9 Head of Account A.1.4.1
Name of JSY – Financial Assistance to Mothers undergoing Project Home delivery
Total Budget (In lakhs) 1.50
Under JSY financial assistance is envisaged to mothers @ Rs. 500 for Home deliveries. The expected expenditure under this programme is as follows
Sl Particulars No.of Unit Total Remarks no Unit cost
1 JSY – Financial Assistance to 300 500 1.50 Mothers undergoing Home delivery
Grand Total 1.50
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Project No. WA -10 Head of Account A.1.4.2
Name of JSY – Financial Assistance to Mothers undergoing Project institutional delivery
Total Budget (In lakhs) 66.62
Under JSY financial assistance is envisaged to mothers @ Rs. 700 for Institutional deliveries. The expected expenditure under this programme are as follows
Budget:
Sl Particulars No.of Unit Total Remarks no Unit cost
1 JSY for women who come to the 8017 700 56.12 hospitals for deliveries
Grand Total 56.12
II. Reduction of home deliveries & safe motherhood About 18% of the population in the district belong to tribal community, which counts to 1,36.062 residing in 2433 colonies in 26001 families. 25 per cent of the total deliveries reported in the district are of tribal. Averages of 4-5 deliveries are reported among tribal mother and few mothers are reported with more than 6 deliveries. The district also had the highest number of home deliveries in the state, which counts to 3-5 percent of total deliveries in the district. The home deliveries are only prevalent in tribal’s of the district which is a greater threat to the health of the mother as well as the new born. Currently the JSY is provided only for two live births.
Goal Promoting institutional deliveries
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Objective
1. To decrease the existing home deliveries the tribal’s below 1 percent 2. To promote safe delivery among tribal’s 3. To reduce maternal morbidity
Process Promoting institutional deliveries through providing JSY to all deliveries conducted from hospitals Activity
1. Create awareness among the tribal mothers that all deliveries conducted at hospitals are eligible for JSY, through the Health Staff & ASHA workers. 2. Paying the amount @ Rs 700/ deliveries
Outcome
1. Increase in percentage of institutional deliveries among tribal . 2. Health Mother and Health family
Budget: Sl Particulars No.of Unit Total Remarks no Unit cost
1 JSY for women who come to the 1500 700 10.50 Reduce hospitals for deliveries (3rd Home delivery onwards Delivery
Grand Total 10.50
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Project No. WA -11 Head of Account A.1.5
Name of 24 hours deliveries Project
Total Budget (In lakhs)
Project No. WA -12 Head of Account A.1.6
Name of Payment to Link Workers/AWW/AWS (other than Project ASHA)
Total Budget (In lakhs)
\
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Project No. WA -13 Head of Account A.1.7
Name of Maternal Death Audit Project
Total Budget (In lakhs)
Situation: No of audits conducted in the last two years: 13 (2009) + 6 (2010)
Process of conduct of maternal audit:
Maternal Death
Preliminary enquiry from MO
JPHN
Report
Medical off ice
Report Detailed enquiry from DMO(H)
DMO(H)
Measures Taken
Major Causes of death identified from Maternal Death Audit
Major Causes of maternal health
Category 06- % 07- % 08- % 09-10 % 10-11 Total % 07 08 09
PPH, Abruptio 6 60 1 16.67 1 10 1 7.7 2 33.333 11 24.44 Placenta
Anaemia 0 0 0 1 7.7 0 1 2.22
Heart Diseases 2 20 1 16.67 0 0 1 7.7 1 16.667 5 11.11
Embolism, 0 1 16.67 2 20 0 0 3 6.67 Thrombosis Cerebral Hemorrhage
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Sepsis 0 1 16.67 1 10 0 0 2 4.44
Rupture ectopic 0 0 1 10 0 0 1 2.22
Others 2 20 2 33.33 5 50 10 77 3 50 22 48.89
Total 10 6 10 13 6 45 100.00
Age Wise Classification of Maternal Death
Category 06-07 % 07-08 % 08-09 % 09-10 % 10-11
Below 20 0 0.0 0 0.0 2 20.0 1 7.7 0
20-25 6 60.0 3 50.0 4 40.0 4 30.8 3
26-30 3 30.0 2 33.3 1 10.0 5 38.5 3
Above 30 1 10.0 1 16.7 3 30.0 3 23.1 0
Total 10 6 10 13 6
Kerala – Wayanad- Maternal Deaths & Causes – Apr’09 to Mar’10 – From HMIS
Abortion Obstructed/prolonged labour Severe hypertension/fits
6-14 yrs 15-55 yrs. Total 6-14 yrs 15-55 yrs. Total 6-14 yrs 15-55 yrs. Total
0 0 0 0 1 1 0 2 2
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Bleeding High Fever Other Causes
6-14 yrs 15-55 yrs. Total 6-14 yrs 15-55 yrs. Total 6-14 yrs 15-55 yrs. Total
0 0 0 0 0 0 0 2 2
Project No. WA -14 Head of Account A. 2
Name of Child Health Project
Total Budget (In lakhs)
Project No. WA -15 Head of Account A. 2.1
Name of IMNCI Project
Total Budget (In lakhs) 0.10
In 4 sub centres where the maximum number of home deliveries occurs we need to train the JPHNs about IMNCI. Me3dical Officers and Staff nurses of concerned PHC i.e. PHC Appapara and PHC Noolpuzha, PHC Pakkom and PHC Mullankolly to be trained in FIMNCI.
Budget:
Sl Particulars No.of Unit Unit Total Remarks no cost
1 FIMNCI training for Medical 1 MO & 1 S/n from UNICEF Officers and Staff Nurses each institution
2 IMNCI training for JPHNs(8 1 10000 0.10 SIHFW JPHN)
Grand Total 0.10
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Project No. WA -16 Head of Account A. 2.2
Name of Facility Based Newborn Care/FBNC Project
Total Budget (In lakhs) 1.00
Situation: In Wayanad 22 children have died up to November 2010 in the district hospital. There is a need for strengthening DHs with NNICU unit.
Apr - Service 2010 May-2010 Jun-2010 Jul-2010 Aug-2010 Sep-2010 Oct-2010
Female child death below 1 day 1 1 1 0 1 1 0
Female child death below 1 month 0 0 0 0 0 0 0
Female child death below 1 week 1 0 2 0 0 1 2
Female child death below 12 months 0 0 0 0 0 0 1
Male child death below 1 day 0 1 0 1 1 0 0
Male child death below 1 month 0 0 1 1 1 0 0
Male child death below 1 week 0 0 0 0 0 0 0
Male child death below 12 months 0 0 0 1 0 3 0
Total 2 2 4 3 3 5 3
Objectives:
To reduce early neonatal, neo natal and infant deaths
Strategy:
1. Rationalized upgradation of health facilities for FBNC 2. Training of Mos and SNs in management of Sick new born
Process:
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1. The currently and those proposed FRUs are in the areas where there are high reported Infant deaths. Therefore the same institutions could be taken up for FBNC. 2. The primary level of care would be provided at newly constructed FRUs and Secondary level care at DHs 3. New born baby corners to be made in the existing facility, near labor ward, in all CHCs. 4. At the district hospital NICUs to be made fully functional with trained staff. 5. The services at DHs would be for example management of Neo-natal jaundice, congenital abnormalities.
Budget:
Sl Particulars No.of Unit Total Remarks no Unit cost
Capital Work:
Construction of building which facilitates two 1 20.00 B.5.6 treatment rooms, Reception cum examination room, mother’s area, nursing station, store room etc.
2 Equipment 10.00 B.4.2
3 Contingencies 1.00
Grand Total 1.00
Project No. WA -17 Head of Account A. 2.3
Name of Home Based Newborn Care/HBNC Project
Total Budget (In lakhs) 0.10
The sub-center strengthening has been proposed in the district where more home deliveries have been reported. In these subcenters the 8 JPHNs are to be trained in the area.
Budget:
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Sl no Particulars No. of Unit Unit cost Total Remarks
1 HBNC Training for 8 JPHN 1 10000 0.10 SIHFW
2 ASHA Training (20 ASHA) 1 20000 0.20 A10.5.5
Project No. WA -18 Head of Account A. 2.4
Name of School Health Programme Project
Total Budget (In lakhs)
Project No. WA -19 Head of Account A. 2.5
Name of Infant and Young Child Feeding/IYCF Project
Total Budget (In lakhs) 1.70
Goal: to achieve 100% healthy children
Objectives:
1. To provide breast feeding IEC materials at all facilities 2. To have breast feeding corners 3. To educate community based health workers in the areas of low breast fed areas. 4. To motivate community to bring about behavior changes in early breast feeding of infants
Strategy:
1. Education materials in local languages to promote early breast feeding 2. Designating areas as breast feeding corners in health facilities 3. Conduct mothers and pregnant women meeting.
Process:
1. Conduct health education class during WHNDs, mothers meeting and ANC clinic 2. IEC at health centers and AWCs 3. Breast feeding corners in all institutions 4. Additional supplements to be provided in case of mothers not able to feed babies. These have to be borne by the PHCs untied fund.
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Budget:
Sl no Particulars No.of Unit Unit cost Total Remarks
1 IEC/BCC 204 SC 500 1.02 B.10.2.1
34 Institutions 1000 0.34
2 Breast feeding corner 34 x 5000 5000 1.70
Grand Total 1.70
Project No. WA -20 Head of Account A. 2.6
Name of Care of Sick Children and Severe Project Malnutrition
Total Budget (In lakhs)
Project No. WA -21 Head of Account A. 2.7
Name of Management of Diarrohea, ARI and Project Micronutrient Malnutrition
Total Budget (In lakhs)
Project No. WA -22 Head of Account A. 2.8
Name of Other Strategies/activities Project
Total Budget (In lakhs)
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Project No. WA -23 Head of Account A. 2.9
Name of Infant Death Audit Project
Total Budget (In lakhs)
Kerala – Wayanad – Births – Apr’09 to Mar’10 Sex Live Birth – Live Birth – Live Birth – Abortion( Ratio at Still Birth Males females Total Induced/Spontaneous birth
1,065 7,709 7,383 15,092 958 157
Infant Death Details-Wayanad April to Dec 2010 SI No of Causes of Infant Death No Children
1 LBW (Premature) 21 2 Asphyxia 21 3 Congenital Heart Disease 26 4 Mecha Aspiration Respiratory Disease 15 5 Septicimia 6 6 Respiratory disease 6 7 Any other disease 11 106
SI No of Age Limit at which infants died No Children 1 <=1 day 33 2 <= 1 week 22 3 < =1 month 16 4 <=6 months 30
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5 <12 months 5 106
Project No. WA -24 Head of Account A. 3
Name of Family Planning Project
Total Budget (In lakhs)
Project No. WA -25 Head of Account A. 3.1.1
Name of Dissemination of manuals on sterilization Project standards and quality assurance of sterilization services
Total Budget (In lakhs)
Sterilization camps are being conducted at major institution in Wayanad district. Though it is difficult to meet organizational expenses with the funds available, So it has been proposed an organizational expenditure Rs. 7500/- for sterilization camps may be effective in improving quality service of sterilization camps. The manuals from the state would on maintaining sterilsation standards would be disseminated at these camps.
Budget:
Sl no Particulars No.of Unit Unit cost Total Remarks
1 IEC & Organisation Expenses 0.030 B.10.2.1
2 Medicines & Consumab les 0.020 B.16.2.3
3 POL & Transportation 0.025 B.12.2
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Project No. WA -26 Head of Account A.3.1.2
Name of Female Sterilisation Camps Project
Total Budget (In lakhs) 6.98
For promoting female sterilization, people from the poorer area is not ready for the sterilization because they afraid to lose the time and wages on the rest days. To overcome this problem it is proposed to give compensation to BPL/SC/ST people for the sterilization of Rs. 600 per case. For APL categories also eligible to get Rs. 250/ case for sterilization to overcome the financial lose during the rest time. The total numbers of camps proposed for this year are 5 camps per block, i.e 25 at the cost of Rs 50,000.
Budget:
Sl Particulars No.of Unit Total Remarks no Unit cost
1 Female Sterilisation – BPL/SC 850 600 5.10 ST
2 Female Sterilisation APL 750 250 1.88
Grand Total 6.98
Project No. WA -27 Head of Account A.3.1.3
Name of NSV Camps Project
Total Budget (In lakhs) 3.30
As part of promoting the male sterilization, people feared to come in to the programme because of financial loss and time through their daily earnings. To overcome the loss of this, Rs.
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1100 has been planned to give for each case. It is an attractive promotional method for male sterilization. The total NSV camps proposed two mega camps in a year @ Rs 36,000.
Budget:
Sl no Particulars No.of Unit Unit cost Total Remarks
1 NSV Camp 220 1500 3.30
2 NSV Training (5 Doctors) 1 35000 0.35 A10.6.3
Grand Total 3.30
Project No. WA -28 Head of Account A 3.1.6
Name of Accreditation of Private Providers for Sterilisation services Project
Total Budget (In lakhs)
Project No. WA -29 Head of Account A 3.2
Name of Spacing Methods Project
Total Budget (In lakhs)
Project No. WA -30 Head of Account A 3.2.1
Name of IUD Camps Project
Total Budget (In lakhs)
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Project No. WA -31 Head of Account A 3.2.2
Name of IUD Services at health facilities Project
Total Budget (In lakhs) 0.43
Currently IUD services at facilities are provided on Wednesdays &Thursdays along with immunization days & ANC days. So far 1774 IUDs are inserted in the last year. So this we expect 2130.now we are giving compensation @20/-per patient. So our expected budget is Rs.42600/-
%age of all reported REPORTED methods Total Reported FP Method (All types) Users 12,416 - Sterilizations 2,482 20% IUD 1,774 14% Condom Users 7,174 58% OCP Users 986 8% Limiting Methods 2,482 20% Spacing Methods 9,934 80%
Budget:
Sl no Particulars No.of Unit Unit cost Total Remarks
1 IUD Services 2130 20 0.43
2 ASHA Incentive 2130 10 0.21 B.1.6
Grand Total 0.43
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Project No. WA -32 Head of Account A 3.2.3
Name of Accreditation of private providers for IUD insertion service Project
Total Budget (In lakhs)
Project No. WA -33 Head of Account A 3.2.4
Name of Social marketing of contraceptives Project
Total Budget (In lakhs)
Project No. WA -34 Head of Account A 3.2.5
Name of Project Contraceptive update seminars
Total Budget (In lakhs) 0.25
At present the beneficiaries are not fully aware about the newer methods of spacing methods. To create awareness among public we should conduct contraceptive updates seminars. We will conduct seminars at block level once an year for JPHN, JHI, ASHA workers AWW Kudumbasree volunteers. In the WHND same information would be given to the community members and those who need more information they would be referred to the nearest PHCs.
Budget:
Sl no Particulars No.of Unit Unit cost Total Remarks
1 Seminars 5 5000 0.25
Grand Total 0.25
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Project No. WA -35 Head of Account A 3.3
Name of POL for family planning Project
Total Budget (In lakhs) 1.80
For the Transportation of the beneficiaries and Facilitators to the camp site some place of the district is very hard to reach areas. We are conducting the camps at major hospitals so the beneficiaries especially tribal people are reluctant to travel to the camp. In order to mobilize the them we have to provide transport facility so we can achieve the desired goal. Also we need to mobilize the equipments and facilitators to the camp.
Budget:
Sl no Particulars No. of Unit Unit cost Total Remarks
1 Mobility support 60 3000 1.80
Grand Total 1.80
Project No. WA -36 Head of Account A 3.4
Name of Repair of Laparoscope Project
Total Budget (In lakhs)
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Project No. WA -37 Head of Account A.4.1
Name of Adolescent services at health facilities Project
Total Budget (In lakhs) 1.17
Adolescence is the age of energy and immaturity. The well package of both is essential for the molding of personality. Adolescent population in Wayanad district is about 42%. Due to the various factors of culture, migration, nuclear family system many of the health care needs of adolescents are not addressed yet. The risk factors of vulnerability operate more in adolescents than other age groups. Identity crisis, emotional immaturity, love and romance, skin problems, adjustment with biological and physical changes, inferiority complex, peer pressure, personality defects, and development of deviant behaviors are some of the problems faced by the adolescents groups. In this circumstance we would like to emerge new project for them, for this nine CHCs Two THQHs one GH and one DH are selected as facility centers.
Budget:
Sl Particulars No.of Unit Total Remarks no Unit cost
Hon Doctor @Rs.250 x 13 Insti tution x 1 0.39 12 months
2 Hon.Counseller @Rs.400 x 13 x 12 0.62
Other contingencies , Documentation , 3 0.16 @100 x 13 x 12
Grand Total 1.17
Project No. WA -38 Head of Account A.4.2
Name of OTHER STRATERGIES/ACTIVITIES Project
Total Budget (In lakhs) 3.10
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Project No. WA -39 Head of Account A.4.2.1
Name of Nutrition supplement for Anemia prevention among Project tribal adolescent Total Budget (In lakhs) 3.10
Birth weight of babies born to tribal women is much lower, when compared to other children. The average weight of a new born tribal baby is between 1.5 – 2 kg where as the average weight of a non tribal new born is around 2.5 kg. Also the child survival at 1 year & 5 years is worse among tribes when compared to general population. This can be directly linked to more members of LBW babies.
In order to decrease infant mortality among tribes it is essential that there should be an improvement in the birth weight of babies. The major care of low birth weight babies in tribes is the higher incidence of Anemia. In order to correct this, it is imperative that proper intervention is made much before the lady become pregnant, ideally during adolescence. This project aims at providing nutritional supplement to tribal adolescent girls and antenatal women so as to improve their Hb level. It is proposed to provide cooked nutritional food (in the form of Veg. Biriyani + 1 egg) every week along with daily supplementation of cross rich foods like ground nut, cake at an average cost of Rs. 50/ case per week. The local women SHG shall be entrusted with the job of preparing and supplying the food. This programme will also improve antenatal check-up and care, since the ladies shall be visiting the sub-centre every week for the food and hence can be regularly followed up in the sub-centre. The nutrition supplement is limited to all the s/c area of Appapara, Pakkom and Noolpuzha PHC’s only.
Budget:
Sl Particulars No.of Unit Total Remarks no Unit cost
Nutrition supplements (Veg Biriyani + Egg + 1 5200 50 2.60 Groundnut cakes) @ Rs 50 x 100 x 52 week
Organisational expenses Documentation& 2 0.50 Other contingencies
Grand Total 3.10
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Project No. WA -40 Head of Account A.5
Name of Urban RCH Project
Total Budget (In lakhs) 2.40
Goal :
To give better health care in the urban tribal colonies
Objective:
1. To provide RCH care to the urban tribal colonies 2. To promote institutional delivery among the tribal population 3. To increase immunization coverage in the urban area
Strategies:
1. RCH camps for slum dwellers. 2. Prompt referral transport facility. 3. Create social awareness about the importance of immunization.
Processes:
1. Conduct special RCH camps in slum areas by mobile medical unit. 2. Incorporate immunization with mobile medical camps. 3. Active field visit by health workers. 4. Make arrangement for prompt payment for referral transport.
Process indicators:
1. Number of RCH camps held as % of camps planned 2. Number of pregnant women registered 3. Number of patients utilizing referral transport facility.
Output:
1. Increased institutional delivery. 2. Increased immunization coverage.
Output indicators:
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1. % of institutional deliveries. 2. % of fully immunized children
Outcome:
Improved health care & status in urban tribal colonies.
Sl no Particulars No.of Unit Unit cost Total Remarks
1 Vehicle hire 12 20000 2.4
Grand Total 2.40
Project No. WA -41 Head of Account A.6
Name of Tribal RCH Project
Total Budget (In lakhs) 7.48
roject No. WA -42 Head of Account A.6.1
Name of Tribal RCH – Mobile Medical Units Project
Total Budget (In lakhs) 1.68
The Tribes in the interior places are not willing to come out to the health institutions from their places due to financial crisis and their traditional belief in order to overcome this situation it is proposed to provide service at their door step.
Budget:
Sl no Particulars No.of Unit Unit cost Total Remarks
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1 Tribal RCH Camp 168 1000 1.68
Grand Total 1.680
Project No. WA -43 Head of Account A.6.2
Name of Tribal RCH – Routine & Specialty Camp Project by PHC / CHC
Total Budget (In lakhs) 5.80
Tribes are reluctant to visit the hospital when they are sick due to their belief and financial crisis and lack of facilities to avoid these circumstances Medical camps has to be arranged nearby their residences/colonies. Three types camps can be organized
1.@ Rs 3000 / camp with one medical Officer
2. @Rs 11000 / Camp with three Medical Officers.
Split – up of the Budget
Tribal RCH Medical Camp
Sl.no. Activity component Amount
1 Hon. For M.Os 1 No. 200 x 1 200
2 Hon. For staff Nurse /Pharmacist 100 x 1 100
Hon for HI / LHI @ 150 150
3 Hon for JPHN and JHI One each 100 x 2 200
4 Hon. For N/A or Attender 1 x 50 50
5 Hon for driver 1 x75 75
6 Medicines 1400
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7 Publicity, Organisational Expenses, documentation & 825 Other Contingencies
Total 3000
Tribal RCH – Specialty Camp
Sl.no. Activity component Amount
1 Hon. For M.Os 3 No. 500 x 3 1500
2 Hon. For staff Nurse /Pharmacist 150 x 2 300
3 Hon for HI and LHI One each 150 x 2 300
4 Hon for JPHN and JHI One each 150 x 2 300
5 Hon. For N/A or Attender 2 x 100 200
6 Hon for driver 1 x100 100
7 Hon. For Clerk 1 x 100 100
8 Medicines 6000
9 Publicity, Organisational Expenses, documentation & 2200 Other Contingencies
Total 11000
Budget:
Sl Particulars No.of Unit Total Remarks no Unit cost
Tribal RCH – Routine Camp by 1 120 3000 3.60 PHC / CHC
Tribal RCH – Specialty Camp 2 20 11000 2.20
Grand Total 5.80
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Project No. WA -44 Head of Account A.7
Name of VULNERABLE GROUP Project
Total Budget (In lakhs)
Project No. WA -45 Head of Account A.8
Name of
Project Other RCH initiatives
Total Budget (In lakhs) 48.15
Project No. WA -45A Head of Account A.8.1
Name of Project Palliative Care Project
Total budget ( in Lakhs) 20.67
HOME CARE PROGRAMME – DISTRICT LEVEL REPORT
1. Registration:-
Sl No Item. Total
1 Total patient s registered in 1216 Palliative care programme
2 Follow up home care 776
3 Total patients registered in 469 PHC special OP
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4 No. of special OP 82 conducted in PHC
5 Total patients attended in 813 PHC special OP
2. Home Care report:- No of Home care 334
Total patients visited 2085 in home care
No of review 42 meetings conducted
Total attendance in 682 review meeting
3. Report of bed ridden cases:- Sl No Total
1 Cancer Patients 268
2 HIV Aids 2
3 Kidney Patients 38
4 Catheterisation 151
5 No of ti mes catherisation 479 changed
6 No of patients requires wound 133 dressing
7 Patients undergone wound 590 dressing
8 Patients given Ryles tube 33
9 Patients requiring any other 42 special treatment aids
10 Patients referred for special 37 treatment
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11 Patients died 347
Palliative Care Project is manage by Institute of Palliative Medicine, Calicut
Auxiliary Nurses : (5 NOs) : 5 x 4500 x 12 270,000/-
1. In Government Health Sector
Training Centre (Department of palliative Care, District Hospital Manathavadi) Staff Nurses : (2 NOs) : 2 x 7600 x 12 182,400/-
Books in Library : 100,000 / -
Furniture, training materials : 100,000 / -
(Table, chair, Almarah etc)
Computer & Accessories : 30,000/-
Photostat Machine : 45,000/-
Audio Visual aids : 75,000/-
Miscellaneous : 15,000
Program in Taluk/General/District Hospitals
Staff Nurses : (2NOs) : 2 x 7600 x 12 182,400 / -
Seed money to initiate home care program : 100,000 /-
2. NGO Sector
To support the training centre Staff Nurse : (1 No) : 1 x 7600 x 12 91,200/-
3. District Co-ordination
• District Co-ordinator : 10,000 x 12x1 120,000/-
• Medical Officer : (1 NOs) : 1 x 23000 x 12 2 76,000/-
• Training (Doctors & Nurses) : 100,000/-
• District Wise Review Meeting/ Training: 100,000 / -
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• Printing : 50,000 / -
• Stationery : 20,000 / -
• Field Team Travel, Phone : 160,000 /
• Documentation Miscellaneous: 50,000/ Grand 20,67,000/-
Project No. WA -45B Head of Account A.8.2 This project is managed Name of Sickle Cell Anemia Project Project by Calicut Medical Total Budget (In lakhs) 27.48 College
Objective of the project
• To set up the facility for diagnosis, steady state management and management of complications of sickle cell disease and health education for the tribal population of Wayanad and Attappady region and the Waynadan Chetties at three levels a) Level I – Primary health centre / Community Health Centre
b) Level II – District/ Taluk hospitals in Wyanad district and Kottathara hospital, Attappady
c) Level III – Medical College, Calicut.
• Enlisting all Sickle cell cases and carriers of Wayanad district and Attappady region through motivated paramedical staff to develop a disease registry. • Developing and practicing standard practice guide lines for managing sickle cell anemia and its complications in the tribal areas.
To determine the presence of other abnormal hemoglobin, if any, and associated inherited hemolytic anemia among tribals of Wayanad and Attappady region and Wayanadan Chetties
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Sickle Cell Disease Project
Screeni Total Screeni Total ng tests Achie Tribal Total ng tests no. of Chetty Name of Name of done ve Achie No. of done in screeni population(d Total CHC PHC upto ment ve tribals Dec, ng tests ata received) Nov, (upto ment 2010 (Tribal) 2010 Nov) Porunnann Porunnann 4706 3657 77.71 57 3702 12 78.67 ore ore 3714 Panamara 7233 6199 85.70 0 6178 21 85.41 m 6199 Vellamund 4932 4314 87.47 0 4314 0 87.47 a 4314 Edavaka 2782 2474 88.93 0 2469 5 88.75 2474 PP Unit D.H 502 418 83.27 0 417 1 83.07 Mananthav ady 418 Appapara 12017 9800 81.55 59 9512 347 79.15 9859 Periya 7238 5482 75.74 0 5482 0 75.74 5482 Kurukkanm 5993 5732 95.64 0 5732 0 95.64 oola 5732 Thondarna 4663 4208 90.24 0 4207 1 90.22 du 4208 Nallornadu 875 0 874 1 875 Total 50066 43159 86.20 116 42887 388 85.66 43275 Meenanga Meenanga 6711 5734 85.44 7 5722 19 85.26 dy dy 5741 Varadoor 5708 5324 93.27 0 5323 1 93.26 5324 Cheeral 3560 3353 94.19 0 2872 481 80.67 3353 Chulliyode 3686 3257 88.36 0 3180 77 86.27 3257 Vazhavatta 4523 3889 85.98 0 3780 109 83.57 3889 Ambalavay 4903 4808 98.06 0 4348 460 88.68 al 4808 Total 29091 26365 90.63 7 25225 1147 86.71 26372 Pulpally Pulpally 1668 1581 94.78 0 1475 106 88.43 1581 Pakkom 6971 4719 67.69 137 4407 449 63.22 4856 Mullenkolly 3055 2491 81.54 0 2459 32 80.49 2491 Chethalaya 5016 4266 85.05 0 3809 457 75.94 m 4266 Poothadi 7551 5859 77.59 0 5476 383 72.52 5859 Noolpuzha 11181 7363 65.85 0 6754 609 60.41 7363 P.P. Unit Sulthan 28 16 57.14 0 14 2 50.00 Bathery 16
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Total 35470 26295 74.13 137 24394 2038 68.77 26432 Meppady Meppady 4752 3766 79.25 34 3697 103 77.80 3800 Kalpetta 2617 2306 88.12 0 2304 2 88.04 2306 THQ Hospital, 24 18 75.00 0 18 0 75.00 Vythiri 18 Sugandhag iri, Mini 2889 2634 91.17 0 2633 1 91.14 PHC 2634 Total 10282 8724 84.85 34 8652 106 84.15 8758 Thariode Thariode 2600 2213 85.12 0 2213 0 85.12 2213 Padinjareth 1554 1283 82.56 0 1283 0 82.56 ara 1283 Vengapally 2762 2286 82.77 0 2286 0 82.77 2286 Kottathara 5080 4404 86.69 20 4424 0 87.09 4424 Pozhuthan 1281 1122 87.59 0 1122 0 87.59 a 1122 Kappakunn 1289 1100 85.34 0 1100 0 85.34 u 1100 Total 14566 12408 85.18 20 12428 0 85.32 12428 Grand 11358 1172 1E+05 116951 83.85 314 3679 81.44 Total 6 65
Budget:
Item Rate Total Subtotal
Personnel 2,80,000
Social worker 10,000x12 1,20,000
Laboratory technician 8,000x12 96,000
Data entry operator 7,000x12 84,000
Equipment 7,00,000
Blood Bank Refrigerator 2,00,000x1 2,00,000
Automated blood cell counter 5,00,000x1 5,00,000
Consumables 2,60,000
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Chemicals 1,00,000 1,00,000
Hb electrophoresis consumables 25,000 25,000
HPLC consumables 40,000x2 80,000
PCR consumables 40,000 40,000
Glassware 15,000 15,000
Medicines 5,00,000
Medicines 5,00,000 5,00,000
Nutrition supplementation kits 7,68,000
Nutrition supplementation kits 160x4800 7,68,000
Other items 2,40,000
Training programmes at various hospitals 50,000 50,000
Travel expenses 1,00,000 1,00,000
Administrative expenses 20,000 20,000
Printing 30,000 30,000
Documentation 20,000 20,000
Contingency 20,000 20,000
Grand Total 27,48,000
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Project No. WA -46 Head of Account A.9
Name of Project Infrastructure and Human Resource Total Budget (In lakhs)
Sanctio In Require Monthly Contract ned position ment Salary
Doctors 170 112 48 12 27000
Specialist Doctors 3 7 33000
JPHN 205 205 15 16 6680
Total Sub centres 204
Staff Nurse 169 169 53 22 7480
Pharmacist 46 40 11 4 6680
Lab Tech 25 24 28 7 6680
Radiographer 5 5 4 1 6680
Ophthalmic Assistant 14 6 1 2 6680
Ayush Doctors (Ayurveda) 4 0 15000
Ayush Doctors (Homoeo) 8 0 15000
Project No. WA -47 Head of Account A.9.1.1
Name of Infrastructure and Human Resource Project ANMs and Staff Nurses Total Budget (In lakhs) 140.74
Sl no Particulars No.of Unit Unit cost Total Remarks
1 Salary for Staff Nurses 75 166800 125.10
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2 Provident Fund @ 12.5% 20850 15.64
Grand Total 140.74
Project No. WA -48 Head of Account A.9.1.2
Name of Infrastructure and Human Resource Project Laboratory Technicians, MPWs Total Budget (In lakhs) 54.90
Sl no Particulars No.of Unit Unit cost Total Remarks
1 Salary for Lab Technician 35 139440 48.80
2 Provident Fund @ 12.5% 17430 6.10
Grand Total 54.90
Project No. WA -49 Head of Account A.9.1.3
Name of Infrastructure and Human Resource Project Specialists Total Budget (In lakhs) 44.55
Sl no Particulars No.of Unit Unit cost Total Remarks
1 Salary for Specialist Doctors 10 396000 39.60
2 Provident Fund @ 12.5% 49500 4.95
Grand Total 44.55
Project No. WA -50 Head of Account A.9.1.4
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Name of Project Infrastructure and Human Resource PHNs at CHC, PHC level Total Budget (In lakhs) 48.63
Sl Particulars No.of Unit cost Total Remarks no Unit
1 Salary for PHNs 27 139440 37.65
2 4 139440 5.58 From A1.1.5
3 Provident Fund @ 12.5% 17430 5.40
Grand Total 48.63
Project No. WA-51 Head of Account A.9.1.5
Name of Infrastructure and Human Resource Project Medical Officers at CHCs/PHCs Total Budget (In lakhs) 218.70
Sl Particulars No.of Unit Total Remarks no Unit cost
1 60 Includes CRS Salary for Medical Officers 324000 194.40 Doctors
2 Provident Fund @ 12.5% 40500 24.30
Grand Total 218.7
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Project No. WA -52 Head of Account A.9.1.6
Name of Infrastructure and Human Resource Project Additional Allowances/Incentives to Medical Officers at CHCs/PHCs Total Budget (In lakhs) 78.00
Sl Particulars No. of Unit Unit Total Remarks no cost
1 Rural Allowance to 70 60000 42.00 Doctors
2 Speciality Allowance 10 60000 6.00
2 Call Allowance to Doctors 6000 Calls for an year (only to 2 THQH, DH and 500 30.00 GH)
Grand Total 78.00
Project No. WA -53 Head of Account A.9.1.7
Name of Others – Computer Assistant/BCC co-ordinator Project etc Total Budget (In lakhs) 1.091
Sl Particulars No.of Unit Total Remarks no Unit cost
1 Salary for RIMS Computer 1 96600 0.97 Assistant
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2 Provident Fund @ 12.5% 12075 0.121
Grand Total 1.091
Project No. WA -54 Head of Account A.9.1.9
Name of Infrastructure and Human Resource Project Human Resources Development – Others
Total Budget (In lakhs) 37.00
Sl no Particulars No.of Unit Unit cost Total Remarks
1 Salary for Ophthalmic Assistant 3 166800 5.0
2 Salary for Pharmacist 15 139440 20.92
3 Salary for Radio Grapher 5 139440 6.97
4 Provident Fund @ 12.5% 4.11
Grand Total 37.00
Project No. WA -55 Head of Account A.9.2.1
Name of
Project Minor Civil Works
Total Budget (In lakhs) 6.00
Sl Particulars No.of Unit Total Remarks no Unit cost
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Refer
Operationalising O.T and Labour Room in From 1 2 100000 2.00 Existing FRUs A.1.1.1
Operationalising O.T and Labour Room for From 2 4 100000 4.00 proposed FRUs A.1.1.1
Grand Total 6.00
Project No. WA -56 Head of Account A.9.2.2
Name of Operationalisation of 24 X 7 PHCs Project
Total Budget (In lakhs) 8.00
Sl no Particulars No.of Unit Total Remarks Unit cost Refer
1 Refurbishment of 24 X 8 100000 8.00 From 7 PHCs A.1.1.2
Grand Total 8.00
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Project No. WA -57 Head of Account A.10
Name of Trainings Project
Total Budget (In lakhs) 7.59
Sl. No of Unit Total Remarks Particulars No unit cost
1 A.10.1 Strengthening of Training Institutions 1 300000 3.00
A.10.3.1 Skilled Birth Attendance / SBA (for 16 SNs) 1 25000 0.25 From A1.1.2 2 A.10.3.1 Skilled Birth Attendance / SBA (for 8 JPHNs) 1 10000 0.10 From A1.1.5
3 A.10.3.2 EmOc Training (for 25 SN) 1 25000 0.25
4 A.10.3.4 MTP training (for 10 Medical Officers) 1 35000 0. 35 From A.1.1.3
5 A.10.3.5 RTI / STI Training (25 MOs) 1 25000 0.25
6 A.10.3.7 Other MH Training (ISD Refresher )
7 A.10.5.1 IMNCI (for SNs) 1 20000 0.20 From A2.1
8 A.10.5.2 Facility Based Newborn Care
9 A.10.5.3 Home Based Newborn Care (For 8 JPHNs) 1 10000 0.10 From A2.3
10 A.10.5.4 Care of Sick Children and severe malnutrition
11 Other training HBNC Training for selected 20000 From A2.3 A.10.5.5 ASHAs 1 0.20
11 A.10.6.1 Laparoscopic Sterilisation Training 1 34000 0. 34
12 A.10.6.2 Minilap Training 1 33000 0.33
13 A.10.6.3 NSV Training 1 35000 0. 35 From A.3.1.3
14 A.10.6.4 IUD Insertion Training 4 28000 1.12
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15 A.10.7 ARSH Training for School Health JPHNs 1 15000 0.15 From A2.4
16 A.10.8.2 DPMU Training 1 20000 0.20
17 A.10.9 Other training (pl. specify) 4 10000 0.40
Grand Total 7.59
Project No. WA -57A Head of Account A.10.7
Name of ARSH Trainings Project
Total Budget (In lakhs) 6.375
Training Activities Training programmes for MOs, S/Ns, JPHN/JHI and ASHA .The trained staff will conduct
AFHS Clinics in CHCs and PHCs.
1. Training of MOs (Rs.50000 per 1 batch of 30 persons) 50000 2. Training of Supervisory Staff (Rs.45000 per 1 batch of 30 persons) 45000 3. Training for JPHNs ( 7000 X 5Blocks) 35000 4. Sensitisation of ASHA workers in selected blocks(Rs.10000 per 50000 block X 5 Blocks) 5. Awareness classes in the community (Rs25000 x 3Taluks) 75000 6. Organising Teen clubs / peer groups (Rs.2000/unit X 5 Units) 10000 7. Contingency expenses (2000 X 5 Units) 10000 AFHS clinics in District Hospitals & Taluk Hospitals These facilities are meant for providing both clinical and counselling services to adolescents on fixed days.
8. Medicines (for THQH & CHCs) 300000 9. IEC/BCC activities at District Level (5000 for each block X 5 25000 Block) 10. Medical Camps in selected Blocks (Rs.1500 per camp X 25 Camps 37500 (5 camps for each block) Grand Total 637500
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Project No. WA -58 Head of Account A.11
Name of Strengthening of District Society Project
Total Budget (In lakhs)
Project No. WA -59 Head of Account A.11.2
Name of Strengthening of District Society Project Strengthening of DHS/DPMU
Total Budget (In lakhs) 52.37
Sl Particulars No.of Unit cost Total Remarks no Unit
DPM 1 483000 4. 83
DMO Allowance 1 72000 0.72
DAO 1 276000 2.76
Accountant 1 138000 1.38
Accountant 1 131100 1.311
PROs 5 165600 8.28 1 Office Secretary 1 103500 1.035
Office Secretary 1 94875 0.949
DEO 1 77625 0.776
JC (D&C) 1 220800 2.208
GBVM Co-ordinator 1 138000 1.38
Asst. Bio Medical Engineer 1 207000 2.07
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Office Assistant 1 62100 0.621
Provident Fund for all category 3.45 @ 12.5%
2 Vehicle Hiring 4 240000 09.60
3 Rent for Building 1 132000 1.32
4 Electricity & Phone charges 138000 1.38
Other over head expenses like 5 500000 5.00 conference and other recurring expenses
6 POL 180000 1.80
7 TA & DA 150000 1.50
Grand Total 52.37
Project No. WA -60 Head of Account A.11.3
Name of Strengthening of District Society Project Strengthening of Block PMU
Total Budget (In lakhs) 16.03
Sl no Particulars No.of Unit Total Remarks Refer Unit cost
1 Salary of Block Co-ordinators 5 276000 13.80
2 TA & DA 50000 0.50
3 Provident Fund @ 12.5% 34500 1.73
Grand Total 16.03
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Project No. WA -61 Head of Account A.11.5
Name of Strengthening of District Society Project Audit Fees
Total Budget (In lakhs) 0.50
Sl no Particulars No.of Unit Unit cost Total Remarks
Refer
1 Audit Fees 0.50
Grant Total 0.50
Project No. WA -62 Head of Account A.11.6
Name of Strengthening of District Society Project Concurrent Audit
Total Budget (In lakhs) 1.20
Remarks Sl. No Particulars No. of Unit Unit cost Total Refer
1 Concurrent Audit 1.20
Grand Total 1.20
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Project No. WA -63 Head of Account A.11.7 Name of Strengthening of District Society Project Total Budget (In lakhs) 9.00
Remarks Sl No. Particulars No.of Unit Unit cost Total Refer
1 Mobility Support to BMO 5 180000 9.00
Grand Total 9.00
DISTRICT HEALTH & FAMILY WELFARE SOCIETY, WAYANAD Year Number of Governing body Number of Executive committee meeting conducted meetings conducted 2005-06 2006 -07 2007-08 1 1 2008 -09 1 1 2009-10 0 1 2010 -11 0 1
Target and achievement for formation of various committees
No. of Ward Health and Sanitation No. of wards in the district No. of No. of Hospital Committees formed health Management Year centers Committees Municip Panchayath Corporation Panchayath Municipal Corporation above SCs formed al
2005-06
2006-07
2007-08
2008-09 434 25 - 434 25 - 34 34
2009-10 434 25 - 434 25 - 34 34
2010-11 459 28 - 434 25 - 34 34
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ACTIVITY WISE PIP
B- ADDITIONALTIES
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Project No. WB -1 Head of Account B.1.1
Name of Selection and Training of ASHA Project
Total Budget (In lakhs) 19.42
Year No. of No. of ASHAs trained No. of ASHA ASHAs st nd rd th th selected I module 2 module 3 module 4 module 5 module on field 2007 -08 839 455 Nil Nil Nil Nil 2008 -09 Nil 384 301 Nil Nil Nil 2009 -10 Nil - 538 839 839 2010 -11 Nil - - - 793 785 785 Total 839 839 839 839 793 785 785
Expense per Number of Particulars Amount Required Batch Batches
ASHA 5th Module 37250 35 13.04 Training
Training for ASHAs selected to replace 212500 3 6.38 drop outs
Grand Total 19.42
Project No. WB -2 Head of Account B.1.2
Name of Procurement of ASHA Drug Kit Project
Total Budget (In lakhs) 29.73
Sl no Particulars Budget Remarks
1 ASHA Drug kit refilling (767 ASHA 26.85 X Rs 3500)
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2 ASHA drug kit for newly selected 2.88 ASHA (76 ASHA X Rs 4000)
29.73
Project No. WB -2 A Head of Account B.1.3
Name of Performance related ASHA incentive Project
Total Budget (In lakhs) 75.0
Particulars Amount Required
ASHA incentive for 2011-12 75.00
Grand Total 75.00
Project No. WB -3 Head of Account B.1.6
Name of Other incentives to ASHA Project
Total Budget (In lakhs) 21.6665
Sl Particulars Budget Remarks no
1 0.4195 From A 1.3
2 0.84 From A 1.3.2
3 0.21 From A 3.2.2
4 0.052 From A 7.1
5 Best ASHA Award (1 ASHA in District) 0.005
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6 Mobility Support to ASHA 10.07
(839 X 100/month X 12 Months)
7 Telephone charges to ASHA 10.07
(839 X 100/month X 12 Months)
8 ASHA incentive for Pregnant women tracking (Rs 20 1.70 X 8500 Cases)
9 ASHA incentive for child tracking (Rs 50 X 8500 4.25 Cases)
Grand total 27.6165
Project No. WB -4 Head of Account B.2.1
Name of Untied Fund for CHC Project
Total Budget (In lakhs) 8.5
Type of Institutions Number Amount per Total Amount Institution
CHC 9 50000 4.50
24 x 7 PHC 8 50000 4.00
Grand Total 8.5
Project No. WB -5 Head of Account B.2.2
Name of Untied Fund for PHC Project
Total Budget (In lakhs) 3.25
Type of Institutions Number Amount per Total Amount Institution
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PHC 13 25000 3.25
Grand Total 3.25
Project No. WB -6 Head of Account B.2.3
Name of Untied Fund for SC Project
Total Budget (In lakhs) 20.4
Type of Institutions Number Amount per Total Amount Institution
Sub-Centre 204 10000 20.40
Grand Total 20.40
Project No. WB -7 Head of Account B.2.4
Name of Untied Fund for WHSC Project
Total Budget (In lakhs) 48.70
Type of Institutions Number Amount per Total Amount ward
WHSC 487 10000 48.70
Grand Total 48.70
Project No. WB -8 Head of Account B.3.1
Name of AMG for CHC Project
Total Budget (In lakhs) 17.00
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Type of Institutions Number Amount per Total Amount Institution
CHC 9 100000 9.00
24 X7 PHC 8 100000 8.00
Grand Total 17.00
Project No. WB -9 Head of Account B.3.2
Name of AMG for PHC Project
Total Budget (In lakhs) 4.00
Type of Institutions Number Amount per Total Amount Institution
PHC 8 50000 4.00
Grand Total 4.00
Project No. WB -10 Head of Account B.3.3
Name of AMG for SC Project
Total Budget (In lakhs) 19.60
Type of Institutions Number Amount per Total Amount Institution
SC 196 10000 19.60
Grand Total 19.60
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Project No. WB -11 Head of Account B.4.2 Name of Strengthening of district sub divisional Project hospitals. CHCs, PHCs
Total Budget (In lakhs) 10
Sl no Particular Budget Remarks
1 10 From A 2.2
Grand total 10
Project No. WB -12 Head of Account B.5.6 Name of Construction of BHO, facility improvement, Project civil work
Total Budget (In lakhs) 20
Sl no Particular Budget Remarks
1 20 From A 2.2
Grand total 20
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Project No. WB -13 Head of Account B.5.7 Name of Major Civil works for operationalisation of Project FRUs
Total Budget (In lakhs) 4
Sl no Particular Budget Remarks
1 4 From A 1.1.1
Grand total 4
Project No. WB -14 Head of Account B.6.1
Name of Corpus Grant to HMS-DH Project
Total Budget (In lakhs) 5.00
Type of Number Amount per Total Amount Institutions Institution
HMS-DH 1 500000 5.00
Grand Total 5.00
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Project No. WB -15 Head of Account B.6.2
Name of Corpus Grant to HMS-CHC Project
Total Budget (In lakhs) 17.00
Type of Institutions Number Amount per Total Amount Institution
HMS-CHC 9 100000 9.00
24 X 7 PHC 8 100000 8.00
Grand Total 17.00
Project No. WB -16 Head of Account B.6.3
Name of Corpus Grant to HMS-PHC Project
Total Budget (In lakhs) 13.00
Type of Institutions Number Amount per Total Amount Institution
HMS-PHC 13 100000 13.00
Grand Total 6.50
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Project No. WB -17 Head of Account B.6.4
Name of Corpus Grant to HMS-GH/THQH Project
Total Budget (In lakhs) 15.00
Type of Institutions Number Amount per Total Amount Institution
HMS-Gen. Hospital 1 500000 5.00
HMS-THQH 2 500000 10.00
Grand Total 15.00
Project No. WB -17 A Head of Account B.7
Name of District Action Plans Project (PIP Preparation - Including Block, Village)
Total Budget (In lakhs) 1.00
Type of Institutions Number Amount per Total Amount Institution PHC 13 500 0.065 24 X 7 PHC 8 1000 0.080 CHC 9 2000 0.180 Gen. Hospital 1 3000 0.030 THQH 2 3000 0.060 Dist. Hospital 1 3000 0.030 DPMSU 1 55500 0.555 Grand Total 1.00
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Project No. WB -17 B Head of Account B.8.2
Name of Orientation Workshops, Trainings and capacity building of PRI Project at State/Dist. Health Societies, CHC,PHC
(Training for PRI Members about NRHM)
Total Budget (In lakhs) 1.00
Activity Number Amount per Total Amount Institution
Training for PRI Members about NRHM 1 100000 1.00
Grand Total 1.00
Project No. WB -18 Head of Account B 10.2.1
Name of BCC/IEC activities for MH Project
Total Budget (In lakhs) 3.07
Sl no Particulars Budget Remarks
1 0.68 From A 1.1.3
2 0.50 From A 1.1.4
3 1.36 From A 2.5
4 0.03 From A 3.1.1
5 0.25 From A 7.1
6 0.25 From A 7.1
Grand total 3.07
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Project No. WB -19 Head of Account B 10.6
Name of BCC/IEC activities Project Other activities
Total Budget (In lakhs) 7.78
Priority issue No. Budget BCC Target area to be Target Group Activity of Objective unit addressed units Total cost To create awareness among Health education women on Tribal population clasess and streat 10 2000/- 20000 Anaemia need for play amoung tribal Appapara, three ANC pregnant Noolpuzha, visits and women and Thirunelli, consumption delayed Chethalayam of iron folic detection of AN acid and complications correction of Subtotal 20000 Anaemia before delivery.
Reduction of Appapara, Increased IMR IMR and Health education Noolpuzha, and MMR and MMR by Tribal population clasess and streat 10 1000/- 10000 Thirunelli, home promoting play Chethalayam deliveries hospital delivery
Subtotal 20000 Lack of To promote Develop posters awareness correct on correct breast- Pulpally, about correct breast feeding practices Porunnannur, Lactating Mothers 105 100/- 10500 breast feeding feeding & distribute to all Thariode, techniques practices Sub centers, PP Meppadi, among among units. Meenangadi lactating lactating Subtotal 10500 mothers mothers Poor Tribal and Minority Pulpally, immunisation To ensure population, Puppet show, Porunnannur, coverage 100% Minority Streat play, Health 5 3000 15000 Thariode, among tribal Immunisation community education Meppadi, and minority coverage leaders Meenangadi population Subtotal 15000 Pulpally, Lack of Improve Adoloscent health Puppet show, CD Porunnannur, awareness adoloscent group in Schools show, Health 10 2000 20000 Thariode, about health health and Colleges education
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Meppadi, related issues Meenangadi among Subtotal 20000 adoloscents Increasing the Pulpally, Creating Health education load of Porunnannur, awareness clasess and CD communicable General Public 125 500 67500 Thariode, among show, Posters, and Non Meppadi, general notice etc communicable Meenangadi public disease Subtotal 67500
Pulpally, Creating Increased Porunnannur, awareness Gender based number of General Public 5 3000 15000 Thariode, among Health Education gender based Meppadi, general violence Meenangadi public Subtotal 15000
Pulpally, Health education clasess and CD Porunnannur, Stigma against Creating General Public 5 2000 10000 Thariode, male awareness show, Posters, Meppadi, sterilisation about NSV notice etc Meenangadi Subtotal 10000
Pulpally, Seminars, Leaaf Lack of Porunnannur, Publicise lets, Hordings, awareness General Public 5 10000 50000 Thariode, NRHM press release and about NRHM Meppadi, activities press conference Activities Meenangadi Subtotal 50000 Observing important health days Subtotal 50000 Printing Newsletters Subtotal 300000 Strengtherning IEC/BCC bureau Subtotal 100000 Exhibition Subtotal 100000 Grand Total 778000
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Project No. WB -20 Head of Account B.11 Name of Mobile Medical Units (Including recurring Project expenditures)
Total budget ( in Lakhs) 16.80
There are 5 TMMUs are functioning under Health services and NRHM allotted 2 more TMMU in Thirunelli and Noolpuzha. For the functioning of additional TMMU allotted in Noolpuzha, government allotted one vehicle and for Thirunelli one additional vehicle should hire on contract basis. NRHM started MMU under PHC Noolpuzha on September 2010 and in PHC Appapara on January 2011.
Sl Particulars No.of Unit Total Remarks no Unit cost
As per state 1 TMMU at Noolpuzha (Staff alone) 1 660000 6.60 guidelines
TMMU at Thirunelli (Vehicle with As per state 2 1 1020000 10.20 Staff) guidelines
Grand Total 16.8
Project No. WB -21 Head of Account B.12.2
Name of Operating cost POL Project
Total budget ( in Lakhs) 0.125
Sl no Particulars Budget Remarks
1 0.025 From A 3.1.1
2 0.10 From A 7.1
Grand total 0.125
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Project No. WA -22 Head of Account B.13
Name of School Health Programme Project
Total Budget (In lakhs) 7.50
Situation:
There are 300 schools in ayanad and 167 are in government sector. The programme is functional only in 27 government HS/HSS/VHSS schools. For every 2500 Children there is one JPHN. Currently 14 JPHNs are performing school health checkups. One posts of JPHN are vacant. JPHNs are basically recruited for the programme from NRHM.
LP schools UP Schools HS/HSS/VHSS TTI Schools Spls School
Gov Pvt Pvt Gov Pvt Pvt Gov Pvt aid Pvt unaid G Pvt Pvt unaid Go Pvt aid aid unai aid unai o v d d v Aid
91 53 6 34 39 2 40 23 5 2 1 2 0 2
Table: School Health Programme in Wayanad till November 2010. No. of students referred number of students given for Medical care No. of Health Education classes taken by Num Number No of ber of Health of schools record Immediate JPH impleme s Care Ns in nting the compl positi program eted Medical JHI/HI/H M Number of Health on Camp Drugs First Aid JPHN S/LHS O Club activities 27 14 11445 1016 2447 2943 2108 1053 28 1 369
Objective:
1. To expand school health programme to other schools in the district
Process:
1. The JPHNs from the respective areas to be involved in the school health programme. 2. There is a need for expansion of programme in 167 government schools. The services provided are immunization, vitamin A supplementation, growth chart, organizing medical camps in the schools for doctor examination, dental speciality camps, adolescent counseling, basic medical care (first aid) and referrals
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3. The JPHNs are to be trained in identifying children in need of special assistance. Therefore JPHN training is necessary in Psychology, counseling, and mental health. Thereby integrating these programmes within the school health component. 4. In the current year the services would be expanded to 36 additional schools and 12 new JPHNs are to be recruited for the same. 5. The school dropouts to be informed to the PHC JPHN for follow and revert them to schools at the earliest.
Budget:
Sl Particulars No.of Unit Total Remarks no Unit cost
1 Printing of Health Records 30000 25 7.50
2 ARSH Training for School Health JPHN 1 15000 0.15 A10.7 (15 Old JPHN and 12 New JPHN)
Grand Total 7.50
Project No. WB -22 A Head of Account 14.4
Name of NGO Programme/ Grant in Aid to NGO Project
Total budget ( in Lakhs) 23.5
Under NPCB 2 NGO are co-operating for the smooth functioning of the programme in Wayanad district. . 1. Ahalya eye hospital group 2. MOSC Karyambady There is only NGOs are working for the smooth implementation of RNTCP programme in Wayanad district. 1. CHAI – Christian Health Association of India
Sl no Particulars Budget Remarks 1 For conducting baseline survey 1.0 As per central government norms 2 Implementation of the programme 22.5 As per central government norms Grand total 23.5
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Project No. WB -22 B Head of Account 15.2
Name of Quality Assurance Project
Total budget ( in Lakhs) 11.00
Sl Particulars Budget Remarks no
1 QCI Lab Accreditation Programme 9.00
(18 labs X 50000)
2 NABH Accreditation Process 2.00
(1 Hospital X 200000) Grand total 11.00
Project No. WB -23 Head of Account B 16.1.1
Name of Procurement of Maternal Health Project
Total budget ( in Lakhs) 26.00
Sl no Particulars Budget Remarks 1 5.00 From A 1.1.1 2 3.00 From A 1.1.1 10.00 From A 1.1.1 4.00 From A 1.1.2 4.00 From A 1.1.2 Grand total 26 .00
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Project No. WB -24 Head of Account B 16.2.2
Name of Drugs and supplies for CH Project
Total budget ( in Lakhs) 1.00
Sl no Particulars Budget Remarks
1 1.00 From A 1.1.1
Grand total 1.00
Project No. WB -25 Head of Account B 16.2.3
Name of Drugs and Supplies for FP Project
Total budget ( in Lakhs) 0.020
Sl no Particulars Budget Remarks
1 0.020 From A 3.1.1
Grand total 0.02
Project No. WB -26 Head of Account B 16.2.5 Name of General drugs and supplies for health Project facilities
Total budget ( in Lakhs) 2.00
Sl no Particulars Budget Remarks
1 2.00 From A 1.1.2
Grand total 2.00
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Project No. WB -27 Head of Account B 19
Name of New Initiatives or Strategic Interventions Project
Total budget ( in Lakhs) 122.425
Project No. WB -28 Head of Account B19.1
Name of District Mental Health Programme Project
Total Budget (In lakhs) 11.86
Goal:
Ensure availability and accessibility of mental health care to all needy.
Objectives:
1. To ensure availability and accessibility of minimum mental health care to all. 2. To encourage application of mental health knowledge in general health care and in social development. 3. To promote community participation in the mental health services development.
Strategy:
1. Integration of mental health with primary health care through the NMHP. 2. Provision of tertiary care system for treatment of mentally ill patients. 3. Eradication of social stigma towards mentally ill person. 4. Providing home care to mentally ill persons. 5. To ensure that patients take medicine regularly. 6. To provide social support. 7. To rehabilitate the patients properly.
Processes:
1. PHC level package of services
a) Identification and referral for confirmation of mentally ill persons at the PHC level. b) Follow up care by medical officers and psychiatrist. c) Train the health workers to educate the family members of the patients about the disease and about the mental support they need. d) Conduct awareness programmes in order to remove social stigma towards mentally ill patients.
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e) Train health workers and volunteers to ensure that patients are taking medicine regularly and for giving them homecare.
2. Basic treatment and counseling at the secondary level. 3. Refer advance cases to tertiary level mental health institute in the state and the referral cost to be borne. 4. Start rehabilitation centers for the mentally ill persons.
Process indicators:
1. Number of mentally ill patients identified at the PHC level. 2. Number of followup cases seen by the medical officer. 3. Number of patients admitted at special mental health institution. 4. Number of training camps held for health workers and volunteers. 5. Number of persons attending awareness programme. 6. Number of homes visited by the home care team. 7. Number of patients attending the rehabilitation centers.
Under mental health programme, 13 camps are conducting every month. Mental health camps are conducting with the support of the CHC/PHC and other major hospitals in Wayanad. The camps are conducting in the following institutions.
SL. No Institution Number of camps per month 1 General Hospital, Kalpetta 2 2 THQH Bathery 2 3 CHC Panamaram 1 4 CHC Pulpally 1 5 CHC Meppady 1 6 CHC Meenangady 1
The Case Load is as follows SL. No Particulars Numbers 1 Old Cases going under treatment 950/Year 2 New Cases Reported 480/Year
Budget:
Sl Particulars No.of Unit Total Remarks no Unit cost
1 Institutional level mental health 34 0.25 8.5 package
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2 1 336000 3.36 Salary for Doctor
Grand Total 11.86
Project No. WB -28A Head of Account B19.2
Name of Project Comprehensive Survey, Screening & detection of Cancer in Wayanad District
Total Budget (In lakhs) 9.40
Problem Statement
The district of Wayanad is an agrarian society and 90% of their income comes from the agricultural sector. Now a day the people have changed their focus from Paddy fields to crops, such as banana plantain, Bitter gourd, areca nuts and other cash crops as they yield more income. The increased and uncontrolled use of chemicals, fertilizers and pesticides to improve production results in pollution of Air, Water, and Soil. Besides this, changing life patterns acts as a major causative factor for cancer. The prevalence of cancer is on the rise and the situation is alarming in Wayanad District. So far no authentic studies on cancer have been conducted in Wayanad district and there is an inadequacy of reliable statistical data regarding the problem. This adds to the significant of the proposal-‘Comprehensive Survey on Cancer in Wayanad District’. This survey aims at collecting data on cancer incidence in the past 5 years in Wayanad District, in order to detect the trend of Cancer in the District.
Objectives:-
1) Review and analysis of previous research studies conducted in Wayanad District. 2) Provide training to ASHAs for conducting the survey 3) Ward level surveys by ASHA volunteers. 4) Data analysis and interpretation. 5) Reporting.
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Comprehensive Survey on Cancer detection & Detection Camp by PHC/CHC
Sl.no. Activity compone nt Amount
1 Training for ASHA Rs.100 x829 (TA50,Food 30,Tea 20) 82900
3 Hon.Resource personRs 500 x 10 (2 per Block) 5000
4 Organizational expenses Rs 3000 x 5blocks 15000
5 Training materials Rs.25x 829 20725
6 Printing Charges survey form 84990
7 Incentive for survey Rs.2 x 169980 house holds 339960
8 Documentation 25000
9 Miscellaneous 10000
Total 583575
10 Training cost for MOs 4 days x 10 x 2000 80000 (5 Male +5Female) TA/DA ,Food, Accomodation & Training materials
11 Hon for Resourse Person 1000 x 3x 4 days 12000
Total 92000
12 Hon. For M.Os 1 No. 1000 1000
13 Hon. for staff Nurse 150
14 Hon for JPHN and JHI One each 100 x 2 200
15 Hon for LHI and HI One each 150 x 2 300
16 Medicines 6000 6000
17 Publicity, Organisational Expenses, documentation & Other Contigencies 2500
Total 10150
10150 x 26 LSG 263900
Grand total 593575 +92000+263900 939475
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Project No. WB -28B Head of Account B19.3
Name of Drug and Alcohol Addiction Prevention Project
Total Budget (In lakhs) 1.05
The non medical use of alcohol and other psycho active drugs has become a matter of serious concern. According to current concepts, alcohol dependence is considered a disease and alcohol a disease agent which causes acute and chronic intoxication, cirrhosis of the lever, toxic psychosis and the like. Further alcohol is an important etiologic factor in suicide, and injuries and deaths due to violence. The health problems for which alcohol is responsible are only part of the total social damage, which includes family disorganization, crime and loss of productivity. In Wayanad district 17.43 % of the total population comprises of Tribes and the problem of alcohol dependence is prevalent among them.
Alcohol dependence and tobacco consumption paves the way for numerous social problems such as violence, suicide, health hazards, and economic problems. The geographical situation provides a favorable atmosphere for the production and sale of illicit liquor and, the Excise and Police officials find it difficult to reach out there. Illiteracy and unemployment add to the severity of the problem.
Outline of the problem
There is a significant incidence of patients relapsing after de-addiction therapy, and an even higher number not opting de-addiction at all.
Details of plan of intervention
To conduct classes to Increase Awareness among the population about the problems caused by alcohol and drug addiction
To institute an award system for those who have successfully completed rehabilitation
Details of beneficiaries of the project
This project is directed towards the people who are susceptible to drug abuse and alcohol addiction , and those who are already addicted in the district
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Plan for monitoring
The arrangement of classes will be according to the availability of experts and will be under the supervision of the Medical officer.
Expected outcomes
We hope to increase the number of people who opt for de-addiction and also to decrease the number of people relapsing. By the awareness classes ,we intend to dissuade the rest of the population from fallin into addiction
Drug and Alcohol Addiction Prevention Pakkam Noolpuzha ,Thirunelly
Sl.no. Activity component Amount
1 IEC awareness programme Against Smoking,Alcoholi sm 21000 and drug Abuse Hon .for Resource person 21x 250 x 4
2 Printing of IEC materials 50 x 10 x 21 x4 42000
3 Light refreshment for participants 50 x10x21x4 42000
Total 105000
Project No. WB -28C Head of Account B19.4
Name of Incentive for pregnant women for ANC check up Project
Total Budget (In lakhs) 8.75
Situational Analysis: About 18% of the population in the district belong to tribal community, which counts to 1,36.062 residing in 2433 colonies in 26001 families. 25 per cent of the total deliveries reported in the district are of tribal. Averages of 4-5 deliveries are reported among tribal mother and few mothers are reported with more than 6 deliveries. Maternal deaths among the tribes are high compared to the other group. Almost all the tribal mothers are anemic and are reluctant to attend the periodic antenatal checkup. Goal:
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Maternal Mortality and morbidity reduction among the tribes Objective
1. To reduce Maternal Mortality 50% 2. To Address the issue of anemia among the tribal mothers 3. To increase the attendance of tribal mothers in the ANC checkup.
Strategy:
1. Addressing the issues through Organizing comprehensive antenatal clinics process
1. For ensuring early registration incentive will be provided to the pregnant mothers @ of Rs 50 per Checkup for 5 times as mobility support. 2. Providing free comprehensive Checkups in the ANC camp including , IFA distribution, providing TT, basic investigation, counseling etc. 3. Ensuring nutrition support to the pregnant women through the existing nutritious supplementation of Anganwadi’s in consultation with ASHA’s.
Outcome
1. Reduction in Maternal mortality among tribes 2. Decrease in low birth weight babies 3. Lowering the incidence of anemia
Budget
Sl Particulars No.of Unit Unit Total Remarks no cost 1 Incentive for pregnant 3500 (Assuming that there women while coming for will be around this much 250 8.75 tribal pregnancies in an year) ANC check up
Grand Total 8.75
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Project No. WB -28D Head of Account B19.5 Name of Special Project for the Empowerment of Unwed Mothers Project in Thirunelli Panchayath.
Total Budget (In lakhs) 2.78
Problem Statement
Thirunelli, a hilly and deep forested area, is situated in the north eastern part of Wayanad, sharing boundary with Coorg district of Karnataka. Total population is 32,200, out of which 12,405 are tribes such as Adiya, Paniya, Kuruma, Kattu naikka, and Kurichia. Various factors like Illiteracy, unemployment, availability of liquor and tobacco are commonly seen in tribal inhabitants . The situation of women in the community becomes more adverse due to the unfavorable social factors. These women are subjected to various forms of oppression discrimination and sexual exploitation. According to the latest statistical data, there are more than 122 unwed mothers in Thirunelli, which is unusually high considering the total population of the area. That is why we are giving special focus on Thirunelli, in this project. So far many researches have been conducted about the problem in this Panchayath. But no comprehensive rehabilitation and prevention programmes have not been undertaken yet. A holistic approach, with special focus on health aspect, is the need of the hour in offering a remedy for the malady.
Objectives:-
1) Conducting survey by employing ASHAs and identifying victims. 2) Strengthening of Oorukootam. 3) BCC activities. (Street plays, documentary shows, folk arts. Etc.) 4) Counseling (Adolescence, Individual and familial level) 5) Legal aid with the help of Legal Services Society. 6) Gender sensitization 7) Clinical facilities ( with the aid of TMMU, Tribal RCH camps) 8) Family welfare measures (integrated with sub-centre and PHC).
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9) Food supplement, nutritional care and other assistance for mother and child in collaboration with Tribal department, Social welfare dept., PRI and Kudumbashree. 10) Vocational Training (Indigenous medicines, forest resources like honey, bamboo products, gooseberry etc.) 11) Marketing: - Tie-up with DTPC, Tribal co-operative societies, Kudumbashree, SHGs etc.
Other Community based Rehabilitation measures. Vulnerable Group- Tribal Women- Thirunelly Panchayath
Sl Particulars No.of Unit Total Remarks no Unit cost
1 Survey incentive to ASHA Rs 2x2600Houses B.1.6
0.052 2 BCC/IEC Folk Arts Rs1000x25 programmes B.10.2.1
0.25
3 Documentary making and presentation 0.25 B.10.2.1 4 Counseling training Rs.150 x 40persons x 3days 0.18 Training materials Rs.50X 40 5 0.02
6 Hon.Resource person Rs.500 x6 0.03
7 Organisation expense 0.03 8 Legal service campaign Rs.3000 x 4 time in year 0.12 9 Nutrimix supplement rs.100 x150persons x12 1.8 10 Vocational training with LSG x Kudumbasree 0.5 11 POL and transportation 0.1 B.12.2 12 Contingencies 0.10 Grand Total 2.78
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Project No. WB -28E Head of Account B19.6
Name of Tobacco Control Programme (NTCP) Project
Total Budget (In lakhs) 11.16
Goal:
Tobacco free community.
Objectives:
1. To promote tobacco cessation programme. 2. To include anti tobacco campaign in the school health programme. 3. To reduce the burden of tobacco related diseases in the society.
Strategy:
1. Create awareness especially among tribal people about the harmful effects of tobacco products. 2. Ensure behavioral changes so that people keep away from tobacco usage. 3. Educate school children about the harmful effects of tobacco control. 4. Identification of tobacco usage related diseases in the society and management. 5. Ensure that patients don’t resort to usage of tobacco products again.
Processes:
1. Conduct social awareness campaigns like street plays, film shows especially among tribal people. 2. Train health workers and volunteers to conduct special campaigns at community level. 3. Sensitize teachers and parents about the risk of school children attracted to the habit of tobacco usage. 4. Make use of health workers and volunteers to prevent shopkeepers near educational institutions from selling tobacco products. 5. Identification of patients suffering from tobacco related diseases in the OPD and prompt referral in needy cases. 6. Counseling of the aforesaid patients at the PHC level.
Process indicators:
1. Number of special campaign programmes conducted. 2. Number of training camps held for health workers and volunteers. 3. Number of shops stopped selling tobacco related products.
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4. Number of patients suffering from tobacco related diseases attended OPD. 5. Number of patients referred to higher center. 6. Number of patients attended the counseling center. 7. % of smokers who quit smoking. 8. % of persons who quit the habit again resorting to it. outcome:
Decrease in number of persons using tobacco related products.
BUDGET
Sl no Components Calculation Total
INR INR
1 Salaries
1.psychologist:Rs.10000/- 10000x12
2.social worker:Rs.8000/- 8000x12
216,000/-
2 Training 200,000/- 200,000/-
3 IEC activity 100,000/- 100,000/-
4 School activity 300,000/- 300,000/-
5 Monitoring of Tobacco 100,000/- 100,000/- Control Laws&Reporting
6 Contingency 100,000/ - 100,000/ -
7 TOTAL 1116,000/ -
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Project No. WB -28F Head of Account B19.7
Name of Non-Communicable Disease Project
Total Budget (In lakhs) 18.31
Situational Analysis
NCD Survey Details
Particulars Total No of Diabetics Hypertension Diabetics in Patients Pregnancy
Male 171401 21141 11993
Female 170930 32544 11899 2926
Total 342331 53685 23892
Treatment Status
Particulars Hypertension Diabetes
under treatment 38067 20492
alternative treatment 8749 2356
dietcontrol 3161
no treatment 3711 1044
Goal:
Early detection and treatment of NCDs
Objectives:
1. Reduction in mortality due to diabetes,hypertension,and acute cardiovascular/cerebrovascular diseases
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2. Reduced hospitalization/incidence of myocardial infarction,stroke and diabetic emergencies 3. Reduced out of pocket expenditure on account of diabetes ,hypertension or its complication 4. Equip the health system to achieve the goal 5. Create awareness among public about the risk factors for developing NCDs
Strategy :
1. Early detection of diabetes and hypertension in people > 30 years.
2. Primary care management/ secondary prevention : maintain adequate control in hypertension & diabetes and reduce eliminate complications & OOPs at this stage.
3. Behaviour modification to ensure primary prevention of diabetes and hypertension.
4. Early detection, social protection and adequate management of common complications of these diseases
Processes:
1. Opportunity screening- in all those > 30 who attend a government health facility.- provides a card with date of screening, findings on all risk factors.( the main purpose of the card is to prevent duplication and double counting- also for risk factor identification.) 2. Screening Camps/Days in work-place: with issue of cards. 3. Screening in the community- with help of ASHA and SHGs for mobilisation and ANMs for taking blood pressure – with confirmation in the PHC by a doctor. ( the level- 1 package) Held as screening camps/days 4. Training of “those” who would be doing annual screening- with taking BP and measuring urine/blood sugar. 5. Procurement of gluco check strips at district level through KMSCL
Process indicators:
1. % of population at risk who were issued screened cards.
2. Number of camps held as percentage of number of camps needed – ( sum of work-places and habitations)
3. Number of trained persons deployed for screening.
4. Total no of NCD cases DIAGNOSED AND TAKING TREATMENT THROUGH THE PROGRAMME
5. No of dropout cases
6. Incidence of NCD related complications among previously diagnosed patients
7. Hospital admission rate due to NCDs
Output :
1. Early detection of NCDs 2. Prevention of development of complications
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Output indicators:
1. % of registered HTs and diabetics at least 70% of what is expected.
2. % of registered HTs and diabetics who were out of control- in last visit- anytime in last one year.
3. % of those in high risk group who adopted 5 positive health practices. ( or risk reduction)
4. % of those who developed complications who were admitted within one hour in a center where they could get cashless service.
Outcome:
1. Decreased morbidity and mortality due to NCDs
Role Of ASHA
ASHA will be a health activist in the community who will create awareness on health and its social determinants and mobilize the community towards local health planning and increased utilization and accountability of the existing health services. She would be a promoter of good health practices. She will also provide a minimum package of curative care as appropriate and feasible for that level and make timely referrals. Her roles and responsibilities would be as follows: · ASHA will take steps to create awareness and provide information to the community on determinants of health such as nutrition, basic sanitation & hygienic practices, healthy living and working conditions, information on existing health services and the need for timely utilization of health & family welfare services. · She will counsel women on birth preparedness, importance of safe delivery, breastfeeding and complementary feeding, immunization, contraception and prevention of common infections including Reproductive Tract Infection/Sexually Transmitted Infection (RTIs/STIs) and care of the young child. · ASHA will mobilize the community and facilitate them in accessing health and health related services available at the village/sub center/primary health centers, such as Immunization, Ante Natal Check up (ANC), Post Natal Check up (PNC), ICDS, sanitation and other services being provided by the government. · She will work with the Village Health & Sanitation Committee of the Gram Panchayat to develop a comprehensive village health plan. · She will arrange escort/accompany pregnant women & children requiring treatment/admission to the nearest pre identified health facility i.e. Primary Health Centre/Community Health Centre/ First Referral Unit (PHC/CHC /FRU). · ASHA will provide primary medical care for minor ailments such as diarrhoea, fevers,and first aid for minor injuries. She will be a provider of Directly Observed Treatment Short course (DOTS) under Revised National Tuberculosis Control Programme. · She will also act as a depot holder for essential provisions being made available to everyhabitation like Oral Rehydration Therapy (ORS), Iron Folic Acid Tablet (IFA), chloroquine, Disposable Delivery Kits (DDK), Oral Pills & Condoms, etc. A Drug Kit
arogyakeralam wayanad Page 172 AROGYAKERALAM WAYANAD PIP 2011-12 will be provided to each ASHA. Contents of the kit will be based on the recommendations of the expert/technical advisory group set up by the Government of India. · Her role as a provider can be enhanced subsequently. States can explore the possibility of graded training to her for providing newborn care and management of a range of common ailments particularly childhood illnesses. · She will inform about the births and deaths in her village and any unusual health problems/disease outbreaks in the community to the Sub Centres/Primary Health Centre. · She will promote construction of household toilets under Total Sanitation Campaign. · Fulfillment of all the se roles by ASHA is envisaged through continuous training and upgradation of her skills, spread over two years or more.
Non communicable life style diseases pose a huge threat to the nation’s public health system both in terms of morbidity, mortality and economic burden it imposes. In order to address one of the greatest public health challenges, the state NRHM has designed a non communicable diseases prevention and control programme in the state – which is the first of its kind in the country and successfully pilot tested in Wayanad district. The essential component of this programme is ASHA service and from there on the NRHM machinery working together with state health service system at various levels.
Role of ASHA in prevention and control of NCDs 1.Conduct NCD screening survey 2.Educate women, men and adolescents regarding the determinants of NCD’s and various associated risk factors like unhealthy diet, physical inactivity, intake of Tobacco and Alcohol and Stress, essentiality of Iodine etc. 3. Promoting a healthy life style during her regular interactions with the community. 4. Assist ANM/LHV in: • Organizing campsWard health Nutrition days on NCD themes • Screening of people at high risk • Advising patients to consult appropriate levels of health care system for diagnosis and treatment 5. Arrange follow up visits. Budget for follow up camps
Sl.no. Activity component Amount Reference
1 Cost of Gluco strip (1500 X 34) 51000
2 Medicines (50000 X 34) 1700000
3 NCD management in pregnant women 80000 From A1.1.2
Total 18,31,000
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Project No. WB -28G Head of Account B19.8 Name of Other Communicable Disease Project SCABIES INFESTATION
Total Budget (In lakhs) 8.6
Sacbies infestation is a major problem among Tribal population, especially children. At least 75 - 80% children is treated hospitals as well as 50 – 60% of tribal population and 30-40 % of adults in tribal colonies suffer from Scabies infestation.This is usually left untreated which results is repeated secondary bacterial infestations, which later lead to renal problem. This may adversely affects the health of tribes, who are already deeply compromised in their health status.
But the treatment available in Govt sector is Lindans lotion which requires three application and proper scrubbing the procedure is usually not correctly followed by the illiterate tribes resulting in recurrence of infectious. To overcome this the earliest method is to Ivermetine tabs in different doses for all common contacts above 2yrs as a single dose
Adult : 12 mg Single dose
Children : 200µg / kg body weight
For children below 2yrs Permethrin cream can be given as a single dose apilot project in this regard was done at PHC padinjarathara and it was seen that the reccurence over one year is very negligible it was seen that complaints to treatment was much better compared to Lindane budget split is as follows
Total Tribal population at Wayanad District -136650
Scabies Case Load SL. No Health Block Average/Year 1 Porunnannur Block 216 2 Thariode Block 180 3 Meppady Block 144 4 Meenangady Block 120 5 Pulpally Block 219 Total (Wayanad) 879
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Budget:
1 Expected no of cases and contact 50000
2 Cost of Ivermetine@RS 15 X 50000 750000
3 Cost of permithrine Cream @rs 55X 1000 55000
4 Other logistics and contingencies 5000
Total 860000
Project No. WB -28H Head of Account B19.9
Name of Family Poly Clinic Project
Total Budget (In lakhs) 15.80
In Wayanad district family poly clinic was started functioning from 12th September 2010 at Kainatty, Kalpetta under General Hospital, Kalpetta. 7 specialty OPs are working weekly five days with two specialty Ops on one day. Family poly clinic is an additional service to the public which providing all kind of specialty service. The bellow reports are showing that the Ops in each specialty is increasing in each month.
GYN & Month PAED ENT GM ORTHO OB OPH SURG TOTAL Sep-10 470 614 365 503 62 248 46 2308 Oct-10 587 768 456 629 78 310 57 2885 Nov-10 622 814 483 667 83 328 60 3057 Total 1679 2196 1304 1799 223 886 163 8250 One more family poly clinic has been sanctioned along with CHC Meenangady and it may start shortly . Budget:
Sl Particulars No. of Unit Total Remarks no Unit cost
1 Infrastructure 1 development at CHC 500000 5.00 Meenangady
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2 Allowance to Specialty 2000 per day for 2 poly clinic, 5 5.20 days in a week, 52 weeks for Doctors one year 3 2 One vehicles for each poly Vehicle Hiring charge 180000 3.60 clinic @15000/month
4 2 Maintenance Expenses 100000 2.00
Grand Total 15.8 0
Project No. WB -28-I Head of Account B19.10
Name of Project District Laboratory for the diagnosis of epidemic prone diseases
Total Budget (In lakhs) 34.715
Name of the identified lab: General Hospital Kalpetta
Situational Analysis:
Schedule tribes constitute a considerable percentage of the population in the district which comes around 18 per cent. There is high incidence of diseases like Chikungunya, Dengue, Leptospira , Hepatitis- A & B, TB, Typhoid, sickle cell etc in the district and tribals are more prone to these diseases.
Even though there are 20 labs functioning in government sector, none of them are performing microbiological examinations. Usually the district depends on neighboring districts and states for microbiological examinations, which causes delay in receiving the reports and treatment. There is also an upsurge in tourism activities in the district which results in more people visiting the district from other states. The recent data on increases in diseases like malaria, typhoid and Hepatitis etc shows that, there is a relation with increase in number of people going to other states for education, employment and the diseases.
Starting a Microbiology laboratory in the district, will serve the purpose of detecting many diseases in the beginning and their by providing early treatment to the patients and for better public health surveillance in the district. The data on the communicable diseases in the district in the last few years is furnished below for your perusal.
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Communicable Disease Data------WAYANAD DISEASE 2003 2004 2005 2006 2007 2008 2009 2010 LEPTO Case 104 114 30 76 97 52 96 68 Death 0 0 1 0 6 12 12 20 DENGUE Case 71 44 5 2 29 8 25 27 Death 0 0 1 0 0 0 0 0 HEP.A Case 180 113 78 253 90 100 278 194 Death 0 0 0 0 0 0 1 0 HEP.B Case 2 7 3 0 16 1 2 64 Death 0 0 0 0 0 0 2 1 TYPHOID Case 114 492 233 270 65 104 114 204 Death0 0 0 0 0 0 1 ADD Case 20930 11424 10751 15135 14544 13580 12571 10460 Death 0 0 0 0 4 0 0 2 MALARIA Case 0 50 18 20 28 25 38 43 Death 0 0 0 1 0 0 0 0 MEASLES Case 241 108 140 147 207 150 Death 0 0 0 00 1 CHICKEN Case 270 326 420 561 267 323 POX Death 0 0 0 10 1 MUMPS Case 109 69 573 375 Death 0 0 0 0 CG Case 3 73 48 305 431
PROPOSED BUDGET OUTLAY (In Lakhs) Budget MINIMUM DIAGNOSTIC SERVICES 17.9 Breakup PHYSICAL INFRASTRUCTURE 1.21 MANPOWER INCLUDING (RECURRING EXPENDITURES & CONTIGENCY ) 15.605 Total Budget in Lakhs 34.715 Budget Main Head Facilities Required Facilities Available Gaps to be Filled In Lakhs MINIMUM DIAGNOSTIC SERVICES Bio-safety cabinet class I 1Number 3 Autoclave (sterilization) 1Number 1.5 Autoclave for decontamination(vertical) 1Number 1.5 Hot air oven 1Number 1 Minimum Incubators 1Number 0.5 Diagnostic Services Binocular microscopes 2 Number 0.8
ELISA reader and washer Hospital 1Number 5 Refrigerator (285 ltrs capacity) 1Number 0.2 Deep Freezer (-20°C) 1Number 2 Centrifuge 1Number 0.4 Micro pipette: (0.2 – 10 μ l, 20
– 200 μ l, 100–1000μ l) thein Present are Noneequipments of the 3 Number 0.3
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Water bath 1Number 0.4 Weighing scale & Mixer 1Number 0.2 Needle Destroyer 1Number 0.1 Computer with printer, scanner, UPS 1Number 1 SUB TOTAL 17.9
PHYSICAL INFRASTRUCTURE Including chair, Office Furniture Table 0.25 3 steel almirah @ Steel Almirah These are to be of Rs 7000 each 0.21 Physical provided for the 5 Steel Shelves Infrastructure Wooden/ Steel Shelves functioning of the @Rs 5000/ each 0.25 office lump sum amount For separating the Room separation / cabin cabins for various formation examinations 0.5 SUB TOTAL 1.21 * Rest of the furnishing works mentioned will be carried out by the institution
MANPOWER/ RECURRING EXPENDITURES Rs 40000/ month Microbiologist for 1 year 4.8 Rs 12000/ month for 1 YEAR At present there are for 3 number of Laboratory Technicians (minimal no positions of the DMLT 4.32 MANPOWER above said posts in Rs 10000/ Month Laboratory Assistants the hospital for 1 year 1.2 Rs7000/ Month Laboratory Attendants for 1 year 0.84 Rs 6000/ Month Cleaner for 1 year 0.72 SUB TOTAL 11.88
CONTIGENCY
Contingency including Photostat, stationary CONTIGENCY items, courier, miscellaneous expenses etc 10000 Minor expenses on equipment repair 20000
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Data collection and communication (phone/internet) 15000 SUB TOTAL 45000
Expected number of Approx tests Approx unit total Name of Test per annum cost(INR) cost(INR) Gram stain smears of clinical specimens like throat swab, 500 35 17500 sputum, CSF etc. Smear examination for malaria 1000 35 35000 Culture blood, stool, CSF etc for bacterial pathogens and perform Antimicrobial 500 200 100000 susceptibility testing on the isolates Recurring ELISA for Viral Hepatitis A & E 200 200 40000 Expenditures for Diphtheria – smear 100 200 20000 a year examination and culture Rapid Latex Agglutination test for meningococcal (during 40000 40000 suspected outbreaks) IgM ELISA for Measles 200 200 40000 Sputum for AFB 500 50 25000 Other tests relevant for locally prevalent epidemic prone 500 200 10000 diseases i.e. ELISA for leptospiroisis etc SUB TOTAL 327500
TOTAL BUDGET OF THE PROPOSAL ( In Lakhs) : MINIMUM DIAGNOSTIC SERVICES + PHYSICAL INFRASTRUCTURE + MANPOWER + RECURRING 34.715 EXPENDITURES + CONTIGENCY (17.9 + 1.21 + 11.88 + 3.275 + .45)
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ACTIVITY WISE PIP C-IMMUNISATION
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ACTIVITY WISE PIP – IMMUNISATION
Part C. IMMUNIZATION. PIP for the year 2011-2012
Total Number of Children 13866
0 to 1 year (Till Nov 2010)
Antenatal care Services Total Number of pregnant woman registered during 2010-2011 (Till Nov 2010) : 10571
Immunization Coverage Item Achievement % BCG 105.75 2010-2011 (Till Nov 2010) OPV 99.31 Measles 68.31 DPT 100.68 Hepatitis A 78.37 TT 92.27 DT 84.26
Usually we conduct the immunization programme using the department fund as well as from LSG. As per the new directions from government, the LSG fund not available. Hence PHC’s find to difficult to conduct outreach immunization camps in various places even though we conduct one camp per sub center, immunization coverage below 80% so we are planned to conduct more outreach camps during 2011-2012 year. In spite various health activities IMR and MMR is very high especially among tribes
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Difficult to reach Areas in the district: a. Chekadi – under PHC Pakkom b. Aloorkunnu – Under PHC Mullankolly c. Thirunelli – Under PHC Appapara d. Mukki – Under CHC Perya e. Mamangalam under CHC Thariode f. Arunamala – Under CHC Meppady g. Muthanga – Under PHC Noolpuzha h. Pattavaya – Under PHC Chulliode
Resistant Areas: 1. Rippon – Under CHC Meppady 2. Karinjakunnu – Under PHC Kottathara 3. Kambalakkadu – Under PHC Varadoor 4. Peechomkode – Under CHC Porunnannur 5. Varambetta - Under PHC Vellamunda
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Project No. WC -1 Head of Account C
Name of IMMUNIZATION Project
Total Budget (In lakhs) 29.69
Situation Analysis: Fully Immunization status of the district is nearly 68.24% of the target group, where as zero doze achievement is 100%. The main target groups are tribes and resistant groups of certain community. Incidents of vaccine preventable deceases in Wayanad district is increasing. In order to avoid drop out of the immunization programme, we have to formulize special strategies. Goal: 100% Fully Immunization coverage. Objective: To avoid drop outs of immunization. Strategy: 1. Special Immunization campaign for resistant groups and tribal colonies. 2. Strengthen IEC/BCC activities 3. Special seminars to community group leaders. 4. Conduct special Immunization camps 5. Increasing community participation Process:
1. Find out the drop out areas 2. Find out the reasons for drop out 3. Conduct Special Immunization camps in drop out areas. 4. Conduct Special Immunization camps in difficult to reach areas 5. Conduct immunization update seminars. Outcome:
• Reduction of drop outs of immunization. • Reduce the incidents of vaccine preventable diseases. • Ensure 100% fully immunization coverage. Head Activity Amount in lakhs RI Strengthening project (Review meeting, Mobility support, 23. 35 C.1 outreach services, etc.) C.2 Salary of Contractual Staffs 0.84 C.3 Training under Immunisation 1.40 C.4 Cold chain maintenance 0.50 C.5 Pulse polio operating costs 3.60 Grand Total 29.69
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Chapter V Disease Control Programmes
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Project No. WD -1 Head of Account D.1
Name of NVBDCP Project
Total Budget (In lakhs) 4.27
Situational Analysis:
The data related to the most common vector borne diseases in Wayanad , in the past five years are tabulated below.
Disease 2006 2007 2008 2009 2010 Dengue Case 2 29 8 25 27 Death 0 0 0 0 0 Chikungunya Case 3 73 48 305 431 Death 0 0 0 0 0 Malaria Case 20 28 25 38 43 Death 1 0 0 0 0 Lepto Case 76 97 52 96 68 Death 0 6 12 12 20
Since 2006 incidence of Dengue, Chikungunya & Malaria is on the rise. Even though the incidence of Lepto has come down in 2010, the case fatality rate has gone up. The afore mentioned data is from both private and public sector hospitals.
Goal:
To contain the increase in incidence of vector borne diseases through effective vector control
Objectives:
1. To reduce Annual Parasite Index for Malarial Parasite 2. To reduce Serum Positivity Rate 3. To Control the Disease prevalence for VBDs
Strategy:
1. Stringent Surveillance of Malaria, Dengue, CG & Lepto 2. Increasing Source Reduction Activities 3. Increasing community participation in vector control measures 4. Inter sectoral coordination regarding Vector Control 5. Sensitization of Health Staff, ASHAs and other NGOs 6. Increase Awareness regarding VBDs
Processes:
1. Increase in Active and Passive Blood Smear Collection
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a. Enhance Fever Surveillance by Field Staff,ASHAs etc b. Ensure Smear Collection of all fever cases reporting in the OPD
2. Ensure standard case definitions based diagnosis 3. Increase Source Reduction activities with the involvement of the community.
a. Making Use of commercially available repellants b. Intensify efforts to reduce actual or potential larval habitats in and around houses c. Provide bed nets for infants d. Promote use of Larvicidal Fish in potential water bodies e. Clear off weeds and grasses f. Create awareness among school children on the importance of Source Reduction activities
4. Rodent control measures to be taken at community level ensuring the participation of related departments(eg LSGD, Veterinary, Agriculture, Water etc) 5. Training of Health Staff, ASHAs and other NGOs in order to decrease the delay in patients seeking medical attention 6. Prompt treatment of vector borne diseases 7. Prophylactic measures to be implemented wherever applicable( Eg: Doxycycline prophylaxis for Lepto).
Process Indicator:
1. API 2. ABER 3. SPR
Output:
1. Decrease in Per Man Hour Catch ( Vector Density ) 2. Decrease in Incidence of Vector Borne Diseases 3. Decrease in complications & Case Fatality rate of respective vector borne diseases
Output Indicators:
1. Vector Density 2. Incidence of Vector Borne Diseases 3. Case Fatality Rate
Outcome:
Decreased incidence of vector borne diseases
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Budget:
Sl. Amount No. Activity - 1 Contractual MPWs
- 2 Incentives to ASHAs for identified districts
0.45 3 Malaria IEC 1.12 4 Training 0.50 5 Epidemic Preparednes and M & E 1.50 6 Dengue & Chikungunya - 7 AES / JE - 8 ELF - 9 KALA-AZAR - 10 Decentralized Commodities 3.60 11 TOTAL Domestic Support - 12 Human Resource
Training - 13 World Bank
Mobility Support - 14
Human Resource - 15
IEC / BCC - 16 GFATM M & E - 17
Others - 18 - 19 TOTAL------World bank + GFATM
Total Budget from NVBDCP 3.60 20
Allocation from NRHM Flexi Fund 0.70 21
GRAND TOTAL 4.27
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Project No. WD -2 Head of Account D.2
Name of National Leprosy Eradication programme Project
Total Budget (In lakhs) 5.80
Situational Analysis:
Presently, the programme is on a back foot in the district. The factors contributing to this are as follows
1. Incomplete District Nucleus; Several Posts are vacant which has adversely affected the smooth functioning of the District Nucleus. Vacancies present now are as follows.
a. Assistant Leprosy Officer b. Medical Officer c. Physiotherapist d. Dermatologist – a fact to be noted here is that there is no dermatologist in the health services in the whole Wayanad District.
2. Apparently Low Prevalence of Hansen’s Disease in the District: This prevalence cannot be considered as the true picture of the distribution of the disease, taking into consideration the fact that all the five cases presently taking treatment have Grade 2 deformities. This points towards late detection. 3. Complacency regarding Hansen’s Disease among the General Public, Health Services and other related departments. 4. Stigma associated with Hansen’s Disease
Goal
1. Decrease the incidence of Hansen’s disease in the district. 2. Rehabilitate the patients disabled due Hansen’s disease. 3. Reduce the Social stigma associated with Hansen’s disease
Objectives
1. Equip the existing Health Services Framework to be able to attain the afore mentioned goal
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2. Early Detection and Prompt Treatment of Hansen’s Disease Cases 3. Enhance Disability Prevention and Medical Rehabilitation 4. Decrease the stigma associated with Hansen’s Disease
Strategy
1. Filling the existing vacancies to the Government 2. Conduct trainings ( Both Fresher and Re orientation) 3. Create awareness about Hansen ’s disease in order to decrease the stigma related to the disease. 4. Establish Rehabilitation Centers deformity cases in order to bring them into the mainstream of the society. 5. Re Constructive Surgeries ( RCS ) at District Hospital, Mananthavady
Processes:
1. Intimate the vacancies in the District nucleus, viz., ALO, MO, Physiotherapist and Dermatologist. 2. Acquire infrastructure (Computers and peripherals) for the District Nucleus for enhanced data collection and data management. 3. Conduct Fresher and Re orientation Trainings for the following categories:
a. Medical Officers b. Supervisory Field Staff viz. Health Supervisors and Public Health Nurses c. Junior Health Inspectors and Junior Public Health Nurses d. ASHAs e. Other NGO workers
4. Conduct inter sectoral coordination meetings to create an awareness about Hansen’s disease among the Local Self Governance Department, and other related Departments. 5. IEC activities in order to create awareness about the disease among the General Public and also to reduce the stigma related to the disease. 6. Conduct camps in all PHCs, especially targeting the tribal areas , in order to enhance case detection rate and decrease the incidence of disabilities. 7. Conduct skin camps in schools of the district in order to pick up Child cases. 8. Co ordinate Skin Camps with RCH / Other Activities
Process Indicators
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1. Defaulter Rate 2. Number of Relapses Reported During the Year 3. Proportion of New Cases Diagnosed Correctly 4. New Disabilities Rate among cases under Treatment 5. Monitoring of Stocks and Store
Output:
1. Increase in Case Detection and emphasis on early detection 2. Decrease in number of Disabled Cases 3. Decrease in Stigma related to Hansen’s Disease
Output indicators:
A. Main Indicators
1. Annual New Case Detection rate ( ANCDR ) 2. Prevalence rate ( PR ) 3. Treatment Completion Rate ( TCR )
B. Additional Indicators
1. Proportion of Grade I Disability Cases 2. Proportion of Grade II Disability Cases 3. Proportion of Female Cases 4. Proportion of Multi Bacillary Cases 5. Proportion of Child Cases
Outcome:
1. Decreased Prevalence of Hansen’s Disease in Wayanad District. 2. Rehabilitation of Disabled Cases. 3. Decreased Stigma related to Hansen’s Disease among all strata of the society.
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Budget:
Sl. Amount No Activity 0.6 1 Contractual Services 0.4 2 Services through ASHA/USHA 0.25 3 OE & Consumables 0.5 4 Capacity Building 0.75 5 IEC/BCC 0.5 6 POL/Vehicle operation & hiring 0.5 7 DPMR 0.5 8 Materials & Supplies - 9 Urban Leprosy Control - 10 NGO - SET Scheme 0.3 11 Review Meeting & Supervision 1.5 12 Cash Assistance 5.8 Total
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Project No. WD -3 Head of Account D.3
Name of RNTCP Project
Total Budget (In lakhs) 44.39
Situation Analysis:
No of new Annualized Total Annualized Cure rate for Plan for the next year smear New smear Proportion of number of total case cases detected in positive positive case TB patients TB Unit patients put detection the last 4 cases put detection tested for on rate (per lakh corresponding Cure rate on rate (per lakh Annualized HIV treatment pop) quarters treatment p op) NSP CDR (85%)
DTC TU 231 105 71 32.42 80% 70% 88% 4:1
Kalpetta 196 70 73 26.12 88% 70% 88% 4:1
Bathery 170 49 78 22.41 87% 70% 88% 4:1
Total 597 224 222 31 85% 70% 88 % 4:1
Goal: 100% detection and optimum treatment of TB cases.
Objectives:
1. Identification of TB cases
2. Optimum treatment to the TB cases
3. Prevention of transmission of TB cases
Strategies
1. Training to Health staffs
2. Strengthening IEC/BCC activities
3. Conduct seminars to general public
4. Conducting detection camps at tribal colonies
5. Infrastructure development of RNTCP unit
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ROLE OF ASHA And NGO
ASHA workers could serve as Directly Observed Treatment Short course (DOTS) under Revised National Tuberculosis Control Programme.the provider in their village and ensure compliance
Since the treatment is of long duration, the ASHA worker has a key role in motivating the patient to complete the treatment and prevent them from stopping midway or drop out
Recognising the side effects of the drugs and knowing how to deal with side effects of drugs and making sure of drug availability at the health facility will help ASHA workers to do this more effectively
Encourage the patient to take sufficient nutrition during treatment and moderate rest at least for the first two months
The family of the patient should be counselled to take precautions at home especially for children and elder persons who can contract the disease quickly
When coughing, the patient must put a protective clean cloth over his mouth to prevent spread of droplets or leave the house and cough in a nearby open space. The cloth should be washed in hot water or with disinfectant thoroughly on a regular basis.
The patient should not have close contact with spouse, children and infants and the elderly within the family at least for two months after starting treatment. Simple hygiene precautions will help in preventing transmission of TB within the family
ASHA workers must keep a watch on the other family members to detect early signs of TB in the members and if necessary, get them examined from time to time
Ensure BCG vaccination of children at birth. This can help prevent TB among small children
TB is also a stigmatising disease. Confidentiality of patient identity must be maintained
Awareness of TB related symptoms and the approach to achieving a cure through self reporting for examination must be stressed at community gatherings as also the importance of good nutrition and taking of complete treatment
Relapse of TB in patients who have had previous treatment is possible. Many times, such patients are considered as new patients. The record of previous treatment should be made known to the health facility where the patient presents for re treatment so that a different drug regimen may be prescribed
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NGOs they can help in a major way in :
* Spreading awareness about tuberculosis (TB),educating communities on its prevention and treatment. * Providing community based care to TB patients. * Training TB health care workers and volunteers * Conducting and supporting operational research through innovative & quality research. Starting from the information campaign to generating awareness about medical facilities available in the neighbourhood, NGOs can provide physical space for Directly Observed Treatment (DOT), track and retrieve defaulters, counsel patients and their family members. Apart from this,with their rich experience at the grass roots they can also develop effective Information, Education &Communication (IEC) material. Local channels of communication, like street plays, puppets shows, etc. can be developed and exhibited by the NGOs. Depending on the capacity of the NGOs, theirpossible areas of involvement can be health education, service delivery, programmeimplementation, training & evaluation. * Consultant(IEC & NGOs), There are several reasons why NGO's participation should be sought in the fight against TB. Many NGOs have a mandate to address health problems, and TB is one of the most serious threats due to the enormous suffering and economic losses it causes. NGOs are well suited to participate in the national effort because of their credibility, access to community, access to vulnerable populations and great flexibility of work. The Revised National TB Control Programme (RNTCP) has recognised this fact and conscious efforts have been made to involve more and more committed NGOs. The following 5 schemes have been evolved under which NGOs can collaborate in RNTCP. 1 : Health Education and Community Outreach NGOs can sensitise, train volunteers, disseminate information, provide counseling to patients, families; sensitise, orient & advocate key groups, develop and revise IEC material according to local context. 2 : Provision of Directly Observed Therapy – NGOs can identify, train and supervise volunteers who will provide DOT. The DOT provider is also responsible for ensuring collection of sputum during treatment and for default retrieval.
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3 : In Hospital Care for TB patients The established and experienced NGOs provide inhospital care for TB patients who require such care.The hospital performs AFB smear microscopy and follow up sputum examination of patients on treatment to those who live in areas covered by the RNTCP. 4 : Microscopy and TreatmentCentre The NGO serves as a microscopy &treatment centre and is designated as such by RNTCP. The NGO provides Acid Fast Bacilli (AFB)* Consultant.
Output
100% detection and optimum treatment to all TB cases.
Sl. Head of Account Amount No
1 Civil works 0.52
2 Laboratory materials 2.15
3 Honorarium 2.00
4 IEC/Publicity 1.83
5 Equipment Maintenance 0.40
6 Training 2.00
7 Vehicle Maintenance 2.20
8 Vehicle Hiring 0.90
9 NGO/PP Support 6.50
10 Miscellaneous 3.35
11 Contractual Services 20.80
12 Printing 1.30
13 Research & Studies -
14 Medical Colleges -
15 Procurement of Vehicles -
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16 Procurement of Equipment 0.20
17 RNTCP- Total 44.15
18 NRHM Flexi pool Additionalities 0.24
GRANT TOTAL 44.39
Project No. WD -4 Head of Account D.4
Name of National Program for Control of Blindness Project
Total Budget (In lakhs) 29.39
Situational Analysis: There are more number of untreated cataract and other ophthalmic cases are in Wayanad district. These problems is mostly seen in tribes and other backward communities
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Goal
Diagnosis and optimum treatment for all cataract cases and other ophthalmic diseases.
Objectives
1. Equip the existing Health Services Framework to be able to attain the afore mentioned goal
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2. Early Detection and Prompt Treatment of cataract cases and other ophthalmic diseases
Strategy
1. Filling the existing vacancies to the Government 2. Conduct trainings ( Both Fresher and Re orientation) 3. Create awareness about cataract cases and other ophthalmic diseases 4. Facilitate eye bank at District hospital 5. Eye donation campaigns
Output:
Increase in Case Detection and emphasis on early detection of cataract and ophthalmic cases
Sl. Amount Activity No. 3.75 1 Cataract Surgery &Other Eye Diseases 5 2 School Eye Screening & Cost of Spectacles 1 3 GIA to Eye Ball Collection 1 4 GIA to Vision Centres - 5 GIA to Eye Bank - 6 GIA to Mobile tele Ophth Unit - 7 GIA to eye Donation center 1 8 IEC 0.9 9 POL 0.3 10 Contigencies 0.5 11 Office Expenses 0.5 12 Training
6 13 Consumables & Minor equipments (Medicine,Sutures etc..)
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- 14 Procrument of Major Opth Equipmt 0.42 15 Honorirum toSPO, DPOs & Clerks 7.92 16 Contractual Surgeon, OA, Counsellor & Cont staff at HQrs 0.6 17 Review Meetings 0.5 18 Repairs of Equipments - 19 Non recurring GIA to NGOs 29.39 Total Project No. WD -5 Head of Account D. 5
Name of IDSP Project
Total Budget (In lakhs) 13.74
Situation Analysis: Prevalence rate of communicable and non communicable disease is increasing. In order to analyze the situation, strengthening of IDSP is essential.
Goal: Strengthening IDSP wing
Objectives:
1. Collecting information from peripherals
2. Analyze the reports
3. Interpretation of reports
4. Initiate corrective measures.
Strategies
1. Training to Health staffs
2. Strengthening IEC/BCC activities
3. Improve reporting system
4. Awareness classes to general public and target groups (NREG Workers)
Output
Prevention and control of communicable and non communicable diseases.
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Data Management: Under IDSP data is collected on weekly epidemic prone diseases on (Monday –Sunday) basis. The information is collected on three specified reporting formats namely “S” (Suspected Cases), “ P” (Presumptive Cases) and “L” (Laboratory Confirmed Cases) filled by Health workers, Clinicians and Clinical Laboratory Staff. When health workers at sub centers suspect a case, they fill out form “S” (Suspect case). The doctors at primary health centers, community health center and hospitals fill form “P” (Probable case /Presumptive case). The cases that are confirmed by the laboratory fill up form “L” (Lab Confirmed Case). Data mangers receive these completed forms from various center, and data compilation and analysis is done at the District level by a team consisting of DSO, Epidemiologists, Data Manager & Data Entry Operator. The weekly data gives the disease trends and occurrence of new disease. Cases representing an unusual or rising trend are investigated by a District Level Team (Rapid Response Team (RRTs) to diagnose and control the outbreak is any. Currently there are 204 “S” , 34 “P” & 21 “L” reporting units spread across 25 Panchayaths and 1 Municipality in the district.
DATA FLOW IN INTEGRATED DISEASE SURVEILLANCE SYSTEM
On line Data Transmission
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The data collected from the reporting units under each districts are compiled and consolidated in the prescribed format and sent to the State Surveillance Unit before every Wednesday . The same data is also entered in the IDSP portal before every Wednesday. For This the NIC has created a single stop web portal www.idsp.nic.in with options for data entry and analysis from the district level upwards related to disease surveillance. It is quicker, easier and more powerful to update than print based media. Usually the data enty is been done by the Data Entry Operator and Data Manager. Once the data is entered in the portal it is easy to produce graphs and charts based on the eneterd data. The below chart represents the online data flow in IDSP.
Online Reporting Structure in IDSP
Apart from this the District Surveillance Unit prepares the Early Warning Signals of Impending Outbreaks and sent it to the SSU on every Monday. Similarly Outbreaks Reports are also prepared as and when it occurs and also sent it to the SSU & CSU on the same day via online. The below table represents the Out breaks identified through the surveillance system in the year 2010 and its outcome. Outbreaks Reported in 2010 - Wayanad
Disease PHC/ CHC Area Month Cases Out Come Cases Controlled Mundakkai Measles Meppady January 10 (Were able to isolate the SubCenter Area cases) Hepatitis-A Noolpuza Ponkuzhi February 6 Cases Controlled
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Paniya Colony (source Identified, Chlorinated the water source, Conducted Medical Camp, Health education Provided etc) Cases Controlled (Intensified Source Meenangadi Chikungunya Meenangadi July 28 Reduction, Fogging, Dry day LSG observation, Medical Camps, IEC Programmes etc) Anapanthy Cases Controlled ADD Noolpuza Kattunayka September 13 (Well Chlorination, Medical Colony Camp, ORS Provided)
Data Analysis under IDSP While collection of good quality of data is important for surveillance programme analysis and interpretation of these data is of equal significance. Weekly data analysis is being done in the DSU on every Thursday either in the forenoon or in the afternoon. DMO, DSO, District Malaria Officers, Technical Assistants, Mass Media Officers, District Lab Technicians, District Nursing Officer, IDSP Epidemiologists, Microbiologist, Data Managers, Data Entry Operators and other Programme officers take part in the data analysis process. On the basis of the discussion conducted during the analysis feedback reports are prepared and communicated to the concerned reporting units for initiating action. Data analysis and action are being undertaken by respective reporting units.
Apart from the weekly reporting the IDSP DSU looks after the daily reporting system act as an hub of accurate information/data by looking after the surveillance activities related H1N1 control measures, IDRV reporting, Vector Control reporting /activities etc.
SL. No Activity Amount
0.80 1 Training 7.18 2 Staff Remuneration 0.85 3 Office Expenses 0.15 4 Broad Band Expenses 0.15 5 Collection & Transporation of Samples 0.15 6 IDSP Reports Including Alerts
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- 7 Printing of Reporting Forms 0.60 8 Review Meetings 0.75 9 Field Visits 0.12 10 ASHA Incentive for Out Break Reporting 0.09 11 Media Scanning & Verification System - 12 Consumables for Kits for Identified Priority District Labs 10.84 Total Additionalities
Sl. No Activity 1 1.50 Training 2 0.50 IEC Materials 3 0.25 Outbreak Investigations 4 0.40 Repairing of IT/EDUSAT Equipments 5 0.25 Innovative Programmes 2.90 Total
Project No. WD -6 Head of Account D.6 Name of National Iodine Deficiency Disorder Control Project Programme
Total Budget (In lakhs) 0.14
Situation Analysis: Incidents of iodine deficiency disease are reported in the district. Hence it is hilly area, adequate interventions is needed to avoid iodine deficiency disorder
Goal: Prevention of iodine deficiency disorders
Objectives:
4. Identification of IDD cases
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5. Optimum treatment to the IDD cases
6. Prevention of IDD cases
Strategies
6. Training to Health staffs
7. Strengthening IEC/BCC activities
8. Conduct seminars to general public
Output
Prevention of IDD cases.
No of identified Goiter case in Wayanad
Sl no 2007 2008 2009 Total Porunnanoore 13 17 15 45 Thariode 7 9 12 28 Meppady 14 13 16 43 Meenangady 6 14 12 32 Pulpally 12 7 13 32 Total Case in 52 60 68 180 wayanad
Seminar at CHC level 5000 Rs 1000 X 5 CHC
Review Meeting 4000 Rs 2000 X 2
Brochure 5000 5000 Nos X Rs. 1
Total 14000
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Chapter VI
E SECTION
INTERSECTORAL CONVERGENCE
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Project No. WE -1 Head of Account E.1 Name of AYUSH Project Total Budget (In lakhs) 55.40
Situation Analysis: 18% of the total population in Wayanad is belongs to tribes. Traditional way of treatment is very popular among these people. General people also interested in these traditional ways of treatment. In order to strengthen their health seeking behavior, we have to strengthen the Ayush department in Wayanad district.
Goal: Strengthening the Ayush
Objectives: Accessibility of Ayush clinics to be enhanced, so that a bigger segment of the population can access the service.
Process:
1. Strengthening the existing clinics
2. Start more number of Ayush clinics.
3. Strengthening IEC/BCC activities.
4. Mobility support to the Medical team to conduct outreach camps.
Outcome:
Popularize Ayush treatments.
Homoeo Cases Reported Last Year
There are 8 Homoeo dispensaries are working under NRHM in Wayanad district. The average cases reported in these dispensaries are shown bellow.
Sl. No Diseases Average/Year
1 Viral Fever 3400/Year
2 Chickenpox 800/Year
3 Mumps 400/Year
4 Measles 320/Year
6 Other Diseases like, Colara, Chikungunya, Dengi fever etc 80/Year
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Under Homoeopathy treatment, more important is giving to preventive actions. So supplying preventive medicines to patients family is very important.
Ayurveda Case Reports
There are 2 Ayush dispensaries working under NRHM in Wayanad district. The average ceses reported in last year is shown bellow
Sl. No Diseases Average/Year
1 Rheumatic diseases 800/Year
2 Skin Diseases 700/Year
3 Allergy Diseases 600/Year
4 Sprain Diseases 150/Year
6 Other General Diseases 900/Day
Human Resource - Remuneration
Medicin Conting Vehicle Total Category es ency Remarks Medical Officer Pharmacist Hiring
Dispensaries @ 20740 pm @ 13210 pm
(consolidated) (consolidated)
Medicines @ 50,000 per Dispensary
Contingency @ 1,00,000 Ayurveda 2 497760 158520 100000 200000 240000 1196280 per Dispensary
1 vehicle @ 20000 per month
Medicines @ 25,000 per Dispensary Homoeo 8 1991040 634080 200000 800000 240000 3865120 Contingency @ 1,00,000 per Dispensary
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1 vehicle @ 20000 per month
Medicines @ 50,000 per Dispensary Unani 1 248880 79260 50000 100000 0 478140 Contingency @ 1,00,000 per Dispensary
Total 2737680 871860 350000 1100000 480000 5539540
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MONITORING AND EVALUATION
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Project No. WM -1 Head of Account
Name of Monitoring & Evaluation / HMIS Project
Total Budget (In lakhs) 8.00
Monitoring & Evaluation / HMIS(District)
Sl.no. Activity component Amount
1 Printing of Reporting Forms and Registers 200000
2 Software Development and Training 100000
3 Stationery & other Contingencies 100000
4 POL & Mobility Support 250000
5 Establishment of Block Level Monitoring Cells 25000 150000 x6
Total 800000
(A.10.3 Monitoring & Evaluation / HMIS)
Cost of Unit Amount Name of Block No. of units Remarks (in Rs) (in lakhs)
District Level 800000 1 8
TOTAL 8
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BUDGET 2011 – 12 SUMMARY (AMOUNT IN `)
PIP WAYANAD 2011 -12 Unit Physical Required fund Cost Targets under NRHM Sl.No. Activity
RCH Flexible Pool A.1 MATERNAL HEALTH
A.1.1 Operationalise facilities (only dissemination, monitoring, and quality) A.1.1.1 Operationalise FRUs
A.1.1.2 Operationalise 24x7 PHCs
A.1.1.3 MTP services at health facilities A.1.1.4 RTI/STI services at health 660000 facilities A.1.1.5 Operationalise Sub-centres
A.1.2 Referral Transport 150000
A.1.3 Integrated outreach RCH services A.1.3.1 RCH Outreach Camps 90000 A.1.3.2 Monthly Village Health and 1177000 Nutrition Days A.1.4 Janani Suraksha Yojana / JSY A.1.4.1 Home Deliveries 150000 A.1.4.2 Institutional Deliveries 6662000 A.1.5 24 Hours Deliveries A1.6 Payment to Link Workers/AWW/AWS (other than ASHA) A.1.7 Maternal Death Audit A.2 CHILD HEALTH A.2.1 IMNCI 10000 A.2.2 Facility Based Newborn 100000 Care/FBNC
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A.2.3 Home Based Newborn 10000 Care/HBNC A.2.4 School Health Programme A.2.5 Infant and Young Child 170000 Feeding/IYCF A.2.6 Care of Sick Children and Severe Malnutrition A.2.7 Management of Diarrohea, ARI and Micronutrient Malnutrition
A.2.8 Other strategies/activities
A.2.9 Infant Death Audit
A.3 FAMILY PLANNING
A.3.1 Terminal/Limiting Methods
A.3.1.1 Dissemination of manuals on sterilisation standards & quality assurance of sterilisation services A.3.1.2 Female Sterilisation camps 698000
A.3.1.3 NSV camps 330000
A.3.1.6 Accreditation of private providers for sterilisation services A.3.2 Spacing Methods A.3.2.1 IUD camps A.3.2.2 IUD services at health facilities 43000 A.3.2.3 Accreditation of private providers for IUD insertion services A.3.2.4 Social Marketing of contraceptives A.3.2.5 Contraceptive Update seminars 25000
A.3.3 POL for Family Planning 180000
A.3.4 Repairs of Laparoscopes
A.4 ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH / ARSH A.4.1 Adolescent services at health 117000 facilities. A.4.2 Other strategies/activities 310000 A.5 URBAN RCH 240000
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A.6 TRIBAL RCH 748000 A.7 VULNERABLE GROUPS A.8 Other RCH Activities A.9 INFRASTRUCTURE & HUMAN RESOURCES A.9.1 Contractual Staff & Services A.9.1.1 ANMs, Staff Nurses, 14074000
A.9.1.2 Laboratory Technicians, 5490000 ,MPWs Specialists (Anesthetists, 4455000 Pediatricians, Ob/Gyn, Surgeons, Physicians, Dental Surgeons, Radiologist, Sonologist, Pathologist,Specialist for CHC A.9.1.3 ) 4863000 A.9.1.4 PHNs at CHC, PHC level Medical Officers at CHCs / 21870000 A.9.1.5 PHCs Additional Allowances/ 7800000 A.9.1.6 Incentives to M.O.s of PHCs and CHCs Others - Computer Assistants/ 109100 A.9.1.7 BCC Co -ordinator etc Incentive/ Awards etc. to SN, A.9.1.8 ANMs etc. Human Resources 3700000 A.9.1.9 Development (Other than above) Other Incentives Schemes A.9.1.10 (Pl.Specify) Staff/ Supervisory Nurses for A.9.1.11 PHCs,CHCs(for AYUSH)
Medical Officers at CHCs/ A.9.1.12 PHCs (for AYUSH) A.9.2 Minor civil works
A.9.2.1 Minor civil works for 600000 operationalisation of FRUs A.9.2.2 Minor civil works for 800000 operationalisation of 24 hour services at PHCs A.10 TRAINING
A.10.1 Strengthening of Training 300000 Institutions
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A.10.2 Development of training packages A.10.3 Maternal Health Training
A.10.3.1 Skilled Birth Attendance / 35000 SBA A.10.3.2 EmOC Training 25000
A.10.3.3 Life saving Anesthesia skills training A.10.3.4 MTP training 35000
A.10.3.5 RTI / STI Training 25000
A.10.3.6 Dai Training
A.10.3.7 Other MH Training (ISD Refresher ) A.10.4 IMEP Training
A.10.5 Child Health Training
A.10.5.1 IMNCI 20000
A.10.5.2 Facility Based Newborn Care
A.10.5.3 Home Based Newborn Care 10000
A.10.5.4 Care of Sick Children and severe malnutrition A.10.5.5 Other CH Training (pl. 20000 specify) A.10.6 Family Planning Training
A.10.6.1 Laparoscopic Sterilisation 34000 Training A.10.6.2 Minilap Training 33000
A.10.6.3 NSV Training 35000
A.10.6.4 IUD Insertion Training 112000
A.10.6.5 Contraceptive Update/ISD Training A.10.6.6 Other FP Training (pl. specify)
A.10.7 ARSH Training 15000
A.10.8 Programme Management Training A.10.8.1 SPMU Training
A.10.8.2 DPMU Training 20000
A.10.9 Other training (pl. specify) 40000
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A.10.10 Training (Nursing)
A.10.10.1 Strengthening of Existing Training Institutions/Nursing School A.10.10.2 New Training Institutions/School A.10.11 Training (Other Health Personnel) Promotional Trg of health A.10.11.1 workers females to lady health visitor etc. Training of AMNs, Staff A.10.11.2 nurses, AWW, AWS Other training and capacity A.10.11.3 building programmes A.11 PROGRAMME / NRHM MANAGEMENT COSTS
A.11.1 Strengthening of SHS /SPMU (Including HR, Management Cost, Mobility Support, field visits ) A.11.2 Strengthening of 5237000 DHS/DPMU (Including HR, Management Cost, Mobility Support, field visits ) A.11.3 Strengthening of Block 1603000 PMU (Including HR, Management Cost, Mobility Support, field visits ) A.11.4 Strengthening (Others) A.11.5 Audit Fees 50000 A.11.6 Concurrent Audit 120000 A.11.7 Mobility Support to 900000 BMO/MO/Others Total A 89752600 Mission Flexible Pool
ASHA B1 B1.1 Selection & Training of ASHA 1942000 B1.2 Procurement of ASHA Drug 297 3000 Kit B1.3 Incentive to ASHAs under JSY 7500000 Incentive under Family B1.4 Planning Services
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B1.5 Incentive under Child Health B1.6 Other Incentives to ASHAs 2761650 B1.7 Awards to ASHA's/Link workers B2 Untied Funds
B2.1 Untied Fund for CHCs 850000 B2.2 Untied Fund for PHCs 325000 B2.3 Untied Fund for Sub Centers 2040000 B2.4 Untied fund for VHSC 4870000
Annual Maintenance Grants B.3 B3.1 CHCs 1700000 B3.2 PHCs 400000 B3.3 Sub Centres 1960000 B4 Hospuital Strenghthening Upgradation of CHSc, PHCs, B4.1 District Hospitals to IPHS B4.1.1 District Hospitals B4.1.2 CHCs B4.1.3 PHCs B4.1.4 Sub Centres B4.1.5 Others Strenghthening of District sub 1000000 divisional hospitals, CHCs, B4.2 PHCs Sub Centre Rent and B 4.3 Contigencies Logistics Management/ B 4.4 Improvement New Constructions/ B 5 Renovation and Setting Up B 5.1 CHCs B5.2 PHCs B 5.3 SHCs/ Sub cetre Setting up of Infrastracture B 5.4 Wing for Civil work Govt Dispenseries/Other B 5.5 Renovations Construction of BHO, facility 2000000 B5.6 improvement, civil works Major Civil Works for 400000 B5.7 Operationali sation of FRUs B 5.8 Major Civil Works for
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Operationalisation of PHCs Civil Works for Operationalise Infection Management and Environment Plan at Health B 5.9 Facilities B 6 Corpus Grant to HMS/ RKS B6.1 District Hospitals 500000 B6.2 CHCs 1700000 1300000 B6.3 PHCs B6.4 Other or if not bifurcated as 1500000 above
District Action Plans B7 (Including Block, Village) 100000
Panchayati Raj Initiative B8 Constitution and Orientation of Community leader & of B8.1 VHSC,SHC,PHC,CHC etc Orientation Workshops, 100000 Trainings and capacity B8.2 building of PRI at State/Dist. Health Societies, CHC,PHC B8.3 Others
B9 Mainstreaming of AYUSH
B9.1 Activit ies other than HR
B10 IEC-BCC NRHM B.10 Strengthening of BCC/IEC Bureaus (state and district levels) B.10.1 Development of State BCC/IEC strategy B.10.2 Implementation of BCC/IEC strategy B.10.2.1 BCC/IEC activities for MH 307000 B.10.2.2 BCC/IEC activities for CH 12500 B.10.2.3 BCC/IEC activities for FP B.10.2.4 BCC/IEC activities for ARSH B.10.2.5 Other activities (please specify) B.10.4 Health Mela
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B.10.5 Creating awareness on declining sex ratio issue B.10.6 Other activities 778000 Mobile Medical Units 1680000 (Including recurring B11 expenditures) B12 Referral Transport B12.1 Ambulance/ EMRI B12.2 Operating Cost (POL) 12500 B13 School Health Programme 750000 B14 PPP/ NGOs Non governmental providers of B14.1 healt h care RMPs/TBAs
B14.2 PNDT and Sex Ratio
B14.3 Public Private Partnerships
NGO Programme/ Grant in 2350000 B14.4 Aid to NGO B14.5 Other innovations( if any)
B15 Planning, Implementation and Monitoring Community Monitoring B15.1 (Visioning workshops at state, Dist, Block level) B15.1.1 State level
B15.1.2 District level B15.1.3 Block level B15.1.4 Other B15.2 Quality Assurance 1100000 B15.3 Monitoring and Evaluation B15.3.1 Monitoring & Evaluation / HMIS B15.3.2 Computerization HMIS and e- governance, e-health B15.3.3 Other M & E B.16 PROCUREMENT B16.1 Procurement of Equipment B16.1.1 Procurement of equipment: 2600000 MH B16.1.2 Procurement of equipment: CH
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B16.1.3 Procurement of equipment: FP B16.1.4 Procurement of equipment: IMEP B16.1.5 Procurement of Others B.16.2 Procurement of Drugs and supplies B.16.2.1 Drugs & supplies for MH B.16.2.2 Drugs & supplies for CH 100000 B.16.2.3 Drugs & supplies for FP 2000 B.16.2.4 Supplies for IMEP B.16.2.5 General drugs & supplies for 200000 health facilities B.17 PNDT Activities B.18 Regional drugs warehouses B.19 New Initiatives/ Strategic 1186000 Interventions (As per State health policy)/ Innovation/ Projects (Telemedicine, Hepatitis, Mental Health, Nutition Programme for Pregnant Women, Neonatal) NRHM Helpline) as per need (Block/ District Action Plans) B.20 Health Insurance Scheme B.21 Research, Studies, Analysis B.22 State level health resources center(SHSRC) B23 Support Services B23.1 Support Strengthening NPCB B23.2 Support Strengthening Midwifery Services under medical services B23.3 Support Strengthening NVBDCP B23.4 Support Strengthening RNTCP
B23.5 Contingency support to Govt. dispensaries B23.6 Other NDCP Support Programmes B.24 Other Expenditures (Power Backup, Convergence etc)
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Routine Immunization C IMMUNISATION
C.1 RI strengthening project 2335000 (Review meeting, Mobility support, Outreach services etc) C.2 Salary of Contractual Staffs 84000 C.3 Training under 140000 Immunisation C.4 Cold chain maintenance 50000 C.5 Pulse Polio operating costs 360000 Total C 2969000 I NVBDCP 427000 1 Operational Cost 1.1 Mobility Support 1.2 Lab Consumables/ Materials 1.3 Review Meetings 1.4 Field Visits 1.5 Formats and Reports 1.6 Communication facility to Staffs 1.7 Repair of Laparoscopes 2 Human Resources 2.1 Remuneration to Contractual MPWs 2.2 Contractual LTs 2.3 Others 3 Trainings 3.1 Training for MPWs 3.2 Training for ASHAs 3.3 Training for M.O.s
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3.4 Training for para-medicals for MDA Other Training & Capacity 3.5 building programmes 4 Procurements 4.1 Procurement -Equipments 4.2 Procurement -Drugs & Supplies 5 ASHA Incentives 6 Referral Services 7 Innovations /PPP/NGOs 8 IEC-BCC Activities 9 Financial Aids to Medical Institutions II. NLEP 580000 1 Operational Cost 1.1 Mobility Support 1.2 Lab Consumables 1.3 Review Meetings 1.4 Field Visits 1.5 Office Expenditures, Formats and Reports 2 Human Resources Contractual Services (State 2.1 SMO, BFO cum AO, Admn. Assistant, DEO) 2.2 State Driver
2.3 District Drivers
3 Trainings
Training for Newly 3.1 appointed medical and para medical staffs Training for existing 3.2 medical and para medical staffs Other Training & Capacity 3.3 building programmes 3.4 Other Training & Capacity
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building programmes 4 Procurements 4.1 Procurement -Equipments 4.2 Procurement -Drugs & Supplies 5 ASHA Incentives 6 Referral Services 7 Innovations /PPP/NGOs 7.1 NGOs 7.2 Pvt. Sector 8 IEC-BCC Activities 9 Financial Aids to Medical Institutions III RNTCP 4439000 1 Operational Cost 1.1 Mobility Support to DOT Providers 1.2 Lab Consumables 1.3 Review Meeti ngs 1.4 Field Visits 1.5 Formats and Reports 2 Human Resources 2.1 Honorarium to DOT Providers 2.2 Contractual Staff Payments 2.3 Others 3 Trainings 3.1 Induction Training Other Training & Capacity 3.2 building programmes 4 Procurements 4.1 Procurement -Equipments 4.2 Procurement -Drugs & Supplies
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5 ASHA Incentives 6 Referral Services 7 Innovations /PPP/NGOs 8 IEC-BCC Activities 9 Civil Works 10 Financial Aids to Medical Institutions IV NBCP 2939000 1 Operational Cost 1.1 Mobility Support 1.2 Lab Consumables 1.3 Review Meetings 1.4 Field Visits 1.5 Formats and Reports 2 Human Resources 2.1 Ophthalmic Surgeon 2.2 Ophthalmic Assistant 2.3 Eye Donation Counselor 2.4 Others 3 Trainings Training /Capacity Building 3.1 for Health personnel’s 3.2 Training of Teachers & Others Other Training & Capacity 3.5 building programmes 4 Procurements 4.1 Procurement -Equipments 4.2 Procurement -Dru gs & Supplies 5 ASHA Incentives 6 Referral Services 7 Innovations /PPP/NGOs 8 IEC-BCC Activities
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9 Financial Aids to Medical Institutions V IDSP 1374000
1 Operational Cost
1.1 Mobility Support 10000 Sample transportation
1.2 Lab Consumables
Conducting Weekly Review & 5200 intersectoral meetings etc
1.3 Review Meetings 20000 Strengthening Surveillance
1.4 Field Visits
1. Registers 2. Annual Reports 32300 0 3. Case study report 4. Investigation report
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1.5
1. Telephone Charges 2.Broad Band Charges 3. AMC Contracts for IT Eqp Office Expenditures 164795 4. Office Stationaries
5. Office Renovation 6. Media Surveillance 7. Miscellanious
1.5 Formats and Reports
2 Human Resources
2.1 Remuneration of Epidemiologists 25000 Remunaration for 12 Months
2.2 Remuneration of Microbiologists 2.3 Remuneration of Entomologists 3 Consultant-Finance
3.1 Consultant-Training
3.2 Data Managers 13500 Remunaration for 12 Months
3.3 Data Entry Operators 8500 Remunaration for 12 Months
3.4 Wage for Cleaning staff 200 Office cleaning weekly for 52
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weeks 3.4 Others
4 Procurements
4.1 Procurement -Equipments
1. purchsing Printer/ Photostat 7000 toner twice a year
4.2 Procurement -Drugs & Supplies 7 Innovations /PPP/NGOs 10000 Lepto Death Prevention
8 IEC-BCC Activities 1.Trainings 44805 2.Posters Printing
Financial Aids to Medical 9 Institutions VI NIDDCP 14000 1 Operational Cost 1.1 Mobility Support 1.2 Lab Consumables 1.3 Review Meetings 1.4 Field Visits 1.5 Formats and Reports 2 Human Resources 2.1 IDD Control Cell- 2.2 Technical Officer 2.3 Statistical Assistant 3 LD C Typist 3.1 IDD Monitoring Lab- 3.2 Lab Technician
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3.3 Lab. Assistant 3.4 Others 4 Procurements 4.1 Procurement -Equipments 4.2 Procurement -Drugs & Supplies 7 Innovations /PPP/NGOs 8 IEC-BCC Activities 9 Financial Aids to Medical Institutions INTERSECTORAL E CONVERGENCE AYUSH 5539540 Monitoring & Evaluation 800000
Budget 2011-12
A - RCH 89752600 B - Additionalities 57956150 Variable Expenses under RCH 15871500 C - Immunisation 2969000 D - Disease control Programmes A) NVBDCP 427000 B) NLEP 580000 C) RNTCP 4439000 D) NBCP 2939000 E) IDSP 1374000 F) NIDDCP 14000 E – Intersectoral Convergence A) AYUSH 5539540 F - Monitoring & Evaluation 800000 Grand TOTAL 16, 67,90,290
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