NRHM - STATE HEALTH SOCIETY-----BIHAR by changcheng2

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									      Dr. I. D. Ranjan      Sri Umesh Kumar (BAS)   Sri Sandip Kumar
C.S. cum Member Secretary   DDC cum Vice Chairman     Podulki (IAS)
     DHS, Kishanganj            DHS, Kishanganj     DM cum Chairman
                                                     DHS, Kishanganj
                                       Index
1 Background
   a) Introduction to NRHM
   b) Introduction to DHAP
   c) Introduction to Kishanganj District
2 Progress so Far
   a) Maternal Health
   b) Child Health
   c) Family Planning
   d) Other Programme
3 Situational Analysis
   a) Health Facilities the District
   b) Human Resources & Infrastructure
   c) Equipment, Drugs & Supplies
   d) RKS, Untied fund & Support Services
   e) Health Services Delivery
   f) Community Participation, Training and BCC
4 Process for Plan Development
5 Objectives
6 Work Plan
7 Monitoring & Evaluation
8 Proposed Budget
   a) RHC-II (NRHM-A)
   b) Additionalities of NRHM (NRHM-B)
   c) Immunization (NRHM-C)
   d) Revised National Tuberculosis Control Programme (RNTCP)
   e) National Vector Borne Disease Control Programme (NVBDCP)
   f) National Blindness Control Programme
   g) National Leprocy Eradication Programme
   h) Iodine Deficiency Disorder Programme (IDDP)
   i) Integrated Disease Survileance Project (IDSP)
   j) AIDS
   k) Summary of Budget
9 List of Abbrevitions
                              Introduction to NRHM
       The National Rural Health Mission (NRHM) aims to provide for an accessible,
affordable, acceptable and accountable health care through a functional public health
system.
       It is designed to galvanize the various components of primary health system, like
preventive, promotive and curative care, human resource management, diagnostic
services, logistics management, disease management and surveillance, and data
management systems etc. for improved service delivery.
The Vision of the Mission
1. To provide effective healthcare to rural population throughout the country with special
   focus on 18 states, which have weak public health indicators and/or weak
   infrastructure.
2. 18 special focus states are Arunachal Pradesh, Assam, Bihar, Chattisgarh, Himachal
   Pradesh, Jharkhand, Jammu and Kashmir, Manipur , Mizoram, Meghalaya, Madhya
   Pradesh, Nagaland, Orissa , Rajasthan, Sikkim, Tripura, Uttaranchal and Uttar
   Pradesh.
3. To raise public spending on health from 0.9% GDP to 2-3% of GDP, with improved
   arrangement for community financing and risk pooling.
4. To undertake architectural correction of the health system to enable it to effectively
   handle increased allocations and promote policies that strengthen public health
   management and service delivery in the country.
5. To revitalize local health traditions and mainstream AYUSH into the public health system.
6. Effective integration of health concerns through decentralized management at district,
   with determinants of health like sanitation and hygiene, nutrition, safe drinking water,
   gender and social concerns.
7. Address inters State and inters district disparities.
8. Time bound goals and report publicly on progress.
9. To improve access to rural people, especially poor women and children to equitable,
   affordable, accountable and effective primary health care.
Goals
1. Reduction in Infant Mortality Rate (IMR) and Maternal Mortality Ratio (MMR)
2. Universal access to public health services such as Women’s health, child health,
   water, sanitation & hygiene, immunization, and Nutrition.
3. Prevention and control of communicable and non-communicable diseases, including
   locally endemic diseases.
4. Access to integrated comprehensive primary healthcare.
5. Population stabilization, gender and demographic balance.
6. Revitalize local health traditions and mainstream AYUSH.
7. Promotion of healthy life styles.
Strategies
(a) Core Strategies:
    Train and enhance capacity of Panchayati Raj Institutions (PRIs) to own, control
     and manage public health services.
    Promote access to improved healthcare at household level through the female
     health activist (ASHA).
    Health Plan for each village through Village Health Committee of the Panchayat.
    Strengthening sub-centre through an untied fund to enable local planning and
     action and more Multi Purpose Workers (MPWs).
    Strengthening existing PHCs and CHCs, and provision of 30-50 bedded
    CHC per lakh population for improved curative care to a normative standard
     (Indian Public Health Standards defining personnel, equipment and management
     standards).
    Preparation and Implementation of an inter-sectoral District Health Plan prepared
     by the District Health Mission, including drinking water, sanitation & hygiene and
     nutrition.
    Integrating vertical Health and Family Welfare programmes at National, State,
     Block, and District levels.
    Technical Support to National, State and District Health Missions, for Public
     Health Management.
    Strengthening capacities for data collection, assessment and review for evidence
     based planning, monitoring and supervision.
    Formulation of transparent policies for deployment and career development of
     Human Resources for health.
    Developing capacities for preventive health care at all levels for promoting healthy
     life styles, reduction in consumption of tobacco and alcohol etc.
    Promoting non-profit sector particularly in under served areas.
(b) Supplementary Strategies:
    Regulation of Private Sector including the informal rural practitioners to ensure
     availability of quality service to citizens at reasonable cost.
    Promotion of Public Private Partnerships for achieving public health goals.
    Mainstreaming AYUSH – revitalizing local health traditions.
    Reorienting medical education to support rural health issues including regulation
     of Medical care and Medical Ethics.
    Effective and viable risk pooling and social health insurance to provide health
     security to the poor by ensuring accessible, affordable, accountable and good
     quality hospital care.
         Introduction to District Health Action Plan (DHAP)
       In order to make NRHM fully accountable the District Health Plan will be the
principle instrument for planning, implementation and monitoring., formulated through a
participatory and bottom up planning process. District Health Mission has been
constituted in the districts as per guidelines.
       As a next step each district has to formulate/design District Health Action Plan
(DHAP). The DHAP will contain situational analysis of the district, objectives and
interventions, work plan and budgets and an M&E plan.
       The DHAP document will be appraised and approved at State level and will be
guiding document for implementation, monitoring & evaluation of NRHM activities in
the district. It is envisaged that decentralized programme management is likely to be more
responsive to the health care needs of local community and will be a step towards
ultimate communalization – a hallmark of NRHM.
        The District Health Mission has been entrusted with the responsibility of steering
formulation and ensuring implementation of the plans. The District Health Plan should as
far as practicable be an aggregation and consolidation of the Village and the Block Health
Plan.
                         Introduction to Kishanganj District
        A portion of Bihar, situated in the North East. Bordering W. Bengal, Bangla Desh
and Nepal has been undeveloped for a long time. The latitude of Gradually, it made some
progress. But, the speed of progress was not so encouraging. Fortunately, it becomes a
district in 1990. It is heartening to see that the day it was declared a district, the progress
and Development activities also commenced giving a new look of the area.
       During the period of Khagada Nawab, Mohammed Fakiruddin, one hindu saint
arrived , he was tired and wanted to rest at this place, but when he heard that this place
name is Alamganj ,the river name is Ramzan and the Jamindar name is Fakiruddin , he
refused to enter at Alamganj. After that the Nawab decided and announced some portion
from Kishanganj Gudri to Ramzan pool gandhi ghat as Krishna-Kunj . As time passed by
the name gets converted to present KISHANGANJ
        During Mughal period Kishanganj district was the part of Nepal and was known as
Nepalgarh. Mughal Emperor Shah Alam appointed Mohammed Raza at Surajapur for
administration. Md. Raza captured the fort of Nepalgarh and name gets converted to
Alamganj and administration gets shifted to Khagara. The Historical "KHAGRA MELA"
is held every year at Kharga, Kishanganj
        Kishanganj was the old and important Sub-Division of Purnea. After the long and
hard struggle of Seventeen Years from people of Kishanganj including Social Workers,
politicians, journalist, businessmen, Farmers etc., the Kishanganj District came into
existence on 14th January 1990.
                                   District Profile
No.                         Variable                              Data
 1.   Total area                                        1884 Sq. K.M.
 2.   Total no. of blocks                               7
 3.   Total no. of Gram Panchayats                      126
 4.   No. of villages                                   815
 5.   No of PHCs                                        7
 6.   No of APHCs                                       9 + 14 (New) = 23
 7.   No of HSCs                                        136 + 49 (New) = 185
 8.   No of Sub divisional hospitals                    1
 9.   No of referral hospitals                          2 (Only one functional)
 10. No of Doctors                                      38 (09 Contractual)
 11. No of Ayush Doctor                                 12
 12. No of ANMs                                         159 (40 Contractual)
 13. No of Grade A Nurse                                24 (18 Contractual)
 14. No of Paramedicals                                 47
 15. Total population                                   1296348 (Census 2001)
 16. Male population                                    669552 (Census 2001)
 17. Female population                                  626796 (Census 2001)
 18. Sex Ratio                                          936/1000 (Female/Male)
 19. No of Eligible couples                             220379 (Census 2001)
 20. Children (0-6 years)                               287937 (Census 2001)
 21. Children (0-1years)                                41094 (Census 2001)
 22. SC population                                      85833 (Census 2001)
 23. ST population                                      47116 (Census 2001)
 24. BPL population                                     262587 (No. of household)
 25. No. of primary schools                             547
 26. No. of Anganwadi centers                           1296
 27. No. of Anganwadi workers                           1239
 28. No of ASHA                                         1368
 29. No. of electrified villages                        508
 30. No. of villages having access to safe drinking water NA
 31. No of villages having motorable roads              518
                    District Health Society, Kishanganj
                             Status of Medical Officer in Kishanganj District
                                                                                           Real Working
Sl.                                     Sanctioned Post   Working Force    Vaccant Post
            Name of Institution                                                                Force
No.
                                       Regular Contract Regular Contract Regular Contract Regular Contract
1     District Hospital, Kishanganj      12        0       1         0      11        0      1
                                                                                                      0
2     Sub. Div. Hospital, Kishanganj      7        0       6         0       1        0      6
                                                                                                      0
3     PHC, Kishanganj                     3        4       2         2       1        2      1
                                                                                                      2
4     PHC, Bahadurganj                    3        4       3         2       0        2      3
                                                                                                      2
5     PHC, Thakurganj                     3        4       2         1       1        3      2
                                                                                                      1
6     PHC, Kochadhaman                    3        4       1         1       2        3      1
                                                                                                      1
7     PHC, Dighalbank                     3        4       3         1       0        3      2
                                                                                                      1
8     PHC, Pothia                         3        4       2         1       1        3      2
                                                                                                      1
9     PHC, Terhagachh                     3        4       2         1       1        3      2
                                                                                                      1
10    Referal Hospital, Chhattargach      4        0       2         0       2        0      2
                                                                                                      0
11    Referal Hospital, Pothia            4        0       2         0       2        0      0
                                                                                                      0
12    APHC, Gangihat                      2        0       1         0       1        0      0
                                                                                                      0
13    APHC, Meharganj                     2        0       0         0       2        0      0
                                                                                                      0
14    APHC, Rupni                         2        0       1         0       1        0      0
                                                                                                      0
15    APHC, Alta                          2        0       0         0       2        0      1
                                                                                                      0
16    APHC, Haldikhora                    2        0       1         0       1        0      0
                                                                                                      0
17    APHC, Padampur                      2        0       0         0       2        0      0
                                                                                                      0
18    APHC, Lakshmipur                    2        0       1         0       1        0      0
                                                                                                      0
19    APHC, Lakshmipur                    2        0       0         0       2        0      1
                                                                                                      0
20    APHC, Damalbari                     2        0       0         0       2        0      0
                                                                                                      0
21    Civil Surgeon Office                1        0       1         0       0        0      1
                                                                                                      0
22    District TB Centre                  1        0       1         0       0        0      1
                                                                                                      0
                                         68        28      32        9      36        19    26        9
                Total
                                              96                41               55              35
                   District Health Society, Kishanganj
                    Status of Para Medical & Other Staff in Kishanganj District
                                                                              Vaccant
Sl. No.              Name of Post           Sanctioned Post   Working Post     Post     Remarks
  1       Drug Inspector                           2               1               1
  2       Food Inspector                           0               0               0
  3       Maleria Inspector                        3               0               3
  4       Surveillance Inspector                   3               0               3
  5       Sanitary Inspector                       8               0               8
  6       Health Educator                          9               4               5
  7       Block Extension Educator                 7               1               6
  8       Nruse Grade 'A'                         12               5               7
  9       Nruse Grade 'A' (Contractual)           44               18             26
  10      Stenographer                             2               0               2
  11      Lady Health Visitor                     31               11             20
  12      ANM                                     167             119             48
  13      ANM ® (Contractual)                     186              40             146
  14      Head Clark                               2               1               1
  15      Clark                                   33               18             15
  16      Pharmasist                               2               1               1
  17      Dispensar                               19               0              19
  18      Compounder                              20               1              19
  19      Opthelmic Assistant                      5               2               3
  20      X-ray Technician                         3               1               2
  21      O.T. Assistant                           3               0               3
  22      Laboratry Technician                    19               5              14
  23      Laboratry Technician (Maleria)           0               0               0
  24      Non Technical Assistant                  0               0               0
  25      Computer                                 7               0               7
  26      Health Worker (HW)                      21               2              19
  27      Basic Health Workar(BHW)                20               10             10
          Basic Health Worker (BHW
  28
          Maleria)                                 2               2               0
  29      Family Planning Worker                  21               10             11
  30      Dispensar                                1               1               0
  31      Driver                                   9               9               0
  32      Fourth Grade Staff                      139             136              3
                   Total                          800             398             402
                                                                                                                                                            DHS, Kishanganj



                                                             District Health Society, Kishanganj
                                                                                    Progress so Far
                                                                                                                                                                       Year 2010-11(Upto
                                 Year 2005-06                Year 2006-07                Year 2007-08                Year 2008-09               Year 2009-10
                                                                                                                                                                          Nov. 2010)
      Indicators
                                                      Targe                       Targe                                                   Targe                        Targe
                          Target     Achiv.     %                Achiv.     %                Achiv.     %     Target     Achiv.     %              Achiv.      %                Achi     %
                                                        t                           t                                                       t                            t
                                                                                                                                                                                 v.
                                                                                                                                                                                        49.39
ANC Registration           53350       7854     15%   58633       10629     18%   65148       28341     44%    65166      39059     60%    66857    47100   70.45%      68547   33854
                                                                                                                                                                                            %
                                                                                                                                                                                        26.03
TT2+Booster                47482       5748     12%   52184       11314     22%   57982       15224     26%    56466      22612     40%    66857    27562   41.23%      68547   17845
                                                                                                                                                                                            %

Intitutional Deliveries                                                                                                                                                                 20.31
                           48500       2145      4%   53303        5837     11%   59225       13158     22%    59242      20377     34%    60779    22642   37.25%      68547   13924
(JBSY)                                                                                                                                                                                      %

PNC (Post Natel                                                                                                                            60779     9224   15.18%      68547    5797   8.46%
                           48500       1478      3%   53303        4334     8%    59225        8424     14%    59242       9249     16%
Care)
RI (Routine
                                                                                                                                                                                        28.55
Immunization)              45105      14758     33%   49571       18332     37%   55079       15813     29%    55095      21482     39%    60779    31206   51.34%      58951   16830
                                                                                                                                                                                            %
Fully Immunization
Complete                                                                                                                                                                                22.32
                           45105       4128      9%   49571        9012     18%   55079        8025     15%    55095       7063     13%    60779               0.00%    58951   13159
Immunization                                                                                                                                                                                %

                                                                                                                                                                                        25.49
Vitamin'A' (Nutrition)    108920      59540     55%   119705      70819     59%   133006      91971     69%   134295      73091     54%   139667               0.00%    58951   15026
                                                                                                                                                                                            %

Sterilization               7811         42      1%    8584        2024     24%    9538        4633     49%     9124       4216     46%     9947     4957   49.83%      10199    1155
                                                                                                                                                                                        11.32
(Family Planning)                                                                                                                                                                           %

                                                                                                                                                                                        41.41
IUD Instrtion               3254        456     14%    3577        2234     62%    3974        2389     60%     3802       1908     50%     4145     2055   49.58%       4248    1759
                                                                                                                                                                                            %

                                                                                                                                                                                        36.72
Oral Pills                 16927       5485     32%   18603        8388     45%   20670        2616     13%    19773       5012     25%    21557    15250   70.74%      22074    8105
                                                                                                                                                                                            %
                                                103                         114                         145                         109                                         12749   125.0
Condom Distribution        78124      80145
                                                 %
                                                      85860       97847
                                                                             %
                                                                                  95400      138310
                                                                                                         %
                                                                                                               91200      99199
                                                                                                                                     %
                                                                                                                                           99426   117183   117.86%    102000
                                                                                                                                                                                    9     0%
Cateract (Eye)              2000      N/A       N/A    2000         855     43%    2000        1214     61%     2000        958     48%     2000     4272   213.60%      2000    3360
                                                                                                                                                                                        168.0
Operation                                                                                                                                                                                 0%

OPD (Outdoor
                            --       160373     --      --       232424     --      --       314087     --      --       365217     --     --      336037      --
Patient)


                                                                                               9
                                                                                                                                                                                  DHS, Kishanganj




                                                                                            ANC Registration
80000



70000                                                                                                                                                        68547
                                                                                                                                66857
                                                                    65148                         65166


60000                                 58633

        53350

50000                                                                                                                                     47100


                                                                                                               39059
40000
                                                                                                                                                                        33854
                                                                                                                                                                                               ANC Registration
30000                                                                            28341



20000

                                                   10629
10000                7854


                                15%                           18%                           44%                           60%                       70.45%                         49.39%
    0
                                 %




                                                               %




                                                                                             %




                                                                                                                           %




                                                                                                                                                      %




                                                                                                                                                                                      %
         Target




                                       Target




                                                                     Target




                                                                                                   Target




                                                                                                                                 Target




                                                                                                                                                               Target
                       Achiv.




                                                     Achiv.




                                                                                   Achiv.




                                                                                                                 Achiv.




                                                                                                                                           Achiv.




                                                                                                                                                                         Achiv.
                  Year 2005-06                  Year 2006-07                  Year 2007-08                  Year 2008-09              Year 2009-10           Year 2010-11(Upto Nov.
                                                                                                                                                                     2010)




                                                                                                  10
                                                                                                                                                                                 DHS, Kishanganj




                                                                                             TT2+Booster
80000



70000                                                                                                                                                                68547
                                                                                                                                    66857


60000                                                               57982
                                                                                                   56466
                                      52184
50000   47482



40000

                                                                                                                                                                                                   TT2+Booster
30000                                                                                                                                            27562
                                                                                                                   22612

20000                                                                                                                                                                           17845
                                                                                 15224
                                                   11314
10000
                     5748

                                12%                           22%                           26%                               40%                           41.23%                        26.03%
    0
                       Achiv.


                                 %




                                                     Achiv.


                                                               %




                                                                                   Achiv.


                                                                                             %




                                                                                                                     Achiv.


                                                                                                                               %




                                                                                                                                                   Achiv.


                                                                                                                                                              %




                                                                                                                                                                                 Achiv.


                                                                                                                                                                                            %
         Target




                                       Target




                                                                     Target




                                                                                                       Target




                                                                                                                                     Target




                                                                                                                                                                       Target
                  Year 2005-06                  Year 2006-07                  Year 2007-08                      Year 2008-09                  Year 2009-10           Year 2010-11(Upto Nov.
                                                                                                                                                                             2010)



                                                                                                  11
                                                                                                                                                                               DHS, Kishanganj




                                                                     Intitutional Deliveries (JBSY)
80000


70000                                                                                                                                        68547


                                                                                                                60779
                                                           59225                     59242
60000
                                 53303

50000   48500



40000

                                                                                                                                                                          Intitutional Deliveries (JBSY)
30000
                                                                                                                          22642
                                                                                               20377
20000
                                                                     13158                                                                             13924

10000
                                           5837
                  2145
                            4%                       11%                       22%                        34%                       37.25%                       20.31%
    0
                            %




                                                     %




                                                                               %




                                                                                                          %




                                                                                                                                      %




                                                                                                                                                                   %
                   Achiv.




                                            Achiv.




                                                                      Achiv.




                                                                                                Achiv.




                                                                                                                           Achiv.




                                                                                                                                                        Achiv.
         Target




                                  Target




                                                            Target




                                                                                      Target




                                                                                                                 Target




                                                                                                                                              Target
            Year 2005-06             Year 2006-07              Year 2007-08              Year 2008-09              Year 2009-10              Year 2010-11(Upto
                                                                                                                                                 Nov. 2010)




                                                                                                     12
                                                                                                                                                                           DHS, Kishanganj




                                                                         PNC (Post Natel Care)
80000


70000                                                                                                                                      68547


                                                                                                              60779
                                                          59225                     59242
60000
                                 53303

50000   48500



40000

                                                                                                                                                                       PNC (Post Natel Care)
30000


20000


                                                                    8424                      9249                      9224
10000
                                                                                                                                                     5797
                                           4334
                  1478
                            3%                       8%                       14%                       16%                       15.18%                       8.46%
    0
                            %




                                                     %




                                                                              %




                                                                                                        %




                                                                                                                                    %




                                                                                                                                                                %
                   Achiv.




                                            Achiv.




                                                                     Achiv.




                                                                                               Achiv.




                                                                                                                         Achiv.




                                                                                                                                                      Achiv.
         Target




                                  Target




                                                           Target




                                                                                     Target




                                                                                                               Target




                                                                                                                                            Target
            Year 2005-06             Year 2006-07             Year 2007-08              Year 2008-09              Year 2009-10             Year 2010-11(Upto
                                                                                                                                               Nov. 2010)




                                                                                                   13
                                                                                                                                                                                    DHS, Kishanganj




                                                                       RI (Routine Immunization)
70000


                                                                                                                     60779
                                                                                                                                                  58951
60000
                                                            55079                     55095

                                  49571
50000
        45105


40000

                                                                                                                               31206
30000
                                                                                                                                                                               RI (Routine Immunization)

                                                                                                21482
20000                                       18332
                                                                      15813                                                                                 16830
                  14758


10000


                            33%                       37%                       29%                            39%                       51.34%                       28.55%
    0
                            %




                                                      %




                                                                                %




                                                                                                               %




                                                                                                                                           %




                                                                                                                                                                        %
                   Achiv.




                                             Achiv.




                                                                       Achiv.




                                                                                                 Achiv.




                                                                                                                                Achiv.




                                                                                                                                                             Achiv.
         Target




                                   Target




                                                             Target




                                                                                       Target




                                                                                                                      Target




                                                                                                                                                   Target
            Year 2005-06              Year 2006-07              Year 2007-08              Year 2008-09                   Year 2009-10             Year 2010-11(Upto
                                                                                                                                                      Nov. 2010)




                                                                                                          14
                                                                                                                                                DHS, Kishanganj




                                                            Complete Immunization
70000


                                                                                               60779
60000                                                                                                                  58951
                                                   55079                 55095

                             49571
50000
        45105


40000




30000                                                                                                                                           Complete Immunization




20000

                                                                                                                               13159

                                     9012
10000                                                      8025                  7063
                4128

                        9%                   18%                   15%                   13%                   0.00%                   22.32%
    0
        Target Achiv.   %    Target Achiv.   %     Target Achiv.   %     Target Achiv.   %     Target Achiv.    %      Target Achiv.     %
           Year 2005-06         Year 2006-07          Year 2007-08          Year 2008-09          Year 2009-10         Year 2010-11(Upto
                                                                                                                           Nov. 2010)



                                                                                 15
                                                                                                                                                      DHS, Kishanganj




                                                                  Vitamin'A' (Nutrition)
160000


                                                                                                     139667
140000                                                                        134295
                                                       133006


                                119705
120000
         108920


100000
                                                                91971


 80000
                                                                                       73091
                                         70819
                                                                                                                                                       Vitamin'A' (Nutrition)
                  59540                                                                                                      58951
 60000



 40000



 20000                                                                                                                               15026


                          55%                    59%                    69%                    54%                   0.00%                   25.49%
     0
         Target Achiv.    %     Target Achiv.    %     Target Achiv.    %     Target Achiv.    %     Target Achiv.    %      Target Achiv.     %
            Year 2005-06           Year 2006-07           Year 2007-08           Year 2008-09           Year 2009-10         Year 2010-11(Upto
                                                                                                                                 Nov. 2010)



                                                                                  16
                                                                                                                                                      DHS, Kishanganj




                                                          Sterilization (Family Planning)
12000



                                                                                                                        10199
                                                                                               9947
10000                                              9538
                                                                         9124
                             8584

 8000   7811




 6000

                                                                                                      4957                                       Sterilization (Family Planning)
                                                          4633
                                                                                4216
 4000




                                    2024
 2000
                                                                                                                                1155


                42      1%                   24%                   49%                   46%                   49.83%                   11.32%
    0
        Target Achiv.   %    Target Achiv.   %     Target Achiv.   %     Target Achiv.   %     Target Achiv.     %      Target Achiv.     %
           Year 2005-06         Year 2006-07          Year 2007-08          Year 2008-09          Year 2009-10          Year 2010-11(Upto
                                                                                                                            Nov. 2010)


                                                                                    17
                                                                                                                                                     DHS, Kishanganj




                                                                     IUD Instrtion
4500
                                                                                                                            4248
                                                                                                   4145
                                                     3974
4000                                                                        3802
                              3577
3500
       3254

3000


2500                                                        2389
                                     2234
                                                                                                          2055
2000                                                                               1908
                                                                                                                                   1759                 IUD Instrtion


1500


1000

               456
 500

                       14%                    62%                    60%                    50%                    49.58%                   41.41%
   0
       Target Achiv.      %   Target Achiv.      %   Target Achiv.      %   Target Achiv.      %   Target Achiv.     %      Target Achiv.     %
           Year 2005-06           Year 2006-07           Year 2007-08           Year 2008-09          Year 2009-10           Year 2010-11(Upto
                                                                                                                                 Nov. 2010)




                                                                                   18
                                                                                                                                                   DHS, Kishanganj




                                                                         Oral Pills
25000

                                                                                                                             22074
                                                                                                    21557
                                                      20670
                                                                             19773
20000
                               18603

        16927

                                                                                                            15250
15000




                                                                                                                                                         Oral Pills
10000
                                       8388                                                                                          8105


                5485
                                                                                       5012
 5000

                                                              2616


                        32%                    45%                    13%                     25%                   70.74%                   36.72%
    0
        Target Achiv.      %   Target Achiv.      %   Target Achiv.      %   Target Achiv.      %   Target Achiv.     %      Target Achiv.     %
            Year 2005-06           Year 2006-07           Year 2007-08           Year 2008-09          Year 2009-10           Year 2010-11(Upto
                                                                                                                                  Nov. 2010)



                                                                                  19
                                                                                                                                                             DHS, Kishanganj




                                                                  Condom Distribution
160000


                                                               138310
140000
                                                                                                                                      127499

120000                                                                                                        117183


                                                                                                                            102000
                                        97847                                          99199          99426
100000                                                 95400
                                                                               91200
                                85860
         78124     80145
 80000

                                                                                                                                                          Condom Distribution

 60000



 40000



 20000


                         103%                   114%                    145%                   109%                   117.86%                   125.00%
     0
         Target Achiv.    %     Target Achiv.    %     Target Achiv.     %     Target Achiv.    %     Target Achiv.     %       Target Achiv.     %
            Year 2005-06           Year 2006-07           Year 2007-08            Year 2008-09           Year 2009-10           Year 2010-11(Upto
                                                                                                                                    Nov. 2010)


                                                                                         20
                                                                                                                                                     DHS, Kishanganj




                                                               Cateract (Eye) Operation
4500
                                                                                                        4272


4000


3500                                                                                                                              3360



3000


2500

       2000                    2000                  2000                  2000                  2000                      2000
2000                                                                                                                                                 Cateract (Eye) Operation


1500
                                                            1214

                                                                                   958
1000                                   855



 500

                       0   0                   43%                   61%                   48%                   213.60%                   168.00%
   0
       Target Achiv.       %   Target Achiv.   %     Target Achiv.   %     Target Achiv.   %     Target Achiv.     %       Target Achiv.     %
          Year 2005-06            Year 2006-07          Year 2007-08          Year 2008-09          Year 2009-10            Year 2010-11(Upto
                                                                                                                                Nov. 2010)


                                                                                    21
                                                                                                                                                        DHS, Kishanganj




                                                                       OPD (Outdoor Patient)
400000

                                                                                            365217

350000                                                                                                             336037
                                                                   314087

300000



250000
                                          232424


200000

                 160373                                                                                                                                   OPD (Outdoor Patient)

150000



100000



 50000


           0                  0     0                  0     0                  0     0                  0     0
     0
         Target Achiv.    %       Target Achiv.    %       Target Achiv.    %       Target Achiv.    %       Target Achiv.     %   Target Achiv.   %
               Year 2005-06             Year 2006-07             Year 2007-08             Year 2008-09          Year 2009-10        Year 2010-11(Upto
                                                                                                                                        Nov. 2010)


                                                                                            22
                                                                                                                                       DHS, Kishanganj


                                                   Section A: Health Facilities in the District
Health Sub-centres
                                    Rural       Sub-centers                        Sub-            Further sub-   Status of building
        Sl.                                                      Sub-centers                                                               Availability of
               Block Name         Population     required                         centers            centers
        No                                                         Present                                            Own   Rented          Land (Y/N)
                                   in 2009      As per norm.                     proposed           required
         1    Kishanganj           125533            25              12             10                  3              7      N/A          Y (In Old HSC)
         2    Bahadurganj          222955            45              19                 23              3             12       5           Y (In Old HSC)
         3    Thakurganj           259255            52              27                 20              5             13      N/A          Y (In Old HSC)
         4    Kochadhaman          284145            57              24                 25              8             12       3           Y (In Old HSC)
         5    Dighalbank           191443            38              19                 15              4              8      N/A          Y (In Old HSC)
         6    Pothia               246120            49              22                 20              7             14       4           Y (In Old HSC)
         7    Terhagachh           134206            27              13                 10              4              7       1           Y (In Old HSC)
                   Total           1463657           293             136                123            34             73       10         Y (In Old HSC)



                                                    Addition Primary Health Centre

              60

              50
                                                                                                                                    Sub-centers required
              40
                                                                                                                                    Sub-centers
              30                                                                                                                    Present

                                                                                                                                    Sub-centers proposed
              20
                                                                                                                                    Further sub-centers required
              10

              0
                     Kishanganj   Bahadurganj   Thakurganj   Kochadhaman       23
                                                                           Dighalbank         Pothia     Terhagachh
                                                                                                                                         DHS, Kishanganj


(APHCs)
                             Rural           APHCs                                                  Further         Status of building
Sl.                                                           APHCs              APHCs                                                       Availability of
           Block Name      Population      Required as                                             APHCs
No                                                            Present           proposed                             Own       Rented         Land (Y/N)
                            in 2009         per norm                                               required
1         Kishanganj        125533              4                   0                3                1                0          0                No
2         Bahadurganj        222955              7                  3                4                0                2          0         Y (In Old APHC)
3         Thakurganj         259255              9                  1                7                1                1          0                No
4         Kochadhaman        284145              9                  2                7                0                2          0                No
5         Dighalbank         191443              6                  2                4                0                1          0         Y (In Old APHC)
6         Pothia             246120              8                  1                6                1                1          0                No
7         Terhagachh         134206              4                  0                4                0                0          0                No
            Total           1463657              37                 9                35               3                7          0                No



      9
      8
      7                                                                                                                           APHCs Required as per norm
      6
                                                                                                                                  APHCs
      5
                                                                                                                                  Present
      4
                                                                                                                                  APHCs proposed
      3
      2                                                                                                                           Further APHCs required

      1
      0
            Kishanganj   Bahadurganj    Thakurganj    Kochadhaman       Dighalbank        Pothia       Terhagachh



                                                                               24
                                                                                                                                            DHS, Kishanganj


                               Primary Health Centers/Referral Hospital/Sub-Divisional Hospital/District Hospital


                                                                                                              PHCs required (After
 Sl.                                                                           PHCs/Referral                                                      PHCs/CHC
          Block Name/sub division              Total Population                                                     including
 No                                                                          /SDH/DH Present                                                       proposed
                                                                                                               referral/DH/SDH)
     1   Kishanganj                                232805                                    2                         2                                  0
     2   Bahadurganj                               258161                                    1                         2                                  1
     3   Thakurganj                                278386                                    1                         2                                  1
     4   Kochadhaman                               284091                                    1                         2                                  1
     5   Dighalbank                                191406                                    1                         2                                  1
     6   Pothia              No. of            246073                           2     Assured   Cont.       2
                                                                                                          ANM                Condition of          0
                                     ANM (R/C)               Building     Building
Sl.   Health Sub              G.P./            ANM (R/C)                              running  power    residing              residential  Status of Status of
                 Population            Posted  134180 ownership condition water supply supply
       Terhagachh
No.7 Centre Name            Villages            in position                     1                           1
                                                                                                         at HSC                 facility           0
                                                                                                                                          furnitures Untied fund
                                      formally              (Govt/Rent) (+++/++/+/#)
                             served                                                  (A/NA/I) (A/NA/I) area (Y/N)            (+++/++/+/#)
                    Total                         1625102                                    9                        13                                  4
 1 Kulamani            10838       7       R           R             Govt.           ++             NA        NA      NA           ++              NA         Exhausted

 2 Belwa               10398       7       R           R             Govt.           +++            NA        NA      NA           +++             NA         Exhausted
     Ghat Bhabhan
            2
 3
     Toli 1.8
                       10268       4       R           R             Govt.           ++             NA        NA      NA           ++              NA         Exhausted

         1.6
 4 Motihara            10288       5       R           R              --                 #          NA        NA      NA             #             NA         Exhausted
           1.4

 5   Daula 1.2         10333       7       R           R             Govt.           +++            NA        NA      NA                         Present
                                                                                                                            PHCs/Referral/SDH/DH NA
                                                                                                                                 +++                          Exhausted
             1
                                                                                                                            PHCs required (After including referral/DH/SDH)
           0.8
 6   Pichhla
           0.6
                       10415       7       R           R              --                 #          NA        NA      NA           #
                                                                                                                            PHCs/CHC proposed      NA         Exhausted
           0.4
 7   Halamala
           0.2
                       10256       6       R           R              --                 #          NA        NA       Y             #             NA         Exhausted
             0
 8 Maheshbathna     11146 Bahadurganj
              Kishanganj      7            R
                                          Thakurganj    R
                                                       Kochadhaman    --
                                                                       Dighalbank        # Pothia    Terhagachh NA
                                                                                                    NA                NA             #             NA         Exhausted


                                                                                    25
                                                                                                                                                  DHS, Kishanganj


             9 Gachhpada        10603       4            R            R           Govt.          +++        NA     NA          NA          +++          NA      Exhausted

            10 Chakla           10223       4            R            R           Govt.          ++         NA     NA          NA           ++          NA      Exhausted

            11 Kolha Banwadi    10656       5            R            R           Govt.          ++         NA     NA          NA           ++          NA      Exhausted

            12 Mahingawn        10109       4            R            R           Govt.          +++        NA     NA          NA          +++          NA      Exhausted

                   Total       125533       67

                                                     Section B: Human Resources and Infrastructure
                                                                          Name of the Block:Kishanganj
        Sub-centre database
ANM(R)- Regular/ ANM(C)- Contractual; Govt- Gov/ Rented-Rent/ Pan –Panchayat or other Dept owned; Good condition +++/ Needs major
repairs++/Needs minor repairs-less that Rs10,000-+/ needs new building-#; Water Supply: Available –A/Not available –NA, Intermittently available-I
                                                                       Name of the Block:Bahadurganj
        Sub-centre database
                                       No. of  ANM            ANM                                Assured     Cont.   ANM       Condition of
                                                                        Building    Building
  Sl.       Health Sub                  G.P./   (R/C)         (R/C)                              running    power  residing     residential  Status of Status of
                           Population                                  ownership    condition
  No.      Centre Name                Villages Posted           in                             water supply supply  at HSC        facility  furnitures Untied fund
                                                                      (Govt/Rent) (+++/++/+/#)
                                       served formally       position                           (A/NA/I) (A/NA/I) area (Y/N)   (+++/++/+/#)
   1 Do Mohni              12709        5        R             R           --              #           NA    NA       NA             #           NA    Exhausted
   2 Jhingakanta           13817        7        R             R           --              #           NA    NA       NA             #           NA     Available
   3 Rupni                 13967        7        R             R          Govt.           ++           NA    NA       NA            ++           NA    Exhausted
   4 Lohagada              12689        5        R             R          Govt.           ++           NA    NA       NA            ++           NA    Exhausted
   5 Natuapada             13849        7        R             R          Govt.           +++          NA    NA       NA            +++          NA    Exhausted
   6 Veerpur (Plashmani)   12358        6        R             R          Govt.           +++          NA    NA       NA            +++          NA    Exhausted
   7 Nishandhra            13816        7        R             R           --              #           NA    NA       NA             #           NA    Exhausted
   8 Laucha                13803        7        R             R           --              #           NA    NA       NA             #           NA     Available
   9 Banswadi              11910        4        R             R           --              #           NA    NA       NA             #           NA    Exhausted
  10 Doharmalani           13193        6        R             R           --              #           NA    NA       NA             #           NA     Available

                                                                                                26
                                                                                                                                         DHS, Kishanganj


  11 Vilashi            12863         6         R     R         --           #          NA        NA         NA            #          NA      Exhausted
  12 Sameshar           12850         6         C     C        Govt.       +++          NA        NA         NA           +++         NA       Available
  13 Khodaganj          11696         5         R     R        Govt.        ++          NA        NA         NA           ++          NA      Exhausted
  14 Gopalpur           13983         7         R     R        Govt.        ++          NA        NA         NA           ++          NA      Exhausted
  15 Altawadi           12634         5         R     R         --           #          NA        NA         NA            #          NA      Exhausted
  16 Murmala            13967         7         R     R        Govt.        ++          NA        NA         NA           ++          NA       Available
  17 Mahadev Dighi      12851         6         C     C         --           #          NA        NA         NA            #          NA      Exhausted
            Total        222955       103
  ANM(R)- Regular/ ANM(C)- Contractual; Govt- Gov/ Rented-Rent/ Pan –Panchayat or other Dept owned; Good condition +++/ Needs major
repairs++/Needs minor repairs-less than Rs10,000-+/ needs new building-#; Water Supply: Available –A/Not available –NA, Intermittently available-I


                                                              Name of the Block: Thakurganj
       Sub-centre database
                              No. of                                                    Assured     Cont.   ANM       Condition of
                                      ANM (R/C)                Building    Building
  Sl.  Health Sub              G.P./            ANM (R/C)                               running    power  residing     residential  Status of Status of
                  Population            Posted                ownership    condition
  No. Centre Name            Villages            in position                          water supply supply  at HSC        facility  furnitures Untied fund
                                       formally              (Govt/Rent) (+++/++/+/#)
                              served                                                   (A/NA/I) (A/NA/I) area (Y/N)   (+++/++/+/#)
   1   Barigachh      9269        4         R        R          --           #          NA        NA         NA             #         NA      Exhausted
   2   Galgalia       8689        4         R        R         Govt.       +++          NA        NA         NA           +++         NA      Exhausted
   3   Churli         9512        5         R        R         Govt.        ++          NA        NA         NA            ++         NA      Exhausted
   4   Churli         8876        4         R        R          --           #          NA        NA         NA             #         NA      Available
   5   Piprithan      9363        4         C        C          --           #          NA        NA         NA             #         NA      Available
   6   Piprithan      9276        4         R        R          --           #          NA        NA         NA             #         NA      Exhausted
   7   Patharia       9810        5         C        C         Govt.       +++          NA        NA         NA           +++         NA      Available
   8   Hulhuli        9589        4         C        C         Govt.       +++          NA        NA         NA           +++         NA      Exhausted
   9   Jangle Bhita   9269        5         C        C          --           #          NA        NA         NA             #         NA      Available
  10   Janta Hat      9687        4         R        R          --           #          NA        NA         NA             #         NA      Available
  11   Khari Basti    10595       5         R        R          --           #          NA        NA         NA             #         NA      Exhausted
  12   Jhala          9835        5         R        R          --           #          NA        NA         NA             #         NA      Exhausted
  13   Kudi Dangi     9586        4         R        R          --           #          NA        NA         NA             #         NA      Available
  14   Rui Dhasha     10868       5         R        R         Govt.       +++          NA        NA         NA           +++         NA      Exhausted

                                                                                  27
                                                                                                                                       DHS, Kishanganj


15   Jirangachh       9608     5        R          R          --           #          NA        NA         NA             #         NA      Available
16   Nischit Pur      9589     5        R          R          --           #          NA        NA         NA             #         NA      Exhausted
17   Barchaundi       8689     4        R          R         Govt.        ++          NA        NA         NA            ++         NA      Exhausted
18   Kharudah         10263    5        R          R          --           #          NA        NA         NA             #         NA      Exhausted
19   Bhogdawar        8993     4        R          R         Govt.       +++          NA        NA         NA           +++         NA      Exhausted
20   Pathamari        9378     4        R          R          --           #          NA        NA         NA             #         NA      Available
21   Kadogawn         9569     4        R          R         Govt.       +++          NA        NA         NA           +++         NA      Available
22   Malingawn        9356     4        R          R          --           #          NA        NA         NA             #         NA      Exhausted
23   Bandarjhula      9659     4        R          R          --           #          NA        NA         NA             #         NA      Exhausted
24   Ziya Pokhar      9851     4        C          C          --           #          NA        NA         NA             #         NA      Exhausted
25   Rasia            10128    5        R          R         Govt.       +++          NA        NA         NA           +++         NA      Available
26   Beltoli          9566     4        R          R          --           #          NA        NA         NA             #         NA      Exhausted
27   Saraikudi        10382    5        R          R          --           #          NA        NA         NA             #         NA      Exhausted
       Total          259255   119


                                                          Name of the Block: Kochadhaman
     Sub-centre database
                            No. of                                                    Assured     Cont.   ANM       Condition of
                                    ANM (R/C)                Building    Building
Sl.  Health Sub              G.P./            ANM (R/C)                               running    power  residing     residential  Status of Status of
                Population            Posted                ownership    condition
No. Centre Name            Villages            in position                          water supply supply  at HSC        facility  furnitures Untied fund
                                     formally              (Govt/Rent) (+++/++/+/#)
                            served                                                   (A/NA/I) (A/NA/I) area (Y/N)   (+++/++/+/#)
 1   Asura            10522     5       R          R         Govt.        ++          NA        NA         NA           ++          NA      Exhausted
 2   Alta             11536     6       R          R         Govt.        ++          NA        NA         NA           ++          NA      Exhausted
 3   Bhewra           11524     6       C          C         Govt.        ++          NA        NA         NA           ++          NA      Available
 4   Kanhaiya Badi    10268     5       R          R         Govt.       +++          NA        NA         NA           +++         NA      Exhausted
 5   Singhari         10598     5       C          C         Govt.        ++          NA        NA         NA            ++         NA      Available
 6   Barbatta         11256     6       R          R         Govt.       +++          NA        NA         NA           +++         NA      Exhausted
 7   Andhasur         11269     6       R          R         Govt.       +++          NA        NA         NA           +++         NA      Available
 8   Deramari         10569     4       R          R         Govt.        ++          NA        NA         NA            ++         NA      Available
 9   Asura            10522     5       R          R          --           #          NA        NA         NA             #         NA      Exhausted
10   Alta             11536     6       C          C          --           #          NA        NA         NA             #         NA      Available
11   Chopra Bukhari   10521     5       R          R          --           #          NA        NA         NA             #         NA      Available
12   Vishanpur        10256     6       R          R         Govt.       +++          NA        NA         NA           +++         NA      Available
13   Bhagal           11254     6       C          C         Govt.        ++          NA        NA         NA            ++         NA      Available

                                                                                28
                                                                                                                                                         DHS, Kishanganj


14    Anarkali         9865           4              C            C         Govt.        ++          NA         NA        NA            ++          NA       Exhausted
15    Bagalwadi        10368          5              R            R         Govt.        ++          NA         NA        NA            ++          NA       Exhausted
16    Pothamari        10278          5              R            R         Govt.        +++         NA         NA        NA            +++         NA       Exhausted
17    Mohammadpur      11259          6              C            C         Govt.        +++         NA         NA        NA            +++         NA       Available
18    Bahikol          10573          5              R            R          --            #         NA         NA        NA              #         NA       Available
19    Kashiwadi        10756          5              R            R         Govt.         ++         NA         NA        NA             ++         NA       Exhausted
20    Badi Jan         10561          4              C            C         Govt.        +++         NA         NA        NA            +++         NA       Available
21    Sahpur           11589          6              C            C          --            #         NA         NA        NA              #         NA       Exhausted
22    Ghurna           11268          6              R            R         Govt.        +++         NA         NA        NA            +++         NA       Available
23    Chargharia       11789          6              R            R         Govt.        +++         NA         NA        NA            +++         NA       Exhausted
24    Bhewra           11392          7              C            C           --           #         NA         NA        NA              #         NA       Available
25    Ruhia            11549          6              R            R           --           #         NA         NA        NA              #         NA       Exhausted
26    Haldikhora       11267          6              C            C           --           #         NA         NA        NA              #         NA       Exhausted
        Total          284145     142

                                                                           Name of the Block: Dighalbank
      Sub-centre database
                                           No. of         ANM      ANM                                Assured     Cont.   ANM       Condition of
                                                                             Building    Building
Sl.      Health Sub                         G.P./          (R/C)   (R/C)                              running    power  residing     residential  Status of Status of
                         Population                                         ownership    condition
No.     Centre Name                       Villages        Posted     in                             water supply supply  at HSC        facility  furnitures Untied fund
                                                                           (Govt/Rent) (+++/++/+/#)
                                           served        formally position                           (A/NA/I) (A/NA/I) area (Y/N)   (+++/++/+/#)
 1 Dhantola               10869              4              R         R     Govt.        ++           NA        NA         NA           ++          NA       Exhausted
 2 Durgapur               11668              6              C         C     Govt.        +++          NA        NA         NA           +++         NA       Exhausted
 3 Sindhimari Janta       11251              5              C         C       --          #           NA        NA         NA            #          NA       Exhausted
 4 Talgachh               11421              5              R         R     Govt.        ++           NA        NA         NA           ++          NA       Exhausted
 5 Laxmipur               10989              4              R         R     Govt.        ++           NA        NA         NA           ++          NA       Exhausted
 6 Patharghatti           11302              5              C         C     Govt.        ++           NA        NA         NA           ++          NA       Available
 7 Dhangra                10897              4              C         C       --          #           NA        NA         NA            #          NA       Exhausted
 8 Tulsia Purana Hat      10986              4              R         R       --          #           NA        NA         NA            #          NA       Available
 9 Tulsia Naya Hat        11559              5              R         R     Govt.        +++          NA        NA         NA           +++         NA       Exhausted
10 Ikra                   11443              6              R         R     Govt.        +++          NA        NA         NA           +++         NA       Exhausted

                                                                                               29
                                                                                                                                           DHS, Kishanganj


  11 Tarawadi             10555       4        R         R      --           #          NA        NA         NA            #          NA       Exhausted
  12 Dogachhi             11687       5        R         R      --           #          NA        NA         NA            #          NA       Exhausted
  13 Kacchunala           12235       6        R         R      --           #          NA        NA         NA            #          NA       Available
  14 Dubri                11745       5        C         C      --           #          NA        NA         NA            #          NA       Exhausted
  15 Gandharwdanga        10786       4        C         C      --           #          NA        NA         NA            #          NA       Available
  16 Dahibhat             10489       4        R         R      --           #          NA        NA         NA            #          NA       Exhausted
  17 Haruadanga           11561       5        R         R      --           #          NA        NA         NA            #          NA       Available
           Total         191443       81
ANM(R)- Regular/ ANM(C)- Contractual; Govt- Gov/ Rented-Rent/ Pan –Panchayat or other Dept owned; Good condition +++/ Needs major
repairs++/Needs minor repairs-less than Rs10,000-+/ needs new building-#; Water Supply: Available –A/Not available –NA, Intermittently available-I

                                                                 Name of the Block: Pothia
       Sub-centre database
                              No. of                                                    Assured     Cont.   ANM       Condition of
                                      ANM (R/C)                Building    Building
  Sl.  Health Sub              G.P./            ANM (R/C)                               running    power  residing     residential  Status of Status of
                  Population            Posted                ownership    condition
  No. Centre Name            Villages            in position                          water supply supply  at HSC        facility  furnitures Untied fund
                                       formally              (Govt/Rent) (+++/++/+/#)
                              served                                                   (A/NA/I) (A/NA/I) area (Y/N)   (+++/++/+/#)
   1   Gilhawadi       10203      5        R         R         Govt.        +           NA        NA         NA            #          NA       Exhausted
   2   Naukatta        10865      6        R         R         Govt.        ++          NA        NA         NA            #          NA       Exhausted
   3   Paharkatta      10256      5        R         R          --           #          NA        NA         NA            #          NA       Exhausted
   4   Taiyav Pur      10178      6        R         R          --           #          NA        NA         NA            #          NA       Exhausted
   5   Fulhara         10120      5        R         R         Govt.        ++          NA        NA         NA            #          NA       Available
   6   Damalbadi       10443      7        R         R          --           #          NA        NA         NA            #          NA       Exhausted
   7   Chichuabadi     10556      6        R         R         Govt.        ++          NA        NA         NA            #          NA       Exhausted
   8   Daluhat         10360      6        R         R          --           #          NA        NA         NA            #          NA       Available
   9   Jagdubb         10547      7        R         R          --           #          NA        NA         NA            #          NA       Available
  10   Sarogora        10650      6        R         R          --           #          NA        NA         NA            #          NA       Available
  11   Chhattargachh   10181      7        C         C         Govt.        +           NA        NA         NA            #          NA       Exhausted
  12   Barodharia      10276      6        R         R          --           #          NA        NA         NA            #          NA       Exhausted
  13   Mirjapur        9689       5        R         R         Govt.        +           NA        NA         NA            #          NA       Exhausted
  14   Chanamana       10263      6        R         R         Govt.       +++          NA        NA         NA            #          NA       Available

                                                                                  30
                                                                                                                                        DHS, Kishanganj


  15   Udgara          10466     6       R          R          --           #          NA        NA         NA            #          NA      Exhausted
  16   Khajurbadi      10256     7       R          R          --           #          NA        NA         NA            #          NA      Available
  17   Shitalpur       10273     6       R          R          --           #          NA        NA         NA            #          NA      Exhausted
  18   Mohania         9752      6       R          R          --           #          NA        NA         NA            #          NA      Exhausted
  19   Pipalwadi       10326     6       R          R          --           #          NA        NA         NA            #          NA      Exhausted
  20   Raipur          10236     6       R          R          --           #          NA        NA         NA            #          NA      Available
  21   Dehalwadi       9562      6       R          R          --           #          NA        NA         NA            #          NA      Exhausted
  22   Baldia Hat      10129     5       R          R          --           #          NA        NA         NA            #          NA      Exhausted
  23   Chhattargachh   10265     6       R          R          --           #          NA        NA         NA            #          NA      Exhausted
  24   Parlawadi       10268     5       R          R          --           #          NA        NA         NA            #          NA      Exhausted
         Total         246120   142
ANM(R)- Regular/ ANM(C)- Contractual; Govt- Gov/ Rented-Rent/ Pan –Panchayat or other Dept owned; Good condition +++/ Needs major repairs++/Needs
minor repairs-less than Rs10,000-+/ needs new building-#; Water Supply: Available –A/Not available –NA,Intermittently available-I
                                                             Name of the Block: Terhagachh
       Sub-centre database
                             No. of                                                    Assured     Cont.   ANM       Condition of
                                     ANM (R/C)                Building    Building
 Sl.  Health Sub              G.P./            ANM (R/C)                               running    power  residing     residential  Status of Status of
                 Population            Posted                ownership    condition
 No. Centre Name            Villages            in position                          water supply supply  at HSC        facility  furnitures Untied fund
                                      formally              (Govt/Rent) (+++/++/+/#)
                             served                                                   (A/NA/I) (A/NA/I) area (Y/N)   (+++/++/+/#)

  1 Benugadh           10403     6       R          R          --           #          NA        NA         NA            #          NA      Exhausted

  2 Khaniabad          10455     6       R          R          --           #          NA        NA         NA            #          NA       Available

  3 Gamharia           10056     5       R          R          --           #          NA        NA         NA            #          NA       Available

  4 Bhaurha            10278     6       R          R          --           #          NA        NA         NA            #          NA       Available

  5 Jhala              10220     6       C          C         Govt.       +++          NA        NA         NA           +++         NA      Exhausted

  6 Hatgawn            10343     6       R          R          --           #          NA        NA         NA            #          NA       Available

  7 Chilhania          10123     6       R          R          --           #          NA        NA         NA            #          NA       Available

  8 Kajleta            10343     6       R          R         Govt.       +++          NA        NA         NA           +++         NA      Exhausted



                                                                                 31
                                                                                                                                                                                                                            DHS, Kishanganj


 9 Bairia             10648            7                         R                      R                 --               #                 NA                 NA                 NA                      #            NA          Available

10 Kamati             10750            7                         R                      R                 --               #                 NA                 NA                 NA                      #            NA          Available

11 Suhia              10182            5                         R                      R               Govt.           +++                  NA                 NA                 NA                     +++           NA          Exhausted

12 Matiyari           10216            6                         R                      R                 --               #                 NA                 NA                 NA                      #            NA          Exhausted

13 Bibiganj           10189            5                         R                      R                 --               #                 NA                 NA                 NA                      #            NA          Exhausted

      Total           134206           77

      ANM(R)- Regular/ ANM(C)- Contractual; Govt- Gov/ Rented-Rent/ Pan –Panchayat or other Dept owned; Good condition +++/ Needs major
  repairs++/Needs minor repairs-less than Rs10,000-+/ needs new building-#; Water Supply: Available –A/Not available –NA, Intermittently available-I
                                                                                      Section B: Human Resources and Infrastructure
Additional Primary Health Centre (APHC) Database: Infrastructure
                                            Building ownership


                                                                 Building condition




                                                                                                                                                                                   residential facility
                                                                                      Assured running
                                             (Govt/Pan/Rent)




                                                                                                        power supply




                                                                                                                                                                                                                                    vehicle (Y/N)
                                                                                                                       (+++/++/+/#)




                                                                                                                                                                                     (+++/++/+/#)
                                                                                                                                       Condition of



                                                                                                                                                      No. of rooms
                                                                                                                                       Labour room
                                                                                       water supply




                                                                                                                                                                                                          MO residing
                                                                                                                                                                                      Condition of




                                                                                                                                                                                                                                     Ambulance/
                                                                                                                                                                     No. of beds
                                                                                                         Continuous




                                                                                                                                                                                                           area (Y/N)
                                                                    (+++/++/#)




                                                                                                                                        (+++/++/#)
                          Population




                                                                                                                                                                                                            at APHC
                                                                                         (A/NA/I)



                                                                                                          (A/NA/I)




                                                                                                                                                                                                                        Status of
                                                                                                                                                                                                                        furniture
                                                                                                                          Toilets
                            served




Sl.         Name of
No.          APHC




 1    Rupni              60245                NF                      #                  NA                    A       Yes                 +++         2             0                 +++                      N       NA           NA

 2    Meharganj          55123 Govt.                                 +++                 NA                    A       Yes                 +++         2             0                 +++                      N       NA           NA

 3    Gangi              58623 Govt.                                 +++                 NA                    A       Yes                 +++         2             0                 +++                      N       NA           NA

 4    Pawakhali          57445 Govt.                                 ++                  NA                    A       Yes                 +++         2             0                 +++                      N       NA           NA

 5    Haldikhora         52369 Govt.                                 ++                  NA                    A       Yes                 +++         2             0                 +++                      N       NA           NA

                                                                                                                                      32
                                                                                                                                                    DHS, Kishanganj


  6    Alta            64712 Govt.             ++        NA        A         Yes            +++       2        0          +++           N     NA          NA

  7    Laxhmipur       63258     NF             #        NA        A         Yes            +++       2        0          +++           N     NA          NA

  8    Padampur        65412 Govt.             ++        NA        A         Yes            +++       2        0          +++           N     NA          NA

  9    Damalbari       69874 Govt.             +++       NA        A         Yes            +++       2        0          +++           N     NA          NA

       Total                      ---          ---       ---       ---       ---            ---       18       0          ---           ---       ---     ---


Additional Primary Health Centre (APHC) Database: Human Resources

                                Doctors                               Laboratory              Pharmacists /               Nurses         Accnt/Peon
                                                         ANM
 Sl.                                                                  Technician                  dresser                 A Grade        s/Sweeper/ Availability
        Name of APHC
 No.                                      In                In                 In                         In                      In        Night   of specialist
                         Sanction                Sanction          Sanction                 Sanction               Sanction
                                        Position          Position          Position                   Position                 Position   Guards

   1   Rupni                2              2         2         1         1         0              1        0          2             2         2              Nil


   2   Meharganj            2              2         2         0         1         0              1        0          2             1         2              Nil


   3   Gangi                2              1         2         2         1         0              1        0          2             2         2              Nil


   4   Pawakhali            2              1         2         2         1         0              1        0          2             2         2              Nil


   5   Haldikhora           2              2         2         2         1         0              1        0          2             2         2              Nil


   6   Alta                 2              1         2         2         1         0              1        0          2             2         2              Nil



                                                                                       33
                                                                                                                                                                                                                                                                  DHS, Kishanganj



 7     Laxhmipur                2         2          2                 1                              1                           0                     1                           0                         2                       2                    2                            Nil


 8     Padampur                 2         2          2                 1                              1                           0                     1                           0                         2                       2                    2                            Nil


 9     Damalbari                2         2          2                 0                              1                           0                     1                           0                         2                       1                    2                            Nil


           Total               18         16         18              11                               9                           0                     9                           0                         2                    16                      18                           Nil

Allopathic (A),Ayush (Ay), Regular (R), Contractual (C) Note:- Out of 16 doctors 14 are in long leave.
                                                         Section B: Human Resources and Infrastructure
Primary Health Centres/Referral Hospital/Sub-Divisional Hospital/District Hospital: Infrastructure




                                                                                                          Assured running water
                                                            Building ownership




                                                                                                                                                                                        Condition of labour
                                                                                 Building condition




                                                                                                                                                                Functional Labour
                                                                                                                                  Continuous power




                                                                                                                                                                                                                                                                Condition of ward


                                                                                                                                                                                                                                                                                    Condition of OT
                                                                                                                                                                                         room(+++/++/#)
                                                             (Govt/Pan/Rent)




                                                                                                             supply(A/NA/I)


                                                                                                                                   supply(A/NA/I)




                                                                                                                                                                                                                                           Functional OT
                                                                                                                                                                                                              No. of rooms
                                                                                                                                                                  room(A/NA)




                                                                                                                                                                                                                             No. of beds
                                                                                    (+++/++/#)




                                                                                                                                                                                                                                                                  (+++/++/#)


                                                                                                                                                                                                                                                                                      (+++/++/#)
                                                                                                                                                     (A/NA/I)




                                                                                                                                                                                                                                              (A/NA)
                                                                                                                                                      Toilets
      Sl.              PHC/ Referral           Population
      No.          Hospital/SDH/DH Name         Served




       1     PHC Kishanganj                     125509      Govt                 +++                       NA                         A                A            A                   +++                       6          6             NA                   +++                     #

       2     PHC Bahadurganj                    258161      Govt                 +++                       NA                         A                A            A                   +++                   10             6             NA                   +++                     #

       3     PHC Thakurganj                     278386      Govt                 +++                       NA                         A                A            A                   +++                       6          6             NA                   +++                     #

       4     PHC Kochadhaman                    284091      Govt                 +++                       NA                         A                A            A                   +++                   10             6             NA                   +++                     #

       5     PHC Dighalbank                     191406      Govt                 +++                       NA                         A                A            A                   +++                   10             6             NA                   +++                     #

       6     PHC Pothia                         246073      Govt                 +++                       NA                         A                A            A                   +++                       8          6             NA                   +++                     #

                                                                                                                                        34
                                                                                                                             DHS, Kishanganj


      7    PHC Terhagachh              134180     Govt   +++   NA      A      A      A       +++         6    6        NA    +++       #

                  PHC          Popn                                     Laboratory         Pharmacist/                                          Store
                                        Doctors          ANM                                                  Nurses         Specialists
             /Referral/SDH/   Served                                    Technician           Dresser                                           Keeper
               DH Name




      8    Refral Chhattargach            --      Govt   +++   NA      A      A      A       +++     12      30        A     +++      +++

      9    SDH Kishanganj              107296     Govt   +++   NA      A      A      A       +++     22      30        A     +++      +++

     10    DH Kishanganj                  --      Govt   +++    A      A      A      A       +++     60      100       A     +++      +++

                  Total                1625102     ---   ---    ---    ---    ---    ---      ---    ---     ---       ---   ---       ---




Primary Health Centres/Referral Hospital/Sub-Divisional Hospital/District Hospital: Human Resources



                                                                        35
                                                                                                                                          DHS, Kishanganj


                                                                                                                              In
                                        Sanc-     In       Sanc-     In       Sanc-        In       Sanc-     In       Sanc-        Sanc-       In
                                                                                                                             Positi
                                         tion   Position    tion   Position    tion      Position    tion   Position    tion         tion     Position
                                                                                                                              on
              PHC
         1                    125509      3        0        13       13         0           0         1        0        0      0      4          2          0
              Kishanganj
              PHC
         2                    258161      3        3        19       12         0           0         1        0        0      0      4          2          0
              Bahadurganj
              PHC
         3                    278386      3        2        29       19         0           0         1        0        0      0      4          2          0
              Thakurganj
              PHC
         4                    284091      3        2        27       13         0           0         1        0        0      0      4          1          0
              Kochadhaman
              PHC
         5                    191406      3        3        19        6         0           0         1        0        0      0      4          0          0
              Dighalbank

         6    PHC Pothia      246073      3        2        26       20         0           0         1        0        0      0      4          2          0

              PHC
         7                    134180      3        3        15        9         0           0         1        1        0      0      4          1          0
              Terhagachh
              Refral
         8                       --       7        2         7        2         1           0         1        0        4      2      2          0          0
              Chhattargach
              SDH
         9                    107296      8        7         7        3         1           1         2        0        4      3      4          2          1
              Kishanganj
              DH
        10                       --      12        1         5        0         4           0         4        0        24     0     12          1          2
              Kishanganj

               Total          1625102




Allopathic (A),Ayush (Ay), Regular (R), Contractual (C)

                                                  Section C: Equipment, Drugs and Supplies

                                                                                    36
                                                                                                                                               DHS, Kishanganj


Availability of Equipment


                                                     District Health Society, Kishanganj
                                           Requirements for improving health facility for better treatment of patients
  Sl.                                          SDH,          PHC,         PHC,          PHC,         PHC,       PHC,       PHC,         Refrel         Total
           Name of Furniture/Equipment
  No.                                        Kishanganj   Bahadurganj   Thakurganj   Kochadhaman   Dighalbank   Pothia   Terhagach   Chhattargach   Requirement
 List of Furniture (including surgical) at PHC
   1 Examination Table                           4            3             3             3            3          3         3             3             25
   2 Writing table with table sheets             5            5             5             5            5          5         5             5             40
     Plastic chairs (for in-patients'
   3 attendants)                                 6            6             6             6            6          6         6             6             48
   4 Armless chairs                              8            8             8             8            8          8         8             8             64
   5 Full size steel almirah                     4            4             4             4            4          4         4             4             32
   6 Labour table                                2            1             1             1            1          1         1             1             9
   7 OT Table                                    1            1             1             1            1          1         1             1             8
   8 Arm board for adult and child               4            4             4             4            4          4         4             4             32
   9 Wheel chair                                 1            1             1             1            1          1         1             1             8
  10 Stretcher on trolley                        2            1             1             1            1          1         1             1             9
  11 Instrument trolley                          2            2             2             2            2          2         2             2             16
  12 Wooden screen                               1            1             1             1            1          1         1             1             8
  13 Foot step                                   5            5             5             5            5          5         5             5             40
  14 Coat rack                                   2            2             2             2            2          2         2             2             16
  15 Bed side table                              6            6             6             6            6          6         6             6             48
  16 Bed stead iron (for in-patients)            6            6             6             6            6          6         6             6             48
  17 Baby cot                                    2            1             1             1            1          1         1             1             9
  18 Stool                                       6            6             6             6            6          6         6             6             48
  19 Medicine chest                              1            1             1             1            1          1         1             1             8
  20 Lamp                                        3            3             3             3            3          3         3             3             24
  21 Shadoless lamp light(for OT and LR)         2            2             2             2            2          2         2             2             16

                                                                                       37
                                                                                          DHS, Kishanganj


 22 side Wooden racks                     4    4    4     4    4    4        4        4           32
 23 Fans                                  6    6    6     6    6    6        6        6           48
 24 Tube light                            8    8    8     8    8    8        8        8           64
 25 Basin                                 2    2    2     2    2    2        2        2           16
 26 Basin stand                           2    2    2     2    2    2        2        2           16
Sundry Articles including Linen
 27 Buckets                               4    4    4     4    4        4        4        4         32
 28 Mugs                                  4    4    4     4    4        4        4        4         32
 29 LPG stove                             2    1    1     1    1        1        1        1            9
 30 LPG cylinder                          4    2    2     2    2        2        2        2         18
 31 Sauce pan with lid                    2    2    2     2    2        2        2        2         16
 32 Water receptacle                      2    2    2     2    2        2        2        2         16
 33 Rubber/plastic shutting               2    2    2     2    2        2        2        2         16
 34 Drum with tap for storing water       2    2    2     2    2        2        2        2         16
 35 IV Stand                              10   4    4     4    4        4        4        4         38
 36 Matress for beds                      6    6    6     6    6        6        6        6         48
 37 Foam Mattress for OT table            2    1    1     1    1        1        1        1            9
 38 Foam Matress for labour table         2    1    1     1    1        1        1        1            9
 39 Machintosh for labour and OT table    8    4    4     4    4        4        4        4         36
 40 Kelly's pad for labour and OT table   4    2    2     2    2        2        2        2         18
 41 Bed sheets                            60   6    6     6    6        6        6        6        102
 42 Pillows with covers                   80   8    8     8    8        8        8        8        136
 43 Blankets                              60   6    6     6    6        6        6        6        102
 44 Baby blankets                         20   2    2     2    2        2        2        2         34
 45 Towels                                60   6    6     6    6        6        6        6        102
 46 Curtains with rods                    20   20   20    20   20       20       20       20       160
 47 Cautery Set                           2    1    1     1    1        1        1        1            9

                                                         38
                                                                                           DHS, Kishanganj


 48 Dowen retractor two sizes                  4            2    2     2    2    2    2    2         18
 49 Lahese forcep                              6            3    3     3    3    3    3    3         27
 50 Intestine Clamp                            8            4    4     4    4    4    4    4         36
 51 Cockles Forcep (Curved)                    4            2    2     2    2    2    2    2         18
 52 Long handle curved scissors                6            3    3     3    3    3    3    3         27
 53 Staurt scissors                            6            3    3     3    3    3    3    3         27
 54 Appron plastic                             12           6    6     6    6    6    6    6         54
 55 Chhappal for OT                            12           6    6     6    6    6    6    6         54
 56 Bandage good quality                       50           25   25    25   25   25   25   25       225
 57 BP Handle and surgical blade               12           6    6     6    6    6    6    6         54
 58 Artery Forcep curved                       48           24   24    24   24   24   24   24       216
 59 Alle's Forceps                             48           24   24    24   24   24   24   24       216
 60 Disecting Forcep                           12           6    6     6    6    6    6    6         54
 61 Niddle holder                              12           6    6     6    6    6    6    6         54
    Seissor lonh handle (Curved and
 62 straight)                                  12           6    6     6    6    6    6    6         54
 63 Retractors-self retaining skin retractor   12           6    6     6    6    6    6    6         54
 64 Devers retractor downs                     4            2    2     2    2    2    2    2         18
 65 Rustesteinal clamp (curved)                8            4    4     4    4    4    4    4         36
    Lanz tissue forcep Plane desecting
 66 forcep                                     4            2    2     2    2    2    2    2         18
 67 Towel clip                                 12           6    6     6    6    6    6    6         54
 68 Cautery Machine                            2            1    1     1    1    1    1    1          9
 69 Ryles Tube 18 no.                          24           12   12    12   12   12   12   12       108
    Airways (Disposible plastic) adult &
 70 child                                      24           12   12    12   12   12   12   12       108
Requirements for a fully equipped and operational labour room
 1 Suction Machine (Elec. & Manual)            4             2   2     2    2    2    2    2         18
 2 Delivery Forceps                            4            2    2     2    2    2    2    2         18
 3 Hegerdilator sets                           4            2    2     2    2    2    2    2         18
 4 Mucus Succker (in dozens)                   2            1    1     1    1    1    1    1          9
 5 Amboo's Bag with mask 0 size                4            2    2     2    2    2    2    2         18
 6 Endotrachale tube (different size)          12           6    6     6    6    6    6    6         54


                                                                      39
                                                                                                                                           DHS, Kishanganj


    7 Laryango scope                              4           2            2            2             2           2           2            2         18
    8 Baby warmer                                 8           4            4            4             4           4           4            4         36
    9 Inculleator                                 2           1            1            1             1           1           1            1          9
    10 Phototherapy shade for baby                2           1            1            1             1           1           1            1          9
    11 Episiotomy set (intestainal catgaut)       10          5            5            5             5           5           5            5         45
    12 Baby tray                                  6           3            3            3             3           3           3            3         27
    13 Baby Weighing machine                      6           3            3            3             3           3           3            3         27
    14 Oxygen mask for baby & mother              24          12          12            12            12          12          12          12        108
    15 Oxygen Cylinder                            6           3            3            3             3           3           3            3         27
    16 Stand light                                12          6            6            6             6           6           6            6         54
    17 Inverter                                   8           4            4            4             4           4           4            4         36
    18 Disposable gloves                          20          10          10            10            10          10          10          10         90
    19 Folys catheter                             24          12          12            12            12          12          12          12        108
    20 Vicryl 1No.                                24          12          12            12            12          12          12          12        108
    21 L P Niddle                                 24          12          12            12            12          12          12          12        108
    22 Intraccoth no. 18 and 24                   72          24          24            24            24          24          24          24        240


    23 Facility for Oxygen administration
    24 Sterilisation equipment
    25 24-hour running water
       Electricity supply with generator
    26 facility
    27 An area eamarked for new-born care
       Emergency drug tray with essential
    28 drugs
Drinking Water/Running Water/Toilet
1   Drinking water                            Deep Boring Deep Boring Deep Boring   Deep Boring   Deep Boring Deep Boring Deep Boring Deep Boring
                                                                                                                                                  Urgently
2       Running water                          Required    Required    Required      Required      Required    Required    Required    Required
3       Toilet for Ootdoor patietnt              Nil          Nil         Nil           Nil          Nil         Nil         Nil          Nil        Nil
4       Toilet for Indoor patient                Nil          Nil         Nil           Nil          Nil         Nil         Nil          Nil        Nil



                                                                                      40
                                                                                                                                DHS, Kishanganj



                                                  Section D: RKS, Untied Funds and Support Services
Rogi Kalyan Samitis:

         Sl. No         Name of Facility           RKS set up (Y/N)     No. of meetings held (in last 3 Months)   Total Funds       Funds Utilized
            1     PHC Kishanganj                          Y                               3                          96780               78%
            2     PHC Bahadurganj                         Y                               3                         213200               43%
            3     PHC Thakurganj                          Y                               3                         198070               56%
            4     PHC Kochadhaman                         Y                               3                         143090               88%
            5     PHC Dighalbank                          Y                               3                         167000               29%
            6     PHC Pothia                              Y                               3                         196800               86%
            7     PHC Terhagachh                          Y                               2                         145200               67%
            8     Refral Hospital Chhattargachh           Y                               3                         980700               73%
            9     SDH, Kishanganj                         Y                               3                         456800               68%
Untied Funds:

         Sl. No            Name of Facility                           Funds received                               Funds utilized
            1     PHC Kishanganj                                          25000                                         Nil
            2     PHC Bahadurganj                                         25000                                         Nil
            3     PHC Thakurganj                                          25000                                         Nil
            4     PHC Kochadhaman                                         25000                                         Nil
            5     PHC Dighalbank                                          25000                                         Nil
            6     PHC Pothia                                              25000                                         Nil
            7     PHC Terhagachh                                          25000                                         Nil
            8     APHC Rupni                                              10000                                         Nil
            9     APHC Meharganj                                          25000                                         Nil
           10     APHC Gangi                                              25000                                         Nil
           11     APHC Pawakhali                                          25000                                        12000
           12     APHC Haldikhora                                         25000                                         Nil
           13     APHC Alta                                               25000                                        25000
           14     APHC Laxhmipur                                          25000                                         Nil
           15     APHC Padampur                                           15000                                         Nil
           16     APHC Damalbari                                          25000                                         Nil

                                                                             41
                                                                                                                                   DHS, Kishanganj



Support Systems to Health facility functioning:
                                                                                Services available
 Sl.
             Facility name             Ambulance   Generator   X- ray              Laboratory services O/I/ NA           Canteen       House
 No
                                        O/I/ NA    O/I/ NA     O/I/ NA   Pathology Malaria/kalaazar        TB    Other   O/I/ NA      keeping
  1     SDH Kishanganj                        I       O         I&O          I              NA               I    NA      NA            NA
  2     R H Chhattargachh                   NA        O         NA          NA              NA             I     NA       NA            NA
  3     PHC Kishanganj                        I       O         NA          NA              NA             I     NA       NA            NA
  4     PHC Bahadurganj                       I       O          O          NA              NA             I     NA       NA            NA
  5     PHC Thakurganj                        I       O         NA          NA              NA             I     NA       NA            NA
  6     PHC Kochadhaman                       I       O         NA          NA              NA             I     NA       NA            NA
  7     PHC Dighalbank                        I       O         NA          NA              NA             I     NA       NA            NA
  8     PHC Pothia                            I       O         NA          NA              NA             I     NA       NA            NA
  9     PHC Terhagachh                      NA        O         NA          NA              NA             I     NA       NA            NA
 10     APHC Rupni                          NA       NA         NA          NA              NA            NA     NA       NA            NA
 11     APHC Meharganj                      NA       NA         NA          NA              NA            NA     NA       NA            NA
 12     APHC Gangi                          NA       NA         NA          NA              NA            NA     NA       NA            NA
 13     APHC Pawakhali                      NA       NA         NA          NA              NA            NA     NA       NA            NA
 14     APHC Haldikhora                     NA       NA         NA          NA              NA            NA     NA       NA            NA
 15     APHC Alta                           NA       NA         NA          NA              NA            NA     NA       NA            NA
 16     APHC Laxhmipur                      NA       NA         NA          NA              NA            NA     NA       NA            NA
 17     APHC Padampur                       NA       NA         NA          NA              NA            NA     NA       NA            NA
 18     APHC Damalbari                      NA       NA         NA          NA              NA            NA     NA       NA            NA
O- Outsourced/ I- In sourced/ NA- Not available



                                                                                  42
                                                                                                                                          DHS, Kishanganj


                                                                Section E: Health Services Delivery
APHC
                                                                                                          Data (Year 2008-09)
No.       Service                          Indicator
                                                                            APHC 1   APHC 2   APHC 3   APHC 4 APHC 5 APHC 6     APHC 7   APHC 8   APHC 9
                       % of children 9-11 months fully immunized
        Child
1                      (BCG+DPT123+OPV123+Measles)
        Immunization
                       % of immunization sessions held against planned
                       Total number of live births
                       Total number of still births
                       % of newborns weighed within one week
                       % of newborns weighing less than 2500 gm
                       Total number of neonatal deaths (within 1 month of
                       birth)
                       Total number of infant deaths
                       (within 1-12 months)
                       Total number of child deaths
                       (within 1-5 yrs)
2       Child Health   Number of diarrhea cases reported within the year
                       % of diarrhea cases treated
                       Number of ARI cases reported within the year
                       % of ARI cases treated                                                  Only OPD Service Available
                       Number of children with Grade 3 and Grade 4
                       undernutrition who received a medical checkup
                       Number of children with Grade 3 and Grade 4
                       undernutrition who were admitted
                       Number of undernourished children
                       % of children below 5 yrs who received 5 doses of
                       Vit A solution
                       Number of pregnant women registered for ANC
                       % of pregnant women registered for ANC in the 1 st
                       trimester
                       % of pregnant women with 3 ANC check ups
                       % of pregnant women with any ANC checkup
          Maternal
    3                  % of pregnant women with anaemia
           Care
                       % of pregnant women who received 2 TT injections
                       % of pregnant women who received 100 IFA tablets
                       Number of pregnant women registered for JSY
                       Number of Institutional deliveries conducted
                       Number of home deliveries conducted by SBA


                                                                                        43
                                                                                                             DHS, Kishanganj

                     % of institutional deliveries in which JBSY funds
                     were given
                     % of home deliveries in which JBSY funds were
                     given
                     Number of deliveries referred due to complications
                     % of mothers visited by health worker during the
                     first week after delivery
                     Number of MTPs conducted
                     Number of RTI/STI cases treated
    Reproductive     % of couples provided with barrier contraceptive
4
       Health        methods
                     % of couples provided with permanent methods
                     % of female sterlisations
                     % of TB cases suspected out of total OP
                     Proportion of New Sputum Positive out of Total
                     New Pulmonary Cases
                     Annual Case Detection Rate (Total TB cases                 Only OPD Service Available
                     registered for treatment per 100,000 population per
5     RNTCP          year)
                     Treatment Success Rate (% of new smear positive
                     patients who are documented to be cured or have
                     successfully completed treatment)
                     % of patients put on treatment, who drop out of
                     treatment
                     Annual Parasite Incidence
                     Annual Blood Examination Rate
    Vector Borne
                     Plasmodium Falciparum percentage
       Disease
6                    Slide Positivity Rate
       Control
                     Number of patients receiving treatment for Malaria
     Programme
                     Number of patients with Malaria referred
                     Number of FTDs and DDCs
                     Number of cases detected
       National
                     Number of cases registered
     Programme
7                    Number of cases operated
    for Control of
                     Number of patients enlisted with eye problem
      Blindness
                     Number of camps organized
                     Number of cases detected
      National
                     Number of Cases treated
      Leprosy
8                    Number of default cases
     Eradication
                     Number of case complete treatment
     Programme
                     Number of complicated cases

                                                                           44
                                                                                                                             DHS, Kishanganj

                      Number of cases referred
         Inpatient    Number of in-patient admissions
    9
          Services
                                                                                   Only OPD Service Available
 10
         Outpatient   Outpatient attendance                                        Not Functional
          services

PHC/Refral Hospital/SDH/District Hospital
                                                                                             Data (Year 2008-09)
No.       Service                         Indicator                                                                           Ref.    SDH,
                                                                     Kne     Bdj      Tkj   Koch    Dig     Pothia   Terha
                                                                                                                             Chhat     Kne
                     % of children 9-11 months fully immunized      68.58% 45.38% 53.47% 40.06% 45.72% 46.35% 70.28%                 30.87%
        Child        (BCG+DPT123+OPV123+Measles)
1
        Immunization % of immunization sessions held against
                     planned
                     Total number of live births                       615   1138  2997      1995     742     4740     836     723      3696
                     Total number of still births                       27      9    118      159      53      195      44      18       152
                     % of newborns weighed within one week            92%    61% 71.37%      53%     61%      62%     94%      0%       41%
                     % of newborns weighing less than 2500 gm         12%     8%     9%       7%      8%       8%     12%      0%        5%
                     Total number of neonatal deaths (within 1                  0
                     month of birth)
                     Total number of infant deaths
                     (within 1-12 months)
                     Total number of child deaths
                     (within 1-5 yrs)
                     Number of diarrhea cases reported within the
2       Child Health year
                     % of diarrhea cases treated
                     Number of ARI cases reported within the year
                     % of ARI cases treated
                     Number of children with Grade 3 and Grade 4
                     undernutrition who received a medical
                     checkup
                     Number of children with Grade 3 and Grade 4
                     undernutrition who were admitted
                     Number of undernourished children
                     % of children below 5 yrs who received 5
                     doses of Vit A solution


                                                                               45
                                                                                                                    DHS, Kishanganj


                   Number of pregnant women registered for        2594   3298   4319   4166   4279   4361   2192      374      2192
                   ANC
                   % of pregnant women registered for ANC in
                   the 1st trimester
                   % of pregnant women with 3 ANC check ups         933  1197   1557     778    495  4046   1620      367       511
                   % of pregnant women with any ANC checkup
                   % of pregnant women with anaemia
                   % of pregnant women who received 2 TT
                   injections
                   % of pregnant women who received 100 IFA
                   tablets
     Maternal      Number of pregnant women registered for
3
      Care         JSY
                   Number of Institutional deliveries conducted     324  1076   2529   2154     773  4425     621     788      3848
                   Number of home deliveries conducted by           125     0     307      0      0    297     12       0         0
                   SBA
                   % of institutional deliveries in which JBSY
                   funds were given
                   % of home deliveries in which JBSY funds
                   were given
                   Number of deliveries referred due to
                   complications
                   % of mothers visited by health worker during
                   the first week after delivery
                   Number of MTPs conducted
                   Number of RTI/STI cases treated
    Reproductive   % of couples provided with barrier
4
       Health      contraceptive methods
                   % of couples provided with permanent methods
                   % of female sterlisations                    29.82% 30.00% 39.11% 37.02% 28.43% 22.06% 22.81%    0.00%   43.72%
                   % of TB cases suspected out of total OP
                   Proportion of New Sputum Positive out of
                   Total New Pulmonary Cases
5     RNTCP
                   Annual Case Detection Rate (Total TB cases
                   registered for treatment per 100,000
                   population per year)


                                                                      46
                                                                                                            DHS, Kishanganj


                      Treatment Success Rate (% of new smear
                      positive patients who are documented to be
                      cured or have successfully completed
                      treatment)
                      % of patients put on treatment, who drop out
                      of treatment
                      Annual Parasite Incidence
                      Annual Blood Examination Rate
     Vector Borne     Plasmodium Falciparum percentage
        Disease       Slide Positivity Rate
6
        Control       Number of patients receiving treatment for
      Programme       Malaria
                      Number of patients with Malaria referred
                      Number of FTDs and DDCs
                      Number of cases detected
        National
                      Number of cases registered
      Programme
7                     Number of cases operated
     for Control of
                      Number of patients enlisted with eye problem
       Blindness
                      Number of camps organized
                      Number of cases detected
       National       Number of Cases treated
       Leprosy        Number of default cases
8
      Eradication     Number of case complete treatment
      Programme       Number of complicated cases
                      Number of cases referred
      Inpatient       Number of in-patient admissions                235   1275      2321
9
       Services
      Outpatient      Outpatient attendance
10
       services
       Surgical       Number of major surgeries conducted             0     0         0     0   0   0   0    0         0
11
        Servics       Number of minor surgeries conducted




                                                                                47
     DHS, Kishanganj




48
                                                                                                                                           DHS, Kishanganj


                                             Section F: Community Participation, Training & BCC
Community Participation Initiatives
                                            No. of VHSC        Total amount                  Number of ASHAs    Number of meetings held   Total amount paid
Sl.                    No. of   No. VHSC                                         No. of          trained
      Name of Block                         meetings held   released to VHSC                                      between ASHA and         as incentive to
No.                     GPs      formed                                          ASHAs
                                             in the block   from untied funds               Round 1   Round 2        Block offices              ASHA

1     Kishanganj        10            Nil       Nil               Nil                117      96        21         8 times in 2009
2     Bahadurganj       20            Nil       Nil               Nil                209     172        37         8 times in 2009
3     Thakurganj        22            Nil       Nil               Nil                243     188        55         8 times in 2009
4     Kochadhaman       24            Nil       Nil               Nil                265     186        79         8 times in 2009
5     Dighalbank        16            Nil       Nil               Nil                179      0        179         8 times in 2009
6     Pothia            22            Nil       Nil               Nil                230     196        34         8 times in 2009
7     Terhagachh        12            Nil       Nil               Nil                125     107        18         8 times in 2009

Training Activities:
                           Rounds of                                                                                   Any specific issue on which need for a
Sl.       Name of                             No. of personnel       Rounds of IMNCI          No. of personnel given
                              SBA                                                                                       training or skill building was felt but
No.        Block                            given SBA Training        Trainings held            IMNCI Training
                         Trainings held                                                                                        has not being given yet
  1    Kishanganj             Yes                     4                         No                     -----                              -----
  2    Bahadurganj              Yes                   6                         No                     -----                              -----
  3    Thakurganj               Yes                   6                         No                     -----                              -----
  4    Kochadhaman              Yes                   5                         No                     -----                              -----
  5    Dighalbank               Yes                   5                         No                     -----                              -----
  6    Pothia                   Yes                   4                         No                     -----                              -----
  7    Terhagachh               Yes                   4                         No                     -----                              -----



                                                                                       49
                                                                                                                          DHS, Kishanganj


BCC Activities:
          Sl. No.          Name of Block                                   BCC Campaigns/activities conducted
            1          Kishanganj                                                          No

            2          Bahadurganj                                                         No

            3          Thakurganj                                                          No

            4          Kochadhaman                                                         No

            5          Dighalbank                                                          No

            6          Pothia                                                              No

            7          Terhagachh                                                          No

District & Block Level Management:
     Sl.
                Name of Block        Health Manager Appointed (Y/N)   Accountant appointed (Y/N)       Store keeper appointed (Y/N)
     No.
      1     Kishanganj                            Yes                            No                                No

      2     Bahadurganj                           Yes                            Yes                               No

      3     Thakurganj                            Yes                            No                                No

      4     Kochadhaman                           Yes                            No                                No

      5     Dighalbank                            No                             Yes                               No

      6     Pothia                                No                             Yes                               No

      7     Terhagachh                            Yes                            No                                No


                                                                           50
                                              DHS, Kishanganj


                 4. Setting Objectives and Suggested Plan of Action
4.1 Introduction
       District health action plan has been entrusted as a principal instrument for planning,
implementation and monitoring of fully accountable and accessible health care mechanism. It has been
envisioned through effective integration of health concerns via decentralized management
incorporating determinants of health like sanitation and hygiene, safe drinking water, women and child
health and other social concerns. DHAP envisages accomplishing requisite amendments in the health
systems by crafting time bound goals. In the course of discussions with various stakeholders groups it
has been anticipated that unmet demand for liable service provision can be achieved by adopting
Intersectoral convergent approach through partnership among public as well as private sectors.

4.2 Targeted Objectives and Suggested Strategies
        During consultation at district level involving a range of stakeholders from different levels, an
attempt has been made to carve out certain strategies to achieve the specific objectives that are
represented by different indicators. The following segment of the chapter corresponds to the identified
district plan objectives demonstrating current status of the indicators along with the expected target sets
that are projected for period of present year (2010-11).

4.3 Health Programmes
4.3.1 Reproductive and Child Health Programme components
4.3.1.1 Maternal Health Care
       Women are the foundation of the Country’s families and communities. Over the years,
Complications of pregnancy and childbirth are the leading cause of death and disability for
childbearing women in many parts of the country. Comprehensive, high-quality maternity care can
help prevent infant and maternal death and disability. No matter where they live, women should have
access to the information and care that keeps them healthy and safe. Engender Health has learned that
when women have access to family planning, fewer women die from risky pregnancies or unsafe
abortions. Our work safeguards women's health.
      Engender Health works with partners to develop practical strategies to strengthen and integrate
maternal health care services into national health systems.
       In the district young girls inter the reproductive phase of their like as victims of under
nourishment and anemia. Their health risks increase with early marriages, frequent pregnancies and
unsafe abortions choices regarding marriage, child bearing and contraception are denied to women.
There is also lack of access to functional reproductive health services and most deliveries are still
carried out by untrained birth attendants especially in the rural areas where there is no effective system
of referral or management in case complications arise through there has been widespread increase of
infrastructure service in the district during the past years, access to these facilities is still varied.
       The immediate causes of maternal mortality are well known. They are sepsis, hemorrhage,
obstruction, anemia, toxemia and unsafe abortions. The larger social determinants of these are also
equally well known – they include educational status of women, poverty levels, social inequities and
access to quality care.

                                                    51
                                               DHS, Kishanganj


       It is evident that all the health / health service indicators of Kishanganj district are as lower as
compared to that of Bihar CDR, MMR IMR , Immunization, Institutional Delivery and Safe delivery is
not better than Bihar State. However efforts in terms of quality and service need to be taken for the
betterment of the present indicators. Service utilization is not good in Kishanganj district. In urban
areas, there is no any Urban Health Centre in the Kishanganj district. In this reason, the slum
population is neglected for proper immunization, Institutional Delivery and Safe delivery.
Field observations show that the blocks Narpatganj, Bhargama andSikti are lagging with respect to no.
of institutional deliveries due to lack of staff, proper health facilities as well as they are unreachable
areas. Further the no. of maternal deaths in that block are much more as compared to other blocks as
these are non tribal belts, far-away sub-centers, unapproachable areas etc.
Constraints:
      Health workers are not able to do 100% pregnancy registration due to different reasons such as
       unreachable areas, personal reasons, illiteracy etc.
      No proper follow-up by workers of ANC cases and monitoring by supervisors, sector doctors etc
      No proper referral service
      Lack of awareness among rural masses / low IEC activities
      Improper access quality antenatal, natal and post natal services may be due to
      Lack of nurse (refers to female MPW or ANM) for providing quality ante-natal care at an
       appropriate time in vicinity of her home.
      Lack of skilled birth attendant in vicinity of home (trained midwife, nurse or doctor).
      Lack of facility providing institutional delivery on a 24 hour basis:
      The Sub-Centre is not usually a site for institutional delivery. 75% approxof sub centres the lack
       of buildings rules it out as an option. Equipment gaps may also contribute to poor service.
      The post-partum mother and the neonate require a visit by a ASHA in the first day after birth
       and at least once more in the first week of the neonate’s life. Given geographical constraints it is
       not possible for the ANM to do so. Only a trained community level care give like the ASHA can
       do so.
      Lack of transport facilities
      Sometimes the nurse is there and resources are not a problem but there is a poor motivation to
       provide services or a reluctance to accept services even when the knowledge and attitudes are
       alright. These gaps are cultural gaps and represent a certain passive discrimination – of caste or
       creed, or of gender.
   The following matrix highlights the indicators that are taken into consideration to achieve the
objectives of reproductive and child health. For each indicator current status has been assessed and
targets have been set that are to be achieved in the period present year plan . In order to attain the set
goals certain strategies are laid out against each indicator.
Table 4.1: Performance Indicators for Reproductive child health


                                                     52
                                           DHS, Kishanganj


Sl.    District Plan             Current Target for   Suggested Strategies and Activities
No.    Objectives                levels* 2010-11
  1.   Universal coverage of                           Strengthening      information      base    of
       all pregnant women                               pregnant women.
       with package of                                 Improvement        in     monitoring      and
       quality ANC services                             supportive supervision of ANM tour
       as per national                                  programme.
       guidelines.                                     Provision of equipment to sub centres,
                                                        APHC, PHC.
                                                       Streamlining logistics.
                                                       Specific interventions for inaccessible areas
                                                       Effective     coordination      with     ICDS
                                                        workers/NGOs and faith based institutions
                                                       Area specific IEC and Behavioral change
                                                        communication strategy.
 2.    Increase in deliveries                          SBATraining of ANM, LHV & Grade A
       with skilled                                     Nurse.
       attendance at birth                             Training of community based midwives
       including institutional                          (long duration training).
       deliveries.                                     Transport facilities to pregnant women.
                                                       Safe Home Delivery by SBAs.
                                                       Improving delivery facilities at sub centres
                                                        and APHC.
                                                       24 hour delivery services at APHC and
                                                        PHC.
                                                       Involving       public sector/private and
                                                        nursing homes in deliveries
                                                       Awareness generation about Janani avam
                                                        Bal Suraksha Yojana in community.
                                                       IEC / Behavioral change communication to
                                                        improve awareness about pregnancy
                                                        complications and need for utilizing
                                                        institutional services for deliveries.
                                                       Involvement of ANMs, ASHA, AWW,
                                                        SHG, VHSC and elected representatives of
                                                        community /faith based institutions in
                                                        identification of pregnant women at high
                                                        risk.
 3.    FRUs (including                                 Identification of health institutions and
       SDH/,Referal/                                    equipping them to provide basic and/ or
       PHC/APHC) made                                   comprehensive emergency obstetric health
       functional as defined                            care.
       in the National RCH-                            Appointing required health professionals
       2 PIP                                            such as gynecologists, anesthetists and
                                                        staff nurses to provide EMOC services.
                                                       Ensuring adequate and safe blood supplies
                                                        by strengthening existing blood storage
                                                        center and opening new blood banks in

                                                 53
                                        DHS, Kishanganj


Sl.   District Plan           Current Target for   Suggested Strategies and Activities
No.   Objectives              levels* 2010-11
                                                      the district.
                                                    Establishing linkages with private nursing
                                                      homes having adequate facilities to
                                                      provide emergency obstetric care services
 4.   Universal coverage of                         IEC & Behavioral change communication
      all eligible pregnant                            to improve awarness.
      women under JBSY                              Improving referral Network.
      scheme                                        ASHA Training and Motivation.
 5.   Increase in                                   Introduction of a package of home based
      percentage of new                               new born care.
      born babies given                             Strengthen referral network.
      colostrums.                                   Strengthen new born care infrastructure
                                                      and facilities in all APHC and PHC.
                                                    Upgrade education infrastructure for
                                                      neonatal services training.
 6.   Increase in                                   Educating mothers on benefits of
      prevalence of                                   immediate breast feeding.
      exclusive breast-                             Educating mothers on need to exclusive
      feeding                                         breast feeding
                                                    Educating mothers on type of supplements
                                                      and also the need to start supplements
                                                      from sixth month onwards
                                                    Reorientation training to service providers
 7.   Percentage of                                 Training to AWWs for identification of
      severely                                        malnourished children.
      malnourished                                  Training of MOs.
      children below 6                              Develop the Neonatal Rehavilitation
      years referred to                               Centre (NRC) in the CHC, SDH and
      medical institutions                            District level hospital.
 8.   Unmet demand for                              Increasing the base of serviceproviders for
      contraception (Total)                           both male and female sterilization services.
      - Spacing                                     Increasing the number of service delivery
      - Limiting                                      points to provide quality male and female
                                                      sterilization services.
                                                    Organizing camps in systematic and
                                                      effective manner.
                                                    Building linkages and involving NGOs /
                                                      FBOs to promote both male and female
                                                      sterilization methods and modern spacing
                                                      methods.
                                                    Social marketing projects to promote
                                                      access to and demand for spacing
                                                      methods.
                                                    Communication campaign to improve
                                                      demand for terminal and modern spacing
                                                      methods.

                                              54
                                                  DHS, Kishanganj


       Sl.    District Plan             Current Target for   Suggested Strategies and Activities
       No.    Objectives                levels* 2010-11
                                                              Conducting Workshops to service providers
                                                                on linkages between spacing of children
                                                                and IMR.
        9.    Number of govt.                                  Ensure posting of trained LMOs, surgeon
              health institutions                                and staff at PHC.
              providing -                                      Skill upgradation of ANMs for IUD
              i) Female sterilization                            insertion services.
              services                                         Collaboration with private practitioners/
              ii) Male sterilization                             institutions on contractual basis.
              services                                         Accridate the private facility for
              iii) IUD services                                  sterilization.
        10.   Number of health                                Orientation training of staff for enhancing
              institutions in                                   ARSH services
              APHC/PHC offering                               Sensitize adolescent and reproductive
              ARSH services                                     groups through local health workers
                                                              Involvement of NGOs
        11.   Number of health                                Identify the health institutions in the district
              institutions                                      and equiped them with lab facilities and
              providing services                                lab technicians.
              for management of                               Training of medical officers in RTI/STI
              STIs and RTIs                                     management.
                                                              Supply medicines in adequate quantity for
                                                                RTI/STI services
                                                              Provide RTI/STI services during RCH
                                                                camps
                                                              Conduct special camps for health check ups
                                                                and RTI/STI services
                                                              Promote partner treatment
                                                              Establish linkages with private practitioners
                                                                providing RTI/STI services

*Source: RCH II and DPMU
4.3.1.2 Child Health and Immunization
Poor outcomes in the child health due to the following reasons:-
  Workers not following the 8/8 quality ante-natal care norms
  Poor nutritional habits
  Early marriages
  Illiteracy among rural masses especially SC/ST.
  Poverty
  Less number of institutional deliveries
Table 4.2: Child health indicators (2008-2009)
  A. Percentage of women who started breastfeeding
                                                                                        12.8
  immediately/within 2 hours of the birth to their children


                                                        55
                                                   DHS, Kishanganj


    B. Percentage of women who gave exclusive breast milk for at
                                                                                        8.7
    least 4 months to their children
    (i) BCG                                                                             59
    (ii) DPT (Three injections)                                                        32.2
    (iii) Polio (Three doses)                                                          30.3
    (iv) Measles                                                                       36.3
    (v) Complete immunizations (BCG + 3 DPT + 3 Polio + measles)                       26.6

 (Source: RCH-DLHS survey 2003, PFI 2007 & Internal MIS data)
        The block wise immunization performance within the district seems to be satisfactory. But when
 this data is compared with the external data like that of SRS, PFI & DLHS there seems to be large
 variance. Possible reason for this can be that the internal data is taken out of vaccine utilization
 whereas the external data represents the actual service delivery.
 Constraints for poor quality of immunization:
    Unavailability of vaccines on time.
    Lack of staff.
    Weak transportation facility.
    Illiteracy
    Drop out of staff duputed on the immunization centre.
    Hard to reach area people unable to come on immunization centre.
 Suggestions for improving the quality of immunization:
    Vacant staff positions should be filled-in as Mission work.
    At least two months stock of all the vaccines at PHC level and 6 months stock in district level.
    Proper transportation facilities for vaccine delivry at immunization centre.
    Maximum IEC coverage so that people should know about the date and venue of
      immunization.
    Immunization work plan must be develop by ANM by calling meeting of VHSC & Local SHG.
 Table 4.3: Performance Indicators for Child Immunization
             Sl.   District Plan Objectives      Current    Target for        Suggested Strategies
                                                 levels*     2011-12
             1.    Increase in percentage of                              To Increase number of sub
                   fully protected children in                              centers and health workers
                   12-23 months as per                                      so that the span area of work
                   national     immunization                                may be concise.
                   schedule.                                              Increase Outreach sessions
                                                                          Ensure adequate posting of
                                                                            ANMs and MPWs.
             2.    Universal coverage with                                Increase IEC at grass root
                   Vitamin A prophylaxis in                                 level with the help of NGOs,
                   5-36 months children.                                    VHSC, SHG.
 *Source: RCH II, 2002-04

4.3.1.3 Family Planning



                                                           56
                                               DHS, Kishanganj


         The availability of family planning does more than enable women and men to limit family size. It
 safeguards individual health and rights, preserves our planet's resources, and improves the quality of
 life for individual women, their partners, and their children. This section provides basic information on
 a range of contraceptive methods, including factors to consider when choosing a method. In all the
 blocks of district Kishanganj the achievement with respect to target in case of Family Welfare is not
 satisfactory.
Table 4.4: Knowledge of Family Planning
                                  Indicator                                              Percentage
 Knowledge of any modern method                                                              45.6
 Any modern spacing method                                                                   27.4
 All modern methods                                                                          17.8
 Knowledge of any traditional method                                                         55.5
 (Source: RCH-DLHS survey 2003)
Table 4.5: Current users of Family Planning
 Any Method (CPR)                                                              27.2
 Any Modern Method                                                             23.5
 Female sterilization                                                           16
 Male Sterilization                                                            0.6
 IUD/Loop                                                                      0.3
 Pills                                                                         5.1
 Condom                                                                        1.1
 Any Traditional method                                                        30.6
 (Source: RCH-DLHS survey 2003 & Internal MIS data)
Table 4.6: Unmet Need
 Percentage of women having unmet need for                                                   38.1
 Limiting                                                                                    14.7
 Spacing                                                                                     23.4
 (Source: RCH-DLHS survey 2003)
 4.3.1.4 RTI / STI and HIV / AIDS Control
 Reproductive tract infections (RTIs) include three types of infection that affect the reproductive tract of
 women and men (Population Council 2001). These are:
 1. Sexually transmitted infections (STIs)—also known as sexually transmitted diseases (STDs)—caused
    by viruses, bacteria, or parasitic organisms that are passed through sexual activity with an infected
    partner.
 2. Infections that result from an overgrowth of organisms normally present in the vagina (endogenous
    infections). These infections are not usually sexually transmitted, and include bacterial vaginosis
    and candidiasis.
 3. Infections introduced into the reproductive tract by a medical procedure (Atrogenic infections) such
    as menstrual regulation, induced abortion, IUD insertion, or childbirth. This can happen if surgical
    instruments used in the procedure are not properly sterilized, or if an infection already present in
    the lower reproductive tract is pushed through the cervix into the upper reproductive tract.



                                                     57
                                                   DHS, Kishanganj


These three types of RTIs overlap and should be considered together. For example, some STIs, like
gonorrhea or chlamydia, can be spread in the reproductive tract if not treated prior to a procedure. In
addition, some non-sexual infections, such as candidiasis, can be passed on through sexual activity.
Challenges to controlling RTIs/STIs
While not all RTIs are curable, they are all preventable. Prevention efforts aim to stop people from
becoming infected, as well as to stop those infected from transmitting their infection to others (PATH
2001). Primary prevention focuses on educating people about personal risk and how to protect
themselves from disease. Abstinence; consistent, correct condom use; mutually exclusive sexual
relationships with an STI-negative partner; and early treatment of STIs are the most effective STI
prevention options. Secondary prevention aims to shorten the duration of disease by promoting early
detection and treatment, and providing acceptable, accessible, and effective care.
The key public health interventions needed to control STIs include:
 Promotion of safer sexual behaviors and primary prevention.
 Condom promotion, supply, and distribution.
 Promotion of appropriate health care-seeking behaviors.
 Integration of STI prevention and care into many existing health care services, including primary
  care, reproductive health care, HIV/AIDS prevention and treatment, and private-sector services.
 Comprehensive syndromic case management.
 Specific targeted services for high-risk groups.
 Prevention and care of congenital syphilis and neonatal conjunctivitis.
 Early detection and effective treatment of symptomatic and asymptomatic infections

Women have a greater risk of RTIs than men due to physiological, social, cultural, and economic
factors. Women are:
 biologically more susceptible than men;
 usually infected at a younger age than men;
 more likely to suffer from complications;
 limited in their ability to protect themselves from high-risk sex or to negotiate condom use;
 more apt to suffer from asymptomatic infections and remain untreated; and
 Less likely to seek treatment, even for symptomatic infections.
The consequences of RTIs, including stigmatization, reproductive impairment, domestic abuse, and abandonment,
can be severe for women. Women have limited ways to protect themselves. Female condoms offer some
protection and may be cost-effective, but their use will depend on how they are promoted and how well they are
accepted. In Kishanganj district till date there are 66 cases of HIV/AIDs have been detected. In the district hospital
Kishanganj there is blood testing facility available. Simultaneously VCTC and STD clinic is also provided in the
SDH hospital. Efforts are needed for health check-ups and partner treatment camps.
 Table 4.7: Awareness of RTI/STI and HIV/AIDS
 (i) Percentage of eligible women aware of RTI/STI                                                         32.4
 (ii) Percentage of eligible women aware of HIV/AIDS                                                       82.7
 (iii) Women who had any symptoms of RTI / STI                                                             27.4
 (iv) Women who utilized government health facility for treatment of RTI/ STI                               4.7
(Source: RCH-DLHS survey 2003)
As tabulated below, 46 cases were detected and all of them were treated in the year 2008-09


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                                              DHS, Kishanganj


Table 4.8: RTI / STI cases - detected and treated in the year 2008-09.
 RTI/STI Cases                                                           Year 2010-11
 Cases Attended                                                            1475
 Cases Treated                                                             1475
Various NGOs are proving condoms as well as they hold various clinics for truckers, travellers etc for
prevention and counselling for RTI/STIs as well as HIV cases. The major constraints are:
 People do not come out in the open about their infections with a fear of being ostracized by the
   community.
 Lack of knowledge about RTI/STI
 Lack of practice of condoms by males
 In-migrating population
Following are the suggestions to counter these issues:
 We need to educate the people regarding RTI/STI a well as HIV/AIDs.
 People need to be made aware of the presence of VCTC/STD clinics.
 Major focus should be on High risk groups and areas by regularly organizing exhibitions, camps,
   melas etc.
 Regular quiz competitions, debates, skits/dramas etc. regarding knowledge of RTI/STI as well as
   HIV/AIDs among truckers, college students, in-migrant laborers.
 NGOs should be made responsible for all these activities and supporting and coordinating the field
   health functionaries

4.3.1.5 Adolescent Sexual and Reproductive Health (ASRH)
        Sexual development is a normal part of adolescence. Fortunately, most adolescents go through
these changes without significant problems. Nonetheless, all adolescents need support and care during
this transition to adulthood, and some need special help.
      The lives of millions of adolescents worldwide are at risk because they do not have the
information, skills, health services and support they need to go through sexual development during
adolescence and postpone sex until they are physically and socially mature, and able to make well-
informed, responsible decisions.
The main issues in adolescent sexual and reproductive health are:
 Sexual development and sexuality (including puberty)
 Sexually transmitted diseases/ HIV/AIDS
 Unwanted and unsafe pregnancies
The reasons that adolescents are at risk include:
 Social and economic environment – For millions of adolescents, sex is linked with coercion, violence
  and abuse – sometimes even by family members or adults with privileged relations. In many
  societies, women are conditioned to be submissive to men, and they find it difficult or impossible to
  refuse early marriage, to space births, or to refuse to have unprotected sex with an unfaithful spouse
  or partner. Additionally, the social environment is critical to healthy adolescent development.
  There are key aspects of this environment, which can prevent adolescents from engaging in
  unsafe/unwanted sexual behaviour, for example, a strong relationship with parents, a connection to
  school and open communication with sexual partners.


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                                               DHS, Kishanganj


   Information and skills (life and livelihood) – In most countries, the great majority of adolescents are
    poorly informed about sexuality and reproduction. Often policy makers, public opinion leaders and
    parents believe that withholding information about sexuality and reproduction from young people
    will dissuade them from becoming sexually active. In fact, good quality sex education does not lead
    to earlier or increased sexual activity among adolescents. Adolescents need life skills in order to face
    the challenges of adulthood. During personal development, an adolescent’s competence develops
    whenever there are opportunities to practice certain skills by understanding and using social
    conventions. Adolescents also prioritise livelihood skills and opportunities as very important to
    them. Many adolescents are victims of exploitative sex because of lack of livelihood skills and
    opportunities.
   Access to health services – Most adolescents (boys and girls, married and unmarried) become
    sexually active before the age of 20, but generally lack access to family planning services (including
    appropriate contraceptives), prevention and care of sexually transmitted diseases, or pregnancy
    care. For many young people, the opening times or location of services make them inaccessible, or
    the care is too expensive. Many health care facilities require the consent of parents or spouses, or
    may be forbidden by law to provide services to adolescents. In addition, the judgmental attitudes of
    many health care professionals often discourage adolescents from seeking advice and treatment
    related to sexual and reproductive health.
   Intervention Areas
   The Common Agenda advocates the following specific measures to prevent unsafe sex and early
    childbearing among adolescents:
   Create a safe and supportive environment through promoting delayed marriage and childbearing,
    expanding access to education and training, and providing income-earning
   Opportunities.
   Provide information and skills (life and livelihood) so that adolescents are better equipped to make
    good decisions.
   Expand access to health services that are affordable, accessible, confidential, and non-judgmental.
   Provide counselling for adolescents.
There are almost no programmes in the area of Adolescent health. The following are the constraints:
   There is a very high degree of under-nutrition and anemia at this age.
   Also growth stunting occurs at this stage if the girl is malnourished.
   Physical and mental development potential and stress due to poor health is also more.
   Adolescence is a period of higher exposure to violence, to sexually transmitted diseases and to
      pregnancy associated morbidity and mortality.
Suggestions:
   These need not only counseling at the individual level.
   But also social mechanisms of support and women's empowerment to address.
4.3.2 Health Infrastructural Indicators
       The performance with respect to certain key activities under NRHM shows that infrastructure
related issues needs to be sorted out to ensure a successful implementation of plan. Next section details
out probable strategies and activities:
Suggested Strategies and Activities:


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                                              DHS, Kishanganj


       Two female MPWs in each sub centre: Sub centers may plan for two MPWs, preferably both
women. The job description and workload of the MPW (F) needs to be lessened and made realistic.
Along with this, workload reatinalisation would be achieved by equal sharing of the work between the
two persons posted at the sub centre. In the first stage this achieved by redefining of the male MPWs
work to be identical with the female MPWs. Except or institutionalization delivery and IUCD insertion,
every task currently done by women can be done by men also. And in the second stage by ensuring that
the second person in the HSC is also a female MPW i.e. converting the male MPW post to a female
MPW post. Without increasing costs or number of sub centers we would be doubling the density of the
most active, effective and critical workforce of the entire system.
        Multi skilling all PHC paramedical: The PHC staffing pattern needs restricting to ensure
utilization of manpower and better functioning of the facility. APHC may plan for having two or three
male multi-skilled employees with a male multi-skilled supervisor and three female multi-skilled
workers (including the section incorporated in the sector) and a female multi-skilled supervisor. There
would also be one medical officer in every PHC (preferably two). These multi-skilled workers must be
skilled in dressing, drug dispensation (the compounder’s) and first contact curative care and in basic
laboratory package as well as in RCH. Between them they should be able to keep the PHC functional
for 24 hours, provide institutional delivery and the other services as proposed in the service delivery
norms. Though the immediate step is only multi-skilling and revising job descriptions, cadre restricting
may follow this. In this process of transition no one has to be dropped unless they are unwilling for
multi-skilling. New recruitments would be into the multi-skilled category and many existing cadre
would die away. Some like staff nurses would function as multi-skilled staffs when posted in a PHC
and can play the role of staff nurse when posted in PHC and district hospitals. We estimate that such
retraining and redeployment would solve a substantial part of the manpower vacancy problem. Each
PHC may also have two staff at class IV qualifications.
Rationalization of Deployment Medical Doctors in the PHC Level
       Differentiated Strategy According to Difficulty Levels: The ideal would have been two medical
officers at every PHC. However this may not immediately be realized due to shortage of potential
recruits and the difficulty in finding even one medical officer per remote area. Therefore we suggest
that APHC be categorized into most difficult, difficult and easy and a different strategy be adopted for
each.
        24 hour Multi-Skilled Paramedical Based Service in al APHC: We recommend that in all APHC
irrespective of category, 24 hour service with emphasis on institutional delivery be insisted on by multi-
skilling and deploying paramedical. The multi-skilled paramedical worker should also be trained in
emergency care management at primary level.
       Daily Visits by PHC Based Doctors for Most Difficult APHC: Where no medical doctors are
available currently, where access is a problem and accommodation facilities are low (category C), even
as efforts are made to fill these posts, the backing up is done by daily visits and in a few distant APHC
two to three visits per week of a medical doctor from the respective PHC. The doctor would be required
to be available during working hours and his stay at the PHC would be insisted on only adequate
accommodation arrangements, governmental or rental are available. Even in this exemption may be
given for special reasons as long as stay is in nearby block town as part of the PHC team and daily


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                                              DHS, Kishanganj


attendance is regular. Family accommodation at the PHC would be easier to organize. In other word,
HMS we should not insist on medical doctors staying in APHC designated category C- most difficult.
       Strengthening AYUSH Doctor’s role while keeping Medical Officers Option open: The use of
medical officers with AYUSH (Ayurvedic scheme) to fill up vacancies where no medical officers are
currently available is welcome. However all the service issues discussed equally affect their
functionality. Moreover currently they would be unable to deliver the notified services of the PHC level
and special training would be needed to close the gaps.
Strengthening of PHC
       Appointment of Six Medical Officers at Least, four of whom at least are specialist or within
them have the required four – skill (Anaesthetist, paediatrician, surgeon, gynecologist) mix. If there are
a number of APHC not having doctors to be looked after with visits, the number posted here may
increase further. Currently the recommended norm is only four doctors per PHC, which is sub – critical.
       Adequate Multi – Skilled Male and Female Paramedical Staff, who can manage the necessary
support work and multi skilled imaging technicians who can also mange X–rays, ultrasound and ECG
too. In addition there would be a unskilled worker category of undifferentiated, interchangeable class
IV functional – chowkidar, peon, sweeper, waterman – all rolled into one. Four qualified staff nurses,
two qualified laboratory technicians and an optometrist are also a must at this level.
      Re-designating the BEE, The block level extension educator may be renamed the block senior
paramedical supervisor and be responsible for capability building, IEC and supervision of the sector
supervisors.
     Adequate Clerical and Accounting Staff, at least two, be provided to every PHC along with a
computer and printers.

RATIONALISATION OF WORK ALLOCATION AND APPROACHES TO IMPROVE OUTREACH
SERVICES
In addition to the above measures improving outreach would require:
Reorganisation of MPW Work Schedule
       MPWs may be required to tour for three days a week, instead of the present one or two days a
week. One day a week should be devoted to review and drawing supplies from APHC. The remaining
two days a week should be devoted to clinical work and other services provided at the sub centre.
These two days are fixed and her clientele should know that she is available there in headquarters on
these two days. In each field visit day, he/she would visit a specified number of houses and hold
meetings with one of the four identified focal groups. Once a month he/she should attend to Block level
review and training. If there are two MPWs posted their two days at the headquarters may be fixed
such that the sub centre is open on four previously specified days every week, which is better than the
current one day a week.
Integration with ASHA Programme
    It is extremely important to develop a mechanism to sustain interactions between MPWs and
ASHA. Such a mechanism is also required for the long – term success of the ASHA programme. The
ASHA programme offers the scope to rationalize and the MPWs job responsibilities more achievable.

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                                              DHS, Kishanganj


The ASHA’s focus is on health education, family level counseling and prompt and adequate
management of diarrhoea and acute respiratory infections. The ASHA also maintains a register for her
village which tracks each family to identify any specific health service gap and motivates the family to
receive this service as the coordinates with the MPW to ensure that the service is delivered. The MPWs
focus is on actual service delivery on RCH and in all national programmes – like immunisaiton,
provision of contraception, care in pregnancy and assistance at delivery and soon and on support to
ASHA, anganwadis and panchayats.
Revised MPW Job Description
A MPWs job description for both male and female worker can be reorganized as:
   Immunization – Children and pregnant women largely at the village visit and camps but
    supplemented by immunization at the sub centre.
   Ante natal care and post partum care at sub centre, with visits to those pregnant women unable/
    unwilling to come.
   Motivation and facilitation for all methods of contraception.
   Training and support to ASHA and local women’s health committees.
   Regular house visits, such that every household is visited once every month (or two months in
    difficult areas) for a set of “case detection, follow up and counseling activities” along with first
    contact curative care where required. (this includes all national programme related activities)
   Focal group discussion / health education sessions/health camps during village visits.
   Curative care during field visits on three days at sub centres on two days.
   Response to epidemic using a graded epidemic response protocol.
In addition to the above male workers would have the following tasks:
   Addressing male youth on adolescent problems and STDs control.
   Interaction with panchayats and with local leaders for facilitation of health programmes.
In addition to the above female MPWs shall have the following tasks:
   Assistance at child birth
   IUCD insertion
   Addressing adolescent girls on health problems
   Having the right number of manpower at the required positions / places is one of the most
important factors for the success any health programme. Also in the rural health centres, especially in
the primary health centres, there are two major problems concerning the doctors and the supporting
medical staff posted there. Firstly, the number of doctors and supporting medical staff is less than what
the norms suggest, problem that is further compounded is by delays in filling up vacancies in health
centres, cases of high absenteeism are also seen sometimes.
Outreach Strategies to Enhance Access
       Lack of roads and transport facilities and natural obstacles and high degree of scatter of hamlets
within a section or sector add to the problems of access. These problems are not remediable by
increasing facilities beyond the norms. Instead they need a high degree of community support and a
high degree of planning and rationalization of the work of the various categories of staff already



                                                    63
                                              DHS, Kishanganj


available. Camps are the major outreach strategies aimed to close outreach gaps but their effectiveness
and even their occurrence in most areas is far from certain.
       A variety of other camps for different vertical programmes take effort and expense to organize
but with uncertain benefits. The ASHA programme has attempted to build on this dimension and
provide a well – supported cadre of trained volunteers in every hamlet. The integration of this force
with the sub centre’s function offers the best scope of advance in improving outreach.
Staff Situation and their Utilization with Relation to Functionality of Centers
       Female paramedical staff is near adequate in numbers. There are serious shortfalls in all other
staff. A converse dimension of this situation is that of all the paramedical staff. Only the female
multipurpose worker and to a lesser extent the sector supervisor female shares the greater part of the
workload. All other categories of staff at HSC and PHC level are characterized by poorly designed work
schedule and are poorly utilized with a high degree of redundant work time. Rationalization of
paramedical work time offers therefore the most effective route to addressing staff adequacy.
       The current work description of the MPW female is unrealistic and is being coped with by
developing a focus on just one or two tasks and informal local arrangements. As a result a number of
essential services are completely left out (e.g. early recognition of child-hood pneumonia or proper
treatment of diarrhea or adolescent health care etc) and the quality of a number of other services, like
antenatal care are seriously compromised. (Almost no pregnant women has her BP taken and blood and
urine examined)
Rationalisation of Drugs and Consumables Supply
        The essential drug list is being implemented. The main deficits are a failure to procure the entire
items of the list, a failure to send samples for quality control, and a failure to exclude drugs not on the
list. Other elements of the drug policy are also not in place. Thus procurement is sporadic, occurring
once or twice a year with quotas to peripheral facilities to distribute the drugs. There are numerous
breaks in supply and the distribution system is unresponsive to changing needs. Restriction of drugs to
a narrow spectrum and breaks in supply are not even perceived as serious within the system reflecting
poor perception of quality of care issues. The problem with consumables is even more serious that with
drugs. Laboratory chemicals seem the worst affected but even gauze and bandages, needles and needle
holders could be in short supply repeatedly.
Rationalization of Equipment
       In equipment we have two types. We have relatively low investment “minor equipement” like
Sahil’s Haemoglobinometer or BP apparatus and infant weighing machines, which, if used, will need
replacement frequently.


And we have more costly “major equipment” like ultrasound and X-rays, which require replacement
less, (up to once in five to ten years), but which require trained manpower to operate and often-
considerable consumables as well.
       In minor equipment we find considerable under utilization, and simultaneously reports of non-
availability. Due to quality of care issues many of this equipment are not utilized. But equally there is a


                                                    64
                                               DHS, Kishanganj


problem that if they are used many of these last only one to three years and then would need
replacement, for which no ready system of purchases and restocking is available.
       In major equipment the main problem is mismatches, between equipment supply and manpower
to use (e.g. ECG machines without anyone who can operate it), between equipment supply and level of
services currently provided at that level (e.g. one neonatal care units supplied to a facility where there is
no caesarean sections or even as many normal delivery neonates per month, (e.g. X-ray machines
running out of film) and between equipment purchase and maintenance. At one level all such
mismatches are attributable to failures of concerned officers. But at another level it points to
governance/ administrative failure, with one committee maximizing purchases, and another set of
persons looking at distribution, and no one looking at training and maintenance or eventual utilization
of equipment.
Infrastructure Adequacy
       The shortfalls in basic availability of buildings are well known. It is in the range of approx 25%
for HSCs. PHC are all in government owned buildings but as yet only an estimated 100% are upgraded
to the 30-bed PHC norm. Toilet construction and maintenance too are major infrastructure inadequate.
Maintenance of buildings is also poor and most buildings are old and need extensive renovation or
replacement.
       Problems with electricity supply are minimal and generator back up is usually available where
there are problems. Problems with water supply are however considerable. Most of these facilities have
a bore-well and hand-pump so that they are functional. However any hospital with inpatient facilities,
even if it were for only conducting normal delivery would require running tap water, bathing facilities
and toilets separately for staff and for patients. Yet only one third of PHC and Referal Hospital and
none of APHC have such a water supply arrangement. Waste management based on segregation of
wastes with proper disposal of each category of biological waste is a relatively untouched area of
intervention.
Table 4.5: Performance indicators of Health Infrastructure
                District Plan Objectives    Current   Target for   Suggested Strategies and Activities
                                            levels*    2007-12
           1.   Number of ASHA functional                           Finish ASHA Selection & Training.
                in the district (received    1167/         1368     Monitoring of working capacity of
                induction training)          1344                     ASHA
                                                                    Increase incentives for ASHA
                                                                      working in difficult areas
           2.   Number of HMS registered/                           Establishment of HMS
                established                             HMS         Selection of members
                                                       formed       Functioning of HMS
                                                        in all      Clear guidelines for working of HMS
                                                       PHC &        Guidelines for expenditure of
                                                        APHC          maintenance grant
                                                                    Orientation and training of elected
                                                                      HMS members
                                                                    Decentralizing the procedure by
                                                                      appointing other representatives
           3.   Number of health care                               Upgradation of health institutions in
                delivery institutions                                 conformity with IPHS


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                                       DHS, Kishanganj


     District Plan Objectives       Current   Target for   Suggested Strategies and Activities
                                    levels*    2007-12
     upgraded                                               Subcenters in government building
     - HSCs                                                 Availability of facilities like water
     - APHCs                                                  supply, electricity, labour table
     - PHC to FRUs                                          Part-time dai at subcenter
                                                            Incentives for ANMs working in
                                                              difficult areas
                                                            Posting of LMOs at APHC and PHC
                                                            Training of LMOs regarding EmOC
                                                            Posting of gynecologists, anesthetist,
                                                              and pediatrician at PHC
                                                            Blood storage center at PHC
                                                            Adequate equipments and supply of
                                                              other material
4.   VHSC constituted                                       Constitution of VHSC
     - Grants given                                         Guidelines for VHSC
                                                            Orientation of VHSC members
                                                            Organization of training for
                                                              sensitizing members on working
                                                              mechanism
                                                            Roles and responsibilities fixed for
                                                              each member of the committee
                                                            Coordination between health and
                                                              sanitation initiatives
5.   Number of HSCs, APHCs                                  Strengthening infrastructure of
     strengthened                                             health centers
     - Additional ANMs hired                                Carry out civil work for SCs with
     - Annual maintenance                                     respect to building, running water
     grants given                                             supply and electricity
                                                            Involvement of gram Panchayat for
                                                              taking land for construction of HSC/
                                                              APHC/PHC
                                                            Ensure equipment and drug supply
                                                            Refresher training course for ANM
                                                            Posting of LMO and staff nurse at
                                                              APHC
                                                            Guideline for use of maintenance
                                                              grant and Regular monitoring and
                                                              reporting system for used grant.
6.   Number of APHC
     strengthened to provide
     24x7 services.
     - 3 staff nurses hired
     - Annual maintenance
     grants given
7.   Mobile Medical Unit facility                           Implement the MMU by
     for unreached people.                                    NGO/Outsourced under PPP.




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                                                   DHS, Kishanganj


                  District Plan Objectives      Current   Target for    Suggested Strategies and Activities
                                                levels*    2007-12
             8.   Number of facilities to be                             Implementation of activities to fill
                  covered for facility survey                             in the identified gaps.
                  - HSCs                                                 Facility survey & HH Survey must
                  - APHC                                                  be done by external agency so that
                  - PHC                                                   proper gaps came into existence.
             5.   Number of villages to be
                  covered for HH survey
            10.   Number of community                                    Organization of regular community
                  hearings planned                                         meetings at SC and PHC level
                                                                         Integration with ASHA and PRI
            11.   District training plan                                 Formulation of district training plan
                                                             District
                  developed and implemented                              Recognition of need of trainings
                                                            training
                                                             plan in     Organization of trainings as per state
                                                            place &        guidelines
                                                           implement     Refresher training of paramedics on
                                                               ed
                                                                           minor ailments
                                                                         Training of MOs for managerial
                                                                           skills, EmOC
                                                                         Training of ANMs for ANC, DOTS
            12.   District BCC plan developed                            Formulation of district BCC plan
                  and implemented                            District    Assessment of communication needs
                                                            BCC plan
                                                                           in the context of NRHM
                                                           developed
                                                               &         Development of communication plan
                                                           implement       and its implementation
                                                               ed        Use of print media, nukkar natak,
                                                                           folk, TV and radio.
            13.   District procurement and                               Formulation of need based plan for
                                                             District
                  logistics plan developed                                 streamlined procurement and
                                                             logistic
                                                               plan        logistics.
                                                           developed     Provide required equipments.
                                                                &        Financial planning for reaching of
                                                           implement
                                                                           supplies at various levels including
                                                                ed
                                                                           ASHA.
                                                                         Well established supply chain
            14.   Number of APHC/PHC                                     Posting of AYUSH practitioners
                  where AYUSH physicians                                 Relocation and appointment of
                  posted                                                   physicians
                                                                         Coordination with other private
                                                                           health facilities
 *Source: District Project Management Unit



4.3.3 Blindness Control Programme
      National Programme for Control of Blindness was launched in the year 1976 as a 100% centrally
sponsored programme. Various activities of the programmes include establishment of Regional Institute
of Ophthalmology, up gradation of medical colleges and district hospitals and block level Primary Health
Centres, development of mobile units, and recruitment of required ophthalmic manpower in eye care



                                                          67
                                                   DHS, Kishanganj


units for provision of various ophthalmic services. The programme also extends assistance to voluntary
organizations for providing eye care services including cataract operations school screening.
The achievements of NBCP are tabulated below:
Table 4.12: Achievements of the National Blindness Control Programme (2010-11)
 Particulars                                                           Achievement
 No. of Urban Eye Camps                                                                   0
 No. of Cataract operations (Total)                                                     3645
 No. of School Screening                                                                  0
 No. of refractive error                                                                  0

Constraints:
  Lack of Education among the masses about the existing facilities: Need of wide publicity.
  Shortage of quality Equipment and medicine.
  Apathy and indifference on the part of health personnel.
  Lack of adequate referral services to take care of complications.
  People have tendency to neglect the aged family members.
  Post operative follow up of people is not being done properly.
  Fear of eye operation.
  Old myths are still prevailing.
 Suggestions:
  Integrate Eye care as part of Primary Health Care
    Involve NGO’s
    Train Ophthalmic Medical Assistants
    Provide Low Cost Spectacles
    Correct Chronic Vitamin-A Deficiency
    Proper survey should be done by health workers
    Proper investigation before operation
    Camp should be done at well equipped hospitals and by surgeon
    Need of strict control to maintain quality.
    Need of change of attitudes.
    Need of designing referral services

 Table 4.13: Performance Indicator for NBCP
                   District Plan Objectives        Current       Targets            Strategies
                                                   levels*     for 2007-12
              1.   Cataract surgery rate                             20000    Conductance of no. of
                   (per lakh)                                                  eye       camps    in
              2.   Percent surgery with IOL                                    coordination     with
                                                                     3645
                                                                               (NGO) Sushrut




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                                                    DHS, Kishanganj


                  District Plan Objectives          Current       Targets              Strategies
                                                    levels*     for 2007-12
             3.   School Eye Screening:                                        strengthening service
                  children in the age group                                     delivery
                  of 10-14 years should be                            1458     developing human
                  screened for refractive                                       resources for eye care
                  errors                                                       promoting outreach
             4.   Oral Health Screening                                         activities and public
                  for                                                           awareness and
                  - Community                                           0      developing institutional
                  - School children                                   25478     capacity
   * Source: District Blindness Control Programme

4.3.5 Leprosy Eradication Programme
       Leprosy continues to remain a serious public health problem in the developing countries,
particularly if one considers that the populations at risk of contracting the disease are very large, and
that more than one-third of all leprosy patients face the threat of permanent and progressive physical
and social disability. It should be emphasized here that the problem of leprosy is for more serious than
what is represented by the numbers alone, particularly in terms of the intense human suffering
involved resulting from the physical deformities and the related social problems.
       Leprosy is a chronic bacterial disease caused by Mycobacterium leprae. It affects the peripheral
nerves, skin and the upper airway. The main clinical presentations are the tuberculoid and lepromatous
forms.
       The exact mode of transmission has been established naso pharyngeal root but household and
prolonged contact appears to be important. Environmental factors such as overgrowing and poor
hygiene facilitate the spread of the disease. The incubation period ranges between 2 months and 40
years. Leprosy is rarely seen in children below three years of age. At present, there is vaccine under trial
as HKML (Heat Killed Mico bacterium laprae obtain from Arma dilo nine bandade), ICRC vaccine
(Indian Cancer research Centre) by Dr. Dave, MW (Mico bacterium Welchi and BCG)
       Unlike some other diseases, such as tuberculosis, there does not appear to be a connection
between leprosy and HIV infection. With the implementation of MDT (Multi Drug Therapy) services
under the programme since 1583, a large number of leprosy cases have been discharged as disease
cured.
      The goal of leprosy elimination is that prevalence rate should be less than one case per 10,000
populations in the coming years. The focus is now being made on voluntary reporting of cases by
promoting intensive IEC / BCC.

Table 4.14: Indicators showing achievements of NLEP 2010-11
 Indicators                                                                                         Status
 New case detection
 M.B.
 P.B.
 S.S.L.


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                                                 DHS, Kishanganj


 Patients put on treatment
 M.B.
 P.B.
 S.S.L.
 Patients treated & discharged
 Disability cases
 Grade I
 Grade II
Suggestions
   Strengthen Health Care Services
   Rehabilitation
   Updation of master register
   Case validation, to have check on wrong diagnosis and re registration
   Prompt and early detection of the cases to avoid deformity and disability,
   Ulcer care foot ware reorientation training of medical & para medical staff.
   Involvement of Lokdoot (old & rehabilitated to have the best IEC.
   Community Education
   Removal False beliefs from the Community
   Financial and personal support and psychological assurances
Table 4.15: Performance indicators for Leprosy Programme
                Indicators                       Curren Target for                Strategies
                                                 t level* 2007-12
            1   Prevalence rate (PR) - leprosy                       Conductance         of        timely
                cases per 10,000 population                          surveillance
            2   ANCDR – New leprosy cases                            Orientation trainings to new staff
                per 11,00,000 population                             Organization of POD camps
            3   Proportion of patients                               Conductance      of    sensitization
                completed treatment                                  workshop at gram panchayat
                                                                     involving      new        panchayat
            4   POD Camps                                            representative
                                                                     Organization of skin diseases
            5   Gram Goshthi                                         diagnosis and education camps
                                                                     Conductance of urban leprosy
            6   Hat – Bazar                                          awareness camps
                                                                     Procurement of TV, VCD, Camera,
            7   School Awareness                                     Mike for IEC
                                                                     Implementation of Project
            8   Health Mela                                          Financial Mgmt. System.
4.3.6 Tuberculosis Control programme
       Tuberculosis (TB) is an infectious disease caused by a bacterium, Mycobacterium tuberculosis. It
is spread through the air by a person suffering from TB. A single patient can infect 10 or more people in
a year. DOTS, known as the Revised National Tuberculosis Control Programme (RNTCP) in India, are a
comprehensive strategy for TB control. DOTS are the only strategy which has proven effective in
controlling TB on a mass basis.


                                                       70
                                              DHS, Kishanganj


       India has adapted and tested DOTS in various parts of the country since 1953, with excellent
results, and the RNTCP now covers more than 120 million populations. The Revised National
Tuberculosis Programme (RNTCP) was launched in the country on 26 March 1957.
Table 4.16: Indicators showing achievements of RNTCP 2010-11.
 Sl. No.     Particulars                                                                  Status
      1      Total Number of OPD
      2      No. of patients whose sputum were examined for
             diagnosis
      3      No. of Smear Positive patients diagnosed
      4      Total Patients Registered & put on DOTS
             a) New Smear Positive
             b) New Smear Negative
             c) New Extra-Pulmonary
             d) Re-treatment cases
      5      No. of Patients put on Non-DOTS
      6      Total Patients under treatment
      7      Annualised case detection rate
Suggestions:
To increase the case detection rate following majors should be taken:
 Increasing referral from the field and from OPD, mobilizing community participation, ensuring
   involvement of Private practioners, NGOs and other sector, intensifying supervisory activities and
   intensifying IEC activities
 TB has a cure, and treatment is inexpensive
 TB control is a very cost-effective health intervention equivalent to that of the well known childhood
   immunization programmes.
 Successful treatment demands education and timely follow-up examination to achieve sputum
   conversion & cure rate up to the desired level.
 Successful treatment requires 6-8 months of consistent, uninterrupted medication
 New drop resistant strains of TB are developing because patients are not completing their treatment.
   These drug-resistant strains are significantly more dangerous to the individual and the community
   because they are more difficult and more expensive to treat.
 The best was to prevent TB is to cure infectious cases in their early stages in order to prevent
   transmission to others.
 TB, control programmes that treat infectious patients by don’t ensure that they are cured risk doing
   more harm than good. Patients who have incomplete treatment can develop and spread drug-
   resistant TB.
Table 4.17: Performance Indicator for RNTCP
               District Plan Objectives    Current Targets for           Suggested strategies
                                           levels*  2007-12
          1.   Proportion of TB suspects                         Increasing the awareness/ visibility
               examined out of the total                         of DOTS among rural masses by
               outpatients                                       distributing pamphlets and group


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                                             DHS, Kishanganj


          2.   Annualized New Smear                            discussions with villagers
               Positive (ANSP) case                            Provide facilities for diagnosis of
               detection rate per 100,000                      TB Patients through integrated
               population                                      general health services.
          3.   Annualized Total case                           Provide optimum treatment nearer
               detection rate per 100,000                      to the residence of the patients.
               populations                                     To prevent infection,
          4.   Treatment success rate                          immunization is done by doing
                                                               BCG Vaccination.
                                                               Health Education to encourage
                                                               patients through Health Workers,
                                                               their relatives and village leaders
                                                               to take full course of treatment.
                                                               Detection of New TB cases
                                                               (Sputum positive, X-ray suspects
                                                               and extra pulmonary cases)
 *Source: District TB Control Programme

4.3.7 Filaria control Programme
       The National Filaria Control Programme was launched in 1955 for the control of filariasis.
Activities taken under the programme include: (i) delimitation of the problem in hitherto unsurveyed
areas, and (ii) control in urban areas through recurrent anti-larval measures and anti parasite measures.
Man, with micro Filaria in the blood is the main reservoir of infection. The disease is not directly
transmitted from person to person, but by the bite of many species of mosquitoes which harbor
infective larvae. Important vectors are species of Culex, Anopheles, Mansonia and Aedes. The
incubation period varies, and micro-Filaria appears in the blood after 2-3 months in B. malayi after 6-12
months in W. bancrofti infections.
Constraints:
 It affects mainly the economically weaker sections of communities
 Result in low priority being accorded by governments for the control of lymphatic filariasis.
 Low effectiveness of the tools used by the control programme
 The chronic nature of the disease and that
Suggestions:
1. Single dose DEC mass therapy once a year in identified blocks and selected DEC treatment in
   filariasis endemic areas.
2. Continuous use of vector control measures.
3. Detection and treatment of micro-Filaria carriers, treatment of acute and chronic filariasis.
4. IEC for ensuring community awareness and participation in vector control as well as personal
   protection measures.
4.3.8 Disease surveillance programme
 Constraints:
 People not following proper hygiene/ sanitation practices even after knowing the ill effects of
   unhygienic conditions
 Bad food habits (such as eating uncovered outside snacks etc)

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                                             DHS, Kishanganj


   Timely immunization as well as supervision not done because of lack of manpower
Suggestions
 Promotion of inter-caste marriages
 Frequent camps in rural areas for solubility tests
 Special medical supervision for +ve cases
 Couples before marriage should go through solubility test
   To improvise the current surveillance situation and supervision under district administration is
    needed.
4.3.9 ASHA programme:
    The concept of ASHA is one of the best health worker programme in our state where the
Community selects a Health Volunteer – called the “ASHA" – the women friend. The concept of
“ASHA” is about Empowerment, Participation, Sharing, Caring, Gender Equity and Self Reliance.
Role of ASHA is:
       Providing elementary Health Education
       Assuming Leadership in Community Action for Health
       Imparting First Aid & OTC Drugs
       Treatment of Minor Ailments
       Ensuring timely referral
       To provide the health service in unreachable villages.
       The ASHA programme is one major crosscutting innovation that has seen considerable grass
roots success. A detailed operational manual and it’s a rigorous sample study based interim evaluation
of the programme is available. This is also an initiative that would take a longer time to succeed and it
needs sustained support at all levels for at least another three to five years.

4.3.10 Urban Health
       On the basis of the study work it is quiet obvious that people should be prepared for tackling
any kind of disaster and at the same time government should make necessary arrangement for making
people aware. Different media of mass communication, awareness and others should be used for
creating consciousness. Not only government agencies, but NGOs are also expected to create mass
awareness. Inclusion of disaster preparedness into school curriculum should be mandatory as in other
disaster prone countries. Targeting children will create an aware generation and minimize life risks.
       The section on urban health therefore focuses only on the municipalities and corporations.
Paradoxically there are large number of hospitals and private clinics- but for the poor in this area of
health, there is not a single approach.
4.3.11 Logistics Management
       The essential drug list is in place and is largely implemented. As Kishanganj district has
storekeepers and officers have been trained in drug and supplies logistics. A computerized inventory
system has been developed in software. The problem with consumables is equally of concern and
laboratory chemicals seem the worst affected but even gauze and bandages, needles and needle holders


                                                   73
                                              DHS, Kishanganj


could be in short supply repeatedly. These would correct with the distribution system becoming fully
operational.
       In equipment there are two types. We have relatively low investment equipments like
Hemoglobinometers or BP apparatus and infant weighing machines- which, if used, will need
replacement frequently. These minor equipments need to be absorbed into the same distribution
system.
        As for costly equipment like ultrasound and X-rays, which require replacement less-up to once
in ten years- but which require trained manpower to operate and considerable consumables as well- the
problem is matching for infrastructure, skills and services provided so that these are adequately
utilized.
4.3.12 Intersectoral Convergence
4.3.12.1 Coordination with ISMs
        There is a large workforce and institutional and infrastructure base within the health department
that is willing to contribute to RCH goals but has been used only minimally for this purpose.
4.3.12.2 Coordination with ICDS and PHED
         Meeting is held at District level for the coordination of Health Department. Health officials have
little faith in coordinating with ICDS and PHED. The vision of intersectoral approach is lacking. More
details about ICDS and PHED are provided in the annexures.
4.3.12.3 Coordination with Panchayats
      Panchayats are not totally involved in participating in the health activities with the health
department. Most of the Panchayats are not aware of the fact that by participating in health activities.
There is no such government policy to link Panchayat directly for increasing the participation of the
Panchayats to the health services.
4.3.13 Infrastructure and Service Delivery Issues
Training and Capacity Building
       Training programmes are few and are driven exclusively by the vertical health programmes of
the day, largely funded from external donors or the central government. As a result whatever trainings
are taking place are arbitrary in choice of trainees and fragmented as strategy. Most training
programmes are of one or two days and relate to a single disease and an immediate campaign for
example one day leprosy training or two days on HIV family counseling or one day on blindness
control and so on. Some persons have received many such training programmes in diverse areas while
some have received none. Then again all MPW (F) had a special round of training in RCH but neither
their supervisors nor male MPWs were exposed to this. The vertical orientation of training leads to
closely associated work of other diseases not being taught – even in much longer capability buildings.
Thus sector supervisors were training on blood smear examination for malarial parasites but doing a
differential counts on that same slide would not be emphasized.
       Almost no training is based on building competencies to attain a level of clinical services in a
given facility. We therefore have a situation where there is a perception within senior officials that the
system is being flooded with training programmes. Yet the system cannot guarantee that in the sub-

                                                    74
                                                DHS, Kishanganj


centres or APHC or PHC of a given district, the level of knowledge and skills needed is now available.
It may not even be able to state; facility-wise what level of skill building has been achieved and what
are the gaps.
Capacity building
       Environmentally-related childhood diseases represent an enormous public health problem,
particularly in developing countries and impoverished communities, where there is often lack of
awareness and knowledge about the effects of chemicals and other environmental hazards on children’s
health.
   Handbook on Children’s Environmental Health - a collection of information that focuses mainly on
    the needs of developing countries.
   Children’s Environmental Health (EH) for the Primary Health Care Sector – preparation of a simple
    training guide and incorporation of EH concepts into existing first level health care services (e.g. into
    the Integrated Management of Childhood Illnesses (IMNCI).
   Training Package for Health Providers
   Leaflets for health care providers - concise information on what health care professionals should
    know about selected environmental risks (e.g. water pollution, lead, chemicals……)
   Pilot Training Activities – for the peer review and field testing of existing materials, using a “train
    the trainers” approach
   Presentations given by experts, visitors.
    The study recognizes that the financing or health care is an important issue and that budgetary
allocations on each facility workforce relate to outcomes. Also that what is adequate utilization or
wasteful relates to amount of investment that has gone into it. These financial aspects are the subject
matter of the subsequent study.
   Mapping the private sector and exploring its possibility of synergy with the public health system
and developing a policy framework for its growth and regulation are yet another issue that we have not
addressed.




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                                                   DHS, Kishanganj


5. Work Plan
5.1 Proposed Activities with Reference to Time Frame
       To make suggested strategies and activities more accountable a model work plan has been
developed. In the matrices below, proposed activities for the performance indicators have been planned
year-wise to give a broad picture as to when the activity could happen. Besides, persons/departments
that share the responsibility for primary activities have also been broadly demarcated.
5.1.1 Work Plan for RCH
        NRHM envisage to have an substantial impact on: (i) reduction in Infant Mortality Rate (IMR)
and Maternal Mortality Ratio (MMR); (ii) universal access to integrated comprehensive public health
services; (iii) child health, water, sanitation and hygiene; (iv) prevention and control of communicable
and non-communicable diseases, including locally endemic diseases; (v) population stabilization,
gender and demographic balance; (vi) revitalize local health traditions and main-stream Ayurvedic,
Yoga, Unani, Siddha and Homeopathy Systems of Health (AYUSH); (vii) promotion of healthy life
styles.
Table 5.1: Work plan for RCH
                         Activity                         Time Frame (from 2009-20012) In percentage
                                                               09-10        10-11         11-12
        I   Objective
        1   Universal coverage of all pregnant women
            with package of quality ANC services as            70.0         80.0          95.0
            per national guidelines
        2   Increase in deliveries with skilled
            attendance at birth including institutional        65.0         75.0          90.0
            deliveries
        3   FRUs (including DHs, PHC/APHC) made
            functional as defined in the National RCH-          45          65             76
            2 PIP
            Activities
        1   Block level microplanning to find gaps in
            infrastructure, manpower, skills &                   -               -          -
            equipments
        2   Filling of equipment gaps                            -               -          -
        3   Streamlining procurement and distribution
            mechanism for supplies at PHC and
            APHC.
        4   Performance incentives for staff
        5   RCH Camps (Minimum of 2 camps per
                                                           To complete   To complete   To complete
            block)
        6   Appointment of contractual staff (ANM,
                                                           To complete   To complete   To complete
            LHV and staff nurse)
       7    Posting of specialists at PHC                      07 PHC            -          -
       8    Referral transport                                 07 PHC            -          -
       9    PPP for ambulance services                         07 PHC      9 APHC           -
       10   PPP for EmOC centres                                DH               -          -
       11   24 hour delivery services at PHC and
                                                               07 PHC            -          -
            APHC


                                                          76
                                             DHS, Kishanganj


12   Training to dais/SBAs (7 day programme)        SBA training 6
                                                                          -                    -
                                                        batches
13   Motivational workshops (1 day)                07 Blocks         07 Blocks     07 Blocks
14   Involvement of private sector/nursing
                                                     To complete
     homes to improve institutional deliveries
15   IEC and BCC activities
II   Objective
1    Universal coverage of all eligible pregnant
                                                         65%             80%               90%
     women under JSY scheme
2    Ensuring all eligible women covered under
                                                         65%             80%               90%
     Janani Suraksha Yojana
III Objective
1    Increase in percentage of new born babies
                                                         50%             75%              95%
     given colostrums
2    Increase in prevalence of exclusive breast-
                                                         90%             95%              98%
     feeding
3    Percentage of severely malnourished
     children below 6 years referred to medical          15%             15%              20%
     institutions
4    Strengthen referral network
5    Orientation of AWWs, SHG women and
     ASHA on importance of breast feeding (1
     day)
6    Workshop on provision of low cost
     nutritious food to AWWs, SHG women
     and ASHA (1 day)
7    Workshop on gender related sensitization
     to MOs (2 day)
8    Reorientation training to service providers
9    IEC for behaviour change of community               20%             20%              20%
10   Unmet demand for contraception
     - Total
     - Spacing                                          1.2%            0.5%              0.1%
     - Limiting                                         15%             10%                5%
11   Increasing Number of government health
     institutions providing
                                                        50%             60%               65%
     i) Female sterilization services
                                                        11%             12%               15%
     ii) Male sterilization services
                                                        3.5%            5.5%               7%
     iii) IUD insertion services
12   Compensation on sterilization                   To complete     To complete       To complete
13   Organization of Cu-T insertion camp             To complete     To complete       To complete
14   Organization of sterilization camps             To complete     To complete       To complete
15   Multi-skill training to staff/ MOs for          To complete     To complete       To complete
     sterilization techniques
16   Procurement of laparoscopes                     To complete     To complete       To complete
17   Social marketing of family planning             To complete     To complete       To complete
     devices
18   Provision of Medical Termination of             To complete     To complete       To complete
     Pregnancy
19   IEC for promotion of male and female            To complete     To complete       To complete
     sterilization


                                                   77
                                                        DHS, Kishanganj


       20   Training to MOs on management of
                                                                To complete     To complete        To complete
            RTI/STI (3 day)
       21   Health check up and partner treatment
                                                                To complete     To complete        To complete
            camps
       22   Adequate medicine supply for RTI/STI
                                                                To complete     To complete        To complete
            management
       23   Training on adolescent counseling (to
            NGOs, paramedical staff, SHG women,                 To complete     To complete        To complete
            AWWs, ASHA (3 day)
       24   Educational programmes in schools
       25   Counseling day at block PHC/CHC                     Once a month      Once a           Once a month
                                                                                  month
       26   Honorarium to counselors
       27   Establish link with private practitioners
       IV Special interventions
        1   PNDT campaign                                           1/year        1/year              1/year
        2   Capacity Building of Staff
        3   Strengthening working capacity of ASHA                               Once in a
                                                              Once in a month                   Once in a month at
                                                                                 month at
                                                                 at AWC                               AWC
                                                                                  AWC
        4   Family health camps at district level (3
                                                                    1/year        1/year              1/year
            day)
        5   HIV/AIDS compaining                                    Continous    Continous           Continous
        6   Develop isolation ward for HIV/AIDS                       --            1                  --
            Patient
        7   Develop District Hospital as ART Centre.                   1            --                  --
       V    Institutional strengthening
        1   Repair/renovation of HSCs                               35
        2   Construction of new HSCs                                70               100               25
        3   Construction of new APHC                                25               15                11
        4   Construction of new PHC                                NIL              NIL               NIL
        5   Construction of Doctor’s & Staff Quarter at        3 APHC & 2       10 APHC &      Remaining All PHC,
            PHC/APHC/HSC                                           PHC             5 PHC         APHC & HSC
        6   Operationalization of mobile clinics                    01                -                 -
        7   Adequacy of equipments at health centers            Continous        Continous
                                                                                                Continous Sypply
                                                                  Sypply          Sypply
       8    Formation of Urban Health Center                        0                 2                -
       9    Establishment of Trauma center                          1                 0                -
       10   Regular monitoring and evaluation at              Ensuring in 07    Ensuring in      Ensuring in 07
            blocks and district                                   Blocks         07 Blocks          Blocks


5.1.2 Work Plan for Health Infrastructure
       Functional and accountable infrastructure being an essential prerequisite for an effective health
delivery system a set of strategies has been neatly designed taking into consideration already existing
infrastructure and the possible constraints.

Table 5.2: Work Plan for Health Infrastructure
                           Activity               Time Frame (from 2009-2012)                 Responsibilities
                                                      09-10      10-11        11-12



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                                         DHS, Kishanganj


                Activity               Time Frame (from 2009-2012)               Responsibilities
                                           09-10      10-11        11-12
1    Finish training of ASHA                                                      Civil Surgeon,
                                          350           2376          2376
                                                                                      MOIC
2    Monitoring of working                                                        Civil Surgeon,
                                       To complete   To complete   To complete
     capacity of ASHA                                                                 MOIC
3    Increase incentives for ASHA      Ensuring in   Ensuring in   Ensuring in    Civil Surgeon,
     working in difficult areas          6 blocks      6 blocks      6 blocks         MOiC
4    Selection of members                HMS           HMS
                                                                                  Civil Surgeon,
                                       formed in     formed in     To complete
                                                                                      MOIC
                                        all PHC       all PHC
5    Orientation of selected                                                      Civil Surgeon,
                                            -             -        To complete
     members                                                                          MOIC
6    Guidelines for functioning of                                                Civil Surgeon,
                                            -        To complete        -
     committees                                                                       MOIC
7    Provide government building
                                           50            50            39         Civil Surgeon
     to existing sub centres
8    Construction of new sub
                                          100           100            25         Civil Surgeon
     centres
5    Filling up vacant posts for
     ANM and MPW at sub-               To complete   To complete   To complete    Civil Surgeon
     centres
10   Additional ANM at sub-
                                       To complete   To complete   To complete        MOiC
     centre
11   Grant for maintenance and
     contingency at sub-centre         To complete   To complete   To complete        MOiC
     level
12   Infrastructural set-up for
                                                                        -         Civil Surgeon
     PHC
13   Recruitment of specialists                                                     Deputy
     (gynecologist, surgeon,                -             -             -        Commissioner,
     pediatrician and anesthetist)                                               Civil Surgeon
14   Contractual appointment of
                                                                                      DHS
     staff nurse and LTs
15   Provision of electricity, water
     supply and staff quarters at           -             -             -             DHS
     APHC
10   Deployment of medical
                                            -             -             -         Civil Surgeon
     doctors at PHC level
17   Repair and maintenance of
                                            -             -             -             MOIC
     equipments
18   Specialized management
                                                                                  State Training
     training (for BMOs, DPOs               -             -             -
                                                                                  Co-ordinator
     and DPM)
15   Specialized communication
                                                                                  State Training
     training (for BEEs, NGOs &             -             -             -
                                                                                  Co-ordinator
     media officers)
20   Awareness generation
     training for health workers,
                                                                                  State Training
     link workers, ICDS workers,            -             -             -
                                                                                  Co-ordinator
     SHG leaders and PRI
     members

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                                                  DHS, Kishanganj


                          Activity              Time Frame (from 2009-2012)                  Responsibilities
                                                    09-10      10-11        11-12
          21   Multiskilling training for                                                     State Training
                                                     -                             -
               paramedical staff                                                              Co-ordinator
          22   Refresher training course for                                                  State Training
                                                     -                             -
               ANMs                                                                           Co-ordinator
          23   Selection of members for                                                       Civil Surgeon,
                                                     -               -             -
               VHSC                                                                               MOIC
          24   Establishment of guidelines                                                    Civil Surgeon,
                                                     -               -             -
               for functioning of committee                                                       MOIC
          25   Interaction between MPWs/                                                      Civil Surgeon,
                                                     -               -             -
               ANMs, AWWs and ASHA                                                                MOIC
          26   Development of guidelines                                                      Civil Surgeon
                                                     -               -             -
                                                                                                  MOIC
          27   Regular monitoring and
                                                                                              Civil Surgeon
               reporting system for used             -               -             -
                                                                                                 MOIC
               grant
          28   Appointment of staff                                                             Deputy
                                                     -               -             -         Commissioner,
                                                                                             Civil Surgeon
          29   Availability of conveyance            -               -             -         Civil Surgeon
          30   Adequate equipments and                                                       Civil Surgeon,
                                                     -               -             -
               medicines                                                                         MOiC
          31   Monthly meeting conducted          Once a          Once a        Once a
                                                                                                  MOiC
               at sub-centre level                month           month         month
          32   Meeting at PHC level to
                                                  Once a          Once a        Once a
               review problems related to                                                         MOiC
                                                  month           month         month
               health delivery mechanism
          33   Organization of training as
                                                     -               -             -
               per state guidelines                                                           Civil Surgeon
          34   District level training of MOs
               for managerial skills and             -               -             -
                                                                                              Civil Surgeon
               EmOC
          35   Well established supply chain     Ensuring        Ensuring      Ensuring
                                                 Supply in       Supply in    Supply in 07    Civil Surgeon
                                                 07 Blocks       07 Blocks      Blocks
          36   Appointment of AYUSH                                                             Deputy
               practitioners at PHC/PHC              -               -             -         Commissioner,
                                                                                             Civil Surgeon
          37   Integration with private
                                                To complete          -             -          Civil Surgeon
               doctors at village level
          38   Assessment of
               communication needs in the       To complete     To complete   To complete
                                                                                              Civil Surgeon
               context of NRHM
          39   Use of print media, folk
                                                To complete     To complete   To complete
               media, T.V. and radio                                                          Civil Surgeon
          40   Financial planning for            Ensuring        Ensuring      Ensuring
               reaching of supplies at           Supply in       Supply in    Supply in 07    Civil Surgeon
               various levels                    07 Blocks       07 Blocks      Blocks
5.1.3 Work Plan for Child Immunization
Table 5.3 Work plan for child immunization


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                                                   DHS, Kishanganj


                          Activity             Time Frame (from 2009-2012)                    Responsibilities
                                                 09-10       10-11         11-12
                Cold chain maintenance for     Ensuring      Ensuring          Ensuring
                                               Supply in    Supply in 7       Supply in 7      Civil Surgeon,
           1    quality assurance of
                                                7 Blocks      Blocks            Blocks             MOiC
                vaccine
                Improving transport            Ensuring
                                                           Ensuring in    Ensuring in 7        Civil Surgeon,
           2    system                           in 7
                                                            7 Blocks         Blocks                MOiC
                                                Blocks
                Monitoring mechanism for       Ensuring    Ensuring in    Ensuring in 7
                                                                                               Civil Surgeon,
           3    adequate supply                  in 7       7 Blocks         Blocks
                                                                                                   MOiC
                                                Blocks
                Organization of weekly         Ensuring
                                                           Ensuring in    Ensuring in 7        Civil Surgeon,
           5    immunization day at sub-         in 7
                                                            7 Blocks         Blocks                MOiC
                center                          Blocks
                Fill-up vacant post of                                                           Deputy
           6    ANMs                               -             -                 -          Commissioner,
                                                                                              Civil Surgeon
                Pulse polio immunization                                                      Civil Surgeon,
           7                                       -             -                 -
                camps                                                                             MOiC
                Catchup round for routine
           8                                       -             -                 -           Civil Surgeon
                immunization
                Close coordination between     Ensuring
                                                           Ensuring in    Ensuring in 7
           9    ANM, AWW and ASHA                in 7                                              MOiC
                                                            7 Blocks         Blocks
                                                Blocks
                Safe injection practices       Ensuring
                                                           Ensuring in    Ensuring in 7
           10   (provision of disposable         in 7                                             MOIC
                                                            7 Blocks         Blocks
                syringes)                       Blocks
                Identification of areas with   Ensuring
                                                           Ensuring in    Ensuring in 7
           11   low immunization                 in 7                                             MOIC
                                                            7 Blocks         Blocks
                coverage                        Blocks
                Involving AWWs, NGOs,          Ensuring
                                                           Ensuring in    Ensuring in 7
           12   ASHA and Panchayat on            in 7                                             MOIC
                                                            7 Blocks         Blocks
                immunization day                Blocks
                Orientation and awareness      Ensuring
                                                           Ensuring in    Ensuring in 7
           13   generation training for          in 7                                             MOIC
                                                            7 Blocks         Blocks
                health workers                  Blocks



5.1.4 Work Plan for Kala- azar under NVBDCP
Table 5.4: work plan for Kala - Azar Control

                         Activity                   Time Frame (from 2009-20012)
                                                                                              Responsibilities
                                                   09-10         10-11       11-12
           1    Use of video display,
                                                                To complete     To complete
                posters, pamphlets,            To complete in                                  District Malaria
                                                                  in each         in each
                booklets, wall painting and      each block                                        Officer
                                                                   block           block
                street plays
           2    Coordination with school                        To complete     To complete
                                               To complete in                                  District Malaria
                education                                         in each         in each
                                                 each block                                        Officer
                                                                   block           block
           3    Fortnightly door to door
                                                                                               District Malaria
                surveillance by health                 -             -                 -
                                                                                                   Officer
                worker

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                                                       DHS, Kishanganj


                            Activity                   Time Frame (from 2009-20012)
                                                                                                    Responsibilities
                                                      09-10         10-11       11-12
            4     Increase blood smear                                                              Civil Surgeon,
                  collection                             -                   -             -        District Malaria
                                                                                                        Officer
            5     Transportation of slides
                                                                                                    District Malaria
                  from collection point to               -                   -             -
                                                                                                        Officer
                  laboratory on daily basis
            6     Functional laboratory at
                                                         -                   -             -         Civil Surgeon
                  PHC/PHC level
            7     Blood examination center at
                                                         -                   -             -         Civil Surgeon
                  each block
            8     Appointment of lab
                                                         -                   -             -         Civil Surgeon
                  technicians
            9     Insecticidal sprays at high                           To complete   To complete
                                                  To complete in                                    District Malaria
                  risk areas                                              in each       in each
                                                    each block                                          Officer
                                                                           block         block
            10    Promotion of Gambuzia                                                             District Malaria
                                                         -                   -             -
                  culture                                                                               Officer
            11    Distribution of medicated                                                         District Malaria
                                                         -                   -             -
                  mosquito nets                                                                         Officer
            12    Acceptance/ treatment of         Ensuring in 7        Ensuring in   Ensuring in
                                                      Blocks             7 Blocks      7 Blocks      Civil Surgeon
                  usage of herbal medicine
5.1.5 Work Plan for RNTCP
Table 5.5: Work plan for TB control
                          Activity                    Time Frame (from 2009-20012)
                                                                                                     Responsibilities
                                                    09-10         10-11         11-12
        1        Interpersonal
                 communication by local         Ensuring in 7         Ensuring in 7   Ensuring in
                                                                                                       DTO, MOiC
                 health workers, NGOs and          Blocks                Blocks         7 Blocks
                 Panchayat
        2        Use of posters, pamphlets,
                                                Ensuring in 07     Ensuring in 07     Ensuring in
                 wall paintings and street                                                             DTO, MOiC
                                                   Blocks             Blocks           07 Blocks
                 plays
        3        Increase awareness of                                                                Health Worker,
                                                Disseminatio          Disseminatio    Disseminati
                 DOTS                                                                                ICDS, NGO, PRI,
                                                 n on VHN              n on VHN       on on VHN
                                                                                                        Education
                                                    day                   day             day
                                                                                                       Department
        4        Community participation                                                              Health Worker,
                                                Ensuring in 07     Ensuring in 07     Ensuring in    ICDS, NGO, PRI,
                                                   Blocks             Blocks           07 Blocks        Education
                                                                                                       Department
        5        Involvement of private         Ensuring in 07     Ensuring in 07     Ensuring in
                                                                                                    DTO , MOIC, BHM
                 practitioners                     Blocks             Blocks           07 Blocks
        6        Promote case detection
                                                Ensuring in 07     Ensuring in 07     Ensuring in
                 through sputum                                                                     DTO , MOIC, BHM
                                                   Blocks             Blocks           07 Blocks
                 microscopy
        7        Complete treatment             Ensuring in 07     Ensuring in 07     Ensuring in
                                                                                                    DTO, MOIC, BHM
                                                   Blocks             Blocks           07 Blocks
        8        Increase accessibility to      Ensuring in 07     Ensuring in 07     Ensuring in
                                                                                                    DTO , MOIC, BHM
                 treatment                         Blocks             Blocks           07 Blocks
        5        Follow-up examination to       Ensuring in 07     Ensuring in 07     Ensuring in   DTO , MOIC, BHM

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                                                       DHS, Kishanganj


                        Activity                      Time Frame (from 2009-20012)
                                                                                                       Responsibilities
                                                    09-10         10-11         11-12
              achieve sputum conversion             Blocks              Blocks         07 Blocks
        10    Establishment of TB cells at      Ensuring in 07    Ensuring in 07      Ensuring in
                                                                                                      DTO , MOIC, BHM
              block level                          Blocks            Blocks            07 Blocks
        11    Quality assurance of              Ensuring in 07    Ensuring in 07      Ensuring in
                                                                                                      DTO , MOIC, BHM
              sputum smear                         Blocks            Blocks            07 Blocks
        12    Regular and uninterrupted         Ensuring in 07    Ensuring in 07      Ensuring in
                                                                                                      DTO , MOIC, BHM
              supply of drugs                      Blocks            Blocks            07 Blocks
        13    Systematic monitoring and         Ensuring in 07    Ensuring in 07      Ensuring in
                                                                                                      DTO , MOIC, BHM
              evaluation                           Blocks            Blocks            07 Blocks
        14    Appointment of field staff        Ensuring in 07    Ensuring in 07      Ensuring in       Civil Surgeon,
                                                   Blocks            Blocks            07 Blocks         DTO, MOIC
        15    Training to DOTS                     Refresher
                                                   Training
                                                                           -               -          Civil Surgeon, DTO
              providers
        10    Sensitization training to
                                                                       Refresher
              MOs providing treatment                  -
                                                                       Training
                                                                                           -          Civil Surgeon, DTO
              at block level


5.1.6 Work Plan for NBCP
Table 5.6: Work plan for Blindness control

                         Activity                       Time Frame (from 2009-20012)                   Responsibilities
                                                      09-10       10-11         11-12
              Organization of eye camps in                       Thrice at
                                                    Thrice at               Thrice at block              DTO , MOIC,
          1   collaboration with private                          block
                                                   block level                   level                      BHM
              agencies/ institutions                              level
              Integrate eye care as a part of
          2                                                -               -               -
              primary health care
              Availability and repair of           Ensuring in          Ensuring     Ensuring in 07      DBO, MOiC,
          3
              necessary equipments                  07 Blocks         in 07 Blocks      Blocks             DPM
              Posting of eye-surgeon at
          4                                                -               -               -             Civil Surgeon
              block level
              Follow-up of treated cases                               Regular
                                                    Regular                            Regular
                                                                      Monitoring                         DTO , MOIC,
          5                                       Monitoring at                      Monitoring at
                                                                       at each                              BHM
                                                   each block                         each block
                                                                        block
          6   Quality control mechanism                    -               -               -           MOIC, DBO
              Streamlined vitamin-A                Ensuring in          Ensuring     Ensuring in 07     DBO, MOIC,
          7
              supply                                07 Blocks         in09 Blocks       Blocks             DPM
              Availability of medicines                               Strenghthe
              during eye camps                    Strenghthen              n          Strenghthen          CIVIL
          8                                       procurement         procureme      procurement &       SURGEON,
                                                   & Supplies            nt &           Supplies         DBO, BHM
                                                                       Supplies
              Sensitization work Shop at                              07 (once at
                                                   07 (once at                        07 (once at        DBO, MOIC,
          9   block level for MOs and                                    each
                                                   each block)                        each block)          BHM
              health workers                                            block)
              Technical training of
         10   ophthalmic medical assistants                -               -               -               CS, DBO,
              at district for skill up-


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                                                        DHS, Kishanganj


                              Activity                   Time Frame (from 2009-20012)               Responsibilities
                                                       09-10       10-11         11-12
                   gradation and new
                   techniques
                   Behaviour change of
            11     community to increase                 -              -              -            CS, DBO, DPM
                   treatment acceptance
                   Interpersonal communication
                                                                                                    DBO, DPM, MO
            12     by health workers and ICDS            -              -              -
                                                                                                      I/C, BHM
                   workers
                   Use of print media, mass                                                          DBO, MO I/C,
            13                                           -              -              -
                   media and folk media                                                                 BHM


5.1.7 Work Plan for NLEP
Table 5.7: Work plan for Leprosy eradication
                              Activity               Time Frame (from 2009-20012)                    Responsibilities
                                                        09-10          10-11            11-12
       1         Recruitment of field staff               -              -                -
       2         Orientation training of new staff    One training    One training   One training
                                                      programme       programme      programme
       3         Updating records                                                                        DLO, DA
       4         Increase case detection and
                                                             -              -              -             CS, DLO
                 referral for treatment
       5         Case validation and re-
                                                             -              -              -           MO I/C, DLO
                 registration
       6         Organization of POD camps                   -              -              -
       7         Organization of Skin Disease
                 Diagnosis, Treatment &
                                                             -              -              -           MO I/C, DLO
                 Education Camps in remote and
                 inaccessible areas
       8         Urban leprosy awareness camps               -              -              -             CS, DLO
       5         Procurement of IEC equipments               -              -              -             CS, DLO
       10        Sensitization workshop for
                                                      07 (once at
                 panchayat members to motivate                              -              -             CS, DLO
                                                      each block)
                 them for community education
       11        Proper counseling by health
                                                      07 (once at     07 (once at    07 (once at
                 worker and MOs to prevent                                                               CS, DLO
                                                      each block)     each block)    each block)
                 deformities
       12        Sensitize community for self
                                                             -              -              -            DLO, MEO
                 reporting
       13        Sensitization workshop at gram                                                       CS, DLO DPM,
                                                             -              -              -
                 Panchayat                                                                                 BHM
                 Community mobilization through
                 interpersonal communication,                                                         CS, DLO DPM,
                                                             -              -              -
                 print media and folk media (in                                                            BHM
                 local dialect)
       14        Provide personal support and
                                                             -              -              -               DLO
                 psychological assurance
6. Monitoring and Evaluation
6.1 Introduction

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                                                      DHS, Kishanganj


       Monitoring and Evaluation is a key and integral part of NRHM and systems are in place at each

level to ensure the monitoring for smooth progress. The Mission Steering Group (MSG) has been set up

at the Center and further the Empowered Programme Committee has also been set up to monitor the

progress. The various societies at the state and the district level have been merged into an Integrated

Society at the state level where it is the executive arm of the State Health Mission.

Monitoring and Evaluation plan would help in providing an overview of progress that has to be

addressed during monthly review meetings held at different levels of the health system. It is strongly

recommended that all activities are monitored and integrated at different levels of the health system to

address the specific NRHM requirements and collated into a single format. As the aim is to ultimately

institutionalize quality assessment in routine monitoring, the performance evaluation mechanism will

mostly rely on ongoing monthly reports, progress report concurrent and mid-term and end-line

surveys.

In line with the objective set and work plan finalized, subsequent section details out the monitoring and

evaluation indicators in matrix form for each programmatic area.

6.1.1 Monitoring and Evaluation Matrix for Health Infrastructure
                         Activity                                Indicator                      Means of
                                                                                               verification
           Strategy 1: Training of ASHA
           Finish training of ASHA                Number of ASHA trained                      DPMU Report
           Monitoring of ASHA                     Monitoring mechanism in place               DPMU Report
           Strategy 2: Establishment of HMS
           Selection of members                   opening of bank accounts for HMS
                                                  members Development and acceptance
                                                                                              DPMU Report
                                                  of model MOU Meetings of CPS/ HMS/
                                                  HMS
           Strategy 3: Functioning of HMS
           Clear guidelines for working of        Guideline formulated and
           HMS                                    Number of HMS members oriented
           Guidelines for expenditure of          Number of orientation/ training session
           maintenance grant                      held                                        DPMU Report
           Orientation and training of elected
           HMS members
           Strategy 4: Upgradation of health institutions
           Provide government building to         Number of sub centres to be               DPMU Report/CMO
           existing sub centres                   provisioned in government building        Report /Health MIS
           Construction of new sub centres        Number of sub centre constructed          DPMU Report/CMO
                                                                                            Report /Health MIS
           Filling up vacant posts for ANM and    Number of ANM and MPW recruited           Health MIS/DPMU
           MPW at sub-centres                                                                     Report


                                                            85
                                            DHS, Kishanganj


              Activity                                 Indicator                        Means of
                                                                                       verification
Additional ANM at sub-centre             Number of additional ANM recruited at      Health MIS/DPMU
                                         sub centre                                       Report
Grant for maintenance and                Grants for maintenance and
contingency at sub-centre level          contingency level provided at sub-
                                         centre level
Infrastructural set-up for PHC           Number of PHC Strengthened
Recruitment of specialists               Number of specialists recruited
(gynecologist, surgeon, pediatrician     (gynecologist, surgeon, pediatrician and   Health MIS/DPMU
and anesthetist)                         anesthetist)                                     Report
Contractual appointment of staff         Number of LTs appointed on
nurse and LTs                            contractual basis
Provision of electricity, water supply Number of APHC wherein provision of
and staff quarters at APHC               electricity, water supply and staff
                                         quarters are made
Strategy 3: Human resource development
Specialized management training          Number of management training
(for BMOs, DPOs and DPM)                 programme organized for BMOs, DPOs
                                         and DPM
Specialized communication training       Number        of   training   programme
(for BEEs, NGOs & media officers)        organized for BEEs, NGOs & media
                                         officers
Awareness generation training for        Number of awareness generation                  Health
health workers, link workers, ICDS       training organized for health workers,     MIS/Training Plan
workers, SHG leaders and PRI             link workers, ICDS workers, SHG
members                                  leaders and PRI members
Multiskilling training for               Number of paramedical staff trained
paramedical staff
Refresher training course for ANMs       Number of refresher training course for
                                         ANMs
Strategy 5: Constitution of Village Health and Sanitation Committees
Guidelines for VHSC                      Number of HMS members oriented               DPMU Report
Strategy 5: Integration with ASHA programme
Interaction between MPWs/ANMs,           Number of meetings held between             Health MIS/MOs
AWWs and ASHA                            MPWs/ANMs, AWWs and ASHA                         Report
Strategy 6: Directions for use of maintenance grant at each level
Development of guidelines                Guidelines developed and formed
Regular monitoring and reporting         Regular monitoring and reporting           CMO office Report
system for used grant                    system in place
Strategy 7: Organization of community meeting
Monthly meeting conducted at sub-        Number of monthly meeting organized
centre level                             a sub centre level
                                                                                    DPMU/Block MOs
Meeting at PHC level to review           Meetings organized at the PHC level
                                                                                       Report
problems related to health delivery
mechanism
Strategy 8: Formulation of district training plan
Recognition of need of trainings         Training need identified
Organization of trainings as per state Number of training organized
                                                                                    DPMU Report/CMO
guidelines
                                                                                    Report /Health MIS
Refresher training of paramedics on      Number of paramedics trained
minor ailments

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                                                    DHS, Kishanganj


                      Activity                                  Indicator                    Means of
                                                                                            verification
        Training of MOs for managerial         Number of MO’s, ANM identified
        skills, EmOC
        Training of ANMs for ANC, DOTS
        Strategy 5: Formulation of district BCC plan
        Assessment of communication needs Assessment of communication needs             DPMU Report/CMO
        in the context of NRHM                                                          Report /Health MIS
        Strategy10: Streamlined procurement and logistic supply plan
        Financial planning for reaching of     Financial Plan at each level in place
                                                                                           DPMU Report
        supplies at various levels
        Well established supply chain          Establishment of supply chain
        Strategy 11: Coordination with private practitioners/ institutions
        Appointment of AYUSH                   Number of AYUSH physicians relocated
                                                                                           DPMU Report
        practitioners at PHC/PHC               and appointed
        Integration with private               Number of private practitioners
                                                                                           DPMU Report
        doctors/ISMP at village level          involved

6.1.2 Monitoring and Evaluation Matrix for Immunisation
                    Activity                                 Indicator                 Means of verification
       Strategy1: Streamlining cold chain system
       Cold chain maintenance for            Institution wherein cold chain is         Logistic Plan/MIS
       quality assurance of vaccine          established and streamlined
       Strategy 2: Logistics of vaccine and disposable supply
       Improving transport system            Transportation system improved             CMO office Report/
                                                                                       Nodal officers Report
       Monitoring mechanism for            Monitoring mechanism in place                CMO office Report/
       adequate supply                                                                 Nodal officers Report
       Strategy 3: Strengthening service delivery
       Organization of weekly              Number of weekly immunization day at          Monthly Progress
       immunization day at sub-center      sub-center                                    Report/Health MIS
       Fill-up vacant post of ANMs         Number of ANMs recruited on                   Monthly Progress
                                           contractual basis                             Report/Health MIS
       Pulse polio immunization camps      Number of pulse polio immunization            Monthly Progress
                                           camp organized                                Report/Health MIS
       Catchup round                       Number of catch up round organised            Monthly Progress
                                                                                         Report/Health MIS
       Close coordination between ANM,     Cordination meeting organized and
       AWW and ASHA                        grievance addressed between ANM,              Block MO’s Report
                                           AWW and ASHA
       Strategy 4: IEC for behaviour change of community
       Identification of areas with low    Number of low immunization coverage
       immunization coverage               area
       Involving AWWs, NGOs, ASHA          Number of AWWs, NGOs, ASHA and
       and panchayat on immunization       panchayat involved on immunization day      DPMU Report/Health
       day                                                                                   MIS
       Orientation and awareness           Number of orientation and awareness
       generation training for health      generation training for health workers
       workers




                                                           87
                                                   DHS, Kishanganj


6.1.3 Monitoring and Evaluation Matrix for Vector Borne Disease Programme
                       Activity                                   Indicator                      Means of
                                                                                                verification
      Strategy1: IEC activities
      Use of video display, posters, pamphlets,     Number of video display, posters
      booklets, wall painting and street plays      ,pamphlets and street plays                  Health
                                                    organized                               MIS/Communicatio
      Coordination with school education            Number of school involved as part            n Plan
                                                    of school education
      Strategy 2: Increased surveillance
      Fortnightly door to door surveillance by       Number of door to door surveillance
      health worker                                  programme organized by health
                                                     worker
      Strategy 3: Early diagnosis and prompt treatment
      Increase blood smear collection                Percentage increase in blood smear
                                                     collection
                                                                                             Health MIS/Nodal
      Transportation of slides from collection       Percentage increase in slides
                                                                                              officers Report
      point to laboratory on daily basis             transported from collection point to
                                                     laboratory on daily basis
      Strategy 4: Strengthening laboratory facilities
      Functional laboratory at PHC/PHC level         Number of functional laboratory at
                                                     PHC/PHC level
      Blood examination center at each block         Blood examination centre                Health MIS/Nodal
                                                     established                              officers Report
      Appointment of lab technicians                 Number of lab technicians
                                                     appointed
      Strategy 5: Preventive measures to reduce chances of outbreak
      Insecticidal sprays at high risk areas         Proportion of high risk areas having
                                                     insecticidal sprays                    Malaria Programme
      Distribution of medicated mosquito nets        Number of medicated mosquito nets         Plan Report
                                                     Distributed
      Strategy 6: Integration with ISM practitioners
      Acceptance/ treatment of usage of herbal       Proportion of members accepting
                                                                                               Health Survey
      medicine                                       herbal medicine


6.1.4 Monitoring and Evaluation Matrix for NTCP
                     Activity                              Indicator                    Means of verification
       Strategy 1: Sensitization of
       community through IEC activities
       Use of posters, pamphlets, wall         Number of posters, pamphlets, wall
       paintings and street plays              paintings and street plays                    Health MIS
                                               conducted/displayed
       Increase awareness of DOTS              Proportion of community members
                                                                                            Survey Report
                                               aware of DOTS
       Strategy 2: Increasing referral from grass root to health institutions
       Community participation                 Proportion of community members
                                                                                            Health Survey
                                               involved
       Involvement of private practitioners    Number of private practioners
                                                                                             Health MIS
                                               involved
       Strategy 3: Treatment strengthening


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                                                          DHS, Kishanganj


                        Activity                                Indicator                     Means of verification
           Complete treatment                       Number of cases completed
                                                    treatment
                                                                                                  RNTCP Report/MIS
           Follow-up examination to achieve         Number of cases followed up
           sputum conversion
           Strategy 4: Infrastructural strengthening
           Establishment of TB cells at block      TB cells established at block level
           level
           Regular and uninterrupted supply of Number of days drug was stocked
           drugs                                   out
           Systematic monitoring and               Monitoring and evaluation plan             RNTCP Report/ Health
           evaluation                              finalized                                    MIS/Logistic Plan
           Appointment of field staff              Number of field staff appointed
           Training to DOTS providers              Number of DOTS provider trained
           Sensitization training to MOs           Number of training session
           providing treatment at block level      organised at the block level


6.1.5 Monitoring and Evaluation Matrix for Blindness Control Programme
                           Activity                                     Indicator                        Means of
                                                                                                        verification
         Strategy 1: Outreach activities
         Organization of eye camps in collaboration       Number of eye camp organized in
                                                                                                     BCP Report/Health
         with private agencies/ institutions              collaboration with private agencies/
                                                                                                           MIS
                                                          institutions
         Strategy 2: Strengthening service delivery
         Posting of eye-surgeon at block level            Number of eye surgeon recruited
         Follow-up of treated cases                       Number of cases followed up
                                                                                                       CMO Office
         Integrate eye care as a part of primary health   Institutions who integrated eye care
                                                                                                    Report/DPMU/Healt
         care                                             as a part of primary health care
                                                                                                           h MIS
         Availability and repair of necessary             Number of equipments repaired
         equipments
         Strategy 3: Adequate drug/vaccine supply
         Streamlined vitamin-A supply                  No of days Vitamin A has been out
                                                       of stock                                      Health MIS/Logistic
         Availability of medicines during eye camps    Number/Type of Medicine being                    plan Report
                                                       supplied at eye camp
         Strategy 4: Capacity building of human resources
         Sensitization Workshop at block level for     Number of sensitization work
         MOs and health workers                        organized at block level for MOs
                                                       and health workers                            Health MIS/DPMU
         Technical training of ophthalmic medical      Number of ophthalmic medical                        Report
         assistants at district for skill up-gradation assistants at district trained for skill
         and new techniques                            up-gradation and new techniques
         Strategy 5: IEC for public awareness on eye care
         Behaviour change of community to increase     Number of community members
         treatment acceptance                          who showed positive behavioral
                                                       change                                       DPMU/Communicati
         Interpersonal communication by health         Proportion of community members                on deptt. report
         workers and ICDS workers                      contacted health workers and ICDS
                                                       workers



                                                                89
                                                   DHS, Kishanganj




6.1.6 Monitoring and Evaluation Matrix for NLEP
                        Activity                                 Indicator                   Means of
                                                                                            verification
      Strategy1: Surveillance for case detection
      Recruitment of field staff                    Number of field staff recruited
                                                                                         LCP Nodal officers
      Orientation training of new staff             Number of new staff oriented
                                                                                         Report/Health MIS
      Updating records                              Proportion of records updated
      Strategy 2: Strengthen service delivery
      Increase case detection and referral for      Number of cases detected and
      treatment                                     referred
      Case validation and re-registration           Number of cases validated and re-
                                                    registered
      Organization of POD camps                     Number of POD camps organized        LCP Nodal officers
      Organization of Skin Disease Diagnosis,       Number of Skin Disease Diagnosis,    Report/Health MIS
      Treatment & Education Camps in remote         Treatment & Education Camps in
      and inaccessible areas                        remote and inaccessible areas
      Urban leprosy awareness camps                 Number of Urban leprosy
                                                    awareness camps organised
      Strategy 3: Collaboration with PRI
      Sensitization Workshop for panchayat          Number of Workshop organized for
      members to motivate them for community        panchayat members to motivate           Health MIS
      education                                     them for community education
      Strategy 4: Prevention of disability and
      rehabilitation
      Proper counseling by health worker and        Proportion of cases counseled by
                                                                                         Block MOs Report
      MOs to prevent deformities                    health worker and MOs
      Sensitize community for self reporting        Proportion of community members
                                                                                            Health MIS
                                                    sensitized
      Strategy 5: IEC to mitigate stigma
      Sensitization Workshop at gram panchayat      Number of Workshop organized at
                                                    gram panchayat level
                                                                                           Health MIS/ lCP
      Community mobilization through                Reach of IEC activity i.e.
                                                                                         Report/Communicat
      interpersonal communication, print media      interpersonal communication, print
                                                                                            ion division
      and folk media (in local dialect)             media and folk media (in local
                                                    dialect)
      Orgination of Trainings as state guideline    No. of Training Organised            DPMU Report/



9. List of Abbreviations

    AIDS          Acquired Immune Deficiency Syndrome
    ANC           Ante Natal Care
    ANM           Auxiliary Nurse Midwife
    APHC          Additional Primary Health Centre
    APL           Above Poverty Line
    ARSH          Adolescent Reproductive and Sexual Health
    ASHA          Accredited Social Health Activist
    AWC           Anganwadi Centre

                                                         90
                                   DHS, Kishanganj


AWH      Anganwadi Helper
AWW      Anganwadi Worker
AYUSH    Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy
BCC      Behaviour Change Communication
BDC      Block Development Committee
BPL      Below Poverty Line
CBO      Community Based Organization
CDPO     Child Development Project Officer
CHC      Community Health Centre
CMO      Chief Medical Officer
DDC      Drug Distribution Centre
DAP      District Action Plan
DF       Deep Freezers
DH       District Hospital
DHAP     District Health Action Plan
DLHS     District Level Household Survey
DOTS     Directly Observed Treatment Short-course
EmOc     Emergency Obstetric Care
FGD      Focus Group Discussion
FRU      First Referral Unit
FTD      Fever Treatment Depot
GP       Gram Panchayat
HMS      Health Management Society
HMIS     Health Management Information Systems
ICDS     Integrated Child Development Services
IDSP     Integrated Disease Surveillance Project
IEC      Information Education And Communication
ILR      Ice-lined Refrigerators
IOL      Intra-Ocular Lens
IUD      Intra-uterine Devices
IPHS     Indian Public Health Standards
LHV      Lady Health Visitor
MDT      Multi Drug Therapy
MMU      Medical Mobile Unit
MOIC     Medical Officer In-Charge
MPW      Multi Purpose Worker
MSG      Mission Steering Group
NBCP     National Blindness Control Programme
NGO      Non Government Organization
NLEP     National Leprosy Eradication Programme
NRHM     National Rural Health Mission
NVBDCP   National Vector Borne Disease Control Programme
PHC      Primary Health Centre

                                         91
                                   DHS, Kishanganj


PPC     Post Partum Centres
PRI     Panchayati Raj Institution
RCH     Reproductive And Child Health
RKS     Rogi Kalyan Samiti
RNTCP   Revised National Tuberculosis Control Programme
RTI     Reproductive Tract Infections
SC      Sub-centre
SC/ST   Scheduled Caste/ Scheduled Tribe
SHG     Self Help Group
SNP     Supplementary Nutrition Programme
STI     Sexually Transmitted Infections
TB      Tuberculosis
TOT     Training of Trainers
UFWC    Urban Family Welfare Centre
VHC     Village Health Committee
VHSC    Village Health and Sanitation Committee
ZP      Zila Parishad




                                         92
                                                                          DHS, Kishanganj



                                              NRHM-PART-A
                                      First Quarterly Allocation 2011-12
Sl.     FMR
                                   Particulars                         QTR- 1           QTR- 2      QTR-3         QTR-4         TOTAL       REMARKS
No.     Code


                               Maternal Health
      A.1.1.1       Operationalise Facilities                         36000.00       36000.00      36000.00      36000.00      144000.00
                    Operationalise Blood Storage units in
1     A.1.1.1
                    FRU                                               246000.00     246000.00      246000.00     246000.00     984000.00
      A.1.1.4       RTI/STI Services at health facilities               0.00         50000.00        0.00          0.00        50000.00
                    RTI/STI        srvices at               health
      A.1.1.4.1     facilities(Equipments                      for
                    PHC@25000/District@50000                                             0.00      150000.00     75000.00      225000.00
      A.1.1.5       Operationalise Sub-centres                                      340000.00                                  340000.00
                    RCH Outreach Services in un-served/
2     A.1.3.1
                    under-served areas (monitoring)                   40000.00       40000.00      40000.00      40000.00      160000.00

4     1.3.2         Monthly Village Health & Nutrition Days
                                                                                    154840.00                                  154840.00
6     A.1.4.1       Home deliveries                                                  25000.00      50000.00      25000.00      100000.00
8     A.1.4.2.1     Rural                                            10000000.00   10000000.00    19250000.00   19250000.00   58500000.00
9     A.1.4.2.2     Urban                                            1080000.00     1080000.00    1440000.00    1440000.00    5040000.00
10    A.1.4.2.3     Caesarean Deliveries                              75000.00       75000.00      112500.00     112500.00     375000.00
      A.1.4.2.4     Accreditation of private medical college         2400000.00     2400000.00    2400000.00    2400000.00    9600000.00
11    A.1.4.3       Other Activities (JSY)                            337500.00     337500.00      337500.00     337500.00    1350000.00
                    1.5.1 Maternal Death Audit 1.1.3
                    Survey on maternal and perinatal
      A.1.5.1
                    deaths by verbal autopsy method
                    (in two districts) @ 850 per death
                                                                      170000.00      170000.00     170000.00     212500.00     722500.00
                Sub Total (Maternal Health)                          14384500.00    14954340.00   24232000.00   24174500.00   77745340.00
                                 Child Health
12    A.2.1         IMNCI                                              30000            30000        55000         55000       170000.00
13    A.2.2         Facility based Newborn Care/FBNC                   20000            20000        20000         20000       80000.00
14    A.2.4         School Helath Programme                              0                0        1187694       2000000      3187694.00
                    Care of Sick children and Severe
15    A.2.6
                    Malnutrition                                       826270           615000      615000        615000      2671270.00
                    Management of Diarrhoea, ARI and
16    A.2.7
                    Micronutrient Malnutrition                         118675             0         118675           0         237350.00
      A.2.7.1       Mobility support to RCH Officers                   75000            75000        75000         75000       300000.00
                  Sub Total (Child Health)                            994945.00      665000.00     1996369.00    2690000.00    6346314.00
                               Family Planning
                    Dissemination of manuals on sterilisation
17    A.3.1.1       standards & Quality assurance of                  44000.00                                                 44000.00
                    sterilisation services
      A.3.1.1.1     Family planing councelor                                         72000.00      72000.00      72000.00      216000.00
      A.3.1.1.2     Mobility support and TA/DA                          0.00         12000.00      12000.00      12000.00      36000.00
      A.3.1.1.3     Training for mamata and ASHA                                    540000.00      540000.00                  1080000.00
18    A.3.1.2       Female sterilisation camp                         120000.00     120000.00      120000.00     140000.00     500000.00
19    A.3.1.3       NSV camps                                                           30000       110000        110000       250000.00
20    A.3.1.4       Compensation for female sterilisation            1000000.00     444000.00     3000000.00    3000000.00    7444000.00
21    A.3.1.5       Compensation for male sterilisation                75000            75000        75000         75000       300000.00
                    Accreditation of pvt.        Provider      for
22    A.3.1.6                                                        1125000.00     1125000.00    1125000.00    1125000.00    4500000.00
                    sterilisation services
24    A.3.2.1       IUD Camps                                         45000.00       45000.00      45000.00      45000.00      180000.00



                                                                                   93
                                                                     DHS, Kishanganj


                   IUD          services         at   Health
25   A.3.2.2                                                     28750.00        28750.00         28750.00       28750.00      115000.00
                   facilities/compensation
26   A.3.2.5       Contraceptive Update Seminars                                                                                  0.00
27   A.3.3         POL for Family Planning/ Others               25000.00        50000.00         75000.00       75000.00      225000.00
                Sub Total (Family Planing)                       2462750.00         2541750.00    5202750.00     4682750.00    14890000.00
                          Innovations/PPP/NGO
30   A.8.1         PNDT and Sex Ratio                                               145000.00                                   145000.00
                   Public Private Partnerships(Chiranjeevi
31   A.8.2
                   Scheme)
32   A.8.4         Other innovations(if any)
             Sub Total (Innovations/PPP/NGO)                            0.00         145000.00           0.00           0.00     145000.00
                    Infrastructure & Human Resource
33   A.9.1.2       Laboratory Technicians (BSU)                 189000.00       189000.00        189000.00      189000.00      756000.00
34   A.9.1.3        Staff Nurse                                 1584000.00      1584000.00       1584000.00     1584000.00     6336000.00
                   Medical     Officers   and     Specialists
35   A.9.1.4       (Anaesthetists, Paediatricians, Ob/Gyn,
                   Surgeons, Physicians)                        210000.00       210000.00        210000.00      210000.00      840000.00
36   A.9.1.5       3. Honorarium of voluntary workers                                                                             0.00
     9.1.5.1       Contracutal Para MedicalStaff

                   (1) Sanitary/Health Inspector
                                                                 96000.00        96000.00         96000.00       96000.00      384000.00
                   (2)Pharmacist
                                                                675000.00       675000.00        675000.00      675000.00      2700000.00
                   (3)Dresser
                                                                270000.00       270000.00        270000.00      270000.00      1080000.00
                   Incentive for ASHA & ANM for Muskan
37   A.9.1.6
                   Ek Abhiyaan                                  1593900.00      1593900.00       1593900.00     1593900.00     6375600.00

                   Minor Civil Works for operationalisation
39   A.9.3.2
                   of 24 hour services at PHCs
                                                                    0               1350000          0              0          1350000.00
                   Operationalise     IMEP    at      health
40   A.9.4
                   facilities(Bio-Wast Management)                                                                                0.00
     Sub Total (Infrastructure & Human Resurce)                 4617900.00      5967900.00       4617900.00     4617900.00     19821600.00
                        Institutional Strenthening
                   Upgradation & Maintenance of Web
     A.10.3.1
                   Server                                         25000                                                         25000.00
     A.10.3.2      HMIS HR                                        36000             36000          36000          36000        144000.00
                   Printing of Revised HMIS Formats
42   A.10.3.3
                   prescribed under NRHM                                             4700                                       4700.00
43   A.10.3.4      HMIS Training                                                    162470                                     162470.00
44   A.10.3.5      Mobility for M&E Officers                     4800.00            4800.00       4800.00        4800.00        19200.00
     A.10.4        Sub Center Rent/Contingency                   32000.00        32000.00         32000.00       33000.00      129000.00
     Sub Total (Infrastructure & Human Resurce)                  97800.00       239970.00         72800.00       73800.00       484370.00
                                  11. Training
                   Maternal Heath Training (Skilled Birth
46   A.11.3.1.1    Attendance / SBA training in Private
                   facilities)                                  264330.00       264330.00        264330.00      264330.00      1057320.00
47   A.11.3.1.4    SBA Supportive Supervision                                                                                     0.00
48   A.11.3.1.5    SBA in private Facilities                    251850.00       251850.00        167900.00      167900.00      839500.00
                   EmOc       Training  of   (Medical
     A.11.3.2
                   Officers in EmOC (batchsize is 8 )                            50000.00                                       50000.00
49   A.11.3.4      MTP Training                                                                   50000.00                      50000.00
50   A.11.3.4.1    MO (MBBS)                                                                                                      0.00
52   A.11.5.1.2     IMNCI (TOT Trg.)                                                             319200.00      159600.00      478800.00
53   A.11.5.1.3    IMNCI (Health Worker Training)               808560.00       2021400.00       2021400.00     1212840.00     6064200.00


                                                                               94
                                                                DHS, Kishanganj


54   A.11.5.1.4     IMNCI (FOLLOW UP Training)                             54860.00         54860.00      54860.00      164580.00
                                                                                                                                      Due to
                                                                                                                                      infilation
                                                                                                                                      of money
                                                                                                                                      the
                                                                                                                                       unit cost
55   A.11.5.2       F-IMNCI and SNCU
                                                                                                                                      has been
                                                                                                                                      raised for
                                                                                                                                      Rs50.00
                                                                                                                                      to
                                                            50000.00       50000.00         50000.00      50000.00      200000.00     Rs100.00
57   A.11.6.2       Minilap Training                        70240.00       70240.00        140480.00      70240.00      351200.00
58   A.11.6.3       NSV Training                                           67800.00         67800.00      33900.00      169500.00
59   A.11.6.4       IUD Insertion Training                 169450.00      169450.00        169450.00     169450.00      677800.00
60   A.11.7         Asha Training                          9000000.00     9000000.00       9000000.00    9000000.00    36000000.00
61   A.11.8         Programe Management Training                                                                          0.00
62   A.11.8.2       DPMU Training                                          58000.00                                     58000.00

                                                                                                                                      District
                                                                                                                                      skilled
     A.11.9         Other Training                                                                                                    lab 7
                                                                                                                                      posting of
                                                                                                                                      mobile
                                                                                                         2460000.00    2460000.00     trainer
                   Sub Total (Training)                    10614430.00    12057930.00      12305420.00   13643120.00   48620900.00
                                12. BCC/IEC
63   A.12.4         Other Activities (IEC)                  200000.00         200000.00     200000.00     200000.00      800000.00
                   Sub Total (IEC/BCC)                       200000.00         200000.00     200000.00     200000.00      800000.00
                              13. Procurement
                    13.1.1 Procurement of equipment
                    14.2. Equipments for EmOC
                    services for identified facilities
                    (PHCs, CHCs) @ Rs 1 Lac / facility /
                    year (in two districts - kishanganj
                    and jehanabad) 14.4. Equipments /
64   A.13.1.1       instruments for Blood Storage              0              274000         274000          0          548000.00
                    Facility / Bank at facilities 14.6.
                    Equipments / instruments,
                    reagents for STI / RTI services @
                    Rs. 1 Lac per district per year



                    Strengthening Life Saving Skills for
65   A.13.1.1.2                                                0                 0             0             0            0.00
                    Anesthesia
66   A.13.2         Procurement of Drug & supplies             0                 0             0             0            0.00
                     Drugs & Supplies for MH (MVA
67   A.13.2.1.1     syringes- MTP)                             0                 0           141360          0          141360.00

                     Drugs & Supplies for MH(delivery
     A.13.2.1.2     kits at HSC)                               0              191280           0             0          191280.00

                    Drugs & Supplies for MH(SBA
     A.13.2.1.3     Drug kits )                                0                 0           122480          0          122480.00

     A.13.2.1.5     Drugs & Supplies for MH(IFA Tab )          0              1524602          0             0         1524602.00
68   A.13.2.2       Drygs & Supply for FP                      0                 0             0             0            0.00
                    Drugs Supplies for FP(Minilap
     A.13.2.3.1     Sets)                                      0              131250           0             0          131250.00

     A.13.2.3.2      Drugs Supplies for FP(NSV Sets)           0              27500            0             0          27500.00
     A.13.2.3.3      Drugs Supplies for FP(IUD Kits)           0                 0           75000           0          75000.00
                    General drugs & supplies for
     A.13.2.5       health facilities                       2000000           8000000       8000000       4000000      22000000.00

                  Sub Total (Procruement)                  2000000.00     10148632.00      8612840.00    4000000.00    24761472.00
                       14. Programme Management


                                                                         95
                                                                     DHS, Kishanganj


                    Strenthening of District Society/DPMU
69    A.14.2        /14.2.1 Contractual Staff for DPMSU           721500.00           721500.00      721500.00       721500.00      2886000.00
                    recruited and in position
                    Strengthening of Financial Management
70    A.14.3                                                       60000.00           105000.00      105000.00        80000.00       350000.00
                    System
         Sub Total (Programme Management)                          781500.00           826500.00      826500.00       801500.00      3236000.00
                       Grand Total                               36153825.00      47747022.00       58066579.00     54883570.00    196850996.00




                                              NRHM-PART-B
                                      First Quarterly Allocation 2011-12
Sl.    FMR
                             Particulars                 Qrt 1                 Qrt 2               Qrt 3            Qrt 4           TOTAL         REMARKS
No.    Code

                        B.1Decentralization


                   ASHA Support system at Distrct
1      B.1.12                                         175000.00          175000.00             175000.00          175000.00        700000.00
                   Level


                   ASHA Support System at Block
2      B.1.13                                         300000.00          300000.00             300000.00          300000.00       1200000.00
                   Level


                   ASHA Support       System     at
      B.1.13.1                                        100000.00          176000.00                                                 276000.00
                   Village Level


       B.1.14      ASHA Trainings                     423000.00          212667.00             210333.00                           846000.00

                   ASHA      drug       kit    and
3      B.1.15                                         3283200.00                                                                  3283200.00
                   Replenishment
       B.1.16      Motivation of ASHA                                    991800.00                                                 991800.00

      B.1.16.1     Cycle for ASHA as Motivation                                                4104000.00                         4104000.00

      B.1.16.2     Bag for ASHA as Motivation                            273600.00                                                 273600.00

      B.1.16.3     I Card For ASHA                                        68400.00                                                 68400.00

4      B.1.18      ASHA Diwas                         410400.00          410400.00             410400.00          410400.00       1641600.00

                   Untied fund for health sub
                   centre, Additional Primary
5      B.1.2                                          1760000.00               0.00                0.00              0.00         1760000.00
                   health Centre and Primar Health
                   Centre
                   Village Health ad Sanitation
6      B.1.21                                         8085000.00                                                                  8085000.00
                   Committee
                   Rogi Kalyan      Samiti    (Seed
7      B.1.22                                         14536600.00        1900000.00                                               16436600.00
                   Money)
                 Sub total (ASHA)                      29073200.00         4507867.00              5199733.00       885400.00      39666200.00

                   2. Infrastructure Strengthening

8      B.2.1       Construction of HSCs(20 Nos.)      7785000.00         7785000.00            7785000.00         7785000.00      31140000.00
                   Construction of building of
       B.2.2       APHCs where land is available      15198000.00        15198000.00           15198000.00                        45594000.00
                   (5315000/APHCs)
                   Construction of residential
       B.2.2B      quarters of old APHCs for staff    9000000.00         9000000.00            9000000.00                         27000000.00
                   nurse
11     B.2.3       Upgradation of PHCs to CHCs        4000000.00         4000000.00            4000000.00                         12000000.00




                                                                                96
                                                                      DHS, Kishanganj


                   Upgrading district hospitals and
12      B.2.4      Sub-Divisional Hospital as per                                                                      0.00
                   IPHC

13      B.2.5      Annual Maintenance Grant                              1300000.00                                 1300000.00

                   Accreditation/ISO:9000
14      B.2.6                                                                                                          0.00
                   certification of Health Facilities
                   Upgradation of Infrastructure of
15      B.2.7                                              0.00                         10000000.00                 10000000.00
                   ANM Training Schools
        B.2.7.1    Construction of ANM hostel                                                         4550000.00    4550000.00
        B.2.7.2    Boundry Wall for 7 PHCz              420000.00        420000.00       420000.00    210000.00     1470000.00
        B.2.8      Staff Quarter in 3 CHCs              9000000.00      9000000.00      9000000.00                  27000000.00
                   Boundry Wall for Sadar
        B.2.9                                                                                         1650000.00    1650000.00
                   Hospital
                   Repair & Boundry of Refral
        B.2.10                                                          5000000.00                                  5000000.00
                   Hospital Chhatargachh
                   Construction of        Additional
        B.2.11                                          4500000.00      4500000.00      4500000.00                  13500000.00
                   Building at CHCs
        B.2.12     DHS Staff Quarter (4 Unit)                                                         5000000.00    5000000.00
     Sub total (Infrastructure Strengthening)           49903000.00     56203000.00     59903000.00   19195000.00   185204000.00

                     3. Contractual Manpower

                    Mobile facility for all health
16     B.3.1. D    functionaries       (ANM)with           0.00         1035000.00         0.00          0.00       1035000.00
                   running


                   Block Programme Management
        B.3.2.                                          1149393.00      1149393.00      1149393.00    1149393.00    4597572.00
                   Unit


17      B.3.4A     Hospital Manager in FRU              150000.00        150000.00       150000.00    150000.00      600000.00

       Sub total (Contractual Manpower)                 1299393.00       2334393.00      1299393.00   1299393.00     6232572.00

                          4. PPP Initiatives

19      B.4.1      Call 102 Ambulance Services            810000          810000          810000        810000      3240000.00

                   1911-Doctor      on     Call     &
20      B.4.2                                             900000          900000          900000        900000      3600000.00
                   Samadhan

                   Advance     Life            Saving
21      B.4.4                                             375000
                   Ambulance(Call-108)

                   Services of Hospital Waste
                   Treatment and Disposal in all
        B.4.6                                             324000          216000          216000        216000       972000.00
                   Government Health facilities up
                   to PHC in Bihar (IMEP)

        B.4.17     Hospital Maintenance                  4050000          4050000        4050000       4050000      16200000.00

                   Availability of Sanitary Napkins
        B.5.3      at Govt. Health Facilities           1500000.00                                                  1500000.00
                   @25000/district/year

                   Procurement of beds for PHCs
        B.5.4                                                                             765000                     765000.00
                   to DHs


                   Cost of IFA for (1-5) years
        B.6.2                                            19200.00                                                    19200.00
                   children (Details annexed)


                   Health Management Information
22       B.8                                              220468          220468          220468        220468       881872.00
                   System




                                                                            97
                                                                  DHS, Kishanganj


                Outsourcing of Pathology &
23     B.9      Radiology services from PHCs          300000          300000          300000        300000      1200000.00
                to DHs.

24    B.10      Operationalising MMU                 1404000          1404000        1404000       1404000      5616000.00

                Monitoring & Evaluation (
25    B.11      State, District and Block Data        300000          300000          300000        300000      1200000.00
                Centre)

                Continuing Medical & Nursing
      B.12                                          500000.00        500000.00      500000.00     500000.00     2000000.00
                Education

                  Equipments/instruments for
                  ANC at Health Facility (Other
     B.13.3                                                          50000.00
                 than SubCentre) @ 50,000 per
                        district per year

26    B.14      Strengthening of Cold Chain                                           70000                      70000.00


27    B.15      Mainstreaming of Ayush               1125000          1125000        1125000       1125000      4500000.00

                Programme     Support         for
     B.15.1                                         300000.00        300000.00      300000.00     300000.00     1200000.00
                AYUSH at District Level

     B.15.1.1   Yoga teacher                        360000.00        360000.00      360000.00     360000.00     1440000.00


28   B.18.1     Bio metric System                                                                                  0.00


                Procurement of SNCU for DH
29    18.2                                          1000000.00                                                  1000000.00
                & NSU for PHCs


30    B.19      De-Centralised Planning               120000          60000           160000        60000        400000.00

                                                                                                                               Salary form
                                                                                                                               December 2010
                                                                                                                               to March 2011 and
31    B.21      ANM (R)                              1136034          384000          384000        384000       2288034       Arrear
                                                                                                                               Rs240043.00(form
                                                                                                                               Jan 2010 to may
                                                                                                                               2010.

32     22       Intersectoral Convergence           820800.00        820800.00      820800.00     820800.00      3283200

         Sub total (PPP Initiatives)                15564502.00     11800268.00     12685268.00   11750268.00   51375306.00
                Grand Total                         95840095.00     74845528.00     79087394.00   33130061.00   282478078.00




                                                                        98
                                              DHS, Kishanganj



                              NRHM-PART-C
                      First Quarterly Allocation 2011-12
                                                                 Budget 2011-12
C.2     ROUTINE                          1st Qtr      2nd Qtr       3rd Qtr       4th Qtr     Total
        IMMUNISATION
C.1     Mobility Support for DIO        24000.00     24000.00       24000.00   24000.00      96000.00
        Rs. 1000 per day 8 days in
        month
C.2     Cold chain maintenance          95000.00         0.00         0.00         0.00      95000.00
        Rs. 10000 per PHC and
        25000 per district per year
C.3.1   Alternative vaccine delivery    31500.00     31500.00       31500.00   31500.00     126000.00
        in NE States, Hilly terrains
        & geograhically from
        vaccine delivery point, river
        crossing etc.hard to reach
        areas in per month @ Rs.
        150 per session for 12
        months (70 Hard to Reach
        Area)
 3.2    Alternative Vaccine Deliery     452400.00    452400.00     452400.00   452400.00    1809600.00
        in other areas @ Rs. 100
        per session sites for
        Approx 14000 Session
        sites in a month & AVD for
        Urban Areas (1305 Sites
        per month)
C.4.1   Focus on slum &                 13000.00     13000.00       13000.00   13000.00      52000.00
        underserved areas in
        urban areas: (Total 130
        sites per Quarter)
C.4.2   Alternate vaccinators             0.00           0.00         0.00         0.00        0.00
        honorarium for urban @ Rs
        1400 per month for 12
        months for under served
        areas
C.5     Social Mobilization of          51600.00     51600.00       51600.00   51600.00     206400.00
        Children through ASHA/
        Link workers & paid
        mobilizers for Under
        served areas & Hard to
        Reach area @ Rs 200/-
        per month for mobilization
        (for 12 months)
C.6.2   Computer Assistants             36000.00     36000.00       36000.00   36000.00     144000.00
        support for District level @
        Rs.12000 per person per
        month for one computer
        assistant in each 1 districts
C.8.2   Quarterly review meetings        9000.00      9000.00       9000.00       9000.00    36000.00
        exclusive for RI at district
        level with one Block Mos,
        CDPO, and other stake
        holders @ Rs. 200 per
        participants for 5
        participants per PHCs 7




                                                    99
                                                DHS, Kishanganj


C.8.3    Quarterly review meetings        205200.00     205200.00   205200.00   205200.00    820800.00
         exclusive for RI at block
         level @ Rs. 100/- PP as
         honorarium for ASHAs and
         Rs. 50 per persons for
         meeting expenses for 1368
         ASHAs
C.9.1    District level orientation for    25000.00     25000.00    25000.00     25000.00    100000.00
         2 days for ANMs MPHW,
         LHV Health Assistants
         Nurse, Mid wife Bees and
         other
C.9.4    One day cold chain                12500.00     12500.00    12500.00     12500.00     50000.00
         handlers training for block
         level cold chain hadlers for
         7 + 1 Sadar Hosp. cold
         chain handlers
C.9.5    One day training of block         7500.00       7500.00     7500.00     7500.00      30000.00
         level data handlers for 7+1
         person.
C.10.1   To develop microplan at           15300.00          0.00     0.00         0.00       15300.00
         sub-centre level @ Rs
         100/- per sub - centre
C.10.2   For consolidation of                0.00            0.00     0.00       19000.00     19000.00
         microplans at block level
         @ Rs. 2000 per block/
         PHC(7) and at district level
         @ Rs. 5000 per district
         for1 districts.
C.11     POL for vaccine delivery          65500.00     65500.00    65500.00     65500.00    262000.00
         from State to district and
         from district to PHC/CHCs
         (@ Rs. 20000/- per
         WIC/WIF point & Rs.
         30000/- per Districts + Rs.
         10000/- for each PHC per
         year),
C.12     Consumables for computer          3000.00       3000.00     3000.00     3000.00      12000.00
         including provision for
         internet access for RIMs
         Rs. 1000 per month per
         district for 1districts.
C.13     1- Red & 1-Black plastic          47412.00          0.00     0.00         0.00       47412.00
         bags etc. @.Rs. 1.50 per
         session for 12 months
C.16     For major AEFI cases              15000.00     15000.00    15000.00     15000.00     60000.00
         investigation for every
         district in a year. @Rs
         1000/- for mobility in the
         field and @ 5000/- for
         specimen shipment to lab
         including travel cost,
         lodging & fooding etc.
               Total                      1108912.00    951200.00   951200.00   970200.00    3981512.00
 C.1     Pulse Polio Operating
         Costs
 C.3     Per Diem to Vaccinators @        1500000.00    750000.00   750000.00   1500000.00   4500000.00
         Rs. 75 per day per
         Vaccinators for actual
         working day


                                                       100
                                           DHS, Kishanganj


C.3   Per Diem to Supervisors @      250500.00     125250.00   125250.00    250500.00     751500.00
      Rs. 75 per day per
      Supervisors for actual
      working day
C.3   Per Diem to Cold chain          43500.00     21750.00     21750.00     43500.00     130500.00
      Handler per sub-depot 1.
      @ Rs. 75 per day for
      actual working day
C.3   3 vehicle per district HQ ad   450000.00     225000.00   225000.00    450000.00    1350000.00
      1 vehicle per sub-depot for
      5 days @ Rs. 1000 per
      vehicle per day (hiring with
      POL)
C.3   4 Ice packs Per                201400.00     100700.00   100700.00    201640.00     604440.00
      Vaccination
      Team/Supervisor & 20 Ice
      Packs per sub-depot/depot
      per day @ Rs. 3 per Ice
      Pack for 5 days & Rs.
      3000/ for HQ
C.3   Mobility Support to            334000.00     167000.00   167000.00    334000.00    1002000.00
      Supervisors @ Rs. 100 per
      day per supervisor for
      actual working day
C.3   Supplies & logistics @ Rs.      66700.00     33350.00     33350.00     66700.00     200100.00
      25 per team & per
      Supervisor for the whole
      activity period
C.3   IEC & Social Mobilization       17500.00      8750.00     8750.00      17500.00     52500.00
      @ Rs 350/- per 40 H- t-H
      Teams for 1 days
C.3   Contigency for Xerox,           34000.00     17000.00     17000.00     34000.00     102000.00
      Stationary etc. for Dist HQ
      Rs 3000/- & for each PHC
      @ Rs. 1750/- per areas for
      the Whole Activities period
C.3   Per Diem to Vaccin Cold         21750.00     10875.00     10875.00     21750.00     65250.00
      Chain Handler at Dist HQ 5
      person & at PHC 3 person
      (including 1 depotholder)
      @ Rs. 50 per person
C.3   Support to WIC for                0.00            0.00      0.00         0.00         0.00
      maintainance Vaccine
      transport from PHI Patna &
      PAYMENT OF PER DIEM
      TO @ VACCINE
      HANDLER @ RS. Per day
      for 7 days
C.3   Support to districts @ Rs.      20000.00     10000.00     10000.00     20000.00     60000.00
      2000 per dist & @ Rs 1000
      per PHC for lifting vaccine
      From WIC/ Districts
C.3   Total A Team Activity          2939350.00   1469675.00   1469675.00   2939590.00   8818290.00
C.3   Total B Team Activity          534846.00    267423.00    267423.00    534846.00    1604538.00
           Total                     3474196.00   1737098.00   1737098.00   3474436.00   10422828.00




                                                  101
                                                   DHS, Kishanganj



                                  NRHM-PART-D
                          First Quarterly Allocation 2011-12
                   National Vector Borne Disease Control Programme (NVBDCP)
FMR                                                                              Budget
Code                    Particulars                 Qrt 1            Qrt 2        Qrt 3       Qrt 4       Total
1      SFW (Rs. 145/- Per SFW x48 for 60
       days)                                         417600                  0            0           0    417600
2      FW (Rs 118/- per FWx240 for 60 days)         1699200                  0            0           0   1699200
3      Office Expenses (@ Rs 250/-per sqad x
       48)                                            12000                  0            0           0     12000
4      Contigency (@ Rs 250/-per sqad x 48)           12000                  0            0           0     12000
5      Transpotation of DDT, District to PHC
       (Rs. 2000/- per Aff. PHC x 7)                  14000                  0            0           0     14000
6      Transportation of DDT, PHC to Village
       (Rs. 1500/- per Aff. PHC x7 )                  10500                  0            0           0     10500
7      Spray equipments, Repair (Rs. 150/- per
       Sqad x 48)                                      7200                  0            0           0      7200
8      Purchase (Rs 800/- per sqad x 48)              38400                  0            0           0     38400
9      Block Level Task force meeting @ Rs.
       2500 x7                                        17500                  0            0           0     17500
10     Training     of      Registered   Medical
       Practitioners (25) @ Rs. 800/- about
       drug policy & case management of Kala-
       Azar patients.                                       0         20,000              0           0     20000
11     Training of Zila Parishad Member ( Per
       Dist. 18 Members) 1 day@ Rs. 500 x 18           9000                  0            0           0      9000
12     Training about         IEC/BCC of PRI
       Members(at least 10 ) @ Rs 500x10               5000                  0            0           0      5000
13     Training cost of ASHA, Case detection,
       IEC/BCC      activity,    IRS,  Complete
       treatment of Kala-Azar patients @ Rs.
       200x1368                                       68400            68400       68400        68400      273600
14     District Mobility for CS Vehicle @ Rs.
       10,000 per month for 2 month                  20,000                  0            0           0     20000
15     District Mobility for ACMO Vehicle @ Rs.
       10,000 per month for 2 month                  20,000                  0            0           0     20000
16     Distrcit Mobility for VBDC Vehicle @ Rs.
       10,000 per month for 2 month                  20,000                  0            0           0     20000
17     Mobility for PHC MO @ Rs. 650/day for
       2 month x 7                                  273,000                  0            0           0    273000
18     DA for Supervision @ Rs. 2000 Per
       Affected PHC x 7                               14000                  0            0           0     14000
19     IEC @ Rs 2000/- per Affected PHC per
       Round x 7                                      14000                  0            0           0     14000
20     Incentive ASHA (@Rs. 100/- per
       projected cases (240) for Complete
       Treatment.                                      6000             6000        6000         6000       24000
21     Loss of Wages Rs. 50/- for 30 days per
       Projected Case (240) During Treatment
       Period                                         90000            90000       90000        90000      360000
22     Strengthening of Bed (10 beds per
       effected PHC @ Rs. 1000/- Bed with
       Mattress x 7                                         0          70000              0           0     70000



                                                        102
                                                 DHS, Kishanganj


23   Mobility for ACMO for Max Rs. 10,000/-
     Per Month for 9 Month (excluding Spray
     period)                                        10000          20000    30000    30000     90000
24   Mobility for VBDC for Max Rs. 10,000/-
     Per Month for 9 Month (excluding Spray
     period)                                        10000          20000    30000    30000     90000
25   Mobility of MI Purchase of 1 Motorcycle
     per district @ Rs. 50,000/- per
     Motorcycle (Except 2 Motorcycle for
     Selected District)                             50000               0        0        0    50000
26   POL for Motorcycle @ 30 Liters Per
     Months @ Rs 58.03/- for 12 Months               5223            5223     5223     5223    20892
27   Emphoteracin Storage in District Level
     @ Rs. 500/- per month for 12 months             1500            1500     1500     1500      6000
28   Emphoteracin Storage in State Level @
     Rs. 1500/- per month for 12 months =Rs
     18,000/-                                            0              0        0        0         0
29   Treatment Card @ Rs 5.00 Per
     Treatment card for 2 Diff. Types of Each
     Card for Projected Case                         2400               0        0        0      2400
30   Register for line Listing record /Loss of
     Wages      record /ASHA Record/Drug
     Record @ Rs. 50/- for 4 Register Per Eff.
     PHC                                             1400               0        0        0      1400
31   Hiring of Warehouse at Dist Level for
     Storage of DDT @ Rs. 5000/- per Month
     for 12 Months                                  15000          15000    15000    15000     60000
32   Kalazar Search Programme (@ Rs.
     750/- Per PHC for 8 months(2 days in a
     month)                                         10500          10500    31500    31500     84000
33   Monthly Emoulment of KTS 6 KTS for 1
     Dist. @ Rs. 14,000/- per Month for 12
     months                                        252000          252000   252000   252000   1008000
34   Monthly Emoulment of VBDC. @ Rs.
     42,000/- per Month for 12 months              126000          126000   126000   126000   504000
35   Monthly Emoulment of D.E.O. @ Rs.
     9,100/- per Month for 12 months                27300          27300    27300    27300    109200
36   Monthly Emoulment of Logistic Asst. @
     Rs. 11,200/- per Month for 12 months           33600          33600    33600    33600    134400
37   IEC for visibility@10,000 per PHC x 7         70,000              0        0        0     70000
38   Special hoarding about IEC for migrant
     people at border block @ Rs 5000x5                  0         25000         0        0    25000
39   Training of LT (2) of Sentinel site @ Rs.
     600 about case detection                            0           1200        0        0      1200
40   Training of MO (2) of Sentinel site @ Rs.
     1000 about case detection                           0           2000        0        0      2000
41   Joint review meeting of KTS and LT @
     Rs. 1500 for 12 Month.                          4500            4500     4500     4500    18000
42   Training of MO for Treatment of Kala-
     Azar critical cases @ Rs1000x15                     0         15000         0        0    15000
43   Training (IEC/BCC, Critical Cases of
     Kala-Azar ) of Doctors of private Clinics
     Nursing Homes @ Rs, 1000 x at least 10         10000               0        0        0    10000




                                                      103
                                                    DHS, Kishanganj


44
       Internet connection @ Rs. 1000x for 12
       months with Modem facility @Rs. 3000,
       Anti-Virus software@ Rs. 2700, Fax
       machine @ Rs. 6000                              14700            3000       3000       3000       23700
45     Contingencies Office Expenditure @ Rs.
       15000 at District and @ Rs. 3000 x 7
       PHC                                              9000            9000       9000       9000       36000
                     Total                          3,420,923         825,223    733,023    733,023   5,712,192



                     National Leprosy Eridication Programme (NLEP)
FMR                                                                             Budget
Code                  Particulars                    Qrt 1         Qrt 2         Qrt 3      Qrt 4      Total
 G.1   Driver's Remuneration @ Rs 4500/- per        13500.00      13500.00      13500.00   13500.00
       month                                                                                          54000.00
G.2    Services through ASHA (performance            8000.00          8000.00    8000.00    8200.00
       based Incentive to ASHA @ Rs. 500/- for
       MB & Rs.300/- for PB)                                                                          32200.00
G.3    Sensitisation of ASHA (half day @ Rs.         3500.00          3500.00    3500.00    3500.00
       2800/- per Batch of 40 Participant) at
       district level                                                                                 14000.00
G.4    DLS(leprosy) for                              4500.00          4500.00    4500.00    4500.00
       rent,telephone,electricity, P & T charges,
       miscellaneous(includes Rs.500/- per
       month honarrium for Account work)@
       Rs.18000/- per district/ year                                                                  18000.00
G.5    Consumable Expenses (Stationery &             3500.00          3500.00    3500.00    3500.00
       etc.) @ Rs. 14000/- per year                                                                   14000.00
G.6    2 days modular training of new entant        24750.00             0.00       0.00       0.00
       Mos @ Rs. 24,750/- per Batch for 1
       batches                                                                                        24750.00
G.7    1 day Orientation training of MOs @ Rs.      11300.00             0.00       0.00       0.00
       11,300/- per Batch of 30 MOs for 1
       batches                                                                                        11300.00
G.8    Refreshal training for one day for Health     6320.00             0.00       0.00       0.00
       Supervisors/LHV/Pharmacists @ Rs.
       6320/- per batch of 30 for 1 batches                                                            6320.00
G.9    School Quiz @ Rs. 500/- per quiz (5 quiz      4300.00          4300.00    4300.00    4600.00
       per block for 7 PHCs / Blocks)                                                                 17500.00
G.10   Health Melas @ Rs. 4000/- per mela            4000.00             0.00       0.00       0.00
       (one health mela per district)                                                                  4000.00
G.11   Sensitization meetings with PRI              27755.00             0.00       0.00       0.00
       members @ Rs. 3965/- per meeting at 7
       PHC / block level                                                                              27755.00
G.12   Leprosy Day Function                          2500.00       2500.00       2500.00    2500.00   10000.00
G.13   Vehicle Operation / hiring, POL &            18700.00      18700.00      18700.00   18900.00
       Maintenance @ Rs. 75000/- per vehicle /
       district                                                                                       75000.00
G.14   Aids & appliances-Rs.7000/- per district                       2000.00    2500.00    2500.00    7000.00
G.15   Supportive medicines @ Rs. 25000/- per        6250.00          6250.00    6250.00    6250.00
       year                                                                                           25000.00
G.16   Laboratory reagents & equipments @            2960.00          2960.00    2960.00    2960.00
       Rs. 11840/- per year                                                                           11840.00
G.18   Urban LEPROCY CONTROL                        12500.00      12500.00      12500.00   12500.00
       Programme                                                                                      50000.00


                                                         104
                                                     DHS, Kishanganj


G.19   Review meetings and Travel Expenses             3000.00         3000.00       3000.00       3000.00      12000.00
                      Total                          157335.00      85210.00        85710.00      86410.00     414665.00



                                National Blindness Control Programme (NBCP)
FMR                                                                                 Budget
Code                    Particulars                    Qrt 1           Qrt 2         Qrt 3         Qrt 4        Total
       For vision Centre                                   0.00          0.00        50000.00          0.00      50000.00
       For Cataract Operation and School Eye         1200000.00    1200000.00      1200000.00    1200000.00    4800000.00
       Screening Program
       Recurring GIA to District Health Societies     166667.00     166667.00       166667.00     166667.00     666668.00

                      Total                         1366667.00    1366667.00      1416667.00    1366667.00    5516668.00



                      Revised National Tuberculosis Control Programme (RNTCP)
FMR                                                                                 Budget
Code                    Particulars                    Qrt 1           Qrt 2         Qrt 3         Qrt 4         Total
 I.1   Civil works                                     18750.00      18750.00        18750.00      18750.00     75000.00
 I.2   Laboratory materials                            62500.00      62500.00        62500.00      62500.00    250000.00
 I.3   Honorarium                                      81250.00      81250.00        81250.00      81250.00    325000.00
 I.4   IEC/ Publicity                                  45000.00      45000.00        45000.00      45000.00    180000.00
 I.5   Equipment maintenance                           10750.00      10750.00        10750.00      10750.00     43000.00
 I.6   Training                                        67750.00      67750.00        67750.00      67750.00    271000.00
 I.7   Vehicle maintenance                             18750.00      18750.00        18750.00      18750.00     75000.00
 I.8   Vehicle hiring                                  60000.00      60000.00        60000.00      60000.00    240000.00
 I.9   NGO/PP support                                      0.00          0.00            0.00          0.00          0.00
I.10   Miscellaneous                                   17500.00      17500.00        17500.00      17500.00     70000.00
I.11   Contractual services                           570250.00     570250.00       570250.00     570250.00   2281000.00
I.12   Printing                                        37500.00      37500.00        37500.00      37500.00    150000.00
I.13   Research and studies                                0.00          0.00            0.00          0.00          0.00
I.14   Medical Colleges                                    0.00          0.00            0.00          0.00          0.00
I.15   Procurement –vehicles                               0.00          0.00            0.00          0.00          0.00
I.16   Procurement – equipment                          5000.00       5000.00         5000.00       5000.00     20000.00
                      Total                          995000.00     995000.00       995000.00     995000.00    3980000.00



                                 Iodine Deficiency Disorder Programme (IDDP)
       Iodine Deficiency Disorder Programme                0.00        23640.00          0.00          0.00      23640.00

                      Total                                0.00     23640.00            0.00           0.00     23640.00



                                 Integrated Disease Survilience Project (IDSP)
 1.1   Epidemiologist(1)                               126000          126000        126000        126000        504000
 1.2   Dist.Data Manager(1)                             60000           60000         60000         60000        240000
 1.3   Data Entry Operator(1)                           36000           36000         36000         36000        144000
 2.1   training of Hospital Doctors                      3700            3700          3700          3900         15000
 2.2   Training of Hospital Pharmasist/Nurses            5000            5000          5000          5000         20000
       Training of Block Health Manager/Block
 2.3   Health Educator                                    1500            1500          1500          1500          6000
 2.4   Training of Data Entry Operators                   1800            1800          1800          2100          7500


                                                           105
                                                    DHS, Kishanganj


  3.1   Mobility Support                               30000          30000    30000    30000    120000
  3.2   Office Expenses                                18000          18000    18000    18000     72000
  3.3   ASHA Incentives for outbreak reporting          3000           3000     3000     3000     12000
  3.4   Consumables for District Lab                   25000          25000    25000    25000    100000
        Collection and Transportation of
  3.5   Samples                                        12500          12500    12500    12500     50000
  3.6   IDSP reports including alerts                    400            400      400      360      1560
  3.7   Printing of reporting forms                     5800           5800     5800     6000     23400
  3.8   Broadband expenses                              6000           6000     6000     6000     24000
3.9.1   Laptop,Photo copy(zerox) machine               20000          20000    20000    20000     80000
3.9.2   mobile and its expenses                         2500           2500     2500     2500     10000
        Social mobilization and intersectoral co-
  4.1   ordination                                      3700           3700     3700     3900     15000
  4.2   Integration of medical college                  3700           3700     3700     3900     15000
  4.3   Community based surveillance                   31200          31200    31200    31400    125000
  4.4   Case based study reports                        3000           3000     3000     3000     12000
    5   Contigency                                      5000           5000     5000     5000     20000
                      Total                           403800          403800   403800   405060   1616460




                                                         106

								
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