AROGYA KERALAM WAYANAD PROGPROGRAMMERAMME IMPLEMENTATION PLAN 2011 --- 11121222 - 2 - 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 - 3 - Chapter 1 EXECUTIVE SUMMARY - 4 - 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. - 5 - 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. - 6 - Chapter II SITUATION ANALYSIS - 7 - 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 - 8 - 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 - 9 - 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 - 10 - 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% - 11 - 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 - 12 - 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 - 13 - CHAPTER III FUNDS ALLOTTED AND UTILIZED TILL 2009-10 EACH CATEGORY - 14 - 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 - 15 - 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)