National Rural Health Mission ANNUAL ACTION PLAN by jfmKqDf

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									National Rural Health Mission
ANNUAL ACTION PLAN FOR 2008-09
   Proposed Activities and Budget


UTTARAKHAND
     Status of Health Indicators
                                      400     440
                                      350            300
70
                               59
60
                                      300
                                      250
50                                    200
                  36                  150
40
                                      100                   100
30       21                            50
20                                      0
10                                           2001 State Targ
0
                                                  Stat. et-
      NFHS-2    NFHS-3      Target-               dept 2012
                             2012
                                                   05
     Institutional Births                   Maternal Mortality
     Contd…

60              56       55
                                      3       2.6     2.55
50
       40                            2.5
40                                                             2.1
                                      2
30
                                     1.5
20                                    1
10                                   0.5
 0                                    0
     NFHS-2   NFHS-3   Target-
                        2012
                                            NFHS- NFHS- Target-
                                               2         3     2012
Contraceptive Use (Modern Methods)         Total Fertility Rate (TFR)
     Contd…

80                        75
                                  50      44      41
70               60
60                                40
50       41
                                  30                      28
40
30                                20
20
                                  10
10
0                                 0
      NFHS-2   NFHS-3   Target-
                         2012
                                        SRS-02 SRS - Target-
                                                  04     2012
     Child Immunization (Full)         Infant Mortality Rate (IMR)
Constraints
 Geographical terrain
 Low density of population in the hill districts
 Shortage of Manpower – ANMs, Staff Nurses, GDMOs and
  Specialists (especially for up-grading health centers to FRUs and
  24 X 7 units)
 Near absence of private providers in the hill districts
PROPOSAL FOR THE
      YEAR
     2008-09
Expenditure status- RCH Flexipool
(Rs. in lakhs)
    2500

    2000
                               Available GOI
    1500                       fund
                               Expenditure
    1000

    500                        Ex. expected
                               by 31/3/08
      0
           2005- 2006- 2007-
            06    07    08
Expenditure status- Mission Flexipool
(Rs. in lakhs)
     4000
     3500
     3000
     2500                       Funds
                                available
     2000
                                Expenditure
     1500
     1000                       Ex. Expected
      500                       by 31/3/08
        0
            2005- 2006- 2007-
             06    07    08
          NRHM – Summary Budget – 2008-09
                  (Rs. in Crores)
                                                2008-09(initial
Sl.              Activities          2007-08        proposal)     08-09 (revised)
      1   RCH - II                      25.14          42.46                  23.64
      2   NRHM                          45.76          69.74                  28.74
      3   Routine Immunization           3.01           3.77                   3.77
      4   IDSP                           2.85           1.32                   1.32
      5   NPCB                           2.25           3.05                   3.05
      6   RNTCP                          3.93           2.94                   2.94
      7   NLEP                           0.51           1.51                   1.51
      8   NVBDCP                         2.17           3.05                   3.05
   9      Deafness CP                                   0.65                   0.65
  10      IDD                                                                  0.18
                         Sub Total      92.98         128.42                  80.37
  11 AYUSH                               5.41            9.98                 9.98
  12 MNGO                                1.95             1.5                  1.5
                         Sub Total       7.36           10.13                 10.13
                                 GRAND TOTAL          138.55                  90.50
RCH FLEXI-POOL
    Maternal Health – 41.09 % of RCH AAP
Maternal Health                                                               Rs. In Lakhs


•   Contractual 120 Staff Nurses (@ Rs. 15000 per month)                            216.0
•   Advertisement in National Dailies for Staff Nurses and other paramedics           4.0
•   Organization of Sub Centre Days                                                  34.4
Integrated outreach RCH services
•   RCH camps                                                                        42.7
•   Implementation of Monthly VHNDs at Anganwadi Centres                            116.8
JSY (details of IEC/BCC in section 12)
•   Institutional deliveries (ID)                                                   500.0
Sub-total Maternal Health (excluding JSY) - 17.34 %                                 414.0
Sub-total JSY                                - 21.15 %                              500.0
    Maternal Health Contd….
Maternal Health Training
•   Training of 216 ANMs / LHVs in SBA                                                      15.6
•   Training of 13 Medical Officers in EmOC                                                 15.0
•   Training of 7 Medical Officers in life saving Anesthesia skills                          7.0
•   Training of 36 Medical Officers in safe abortions                                        3.2
Orientation of Dai / TBAs on safe delivery
•   TOT for DAI training                                                                     0.4
•   Training of DAI on Safe Delivery (@ Rs. 17,000 for a batch of 10 = 60 batches)          10.2
•   Dai kits to 600 dais @ Rs. 1000 approx./kit                                              6.0
                                                     Sub-total Maternal Health Training    57.40
                                     Grand Total                                          971.40
    Child Health – 12.45 % of RCH AAP
                                                                                       Rs. In Lakhs



•   Implementation of School Health Program (ANM twice a year @ Rs. 1000/visit for           112.9
    medicines)
•   Implementation of Infant and Young Child Feeding (IYCF) activities in districts.            1.9
•   Block level trainings on IYCF                                                               7.0
•   Contingency of State Immunization Officer                                                   0.6
•   Vaccine transportation from DWCS to BPHC/CHC                                              10.0
•   Vaccine transportation from State to DWCS                                                   1.0
•   POL for Gensets - 84 sites @ Rs. 6000                                                       5.0
•   Maintenance of Gensets - 84 sites @ Rs. 7500                                                6.3
•   Maintenance and POL of WIC at 3 sites @ Rs. 50000                                           1.5
    Promotion of breast feeding practice                                                       6.0

Sub-total Child Health                                                                       152.4
 Child Health                             Contd…


Child Health Training                                                                Rs. In Lakhs


IMNCI Training for 250 Medical Officers                                                       80.0
IMNCI Training for ANMs / LHVs                                                                  8.0
Training on FBNC for 26 Medical Officers at FRUs                                              15.6
Training on FBNC for SNs                                                                      23.4
Training of MOs of District Hospitals                                                           6.0
Training of SN of District Hospitals                                                            9.0
                                                   Sub-total Child Health Training          142.0

                                                                      Grand Total           294.4
     Family Planning – 11.07% of RCH AAP
FAMILY PLANNING                                                                             Rs. In
                                                                                           Lakhs

•   Organize NSV camps in districts.                                                                  13.0
•   Compensation of Sterilization Acceptance                                                         200.0
•   Transportation of FP commodities from State to Districts                                           0.7
•   Transportation of FP commodities from Districts to Blocks                                          1.6
•   Operational Expenses of Mobile Health Clinics in Tehri and Chamoli                                40.0
                                                              Sub-total Family Planning              255.4


Family Planning Training
Laparoscopic sterilization training for medical officers                                               0.9
Minilap training for medical officers                                                                  2.7
Contraceptive update/IUD Training                                                                      2.6
                                                      Sub-total Family Planning Training              6.2
                                        Grand Total                                                261.6
    ARSH – Urban Health - Innovations

ARSH                                               1.05 %
•    Sensitization workshops for PRI, ICDS, Edu., Health departments                     5.2
•    Health Camps in 10 districts (twice a year) (100 grps/distt.)                      20.0
                                                                     Sub-total ARSH     25.2
URBAN RCH                                         5.07%
•    Implementation of Urban RCH plan/ activities                                      123.6
INNOVATIONS/ PPP/ NGO                              0.76%
•    PNDT Campaign at State level                                                        7.0
•    PNDT Campaign at District level                                                     9.1
•    Two NGO experience sharing workshops on ARSH                                        2.0
                                                     Sub-total Innovations/ PPP/ NGO    18.1
    Infrastructure, HR and Institutional
    Strengthening
INFRASTRUCTURE AND HUMAN RESOURCES                               2.53 %                   Rs. In Lakhs


•   Performance based incentives to Specialists (40 spl./ month @ Rs. 4000/mnth)                   19.2
•   Honorarium for Part Time Dai - attached with existing 1765 Sub Centres                         21.1
•   Rent for Sub Centres (for 765 not in Govt. building)                                           22.9
INSTITUTIONAL STRENGTHENING                                     2.87%
•   Mobility Expenses to State RCH Officer                                                           2.4
•   Contingency Expenses to State RCH Officer                                                        1.8
•   Mobility Expenses at District RCH/NRHM Officer                                                 15.6
•   Contingency expense for District RCH/NRHM Officers                                               7.8
•   Monthly Review Meeting at State level                                                            1.8
•   Monthly Review Meeting at District level                                                         7.8
•   Quality Assurance interventions at State & Districts                                           30.0
•   Printing of Formats of reporting of RCH activities by ANM                                        1.0
                                                  Sub-total Institutional Strengthening            68.2
Training Activities (Other than M&CH and FP)
8.79% of RCH AAP

Strengthening of Training Institutions (SIHFW, ANMTCs, etc.)                               Rs. In Lakhs


•    Construction and Establishment of SIHFW at Haldwani                                            137.0


Programme Management and other Trainings
Training of SPMSU / DPMSU/ Block PMU staff                                                            10.0
Orientation of PRI members on NRHM and their roles/responsibilities                                   45.0
Two days TOT of MOs on NRHM at State level (@ Rs 1200/ person per day)                                    0.8
Two days district wise training of MOs on NRHM (@ Rs 1200 / person per day)                           15.1

                                                                      Sub-total Training           70.90
                                                                         Grand Total            207.90
 BCC/IEC and Procurement
BCC / IEC                                          7.99 %                           Rs. In Lakhs


BCC/IEC activities for MH intervention (except JSY)                                           61.0
BCC/IEC activities for JSY                                                                    92.4
BCC/IEC activities/campaigns for child health                                                 21.1
BCC/IEC activities/campaigns for family planning                                               6.1
BCC/IEC activities/campaigns for ARSH                                                          5.6
Periodical on NRHM                                                                             3.0
Sub-total BCC/ IEC                                                                          189.3
PROCUREMENT                                        0.50%
Repair/procurement of Laparoscopes / Laprocators                                               9.0
Procurement of IUD kits                                                                        3.7
                                                            Sub-total Procurement             12.7
 Program Management - 5.79%
                                                                             Rs. In Lakhs
Program Management
Salary of SPMSU Staff                                                                       8.0
Mobility expenses of SPMSU Staff                                                            2.4
Contingency expenses of SPMSU Staff                                                         1.4
Salary of DPMSU Staff                                                                   57.7
Mobility expenses of DPMSU Staff                                                        23.4
Contingency expenses of DPMSU Staff                                                     18.7
Annual audit of the programme                                                               5.0
Concurrent audit                                                                        15.0
Salary of SNGOC                                                                             3.1
TA/DA of SNGOC                                                                              1.2
RCH - Finance Assistant with Computer Knowledge                                             0.9
                                                  Total Program Management            137.0
NRHM ADDITIONALITIES
NRHM Additionalities
                                                                       Rs. In lakhs

                                                                        Total
Sl                          Head                        Unit   Rate
                                                                       amount
1. ASHA
     Training of Vth Module
     Travel - (post training) to PHC or health centre   1000   10000        100.0


     ASHA Resource Centre
     ASHA Drug Kits (9850 kits @ Rs. 1000/kit)          9850    1000         98.5
 NRHM Add.Contd…
                                                                             Rs. In lakhs

2.   Salary of Contractual ANMs In difficult terrain areas   200    90000       180.0

     AMG to 500 Sub Centre                                   500    10000         50.0

     Untied funds for 1765 Sub Centre                        1765   10000       176.5

     Untied fund for 229 PHCs                                229    25000         57.2

3. AMG fund for 100 PHCs                                     100    50000         50.0

     Untied funds for 52 CHC                                 52     50000         26.0

     AMG fund for 52 CHCs                                    52     100000        52.0

     VHSC – 3614 panchayats / villages                       3614   10000       361.4
  NRHM Addl. Contd…
Sl.                           Head                  Unit   Rate      Amount

      Drug Kits for Health Institutions
4. SC kits for 1765 (Kit A &, Kit B)                1765     5000       88.2
      The cost of STI/RTI kits (PHC 229 & CHC 52)   281     15000       42.1

5. ANMTCs (additional) under PPP mode                2     2500000      50.0
 NRHM Addl. Contd…
                                                              Rs. In lakhs

Sl.                     Head                  Unit   Rate     Amount

6.    Health Resource Centre                                         10.0

7.    Allowance for ANMs traversing on Foot   3300     360           11.8

8.    Recharging of Mobile Phones to ANMs     1614    2760           44.5

9.    Salary of ANMTC tutor on contract       12     144000          14.4

10.   Emergency Transport Services                                 1030.0

11.   Procurement & Logistics Supply                                120.0
          management systems
      NRHM Addl. Contd…

Sl.    Head                                           Unit   Rate       Amount

12.    Microbiologist – IDSP (@ Rs. 20,000/ month)    1      240000     2.4

13.    Block PMU (Salary, Mobility and Contingency)   84     120000     100.8

14.    Training of AYUSH Medical Officers                               7.5

15.    Construction of ANMTC - DDN                    1      20400000   204.0

                                                             TOTAL      28.74
       Activities proposed to be continued from the un-spent
              funds of NRHM available at State Level
                           (Rs. In Lakhs)
Sl.                  Name of the Activity             Unit   Rate         Total amount
 I     Seed Money to 16 District Hospitals             16      500000              80.0
 II    Seed Money to 12 Sub District Hospitals         12      100000              12.0
III    Seed Money to 51 CHCs                           51      100000              51.0
IV     Allowance for ANMs traversing on Foot          3300          360            11.8
 V     Up-gradation of 10 CHCs to 24 X 7 (IPHS)        10     1000000             100.0
VI     Up-gradation of 7 District Hospitals to IPHS    7      2000000             140.0
VII    Transit Homes                                   4       120000               4.8
VIII   GNMTC Nainital - Renovation                           13200000             132.0
IX     ANMTC Pithoragarh - Renovation                         3000000              30.0
 X     Concurrent Monitoring                                  2000000              20.0
XI     Computerization and E-Health                           5000000              50.0
XII    Public Health Manual - Upgradation                     1000000              10.0
XIII   Mobile Medical Units                                  50800000             508.0
                                                               TOTAL             1149.6
      Approved activities in 2007-08 not implemented and
                         to be dropped
                         (Rs. in Lakhs)

Sl.                                  Head     Total amount

 I    Satellite Telephone
                                                       20.0
II    Increase in Rent of PHC
                                                       33.0
III   Study on Nutritional Status
                                                       10.0
IV    Establishment of Call Centre
                                                       31.9

                                                       94.9
State contribution to NRHM activities
(AAP for RCH+Mission flex, as presented to GOI=52.38
crores)

Head                                                             Unit          Rate                 Total amount


Construction of New Sub Centres as per IPHS standards                   294           1164965.986        342500000


Constructiin of New PHCs as per IPHS standards                            5              4000000          20000000


Establishment of New PHCs                                                26               451462          11738000


Establishment of Sub centres (Satellite Sub Centres)                    453                16289           7379000


Construction and Renovation of New ANMTCs                                 2              4000000           8000000


Establishment of New ANMTCs                                               2              5000000          10000000


Up-gradation of Sub Centers as per IPHS                                 200               160000          32000000


Extra honorarium (Rs. 400) to Dai at Sub Centre                         1765                4800           8472000


Clinical training for Medical and Paramedical Staff (proposed)                                             3000000


                                                                                                         443089000
     Issues
 Rs. 3 crores required in RCH flexipool to cover all program
    liabilities as of 31/3/08.
   State has increased its spending many times in 2008-09. The
    allocation for next year should be increased to provide
    adequately for proposed activities.
   JSY beneficiaries have gone up to 55000 in 2008-09. Additional
    funds will be required next year for JSY (about 10 crores).
   Sterilization compensation money earmarked for 2008-09 is Rs.
    2 Cr. With enhanced compensation rates, extra allocation of
    about 3 crores would be required.
   Family Planning division has to issue the consent for new
    subcenters under 11th plan (as per 2001 census).
Thank you

								
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