Minutes_Rajasthan by keralaguest

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									                           MINUTES OF THE SUB GROUP MEETING

Date: 2-2-2010
Venue: Conference Hall, DMHS, Swasthya Bhawan,Jaipur


Welcome
The subcommittee meeting started with a Welcome note by MD NRHM Rajasthan Mr. Bhawani
Singh Detha.

The meeting was presided by Joint Secretary, MOHFW,GOI Mr. R.S.Shukla
Later on Principal Secretary Health Rajasthan, Mr.G.S.Sandhu joined in.


       Mr. R.S.Shukla, Joint Secretary,MOHFW,GOI
       Informed that he had a discussion with Secretary Finance for increasing the salary of
       specialist from 40,000 to 60,000 and the file for this regard have already been moved..
       Based on his recent field visit in the last 3 days, he shared his experiences .Drawing
       attention on JSY break up he advised the CMOs/DPMs to observe data more closely and
       try and figure out the ratio of BPL deliveries among the total institutional ones, he
       quoted example of the state ghee scheme, which is applicable to the first child born
       among BPL and so the subsection of the subsection was very small and so impacts have
       to be measured. Thus to make a difference this target audience had to be captured. A
       CMO should be able to guide his team, to reach such people and design BPL specific
       strategies.
       He also had a query that how much load can a CHC actually carter to interms of
       institutional deliveries.
       His next concern was regarding ASHA functioning. As this is the only state that pays a
       sum assured of Rs 500+400 approx to an ASHA. Thus it should be assured that she
       should perform a particular minimum set of activities irrespective of the fact if she is
       getting incentive for it or not, based on the health profile of that area. They need to be
       trained in vertical disease control programs also if it is a known priority in the area it
       needs to be focused more. Giving example of leprosy he reiterated the fact that they
       need to have basic understanding of local public health problems.
       The supervisory structure of ASHA should be working in tandem with the Health staff so
       that coordination and the MO, and supervisory staff should know what each one is
       doing.
       Subcentre conducting need to be prioritised and strengthened based on work load and
       location.
Presentations
Part A-RCH Program -Director RCH, Govt of Rajasthan
Part B-NRHM Additionalities-Mr Bhawani Singh Detha, MD NRHM, Govt of Rajasthan
District Health Plan- Barmer

Detailed Minutes and Comments

Sl       Observations                               Comments
Part A   RCH
         Maternal Health
         Dr Sikdar Asst Commissioner Family
         Planning, MOHFW,GOI had also been to
         field recently and had certain
         observations to share especially with
         regard to the institutional delivery.
         Certain institutions are performing 200-
         300 Normal deliveries but no caesarean
         or 1-2% CS despite having FRU facility.
         Fatehpur even when declared an FRU
         has no BSU, similarly Lakshmangarh has
         no gynaecologist.

         Dr Anil Agarawal, Unicef                   Ensure SBAs in CHC and PHCs
                                                    At least ensure basic services like
                                                    partograph , SBA at PHC

                                                    Focus should be on monitoring.

         UNFPA Dr Sunil Thomas                      Dai training not approved under GOI
         Maternal health Initiative deliveries
         increased by 70% . Rajasthan have
         promoted evidence based practice - use
         of partograph
                                                    Rs 1400 given for ID to be varied
         Dr. Sangeeta, Assistant Commissioner,
         Child Health, MOHFW, GOI                   according to the kind of institution.
                                                    Difference in incentive between
                                                    normal, C-section, babies with low
                                                    birth weight.

         Dr.Iyengar, ARTH                           Focus on BEMOC operationalisation
         Quality of care is decreasing because      Labor rooms to be constructed,
         of increase in numbers.                    equipments to be purchased.
         Number of still births, neonatal           If stay is increased up to 48 hrs so
         deaths should be monitored.                better stay arrangement s/ premises
Number of MTP cases reported is                are required,
going down; at least 1 facility per            Hypothermia cases to be looked
block should report MTP.                       upon(proper provision to be made for
                                               new born to prevent them from
                                               hypothermia)

Child Health
Dr Sikdar
At the MTC at Sikar child is kept for just 1
week instead of 2 week,to which Asst
Commissioner DC division added that
children coming to these MTCs are not
grade III and IV malnourished but
relatively healthy ones.                       Director RCH Govt of Rajasthan replied
Dr Sangeeta Saxena asked about                 that they are providing Iron and B-
Nutritional supplement given in Mid day        complex tablets as supplements in school
meal in school by department of health         and nothing else.

Dr Avtaar Singh Dua ,unicef
There is decrease in neonatal mortality
rate in Urban areas but there is no
decrease in neonatal mortality rate in
the rural areas during the last few years
Although new born stabilizing unit have
been established the awareness of same
have to be spreaded

A matter of concern is the OPV
vaccination rate is less than DPT
vaccination rate although there is
contraindication for DPT Vaccine but no
contraindication for OPV vaccine
In routine Immunization missing children
and drop outs to be addressed

Dr. Sangeeta, Assistant Commissioner,          Looking at total number as a whole in
Child Health, MOHFW, GOI                       IMNCI that is 17000 looks large but in
                                               how many years should be what
She acknowledged the fact that                 needs o be observed, secondly the
Rajasthan is the only state to start           denominator is very large and cannot
SNUs, NRC                                      be overlooked by state.
                                               Incentive should be over and above a
                                               level of normal performance of a
                                               person and not without riders.
                                               She raised her objection to selection
                                               criteria of children coming to NRC on
                                       top paying Rs 100/- to mothers didn’t
                                       seem an appealing idea to her to
                                       which additional director RCH replied
                                       that this is wage compensation to
                                       mother who loses her wages from
                                       NAREGA .The Rs 30/-given earlier did
                                       not attract mother .On which she said
                                       that it may become a resource
                                       generation activity, but the UNICEF
                                       replied that it was not so . Follow up of
                                       these children was her other concern.

                                       Yashoda evaluation has not been
                                       favorable and so scaling up was not
                                       good idea and secondly what happens
                                       after NIPI funding over.
                                       Dai can help in reduction of neonatal
                                       mortality, post natal care

Dr Iyengar, Arth                       Supporting transport of new born up
                                       to district and back
                                       Support transport for SNCU cases
                                       SBA training to include neonatal care.

Family Planning
   Dr. Sikdar

Population stabilization what are the Director RCH replied plan have been laid
structure and policies in place.      on basis of three major indicators ,MMR
                                      ,IMR and Population stabilization policy
Called Rajasthan as receptive and 2002 which became defunct but will take
responsive state                      three months to role down Performance
                                        needs to be scaled up
Fund utilization is 90% in NRHM         FP- strategies are well planned
HRD-understaffing is an issue           Fixed day strategy needs detailed
                                        break up
Training plan needs to be developed 80 lakhs for social marketing needs
properly. Also place of posting in case detailed breakup
of doctors should be specified before NSV- mega camp is no longer a
the training                            terminology it is only camps

Quality assurance- quality check up of Proposal for Creation of NSV Resource
sterilization cases(loss of insurance centre to be incorporated in PIP
cases, many failures)
                                       Spending too much on NSV camps is
Insurance issue needs to be resolved. not useful
Compensations very heavy as
hospital reporting failure due to poor Relocate the budget for POL in
choice of patient. Women with even NSV(delinked from volume)
3 months of pregnancy are being Rs.50 should be given to ASHA (as
entertained                            blanket policy) to ensure the retention
                                       of IUD after getting it ensured by ANM
                                       Break up for Rs 500/- case IUD to be
                                       provided by state.

                                       Milan Baithaks- last year only 9000
   Dr.Iyengar, ARTH
                                       happened how it can be up scaled to
                                       40,000 baithaks in a year- justification
                                       is required.

                                       For laparoscopic instruments ,AMC
                                       should be done for 3 years
                                       F&P supply – Rs.7 crore- justification
                                       needed.
                                       Use of miscellaneous budget

                                       NVA kits are costly so medical abortion
                                       kits should be procured at state level
                                       and given t the needy.
                                       Post partum IUD insertion with the
                                       consent of females

ARSH                                   AFHS should focus on both adolescent
Dr Iyengar                             girls- married and unmarried
                                       Social marketing of sanitary napkins-
                                       Unclean menstrual practices have not
                                       been known to be associated with
                                       RTI/STI
                                       Sanitary napkins are needed for dignity
                                       , empowerment of women
                                       To see the sustainability of the scheme
                                       in long term scenario (Social marketing
                                       of sanitary napkins) if P&G is not the
                                       partner
HR
Dr Sikdar
It was also observed in the field that a
subcentre with two ANMs instead of
dividing their area of field work they
have divided the days and bot come for 3
days each.
HRD-understaffing is an issue

JS(RS)
His second concern was a large fleet of
AYUSH doctors working in far flung areas
and their mainstreaming in true sense
into NRHM.AYUSH drug for Anemia not
getting dispersed because allopathic
doctors     were    not    having    the
information.Hence within institution
sensitization for use of such drugs and
availability should be ensured in the
system. Similarly in Rajasthan Ayurveda
may be explored to address some issues
in NCD.

Dr Anil Agarawal, Unicef
Incentives to specialist working in that
Barmer

JS.                                        Advised to employ more additional ANMs
                                           in backward area
Trainings

Dr Avtaar Singh Dua ,unicef                Training of health worker should be
                                           expedited


Dr Mathai,NIHFW
                                           Comprehensive training plan is necessary
Training component is lacking
                                           How     many     people        should   be
Training program have not been trained?What is the plan for training?Who
integrated                                 all will be trained?What is the
What will be the interdistrict variations? capacity?Who all will be left out and why?
Developing district based training plans
                                           Training plan needs to be developed
                                           properly. Also place of posting in case
                                           of doctors should be specified before
                                           the training
                                          Training: Need for increase in the
                                          faculty skills-faculty development
Dr Sikdar                                 Program.MO s trained in LSAS have a
                                          problem in practice? The equipments
                                          used in Medical colleges are different
                                          from those in districts and hence
                                          hands on at district level are a
                                          requirement.

Mr.Gautam, NHSRC                          Quality and Impact Evaluation that is a
                                          third party evaluation is required
                                          Old curriculum for ANM needs
                                          revision.

Monitoring and Supervision
Dr Sikdar
Joint director and all other officials -PIP must specify supervisory structure
should be involved in Monitoring and procedure /program till sub-centre level
Evaluation
                                       Who will be supervisory person?
    Joint secretary                    Whom they will supervise
                                       Frequency of supervision whether
                                       monthly or weekly
                                       Which program officers will be looking
                                       into it?
                                       Structure/ personal / protocol /check list
                                       and guidelines for supervision
                                       Supervision to be part of PIP

                                          Ensure it has been used rightly. Ensure
                                          whether Doctors are going on the field or
                                          not.
NIPI ,Dr SP Yadav
Mobility is a very important component.
Monitoring and supervision depends
upon sector medical officer. There is a
need for a sector medical officer for
effective monitoring and supervision

HMIS,PROMIS
Dr Sikdar
HMIS- discrepancy in data needs to
be improved and use of HMIS for
district planning needs to be ensured
                                             Annual & quarterly data needs to be
HMIS-Ms Gurpreet, Statistics                 updated
                                             Mobility support is a good initiative
                                             Online tracking system needs to be
                                             stabilized
                                             SHSRC proposed to conduct a
                                             workshop but details not clear
                                             Duplication of studies by SHSRC so
                                             clarification needed
                                             Data needs to be uploaded and
                                             updated regularly.
                                             State MIS needs to be compatible with
                                             national HMIS
                                             15 high focus district –budget to be
                                             allocated
     Mr.Gautam, NHSRC
                                             MIS: Form C to E at all levels are
                                             present in state and can be
                                             incorporated with the HMIS

                                             Logistics: Stockouts –timing and
                                             quantity of indents have to be taken
                                             care of hence pharmacists and
JS                                           storekeepers need to be trained.
Formats have been developed but
not disseminated to districts
VBD data is being delayed

Program Management Unit                      Strengthening of SPMU DPMU needs
Ms Mona Gupta,TMSA                           to be done. Also salaries to be
                                             increased

Infrastructure                               Rationalization of the institutions needs to
NIPI ,Dr SP Yadav                            be done (there are sub centers at 500 and
                                             7000 population)


IEC/BCC                                      State should make use of the rich resource
JS                                           they have and should use funds allotted
The third major concern was IEC on           under IEC as a whole by various
which the Js observation in field was that   departments from RCH to disease control
Rajasthan had good IEC material              coming together.
available but the wall paintings only
shoed JSY and TB slogans posted on           IEC to be aimed at KAPB
them.                                        IEC for RI should be planned
                                            Instead of spreading further we should
    Dr Avtaar Singh Dua ,UNICEF             focus on improving the IEC activities

                                            NIPI has provided money to state for
    Dr SP Yadav, NIPI                       slogans writing toIECdivision of the state
                                            but no slogans have been received yet

    Director IEC, Govt of Rajasthan
    All IEC is based on VCD
    VCD is designed such as to have open
    discussion

    Training of IEC Coordinator taken up
    based on area specific public health
    need

    Workshops to be organized at state,
    district, divisional level

    Area wise IEC to be planned.
    Modes of IEC- mass media, traditional
    media, folk media, Gram Swasthya
    Yojana , as village panchayat due to
    good sanitation conditions are also
    promoted

    Mr Iyengar, ARTH                        Advised the state that if the state is
                                            adopting sanitary napkin strategy of P&G
                                            it is in lieu providing free IEC worth lakhs
                                            to the company and hence on some
                                            occasion media may point out these.
B   NRHM Additionalities                    ASHA Sahyogini is a very important link
    ASHA                                    Strengthen counseling of ASHA’s
    Consultant ,Care                        Involvement of ASHA


                                            Training of ASHA in leprosy has not been
       Dr Sinha, TB Consultant              carried out
                                            The central government has issued a
       Dr Thorat, Asst. Dept of Leprosy     manual for ASHA training in Leprosy but
                                            the same has not yet been started
                                              JMC can be used for similar functions.

Dr Anil Agarwal, UNICEF

In Barmer due to qualification being a
barrier even when level of educational
qualification lowered down for particular
district getting daughter in law as ASHA
is not possible in most of the areas

Consultant ASHA
Backlogs in training are too much

RKS/Untied Fund/AMG

Mr Sikdar also shared his observation         Replying to this Director RCH Govt of
regarding untied fund in which he             Rajasthan said that the rest of the rest of
observed that PHC was receiving .75 lacs      the money was going through MMJRK
as compared to 1.25 lacs fixed,CHC it is      route and was being used for same
1.25 lacs as compared to 2.5 lacs fixed.      purpose as conceptualized plan but in an
                                              organized way.On which Mr Sikdar asked
                                              him to seek GOI permission as all untied
                                              funds / RKS should be directly given to the
                                              institutions.

        VHSC
Mr Iyengar
Robust strategy required for VHSC

Consultant VHSC
Help of NHSRC to implement
program properly and organize a
workshop
Quality assurance                             Assessment of Institutions, Quality
UNFPA Dr Sunil Thomas                         Assurance lacking infrastructure ,services
                                              and feedback to provide improvement

MMU/EMRI                                      MMU/EMRI apex separate sanction may
Mr. Anil Garg ,FMG                            be taken.

District/Block Plan
Dr Avtaar Singh Dua ,UNICEF

Process of planning is better as it goes to   Dist needs support in block level plans
block level                                   Use of data locally needs to improve
                                             Proper implementation of village
    Consultant VHSC                          health plans
    PIP process is changed a lot in last 4-5 Help of NHSRC to implement program
    years. Its been intensive process        properly and organize a workshop

                                                  Resource mapping to be done
    NIHFW, Dr. T. Mathiyazhgan                    SWOT should be done

                                                  Providers mapping still to be taken fully by
                                                  all backward districts.
    Dr Anuradha Jain ,Consultant Planning ,
    NHSRC
    Distance mapping done for Barmer and
    Jaisalmer to rationalize ,service delivery,
    HR,MMU movement and identifying hard
    to reach villages and subcentre, PHC
    based on distances which was one of the
    parameters
    Difficult area mapping done by all 15
    districts.

C           Immunization

    Mr. R.S.Shukla,Joint Secretary,               .On which the JS cautioned the state and
    MOHFW,GOI enquired on the actual              district not to entertain such data and take
    rates of measles immunization in Barmer       due corrective methods as their demand
    to which the DPM replied that even            for vaccines from GOI is on this data and
    though the reports claim it to be 90% the     this leads to further vaccine wastage.
    exact situation is only 50%
                                                  A matter of concern is the OPV
    Dr Avtaar Singh Dua ,UNICEF                   vaccination rate is less than DPT
                                                  vaccination rate although there is
                                                  contraindication for DPT Vaccine but no
                                                  contraindication for OPV vaccine
                                                  In routine Immunization missing children
                                                  and drop outs to be addressed
                                                  Operational plan to be formulated
                                                  IEC for RI should be planned

D            Disease Control Program              Improving the supervision and monitoring,
             RNTCP                                training should be initiated and facilities
         Dr Sinha, TB Consultant                  like sputum microscopy, lab technician
    8 districts are poor performing –             should be improved.
    jaisalmer,barmer,Nagaur,Sikar,Jhunjhunu       Involvement of ASHA and the IEC
                                                  Additional lab in Jodhpur (3rd lab under
                                                  NRHM needed
NLEP                                      There are no centres for rehabilitation of
Dr Thorat, Asst. Deputy Director          leprosy related disability cases
General Leprosy                           State has not recognized any Government
Whether the endemicity is low or the center for doing surgery .Incentive is
activities have been slowed down is not Rs5000 per case
clear                                     In PIP write up part on leprosy is missing.
                                          The situational analysis of highlighting
The cases are not being diagnosed leprosy is not there. Random sampling
because of the slowing of the activities. needs to be done.
The treatment completion rate is less 29 posts of DLO is vacant
than 80% in Rajasthan whereas National Training of ASHA in leprosy has not been
is 92%                                    carried out
                                          The central government has issued a
                                          manual for ASHA training in Leprosy but
                                          the same has not yet been started
                                          There is no mention of leprosy colonies
                                          .There are 10-15 colonies in Rajasthan in
                                          which around 500 people are residing
                                          The supporting facilities and medicines is
                                          not mentioned in the program
                                          There is no proposal of providing
                                          incentives to ASHA
                                          Training need assessment needs to be
                                          carried out and this should be reflected in
                                          PIP
                                          In certain component the budget is on
                                          higher side and needs to be scaled down
                                          In case of training and rehabilitation
                                          budget is not carried as per the norms
                                          Proposed budget is 250 lacs which needs
                                          to be reduced to 150-160 lacs
                                          In this financial year till now 117 lacs was
                                          released and 107 lacs was utilized
                                          The hidden cases is a real cause of concern
                                          .A study in UP conducted recently was a
                                          wake up call and more aggressive case
                                          detection and eradication is required

        NVDCP
NVBDCP                                     Wages should be adequately provided.
2Apex labs in Medical colleges. Dengue     Timing is very important .Micro plan
and Chikungunya Area have already been     should be prepared and its activity and
decided but referral labs have not been    gaps should be identified.
set up.
                                           Supervisory microplan to be part of PIP
JS                                         Hindustan Insecticide Limited (HIL) may be
                                           the possibility for purchasing DDT,
                                           Parathion -Dr Sharma of to be contacted.
E          Convergence

    Dr Avtaar Singh Dua ,unicef                Only one CDPO post is filled other
                                               positions are vacant in Barmer
                                               At district level, a core group to be
                                               formed to supervise Maternal Health,
    Consultant CARE                            Child Health- to have better
                                               convergence between Department of
                                               ICDS & Health
       Principal Health Secretary, Govt of
       Rajasthan
    Lot of convergence should take place
    between departments like ICDS,
    WCD, Social Welfare Dept. to have
    better results
                                               Salary of AYUSH doctor is less than
    AYUSH                                      Allopathic doctor and both should be
    ,Dept of AYUSH                             graded same.

    JS
    His second concern was a large fleet of
    AYUSH doctors working in far flung areas
    and their mainstreaming in true sense
    into NRHM.AYUSH drug for Anemia not
    getting dispersed because allopathic
    doctors     were    not    having    the
    information.Hence within institution
    sensitization for use of such drugs and
    availability should be ensured in the
    system. Similarly in Rajasthan Ayurveda
    may be explored to address some issues
    in NCD.

       Principal Health Secretary, Govt of
       Rajasthan
    Mainstreaming of AYUSH doctors,
    role of AYUSH doctors has to be
    widened
    FMG
      Anil Garg, Finance MoHFW

    SHS earned 9.32 crores in last year as
    interest. No mention of this in ROP
    Uploading of FMR done in monthly
    basis
Quarterly FMR is not yet sent to
MoHFW

Accounting system to be developed
on tally system

Summary of advances can be done,
how it can be settled

Statutory audit- only 1 auditor needs
to be appointed for whole program
and all districts

E-transfer of funds to be done
Strengthening of accounts/finance, to
be given preference in presentation

State government          should give
expenditure details of civil works How
much work have been finished and
amount spent clearance from architect
may be taken and UC booked and how
much work is under progress amount
booked for the same.
                                          Districts are being provided fund activity
Dr Sikdar,Asst Comm ,FP                   wise , but this should be stopped and
Division,MOHFW,GOI                        lumpsum amount may be given. To this
                                          director RCH , Govt of Rajasthan replied
                                          that this was their till last year but is not
                                          being followed this financial year.
                                          Salary of AYUSH doctor is less than
                                          Allopathic doctor and both should be
                                          graded same.


                                          Formats for providing details of FRUs,
                                          24x7PHCs, Trainings, etc.; to be
                                          incorporated as annex to the existing PIP.

Others
   Mona Gupta
Barriers are not looked upon
Targets set are very ambitious so
realistic targets needs to be set up
Details of urban, tribal health missing
Annexure are missing (A,B,C,D,E,F)
                A quarterly work plan along with the
                budget should be set

                Mr Iyengar
                Civil registration of birth & death
                needs to be done
                No provision like PF, gratuity for the
                NRHM staff



Major points raised in the Sub Committee meeting for the state of Rajasthan to incorporate
in their PIP:

   a. The proposed PIP for 2010-11 (by major components - A, B, C, D) should not exceed more that
       25% of the approved PIP for 2009-10. Any additional budget proposed (like say for MMJRK,
       MMUs at Block level, etc.) may be annexed separately as demands over and above the proposed
       PIP for 2010-11. If and when the approvals come for these additional components, it'll be over
       and above the PIP.

   b. The state needs to prepare a detailed list of the following:
         i. FRUs – facility details of key infrastructure, manpower, workload
        ii. 24x7 PHCs – facility details of key infrastructure, manpower, workload
       iii. Trainings – details of trainees and training facilities
       iv. 15 high focus districts – special requirements, need based strategies

   c. Details of monitoring and supervision structure from state to PHC level

   d. Any increase proposed in civil works, procurement and trainings may first address the
      backlog of the previous years, and only after ensuring completion of the backlog, new
      plan may be proposed.
List of Participants for the Sub Committee meeting on February 2, 2010 at Jaipur, Rajasthan

S.no      Name                         Designation
          Sh.Bhawani Singh Detha       MD, NRHM
          Dr. O P Gupta                Director (PH)
    1     R.M.L. Jain                  Dons (RCH)
    2     B.Praveen                    Director, ICDS
    3     Dr.Sangeeta G.Sexena         Asst.Commissioner (Child Heath)
    4     DR.S.K.Sikdar                AC (FPI)
    5     Anil Garg                    F.C., NRHAM-Fin
    6     Dr.Sharad
    7     Hena Gupta                   TMSA, RCH
    8     Sukhvinder Kuar              Stats Div, MOHFW
    9     H.R.Yadev                    Dy.Director, RO Officer Jaipur
   10     Mr.Gautam Chakraborty        Sr.Counsultant, NHSRC
   11     Dr.Anurdha Jain              Consultant, NHSRC
   12     Vaidehi Agnihotri
   13     Dr.Manik Relan               Intern, NRHM
   14     Dr.Divya Persai              Intern, NRHM
   15     D.P_______                   Consultant MM BP
   16     Poonam Bhargara              Co-IEC, NRHM
   17     Surbhi Bhardwaj              TL,SARC
   18     Poonam Kulshrestha           (JMC-CO)
   19     Jyothi Srivastwa             (JMC-CO)
   20     Dr.P.C.Ramka                 AD (HR)
   21     Dr.Indra Gupta
   22     Dr.K.K.Kanonya
   23     Vaisla Tam                   CO-IMNCI & BPL
   24     Biyanka Kapoor
   25     Dr.D.M.Thorat                ADG
   26     Dr.S.P.Yadav                 Sr.Pgro officer
   27     Avtar Singh                  Health Speclist
   28     Dr.Atul Aggarwal             SPO-NIPI
   29     Pradeep Choudhay             DEO NRHM
   30     Hemant Acharya               WHO-RNTP Counsultant, Noodal Officer
   31     J.P.Jat                      STO
   32     Dr.S.K.Sinha
   33     Dr.K.N Gupta
   34     Dr.P.C..Dhamoder             AD (AYUSH)
   35     Dr.Survesh Kumar
   36     Dr.G.S.Sharma                Counsultant
37   Dr.T.Maltiryazhagan
38   Deepti Georg
39   Kamlesh Bansal              DPM,Barmer
40   Dr. G.S.Charan              Dy.CM&HO
41   Dr. Navodra Kudajya         DO (FW)
42    Dr. Naresh Kumar           State NO JSY
43    P.D.Bastia                 RM CARE Raj
44   Vandana Mishra              State Representative
45    Dr. Chandrakant Lahariya   WHO-NPSP
46    Dr. Anuradha Aswal         NRHM
47   Dr. K.L.Sehra               AD RCH
48   Rakesh Kumar                CO-HRD,NRHM
49   Prafull Sharma              CO-Plan,NRHM
50   Hanuman Prasad              FA,NRHM
51   b.k.Dosi                    Add. Director
52    P.N. Vijayvergis
53   Jai Singh Shekhewat         SPM-NRHM
54    Vishal Pandit              SF-NHSRC
55   Ram Karan Singh             NRHM
56   Annet J.Bishwas             ASPM-NRHM
57   Meeta Sharma                CFA-NRHM
58   Bharti Gaur                 CO-ASHA,NRHM
59   R.K.Mishra                  Ex. Ex.-NRHM
60   P.K.Tayal                   A.E,NRHM
61   S.Sharma                    CO,MMG
62    Dr. Sheetal Joshi          CO,JSY
63    Parima Chauhan             CO-IT (MMRK)
64    Poonam Bishnoi             Prayas
65    Umesh Kumar Singh          CO-URCH
66    Akhilesh Sharma            DPM-Jaipur
67    Lalit Kumar Tripathi        CO-ARSH
68   Archana Sharma              CO-NGO
69    lala Ram
70   Sudhindra K.Sharma
71   Kumaril Agarwal             DPM-Udaipur
72   Dr. B.L.Mishra              Add. CM& NO,Udaipur
73   Dr. R.N.Bairwaz             CM&NO
74   Dr.Narendra Godara          CO.MH&PRU
75   Dr. B.S.Babel               CO,MH &PRU
76    V.K.Vyas                   C.C.O
77    Dr. R.J,Ralhone
78   Dr. Navdeep Singh
79   Dr. Harendra Singh      CM&HO,Bharatpur
80   Dr. G.S Rao             DPM,Bharatpur
81   Dr. Vidya Sen           Finance Cons,NVBDCP
82   Dr. K.K.Mathur          Sr. Regional Director
83   Dr. B.R.Meena           ADDMEHS(RH)
84   Kriti Lakhwani          RO-SHSRC
85   Neha Pareel             RP-SHSRC
86   Mahtab Alam             RO-SHSRC
87   Deep Singh Chauhan      BPM( Khandala )
88   Atal Behari Bharadwaj   PA TO MD
89   Veena Sharma            PO,SARC
90   Gautam Sadho            IIHMR
91   Sunil Thomas            UNFPA
92   Shri. Ram Meena         Director IEC
93   Dr. Akhilesh Bhargava   Director,SIHFW
94   Somesh Singh            CO-IT
95   Dr. S.D.Gupta           IIHMR

								
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