MEETING STATE HEALTH
MISSION
NRHM
04-09-2009
NATIONAL RURAL HEALTH MISSION (2005-2012)
•
NRHM launched by Hon’ble Prime Minister on 12/4/2005.
•
100% by GoI for 2005-06 and 2006-07 and 85:15 from 2007-08 to 2011-12.
•
Aimed to ensure affordable, quality health care to the poorest house holds in
remotest areas.
•
Special focus on 18 low performing States which have weak public health indicators
and weak infrastructure.
•
Punjab is among the nine high performing States- Punjab, Haryana, Gujarat,
Maharashtra, Karnataka, Kerala, Tamil Nadu, Andhra Pradesh, West Bengal.
2
HISTORICAL PROSPECTIVE
• RCH-II (2005-2010) aimed at reducing IMR and MMR was
already in progress.
• Programme for control of various diseases were already in
progress for the last more than 15-20 years.
• Government felt the need to integrate all ongoing health
programme into one programme and consolidate the work
being done by other departments.
• NRHM encompasses –
– RCH – II including immunization
– All individual disease control programme
– Flexi-pool as per requirement of the State
– Convergence with other departments like AYUSH, Water
Supply and Sanitation, Nutrition, Woman and Child
Development, Rural Development and Panchayats.
NRHM OBJECTIVES
• Universalized access to quality health care especially to rural poor
with focus on women and children.
• Reduced Infant Mortality Rate and Maternal Mortality Rate.
• Ensuring population stabilization & gender equity.
• Prevention and control of communicable and non-communicable
diseases.
• Access to integrated comprehensive primary health care.
• Mainstream AYUSH- Integration of AYUSH with mainstream health
institutions .
• Emphasis on potable drinking water, hygiene, sanitation and
nutrition.
4
NRHM STRATEGIES
•
Decentralization of the process of health planning and management from Village to
District level.
•
Involvement of PRIs and Village Health & Sanitation Committees.
•
Up-gradation of existing health institutions from Sub Centres to District Hospitals as
per Indian Public Health Standards (IPHS).
•
Flexible financing- untied funds for filling up the gaps in infrastructure and other
related activities.
•
Manpower requirement- recruitment of doctors, and paramedical staff in relation to
Woman & Child Health.
•
Improved management through capacity building- provision of computers, computer
operators, establishment of State, District and Block Programme Management Units
(PMUs).
•
Integration of AYUSH with the mainstream health institutions including recruitment
of Ayurvedic/Homeopathy doctors at PHC and CHC level.
•
Intersectoral Convergence with Nutrition, water and sanitation programmes.
•
Promotion of Public Private Partnership for achieving public health goals.
NRHM IN BRIEF
• Reduction in IMR and MMR through institutional deliveries Recruitment of Gyne, Paed, Anaesth, Medical Officers (Female), Staff
Nurse, ANM, ASHAs, Various Incentives, Upgradation of PHC, CHC for
24 hrs. delivery.
• Decentralization – Transfer of funds where needed. Untied funds and
Maintenance Grant for SC, PHC, CHC; Funds for Rogi Kalyan Samiti,
VHSC.
• Involvement of Community – State Health Society, District Health
Society, Planning and Monitoring Committees at Block, District and State
Level, Village Health and Sanitation Committees.
• Convergence – No separate funds but Department of Health expected to
work in close coordination with other Departments like – Women and
Child (ICDS), Water Supply and Sanitation, Education and Department of
Rural Development. Besides AYUSH to be integrated with Allopathic
Health Institutions.
KEY COMPONENTS OF NRHM
System strengthening
Community Partnership
Improved services
Infrastructure development
Village level planning
Monitoring through
computerisation
ASHA
Improved financial
management &
Human Resource
Village Health &
Nutrition Days
Specialist Services – On
call/contract
Public Private Partnership
Village Health &
Sanitation Committees
Immunization
strengthening
Telemedicine
Mobile Medical Units
Intra & inter sectoral
convergence
Increased involvement of
PRIs
24-Hour- delivery
services
Emergency Obstetric
Services
IMNCI
Adolescent health
Family welfare services
Accessibility, Approachability and Quality
NRHM – ILLUSTRATIVE STRUCTURE
Health Manager
BLOCK LEVEL HEALTH OFFICE –---------------
Accountant
Store Keeper
Accredit private
providers for public
health goals
100,000
Population
100 Villages
BLOCK
LEVEL
HOSPITAL
Ambulance
Telephone
Obstetric/Surgical Medical
Emergencies 24 X 7
Round the Clock Services;
30-40 Villages
Strengthen Ambulance/
transport Services
Increase availability of Nurses
Provide Telephones
Encourage fixed day clinics
CLUSTER OF GPs – PHC LEVEL
3 Staff Nurses; 1 LHV for 4-5 SHCs;
Ambulance/hired vehicle; Fixed Day MCH/Immunization
Clinics; Telephone; MO i/c; Ayush Doctor;
Emergencies that can be handled by Nurses – 24 X 7;
Round the Clock Services; Drugs; TB / Malaria etc. tests
5-6 Villages
GRAM PANCHAYAT – SUB HEALTH CENTRE LEVEL
Skill up-gradation of educated RMPs / 2 ANMs, 1 male MPW FOR 5-6 Villages;
Telephone Link; MCH/Immunization Days; Drugs; MCH Clinic
VILLAGE LEVEL – ASHA, AWW, VH & SC
ASHAs, AWWs in every village; Village Health & Nutrition Day
Drug Kit, Referral chains
NRHM FIVE COMPONENTS
(PART- A)
(PART- B)
(PART- C)
RCH AND RELATED
ACTIVITIES
(RCH FLEXI POOL)
INITIATIVES UNDER NRHM
OTHER THAN RCH
(MISSION FLEXI POOL)
IMMUNIZATION
STRENGTHENING
PROGRAMME
(PART- D)
(PART- E)
NATIONAL DISEASE
CONTROL PROGRAMMES
INTER SECTORAL
CONVERGENCE
SCHEMES
INSTITUTIONAL ARRANGEMETS UNDER
NRHM
STATE LEVEL
• State Health Mission chaired by Hon’ble Chief Minister.
• State Health Society chaired by Chief Secretary.
• Merger of all vertical societies into State Health Society.
• Signing of MoU with GoI.
• State Level Planning and Monitoring Committee headed by
Hon’ble Health Minister
INSTITUTIONAL ARRANGEMETS UNDER
NRHM
DISTRICT LEVEL
• District Health Mission chaired by Chairman Zila Parishad.
• District Health Society chaired by Deputy Commissioner.
• District Planning and Monitoring Committee headed by Zila
Parishad Chairman.
• Rogi Kalyan Samities in District/Sub Divisional Hospitals.
• Merger of all vertical societies into District Health Society.
..contd.. INSTITUTIONAL ARRANGEMETS UNDER NRHM
BLOCK LEVEL
• Block Planning and Monitoring Committees at Block PHC.
• PHC Planning and Monitoring Committees at PHC level.
• Rogi Kalyan Samities for CHCs
VILLAGE LEVEL
• Village Health & Sanitation Committees in each village.
• Accredited Social Health Activist (ASHA) for every 1000
population.
HEALTH INDICATORS
SN
1
2
3
CATEGORY
Crude Birth Rate
(SRS 2007)
Total Fertility Rate
(SRS 2007)
NFHS-III
Death Rate
(SRS 2007)
4
Sex Ratio at Birth
(SRS 2007)
5
Sex Ratio (0 to 4 years)
(SRS 2007)
INDIA
PUNJAB
23.1
17.6
2.7
2.7
2.0
2.0
Tamil Nadu (1.6), Kerala (1.7), AP (1.9), HP (1.9),
W.B.(1.9)
7.4
7.0
J &K (5.8), W. Bengal (6.3), Haryana (6.6),
Maharashtra (6.6), Kerala (6.8), Rajasthan (6.8)
837
AP (915), Assam (939), Bihar (909), Chatisgarh
(969), Himachal (931), Jharkhand (927), Karnataka
(926), Kerala (958), Madhya Pradesh (913), Orissa
(933), TN (944), W. Bengal (936)
838
AP (942), Assam (950, Bihar (940), Chatisgarh
(954), Himachal (945), Jharkhand (926),
Karnataka (925), Kerala (962), Madhya Pradesh
(935), Orissa (952), TN (950), W. Bengal (964)
901
914
BETTER STATES
Kerala (14.7), Himachal Pradesh (17.4), Tamil Nadu
(15.8)
TOP
HEALTH INDICATORS :
MATERNAL HEALTH
SN
Category
India
Punjab
Better States
6
Maternal Mortality
Ratio (SRS 2001-03)
(SRS 2004-06)
301
254
178
192
Gujarat (172), Haryana (162),
Kerala (110), Tamil Nadu
(134), Maharashtra (149)
7.
Infant Mortality Rate
(SRS 2007)
NFHS-III
55
57
43
42
Kerala (15), Tamil Nadu (31),
Maharashtra (38), Himachal
Pradesh (36)
TOP
HEALTH INDICATORS :
ANTE NATAL CHECK UP
SN
Category
8.
Ante Natal Care
(3 or more visits)
NFHS-III
DLHS – III
9.
Institutional deliveries
NFHS – III
DLHS – III
Pregnant women who
are anemic (%age)
10.
NFHS – III
DLHS-III
India
Punjab
50.7
75.3
72.5
65.1
41
47
57.9
53
63.3
41.6
Better States
Kerala (93.5), Tamil Nadu (96.5),
Maharashtra (75.3)
Andhra Pradesh (71.8), Goa
(96.3), Karnataka (65.1), Kerala
(99.4), Maharashtra (63.6),
T. Nadu ( 94.1)
Goa (36.9), HP (37.0), Kerala
(33.1), Manipur (36.4)
TOP
HEALTH INDICATORS :
CHILD HEALTH
SN
11
12
Category
Breast Feeding (%age)
(i) Children under 3
years
breast fed within one
hour of birth
NFHS-III
DLSH-III
%age of children fully
immunized
NFHS-III
DLSH-III
India
23.4
40.2
44.0
54.1
Punjab
10.3
44.6
60.0
79.9
Better States
Assam (65.7), Goa
(61.5), Kerala (65.3),
Meghalya
(75),
Mizoram (78.4), Orissa
(63.7), Sikkam (64.7),
Tamil Nadu (77.5)
Goa (93.4), Himachal
Pardesh (82.3), Tamil
Nadu (83.2)
TOP
Health Indicators – India and World
Sr.
No.
Item
India
Best Countries
Neighboring countries
1.
Infant Mortality Rate
56
Iceland
(2)
Norway, Sweden
& Japan
(3)
1.
2.
3.
4.
5.
Sri Lanka
China
Bangladesh
Nepal
Pakistan
(12)
(23)
(54)
(56)
(79)
2.
Maternal Mortality Ratio
450
Ireland
(1)
Sweden & Italy (3)
1.
2.
3.
4.
5.
China
Sri Lanka
Pakistan
Bangladesh
Nepal
(45)
(58)
(320)
(570)
(830)
3.
Life Expectancy at Birth
63.7
Japan
(82.3)
Hong Kong (81.9)
1.
2.
3.
4.
5.
China
Sri Lanka
Pakistan
Bangladesh
Nepal
(72.5)
(71.6)
(64.6)
(63.1)
(62.6)
Source Human Development Report 2007-08
TARGETS FOR PUNJAB UNDER NRHM
At the start of RCH
SRS 1998-1999
Present
Status
2008-2009
Target by
2009-2010
Total Fertility Rate
2.5
2.1
1.8
Infant Mortality Rate
49
43
<30
199
178
192
<100
Institutional Deliveries
37.5%
(NFHS II)
52.5
80%
ANC Check-up with 03
contacts
58.4%
(NFHS II)
72.5
100%
Indicators
(per 1000 live births)
Maternal Mortality Ratio
(per 100000 live births)
TOP
HEALTH INSTITUTIONS
PUBLIC
SECTOR
PRIVATE
SECTOR
MEDICAL COLLEGES
3
5
DISTRICT HOPITALS
20
SUB DIVSIONAL HOSPITALS (Total no. of Sub
Divisions 78)
36
COMMUNITY HEALTH CENTRES
129
INSTITUTIONS
BLOCK PHCs
983
(114 PHSC, 15 DHS)
118
- BLOCK PHCs AND SDH
5
- BLOCK PHCs AND CHCs
72
- ONLY (EXCLUSIVE) BLOCK PHCs
41
TOP
HEALTH INSTITUTIONS
INSTITUTIONS
TOTAL PHCs – EXCLUSIVE
PUBLIC
SECTOR
394
- PHCs (MINI PHCs) – EXCLUSIVE
353
- PHCs BLOCK – EXCLUSIVE
41
TOTAL PHCs – EXCLUSIVE + AT CHC/SDH
394 + 77 = 471
SUBSIDIARY HEALTH CENTERS
1187
SUB-CENTRES AT VILLAGE LEVEL
2950
CLINICS /DISPENSARIES
PRIVATE
SECTOR
3046
TOP
FINANCIAL REPORT FOR THE YEAR 2005-10
Rs. in lakhs
Approved Plan
Year
Opening
Balance
GOI
State
Share
15% from
Releases
Total
2007-08
1
2
3
4
Unspent
Expendit % of
Balance
Funds
Funds
Total
ure
Utilizatio (Bank
released released Funds
Balance
Incurred
n
by GOI by State Available
SHS)
5
6
7
8 (2+6+7)
9
10
11 (8-9)
9820.8
8103.3
0
8386.45
5971.37
61%
2415.08
16272
14194
0
16609.1
8326.24
46%
8282.9
Not
2005-06
283.2
9820.8
Required
Not
2006-07
2415.1
16272
2007-08
8282.9
16197
2841
19038
11516.2
0
20504.2 10469.28
53%
9329.89
2008-09
9329.89
17324
2600
19924
17821
2884
30034.98 17524.71
58%
12510.57
2009-10
12510.57
(July 09)
21805
3271
25245
5410
0
17920.57 4911.33
21.52
13009.24
Required
TOP
FINANCIAL REPORT FOR THE YEAR 2005-10
Opening Balance 2009-10
District Health Societies
State Health Society
-
Rs. 12510.57 Lakhs
Rs. 5686.07 Lakhs
Rs. 6824.50 Lakhs
Closing Balance 2009-10 (July 2009)
District Health Societies
State Health Society
-
Rs. 13009.24 Lakhs
Rs. 10673.15 Lakhs
Rs. 2336.09 Lakhs
TOP
FINANCIAL REPORT FOR THE YEAR 2005-10
Status of State Contribution
2008-09
GOI share as per PIP
State share
Total
Release by GOI
Matching State share
Released by State
Balance yet to be received
-
173.23 crore
26.00 crore
199.23 crore
178.03 crore
31.35 crore
21.79 crore
9.56 crore
-
218.05 Crore
32.71 Crore
1.69 Crore
252.45 Crore
54.10 Crore
9.55 Crore
9.55 Crore
2009-10
GOI share as per PIP
State share
Unspent Balance
Total
Release by GOI
Matching State share
yet to be received
TOP
ANNUAL PLAN 2009-10
Rs. In lakhs
Part
A
B
C
D
Component
RCH - Flexipool
Maternal Health, Child Health, Family Planning, ARSH,
Infrastructure, Training & BCC.
NRHM- Additionalities
Mandatory Funds- Untied Funds, Annual Maintenance Grant &
Corpus Grant to RKS
Upgradation of Institutions- Civil Works, Drugs, Equipment,
Mobile Medical Units, Emergency Response Services &
Programme Management
Immunization
National Disease Control Programme
Approved
Allocation
6412
11276
280
1365
- RNTCP, NLEP, IDSP, NVBDCP, NIDDCP & NPCB
E
Inter sectoral Convergence
AYUSH, Convergence with PRIs, ICDS & PHED
Family Welfare Direction & Administration -2211
Total
0
5912
25245
TOP
Important Items of Expenditure – Rs. 252 Cr.
PARTICULARS
Salaries under NRHM
Mandatory Provisions for Untied Funds & Annual
Maintenance Grant
Upgradation of health institutions
National Disease Control Programmes
Immunization
Maternal Health
Family Planning
Training
Behaviour Change Communication
AMOUNT (in
Crores)
100.86
28.12
14.20
13.65
2.80
6.10
11.17
6.54
3.67
TOP
Important Items of Expenditure …contd.
PARTICULARS
AMOUNT
(in Crores)
Construction & Repair of SCs
8.65
Drugs for PHCs/CHCs/SDHs/DHs
7.18
Equipment for PHCs/CHCs/SDHs/DHs
3.97
Recurring Cost of MMUs
3.60
ASHA Training
Emergency Response Services
School Health Programme
Total
4.49
25.61
2.00
252.45
TOP
ACHIEVEMENTS
2008-09 & 2009-10
(July 09)
TOP
RECRUITMENTS-SUMMARY
Filled up during
2005-06
to
2007-08
Filled up
during 200809
Filled up
during 2009-10
Total Filled up
Vacant
SN
Category
Total
Sanctioned
1
SPMU
48
32
16
2
41
7
2
DPMU
140
71
72
20
140
0
3
BPMU
394
228
118
53
394
0
Gynae
60
13
13
9
21
39
Paed.
60
14
11
6
24
36
Nurses
560
180
120
65
347
213
MO (F)
196
20
54
36
86
110
Nurses
588
174
129
155
403
185
Gynae
15
-
-
10
10
5
0
134
17
154
14
59
-
43
52
116
230
0
1338
1338
130
3231
791
4
5
FRU
PHC
24x7
DHs
6
MMU
168
7
MO - PHCs
95
8
MPHW(F) – Urban
Slums
230
9
ANMs – Sub Centres
1468
Total
4126
330
1062
2180
373
TOP
PART A- RCH FLEXI POOL
Rs. In lakhs
SN
Sub Components
Allocation
Expenditure
2008-092008-09
Maternal Health ( Referral
1
Transport, VHND etc.)
Janani Suraksha Yojna
( JSY, Incentive to ASHA)
Allocation
Expenditure
2009-10 (up to July 09)
235.00
444.26
120.00
160.00
186.00
417.18
490.00
150.35
2
ASHA
334.50
71.18
0
0
3
Child Health & IMNCI
86.15
7.37
25.30
0
4
Family Planning
920.60
835.82
1116.50
267.08
5
ARSH
27.07
15.75
38.23
6.78
135.60
155.42
165.60
77.97
64.84
26.91
62.80
2.29
442.50
77.53
295.00
51.00
6
7
(Compensation)
Urban RCH ( Salary of
MPHW (F))
PNDT Sex Ratio (Awards to
Panchayat, Decoy patients,
Informers, sting operations)
Innovations / PPP/NGO
PART A- RCH FLEXI POOL
(Contd..)
Rs. In lakhs
SN
Sub Components
Allocation
Expenditure
2008-09
8
Infrastructure & Human
Development (Specialist
Doctors,, Female Medical
Officers, SNs)
Logistic Management
Quality Assurance and Infection
Control Programme
Allocation
Expenditure
2009-10 ( up to July 09)
1558.50
664.12
2547.39
314.27
323.34
170.23
61.76
53.93
461.88
151.00
654.09
28.13
291.76
254.03
367.82
47.97
122.50
437.71
53.55
34.64
414.22
97.78
6412.26
1292.19
HMIS Monitoring and Evaluation
9
10
11
Training
Behaviour Change
Communications
Procurement
13
Programme management Units
SPMU and DPMUs
347.26
278.13
12
Flexi pool
157.50
112.96
5695.00
4119.60
Total A (RCH II)
ACHIEVMENTS - PART A
Reproductive & Child Health Programme
Reproductive and Child Health Programme focus on reducing
MMR and IMR. Presently MMR of the State is 192 and IMR is
43. Target is to reduce MMR less than 100 and IMR to less than
30 by 2010.
This can be reduced only by improving ANC coverage and
promoting institutional deliveries.
State focuses on Up gradation of institutions and community
mobilisation.
TOP
ACHIEVMENTS - PART A
MATERNAL HEALTH
(1) Up-gradation of 196 PHCs to 24x7 PHCs
– 75 PHCs upgraded to 24x7 PHCs in 2007-08, 26 PHCs in
2008-09 and 95 PHCs in 2009-10 for providing 24 hours
delivery services. Total upgraded 196.
– In each 24x7 PHC, 1 Medical Officer (Female) and 3 Staff
Nurses on contract basis are being provided.
– Out of 196 Medical Officer (F), 86 posts have been filled up
leaving 110 posts vacant.
– 403 Staff Nurses are in position (Target - 588).
– Generator set provided at 75 PHCs and for remaining 26 the
process is on.
– Labour room etc. constructed.
TOP
ACHIEVMENTS - PART A
MATERNAL HEALTH (Contd..)
(2) Up-gradation of 114 CHCs to FRUs
– 50 CHCs in 2007-08, 10 in 2008-09 and 52 in 2009-10
upgraded to First Referral Units (FRUs). Facility for a
complicated delivery including blood transfusion.
– 1 Gynecologist, 1 Pediatrician and 5 Staff Nurses to be
appointed.
– So far 21 Gynecologist, 24 Pediatricians have been appointed.
Anesthetists on call in all the FRUs.
– 347 Nurses are in position (Target – 560).
TOP
ACHIEVMENTS - PART A
MATERNAL HEALTH (Contd..)
(3)
•
Signages for these 101
and
60
institutions
developed. Order given.
•
On line monitoring of
performance of these
institutions
through
PEC, work given.
•
Biometric based on-line
attendance system for
these institutions.
TOP
ACHIEVMENTS - PART A
MATERNAL HEALTH (Contd..)
(4) Recruitment of ANMs :
– 486 ANMs recruited in December 2008 to fill up all the
vacant post of ANMs in the Sub-Centers (2858) under
Central Government Scheme 2211.
– 1161 ANMs recruited in December 2008 as 2nd ANM for
the Sub-Centers having population of 6000 or more.
– All these ANMs have been recruited district wise and there
is no provision for their transfer. They can never be
transferred outside the district.
TOP
ACHIEVMENTS - PART A
MATERNAL HEALTH (Contd..)
(5) Village Health and Nutrition Day :
– PIP 2008-09 : Rs. 1.10 crore
– The amount has been released and a sum of Rs.7.71 lac has
been utilized.
– Work started late in 2008-09 and would be systematized in
2009-10.
(6) Abolition of user fee for delivery related work in
Govt. Hospitals (Rs. 300/900)
TOP
ACHIEVMENTS - PART A
MATERNAL HEALTH (Contd..)
(7)
Promotion of Breast feeding : Rs. 25 lakh initiative through
Breast Feeding Promotion Network of India (BPNI) in two
districts – GDS and FZR for promotion of Breast Feeding. Project
includes Training of Middle Level Trainers and the front line
workers on breast feeding, complementary feeding and HIV
counseling through Breast Feeding Promotion Network of India
(BPNI). 16,000 (ASHAs & ANMs) to be trained as Front Line
Workers.
TOP
ACHIEVMENTS - PART A
ASHA
• One ASHA to cover 1000 population. No pay but incentives
based on performance.
• Important incentives – Rs. 50/- to 200/- for delivery,
Immunization, family planning, RNTCP, Blindness Control,
Toilet Promotion, Registration of Births and Deaths, Intimation
regarding death of mother and infant etc.
• 17279 ASHA selected in the State, 163 yet to be selected.
• ASHA training for Module-1 completed
• In the FY 08/09, Rs. 301 lakh was disbursed to ASHAs for
various incentives
• In the FY 09/10 upto June 2009 – Rs.197.46 lakh. have been
spent for ASHA.
• In the FY 09/10 upto June 2009 – Rs. 105.83 lakh was distributed
to ASHA for various incentives.
TOP
ACHIEVMENTS - PART A
ASHA
• Provision of Rs. 4.49 crore for training of ASHAs in the PIP 2009-10.
•
•
•
•
•
•
•
•
In the FY 2008-09
Training at the State level for district trainers of ASHA completed in July 2008.
Training at the District level for Block level trainers completed in August, 2008.
Master Trainers of ASHA include members of different departments like
Education, Social Security, Women and Child Development, Rural
Development.
Mother NGOs are also trained as Master trainers of ASHA at State and District
level.
Training at the Block level for ASHAs has been conducted and 15203 ASHAs
trained.
ASHA Module has been translated in Regional Punjabi language.
Training of ASHAs at Block level planned through credible and capable health
NGOs in 4 districts.
ASHA Drug Kit has been procured and distributed to ASHAs after the training
of ASHAs at Block level.
TOP
ACHIEVMENTS – PART A
MATERNAL HEALTH (Contd…)
(8) Posting Position of Gynecologists/ Female Medical Officer
NRHM
SN
1
2
Name of the
Institution
DH – Gynae
SDH – Gynae
Regular
Inst. Upgraded
upto 2008-09
36
Inst.
Upgraded
upto 2009-10
No
Gynae
/FMO
10
1
33
-
-
6
3
CHC – Gynae
69
12
9
33
4
24 x 7 PHC – FMO
3
50
36
108
5
Non Sanctioned Posts
11
6
Gynae administrative
post
27
TOTAL
TOP
ACHIEVMENTS - PART A
MATERNAL HEALTH (Contd..)
(9) Institutional Deliveries in Govt. Institutions: 2008-09
SN
Institute/ Category
Institutional
Deliveries
2008-09
Institutional
Deliveries
2007-08
Difference In
No. of
Deliveries
%age
Increase over
2007-08
1
DH
22209
19991
2218
11.09
2
SDH
14270
13100
1170
8.93
(a) CHCs(PHSC)
13535
8248
5287
64.1
(b) CHCs(DHS)
874
281
593
211.03
4
CHCs as FRUs
8928
4693
4235
90.24
5
24x7 PHCs
6752
1090
5662
519.45
66451
44451
22000
49.49
3
6
STATE TOTAL
TOP
INSTITUTIONAL DELIVERIES IN GOVT.
APRIL – JULY 09:
SN
Institute/ Category
Institutional
Deliveries 2009-10
Institutional
Deliveries 2008-09
%age Increase over
2008-09
1
DH
7301
5996
21.76
2
SDH
4945
3756
31.6
12246
9752
25.57
(a) CHCs(PHSC)
6229
3275
90.2
(b) CHCs(DHS)
383
225
70.22
4
CHCs as FRUs
3999
2213
80.70
5
PHCs
3358
1798
66.76
(a) 24x7 PHCs
3532
1638
115.63
Satellite
Hosp+RH+Others
213
169
36.03
17714
9318
90.10
1931
1731
11.55
31891
20801
53.31
Sub total (Urban)
3
6
Sub total (Rural)
7
8
Medical Colleges+ ESI
Hosp+ other allied Inst
STATE TOTAL
DELIVERIES – RURAL/URBAN
Rural Area Institutions
% age increase
Urban Area Institutions
% age increase
TOTAL
% age increase
2007-08
2008-09
10065
23511
34420
133.59
43019
14177
44485
24.98
66530
24548
49.56
2009-10
(Upto July)
10371
43.53
TREND- MONTH WISE INSTITUTIONAL DELIVERIES IN
GOVT. INSTITUTES (2007-08 , 2008-09 & 2009-10)
8000
2007-08
7473
2008-09
2009-10
6781
7000
6586
6067
6222
6159
6101
6055
5848
6000
5830
5458
5695
5158
5000
4465
4641
3838
4000
4395
4364
4164
3974
3342
3864
3640
3301
3000
3043
3227
3110
2762
2000
1000
0
TOP
JANANI SURAKSHA YOJANA
Estimated Number of Cases :
Estimated number of deliveries in a year in the State of Punjab
= 5,00,000
Estimated number of deliveries of BPL/SC/ST @ 35%
= 1,75,000
Estimated number of Beneficiaries upto 2 living Children @ 50% = 87,500
Financial Assistance :
Home Delivery
-
Rs. 500
Institutional Delivery
-
Rs. 600/ 700 for Urban and Rural women
TOP
ACHIEVMENTS - PART A
JANANI SURAKSHA YOJANA (Contd..)
Yearly Progress JSY :
Year
Number of Beneficiaries
Expenditure
(Rs. In Lakhs)
For Home/
Non
Institutional
Delivery
For
Institutional
Delivery
Total
2005-06 (Full)
7489
4106
11595
70.99
2006-07 (Full)
9466
6613
16079
88.69
2007-08 (Full)
16453
12823
29256
170.90
2008-09
40350
27561
67911
383.92
2009-10 Upto July
15109
8886
23995
TOP
ACHIEVMENTS - PART A
PNDT & SEX RATIO
•
•
•
Sex Ratio in the age group 0-6 was 798 as per 2001 census. As per latest SRS data
it has increased from 796 in 2001 to 838 (0-4 age group) in 2006.
A campaign has been launched to strictly enforce the provisions of PNDT Act1994. There are 1356 Ultrasound Centres in the State.
Action taken so far :
–
–
–
•
•
The licenses of 305 Centres were suspended or cancelled. 99 Court Cases/FIRs launched in the
State for violation of the act.
10 persons have been convicted for violation of PNDT Act and have been awarded
fine/imprisonment varying from 3 months to 3 years.
11 Panchayats awarded Rs. 3 lac each during year 2006-07.
Incentives in force:
–
–
Awards to Panchayats having > 1000 population.
Awards to decoy patients (Rs. 10,000/-).
–
–
Awards to Informers (Rs. 25,000/-)
Awards for sting operations (Rs. 50,000/-)
Fresh Sex Survey : Contract for survey of sex ratio for 25% population awarded in October
2008 to an agency, report expected by first week of March 2009.
TOP
ACHIEVMENTS - PART A
PNDT & SEX RATIO (Contd..)
Other Schemes for female child :
• Balri Rakshak Yojna (Health Department)
• Kanya Jagriti Jyoti Scheme (Woman and Child)
•
•
•
•
Mahila Jagriti Yojna and Swayamsidha
Kishori Shakti Yojana (Woman and Child)
Dhan Lakshmi (GoI)
Nanhi Chhan
TOP
ACHIEVMENTS - PART A
INNOVATIONS – SURAKHIT JANEPA YOJANA
(PPP)
• Rs. 2 crore provided in PIP 2008-09 for private health
institutions for deliveries in BPL/ SC families.
• Rs. 4100 per delivery provided in the original
guidelines.
• We have now vide letter dated 11/2/2009 revised the
rates to Rs. 1700 per delivery and authorized the
District Health Societies to empanel private health
institutions.
• The scheme would be implemented till 30/10/2009.
TOP
ACHIEVMENTS - PART A
NGOs
•
•
•
•
•
A sum of Rs. 2.42 crore has been provided for NGOs in the PIP of 2008-09.
MNGO/ FNGO scheme was launched in 6 districts – Ropar, SAS Nagar,
Patiala, Nawanshehar, Fatehgarh Sahib and Ferozepur during 2007-08 and their
second installment of Rs. 15 lac per district has been released to 3 MNGOs in 6
districts.
MNGO/ FNGO scheme has been extended to 8 more districts in the current year
2008-09. Applications were invited and 8 MNGOs have been selected. These
MNGOs has been given grant-in-aid of Rs. 15.00 lakh per district.
For the remaining 6 districts applications have been invited and field appraisals
conducted at district level. The 5 MNGOs has been recommended by State
NGO Committee for final approval of GOI.
Service NGOs : The 2 Service NGOs for Ludhiana and Amritsar have been
given Rs. 15 lac each. SNGOs for 2 districts Bathinda and Gurdaspur State
NGO Committee has recommended for approval of GOI.
TOP
ACHIEVMENTS - PART A
TRAINING
2008-09
Planned
20 Types
Employees
(7574)
Conducted
100%
(5540)
Achievement
60-100%
(73.14%)
2009-10
Expenditure
1.30 cr
Planned
20 Types
Employees
Conducted
All Started
Achievement
70-95%
Expenditure
22.8 lacs
Strengthening of Training Centres – State of Strengthening of Training Centres – 1.80
the art equipments supplied to all Training Crores earmarked for repair/ renovation and
Centres
upgradation – Work being done by PHSC,
Mohali
ACHIEVMENTS - PART A
HMIS – MONITORING AND EVALUATION
• NHSRC – HMIS: Data from April 2008 onward
is being uploaded on the HMIS portal as desired
by GoI.
• Data Block wise from November 2008 uploaded
at district level. SAs from Blocks come to the
district headquarter to upload the data.
TOP
ACHIEVMENTS - PART A
CIVIL REGISTRATION SYSTEM
• Birth and death registration – As per the latest data
the registration in the State is nearly 95%.
• There is a provision of Rs. 0.40 crore in the PIP
2008-09 and of Rs.0.79 Crore in the PIP 2009-10 for
computerization of Civil Registration System (CRS).
• EoIs for digitization and computerization of CRS
were invited in January 2009 and WIPRO is taking
up two districts under e-governance project. State
may allot the work of CRS to WIPRO for remaining
districts on successful completion model of two
districts.
TOP
ACHIEVMENTS - PART A
BCC
UNDER THE BCC/IEC COMPONENT OF NRHM PUNJAB, THE FOLLOWING
ACTIVITIES HAVE BEEN EXECUTED
Funds at a glance -2008-09
Total budget
: Rs. 291.76 Lacs
Total expenditure till 31-3-2009
: Rs. 254. Lacs
Utilization of Funds
100%
Funds at a glance -2009-10
Total budget
: Rs. 367.82 Lacs
Total expenditure till 30.07-2009
: Rs. 47.97 Lacs
TOP
TRANSLATION AND PRINTING
•
•
NRHM material was translated and prepared.
Detailed guidelines were circulated to
–
–
–
–
–
Sarpanches,
ASHA,
ANM,
SMOs,
Gynecologists and others involved.
TOP
PART B- NRHM ADDITIONALITIES
Rs. In lakhs
SN
Sub Components
2008-09
2009-10
B
NRHM Additionalties
Allocation
Expenditure
Allocation
Expenditure
upto July 2009
a
Village Health & Sanitation
Committees
1230.00
1824.44
1273.80
197.16
b
ASHA - proposed under RCH II
0
449.00
213.55
c
SC Untied Fund & Maintenance
286.20
301.94
285.80
4.29
121.00
108.78
99.00
4.02
64.00
54.01
63.00
31.58
d
e
PHC Untied Fund &
Maintenance
CHC Untied Fund &
Maintenance
f
Annual Maintenance Grant
162.00
199.25
454.00
22.61
g
Mobile Medical/ Health Units
397.40
859.75
360.00
65.25
h
Upgradation of CHC
1091.80
625.53
811.40
793.41
I
Upgradation of PHC
821.43
850.00
658.62
33.92
j
Upgradation of SC
725.38
145.79
1551.88
275.84
PART B- NRHM ADDITIONALITIES (Contd..)
Rs. in lacs
SN
Sub Components
2008-09
2009-10
Allocation
Expenditure
Allocation
Expenditure (Upto
July 2009)
k Upgradation of SHC
600.00
96.00
0.00
21.45
l
100.00
0.00
488.00
0.00
m Upgradation of DH
370.00
143.88
689.50
52.71
n School Health
500.00
174.53
200.00
77.36
o Strengthening of Programme Management
476.56
150.79
254.88
57.36
p Strenthning of Logistics Management
50.00
0.00
0.00
0.00
q Rogi Kalyan Samitiis
12.33
0.00
648.15
0.00
r Emergency Response Services
937.50
0.00
2561.00
0.00
s Mobile Phones for ANMs
134.00
0.00
24.70
0.00
0.00
42.08
0.00
0.00
Major Civil Works for FRUs
200.00
0.00
Other Activities
226.47
0.00
B NRHM Additionalties
t
Upgradation on SDH/ FRUs
District Action Plan
u SHC under Rural Development Board
0.00
638.60
0.00
0.00
v Health Mela
0.00
2.86
0.00
3.31
w Panchayati Raj Initiative
Total B
10.60
8079.60
6218.23
11299.20
1864.42
ACHIEVMENTS - PART B
VILLAGE HEALTH AND SANITATION
COMMITTEES (VHSC)
• 12592 VHSCs constituted upto 30/6/09.
Almost Complete.
• Untied Grant of Rs. 10,000 each for 2007-08,
2008-09 and 2009-10 released and deposited in
the bank account.
• So far, a sum of Rs. 19.16 crore has been spent
out Rs. 38 Crore.
TOP
ACHIEVMENTS - PART B
MOBILE MEDICAL UNIT (MMUs)
• 24 MMUs deployed in districts. 4 districts Faridkot, Bathinda,
Mansa and Barnala have one additional MMU.
• Cost of each MMU Rs. 36.00 lacs. Full Bus chassis used for
MMUs. Has the facility of ECG, X-Ray and Lab.
• 1 MO(F), 1 MO(M), 1 Radiographer, 1 Lab Technician, 1 Staff
Nurse, 1 Pharmacist (Regular) and 1 Driver and 1 Helper provided.
• 13 MO(F) and 21 MO(M) recruited.
• Instruction issued for free treatment and medicine (Rs. 7500 per
month) issued.
• The works of MMUs is monitored through GPS Tracking System.
TOP
ACHIEVMENTS - PART B
UNTIED FUNDS AND MAINTENACNE GRANT
Component
Untied Funds
Annual
Maintenance
Grant
Rogi Kalyan
Samitis
Amount/Scope
2007-08
2008-09
2009-10
Remarks
Rs. 10,000
2858 SCs
2858 SCs
2947 SCs
Funds Released
Rs. 25,000
484 PHCs
484 PHCs
396 PHCs
Funds Released
Rs. 50,000
Nil
128 CHCs
126 CHCs
Funds Released
Rs. 50,000
484 PHCs
100 PHCs
396 PHCs
Funds Released
Rs. 1 Lac
Nil
112 CHCs
112 CHCs
Funds Released
Rs.5 Lac
20 DHs
Nil
20 DHs
Funds Released
1 Lac
36 SDHs
Nil
36 SDHs
Funds Released
1 Lac
110 CHCs
Nil
114 CHCs
Funds Released
TOP
ACHIEVMENTS - PART B
UPGRADATION OF HEALTH INSTITUTIONS
(1) Sub-Centres : Rs. 7.25 crore PIP 2008-09 and
Rs.15.51 Crore PIP 2009-10.
–
954 Second ANMs for the Sub-Centres having more than
6000 population. Pay of these second ANMs is booked here.
Sub-Centres
New Construction
Renovation
FY 08/09
50
77
FY 09/10
60
150
TOP
ACHIEVMENTS - PART B
UPGRADATION OF HEALTH INSTITUTIONS (Contd..)
(2)
(3)
Up-gradation of CHCs : 128 CHCs at a cost of
Rs. 20 lakh per CHC during 2005-06 to 2008-09.
Work almost completed.
Upgradation of SDH: Proposed 25 SDHs @ Rs.
10 lakh per SDH during 2009-10.
TOP
ACHIEVMENTS - PART B
UPGRADATION OF HEALTH INSTITUTIONS (Contd…)
(4)
Upgradation of other Institutions: -
Category
Amount
required
Provided
Provided in
in 2008-09 2009-10
New PHC -Adampur and Ghuda
2.70 Cr.
New CHC – Zirakpur
3.00 Cr.
New RH – Morinda
2.00 Cr.
Upgradation of SDH - Batala, Patti
and Pathankot.
7.15 Cr.
1.00 + 5.50 Cr.
DH- Mohali, Patiala, Gurdaspur,
Ludhiana and Bathinda
17.00 Cr.
3.70 Cr.
DH- Faridkot and Sangrur
2.00 Cr.
2.70 Cr.
1.00 Cr.
2.00 Cr.
2.00 Cr.
1.40 + 5.00 Cr.
(ACA, FTGH)
2.00 Cr.
TOP
ACHIEVMENTS - PART B
DRUGS AND EQUIPMENTS
(1) Drugs
–
(Rs. in lacs)
PIP provision : 2007-08
2008-09
2009-10
PHC
1662
484
97
CHC
90
360
290
SDH
-
-
108
DH
-
-
200
–
Procured for Rs. 17.68 crore from the CPSUs for PHCs
and Sub-Centres.
–
For CHCs – funds being transferred to PHSC for
purchase of medicines. Tenders received and under
process.
TOP
ACHIEVMENTS - PART B
DRUGS AND EQUIPMENTS (Contd..)
(2) Equipments
– PIP provision :
(Rs. in lacs)
2008-09
2009-10
PHC
130.46
97
CHC
621.32
200
-
100
DH
– The requirement has been finalized by PHSC and
tenders were floated and received by PHSC.
– Orders are being placed.
TOP
ACHIEVMENTS - PART B
SCHOOL HEALTH
• Out of 22706 schools which were to be covered in
2008-09, 20001 schools (89%) have been covered by
Government Doctors.
• 32,64,926 of students are in Primary and Secondary
level schools, 2697739 examined in 2008-09 and
266064 examined till 30/6/09
• School Health Cards have been got printed by
Education Department (upto class 8th ) and NRHM
for Secondary/ Senior Secondary Schools.
• IFA and Albendazole Tablets, Scabies Lotion
distributed to School Children.
TOP
ACHIEVMENTS - PART B
SCHOOL HEALTH (Contd..)
Free Treatment for CHD and Cancer
• Decision taken on 4/11/2008 for free treatment of students (up-to
+2 level) studying in Govt. & Govt. aided schools suffering from
Congenital Heart Disease (CHD) and Rheumatic Heart Disease
(RHD) in PGI Chandigarh. Their treatment would cost about Rs.
50,000 to 1,25,000. So far 72 students have been treated at PGI.
• 7 Students suffering from Cancer referred to PGI for treatment.
• Referral treatment of students in Govt. Hospitals made free w.e.f.
July 2009.
TOP
ACHIEVMENTS - PART B
EMERGENCY MEDICAL RESPONSE SYSTEM
PIP Provision – Rs. 9.37 crore in 2008-09
• Tenders invited and work awarded to EMRI Hyderabad on 30/12/2008 for
90 ambulances and the control facility.
• The matter was kept on hold due to SATYAM Episode.
• Rs. 25.61 Crore in 2009-10. GOI has now allowed
Capital Cost from NRHM
Recurring Cost
- GOI
State
1st year
60%
40%
2nd year
3rd year
4th year
40%
20%
0%
60%
80%
100%
TOP
ERS contd
Punjab
Phase
No of Ambulance
Capital Cost
Recurring Cost
Phase I
90
990 Lakh
1782 Lakh
Phase II
150
1650 Lakh
2970 Lakh
Total
240
2640 Lakh
4752 Lakh
ACHIEVMENTS - PART B
MOBILE PHONES FOR ANMs
• PIP Provision - Rs. 1.34 crore in 2008-09 and Rs.
0.23 crore in 2009-10.
• Bids have been received and the work is being
allotted.
• NSHRC has designed mobile based application for
monitoring the performance of ANMs. It would be
operationalized.
TOP
ACHIEVMENTS - PART C
IMMUNIZATION
Activity
Monthly Target
2007-08
Achievement
2008-09
2009-10
2007-08
2008-09
Upto 30/06/09
Gain/
Loss %
Fully
immunized
39358
38751
38625
379983
362312
97884
-3
BCG
39358
38751
38625
423539
386171
97884
-14.6
DPT
39358
38751
38625
410939
330907
115789
16.6
OPV-3
39358
38751
38625
440939
346783
115954
12.9
Measles
39358
38751
38625
379983
362312
106768
2.3
Hep. B
39358
38751
38625
36383
271634
108223
38.2
TT-2 (PW)
45335
44588
44450
388211
364220
114375
3.2
TOP
ACHIEVMENTS - PART C
IMMUNIZATION Contd..
• Expenditure in 2008-09 was Rs. 4.23 Cr. against the
allocation of Rs. 12.34 Cr. Allocation during 2009-10 is
Rs. 10.09 Cr.
• As per NFHS-III (2006), the immunization coverage was
60% whereas as per DLHS-III (2008), it was 80%.
TOP
PART DNATIONAL DISEASE CONTROL PROGRAMME
Rs. In lakhs
Allocation
SN
Expenditure
Allocation
Sub Components
2008-09
a
RNTCP (T.B.)
b
Expenditure
Up to July 09
2009-10
522.16
439.04
616.30
77.83
Leprosy
0.76
105.17
130.30
9.44
c
IDSP
79.91
95.91
142.45
0
d
National Iodine
Deficiency Disorder
Control Programme. NIDDCP
20.00
0.00
20.00
0
e
Malaria & Vector Borne
212.36*
32.25
107.35
3.06
f
Blindness Control
637.50
81.46
350.00
10.87
1366.40
101.20
Total D
* Includes in-kind grant of Rs. 148.00 lakh.
TOP
ACHIEVMENTS - PART D
RNTCP (Contd..)
Year wise RNTCP Performance of Punjab
Year
Suspects
examined per
Lac per
quarter
(150/lac/qtr)
Total TB
cases put
on DOTs
Annualized
total case
detection
rate
(180-257)
Annualized new
smear positive
case detection
rate 6795(70%)
3 month
conversion
rate of
NSP
patients
(>90%)
Cure rate
of NSP
patients
(>85%)
Success
rate of
NSP
patients
(85%)
2005
140
30764
118
46 (48%)
81%
81%
84%
2006
149
34538
133
52 (55%)
87%
84%
86%
2007
(National)
143
1475587
130
52(55%)
89%
84%
86%
146
35875
136
53 (56%)
88%
83%
85%
154
38456
143
58 (61%)
84%
80%
83%
165
69
90%
85%
73%
2007
(Punjab)
2008
2009
National Leprosy Eradication Program
 Punjab is a low endemic state.
 During 2008-09, new leprosy cases detected and brought under
treatment were 933.
 Out of 933, the 180 patients are Punjabi cases.
 Total No. of Cases detected during the year 2007-08 were 964.
 Out of 964, the 196 patients are Punjabi cases.
 Prevalence Rate comes to 0.32 per 10000 population.
 State achieved the goal elimination set by Govt. of India i.e. less than 1
case/10000.
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS
Prevalence of Blindness in the State is 9.5 per 1000 Population as compared to
11.2 of all India .
Estimated No. of cases (incidence) of blindness per year in Punjab= 49072
Estimated No. of cases (incidence) of blindness per year in India = 2132048.
The cataract surgical coverage is 105% in the year 2007-08 and 94.8% in the year
2008-09.
To encourage eye donations ,camps are organized from 25 August to 08September .
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS
Contd..
ACHIEVEMENTS
Cataract Operations
Year
Cataract Operation
IOL Implantation
Target
Performance
%
Cataract
Target
Performance
% IOL
2007-08
1,60,000
1,67,256
105.0
1,60,000
1,52,353
95
2008-09
1,80,000
1,70,572
94.8
1,62,000
1,60,878
99.3
2009-10
(Upto July)
60,000
(Prop)
38,360
63.0
54,000
35,175
65.1
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS
Contd..
ACHIEVEMENTS Contd..
School Eye Screening Programme, Eye Donation and Teacher Trained:Particulars
Target for
the
year
2008-09
Performance
2008-09
% Age
2008-09
Target for
the year
2009-10
Performance
2009-10
% Age
2009-10
School
Children
Screened by DBCS
2,38,095
4,69,055
197.0
116667
152170
130.00
School
Children
Detected
with
Refractive errors
16,667
35,876
215.3
7000
8810
136.00
No.
of
Free
Spectacles given to
Children
5,000
5924
118.5
2100
2427
600
247
41.2
267
89
4,000
2580
65
1333
2805
Eye Donation
Teacher Trained
210.00
ACHIEVMENTS - PART D
INTEGRATED DISEASE SURVEILLANCE PROJECT (IDSP)
1. Infrastructure Development
•
•
•
•
•
Launched in the State in Phase-3 on 12th June, 2007.
State Surveillance Officer, District Surveillance Officers in all districts nominated.
State Surveillance Unit and District Surveillance Units established.
IT networking through broadband, EDUSAT system at SSU , 3 Govt. Medical
Colleges and all districts.
MoU signed with five Private Medical Colleges and private practitioners in the
districts.
2. Lab. Upgradation
•
•
Up gradation of State Public Health Lab. at CH Mohali, District Labs in all the
Civil Hosp. and provision of heavy metal testing in drinking water under Water
Quality component, supplied equipment and reagents.( Approx 24 lacs)
20 CHCs (1 in each Distt.) selected for up gradation. ( Approx 4 lacs)
TOP
ACHIEVMENTS - PART D
NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME.)
In Punjab, Dengue and Malaria are of main public
concern. Although three random cases of Japanese Encephalitis
have been reported in the State in 2008. No case of Chikungunya,
Kala Azar and Filaria have been reported in the State.
In the year 2009-10 only 4 cases of PF Malaria has been
detected.
Year
Disease
Confirmed cases
Death
April 2008 to
March 2009
Upto June 2009
Dengue
4349
21
Nil
Nil
April 2008 to
March 2009
Upto June 2009
Malaria
2494
Nil
637
TOP
ACHIEVMENTS - PART D
NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME (Contd..)
• Six Apheresis machines have been procured.
• 7 districts of the Punjab State have Blood Cell
Separator units.
• 10 Blood Cell Separator Units procured.
• Apart from above, effective steps shall be undertaken
to further strengthen the surveillance to lower the
number of Malaria cases. A strict watch shall be kept
on Japanese Encephalitis during the year 2009-2010.
TOP
PART EINTERSECTORAL CONVERGENCE
Rs. In lakhs
SN
Sub Components
Allocation Expenditure
2008-09
a
b
c
Convergence with
424.80
AYUSH (Pay of
AMOs)
Co ordination &
75.15
Orientation with PRIs
Special innovation for
33.45
Minorities
Total E
533.40
Allocation
Expenditure
(upto July 09)
2009-100020002009-10
77.90
715.00
155.17
40.00
0
0.00
0
0
117.90
0
155.17
TOP
PART-II OF NRHM (CSS-2211)
•
•
•
The salary of ANMs deputated in 2950 SubCentres is paid by GoI under 100% GoI
Scheme.
A sum of Rs. 59.32 Cr. was utilized against the
allocation of Rs. 59.34 Cr. in 2008-09.
Allocation in 2009-10 is Rs. 59.12 Cr.
PART E
CONVERGENCE WITH AYUSH
• Against 121 AMOs, 108 MOs have been appointed in
November 2008.
• Against 112 HMOs, 94 HMOs have been appointed
in January 2009.
• In 2009-10 in 121 Dispensers are to be appointed.
TOP
PART E
COORDINATION WITH PRIs (Rural Development Department)
• In the FY 08/09 Rs. 40 lac for coordination and
orientation with PRIs.
• Guidelines being got printed in Punjabi and circulated
to all Gram Panchayats.
• State Institute of Rural Development has organised
training and orientation of Gram Panchayats.
Approximately 15,000 representatives of VHSCs,
Block/PHCs Monitoring and Planning Committee
given training for NRHM.
TOP
PART E
CONVERGENCE – WATER SUPPLY AND SANITATION
•
Joint BCC campaigns by health and PHED department on sanitation and toilet
use.
•
ASHA, AWW and ANM oriented to communicate with the community on
sanitation and toilet use. Incentive of Rs. 50/- per toilet given to ASHA.
•
Improve sanitation and toilet facilities in all schools and promote use of toilet
and clean water in all schools through a joint campaign.
•
Coordination meeting between WSS and health department through the District
and State Health Missions. The head of the WSS in both district and state
headquarters to be invited to participate in the meetings of the NRHM.
PART E
DRINKING WATER SUPPLY
• Out of 11623 villages, a total of 5724 habitations (2241 NC and 3483 PC)
are yet to be covered. These will be covered by 2012.
• For Rural Areas, there are various schemes – Accelerated Rural Water
Supply Scheme (Rs. 120 crore), NABARD (Rs. 120 crore), World Bank
(Rs. 150 crore), Rajiv Gandhi National Drinking Water Mission (Rs. 28
crore), RO Process (Rs. 19.61 crore) for clean drinking water.
• Out of 327 villages RO system commissioned in 107 villages, and will be
commissioned in 140 villages as soon as electricity connection is installed
and remaining in process
TOP
PART E
SANITATION
• Sewerage works will be executed in urban areas under JNNURM and
JBIC Projects.
• Rs. 100 Cr. provided for rural toilets during 2009-10.
• Under Total Sanitation Programme of GoI, a sum of Rs. 70 has been
sanctioned for providing toilets in schools, Aanganwadi Centers,
Community toilets and individual toilets.
• Under World Bank Project, there is a provision for laying underground
sewer in 100 villages and cleaning of village ponds in 1000 villages.
TOP
PART E
SANITATION
Nirmal Gram Puruskar
Under TSC Nirmal Gram Puruskar is awarded by the GOI to the Villages
where people are not going for toilet in open places.
• 22 Villages awarded with Nirmal Gram Puruskar in 2008-09.
• Target to cover 251 more villages in 2009-10.
TOP
PART E
CONVERGENCE WITH EDUCATION DEPARTMENT
• School Health programme to provide health check up to all school going
children.
• Special campaign for treatment of Rheumatic Heart Disease and
Congenital Heart Disease among School going children.
• Orient secondary school teachers on the Adolescent issues and
availability of health services in the public health facilities.
• Undertake a joint campaign with the Education Department on the illeffects of habit forming practices.
• Encourage Education Department to promote co-production of health by
students through practices such as Yoga and physical exercises.
• Use the opportunity of NSS camps in colleges to involve youth on health
issues. Orientation of youth done during the camps and they could be
encouraged to undertake campaign on behalf of the health department.
• IEC campaign through school children i.e. awareness generation rallies,
poster competitions, wall painting by children.
TOP
PART E
SCHOOL – WATER & TOILETS
• A campaign was launched to provide toilets and
drinking water to all schools during 2008-09.
• As of now 195 schools are without toilets and 18
schools without drinking water. These would be
covered in three months.
• The number of toilets are inadequate as per the student
strength in some of the schools. A total of 5089 schools
do not have adequate number of toilets. These would be
covered in the current year.
• Funds to the extent Rs. 20000.00 per school for Girls
toilet and Rs 20000.00 for Boys toilets provided from
Total Sanitation Campaign (TSC)
TOP
ACHIEVMENTS - PART E
Convergence with DWCD
•
Observe VHND strengthen fixed health and nutrition day at village level.
ASHA to mobilize women and children for the fixed health and nutrition
day.
•
AWW to be a part of the Village Health and Sanitation Committees and
inform the VHSC about the activities of the ICDS.
•
AWW to facilitate referral of women to appropriate health facilities for
institutional deliveries, RTI/STI, MTP, violence and any other
gynaecological and other morbidity
•
AWW and ASHA to counsel the adolescent girls on the provision of
adolescent health in various health facilities. AWW and ASHA to be
informed of the provision.
•
A joint strategy meeting on BCC is done at the state and district level to
evolve common communication strategy between the two departments
and ensure convergence.
•
AWW along with ASHA to participate in routine immunization and in
special campaigns like pulse polio and mobile community.
ACHIEVMENTS - PART E
NUTRITION
• Under ICDS Programme (50:50) the State
Government will be spending Rs. 100 crore in 200910.
• Under
Kishori
Shakti
YoMarcha
(Nutrition
for
adolescent girls) will spent Rs. 5.00 crore through
Woman and Child Development.57921 beneficiaries
• Under these ICDS programmes a total of 13.86 lakh
children and mothers were provided nutrition.
TOP
SYSTEMATIC CHANGES 2008-09
(1) District wise recruitment of ANMs and Nurses –
There was a practice in the state to depute these employees at the
places other than the places from which they were drawing their pay.
This practice has been completely stopped and now these employees
have been recruited in the NRHM district wise.
There is no provision what so ever for transfer of these employees
from one district to the other district.
The deputation of existing employees have been cancelled and the
ANMs have been sent to their proper places of posting.
(2) Increase in the pay of Gynecologists and Medical Officer (F)
recruited under NRHM – The existing pay of these employees
under NRHM was increased by Rs. 5000/- to as under in 2008-09:
Gynecologists
:
Rs. 30000+Incentives
Pediatricians
:
Rs. 30000+Incentives
MO (F)
:
Rs. 25000+Incentives
TOP
SYSTEMATIC CHANGES 2008-09 Contd…
(3)
Special Incentive for Remote Areas - A
special incentive of Rs. 5000/10000/- and
Rs. 10000/15000/- provided in the annual
plan of 2009-10 for MO(F) and Gyne.
working in remote and extreme remote PHC
and CHCs. These are being identified.
TOP
SYSTEMATIC CHANGES 2008-09 Contd…
(4) Medical Officers under NRHM in PHCs – Large number of
PHCs were without any medical doctor and this problem was
more acute in the southern of the state. The state government
accordingly in the month of December gave an advertisement
for filling up 97 posts of MOs in PHCs which were without
any doctor in the 10 southern districts. We have been able to
fill up 59 posts for these PHCs.
(5) Rationalization of postings and transfers –
There was an acute shortage of doctors in PHCs and CHCs.
Part of this shortage was on account of irrational deployment
of the doctors specially the specialists who were deputed in
excess of the resistance at CHCs/PHCs/DH/SDH. The
Department in July 2008 carried out a comprehensive exercise
to remove the excess staff to vacant places. As on date only 40
CHCs are without Gynecologists.
TOP
SYSTEMATIC CHANGES 2008-09 Contd…
(6) Recruitment on regular basis –
(a) Medical Officers – The State Government has appointed
100 MOs through PPSC.
- The Government has approved recruitment of another 212
MOs through PPSC.
(b) Specialists – 2 rounds of recruitment were carried out to
appoint 165 MO (specialists) i.e. MD/MS in the department.
53 specialists doctors have already been issued appointment
letters in March 2009. Remaining posts are being filled up.
TOP
SYSTEMATIC CHANGES 2008-09 Contd…
(c )
Regular recruitments - The State Government has
also decided that recruitment of doctors would be
carried out every year to fill up the vacancies
arising from retirement, selection in medical
colleges and resignations.
(7)
Tele-medicine- Government Medical Colleges and
all the 20 District Hospitals have been linked to
PGIMER to receive specialized services through
tele-medicine.
Necessary equipment and
connectivity have been provided.
TOP
SYSTEMATIC CHANGES 2008-09
Contd…
(8) Super-Specialty Cancer Hospitals- The incidence of Cancer in Punjab has
increased in recent years. The State Government got a study conducted from the
Department of Community Medicine, PGI, Chandigarh and they reported that the
increased incidence was due to increased use of pesticides especially in the cotton
growing districts.
The State Government decided to set up two Super-Specialty Cancer
Hospitals in Public- Private- Partnership –
-Super-Specialty Cancer and Cardiac Hospital, Bathinda
-Super-Specialty Cancer and Trauma Hospital, Mohali
Land has been earmarked in the existing hospitals for the private parties. Bids
have been invited and work has been allotted to Max Healthcare Institute Limited
against upfront fee of Rs. 1.58 crore of Bathinda and Rs. 4.73 crore for Mohali
and 5% revenue share at both the places. The party would commission the
hospitals within 2 years i.e. by 31/3/2011.
TOP
SYSTEMATIC CHANGES 2008-09 Contd…
(9) New Hospitals(i) Satellite Hospital- State Government secured an Additional
Central Assistance of Rs. 10 crore for construction of 4
satellite hospitals in slum basties of Bathinda. The amount
was received in February, 2009 and the work has been
started.
(ii) Mother and Child Hospital at Fatehgarh Sahib- The State
Government secured Rs. 5 crore from the Government of
India as Additional Central Assistance for completing the
Mother and Child Hospital at Fatehgarh Sahib. These two
hospitals are now being given to PIDB for PP project.
TOP
NEW ACTIVITIES 2009-10
UNDER MATERNAL HEALTH PROGRAMME
INSTITUTIONAL DELIVERIES – 51 % IN THE STATE, STATE AT NO. 10 IN THE
COUNTRY. NO. OF DELIVERIES IN GOVERNMENT HOSPITALS IN 2008-09 (March) IS
53530 AGAINST 37916 IN 2007-08, AN INCREASE OF 15614 (41.81 %). STILL
GOVERNMENT HOSPITLAS ACCOUNT FOR ONLY 13 % OF TOTAL BIRTHS IN THE
STATE. PLAN TO INCREASE THIS NUMBER.
UNDER NRHM
•
REFERRAL TRANSPORT @ RS. 200/- FOR BPL/SC/ST . A TOTAL Rs. 90 LAKH
PROPOSED
•
DURING 09/10 96 MORE PHCs TO BE STRENGTHENED AS 24 x 7 CENTRES. 101 PHCs
ALREADY TAKEN UPTO 2008-09
•
DURING 09/10 52 MORE CHCs TO BE STRENGTHENED AS FRUs. 60 CHCs ALREADY
TAKEN UPTO 2008-09
•
PREGNANCY TRACKING AND WORK DONE BY ANMs – WILL PROPOSE A NEW
SCHEME FOR RS. 70 LACS + 140 x 12000 = 87 LACS.
•
PILOT PROJECT – WILL PROPOSE FOR ON LINE REGISTRATION OF PREGNANCIES.
TOP
NEW ACTIVITIES 2009-10
STATE GOVERNMENT INITIATIVES –
•
NEW PLAN SCHEME – ASSISTANCE FOR INSTITUTIONAL DELIVERIES TO
BPL/ SC FAMILIES (RS. 10 CRORE) – RS. 1500 PER BIRTH UPTO TWO
CHILDREN.
•
MONITORING OF WORKS DONE BY GYNAECOLOGISTS – MONTHLY
MONITORING AND ISSUANCE OF LETTERS.
- REGULAR GYNE : 11, 7, 10 ABOVE AVERAGE, AVERAGE, BELOW AVERAGE
- NRHM GYNE : 6, 3, 5
30, 20, < 20
- SMC : 47, 25, 85
15, 10, <10 PER MONTH
UNDER CHILD HEALTH PROGRAMME
PROMOTION OF EXCLUSIVE BREAST FEEDING THROUGH TRAINING, IEC AND
FOCUSED GROUP DISCUSSIONS. RS. 50.00 LAKH PRPOSED DURING THE FY
09/10
–UNDER ARSH PROGRAMME –SEVEN MORE DISTRICTS TO BE COVERED IN THE YEAR 09/10 (BARNALA,
HOSHIARPUR, MANSA, MOGA, NAWANSHAHAR, ROPAR AND TARN
TARAN).
TOP
NEW ACTIVITIES 2009-10 (Contd..)
•
Multi purpose youth friendly centers in 4 districts – Rs. 2 lakh per district
proposed.
•
Provision of sanitary napkins through social marketing to adolescent girls
TO ENFORCE PC PNDT
•
Award money for sting operation @ rs. 50,000/- per operation
UNDER PPP MODEL
•
To outsource 20 PHCs for 24x7 services @ rs. 70,000/- per PHC.
TRAINING
• 5 more districts added for sba
• IMNCI training of LHVs, ANMs, AWWs, school teachers to continue and
completed during this year
• IUD insertion training using alternative methodology – 4 selected districts initially
TOP
NEW INITIATIVES -ADDITIONALITIES
• MEDICAL OFFICER FOR 50 PHCs WITHOUT
DOCTORS @ Rs. 25,000 PER MONTH PER MEDICAL
OFFICER
• INCENTIVES
TO
DOCTORS
EXTREMELY REMOTE AREAS
WORKING
IN
• ENGAGEMENT OF 5 HOSPITAL ADMINISTRATOR
• ONE GYNAECOLOGIST FOR 15 DHs
TOP
Thank You
PIP 2009-10
MATERNAL HEALTH
Rs. 120.00 LAKH HAS BEEN APPROVED FOR THE FY 09/10
FOR ACTIVITIES UNDER MATERNAL HEALTH
•
•
•
Early registration of pregnancies and ensuring institutional
delivery
REFERRAL TRANSPORT @ RS. 200/- FOR BPL/SC/ST
FAMILIES
24 HR DELIVERY SERVICES IN IDENTIFIED PHCs
– During 09/10 96 more PHCs to be strengthened 101
PHCs already taken upto 2008-09
– 20 PHCs to be outsourced for providing 24X7 services
– Human resource and infrastructure strengthening
Contd…
107
MATERNAL HEALTH
24 HR CEmONC SERVICES IN SELECTED CHCs
•
During 09/10 52 more CHCs to be strengthened 60 CHCs
already taken upto 2008-09
•
Provision of Obstetrician, Paediatrician and 5 S/Ns
•
New born care corners in the identified CHCs.
•
Blood storage units in the identified CHCs.
Contd…
108
MATERNAL HEALTH
JANANI SURAKSHA YOJNA
RS. 490.00 LAKH HAS BEEN APPROVED FOR THE FY 09/10
• Implementation to be as per GOI guidelines
• Payments to be through bearer cheques
• Incentive of Rs. 200.00 to ASHA
ACCREDITED SOCIAL HEALTH ACTIVIST (ASHA)
RS. 462.70 LAKH HAS BEEN PROPOSED DURING THE
FY 09/10
• Total 17285 ASHAs selected .
• Trainings and supply of drug kits.
• ASHA resource centre as a part of the state resource centre
to be established funds to be utilized from the PIP 08/09
approvals.
109
CHILD HEALTH
Rs. 25.30 LAKH HAVE BEEN APPROVED FOR THE FY 09/10
– New programme of integrated management of neonatal and
childhood illnesses (IMNCI) in 4 districts (Amritsar, Tarn
Taran, Ludhiana and Patiala)- already launched
– Strengthening IMNCI cell at state & 4 districts by providing
data recording & analysis support and training facilities.
– IMNCI training for 22 tots, 360 MOs, 76 SNs, 335 LHVs and
967 ANMs, 780 AWW (identified districts) & DIOs of all 20
districts
– Strengthening of
immunization)
immunisation
services
(details
under
110
CHILD HEALTH
– 25 new born care centres established, 35 are in process at CHC
level, total 112 centres are to be established upto 09/10.
– Distribution with training of manual mucus suckers to SBAs
– Promotion of exclusive breast feeding through training, IEC
and focused group discussions
– Promotion of deliveries by SBAs by providing trainings and
sensitization through IEC activities
111
BREAST FEEDING SCHEME
Rs. 25.00 LAKH APPROVED FOR THE FY 09/10
• State-wide behaviour change effort to promote breastfeeding by
involving all grassroot workers (ANMs/ AWWs/ ASHAs).
• At PHC level Medical Officer, staff nurse to be sensitized.
• ANMs/Male Health Workers to counsel mothers for breastfeeding.
• Booklets to mothers on exclusive breast-feeding.
• Train ASHAs, TBAs, AWWs, ANMs, LHVs, Male Workers to
improve their counselling skills for breast-feeding
• Adequately qualified ASHAs to be trained as breast-feeding
counsellor at CHC level
• Supplementary diet in kind to BPL/ SC/ ST mothers for
promoting breast-feeding.
112
FAMILY PLANNING
Rs. 1116.50 LAKH APPROVED FOR THE FY 09/10
– Dissemination of revised manuals on sterilization standards and quality
assurance of sterilization services
– Organizing female sterilization & IUD insertion camps in districts -one
camp per month per block-
– Organizing NSV camps – 40 camps per month in the state
– Printing of sterilization files, printing of cards, insurance manuals and
purchase of computers- continues process
– Compensation package for sterilization / IUD as per GOI guidelines
113
ARSH
Rs. 38.23 LAKH APPROVED FOR THE FY 09/10
– 13 districts covered upto 08/09.
– Seven more districts to be covered in the year 09/10 (Barnala, Hoshiarpur, Mansa,
Moga, Nawanshahar, Ropar and Tarn Taran).
– Adolescent Friendly health services through 1057 special clinics (PHCs, CHCs, civil
hospitals and selected sub centres) to be provided i.e. management and treatment of
anemia, menstrual disorders, tt immunization, nutrition counselling, management &
treatment of RTIs/STIs and reducing the incidence of HIV/AIDs
– Printing of ARSH IEC material for dissemination to health care providers &
stakeholders
– Printing of guidelines, handouts, facilitator guides for MOs ANMs, LHVs
– Under IEC activities advocacy workshop at state 7 districts & all blocks in the
selected districts
– Multi purpose youth friendly centers.
– Provision of sanitary napkins through social marketing to adolescent girls
114
URBAN RCH
Rs.165.60 LAKH APPROVED FOR THE FY 09/10
– Contractual appointment of 230 MPHWs in slum
areas of the state to continue
115
PNDT & SEX RATIO
Rs. 62.80 LAKH APPROVED FOR THE FY 09/10 :
– Orientation programme for programme managers and service providers on PC PNDT
– Organization of seminars, workshops of prominent personalities on the declining sex
ratio
– Manpower & operational support for PNDT cell at the state HQ by induction of a
lawyer, social scientist,
– Annual analysis of sex – ratio in the state on the basis of institutional deliveries and
civil registration data.
– Monitoring of sex ratio at birth through ASHA.
– Award money for sting operation @ Rs. 50,000/- per operation
– Award money for informers @ Rs. 20,000/- & provision for decoy patients- @ Rs.
10,000/- .
– Award to panchayats – Rs. 1.5 lac, 2 best performing panchayats in each district.
116
INNOVATIONS / PPP / NGO
Rs. 295.00 LAKH APPROVED FOR THE FY 09/10
•MNGO & NGO (SNGO)
– Preparatory phase to newly selected MNGOs for proposal development.
– 1st instalment of grant in aid for 12 months to 5 MNGOs
– Service NGO scheme
– Preparatory phase to newly selected SNGOs for proposal development (04
SNGOs)
– 1st instalment of grant in aid for 18 months to existing SNGOs
– Promotional activity for seminar/ workshop/ review meeting/ study tours as
per need assessment
– To outsource 20 PHCs for 24x7 services @ Rs. 70,000/- per PHC.
117
INSTITUTIONAL STRENGTHENING
LOGISTICS
Rs. 13.20 LAKH APPROVED FOR THE FY 09/10
– Development of inventory management system and software
development is in process
– POL for transportation of supplies from state up to sub centre
level
– Strengthening of warehouse facilities.
118
HMIS
Rs. 74.76 lakh APPROVED FOR the FY 09/10
• Strengthening of HMIS system at state level by providing computers &
peripherals
• 173 Computer Operators on contract recruited- 2 Programmers 2 Hardware
Supervisors, 1 System Analyst on contract to be recruited – 1 Hardware
Supervisor already recruited
• Operationalization of new MIES formats
• Internet connectivity upto block level
• Need assessment study on strengthening HMIS.
• Mid term and endline evaluation study through external agencies.
• Establishing CRS, preservation and digitalization of CRS reports
• Printing of new formats, compilation sheets and publication and
dissemination of state level reports on various health indicators.
• Training and monitoring by the M & E team.
QUALITY ASSURANCE
– Quality assurance committees at State, District and Block
Level
– Patient Satisfaction Survey is being conducted through
private agency
– Training for management of waste
– Training of staff for segregation & treatment of medical
waste
120
TRAININGS
•
Strengthening & Upgradation of Training Institutes – As per GOI Guidelines
– SIHFW, Mohali; HFWTC, Amritsar
– MPHW (M) Training Centres – Kharar, Nabha
– ANM Training Centres – Hoshiarpur, Nangal, Sangrur, Gurdaspur, Moga, Bathinda
•
Strengthening of District Training Centres
• SIHFW/ HFWTC
–
–
–
–
–
–
–
–
–
BCC Skill Building Training for Medical Officers
BCC Skill Building Training for Paramedicals
Integrated NRHM Training for Rural Medical Officers
TOT for IUCD Insertion using Alternative Methodology
Computer Training for MOs
Computer Training for Clerical staff
TOT for RTI/ stI
TOT for ARSH
Integrated NRHM Training of ANMs (Contractual under NRHM)
121
TRAININGS
• Districts – Apart from most of the trainings conducted during
2008-09 New Trainings added
– 5 more districts added for SBA
– IMNCI Training of LHVs, ANMs, AWWs, School Teachers to
continue and completed during this year
– IUD Insertion Training using Alternative Methodology – 4
selected districts - initially
122
BEHAVIOUR CHANGE
COMMUNICATION
Rs. 367.82 LAKH APPROVED FOR THE FY 09/10
– Strategies for Intra Communication designed
– Printing of booklets for adolescents on ARSH issues.
– Implementation of BCC strategy as per GOI guidelines
– Focus group discussions, wall paintings, hoardings, folders, posters, radio/TV coverage,
newspapers adds & folk media for components of maternal health, child health, family
planning, JSY, ARSH, water and sanitation, gender and sex ratio
– Advocacy workshop at state, district & block level on issues of early registration of
pregnancy, ANC and institutional delivery
– Flip book for neonatal care and NSV etc.
– Strengthening of BCC/IEC bureau (state & district level)
– School based activities on sanitation purchase of exhibition stand and digital camera.
– Educational material for life style diseases
123
PART-B
NRHM ADDITIONALTIES
124
NRHM-ADDITIONALITIES
SN
ACTIVITY
(RS IN LAKHS)
BUDGET
APPROVED
(Rs. In Lakhs)
1
VILLAGE HEALTH & SANITATION COMMITTEES
1273.80
2
ASHA
449.00
3
SC UNTIED FUND
285.80
4
PHC UNTIED FUND
99.00
5
CHC UNTIED FUND
63.00
6
ANNUAL MAINTENANCE GRANT(1443 SC, 396 PHC
& 112 CHCs
454.00
7
MOBILE MEDICAL/ HEALTH UNITS
360.00
8
UP-GRADATION OF CHC
811.40
9
UP-GRADATION OF PHC
658.62
10
UP-GRADATION OF SC
1551.00
Contd…
125
(RS IN LAKHS)
NRHM-ADDITIONALITIES
SN
ACTIVITY
BUDGET APPROVED
(Rs. In Lakhs)
0.00
11
UP-GRADATION OF SHC
12
UP-GRADATION ON SDH/ FRUS
488.00
13
UP-GRADATION OF DH
689.50
14
SCHOOL HEALTH
200.00
15
ROGI KALYAN SAMITIES
648.15
16
STRENGTHENING OF PROG.
MANAGEMENT
371.31
17
ADDITIONAL ACTIVITIES(EMRI,CELL
PHONE, ZINC SULPHATE)
2617.04
18
CRS
78.70
19
MAJOR CIVIL WORKS
200.00
TOTAL B
11298.32
126
NRHM Additionalities
Mandatory Provisions
Untied Funds and Annual Maintenance Grant
Funds to 12673 VHSCs @ Rs. 10,000.00 – Provided
Untied Funds
Sub Centre 2858 @ Rs. 10,000.00 – Provided
PHCs 396 @ Rs. 25,000.00 – Provided
CHCs 126 @ Rs. 50,000.00 – Provided
Annual Maintenance Grant
Sub Centre 1443 @ Rs. 10,000.00 – Provided
PHCs 396 @ Rs. 50,000.00 – Provided
CHCs 112 @ Rs. 1,00,000.00 – Provided
127
NRHM Additionalities
Rogi Kalyan Samiti
Rs. 5.00 lakh per district hospital – Provided
Rs. 1.00 lakh per sub-divisional hospital/ CHC– Provided
ASHA
Funds @ Rs. 200/- per ASHA per month claimed in NRHM Part-B
and Rs. 2300/- per ASHA claimed for training in Part-A.
128
NRHM Additionalities
Mobile Medical Unit
Approval was sought for deploying 4 additional MMUs in the State
out of the funds already available in the PIP 08/09, in the southern
districts of the State where health facilities are lacking due non
availability of manpower. In these 4 districts two MMUs have
already been provided. In 4 districts where presently no MMUs in
place, MMUs needs to be provided.
Medical Officers in Mini PHCs – demand for additional 100
MOs not justified, State should bear this expenditure
Additional posts deleted. 59 Medical Officers in Mini PHCs in place
so salary may kindly be allowed for only one year 2009-10.
129
NEW INITIATIVES -ADDITIONALITIES
• Medical Officer for 60 PHCs without doctors @ Rs. 25,000 per
month per Medical Officer
• Incentives to doctors working in extremely remote areas
• Engagement of 5 Hospital Administrator
• One Gynaecologist for 15 DH
Part-C
130
UNTIED FUNDS
VILLAGE HEALTH & SANITATION COMMITTEES
• Funds to 12673 VHSCs @ Rs. 10,000.00 – Provided
UNTIED FUNDS
•
•
•
Sub Centre 2858 @ Rs. 10,000.00 – Provided
PHCs 396 @ Rs. 25,000.00 – Provided
CHCs 126 @ Rs. 50,000.00 – Provided
ANNUAL MAINTENANCE GRANT
•
•
•
Sub Centre 1443 @ Rs. 10,000.00 – Provided
PHCs 396 @ Rs. 50,000.00 – Provided
CHCs 112 @ Rs. 1,00,000.00 – Provided
131
MOBILE MEDICAL UNITS (MMUs)
– Recurrent cost for 24 MMUs @ Rs. 15 lakh P.A. Rs. 360.00
lac proposed for FY 09/10
– Recurrent cost for salaries, medicines etc for 24 MMUs
132
UPGRADATION OF INSTITUTIONS
UPGRADATION OF CHCs TO IPHS
Rs. 811.40 LAKH APPROVED FOR THE FY 09/10
– Construction of 6 new CHCs @ Rs.200 lakh. Work to be initiated in 09/10 4
CHCs on priority and continue to 10/11. Rs. 300 lakh proposed
– Drugs @ Rs. 2.3 lakh per CHC per annum - Rs. 289.80 lakh proposed.
– Equipment/furniture for CHCs based on facility survey Rs. 221.60 lakh
proposed
UPGRADATION OF SDH/FRUs
Rs. 488.00 LAKH APPROVED FOR THE FY 09/10
– Major repair and renovation of 4 SDHs Rs. 130 lakh Approved
– Repair renovation and alteration of existing 25 SDH @ Rs. 10.00 lakh.
– Drugs @ Rs. 3.00 lakh for 36 SDH
133
UPGRADATION OF INSTITUTIONS
UPGRADATION OF PHCs FOR 24 HRS SERVICES
RS. 658.62 LAKH APPROVED FOR THE FY 09/10
–
–
–
–
Upgradation of 97 PHCs for 24x7 services Rs. 200 lakh
Equipment & furniture for 97 PHCs
Drugs @ Rs. 1.00 lakh per 24X7 PHC P.A.
Medical Officer for 60 PHCs without doctors @ Rs. 25,000 per month per Medical
Officer
– Incentives to doctors working in extremely remote areas
UPGRADATION OF SUB CENTRES
RS. 1551.88 LAKH APPROVED FOR THE FY 09/10
– Construction of 353 existing SCs located in rented buildings in phases out of which
100 to be taken up in 09/10. Rs. 640.00 Lacs
– 823 existing SCs need restoration, out of which 150 will be taken up in 09/10 @ Rs.
1.5 lakh per SC
– Salary of 2nd ANM in 954 SCs.
134
UPGRADATION OF INSTITUTIONS
UPGRADATION OF DISTRICT HOSPITALS
Rs. 689.50 LAKH APPROVED FOR THE FY 09/10
–
–
–
–
–
Drugs @ Rs. 10 lakh per DH PA
Equipment/furniture based on Facility Survey Rs. 100 lakh proposed
Upgradation of District Hospitals Sangrur, Faridkot Rs. 200 lakh proposed
Engagement of 5 Hospital Administrator
One Gynaecologist for 15 DH
ROGI KALYAN SAMITIS
Grant in Aid to Rogi Kalyan Samities at
PHC/CHC/SDH
@ Rs. 1.00 Lakh
DH Level
@ Rs.5.00 Lakh
135
SCHOOL HEALTH
• Provision for screening of all the School Children for which
Rs. 200 lakh have been Approved.
• Special focus on RHD and CHD treatment at PGI
136
OTHER ACTIVITIES
• Funds Approved Rs. 2617.04 lakh
• Capital cost of 90 Ambulances and infrastructure for
ERS (proposed in additional over planning activities)
• Cell phone to State Officers/Civil Surgeons, DPMs,
Block SMOs, LHVs and ANMs
• Procurement of Calcium & Zinc Sulphate tab.
137
PART-C
IMMUNIZATION
138
PART C- IMMUNIZATION: BUDGET
S.N.
ACTIVITY
BUDGET APPROVED
(Rs. In Lakhs)
1
Mobility Support for Supervision
10.83
2
Cold Chain Maintenance
4.72
3
Mobilization of Children Through ASHA/ Mobilizers
130.00
4
Alternative Vaccine Delivery: For RI Session in Other Areas
34.30
5
Support For Computer Asst. For RI Reporting
12.72
6
Printing & Dissemination of Cards Etc.
27.50
7
Review Meetings
15.15
8
Trainings
14.91
9
Microplanning
4.43
10
POL For Vaccine Delivery From State To District & From
District To PHC/CHCs
20.00
11
Consumable for Computer E.G. Internet etc.
0.08
12
Injection Safety
Enhansed Immunisation coverage in Urban & Peri Urban
colonies
1.05
13
TOTAL
4.58
280.27
139
IMMUNIZATION
• BUDGED APPROVED FOR Rs. 280.27 LAKH FOR THE YEAR 09/10
•
Alternate Vaccine Delivery, Mobilization of Children, Slums and under served areas, strengthening and
monitoring, computerization as per GOI guidelines.
•
State specific strategies
•
Social mobilization to increase awareness to serve uncovered and leftover children
•
Enhanced immunization coverage and urban and peri urban colonies
•
Waste disposal plan at PHCs level
•
Totally micro-plan based at the sub-centre level
•
Pulse-polio drive strategy used in uncovered urban areas
•
Monitoring and supervision at state, district and PHC level
•
Identification & coverage of slums areas
•
State wide immunization in partially covered/ uncovered areas on Saturdays
•
Training /orientation of DIO/DFPO and other functionaries
140
PART-D
NATIONAL DISEASE
CONTROL PROGRAMME
141
PART D- NDCP : BUDGET
SN
ACTIVITY
BUDGET APPROVED
(Rs. In Lakhs)
135.00
1
National Vector Borne Disease Control Programme
(NVBDCP)
2
Integrated Disease Surveillance Programme (IDSP)
142.42
3
National TB Control Programme (RNTCP) - Approved
616.30
4
National Leprosy Eradication Programme (NLEP ) approved
131.00
5
National Blindness Control Programme (NBCP)
350.00
6
National Iodine Deficiency Disorder Control
Programme (NIDDCP) - Approved
20.00
TOTAL
1394.72
142
PART D- NVBDCP : BUDGET
S. NO
ACTIVITY
BUDGET
APPROVED
(Rs. In Lakhs)
1
Incentive to ASHA
0.00
2
Supplies, Consumables and Medicines
2.00
3
Indoor Residual Spray (IRS)
Anti Larval Measure in Urban And Peri-urban Areas
0.00
4
5
40.00
0.00
6
Entomological Monitoring
IEC
20.00
7
Training
10.00
8
MIS (NAMMIS)
5.00
MALARIA TOTAL
77.00
Dengue and Chikungunya
58.00
Japanese Encephalitis IEC
0.00
GRAND TOTAL
135.00
143
PART D- IDSP : BUDGET
S.N.
Activity
Amount
approved
1
Incremental staff/ personnel
+ Operational cost
132.95
2.
Training cost
0
3.
4.
IEC
Lab. equipment etc.
5.00
4.50
Total
142.42
144
PART D- RNTCP and NLEP :
Formal approval received for an outlay of Rs. 616.30 for
RNTCP from the Concerned Division and budget revised
accordingly in the PIP
Formal approval received for an outlay of Rs. 131.00 for
NLEP from the Concerned Division and budget revised
accordingly in the PIP
145
PART D- NBCP : BUDGET
Sr.
No
Particulars
Approved Amt
1
Grant-in Aid to NGOs for free Catract Operations (Annual target for
free catops 1,80,000 & for IOL 1,62,000 for which the achievement
of the State is 107% in the year 2007- 08 & 88% upto Jan. 2008-09
198.40
2
GIA for School Eye Screening. Provision for supply of spectacles,
medicines and other supplied for school eye care programme.
3
4
5
Grant for Medical Colleges (there are 3 Medical Colleges in the
State.
Grtant-in-Aid for Govt. Medical College Faridkot & Medical College
Patiala @ 20.00 lakh each
Distt. Hospitals
1)
2
Phaco
Machines
@
12,00,000
2)
5
Yag
Laser
@
10,00,000
3) Maintenance of ophthalmic equipments 16,00,000
Establishing & Strengthening and supply to New Vision Centres at
CHCs and Sub-Distt. Hospitals at 25 centres @ 50,000 in the
border and remote areas of the State.
40.00
5.00
146
PART D- NBCP : BUDGET
Sr. No
Particulars
6
Recurring GIA to Eye Banks (there are 4 eye banks in the State).
Which has got collection of more than 100 eye balls
7
Non-recurring GIA to Eye Donation Centre @ Rs. 1 lakh for 10 eye
donation centres
8
Recurring GIA to Eye Donation Centres
9
Training for PMOAs and MPHWs
10
IEC activities World Sight days and Fortnight at 20 districts @ 50,000
and 100 eye donation awareness camps in remote and border areas at
PHCs and CHCs level @ 15,000 for each camp.
Approved Amt
1.00
147
PART D- NBCP : BUDGET
Sr. No
Particulars
Approved Amt
11
SBCS Remuneration other activities & Contingency
12
Financial assistance for other diseases Glucoma,
Diabetic
Retinopathy,
Laser
Tech.,
corneal
transplantation,
childhood blindness, squint surgery etc.
13
Maintenance of Tele Ophthalic Van and the staff
14
Ophthalmic Surgeon
30.00
15
Ophthalmic Assistant
9.60
16
Eye Donation Consellor
6.00
17
GIA for strengthening of RIO
60.00
Total
350.00
PART D- IDDCP : BUDGET
Activity / Item
2009-10
(Rs. In Lakhs)
Salary
Salary for Punjab State IDD Cell
6.00
Salaries for lab technician, Lab astts. And
other staff of IDD monitoring laboratories
3.50
Monitoring and IEC
Cost for IDD surveys/ monitoring
2.50
IEC Activities for the programme
8.00
Total
20.00
149
PART-E
INTER SECTORAL
CONVERGENCE
150
PART E- INTERSECTORAL
CONVERGENCE AYUSH –
–
To meet the health needs and harness the potential of indigenous
health knowledge convergence with AYUSH
–
Contractual appointment of one AYUSH doctor and dispensor
(in phased manner)
–
Contractual appointment of one AYUSH doctors (Homeopathy)
and dispensor (in phased manner)
151
SPECIAL PROGRAMME FOR
MINORITIES- CARRY OVER ACTIVITIES
• Outreach camps to be held 20 in every month @ Rs 10000 per camp for
providing family welfare services and dissemination of information on
RCH components and also counselling on various issues like FP,
adolescent health and early registrations of pregnancies
• Audience specific communication material in Urdu, Punjabi pertaining to
themes like age at marriage, immunization, sterilization, CC use, IUD,
OCP, male involvement, child health issues (pamphlets, hoardings, wall
paintings)
• Meetings/workshops with stakeholders and opinion leaders
• Peer educator
152
SPECIAL PROGRAMME FOR
MINORITIES
Special Innovative Programme for Minorities
Activity / Item
Camps to be held 20 in every month @ Rs. 10000 per camp for
providing Family Welfare services and dissemination of information on
RCH components and also counselling on various issues like FP,
Adolescent health and early registrations of pregnancies (Rs 3000/- for
arrangements, mobility, and referral , Rs 6000/- for Drugs and supplies,
Rs 1000/- for miscellaneous )
Peer Educator 20 @ Rs. 1000/-p.m
Audience specific communication material in Urdu, Punjabi pertaining
to themes like age at marriage, immunization, sterilization, CC use,
IUD, OCP, Male involvement, Child Health Issues (Pamphlets,
Hoardings, wall paintings)
Meetings/Workshops with Stakeholders and opinion leaders
Total
2009-10
24.00
2.40
6.00
1.05
33.45
153
CONVERGENCE WITH PRIs
BUDGET
PROPOSED
(Rs. In Lakhs)
BUDGET
MODIFIED
(Rs. In Lakhs)
Preparation of guideline on role of PRIs printed and
disseminated in local language to all PRI members and other
key stakeholders in NRHM. 3 lakh copies @ Rs. 5 per copy
15.00
15.00
Preparation of module to orient PRIs on their role in NRHM
0.15
0.15
Discussion with Panchayati Raj Department on orientation of
PRI representatives
40.00
0.00
20.00
20.00
75.15
35.15
Activity / Item
Organise advocacy meetings with PRIs on key issues such as
maternal health, JSY, PNDT and GBV. SHSRC and Centre for
Communication to jointly provide support in preparing
advocacy materials. Advocacy to be organised in each district
by the District Health Mission. A provision of Rs 1 lakhs per
district made, detailed budget to be prepared by each district
Total Budget
POSITION WITH REGARD TO CONCURRENT
AUDIT AND HMIS
Concurrent Audit – The work for 2008-09 was allotted to M/s. N. C. Mittal &
Association, New Delhi vide this office letter dated 28.01.2009 for Rs. 5.40 lacs after
inviting bids through newspapers.
For 2009-10 we are again inviting bids through newspapers and work has been
allotted to M/s A Agarwal & Associates of Chandigarh.
HMIS – Monitoring and Evaluation
•
•
•
NHRC – HMIS : Data from April 2008 to October 2008 uploaded on the HMIS portal.
Data Block wise from November 2008 uploaded at district level. SAs from Blocks
come to the district headquarter to upload the data.
Other initiatives of the State Mission –
Website : Website of Punjab NRHM www.pbnrhm.org launched in June
2008.
Service particulars : Service particulars of doctors with complete bio-data
prepared and uploaded.
GIS – Administrative maps upto village level have been digitized by Punjab
Remote Sensing Agency, Ludhiana. The work of health functionaries would
be monitored through this GIS enabled system.
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