FINAL National Rural Health Mission State Action Plan Uttar Pradesh (2009 - 2010) Department of Family Welfare Uttar Pradesh (As approved by Govt. of India) Contents Preface 1. UTTAR PRADESH – PROFILE .......................................................................... 1 2. KEY ACHIEVEMENTS & LESSONS LEARNT .................................................. 4 3. PROCESS OF PLAN PREPARATION .............................................................. 7 4. GOALS & OBJECTIVES .................................................................................... 8 5. THRUST AREAS FOR CONCERTED ACTION ............................................... 20 6. RCH II PROGRAMME OBJECTIVES & STRATEGIES ................................... 27 1. MATERNAL HEALTH .............................................................................. 27 2. CHILD HEALTH INTERVENTIONS ......................................................... 36 3. FAMILY PLANNING ................................................................................. 54 4. ADOLESCENT HEALTH ......................................................................... 62 5. URBAN RCH ............................................................................................ 64 6. INFRASTRUCTURE & HUMAN RESOURCES ...................................... 77 7. INSTITUTIONAL STRENGTHENING ...................................................... 80 8. TRAINING ................................................................................................ 85 9. PUBLIC PRIVATE PARTNERSHIPS (PPP) ............................................ 96 10. PCPNDT .................................................................................................. 99 11. BEHAVIOUR CHANGE COMMUNICATION (BCC) .............................. 105 12. PROCUREMENT ................................................................................... 123 13. PROGRAMME MANAGEMENT ............................................................ 125 14 ADDITIONAL COMPONENTS ............................................................... 135 7. BUDGET SUMMARY (PART A - RCH FLEXIPOOL) ..................................... 136 8. BUDGET DETAILS (PART A - RCH FLEXIPOOL) ........................................ 138 9. WORK PLAN (PART A - RCH II) ................................................................... 163 10. DISTRICT-WISE ALLOCATION (PART - A) ................................................ 179 i 11. MISSION FLEXIPOOL (PART – B) ............................................................... 181 1. ASHA SCHEME ..................................................................................... 181 2. VILLAGE HEALTH INDEX REGISTER (VHIR) ..................................... 186 3. STRENGTHENING OF TRAINING INSTITUTIONS ............................. 186 4. SUPPORT FOR PRE SERVICE TRAINING OF BASIC HEALTH WORKER MALE / FEMALE ................................................................... 187 5. STRENGTHENING AND UPGRADATION OF DHs & CHCs ................ 188 6. PROCUREMENT OF EQUIPMENTS FOR DOTS PLUS ...................... 193 7. MOBILE MEDICAL UNITS ..................................................................... 193 8. EMERGENCY MEDICAL TRANSPORT SERVICES ............................ 194 9. UNTIED GRANT TO HEALTH FACILITIES........................................... 197 10. ANNUAL MAINTENANCE GRANT (AMG) ............................................ 198 11. ANNUAL ASSISTANCE TO ROGI KALYAN SAMITIS (RKS) ............... 198 12. CAPACITY BUILDING OF ROGI KALYAN SAMITIS (RKS) ................. 199 13. ORIENTATION OF VHSC MEMBERS ON THEIR ROLES & RESPONSIBILITIES UNDER NRHM .................................................... 199 14. BIANNUAL ORIENTATION OF PRIs DURING BDC MEETINGS ......... 199 15. SAAS BAHU SAMMELAN ..................................................................... 200 16. REPAIRS OF REGIONAL DRUG WAREHOUSES ............................... 200 17. CONSTRUCTION OF DRUG WAREHOUSES ..................................... 200 18. OPERATIONAL EXPENSES OF DRUG WAREHOUSES AT DISTRICT LEVEL .................................................................................................... 200 19. CONSTRUCTION OF 110 CHCs .......................................................... 201 20. PROVISION OF ACCOMMODATION FOR EMERGENCY DUTY DOCTORS AT CHCs ............................................................................. 201 21. REPAIRS OF RESIDENCES AT CHCs ................................................. 201 22. CONSTRUCTION OF NEW SUB-CENTRES ........................................ 202 23. REPAIR OF SUB-CENTRES ................................................................. 202 24. ELECTRICITY PROVISION AT SUB-CENTRES .................................. 202 25. ESTABLISHING CLOSED USER GROUP (CUG) NETWORK ............. 202 26. SCHEME FOR MEDICAL OFFICERS AND NURSES FOR PURSUING POST-GRADUATION ............................................................................ 202 ii 28. DEPLOYMENT OF CONTRACTUAL AYUSH DOCTORS AT 24 HOUR NON-FRU CHCs AND PHCs ................................................................. 203 29. ESTABLISHING CONCURRENT AUDIT SYSTEM FOR NRHM .......... 203 30. OPERATIONALISATION OF HEALTH MIS .......................................... 204 30. DISTRICT ACTION PLANS (DAPs) ...................................................... 205 31. COMMUNITY MONITORING ACTIVITIES ............................................ 205 32. MANAGEMENT DEVELOPMENT TRAININGS .................................... 205 33. PROGRAMME MANAGEMENT ............................................................ 207 34. COLD CHAIN STRENGTHENING ......................................................... 207 35. IEC/BCC CAMPAIGN FOR PROMOTION OF PROPER HEALTH & HYGIENE BEHAVIOURS ...................................................................... 207 36. PROCUREMENTS................................................................................. 208 37. STRENGTHENING OF JE EPIDEMIC WARD AT BRD MEDICAL COLLEGE, GORAKHPUR ..................................................................... 210 38. HARDWARE FOR IMMUNIZATION ...................................................... 210 12. BUDGET SUMMARY (PART B – MISSION FLEXIPOOL) ............................ 211 13. ROUTINE IMMUNIZATION (PART C) - UIP PLAN ...................................... 213 A. ROUTINE IMMUNISATION PROGRAMME .......................................... 213 B. PULSE POLIO IMMUNIZATION ............................................................ 240 14. BUDGET SUMMARY - IMMUNIZATION STRENGTHENING (2009-10) ..... 241 15. NATIONAL DISEASE CONTROL PROGRAMMES (PART D) ................... 257 1. NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS ............. 257 2. NATIONAL LEPROSY ERADICATION PROGRAMME ........................ 267 3. INTEGRATED DISEASE SURVEILLANCE PROJECT ......................... 291 4. REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME ...... 304 5. NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME ... 325 6. NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME ....................................................................................... 344 16. BUDGET SUMMARY (PARTS A to D) : 2009-10 ......................................... 348 17. INTERSECTORAL CONVERGENCE (PART E) .......................................... 349 iii Annexes Self Appraisal of State PIP List of All Functional FRUs (2008-09) List of CHCs Proposed as FRUs in 2009-10 List of District Women Hospitals Proposed as FRUs in 2009-10 List of District Combined Hospitals Proposed as FRUs in 2009-10 List of CHCs/Block PHCs Working as 24 x 7 Facilities List of District Male Hospitals Record of Proceedings iv 1. UTTAR PRADESH – PROFILE Demographic Profile Uttar Pradesh, with an area of 0.24 million sq. kms, accounts for approximately 7 percent of the total landmass of the country. As per Census 2001, the State had a population of around 166 million and accounted for approximately 16 percent of the country's population. The current population of the State, according to the population projections, is nearly 187 million. For planning and development purposes, the State is divided into four distinct regions on the basis of homogeneity, contiguity and economic criteria. These regions are— Western, Central, Eastern and Bundelkhand. These regions are further subdivided in 18 divisions and 71 districts, Kanshi Ram Nagar being the newly formed district. The districts are divided into tehsils (304) and developmental blocks (820). In all, there are 107,164 revenue villages, approximately 682 cities and towns, 8135 Judicial Panchayats (Nyaya Panchayats) and 52,028 Gram Panchayats in the State (Census 2001) Uttar Pradesh is the 9th most densely populated State with a population density of 689 persons per sq. km (Census 2001), as against the national average of 324 persons per sq. km. Out of the total population of the State, more than 79 percent (13.15 crores) live in the rural areas, while the remaining 21 percent (3.45 crores) live in the urban areas. Since the majority of the population lives in the rural areas, agriculture is the primary occupation of the people in the State. However, there are variations across the districts, with districts like Lucknow, Ghaziabad, Meerut, Agra and Kanpur having relatively large urban populations Demographic Profile of Uttar Pradesh vis-à-vis India Indicators Uttar Pradesh India Population Density (2001) 689 324 Sex Ratio (2001) 898 933 Scheduled Caste (2001) 21% 16% Scheduled Tribe (2001) 0.1% 8% Literate Male (2001) 70%