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NATIONAL PROGRAMME COORDINATION COMMITTEE (NPCC)

APPRAISAL OF STATE PIP(PUNJAB)

March17, 2008

NIRMAN BHAWAN, NEW DELHI

NATIONAL RURAL HEALTH MISSION PUNJAB

PUNJAB HRY HP RAJASTHAN INDIA

BIRTH RATE(SRS 2005)

18.1 24.3 20.0 28.6 23.8

DEATH RATE(SRS 2005)

6.7 6.7 6.9 7.0 7.6

SEX RATIO (CENSUS 2001)

876 861 968 921 933

IMR(SRS 2005) 44 60 53 68 58

TFR(SRS 2005) 2.1 2.8 2.2 3.7 2.9

ANTE NATAL CARE (AT LEAST 3 CHECKUP) (%) (SRS 2005)

72.5 58.8 62.6 41.2 50.7

INSTITUTION DELIVERY (%) (SRS 2005)

52.5 39.4 45.3 32.2 40.7

MATERNAL MORTALITY RATIO 178 162 - 445 301

CONTRACEPTIVE USE (%) 63.3 63.4 72.6 47.2 56.3

VACCINE COVERAGE (%) 60.1 65.3 74.2 26.5 43.5

PRESENT STATUS AS COMPARED TO NEIGHBORING STATES AND ALL INDIA

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INDICATORS AT THE START OF

RCH SRS 98/99

PRESENT STATUS07/08

TARGET

TFR 2.5 2.1 1.8

IMR(PER 1000 LIVE BIRTHS)

49 44 <30

MMR(PER 100000 LIVE BIRTHS)

199 178 <100

INST. DELIVERIES 37.5%(NFHS II)

52.5 80%

ANC CHECK-UP WITH 03 CONTACTS

58.4%(NFHS II)

72.5 100%

INDICATORS & GOALS

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INSTITUTIONAL ARRANGEMENTSINITIATIVES STATE LEVEL DISTRICT

LEVELBLOCK LEVEL / VILLAGE LEVEL

Setting up of the Health Missions

On 26th October 2005 constituted.

On 17th August 2005 constituted.

Not applicable

Incorporation of Health Societies

Incorporated on 26th February 2007

Incorporated from 26th August 2005 to January 2006.

Block Health Committees notified on 11.12.2007. 11319 Village Health & Sanitation Committees (VHSCs) constituted on 21.10.2007.

Integration of Vertical Programs

Integrated Integrated Integrated

Merger of Vertical Societies

Done on 21.12.2007

Being Done Not required

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INSTITUTIONAL ARRANGEMENTS

INITIATIVES STATE LEVEL

DISTRICT LEVEL

BLOCK LEVEL / VILLAGE LEVEL

Constitution of RKS Not required Already notified and are operational

At Block Level Community Health Centres already notified and are operational.

Program Management Units Recruitment completed

Recruitment completed

Recruitment under process at block level.

Decentralized planning and implementation of various activities to PRIs.

PIP for FY 08/09 appraised by Sub Group on 28.2.08

IDHAPs prepared for all districts. Facility Surveys completed.

Block level plans and village level plans prepared and incorporated in State PIP . Facility Surveys completed.

The Department has decided in principle to out source the setting up of State Health System Resource Centre and for finalization of consultancy firms. Offers have been invited and short listing is being done.

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RCH • OUT OF 75 PHCs UNDERTAKEN UPTO 2007-08 FOR 24 HOUR

DELIVERY SERVICES WORK AT 40 PHCs COMPLETED• ONE LAKH MANUAL MUCUS SUCKERS DISTRIBUTED, DAI KITS &

GENERATORS PURCHASED • OUT OF 50 CHCs UNDERTAKEN UPTO 2007-08 FOR CEmONC, NEW

BORN CARE CENTRES WITH BLOOD STORAGE FACILITY SET UP IN 25 CHCs

• CONTRACTUAL APPOINTMENTS OF 90 DOCTORS/ SPECIALISTS AND 345 STAFF NURSES COMPLETED UNDER MATERNAL HEALTH.

• UNDER JSY, INCENTIVES TO 18000 BENEFICIARIES DISTRIBUTED TILL JANUARY 2008.

• UNDER COMPENSATION STERILIZATION- 70273, IUDs INSERTION-233424 AND CONTRACEPTIVE USERS-325940, NSV-7764 UPTO 3RD QUARTER

• NSV 9000 CASES UPTO JANUARY 2008. TARGET 2007-08: 10000• INITIATIVES TAKEN FOR HIRING CONSULATNCY FOR CONDUCTING

SURVEY ON SEX RATIO, IMR & MMR

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NRHM FLEXI POOL• Rs.285 LAKH UNTIED FUNDS TRANSFERRED FOR SUB

CENTRES. FUNDS UTILIZED. UCs UNDER PROCESS.

• Rs.1131 LAKH RELEASED TO 11319 VHSCs, UCs by 31.03.2008

• 13190 ASHAs SELECTED. Rs.1.32 Cr. RELEASED, UCs by 31.03.2008

• UNTIED GRANTS RELEASED TO PHCs- Rs.121 LACS, Rs.664 LAKH TO CHCs-STAND UTILIZED

• Rs. 244 LAKH DISTRIBUTED TO RKS- STAND UTILIZED

• IN 116 CHCs RENOVATION WORKS AT Rs. 20 LAKH HAS BEEN DONE IN 1st PHASE.

• AWARDS FOR MMUs GIVEN, DELIVERY EXPECTED BY END MARCH 08. Rs. 440 LAKH ALREADY UTILIZED OUT OF 829 LAKH

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IMMUNIZATION• Rs. 125 LAKH ALLOCATED TO DISTRICTS FOR

IMMUNIZATION ACTIVITIES.• Rs.680 LAKH FOR DIFFERENT PP ROUNDS

SPENT- NO NEW CASE of POLIO REPORTED

NDCP• FOR RNTCP, Rs. 258 LAKH SPENT• FOR NVBDCP, Rs.51 LAKH SPENT• FOR NLEP, Rs.33 LAKH SPENT• FOR NPCB, Rs.320 LAKH ALLOCATED FOR

PURCAHSE OF EQUIPMENT AND IEC• FOR IDSP, Rs.31 LAKH SPENT ON 12TH

JANURARY, 2008 PILOT PROJECT ON LIFE STYLE DISEASES LAUNCHED IN JALANDHAR

FINANCIAL PERFORMANCE 2007-08

  OP BALANCE 1-4-07

APPROVED OUT LAY

FUNDS RELEASED

FUNDS AVAILABLE DURING

07/08

TOTAL ANTICIPATED EXPENDITURE

F W - 5511 4013 4013 5511

RCH II 2566 5109 - 2566 3252

NRHM 5459 6773 3008 8467 8243

IMM. 50 185 85 135 185

PP - 680 680 680 680

NDCP 271 1105 457 728 1317

TOTAL 8346 19363 8243 16589 19188

Rs. In LAKH

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RESPONSE TO THE APPRAISAL REPORT OF

THE SUB GROUP

Comment1.

Regarding payments being made to ASHA, it should be program-wise and not in consolidated manner. Further, all such payments to be made through cheque only. In no circumstances cash payments are to be made.

Response AddressedPayments to ASHAs will be through bearer cheques

Comment2.

Since Punjab is not a high focus State booking of expenditure for ASHA to be made against RCH flexi pool head

Response Addressed

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Comment3.

In respect of up gradation of CHCs to IPHS the status of each activity under the program needs to be indicated, such as human resource etc. Similarly, in respect of 24 x 7 PHCs, how many have been completed and how many are in the process of completion. Similarly, FRUs position of anesthetists etc. are to be given.

Response Addressed75 PHCs taken up for 24x7, 40 have been completed. 32 Female Medical Officers, 25 obstetricians & Gynecologists and 18 Pediatricians appointed on contract, 22 Anesthetists engaged on call basis

Comment4.

About NSV activity, previous year’s progress was significantly low, only 8%, the current year status to be indicated.

Response 9000 cases up to January 2008. Target for 07/08 is 10,000.

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Comment5.

In regard to institutional deliveries, through Public Private Partnership, the strategy of Chiranjivi Jojana of Gujarat is to be followed, instead of the separate cost per delivery as indicated in the PIP. Since, in this system there is chance of tempering the actual position and most of the deliveries may be shown under caesarean cases only..

Response Addressed. Single package for each delivery introduced

Comment6.

Under BCC activity, in respect of inter-personal communication, the same should be from within the House only i.e. State’s own person.

Response Incorporated

Comment7.

Service guarantee in PHCs should be there and the monitoring component should be kept very strong to achieve good and quality progress.

Response Will be addressed during the course of implementation. 12

Comment8.

It appears, the State governance issue is one of the major crises. This needs to be tackled with better management policy.

Response Every effort will be made to improve this.

Comment9.

Since the State of Punjab is already having sufficient buildings, the State should make these functional first for the purpose the same were constructed, instead of going for further civil constructions.

Response Addressed. Minimal civil works proposed. Only one new CHC proposed to be constructed.

Comment10.

Since an amount of Rs. 10,000/- per SC is being given every year as untied fund further projection of funds requirement for SC seems not justified. The strategy followed by Haryana State in this regard may be followed.

Response Incorporated as suggested.13

Comment11.

Since immunization is also an activity under the NRHM strategy, it should not be seen as a vertical program.

Response Suggestion well taken.

Comment12.

The ANMs who are on deputation in other districts need to be repatriated and the same need to be certified.

Response Orders for cancellation of deputations issued

Comment13.

Under AYUSH instead of fresh recruitment of doctors and para medicos, they are to be re-located in PHCs and CHCs

Response Suggestion well taken, action will be taken accordingly.

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Comment14.

Under Disease Control Program, it appears the plan is very ambitious, hence, the achievement of Goal needs to be looked into. Salary component charged is very high.

Response Goals revised. Salary discrepancy removed.

Comment15.

Audit Report of 2006-07 for NVBDCP is pending

Response Audit report sent on 11.03.2008

Comment16.

In respect of each and every budgeted item, it should be linked with physical target to be achieved.

Response Being looked into.

Comment17.

For inter-sectoral convergence, no separate budget needs be charged

Response Budget being charged under NRHM only

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Comment18.

Executive Director, HNSRC pointed out that in respect of GDP , the performance of the State is very poor and the sex ratio is in declining trend..

Response Comments well taken. All efforts are being made to improve the sex ratio.

Comment19.

No budgeting for New Born Care activity. The IMR of the State is very poor.

Response Innovative New Born Care activities added

Comment20.

Instead of paying rent for AYUSH dispensary, re-locating needs to be done.

Response Addressed

Comment21.

No meeting of State Health Mission and District Health Mission have been conducted.

Response Will be conducted soon.

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Comment22.

In 50% of PHCs not even a single Medical Officer is available

Response New recruitments are under process

Comment23.

In respect of PHCs facility survey needs to be conducted.

Response Facility surveys completed, report submitted

Comment24.

Since already compensation package exists, again separately the same cannot be charged in the budget.

Response Discrepancy corrected.

Comment25.

The training activity is not proper, like multi skilling training not being done considering them under NRHM, focus is for skilled service providers

Response Addressed. Multi skilling training being undertaken.

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Comment26.

Under Urban Health Component, Urban slum project needs to be acted upon for migrant population, such as in harvesting season.

Response Will be considered for next year

Comment27.

The Bathinda District Area where Cancer is in alarming stage need to be considered..

Response Addressed. Four Mobile Cancer Vans proposed for cancer prone belt.

Comment28.

In regard to purchase of computer, duplication to be avoided, not to charge this item separately for each program

Response Suggestion well taken for compliance

Comment29.

There is huge unspent balance with the State (about 60 crores) for which UCs need to be sent.

Response UCs being collected from field and will be submitted at the earliest possible

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Comment30.

The State’s share of 15% of the total budget is to be credited to the State Health Society and to be booked under Mission Flexi pool

Response State’s share will be provided.

Comment31.

For 2008, RCH II F.P.- Rs. 48.82 crores

Mission F.P.- Rs. 41.92 crores

Total - Rs. 90.74 crores

+ unspent balance of

(2007-08)

+ 15% States share

Response The State PIP 2008-09 is indeed over budgeted but the State is now well on its feet for implementation of the program at a much faster pace. Activities proposed in the PIP may be approved in principle, implementation will be well within the overall allocation/ availability of funds.

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PROPOSED INITIATIVES IN 2008-09

PART A RCH-II

MATERNAL HEALTHRs. 496.84 LAKH HAS BEEN PROPOSED DURING THE FY 08/09 FOR ACTIVITIES UNDER MATERNAL HEALTH

• EARLY REGISTRATION OF PREGNANCY AND ENSURING INSTITUTIONAL DELIVERY – INCENTIVE TO LINK WORKERS @ RS. 200/- PER ACTIVITY

• MINIMUM 3 ANCs BY ANM OR MO AND 3 PNCs• ENSURING SAFE DELIVERY AT HOME

– TBAs/ANMs EQUIPPED WITH DISPOSABLE DAI KITS

• 24 HR DELIVERY SERVICES IN IDENTIFIED PHCs– DURING 2008-09 25 MORE PHCs TO BE STRENGTHENED 75 PHCS ALREADY

TAKEN UPTO 2007-08

– INFRASTRUCTURE SUPPORT

– FEMALE MEDICAL OFFICERS AND STAFF NURSES ON CONTRACT

– GENERATOR FACILITIES TO BE PROVIDED

– PROVISION OF TELEPHONE FACILITIES

Contd…

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MATERNAL HEALTH

24 HR CEmONC SERVICES IN SELECTED CHCs

• 50 CHCs STRENGTHENED FOR CEmONC SERVICES UPTO 2007-

08

• 10 MORE CHCs ARE PROPOSED TO BE TAKEN UP IN 08/09.

• 5 STAFF NURSES PER CHC TO BE RECRUITED- ON CONTRACT

• OBSTETRICIAN, PEDIATRICIANS, OT ASSISTANTS ON CONTRACT

• ANAAESTHETISTS ON CALL BASIS FROM A PANEL

• NEW BORN CARE CORNERS IN THE IDENTIFIED CHCs.

• BLOOD STORAGE UNITS IN THE IDENTIFIED CHCs.

Contd…

PART A RCH-II

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JANANI SURAKSHA YOJNARS. 216 LAKH HAS BEEN PROPOSED DURING THE FY 08/09

•IMPLEMENTATION TO BE AS PER GOI GUIDELINES •PAYMENTS TO BE THROUGH BEARER CHEQUES

ACCREDITED SOCIAL HEALTH ACTIVIST (ASHA)

• TOTAL 13190 ASHAs SELECTED. RS. 780 LAKH PROPOSED DURING THE FY 08/09 FOR INCENTIVES, TRAININGS AND SUPPLY OF DRUG KITS.

• ASHA RESOURCE CENTRE AS A PART OF THE STATE RESOURCE CENTRE TO BE ESTABLISHED. RS. 76 LAKH PROPOSED FOR THIS IN THE FY 08/09

PART A RCH-II

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CHILD HEALTHRS. 630.89 LAKH HAVE BEEN PROPOSED DURING THE FY 08/09

– NEW PROGRAMME OF INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESSES (IMNCI) IN 4 DISTRICTS (AMRITSAR, TARAN TARAN, LUDHIANA AND PAITALA)- 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 IMMUNISATION SERVICES (DETAILS UNDER IMMUNIZATION)

– 25 NEW BORN CARE CENTRES ESTABLISHED AT CHC LEVEL, TOTAL 35 MORE TO BE ESTABLISHED UPTO 2008-09.

– DISTRIBUTION WITH TRAINING OF MANUAL MUCUS SUCKERS TO SBAs

– PROMOTION OF EXCLUSIVE BREAST FEEDING THROUGH IEC AND FOCUSED GROUP DISCUSSIONS

– PROMOTION OF DELIVERIES BY SBAs BY PROVIDING TRAININGS AND SENSITIZATION THROUGH IEC ACTIVITIES

PART A RCH-II

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BREAST FEEDING SCHEME

RS. 188.04 LAKH PRPOSED DURING THE FY 08/09

• State-wide behaviour change effort to promote breastfeeding by involving all grass root workers (ANMs/ AWWs/ ASHAs).

• At PHC level Medical Officer, staff nurse to be sensitized.• ANMs/Male Health Workers to counsel mothers for

breast-feeding. • 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.

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FAMILY PLANNINGRS. 1063.32 LAKH PRPOSED DURING THE FY 08/09

– 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

– PROCUREMENT OF NSV SETS & LAPAROSCOPES- REPAIR OF LAPAROSCOPES

– COMPENSATION PACKAGE FOR STERILIZATION / IUD AS PER GOI GUIDELINES

PART A RCH-II

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ARSHRS. 27.07 LAKH PROPOSED DURING THE FY 08/09

– NEW PROGRAMME INTRODUCED BY GOI FROM YEAR 2007-08.

– 6 DISTRICTS COVERED DURING 2008-08.

– SEVEN MORE DISTRICTS TO BE COVERED IN THE YEAR 2008-09 (GURDASPUR, FARIDKOT, MUKATSAR, FATEGARH SAHIB, KAPURTHALA,MOHALI,PATIALA).

– ADOLESCENT FRIENDLY HEALTH SERVICES THROUGH 640 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 COUNSELING, 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

– STATE LEVEL WORKSHOP

– UNDER IEC ACTIVITIES ADVOCACY WORKSHOP AT 7 DISTRICTS & ALL BLOCKS IN THE SELECTED DISTRICTS

PART A RCH-II

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URBAN RCHRs.116.40 LAKH PROVIDED DURING THE FY 08/09

– CONTRACTUAL APPOINTMENT OF 230 MPHWs IN SLUM AREAS OF THE STATE TO CONTINUE

– OUT REACH CAMPS 6 CAMPS PER DISTRICT IN 08/09

– MOBILITY ALLOWANCE @ RS. 500/- PER MONTH PER MPHW TO CONDUCT HOUSE TO HOUSE SURVEYS AND SPECIAL IMMUNIZATION DRIVES TO REDUCE DROP OUTS.

PART A RCH-II

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PNDT & SEX RATIO

Rs. 97.57 LAKH PROVIDED DURING THE FY 08/09 :

– THIRD PARTY SURVEY FOR SEX RATIO AT BIRTH

– 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.

– MONITORING OF ENFORCEMENT OF PNDT ACT THROUGH MOBILITY SUPPORT TO STATE & DISTRICT LEVEL OFFICERS (POL)

– 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.

PART A RCH-II

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INNOVATIONS / PPP / NGORs. 468.50 LAKH PROPOSED DURING THE FY 08/09

– MNGO & NGO (SNGO)– SELECTION OF MNGOs AND SNGOs FOR DIFFERENT DISTRICTS - 11 MNGOS

SELECTED COVERING 14 DISTRICTS OUT OF 20 COMPLETED, REAMINING 6 TO BE COVERED DURING FY 08-09

– PREPARATORY GRANT TO NEWLY SELECTED MNGOs FOR PROPOSAL DEVELOPMENT @ Rs. 1.00 LAKH PER MNGO.

– Ist INSTALMENT OF GRANT-IN-AID FOR 18 MONTHS TO NEWLY SELECTED MNGOS

– IInd INSTALMENT OF GRANT-IN-AID FOR 12 MONTHS TO Already EXISTING MNGOs

– Ist INSTALMENT OF GRANT-IN-AID FOR 18 MONTHS TO EXISTING SNGOs – PREPARATORY GRANT TO NEWLY SELECTED SNGOs FOR PROPOSAL

DEVELOPMENT – PPP INOVATIONS FOR CEmONC SERVICES – SURAKHIT JANEPA YOJNA (SJY)– PROMOTIONAL ACTIVITIES- SEMINARS/WORKSHOPS/REVIEW MEETINGS OF

MNGOs/ SNGOs.

PART A RCH-II

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SURAKHIT JENEPA YOJNA (SJY) FOR BPL/ SC WOMENRs.200 LAKH PROPOSED DURING THE FY 08/09.

– CONTRACTING OUT ACCREDITED PRIVATE PRACTITIONERS/NGOs FOR PROVISION OF ANC/PNC/ MATERNITY SERVICES IN UNSERVED/UNDERSERVED RURAL/URBAN AREAS

– IDENTIFICATION /REGISTRATION /TRACKING OF BENEFICIARIES BY ANM/ AWW/ ASHA AND MO I/c OF THE CONCERNED PHC/CIVIL DISPENSARY ETC.

– AVERAGE FIXED RATE FOR ECH DELIVERY (NORMAL, CAESAREAN OR COMPLICATED) INCLUDING ANC, PNC, MEDICINES, TRANSPORT, LINK WORKER INCENTIVE REFERRAL ETC.

PART A RCH-II

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LOGISTICSRs. 78.85 LAKH PROPOSED DURING THE FY 08/09

– POL FOR TRANSPORTATION OF SUPPLIES FROM STATE UP TO SUB CENTRE LEVEL– STRENGTHENING OF WAREHOUSE FACILITIES.

HMISRs. 474.44 LAKH PROPOSED DURING THE FY 08/09

• 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.

PART A RCH-II

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QUALITY ASSURANCE

Rs. 22.76 LAKH PROPOSED DURING THE FY 08/09

– QUALITY ASSURANCE COMMITTEES AT STATE, DISTRICT AND BLOCK LEVEL

– PATIENT SATISFACTION SURVEY WILL BE CONDUCTED THROUGH PRIVATE AGENCY

– PURCHASE OF HOT AIR OVENS, AUTOCLAVES, NEEDLE SYRINGE DESTROYERS FOR 60 CHCs AND 100 PHCs

– TRAINING FOR MANAGEMENT OF WASTE

– TRAINING OF STAFF FOR SEGREGATION & TREATMENT OF MEDICAL WASTE

– ENACTMENT OF NURSING HOME REGISTRATION ACT

PART A RCH-II

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TRAININGSRS. 543.88 LAKH PROPOSED DURING THE FY 08/09

– REPAIR & RENOVATION OF SIHFW, ANM-TCs D-TCs AND PROVISION OF TRAINING AIDS

– 5 FACULTY POSTS ON CONTRACT – PREPARATION OF TRAINING MATERIAL AND OPERATIONAL COST OF

SIHFW– TRAININGS PLANNED FOR THE YEAR 2008-09 AND ACHIEVEMENTS TILL

DATE :• PDC TRAINING FOR 80 DISTRICT LEVEL OFFICERS- • BCC SKILL BUILDING TRAININGS FOR 300 MOS – YET TO BE TRAINED• BCC SKILL BUILDING TRAININGS ANMS+ LHVS+ HW(M)+ HS (M) + BEE +

DY. MEIO• SBA TRAINING OF ANMS LHVS• TOT ARSH TRAINING FOR 28 STATE AND DISTRICT MANAGERS, • 288 MOS, 180 ANM, LHV, MPHW (M), AWW OF THE DISTRICTS

IDENTIFIED DURING 2007-08.• 360 MOS 840 ANMS/LHVS TO BE TRAINED IN THE YEAR 2008-09• SBA TRAINING FOR 60 ANM, 60 LHV, 60 SN – 15 ANM, 15 LHV, 15 SN

TRAINED; 100 MO (PHC)-

PART A RCH-II

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TRAININGS• LIFE SAVING ANESTHESIA SKILLS

– TOT FOR ANESTHESIA SKILL TRAINING– TRAINING OF MBBS DOCTORS IN LIFE SAVING SKILLS- 18 BATCH – ORIENTATION OF TRAINING OF 40 DISTRICT ANESTHETIST-

• CONTRACEPTIVE UPDATE TRAINING FOR 1200LHV/ANM –

• CONTRACEPTIVE UPDATE TRAINING FOR 1200 HW (M)-

• IUD INSERTION TRAINING TO 1200 LHV/ANMS

• MTP TRAINING FOR 120 MOS

• RTI/STI TRAININGS FOR 30 DISTRICT PROGRAMME OFFICERS, 800 MOS, 1200 SNS/ANM/LHV.

• TRAINING OF MOS, PARA MEDICS ON ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH.

• IMEP TRAINING FOR MOS AND PARA MEDICS.

• INDUCTION TRAINING OF DPMU

• INTEGRATED NRHM TRAINING FOR MOs OF ‘PRIVATE SERVICE PROVIDERS’ SCHEME

PART A RCH-II

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BEHAVIOUR CHANGE COMMUNICATIONRS. 352.50 LAKH PROPOSED DURING THE FY 08/09

– STRATEGIES FOR INTRA COMMUNICATION DESIGNED AND RS 33.92 LACS PROPOSED

– 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

PART A RCH-II

37

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A: RCH-II BUDGET FOR THE YEAR: 2008-09 A: RCH-II BUDGET FOR THE YEAR: 2008-09 (RS IN LAKHS)

S. NO ACTIVITY BUDGET 1 MATERNAL HEALTH + JSY 496.84

2 CHILD HEALTH 630.89

3 FAMILY PLANNING 1063.32

4 ADOLESCENT HEALTH 27.07

5 URBAN RCH 116.40

6 ASHA 820.14

7 PNDT 97.57

8 INNOVATIONS/PPP/NGOS 468.50

9 INFRASTRUCTURE AND HUMAN RESOURCE 1787.40

10 INSTITUTIONAL STRENGTHENING 576.05

11 TRAINING 543.88

12 BCC/IEC 352.50

13 PROCUREMENT 505.44

14 PROGRAMME MANAGEMENT 567.22

15 Flexi pool 100.00

TOTAL (EXCLUDING COMPENSATION FOR STERILIZATION)

8153.21

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PART B- NEW INITIATIVES UNDER NRHM

VILLAGE HEALTH & SANITATION COMMITTEESRS.1230 LAKH PROPOSED.

– DISSEMINATION OF GUIDELINES OF VHSC IN LOCAL LANGUAGES.

– PROVISION FOR UNTIED FUND @ RS. 10000/- PER VHSC PER ANNUM.

UNTIED FUNDS FOR SUB CENTRES, PHCS, CHCS– RS. 10,000/ P.A. PER SUB CENTRE FOR 2862 SUB

CENTRES. – RS. 25,000/- P.A. PER PHC FOR 484 PHCs – RS. 50,000/- P.A. PER CHC FOR 128 CHCs

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ANNUAL MAINTENANCE GRANTS

RS. 615 LAKH PROPOSED FOR ANNUAL MAINTENANCE GRANTS.

– @ RS. 10000/- P.A. PER SUB CENTRE

– @ RS. 50000/- P.A. PER PHC.

– @ RS. 100000/- P.A. PER CHC

MOBILE MEDICAL UNITS (MMUs)

– RECURRENT COST FOR 20 MMUs @ RS. 397.40 LAKH P.A. Rs. 397.40 LAC PROPOSED FOR FY 08-09

– RECURRENT COST FOR SALARIES, MEDICINES etc FOR 20 MMUs

PART B- NEW INITIATIVES UNDER NRHM

40

UPGRADATION OF CHCs TO IPHS

Rs. 2359.01 LAKH PROPOSED DURING THE FY 08/09 – 42 CHCS IN WHICH ADEQUATE INFRASTRUCTURE COULD NOT

BE PROVIDED UNDER THE WORLD BANK PROJECT DUE TO CONSTRAINT ON FUNDS WILL BE TAKEN UP FOR UPGRADATION IN PHASES UPTO YEAR 2012.

– NEW ADDITIONAL 1 CHC TO BE CONSTRUCTED in 2008-09. – EQUIPMENT, FURNITURE FOR ALL CHCS AS PER IPHS NORMS

IN PHASES.– PROVISION FOR DRUGS @ RS. 10.00 LAKH P.A. PER CHC (50%

CHCS) RS. 560 LAKH. – MOBILITY SUPPORT FOR MO FOR HOLDING CLINICS IN PHCs @

RS. 48000/- P.A. PER PHC. – MANPOWER SUPPORT AS PER IPHS NORMS IN PHASES

PART B- NEW INITIATIVES UNDER NRHM

41

UPGRADATION OF PHCs FOR 24 HRS SERVICESRS. 2570.93 LAKH PROPOSED DURING THE FY 08/09

– EQUIPMENT & FURNITURE FOR 578 PHCS IN PHASES– DRUGS @ RS. 3.00 LAKH PER PHC P.A. – SALARY FOR NEW STAFF AS PER IPHS NORMS IN PHASES.

UPGRADATION OF SUB CENTRESRS. 3553.82 LAKH PROPOSED DURING THE FY 08/09

– CONSTRUCTION OF 403 EXISTING SCs LOCATED IN RENTED BUILDINGS IN PHASES OUT OF WHICH 50 TO BE TAKEN UP IN 2008-09.

– 900 EXISTING SCs NEED RESTORATION, OUT OF WHICH 77 WILL BE TAKEN UP IN 2008-09

– CONSTRUCTION OF 615 SCs REQUIRED AS PER IPHS NORMS.– SALARY OF ANMS ONE ADDITIONAL ANM IN ALL EXISTING 2862 SCs. 2

ANM FOR 615 NEW SCs.

PART B- NEW INITIATIVES UNDER NRHM

42

UPGRADATION OF SHCs (ALTERNATE HEALTH DELIVERY SYSTEM)

– DRUGS FOR 1310 SHCS Rs.600 LAKH.

UPGRADATION OF SDH/FRUs

Rs. 300 LAKH PROPOSED DURING THE FY 08/09

– EPAIR, RENOVATION, ALTERNATION OF SDHs.

UPGRADATION OF DISTRICT HOSPITALSRs. 370 LAKH PROPOSED DURING THE FY 08/09 (TOTAL 3700 LAKHS) PHASED OUT IN PLAN PERIOD

– THREE NEW DISTRICTS CREATED WHERE THE EXISTING SDHs ARE TO BE UPGRADED TO 100 BEDDED DHs.

– HOSPITALS AT GURDASPUR AND LUDHIANA TO BE UPGRADED TO 200 BEDDED HOSPITALS IN PHASES

PART B- NEW INITIATIVES UNDER NRHM

43

SCHOOL HEALTH• PROVISION FOR SCREENING OF ALL THE SCHOOL

CHILDREN FOR WHICH RS. 500 LAKH HAVE BEEN PROPOSED.

ROGI KALYAN SAMITIS • PROVISION FOR PRINTING OF GUIDELINES OF

RKS IN LOCAL LANGUAGE• ANNUAL CONVENTION OF RKSs.

PART B- NEW INITIATIVES UNDER NRHM

44

BUDGET FOR THE YEAR: 2008-09 S. NO ACTIVITY BUDGET

1 VILLAGE HEALTH & SANITATION COMMITTEES 1230.00

2 SC UNTIED FUND & MAINTENANCE 286.20

3 PHC UNTIED FUND & MAINTENANCE 121.00

4 CHC UNTIED FUND & MAINTENANCE 64.00

5 ANNUAL MAINTENANCE GRANT 615.20

6 MOBILE MEDICAL/ HEALTH UNITS 397.40

7 UP-GRADATION OF CHC 2359.01

8 UP-GRADATION OF PHC 2570.91

9 UP-GRADATION OF SC 3553.82

10 UP-GRADATION OF SHC 600.00

11 UP-GRADATION ON SDH/ FRUS 300.00

12 UP-GRADATION OF DH 370.00

13 SCHOOL HEALTH 500.00

14 ROGI KALYAN SAMITIES 12.33

15 Strengthening of Prog. Management 476.56

16 Strengthening of Logistics Mgmnt. 50.00

TOTAL B 13506.45

PART B- NEW INITIATIVES UNDER NRHM(RS IN LAKHS)

• 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

• VISITING UNCOVERED AREAS BOTH URBAN AND RURAL THROUGH MOBILE TEAMS

• 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

PART C- IMMUNIZATION

46

SR. NO.

ACTIVITY BUDGET

1 ALTERNATIVE VACCINE DELIVERY 90.05

2 MOBILIZATION OF CHILDREN BY AWW/TBA/ASHA

55.30

3 STRENGTHENING OF MONITORING AND SUPERVISION

9.18

4 COMPUTER ASSISTANT TO DIOS, ADDITIONAL SUPPORT FOR SLUMS & UNDERSERVED AREA AND REVIEW MEETINGS

97.40

TOTAL 251.93

BUDGET FOR THE YEAR: 2008-09 (RS IN LAKHS)

PART C- IMMUNIZATION

47

RNTCP• PUNJAB IS MAINTAINING CURE RATE MORE THAN 85%• CASE DETECTION RATE IS 60%, TARGET TO INCREASE IT TO 70% DURING 08/09.• TRAINING FOR HEALTH FUNCTIONARIES ON T.B/HIV• INVOLVEMENT OF NGOS AND PPP • RS. 606.67 PROPOSED / BUDGET RECEIVED TO 739.68 AS PER APPRAISAL BY THE SUB

GROUP.

NLEP• PUNJAB IS THE LOW ENDEMIC STATE BECAUSE OF PR 0.32 PER 10,000 POPULATION WHICH

IS MUCH BELOW THE NATIONAL PR OF 0.7• ACTIVITIES FOR IEC, TRAININGS ARE TO BE UNDERTAKEN• INCENTIVE FOR DETECTION OF LEPROSY CASE @ RS. 100/- PER CASE.• SUPPORTIVE MEDICINES AND SUPPLIES• PROGRAMME STRATEGY AS PER GOI GUIDELINES.

NPCB• PR IN STATE IS 0.7% (NATIONAL PR IS 0.8%)• PURCHASE AND INSTALATION OF PHACO MACHINES• STRENGTHENING AND SUUPLIES TO NEW VISION CENTRES IN ALL 20 DISTRICTS.• SUPPLY OF SPECTACLES AND OTHER SUPPLIES UNDER SCHOOL EYE CARE PROGRAMME• EYE DONATION CAMPS.• TRAINING OF OPHTHALMOLOGICAL SURGERY (TO BE ORGANIZED BY GOI)

PART D- NDCP

48

IDDCP• PUNJAB IS THE LOW ENDEMIC STATE FOR IODINE DEFICIENCY DISEASE• STATE HAS ESTABLISHED AN IDD MONITORING LAB IN CHANDIGARH FOR

IODINE ESTIMATION OF SALT SAMPLES• STATE HAS CONDUCTED SURVEY FOR DETECTION OF IODINE DEFICIENCY

DISORDERS IN 2007 IN FOUR DISTRICT NAMELY ROPAR, FG SAHIB, N.SHAHAR AND BATHINDA: IDD : 5.33% IN ROPAR, 0.02% IN NAWANSHAHAR, 0.2% IN F.G. SAHIB AND 2.33% IN BATHINDA.

• IEC ACTIVITIES FOR THE PROGRAMME

NVBDCP• ACTIVE & PASSIVE SURVEILLANCE … • RAPID RESPONSE TEAMS AND CONTROL ROOMS.• MALARIA CLINICS – 673 AS PER NATIONAL NORMS COMPLETE• MAINTENANCE OF HATCHERIES AT DISTRICT LEVEL• TRAINING OF MOS AND PARA MEDICS• 100% COVERAGE OF MALARIA +VE CASES• STRATEGY – AS PER GOI GUIDELINES• AUGMENTATION OF MANPOWER, TRAINING AND INTRODUCTION OF PPP &

PROVISION OF LOGISTICS

PART D- NDCP

49

IDSP• SYNDROMIC SURVEILLANCE FOR COMMUNICABLE

DISEASES LAUNCHED

• REPORTING OF EARLY WARNING SIGNALS OF OUTBREAKS ON WEEKLY BASIS STARTED

• IDENTIFICATION OF DISTRICT HEALTH LABORATORY DONE

• ELISA READER MACHINE AT 20 SITES

• INFRASTRUCTURE UPGRADATION ALL DSUS

• TRAINING OF AYUSH MOS

• TRAINING AND CAPACITY BUILDING OF MEDICAL OFFICERS AND PARA MEDICALS

PART D- NDCP

50

BUDGET FOR THE YEAR: 2008-09 (RS IN LAKHS)

S.NO ACTIVITY BUDGET

1 NATIONAL TB CONTROL PROGRAMME (RNTCP) 739.68

2 NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) 210.58

3 INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP)

222.46

4 NATIONAL IODINE DEFICIENCY DISORDER CONTROL PROGRAMME (NIDDCP)

20.00

5 NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME (NVBDCP)

513.56

6 NATIONAL BLINDNESS CONTROL PROGRAMME (NBCP) 670.00

TOTAL 2376.28

51

PART D- NDCP

51

RS. 1412.67 LAKH HAS BEEN PROPOSED FOR THE FY 08/09

AYUSH

– TO MEET THE HEALTH NEEDS AND HARNESS THE POTENTIAL OF INDIGENOUS HEALTH KNOWLEDGE CONVERGENCE WITH AYUSH

– CONTRACTUAL APPOINTMENT OF ONE AYUSH DOCTOR (IN PHASED MANNER)

– CONTRACTUAL APPOINTMENT OF ONE AYUSH DOCTORS (HOMEOPATHY)

PART E- INTERSECTORAL CONVERGENCE

52

INNOVATIONS FOR VUNERABLE POPULATION

• 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 (PAMPHELETS, HOARDINGS, WALL PAINTINGS)

• MEETINGS/WORKSHOPS WITH STAKEHOLDERS AND OPINION LEADERS

• PEER EDUCATOR

• SPECIAL PROGRAMME FOR CONTROL OF CANCER IN THE MALWA REGION

• STRENGTHENING OF TB CENTER AT PATIALA

53

PART PARTICULARS AMOUNT (RS. IN LAKH)

A) RCH – II 8153.21

B) NEW INITIATIVES UNDER NRHM. 13506.45

C) STRENGTHENING OF IMMUNIZATION 251.93

D) NATIONAL DISEASE CONTROL PROGRAMME

2376.28

E) INTERSECTORAL CONVERGENCE 1412.67

F) CENTRALLY SPONSORED SCHEMES 7164.00

TOTAL = 32864.54

OVERALL BUDGET

54

THANK YOU