In order to develop the District Action Plan under NRHM Government of India has

send guidelines for developing District Action Plan. Considering the above

guidelines the following steps have been under taken to finalize the DAP under

NRHM.

Information regarding the district has been collected from census data and

DLHS data commissioned by Government of India.

Information is also collected from various departments, which are involved

in achieving NRHM goals and objectives.

Programme implementation plan, which is an integral part of the NRHM

has been taken into consideration in developing the District Action Plan.

Various development schemes of the Government, implemented currently

have also been taken into consideration.

District Focused Group Discussions (FGDs) held in villages, CHC/PHCs,

block functionaries, Urban slums and district level Officials during the

preparation of District PIPs for identifying perception, practices &

problems related health related issues have been utilized in identifying the

interventions under NRHM District Action Plans.

The intervention proposed to achieve NRHM goals in the districts

Budget and timelines for the interventions have been set considering the

norms and guidelines of Government of India.

Monitoring and Implementation mechanism has also been incorporated in

the District Action Plan.

1. District Profile – FaizabadThe city of Faizabad originally known as  Faizabad, is situated in Eastern India, in Uttar Pradesh State, on the bank of River Saryu, about 130 k.m. east of  Lucknow. Ali Vardi Khan, nawab of Bengal (1676-1756), founded the city in 1730. During the reign of Shuja-ud-daula, Faizabad attained a very rich prosperity. The Nawabs graced Faziabad with several beautiful buildings; notable among them are the Gulab Bari, Moti Mahal and the tomb of Bahu Begum. Gulab Bari is a beautiful building of fine architecture, standing in a garden surrounded by a wall, approachable through two large gateways. These buildings are particularly interesting for their assimilative architectural styles. Faizabad is a place of sugar refineries and mills for extracting oil from seeds. It is a big market centre too. Ayodhya, which is one of the famous religious centre and an

1

PLLANING PROCESS

Planning Process

PLLANING PROCESS

Planning Process

important place of Hindu pilgrimage of India is located across the river and form a part of Faizabad. This district has a many educational institutions including Dr. Ram Manohar Lohia University and Narendra Dev Agricultural University.

Tourist Place are, Gulab Bari, Maqbara, GuptarGhat, Hanuman Garhi and a lots of tourist places are in Ayodhya, which is about 6 km. away from Faizabad.

The basic population statistics according to Census of 2001 are given below:

Population Indicators

Table-1

Sl.No. Index Uttar Pradesh

District

1 Population In Crore In Lakhs

Male 8.75 10.77

Female 7.86 10.11

Total 16.60 20.88

2 Population

Rural 13.15 18.08

Urban 3.45 2.81

3 SC/ST Population (%) 21.23 22.61

BPL Population 5.00 28.48

10 Percentage population increase (1991-2001)

25.80 23.87

11 Percent literate

Male 70.23 69.41

Female 42.98 42.25

Total 57.36 57.48

12 Density (Population/sq. km.) 690 892

13 Sex Ratio (Female/Male per 1000) 898 939

2

14 Population (0-6) 3.04 3.68

15 Total Couples # 2.82 3.54

16Size of villages

1-50026793 250

501-200052367 719

2001-500016302 247

5000 +2480 31

Estimated figure 17 % of Population

Table 1 provides the population characteristics of the district in comparison to the state. According to 2001 census, the total population of the district was enumerated as 20.87 lakhs of which 10.76 lakhs are males and 10.11 lakhs are females. The district accounts for about 1.26 per cent of the total population of the state. While one in seven persons in the district reside in urban areas, it is around two per ten persons in the state. Around 88.7 percent of the population in the district is Hindus and 11.2 percent is Muslims. SCs/STs constituted around 31% of the population in the district that was much higher than the state average (21 percent). The decadal growth rate during 1991-2001 recorded in the district was 23.87 per cent equal to state average of 23.8 per cent. The population density in 2001 was 892 persons per sq. km. The sex ratio of 953 females per 1000 males is higher than the state level (898 in 2001). The child sex ratio in age group 0-6 in the district is 952 females per 1000 males, which is higher than the state average (916).

Public Health and other Department Infrastructure in the District Table-5

Health Facility

Number

TotalGovernment

BuildingsRented

Medical Colleges (AYUSH) 1 1 -District Hospital Male 1 1 -District Hospital female 1 1 -Other District Level Hospital 1 1 -District PPC 1 1 -Urban Family welfare Centres 1 - 1

Urban Health Post 5 0 5CHCs 6 6 -Block PHCs 5 6 -Sub Block PHCs ( APHC/NPHC) 28 20 08Subcentres 246 172 74

3

AWW Centres 1901 1518 383ASHAs 2056Others ESI Hospital 0 0 0

Basic Development Indicators for District

The number of blocks, tehsil, panchayat etc. are as under:

S.N. Index No.1

No. of Tehsils5

2 No. of Developmental Blocks 113 No. of Gram Sabhas 7294 Nyay Panchayats 1305 Revenue Villages 12476 Municipalities 03

Details of Panchayati Raj Institution/ Urban Ward Committees –

District – Faizabad

Table-6S.NO Block No. of

Urban Wards Commi

tees

No. of Gram Sabha villages

No. of Reven

ue Villag

es

Total Nyay

Panchayats

Total ZP members

BDC/Mandal members

Panchayat Pradhans

            M F T M F T M F T

4

1 Bikapur - 59 136 11 2 1 3 44 31 75 24 35 59

2 Taarun - 84 160 14 2 2 4 50 38 88 35 49 84

3 Maya Bazar - 71 110 16 3 - 3 42 35 77 29 42 71

4 Poora Bazar - 61 102 14 2 1 3 46 33 79 34 27 61

5 Sohawal - 53 71 12 2 2 4 56 32   33 20 53

6 Masodha 1 71 91 15 2 2 4 61 34 95 42 29 71

7 Haringthanganj - 55 97 9 2 1 3 37 29 66 27 28 55

8 Milkipur - 69 113 10 1 2 3 50 28 78 38 31 69

9 Amani Ganj - 69 108 11 - 2 2 47 30 77 38 31 69

10 Rudauli 1 90 164 10 1 3 4 67 39 106 47 43 90

11 Mavai - 47 76 8 - 3 3 42 27 69 26 21 47

  Total 2 729 1228 130 17 19 36 542 356 810 373 356 729

Note-2010-11 NO of revenue villege is 1228 as per Revenue department information in Fy 2011-12 the Revenue villeges will be 1247. The details of which is not available

District Manpower-Public

Sanctioned In Position Vacant

Chief Medical Officer 01 01 00Chief Medical Officer(F.W.)

01 01 00

Addl. CMOs 09 01 08Dy. CMOs 09 04 05Dy. CMO NRHM 01 01 00District Malaria Officer 01 01 00DTO 01 00 01District Leprosy Officer 01 01 00DHEIO 01 01 00HEO 11 11 00ANMs 292 268 24

District Infrastructure

Index StatusDistrict Hospital 01District Women Hospital 01Other District Level Hospital 1District PPC 01CHC (Block level) 05

5

B HPC 06Addl./New PHCs (Total) 28

Govt. Accommodation 21Other Govt. Accomodation 02

Private Accommodation 05Sub-Centres (Total) 246

Govt. Accommodation 174Private Accommodation 74

First Referral Units (FRU) 04 (3 CHC & 1 DWH)

24x7 Units 8Accredited Sub-Centres (JSY) 34Rogi Kalyan Samiti (RKS) 14VHSC 729Urban Health Posts 05ASHA 2056

Targets and Achievement of Main NRHM activities for Yr.2010-11Table-4S.L. Main NRHM activities

TargetsAchievement (Jan

11)1 JSY2 RCH Camp3 School Health Programme

4Sterilization

NSVFemale

5 Saloni Scheme6 Training- Skill Birth Attendant7 Periodic Training for ASHAs

Targets for the FY 2011-12S.L. Main NRHM activities Targets

1 JSY2 RCH Camp3 School Health Programme

4Sterilization

NSVFemale

5 Saloni Scheme6 Training- Skill Birth Attendant

6

4. Situational AnalysisUttar Pradesh has the highest birth rate and the highest fertility rate. Female

literacy situation in Uttar Pradesh is also dismal. Uttar Pradesh being the most populous state in the country has Total Fertility Rate of is 3.99. The Infant Mortality Rate is 73 and Maternal Mortality Ratio is 517 (SRS 2001 - 03) which are higher than the National average. Among all major Indian states, Uttar Pradesh has the highest under five mortality rate, the second highest crude death rate. The Sex Ratio in the State is 898 (as compared to 933 for the country). Poverty is also dominant factor of the sate as nearly 32% population lives under poverty line. The per capita income of the state is second lowest in the country. Life expectancy being the third lowest as compared to country is short and uncertain.

District Faizabad being part of the state, is not different from the state, many of the indicator which is low at state level is more pathetic in the district. And other common indicator like Low ANC, low immunization, high fertility is another worrying situation.

Since, implementation of NRHM in Faizabad district during year 2009-10, health scenario of the district has improved to some extent. Institutional delivery has increased, health seeking behavior has changed, and health infrastructure has been upgraded. Now all BPHC has been upgraded to provide 24x7 facilities. Four units have been developed and now providing FRU facility. Human resource gaps has been tried to fill through contractual recruitments. But we have still to go a long way to fulfill the mission goals and objectives.

Similarly the status of infrastructure in the district has also been analyzed for addressing the gaps identified for ensuring quality health service delivery for the community. Considering the above parameters and analysis, along with availability of infrastructure and manpower, economic, social and geographical situation of the district, strategies and inventions have been identified .

Based on situational analysis and in view of objectives of NRHM following strategies has been identified for the district that will be implemented during year 2011-12.

PART A : RCH Flexi Pool

[MATERNAL HEALTH]

A.1JANANI SURAKSHA YOJNA

 

Description Expected Nos.

Total Institutional Deliv. (Rural) (80% @Rs.2000 & 20% @ Rs.1650) 32515

7

RCH Flexi Pool

Maternal Health

Infrastructure

Human Resource

Child Health

Family Planning

Adolescent Health

TrainingLogistic

Total Institutional Deliveries (Urban) @ Rs.1000/- per benef. 4538

Caesarean Deliveries (@ Rs.1500/- per Beneficiary) 539

Home Deliveries (@ Rs.500/- per beneficiary) 756

Total No. of Deliveries under JSY 38347

No. of Blocks (as per RD Deptt.) 11

Admin. Expenses - BPHC (@Rs.0.50 lacs/Yr per BPHC) 6

Admin. Expenses - Non FRU CHC (@ Rs.0.75 lacs/Yr per unit) 3

Admin. Expenses - FRU CHC (@ Rs.1.80 lacs/Yr per FRU CHC) 3

Admin. Expenses - Dist. Level (@ Rs.2.77/Rs.2.78 lacs per year per District) 1

Admin. Expenses - DWH/DCH (@ Rs.3.00 lacs/Yr per unit) 2

Printing of formats, Registers, etc. at District level (@Rs.6/- per beneficiary)

42182

IEC (@Rs. 0.30 lacs per block/yr + Rs.0.50 lacs for district 0 

Sub - Total 23.95

Total of JSY 708.73

JSY is the prime strategy in the NRHM with the objective to increase the institutional deliveries so that the reduction in MMR objective is achieved. The scheme comprises of the payments to the beneficiary and ASHA for food, transportation and motivation.

During the current year the performance and outcome of JSY have been quite encouraging. This scheme has widely boost-up the institutional delivery in the district and the same time, it has also increased the public’s faith in public health facilities. In the year 2010-11 target assigned to the district is 34313 and at the end of Jan 11 district has achieved 30325 against target which is around 90%. This fact is also indicated in DLHS-3 survey reports regarding Institutional delivery. Under administration expenses head, for all levels 4% budgetary hike is recommended as target of district has been raised by 20%.

A1.2 Saubhagyawati Surakshit Matritva Yojana In the fy yr.2010-11 there was 3 private Hospital/Nursing home accredited these all 3 nursing home will continue in the next Fy. Year 2011-12. Name of the private nursing home are given below.

1. Vishal Nurshing Home -Ayodhya2. Dr. V.P. Singh Hospital & Siddique Surgical Centre-Rudauli3. Sitaram Medical Centre-Naka,Faizabad

The above nursing home are not in function. In the year 2011-12 we are hoping to accredited 5 new private nursing home under this scheme. A1.3 : RCH Camp at CHCs / BPHCs

8

Availability of daily services on routine basis to improve service access and address unmet need of RCH services at block PHCs/CHCs will take time. In the interim a regular forum for reproductive health service delivery has to be provided. RCH camp provides an array of MCH & family planning services under one roof, periodically, on an assured basis. These services include:

Counseling for FP and provision of spacing services viz. IUCD, oral pills and condoms Female sterilization services- laparoscopic tubal ligation and/or minilap No Scalpel Vasectomy (NSV) Pregnancy test for all female sterilization clients ANC with TT immunization and IFA distribution with counseling Child immunization services Gynecological check-up by lady medical officer RTI/STI diagnosis and treatment services ANC and follow-up card to be given to clients Transport facility to sterilization clients. RCH camps have been institutionalized to provide good quality RCH services on regular basis through block PHCs/CHCs in rural areas in planned manner on fixed day fixed site basis so as to insure 12 camps per block per year.

A.1.4 : Provision of RTI/STI services .

Absences of RTI/STI diseases are essential for the reproductive health of both men and women and are critical for their ability to meet out reproductive goals. The prevalence of RTI/STIs among women is estimated to around 34%. In order to provide the proper medical treatment and counseling to people suffering from RTI/STI disease, the RTI/STI services would be provided at FRUs of the district. Facilities for confidential counseling would also be strengthened at these units. At present RTI/STI services are not being provided in the district. The DHS proposes 1 New CHC in 2011-12 as FRU hence RTI/STI Kit is needed for this site also along with last years 4 sites in year 2010-11. A1.5 Family Friendly Hospital InitiativesCHC Bikapur-FRU has been selected as family Friendly Hospital in the year 2010-11.CHC Sohawal has been recommended as family Friendly Hospital for the Fy 2011-12.

A1.6 Maternal Death AuditAccording the survey of SRS in UP rate of maternal death was 440 per 1 lac

.while in India 254 per 1 lac live birth. To achieve the target of NRHM by 2012 we

have to achieve the 100 per 1lac live birth rate. To achieve this target we have to

make audit of Maternal Death to find out the gaps, to reduce it for achieve the

target. A.1.5.1

Provision of MDA for CHC(FRU) under RCH Flexi pool as per details, Budget is mentions in PIP Rs.0.72 A.1.5.1

A1.7 Pregnant Women & Child Tracking

9

Orders have been received from Add secretary and mission Director NRHM

ministry of Health and Family welfare Gov. of India to reduce MMR & IMR up to the

acceptance level following efforts should be made on priority basis.

* ANM of the area has to register all the pregnant ladies with their name and

full residential details. Not only this they will arrange all ANC, institutional delivery,

PNC, registration of new born infant ( By name),their full immunization and tracking

in case of dropout. Computers, peripherals, internet facility and data managers are

posted at all block level CHC’s. Tracking of pregnant women and children have

been started at block level facility. for 2011-12 the target for tracking of pregnant

women is 82995 and for Children is 70395.

Provision of Pregnant women & Child tracking under RCH Flexi pool as per details, Budget is mentions in PIP Rs.1.24 A.1.5.1

A1.8 MCH Centers: Recently government has introduced concept of designating and making

functioning health facilities as Mother and Child Health Centers which will

provide all essential services to a woman and children. These facilities may be

a sub center, PHC, CHC, DWH. Under this concept designated facility will be

referred as L-1, L-2 and L-3 facilities. These designated facilities will be

strengthened both in terms of Manpower, training of manpower, instruments

and equipments under NRHM. The table given below gives list of facilities

identified from this block.

Sl.No. Facility Name Operational as

Level 3/2/1Proposed for 2011-12

as Level 3/2/11 DWH 2 32 Bikapur 2 33 Rudauli 2 34 Sohawal 2 35 Poorabazar 1 26 Mikipur 1 27 Khandasa 1 28 Hairingtanganj 1 29 Tarun 1 210 Masaudha 1 211 Mavai 1 212 Mayabazar 1 2

Up gradation & Strengthening of MCH Center in Level 1, 2 & 3 by Human resource, Equipment, Pathalogy & Other logistic are analyzed and proposed with the financial recommendation under this head.

Equipments (As per MCH Plan)   For L-1 Facility 34

10

For L-2 Facility 18 For L-3 Facility 4

Sub Total (Equipment MCH facility)  Procurement (As per MCH Plan) Budget for Bed only. ILR/DF will be supplied by GOI  

For L-1 Facility 34 For L-2 Facility 18 For L-3 Facility 4

A.2 CHILD HEALTH

To reduce the Neo-Natal mortality & under 5 mortality through engagement of ASHA/ANM/LHV to community, CCSP program is being implemented. Under this program, after getting the training, ASHA have to do door to door contact with community to have vital examination of new born baby up to one month. She will take weight of the baby, counsel the mother for breast feeding. If the condition of baby is not satisfactory, ASHA have to coordinate with ANM for referring the baby. The training is satisfactorily going on in the district at one site, viz, ATC Darshan Nagar, Faizabad. The performance of CCSP training of Faizabad district is as under:

Training Status (Up to jan 11):-Progress of Comprehensive Child Survival Programme (CCSP) Faizabad

Month - Jan 2011

S.N

o.

Dis

tric

t

Tot

al N

o. o

f b

lock

s

No.

of

blo

cks

CC

SP

Trg

. Com

ple

ted

Nam

e of

blo

ck

Tot

al N

o. o

f A

NM

/LH

V

Tot

al N

o. o

f A

NM

/ LH

V t

rain

ed

% o

f L

HV

/AN

M t

rain

ed

Tot

al N

o. o

f A

SH

A

Tot

al N

o. o

f A

SH

A t

rain

ed

% o

f A

SH

A t

rain

ed

No.

of

AS

HA

pro

vid

ed w

ith

AS

HA

Kit

1 2 3 4 5 6 7 8 9 10 11 12

1

Fai

zab

ad

11 10

Tarun 34 34 100 220 198 90 220

Milkipur 26 17 65 195 167 86 195

Sohawal 33 27 82 190 169 88 190

H/Ganj 21 23 109 165 147 87 165

Poorabazar 30 25 83 185 156 84 185

Masaudha 33 22 67 190 145 76 190

mayabazar 29 29 100 196 152 76 196

11

Bikapur 27 17 62 180 140 77 180

Khandasa 26 24 92 173 131 76 173

Mavai 23 11 47 152 59 38 152

Total 282 229 81 1846 1464 77 1846

Total 11 blocks of Faizabad district is to be covered out of which 10 blocks have been taken up till Jan11. f these 10blocks, fully saturated under program while remaining 01block is in process.

CCSP training ASHA,ANM,LHV (3rd phase)-Expected no of participant 1684 are need to 3rd phase CCSP training and 67 batch are scheduled so the budget are required Rs 143.54 for 3rd Phase training.

CCSP training of Supervisor (in 1st & 2nd phase –

116 ANM/LHV have been trained in the fy year 2009-10 out of 317 so

201 ANM/LHV are needs to be trained of Supervisor Training. Budget is

required Rs 19.63 lac.

No. of 12 Batches to be organized and Budget @ Rs. 35400 per batch, No. of 3

Batches to Super vised and Budget for Observer Visit @ Rs. 4550 per Batch And

the budget are shown in DAP

Site Strengtheing-Strengthening of CCSP Training Sit @ Rs. 215000 per site for 1 sites and And the

budget Rs 2.34.

IYCFBreastfeeding provides the best health benefits when started immediately after an infant's birth, continued exclusively (without introducing other foods, liquids, or water) for the first six months of life, and then continued along with suitable complementary feeding through age two or longer. For increasing awareness in the society Mass Awareness Campaign during world Breastfeeding week at District level will be conducted so budget is required Rs0.50 lac.

Bal Swasthaya Poshan Maah (BSPM)

Vitamin A is an important micronutrient for maintaining normal growth, regulating cellular proliferation and differentiation, controlling development, and maintaining visual and reproductive functions. Diet surveys have shown that in India intake of Vitamin A is significantly lower than the recommended daily allowance in all; over decades there has not been any improvement in dietary intake of vitamin A rich fruits and vegetables.

With joint support of UNICEF, ICDS and Health department, BSPM activity is being implemented in the district. Under this activity, every year, children below 5 years of

12

age, will be immunized, counseling will given on nutrition, malnourished children would be referred. It is proposes to replicate this activity is year 2010-11 also. Requirement of vitamin A syrup would be ensured through various sources. To strengthen the programme 2 joint meeting of Health & ICDS planed at district level @ Rs 5000 per meeting and 2 joint orientatin meeting Health & ICDS on BSPM module planed at Block level @ Rs 3000 per meeting. dissemination meeting planed at district level @ Rs5000 per meeting for 2 rounds.

School Health ProgrammeThe objective of the programme is to conduct medical examination of school children for early detection of anemia, nutritional disorders, worm infestations, refractory error, dental caries etc. on site treatment for common illness and referral of children requiring detailed examination & treatment.

In current year 60 schools per block are covered. This Programme is successfully going on in the district. In view of the success and need of this Programme, It is proposed to cover additional 10 schools from each block ie total 770 school of District. During 2011-12, it will be ensured that all schools of all blocks are covered during Programme implementation. Training of district, block level trainers will be done and after that teachers will be trained accordingly. For proper implementation of plan various equipments eg. weighing scale, height/weight chart and measuring tapes are required .

Training of 40 Schools earlier covered will be completed during this year 2010-11 thus training of 30 school for 2011-12 has been proposed.

FAMILY PLANNINGA3.1 : Dissemination Workshop at DistrictIt is necessary that all service providers are kept updated with knowledge of advancement in family planning sectors, GOI guidelines, treatment protocol for Family planning services. It is proposes to organize a dissemination workshop of all service providers of District Hospital, District Women Hospital, CHCs, BPHCs and district level nodal officer. This workshop would be of one day and following topics would be discussed with participants

Concept of Quality family planning services Importance and effects of quality services Components of Quality Family planning services etc.

Experts from related field would be invited to provide their views. Budgetary provision for arrangements, stationery, honorarium etc. is proposed line with last year pattern for year 2011-12 also.

NSV camps in District Male participation is critical to success of population stabilization efforts. With the availability of NSV services, a new opportunity can be explored for improving the male participation in population control. Detailed guideline for camp planning, human resources, IEC, service delivery and training service provider is available for implementation. To achievement of the family planning obejective it is propose 6 NSV Camp at district @ Rs 35000 per camp.

Compensation for family planning AcceptorsSr. No. Particular Total no of Total budget in

13

Clients Lac 1. Compensation for Female

Sterilization4819 48.19

2. Compensation for NSV Acceptance

131 1.97

Provision of Compensation for family planning Acceptors under RCH Flexi pool,

which is mentions in Budget Sheet under Part A-RCH Flexi pool

Spacing Methods-IUD SERVICES

Spacing Methods -    

IUD services at health facilities/compensation 20817 Rs. 4.16

Accrediation of private providers of IUD services   Rs. 0.05

Family Welfare Counsellor@9000 per month (1 each at Block level and 2 at Disrict level hospital)

17 Rs. 18.36

Sub Total -   Rs. 75.83

Family Welfare counselor In PIP of year 2010-11, there was provision of hiring a Family Planning Counselor at district level. It is proposed that in year 2011-12 there should be provision for District level hospital.

ARSHGrowth during adolescence is faster than at any other time in an individual’s life except the first year. Good nutrition during adolescence is critical to cover the deficits suffered during childhood. A large percentage of adolescents in the state, suffer from nutritional deficiencies. Dietary intake with respect to adequate availability of food in terms of quantity and quality, ability to digest, absorb and utilize food and the social discriminations against girls can greatly affect the adequate nutritional status of adolescent girls. . The objective of the programe is to improve the health and nutritional status of the adolescent girls (10-19 years) by ensuring

- Health education- Nutrition and hygiene counseling- reducing nutritional anemia (iron supplementation, de-worming)

Intervention was envisaged in the PIP for 2010-11. Till then this activity is being implemented successfully in Faizabad district.

Saloni Scheme -    

No. of Blocks in District 11  

No. of Schools to be covered (10 Schools per block) 110  

No. of Benificiaries (150 per school) 16500  

Sensitization Workshop at District level 1 Rs. 0.15Budget for Visit of Medical Team (@Rs.300/- per visit x 2 visits per school)

220 Rs. 0.66

Budget for Preparing Saloni Sabha (Rs.300/- p.m. per school x 10 months)

1100 Rs. 3.30

Procurement of IFA tablets (100 mg tablets) for all schools 1650000 Rs. 1.98

14

Procurement of deworming tablets for all schools 2 tab/Benf. 33000 Rs. 0.66

Sub-Total (Adolescent Health) -   Rs.6.75

URBAN RCHUrban RCH plan /activities -    

Building 5 4.2

Manpower(1Doctor @ 30000/month,1Staff Nurse@ 15000/month,2 ANMs@9000/month,2 Security guards @ 4000/month,1 Ayah 4000/month,& 1 Sweeper 2000/month

5 46.2

Other Expenses 5 2.03

IEC 5 0.5

Sub total (Urban RCH) -   52.93

For extra 2 Urban RCH centre is required in Manyavar Kanshiram Avas Yojana and Delhi Darvaja Urban Slum for which budget for hiring of building,manpower,Medicines,IEC and other expenses is required.A.6 PROVISION OF HUMAN RESOURCETo ensure quality and timely availability of health services it is very compulsory that service providers are posted/ available at health units. But due to shortage of medical officers and paramedical personal this motive becomes difficult to be achieved. Considering this, trained personal are being hired on contractual basis to fill the manpower gaps. In year 2010-11, many manpower were recruited and they are working. Service of these personal will be continued in year 2011-12 also. The list of recruited personal under Part-A are as under

A9. INFRASTRUCTURE & HR :-    

Contractual Staff & Services -    Position No. Budget

Contractual ANM (@Rs.11000/- pm in rural & Rs 9000 /-pm in urban)    

Rural 20 Rs. 26.40

Urban 0 Rs. 0.00

Rural ANM (2nd) trained under NRHM in year 2009-10 & ready to be deployed (@Rs.11000/- pm in rural) 8

Rs. 10.56

Staff Nurse in the district (@Rs. 17000/-pm in rural & Rs.15000/- pm in urban) 

 

Rural 28 Rs. 57.12

Urban 18 Rs. 32.40

MBBS (Male/Female) @ Rs. 35000/-pm in rural & Rs.30000/- pm in urban (only lady doctors in DWH & DCH)  

 

Rural 5 Rs. 21.00

Urban 4 Rs. 14.40

BDS (Male/Female) @ Rs. 35000/-pm in rural & Rs.30000/- pm in urban (BDS doctors to be calculated on the basis of availability of dental chairs.  

 

Rural 3 Rs. 12.60

Urban 0 Rs. 0.00

Specialist at On Call basis for CHC (@ Rs.1500/- per visit) No. of calls for one year 50

Rs. 0.75

Specialist at On Call basis for Dist. Hospital, Male/DCH/Female (@ Rs.1250/- per visit) 100

Rs. 1.25

15

Specialist at DWH/DCH/CHC/MCH facility (@ Rs. 50000/- pm for MS/MD/MDSin rural areas & Rs. 45000/-pm in urban units )  

 

Rural 6 Rs. 36.00

Urban 4 Rs. 21.60

Specialist (Diploma Holders) at DWH/DCH/CHC/MCH facility (@ Rs.40000/-pm in rural areas & Rs. 35000/- in urban units)  

 

Rural 5 Rs. 24.00

Urban 4 Rs. 16.80

Paramedical staff/LT for CHC (@ s. 12000/-pm) 8 Rs. 11.52

Paramedical staff for DH/DWH/DCH (@ Rs.10000/- pm) 3 Rs. 3.60

Dark Room Assitant for CHC @ Rs 9000/-pm 6 4.32

Data Assistant ( @ Rs.10000/- pm) 3 Rs. 3.60

Sub Total (Human Resources) -   Rs.297.92

A.7 INSTITUTIONAL STRENGTHENING: Logistic management/improvementMany times, supply from State source are not being delivered timely to lower units like CHC/PHC/APHC/Sub Centers due to shortage or non-availability of transport facility at district H.Q. Timely delivery and receiving of supply at lower units is very necessary for effective implementation of NRHM activities. Recognizing this, it is proposed to continue the Decentralized Fund for Transport of supplies activities as envisaged in the last year PIP. The broad level of facility would be:-

Logistics management/ improvement  Phy.no Rate   AmountA.D level @ Rs 60000/- 1 .60 0.60

District Level (@ Rs. 40000/- per year) 1 0.40 0.40

Block Level (@ Rs. 15,000/- per block per year)11 0.15 1.65

Total     2.65

A5 Rent for Sub CentersIt is proposed to provide the rent for all sub centers those running in private accommodation for year 2010-11. In year 2010-11 budget sanctioned for 158 Rented sub centers . where as there were 112 Rented sub centers in the district . Therefore, , It is proposed for rent of 112 sub center for year 2011-12.A.10 SBA Training

A Skilled Birth Attendant (SBA) is defined as "an accredited health professional - such as midwife,doctor or nurse - who has been educated and trained to achieve proficiency in the skills needed to manage normal (uncomplicated) pregnancies, childbirth and immediate postnatal period and in the identification, management and referral of complications in women and newborns." “Skilled Birth Attendant” is considered as a person who can handle common obstetric and neonatal emergencies, recognize when the situation reaches a point beyond his/her capability and refers the woman or the newborn to a FRU/appropriate facility without delay. Government has taken policy initiatives to empower the ANMs/LHVs/SNs (4 participant per batch for 21 days training) to make them competent for undertaking certain life saving measures. These measures are as follows:

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Permission to use Uterotonic drugs for prevention of PPH. Permission to use drugs in emergency situations prior to referral for stabilizing the

patient. Permission to perform basic procedures at community level in emergency

situations.

This training is most important among various trainings planned to reduce maternal mortality.

Training will be implemented in year 2009-10 . considering the importance of this activity, It is proposes to continue the training programe further in Faizabad district.

Training- Skill Birth Attendant -    

Training at DWH/Combined Hospital - DWH  

Target at DWH 56 -No. of Particpants per batch 4 -No. of Batches & Budget @ Rs.110430/- per batch 14 Rs.15.46

New Site Stregthening at DWH 0 Rs.0.00

Existing site stregthening 1 Rs.0.15

Sub Total (DWH-SBA) -   Rs.15.61

Training at FRU/24X7 -    

Name of the selected Training Site FRU/24X7 0 -

Target at FRU/24X7 36  

No. of Particpants per batch 4  

No. of Batches & Budget @ Rs.110430/- per batch 9 Rs.9.94

New Site Stregthening at FRU 1 Rs.0.40

Existing site stregthening 0 Rs.0.00

Sub Total (FRU-SBA) -   Rs.10.34

Sub Total (SBA Training) -   Rs.25.95

PROGRAM MANAGEMENTIt is proposed that as per the norms of Honorarium of contractual staff should be increased 10% for the fy year 2011-12

PART B : MISSION FLEXI POOLASHA Scheme

ASHA has been established as a grass-root institution to foster various health

related activity at the village level. ASHA, the village resident, who is familiar with

the social and economic scenario of the village will work in close coordination with

the health functionaries, PRI and the community. She will organize and coordinate

village level awareness activity, maintain database, counseling and referral

arrangements.

As ASHA will not get any salary or fixed honoraria to carry out above activities, she

will be paid activity wise incentives depending on her overall performance,

including death and birth registration.

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There are various interventions that are budgeted against her performance, such

as VHIR, JSY, TB, and immunization etc. but other than above activities, a sum of

Rs. 5000/= has been provided to each Village RCH committee to be disbursed

through ANMs as performance related incentive to ASHA.

Total no of ASHA is 2056. 82 ASHAS out of 2056 have been left the work due to reason of engaged in other jobs. District requires 82 ASHAs to be selected & to be trained accordingly in module 1 & 2 to 3.

Budget of ASHA sammelan Has been revised as per new guide lines.Provision of ASHA Scheme under Mission Flexi pool, which is

mention in Budget Sheet under Part B- Mission Flexi pool ,

Sl. No.

Name of CHC/PHC

Target of ASHA

selection

No. of ASHA Selected

Ist phase 7 days Training

2nd phase 12 days Training

3rd phase 4days Training

No. of ASHA Trained

No. of ASHA Trained

No. of ASHA Trained

1 Sohawal 190 190 190 190 In process2 Bikapur 180 180 180 180 1773 Poorabazar 185 185 185 185 1504 Milkipur 195 195 195 185 1665 Rudauli 210 210 208 204 1806 Mayabazar 196 196 196 196 1847 Tarun 220 220 220 220 In process8 Hairingtanganj 165 165 165 165 1559 Mavai 152 151 151 151 14510  Khandasa 173 173 173 173 In process11 Masaudha 190 190 190 181 166

Total 2056 2056 2053 2030 1323

Replenishment of ASHA Kits Replacement of ASHA Kits at six monthly interval i.e. twice in a year for an

average of 95 percent working ASHA that is 1953. Incentive to ASHAs Performance based incentive under add. For 90 percent ASHA on an average of Rs. 600 per ASHA per month as per voucher & verification of performance that is 1850.Award to ASHA

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Annual Award for best performing ASHA for 1 ASHA@ Rs 5000 in each block. for motivation other ASHA to work and deliver services.Annual ASHA Sammelan

As per state guide line.Mobility to ASHAs

Mobility of ASHA proposed for all district CHC & PHC @ Rs. 30 P.M. per ASHA for 95 percent ASHA.Block level ASHA Payment Register

Keep the record of ASHA a payment through ASHA payment register for all district block @ Rs. 250 per register is being made by this head. Budget to be needed for 11 blocks.

Printing of Voucher Booklet for ASHA 50 Rupees per booklet for 2056 ASHAs worker proposed.

Budget ASHA Mentoring Group At district level ASHA mentoring group for monitoring & supervision of

ASHA worker @ Rs. 10000 P.A.

Untied Grant to Facilities

To meet out the local requirement of CHC/PHC/APHC/Sub Centers for which no specific budget is allocated from district, these funds can be utilized for local need of the facilities except paying salary, vehicle purchase, recurring expenses. For the utilization of such funds all units have prepared comprehensive annual plan. it is decided that all facilities would develop an annual plan & put before RKS for approval before initiating utilization of untied grant during year 2011-12 also and for this it is proposed that the untied fund allotment for tfollowing health units should be continued for the year 2011-12.

Facility Number of Untis for Untied FundCHCs 11PHCs 28Sub Centers 246VHSC 729Revenue Villege 1243

B.3: AMG to FacilitiesThere are certain maintenance works which are needed for CHC/PHC/APHC/Sub centers building running in Govt. building. For the utilization of such funds all units have prepared comprehensive annual plan. It is decided that all facilities would develop an annual plan & put before RKS for approval before initiating utilization of AMG during year 2011-12 also and for this it is proposed the AMG fund allotment for following health units should be continued.

Facility Number of Untis for AMG Fund

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CHCs 11PHCs 19Sub Centers 134

B.4: Fund to RKSRogi Kalyan Samiti is a simple, yet effective management structure, which is a registered society, acting as a group of trustees for DH/DWH/CHC/PHC to manage the affairs of the hospitals. It consists of members from local P.R.I., NGOs, local elected representatives and officials from Government Sector, who are responsible for proper functioning and management of hospitals. The RKS is free to prescribe, generate and use the funds placed with it, as per its best judgment for smooth functioning and maintaining the quality of services.

It is decided that all facilities would develop an annual plan & put before RKS for approval before initiating utilization of RKS during year 2011-12 also and for this It is proposed the RKS fund allotment for following health units should be continued.

Details of RKS

Facility Number of units for RKS fundDist. Hospital 1District Women Hospital 1Shri Ram Hospital 1CHCs 11PHCs 28

B.5 Regional Drug ware house:It is proposed to replicate the sanction as per PIP of year 2010-11Mobility Support for Monitoring & Supervision.

Mobility Support to DWH & District Combined Hospital -    

Mobility Support to DWH/DCH @Rs.20000/- Per month. 1 Rs.2.40Sub Total (Funds for Mobility Support to DWH & DCH) -   Rs.2.40

Mobility Support for Monitoring & Supervision -    

Mobility Support to C.M.O(F.W(@Rs.20000/- Per month. 1 Rs.2.40

Mobility Support to District Community Mobilizer (@Rs.1000/-per day X 8 days/month)

1 Rs.0.96

Mobility Support to District Account Manager (@Rs.1000/-per day X 6 days/month)

1 Rs.0.72

Mobility Support to Dy. CMO-NRHM (@Rs.1000/-per day X 8 days/month) 1 Rs.0.96Sub Total (Mobility Support for Monit. & Supervision) -   Rs.5.04

Supervision of ANM/ASHAsProposal for one full time hired vehicle @ Rs20000 per vehicle for 11 blocks for all the working days. in Budget Sheet under Part B- Mission Flexi pool, Rs. 26.40Vehicle Support for SpecialistOne vehicle for 11 blocks total 2 vehicle @ 20000/- p.m. is being proposed for specialist to provide outreach medical care facilities. Vehicle will be used to mobilized specialist & functionary from district to services provision unit. in Budget Sheet under Part B- Mission Flexi pool, Rs. 4.80

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Diesel for Generator for District HospitalsTotal Electricity supply on an average in district Faizabad urban area is 16 hours per day including breakdowns. To maintain uninterrupted power supply for district 03 District level hospitals through generator backup Rs. 1 Lac. P.M. is being perposed. in Budget Sheet under Part B- Mission Flexi pool, Rs. 36.0Diesel Support for Generator in Fully Functional CHC.Total 6 CHC and 5 PHC are providing services as as 24X7. Electicity supply in ruler area is on an average 10 hours per day. To maintain cold chain smooth running of labour room & Emergency, uninterrupted water supply electricity backup through genset is an almost essential Rs. 35,000 P.M. per unit is being proposed in this head. Facility for hiring generator has to be included. in Budget Sheet under Part B- Mission Flexi pool Rs. 62.04.

Saas Bahu Sammelans (1 each at District)As experiences gathered from previous year SAAS BAHU SAMMELAN has being popularized by its impact on family perticulary in change of behavior with in the family develop, health seeking attitude & careing children & pregnant women, resulted in increase in institional deliveries & reporting complication. It is recmended that the SAAS BAHU SAMMELAN to continioue in 2011-12 with integreation at block level SAAS BAHU SAMMELAN. in Budget Sheet under Part B- Mission Flexi pool, B.7.1 Rs. 1.50Pradhan Sammelan at Tehsil Level

In view of feed back & proper dissemination of messages & to create sensibility in ownership of the programme. Pradhan sammelan at all tehsil are being proposed. Unit cost to meet out venue arrangement & other expenses to sum of Rs. 40000 per sammelan for 5 tehsils are being proposed. Sammelan will be on an annual basis.Provison of Pradhan sammelan are shown in Part B- Mission Flexi pool, B.8.1 Rs. 2.0Swasthya Mela(SPY)In Swasth parichan yojana, two days health examination camps are being organized in every block level rendering specialist services, providing referral transport, curative & preventive services as well as counseling. Such two days camps in a month are planed for the year 2011-12 in district meet out the expenses on the camps unit cost is calculated as per guideline and are being proposed. Provision of Swasthya Mela are shown in Part B- Mission Flexi pool, B.10.1 Rs. 26.40Concurrent Audit

Provision of Concurrent Audit under Mission Flexi pool, which is mention

in Budget Sheet under Part B- Mission Flexi pool , Heading B27.5. Concurrent

Audit Rs .60

Health Management Information System (HMIS):-HMIS is a most sensitive tool for the monitoring of health & family welfare services. It is essential required that the monitoring of HMIS data at all level by the designated supervisors. Data is generated at sub center level from village level data, at block level from sub center & PHC level & at the district level from Block level data. Hence district HMIS nodal’s & block nodal’s to

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be provided mobility support to visit data generations centre’s. For compilation & computation & analysis of data internet connectivity has been given to all block level CHC’s recommendation of hiring of vehicle for HMIS nodal & Block HMIS nodal officer payment for internet connectivity & procurement for stationary & consumables has been made in this sub head. Part B- Mission Flexi pool, B.21. Rs. 3.10Programme Management-Mobility for additional director @Rs 3000 per month for 12 month and Contingency Expenses @ Rs 5000 per month total budget is Rs 0.96 lac.Operational Cost for Block Project Management UnitHonarium for Block data Assistant @ Rs 10000 per month for 11 Block data assistant so total budget is required Rs 13.20 lac and communication support to Block project manager @ Rs 500 p.m for 11 BPM so total budget is required Rs 0.66 lac. Provision of Contractual Staff (AYUSH)

As gap analysis made & integration of AYUSH services in NRHM AYUSH lady doctors, male doctors & AYUSH Pharmacists are posted at the different level of facilities. Provision for payment of honoraria under this head is being made for them.

Provision of Contractual Staff (AYUSH)

Position

ISM Lady Doctors (@ Rs.24,000/- per month) 11AYUSH Doctors (@ Rs.24,000/- per month) 10AYUSH Pharmacists (@ Rs.9,000/- per month) 10Sub-Total (Contractual Staff - AYUSH) 31

Provision of Concurrent Audit under Mission Flexi pool, which is mention

in Budget Sheet under Part B- Mission Flexi pool , Heading B14.1. Rs 71.28

Integrated Skill Refresher Training For ANM & LHV-Integrated skill Refresher Training for ANM & LHV proposed for the fy year 2011-12.Total work load for the year 2011-12 is 128 and total no of proposed batches is 8 and budget for this Rs 13.28 lac required.

Infrastructure & Manpower for UIP-(for Strengthening of VHND)Infrastructure-Construction of new Cold Chain room at District level Hospital depending availability of Space@ Rs 5.00 lac one time for 1 unit to be required and budget to be needed Rs 5.00 lac. POL for district cold chain maintenance to be needed for 1 unit @ Rs 5000 per month.Mobility Support for the supervision of VHND session is being provided for all 8 VHND session in month at block level.

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Incentivized antenatal registration & preparation of MCH Card by ASHA, ANM, AWW are being made to catch up all pregnant women. Also involvement of Pradhan & Block Pramukh by award.

Part C- Routine Immunization

PART C- ROUTINE IMMUNIZATION

Under this part it is proposed to carry out the Routine Immunization activities in rural as well as Urban areas of the district. Under this Part following activities would be carried out.In the state of Uttar Pradesh, the RI sessions are held for 2 days in a week –

Wednesdays and Saturdays, thus with the possibility of 8 sessions per sub centre

per month. DAP proposes to hold 4 - 8 session in a month for any sub-centre

as required according to its

population, for effective service delivery to fill the huge gap in service

delivery.

The components of Alternative Vaccine Delivery, Mobilization of Children for

RI at session sites by ASHA/Non ASHA, hiring service provider in urban

slums and underserved areas will be done as was done and proposed in

previous year. Provision for RI mentions in Budget Sheet under Part c (R.I.)

Rs 87.80

C1: Review of Dist. Block & Sub Center level Routine Immunization Micro plan

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It is proposed that in addition to other activities sanctioned last year, the “Vaccine Delivery” for rural and urban area a different mechanism may be adopted. It is proposed that, for vaccine delivery required number of vehicle may be hired. This vehicle will be entrusted responsibility of picking Vaccine Carries from PHC/CHC/other points and drop the Vaccine Carrier at Immunization site where ANM is present for vaccination. After the vaccination is completed, the vehicle will pick the Vaccine Carrier from that point and submit in evening back to respective sites from where it had picked in the morning. Block monitor would be given responsibility to monitor the vaccine carrier picking and dropping activity of vehicle. Payment shall be made to the vehicle owner as per Block Monitor’s report. Vehicle owner would be paid at the rate of Rs.700/- per vaccination day. This will relieve the ANM from burden/responsibility of picking the vaccine carrier, carrying to vaccination site then going back to drop the carrier at her PHC/CHC. It will be very easy mechanism that will enhance the working capacity of ANM with only marginal extra cost.

C2: Printing activities & other Expenses for strengthening Service DeliveryPrinting of format and immunization register for each ANM is remanded. C3: Social Mobilization (For ASHA/Link workers in Rural /Urban areas.C4: Alternate Vaccine delivery for session in Rural / Urban AreasC5: Honorarium of contractual Computer Asst. for DIO.C6: Mobility support for supervision & monitoring.For proper supervision and monitoring of immunization sessions, mobility support for district level officers other than DIO should be allocated.

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