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					District Health Action Plan
             Year 2011-12
   District: Saraikela Kharsawan




      District Health Society
National Rural Health Mission
     District Saraikela-Kharsawan
     Department of Health & FW
      Government of Jharkhand



                                    1
                                      ACKNOWLEDGMENT
                                      ACKNOWLEDGMENT


Recognizing the importance of Health in the process of economic and social development and
improving the quality of life of our citizens, the Government of India has resolved to launch the
National Rural Health Mission to carry out necessary architectural correction in the basic health care
delivery system.

This District Health Action Plan (DHAP) is one of the key instruments to achieve NRHM goals.
This plan is based on health needs of the district.

After a thorough situational analysis of district health scenario this document has been prepared. In
the plan, it is addressing health care needs of rural poor especially women and children, the teams
have analyzed the coverage of poor women and children with preventive and promotive
interventions, barriers in access to health care and spread of human resources catering health needs
in the district. The focus has also been given on current availability of health care infrastructure in
pubic/NGO/private sector, availability of wide rage of providers. This DHAP has been evolved
through a participatory and consultative process, wherein community and other stakeholders have
participated and ascertained their specific health needs in villages, problems in accessing health
services, especially poor women and children at local level.

The goals of the Mission are to improve the availability of and access to quality health care by
people, especially for those residing in rural areas, the poor, women and children.

I need to congratulate the department of health of Jharkhand for its dynamic leadership of the health
sector reform programme and we look forward to a rigorous and analytic documentation of their
experiences so that we can learn from them and replicate successful strategies. I also appreciate their
decision to invite PHRN to facilitate the process in the district.. The proposed location of HSCs,
PHCs and its service area reorganized with the consent of ANM, AWW, male health worker and
participation of community has finalized in the block level meeting.

I am sure that this excellent report will galvanize the leaders and administrators of the primary
health care system in the district, enabling them to go into details of implementation based on
lessons drawn from this study.



                                                                      ( Sri Ashok Kumar Mishra )
                                                                         Deputy Commissioner
                                                                         Saraikela-Kharsawan




                                                                                                     2
                                    ABBREVIATIONS
                                    ABBREVIATIONS

ABER    Annual Blood Examination Rate            IPHS    Indian Public Health Standard
ACMO    Assistant Chief Medical Officer          IUCD    Intra Uterine Contraceptive Device
ANC     Ante-Natal Care                          IYCF    Infant and Young Child Feeding
ANM     Auxiliary Nurse Midwife                  JSY     Janani Suraksha Yojana
ANMTC   ANM Training Centre                      LHV     Lady Health Visitor
APHC    Additional PHC                           MMR     Maternal Mortality Ratio
API     Annual Parasite Index                    MO      Medical Officer
        Adolescent Reproductive and Sexual       Mo      Ministry of Health and Family
ARSH    Health                                   HFW     Welfare
ASHA    Accredited Social Health Activist        MOIC    Medical Officer Incahrge
        Ayurveda, Yoga and Naturopathy, Unani,
AYUSH   Siddha and Homoeopathy                   MTC     Malnutrition Treatment Centre
                                                         National Buildings Construction
BCC     Behaviour Change Communication           NBCC    Corporation Ltd.
BPL     Below Poverty Line                       NFHS    National Family Health Survey
CHC     Community Health Centre                  NGO     Non Governmental Organisation
                                                         National Iodine Deficiency
CMO     Chief Medical Officer                    NIDD    Disorder Control Programme
                                                         National Leprosy Eradication
DDM     District Data Manager                    NLEP    Programme
                                                         National Programme on Control on
DDT     Dichloro Diphenyl Trichloro-ethane       NPCB    Blindness
DGHS    Directorate General Of Health Service    NRHM    National Rural Health Mission
DH      District Hospital                        NSV     Non-scalpel Vasectomy
                                                 NVDC    National Vector Borne Disease
DHAP    District Health Action Plan              P       Control Programme
DHS     District Health Society                  OCP     Oral Contraceptive Pill
DIO     District Immunisation Officer            PHC     Primary Health Centre
        District Level Household and Facility
DLHS    Survey                                   PIP   Programme Implementation Plan
DLO     District Leprosy Officer                 PMU   Programme Management Unit
DPM     District Programme Manager               PPP   Public Private Partnership
DTC     District Training Centre                 RCH   Reproductive and Child Health
DTO     District TB Officer                      RDK   Rapid Diagnostic kit
FRU     First Referral Unit                      RKS   Rogi Kalyan Samiti
                                                       Revised National Tuberculosis
HMIS    Mealth Management Information System     RNTCP Programme
HSC     Health Sub Centre                        SC    Scheduled Caste
ICDS    Inetegrated Child Development Services   SDH   Sub Divisional Hospital
        Integrated Counselling and Treatment
ICTC    Centre                                   SNCU    Sick Neonatal Care Unit
IDSP    Integrated Disease Surveillance          SPM     State Programme Manager
        Information Education and
IEC     Communication                            SRS     Sample Registration System
        Integrated Management of Neonatal and
IMNCI   Childhood Illnesses                      ST      Scheduled Tribe
IMR     Infant Mortality Rate                    TFR     Total fertility Rate
IPC     Intra Personal Communication             UF      Untied Fund
                                                 VHC     Village Health Committee




                                                                                        3
                        Reference Material:


1. NRHM – Framework for Implementation
2. Broad framework for preparation of district health action plans
3. Indian Public Health Standards (IPHS), DGHS, MoHFW
4. Gram Swasthya & Poshan Diwas
5. DLHS – 3
6. NFHS – 3
7. SRS Bulletin 2009
8. Gram Swasthya Samiti (VHC) & Sahiyya guidelines, Govt. of Jharkhand
9. RNTCP Performance report
10. Census
11. District HMIS Reports
12. Facility Survey Output Data




                                                                         4
                         Contents



                                                 Page No.
   I.   Planning Process                            06
  II.   Summary of Budget                           09
 III.   Background Information of the district      11
IV.     Situation Analysis                          16
 V.     NRHM – Goals & Objectives                   21
VI.          Infrastructure                         24
VII.         Human Resource                         31
VIII.        Technical Component
 A.          Maternal Health & Child Health         36
 B.          NRHM Additionalities                   58
 C.          Disease Control Programmes             78

          1. RNTCP                                  79

          2. NVBDCP                                 85

          3. NLEP                                  117

          4. Blindness Control Programme
                                                   124
             (NPCB)

IX.       Innovation                               126

 X.       Work plan & Budget                       127

XI.     Annexure I                                 142

XII.    Annexure II to V ( Malaria )             143-146




                                                            5
                                      PLANNING PROCESS
                                      PLANNING PROCESS
        The District Health Action Plan (2011-12) of Saraikela-Kharsawan has been prepared under
the guidance of Deputy Commissioner with a joint effort of a Chief Medical Officer and Additional
Chief Medical Officer, the Program Officer, DPMUs and various M.O.-PHCs as well as the other
concerned departments under a participatory process. The field staffs of the department too have
played a significant role. Public health resource Network has provided technical assistance in
estimation and drafting of this plan.



                                   Summary of Planning Process
   Training of district team for preparation of DHAP- one day orientation at the state, district
   level orientation cum meeting, formation of planning team at the district, drafting team,
   block level consultations. FGD, interviews with Sahiya, Planning meeting involving all the
   programme officers,
   Preliminary meeting with CMO and ACMO along with other concerned officials

   Data Collection for Situational Analysis – MOIC meeting chaired by CMO/CS

   Block level consultations with MOICs and BPMUs


   Writing of situation analysis

   District Planning workshop to review situation analysis and prepare outline of district
   health plan – the meeting was chaired by CMO and facilitated by ACMO. The workshop was
   attended by MOICs, and the key health functionaries at the district level.

   District Consultations for preparation of 1st Draft

   Preliminary appraisal of Draft

   Final Appraisal

   Final DHAP : Submission to DHS and State

   Printing and Dissemination




                                                                                                   6
                            DISTRICT PLANNING TEAM
                            DISTRICT PLANNING TEAM


Sl.No   Name                                         Designation

                                                     CS, SARAIKELA-
 1.     Dr. S. S. HARIJAN
                                                     KHARSAWAN

                                                     ACMO, SARAIKELA-
 2.     Dr. S. S. HARIJAN
                                                     KHARSAWAN

                                                     DRCHO , SARAIKELA-
  3     DR. MAHESHWAR PRASAD
                                                     KHARSAWAN

                                                     DTO , SARAIKELA-
 4.     DR. M. DHAWARIYA
                                                     KHARSAWAN

                                                     DLO, SARAIKELA-
 5.     DR. S. K. JHA
                                                     KHARSAWAN

                                                     DMO, SARAIKELA-
 6.     DR. J. MANJHI
                                                     KHARSAWAN

                                                     DPM, SARAIKELA-
 7.     MR. DEVENDRA BH. SHRIVASTAVA
                                                     KHARSAWAN

                                                     DPC, SARAIKELA-
 8.     MR. D. C. MAHATO
                                                     KHARSAWAN

                                                     DAM, SARAIKELA-
  9     MR. ANAND KISHORE SAHU
                                                     KHARSAWAN

                                                     DDM, SARAIKELA-
 10     MR. DILIP KUMAR
                                                     KHARSAWAN




                                                                          7
                                  DISTRICT RURAL HEALTH SOCIETY
                                  DISTRICT RURAL HEALTH SOCIETY

         Governing Body                    Executive Body                           Ex – Officio
Sl.No.    Occupation       Degisnation     Sl.No      Occupation      Degisnation   Sl.No.   Occupation Degisnation
         Deputy                                    Deputy
  1                         Chairperson                               Chairperson                          Member
         Commissioner                        1     Development                        1          MP
                                                   Commissioner
         Deputy                                    Civil Surgeon –
  2      Development       Vice Chairmen                               Secretary                           Member
                                             2     Cum – Chief                        2         MLA
         Commissioner                              Medical officer
         Civil Surgeon –
  3      Cum – Chief         Secretary                                  Member                             Member
                                             3     A.C.M.O                            3         Care
         Medical Officer

                                                   Deputy
         District                                  Suprintendent,       Member                             Member
  4                          Member          4                                        4        TSRDS
         Welfare                                   Sadar hospital,
         Officer                                   Seraikella

         Programme           Member                                     Member                             Member
  5                                          5     District T.B                       5        Vikash
         Director,
                                                   Officer                                     Bharti
         D.R.D.A

         District            Member                                     Member                             Member
  6                                          6     District Leprosy                   6
         Programme                                                                             EKJUT
                                                   Officer
         Officer

         District
                             Member                District             Member                Corporate    Member
  7      Programme                           7                                        7
                                                   Immunisation                              Representat
         Officer                                                                                 ive
                                                   Officer
         ( AYUSH )
         Secretary, Red
         Cross Society,      Member                District             Member                             Member
  8                                          8                                        8
         Saraikella                                Blindness                                    Media
                                                   Control Officer
         District                                                     Member
  9      Programme           Convener        9     Sahyogi Mahila                     9
                                                                                             Lokhit
                                                                                                           Member
         Manager                                                                             Sanstha

                                                   District Account
                                                                        Member
                                            10     Manager

                                                   Secretary, Red
                                            11
                                                   Cross Society,       Member
                                                   Saraikella

                                                   District
                                            12
                                                   Programme           Convener
                                                   Manager




                                                                                                              8
                           SUMMARY OF BUDGET
                           SUMMARY OF BUDGET
1   V. A        Reproductive & Child Health (RCH – II)              5,93,41,517
    A.1         Maternal Health                                       42806400
    A.2         Child Health                                           1053800
    A.3         Family Planning                                        6543500
    A.4         ARSH                                                     15000
    A.6         Tribal Health                                          1105000
    A.7         Vulnerable Group                                             0
    A.8         Innovation/ NGOs/ PPP                                   500000
    A.9         Infrastructure and Human Resource                            0
    A.10        Institutional Strengthening                                  0
    A.11        Training                                               4489817
    A.12        BCC/ IEC                                               1067000
    A.13        Procurement                                                  0
    A.14        Program Management                                     1761000

2   V. B        NRHM Additionalities                                 92363000

    B.1         Hospital manager                                        314000
    B.2         Ambulance maintains and others                          200000
    B.3         Untied Fund                                            2565000
    B.4         VHSCs Untied fund                                     11650000
    B.5         Annual Maintenance Grant                               3290000
    B.6         RKS Grant                                              2400000
    B.7         Human Resource                                        26838000
    B.8         Infrastructure Upgradation                            22500000
    B.9         Mobile Medical Unit                                    6000000
    B.10        Community Participation                                5109500
    B11         School Health Programme                                1595000
    B.12        BPMU Salary and Others .                               2400000
    B.13        Cold chain support ive staffs                           120000
    B.14        Mainstreaming AYUSH                                    6285000
    B.15        DPMU Salary                                             924000
    B.16        DHAP , BHAP and VHAP                                    172500
    SUB TOTAL   RCH + NRHM ADDITIONALITIES                          151704517
3   V. C        Routine Immunisation                                 15,50,000
4   V. D        Disease Control Program                              29528292
    D.1         RNTCP                                                  2507900
    D.2         NVBDCP                                                25174187
    D.3         NBCP                                                    429605
    D.4         IDSP                                                    560000
    D.5         NLEP                                                    856600
5   V. E        Convergence                                             100000
6   6.1         Establishment of Regional Cold Chain Depot.             300000
    6.2         Set up of Counselling Kiosk for Vulnerable group.       850000
                   GRAND TOTAL:                                      184032809


                                                                              9
DISTRICT MAP
DISTRICT MAP




               10
               BACKGROUND OF SARAIKELA-KHARSAWAN DISTRICT
               BACKGROUND OF SARAIKELA-KHARSAWAN DISTRICT
Overview

Seraikella Kharsawan district was created in 2001 after the birth of Jharkhand. It formed a part of West
– Singhbhum, which had twenty three blocks. Eight blocks have been separated and grouped together
to be named as Seraikela-Kharsanwan.

Early History of Seraikela
In the year 1620, Kumar Bikram Singh I, the third Maharaja Jagannath Singh, established the Seraikela
state, which was merged with Bihar state after independence and ranked as subdivision merged with
the boundaries of Kharsawan state. Later on the basis of territories act in 1950, 39 villages of Chandil,
Nimdih and Tamar area were included into it.

1. Religious faith and Festivals of Seraikela-Kharsawan
Majority of the population in this district are scheduled tribes and mainly depends upon agriculture and
forest produce. The main tribes of the area are Ho, Santhal and Oraon. Besides tribal population inhabit
in this area who belong to religious beliefs and practices. Non-Tribal populations belong to other
religious like Hindu, Muslim, Christians, Sikh & Jain and Buddhists.

Religious faith in Tribal community
The majority of Tribal population belongs to Ho community. Basically dependent on cultivation Ho
communities believe in nature. They believe in Sarna religion .The village has its sacred grove Sarna
place or Jahira where the village God Desauli resides with his consort Jahira Buri. Naser Bonga residing
in water is the presiding deity of water. The main God and Goddesses in Ho community are Sing Bonga,
Marang Bonga, Deshauli, Pawnee, Nage Era & Bindi Era:
In Ho community there is a separate kitchen cum worship room known as Andi. After the death of a
family member they establish the soul in Andi where the soul is being worshipped regularly. At the time
of difficulties they worship them to keep their family in good health and peace. They use to address
these holy souls as “Hadanko-Tudanko” which means such elders who are in sleeping stage.

There is no place for idolatry in traditional Ho religion. The religion is entirely practical concerned with
happiness in this world. Hos believe that death is caused by the escape of the soul through mouth,
nostrils or the eyes. The soul is ordinarily invisible, but may appear at will in any form. There is no
concept of good or evil and corresponding belief in heaven or hell associated with soul.

Fairs and Festivals of Seraikela-Kharsawan

The tribal and non-tribal populations are almost in equal ratio. During the time of different festivals
people maintain communal harmony, no matter which festival it is, they do not hesitate to invite their
neighbors and friends to their houses at the time of festive occasion. Communal tensions and religious
antagonism are rarely seen in this area.

Ho Festival: The Ho has to earn his living by the sweat of his brow. But the drudgery of economic life is
intermittently relieved by a regular cycle of festivals. Each festival is marked by the following features:

All the festivals are based on religious faith. In each festival Dance, instrument and songs are essential
entity to celebrate. They celebrate all the festivals collectively in mass with song dance and instruments.
They never celebrate any festival individually .The main festivals are Maghe , Baa , Hero , Jomnamah ,
Kolom , Damurai , Damurai , Batauli .




                                                                                                          11
Distribution of Population

 Total area (In Sq. Km) (Source Block Data)                         2724.55

 Total no. of Gram Panchayat (Source Block Data)                      135

 Total no. of Revenue Villages (Source Block Data)                   1190

 No. of Sub divisional Hospital                                        0

 No. of CHC                                                            8

 No. of Referral Hospital                                              0

 No. of PHCs                                                          11

 No. of HSCs                                                          194

 No. of Anganwadi Centers (Source Block Data)                        1370

 Total Population (Source Block Data)                               1076688

 Male population (Source Block Data)                                541897

 Female population (Source Block Data)                              534791

 Sex Ratio                                                            987

 Adolescent population (10-19yrs) (Source Block Data)               184764

 Women (Source Block Data)                         15 -49 years      30710

                                                   Above 49 years    51402

 Child population: (Source Block Data)             0-12 months       26708

                                                   13 months - 60    26279
                                                   months (5 yr.)

 SC population :    (Source Block Data)            Total             69389

                                                   Male              35458

                                                   Female            33713

 ST Population (Source Block Data)                 Total            321930

                                                   Male             164085

                                                   Female           157845

 PTG Population (Source Block Data)                Total             1825
                                                   Male               954
                                                   Female             871
 BPL Population (Block Data)                                        545157
 No. of Eligible Couples (Source Block Data)                        165313




                                                                              12
HR Position in Saraikela-Kharsawan

No. of Doctors (Govt. + Pvt.)                                 104
Government                   Total                            59

                            MBBS                              41

                            BHMS (Homeopathy)                  2

                            BAMS (Ayurvedic, Unani)            4

                            Specialist ( Gynaecologist)        4

                            Specialist ( Anesthatist)          1

                            Specialist ( Surgeon)              2

                            Specialist ( Paediatritian)        0

                            Specialist                         5

                            MBBS Multiskilled in EmOC          1

                            MBBS Multiskilled in Anesthasia    0

Private (Attach list with   Total                             44
Name, specialization if
any, address, contact       MBBS                              23
number)                                                       17
                            BHMS (Homeopathy)

                            BAMS (Ayurvedic, Unani)            4

No. of ANMs                 Total                             385

                            Regular                           98

                            Contactual                        287

No. of Male Health          Total                             19
Worker
                            Regular                           19

                            Contactual                         0

  No. of Grade A Nurse      Total                              9

                            Regular                            0

                            Contactual                         9

No. of Paramedicals                                           23
(LT+Pharmacist+Dresser)     Total
                            Regular                            1

                            Contactual                        22

No. of MPW                                                    44



                                                                    13
Administrative and Socio Economic

No. of Anganwadi Workers (Source Block Data)                         1358

No. of Village Health Committees (Source Block Data)                 1145

No. of Sahiyya (Source Block Data)                                   1811

Total No. of SHG/ Mahila Mandals (Source Block Data)                 765

No. of Primary Schools (Source Block Data)                           771

No. of Seconday Schools (including Middle and High schools)          339

No. of villages having source of drinking water:                     1479
(Source Block PHED offfice)
                               Well                                  1875

                            Tube Well                                3404

                            Pond River                                63

                           Piped Water                                35

No. of Inaccessible villages (Hard to reach /which are devoid of     67
health services) - Attach list of such villages with approximate
distance from CHC)
No. of PTG villages (Attach list of such villages with approximate    25
distance from CHC, population) (Source Block Data)
No. of villages having motorable roads                               866

No. of village having Community Hall (Source Block Data))            152

No. of village have Telephone Facility                               212




                                                                            14
Health facility
No. of CHC 24 x7 functional                                                     8

No. of PHC 24 x7 functional                                                     3

No. PHC running in HSC building                                                 6

No. CHC running in PHC building                                                 0

No. SDH / Referral running in PHC/CHC building                                  0

                      Facility Services                        Available   Functional      Not
                                                                                        Functional
                                                                   6           4            1
Ambulance for assured referral
                                                                   6           4            1
Genset
                                                                   0           0            0
X-ray
Laboratory (Functional if, Urine and HB test are                   6           6            0
happening along with malaria and sputum test)
                                                                   2           0            1
Blood Storage/ Blood bank
                                                                   0           0            0
Malnutrition Treatment Centre     (MTC)
                                                                   0           0            0
New born corner
                                                                   0           0            0
Sick New borne Care Unit (SNCU)
                                                                   7           6            0
Cold Chain
                                                                   1           1            0
ARSH clinic
                                                                  12           7            3
Toilets
                                                                   7           5            0
Toilets for female
                                                                   7           5            1
Computer
                                                                   4           3            0
Internet facility
                                                                   6           3            2
Telephone facility
                                                                   7           4            2
Residential facility for staff
                                                                   7           4            2
Sahiyya Desk
Waiting hall for patients/attendants                              2
                                                                  50
Number of Beds available in the facility (District Hospital)
                                                                  26
Number of rooms in the facility (District Hospital)
Average number of OPD per day (As per data of April to            60
Sept 2010)
Average number of IPD per month (As per data of April to          90
Sept 2010)
Average number of Delivery per month (As per data of              28
April to Sept 2010)
                                                                                                 15
                                 SITUATIONAL ANALYSIS
                                 SITUATIONAL ANALYSIS

KEY HEALTH INDIACATORS OF SARAIKELA-KHARSAWAN.

The current situational analysis of the district of SARAIKELA-KHARSAWAN has been drown
form census 2001, NFHS-2 &3 and DLHS 2 &3 reports. These indicators help in indicating the
health scenario. In SARAIKELA-KHARSAWAN form a qualitative and quantative point of view.

                                                                         46
Infant Mortality Rate (IMR) (SRS 2009)
                                                                        312
Maternal Mortality Ratio (MMR) (SRS 2009)
                                                                        25.8
Crude Birth Rate (CBR) (SRS 2009)
                                                                        7.1
Crude Death Rate (CDR) (SRS 2009)
                                                                       56.66
Full Immunisation %age (HMIS - Apr 2009 to March 2010)
%age of preganant women registered (HMIS - Apr 2009 to                  58.3
March 2010)
%age of preganant women having 3 ANCs (HMIS - Apr 2009                 28.86
to March 2010)
Institutional Delivery %age (HMIS - Apr 2009 to March                  38.09
2010)
Anaemia among children 6 month to 3 year                                14%
(Source District Data)
                                                                        33%
Anaemia among Preganant women (Source District Data)
Annual Blood Examination Rate (ABER) - Malaria (Jan 2009              10.27%
to Dec 2009)
Annual Paracite Incidence (API) - Malaria (Jan 2009 to Dec             4.24%
2009)
                                                                       0.54%
PF percentage - Malaria (Jan 2009 to Dec 2009)
                                                                        1%
Kala azar Incidence (In numbers) (Jan 2009 to Dec 2009)
Annual Case Detection Rate - Tuberculosis (Jan 2009 to Dec              70%
2009)




                                                                                         16
                                PHYSICAL TARGET FOR YEAR 2011-12


                                                                            Institutional                           Fully immunizations
        Block   Projected Population   2011-12   Pregnant women   Infant                     Home delivery target
                                                                           delivery target                                  target

                           101144                    2388         2076         1433                  955                   2076
Saraikela
                                                     8575         7800         5145                 3430                   7800
Gamharia                   292769
                                                     3955         3432         2373                 1582                   3432
Rajnagar                   148250
                                                     3856         3348         2314                 1542                   3348
Chandil                    147578
                                                     2868         2484         1721                 1147                   2484
Nimdih                     113994
                                                     3352         2904         2011                 1341                   2904
Ichagarh                   119097
                                                     1948         1692         1169                  779                   1692
Kuchai                      64971
                                                     2388         2076         1433                  955                   2076
Kharsawan                   88884
TOTAL                      1076688                   29330        25812        17598               11732                  25812




                                                                                                                                          17
                  FINANCIAL ACHEIVEMENT TILL OCTOBER 2010
                                                                     Activities in %
 Name of Block                                       Hospital     Annual         Annual         Untied     Untied     Untied
                  Routine                 Family                                                                                 Untied
                                 MMJSSA              Management   Maint. Grant   Maint. Grant   fund for   fund for   fund for
                  Immunization            Planning                                                                               fund VHC
                                                     Society      for CHC        for PHC        CHC        PHC        HSC
Chandil               72           83        31          65           54               23         60          58         53         36

Gamharia              100          68        78          49           13               48         25          65          5         47

Ichagarh              57           28        15          11           30                0          4          99         46         27

Kharsawan             99           89        25          45           58                0          0           0         52         40

Kuchai                92           58        31          33           31                0         37           0         28         29

Nimdih                97           76        24          80           29                0         64           0         64         35

Rajnagar              45           82        45          12            7               23         19          64         46         30

Seraikella            98           100       26          58            9               100         0         100         41         40

Sadar Hospital/
                      84           26        78          19            0                0          0           0          0          0
DHQ/Others

     Total            83           72        47          34           30               37         27          68         47         36




                                                         18
                                                                                      District Health Profile
                                                                         Name of District : Saraikela-Kharsawan
                                            Infant Mortality rate                                         46
   Key
Population                                  Maternal mortality rate                                       312
indicators                                  Crude birth rate                                              25.8
                                            Death rate                                                    7.1
                                            Total Fertility Rate                                          3.6
                                                                                                                            DLHS 2 (02-04)           Jharkhand
                                           District Level Household & Facility Survey                      DLHS 3 (07-08)                    Trend
                                                                                                                             (Jharkhand)               DLHS 3
                                      Girls marrying below 18 years                                              26.8             48          -          36
                                      Birth order 3+                                                             36.5            64.3         -         51.4
                                      Current use of any FP method                                               37.4            35.3         +         34.9
Key RCH Indicators (in percentages)




                                                                                                                 34.0           34.2           -        34.7
                                      Total unmet need
                                      Pregnant women who registered in the first trimester                       49.9           27.5          +         30.9
                                      Pregnant women receive at least 1 TT injections                            70.5           48.2          +         54.9
                                      Pregnant women receive 3 ANC                                               50.9           30.7          +         30.5
                                      Pregnant women receive 100 IFA Tablets                                     30.0            12           +         19.1
                                      Delivery assisted by a skilled attendant at home                            7.4            7.7          -          8.9
                                      Institutional births                                                       24.4           21.2          +         17.8
                                      Children with full immunization                                            69.3           25.7          +         54.1
                                      Children with Diarrhoea treated within last two weeks who
                                                                                                                 23.2           67.2           -        52.3
                                      received treatment
                                      Children with Acute Respiratory infections in the last two weeks
                                                                                                                 46.5           58.4           -        56
                                      who were given treatment
                                                                                 19
                                           Infrastructure

                            CHCs                           PHCs                          HSCs
       Blocks    Existing          Proposed     Existing          Proposed    Existing          Proposed
                 (In No.)           (In No.)    (In No.)           (In No.)   (In No.)           (In No.)
Kuchai              1                 1               0              2          14                 8

Kharsawan           1                 1               0              3          21                 5

Chandil             1                 1               2              6          26                 17

Ichagarh            1                 1               1              4          27                 8

Nimdih              1                 1               1              4          30                 0

Seraikela           1                 0               2              4          24                 3

Gamharia            1                 1               2              10         20                 14

Rajnagar            1                 1               3              6          32                 10

         Total      8                 7               11             39         194                65




                                                 20
                                NRHM – GOALS & OBJECTIVES
                                NRHM – GOALS & OBJECTIVES


The National Rural Health Mission (NRHM) has been launched with a view to bringing about
remarkable improvement in the health system and the health status of the people, predominantly
those who live in the rural areas of the country. The Mission seeks to provide universal access to
equitable, affordable and quality health care which is accountable at the same time responsive to the
needs of the people, reduction of child and maternal deaths as well as population stabilization,
gender and demographic balance. In this process, the Mission would help achieve goals set under
the National Health Policy and the Millennium Development Goals.


To achieve these goals NRHM will:
   o Facilitate increased access and utilization of quality health services by all.
   o Forge a partnership between the Central, state and the local governments.
   o Set up a platform for involving the Panchayati Raj institutions and community in the
     management of primary health programmes and infrastructure.
   o Provide an opportunity for promoting equity and social justice.
   o Establish a mechanism to provide flexibility to the states and the community to promote
     local initiatives.
   o Develop a framework for promoting inter-sectoral convergence for promotive and preventive
     health care.
The Objectives of the Mission:
   o Reduction in child and maternal mortality
   o Universal access to public services for food and nutrition, sanitation and hygiene and
     universal access to public health care services with emphasis on services addressing
     women’s and children’s health and universal immunization
   o Prevention and control of communicable and non-communicable diseases, including locally
     endemic diseases.
   o Access to integrated comprehensive primary health care.
   o Population stabilization, gender and demographic balance.
   o Revitalize local health traditions & mainstream AYUSH.
   o Promotion of healthy life styles.
The expected outcomes from the Mission as reflected in statistical data are:
    IMR reduced to 30/1000 live births by 2012.
    Maternal Mortality reduced to 100/100,000 live births by 2012.
    TFR reduced to 2.1 by 2012.
    Malaria Mortality Reduction Rate - 50% up to 2010, additional 10% by 2012.
                                                 21
    Kala-azar Mortality Reduction Rate - 100% by 2010 and sustaining elimination until 2012.
    Filaria/Microfilaria Reduction Rate - 70% by 2010, 80% by 2012 and elimination by 2015.
    Dengue Mortality Reduction Rate - 50% by 2010 and sustaining at that level until 2012.
    Cataract operations-increasing to 46 lakhs until 2012.
    Leprosy Prevalence Rate –reduce from 1.8 per 10,000 in 2005 to less that 1 per 10,000
     thereafter.
    Tuberculosis DOTS series - maintain 85% cure rate through entire Mission Period and also
     sustain planned case detection rate.
    Upgrading all Community Health Centers to Indian Public Health Standards.
    Increase utilization of First Referral units from bed occupancy by referred cases of less than
     20% to over 75%.
    Engaging 4,00,000 female Accredited Social Health Activists (ASHAs).

The expected outcomes at Community level
    Availability of trained community level worker at village level, with a drug kit for generic
     ailments.
    Health Day at Aanganwadi level on a fixed day/month for provision of immunization,
     ante/post natal checkups and services related to mother and child health care, including
     nutrition.
    Availability of generic drugs for common ailments at sub Centre and Hospital level.
    Access to good hospital care through assured availability of doctors, drugs and quality
     services at PHC/CHC level and assured referral-transport-communication systems to reach
     these facilities in time.
    Improved access to universal immunization through induction of Auto Disabled Syringes,
     alternate vaccine delivery and improved mobilization services under the programme.
    Improved facilities for institutional deliveries through provision of referral transport, escort
     and improved hospital care subsidized under the Janani Surakshya Yojana (JSY) for the
     below poverty line families.
    Availability of assured health care at reduced financial risk through pilots of Community
     Health Insurance under the Mission.
    Availability of safe drinking water.




                                                22
                                     INFRASTRUCTURE


                  Projected                                            AYUSH

Sl.               Population                                  Stand
                                                                        Stand
                                                                                     Co-
        Block      2011-12 SDH CHCs PHCs HSCs                 alone
                                                                        alone
                                                                                   located
No                                                                     AYUSH
                   (based on                                 AYUSH                 AYUSH
                  Census 2001)                                        Dispensari
                                                              Hosp.                Services
                                                                          es

                    101144
1     Saraikela                  0      1         02   24      0          3


2     Gamharia      292769       0      1         02   20      0          3

3     Rajnagar      148250       0      1         03   32      0          3

4     Chandil       147578       0      1         02   26      0          3

5     Nimdih        113994       0      1         01   30      0          2

6     Ichagarh      119097       0      1         01   27      0          1

7     Kuchai         64971       0      1         0    14      0          1


8     Kharsawan      88884       0      1         0    21      0          3


         Total     1076688       0      08        11   194     0         19




                                             23
                                                                      INFRASTRUCTURE
                                                                      INFRASTRUCTURE
                                                             Community Health Centre
Data Source- District Administration.
                            Total Amount
                            sanctioned (in   Amount received         Financial                                            Propososed      Plan
                 CHC                                                               Balance                                                                       Budget
                             lacs) (Under           till             Progress                  Agency        Physical       period of      for   Construction
 CHC Name     Sanctioned                                                           Amount                                                                       (in lacs)
                           Departmental or   Sept,2010(include    (expenditure               /Contractor     Progress      completion    2011-   for 2011-12
               (Yes/No)                                                             (9-10)                                                                      2011-12
                            NRHM or any        07,08, 09 etc)    till Sept,2010)                                          (in months )   2012
                                other)

 Gamharia       Yes              0                  0                  0                0    Health Dept        0              0          0           0            0

                 No
Kharsawan                        0                  0                  0                0        0              0              0          0           0            0

                 No
  Chandil                        0                  0                  0                0        0              0              0          0                        0

                                                                                              Special      Roof casting                          Upgradatio     3480000
  KUCHAI         Yes         15000000           15000000          15000000              0                                 12 Month        0
                                                                                              Division     Completed                                 n             0

                                                                                                           Completed
                                                                                              Special                                            Upgradatio
  Nimdih         Yes         41707920           31734700          31734700              0                  but without         0          0                     9973220
                                                                                              Division                                               n
                                                                                                            Sanitation

                 No
 Saraikela                       0                  0                  0                0        0              0              0          0           0            0

                 Yes
 Rajnagar                        0                  0                  0                0    Health Dept        0              0          0           0            0


 Ichagarh        No              0                  0                  0                0        0              0              0          0           0            0


                                                                                   24
PROGRESS REPORT OF CHC




                                                                                                                     No. of rooms

                                                                                                                                    No. of beds
    CHC           Assured running water       Continuous       Toilets with running    Functional    Condition of                                 Functional   Condition of   Condition of
    Name           supply in the facility    power supply         water supply        Labour room    Labour room                                     OT           OT             ward


                                                                                                     Needs Minor                                               Needs Minor    Needs Minor
  Gamharia                 Available           Available            Available          Available       Repair           5              4          Available      Repair         Repair

                                                                                                     Needs Minor                                               Needs Minor    Needs Minor
 Kharsawan                 Available           Available            Available          Available       Repair           2              6          Available      Repair         Repair

                                                                                                     Needs Minor                                    Not        Needs Major    Needs Major
   Chandil                 Available           Available            Available          Available       Repair           2              2          Available      Repair         Repair

                                                                                                     Needs Minor                                    Not        Needs New      Needs New
   KUCHAI            Irregular Supply          Available          Not Available        Available       Repair           0              0          Available     Building       Building

                                                                                                     Needs Minor                                                              Needs New
   Nimdih                  Available        Irregular Supply      Not Available        Available       Repair           2              6          Available         0          Building

                                                                                                                                                    Not                       Needs New
  Saraikela                Available        Irregular Supply        Available          Available    Good Condition      3              2          Available         0          Building

                                                                                                                                                    Not                       Needs New
  Rajnagar                 Available        Irregular Supply        Available          Available    Good Condition      3              2          Available         0          Building

                                                                                                     Needs Major                                    Not        Needs New      Needs New
  Ichagarh                 Available           Available            Available          Available       Repair           4              2          Available     Building       Building

*Data Source- Block CHC.


                                                                                        25
THE ABOVE TABLE DEPICTS THAT

                                                         Toilets




                                                                                                   No. of rooms



                                                                                                                  No. of beds
                              Assured
                                             Continuo     with
                              running                               Functional   Condition of                                   Functional   Condition   Condition
          Item                               us power   running
                           water supply                            Labour room   Labour room                                       OT         of OT       of ward
                                              supply      water
                           in the facility
                                                         supply


 Total Available                 7              5          6           8                           21             24                3


 Total Not Available             0              0          2           0                                                            5

 Total Irregular
 Supply                          1              3

 Total Good
 Condition                                                                             2                                                        0           0

 Total Needs Major
 Repair                                                                                1                                                        1           1

 Total Needs Minor
 Repair                                                                                5                                                        2           2

 Total Needs New
 Building                                                                              0                                                        2           5
*Data Source- Block CHC.


There are Eight CHCs exists in Seraikella Kharsawan District, out all these CHCs Water Supply Facilities available only in seven CHCs and there is a need to make
water facility available in rest one CHC. Similarly there are five CHCs which have the continues Supply of power , in three CHCs there is irregular power supply .
Toilet facility is available in only six CHCs and in two CHC there is no toilet facility available. Two Labour Rooms are functional, one require major repair and rest
require minor repaire. Out of existing CHCs only two CHCs have Functional OT. Condition of ward is not good in all the CHCs.




                                                                                 26
                                                             Primary Health Centre

PROGRESS REPORT OF PHC



                                         Total Amount
                                      sanctioned (in lacs)     Amount received          Financial
            Total PHC    Total PHC                                                                                         Total New            Total      Budget
                                            (Under               till Sept,2010         Progress        Balance Amount
Total PHC   Sanctioned   Sanctioned                                                                                      Construction for   Upgradation   (in lacs)
                                        Departmental or       (include 07,08, 09    (expenditure till       (09-10)
               Yes          No                                                                                              2011-12         for 2011-12   2011-12
                                         NRHM or any                   etc)            Sept,2010)
                                             other)




   8            5            6            28114000               28114000               23246313          4867687               1               5            0




                                                                                   27
CONDITION OF INFRASTRUCTURE (PHC)



                            Assured
                                                       Toilets with
                            running       Continuous                  Functional    Condition                                       Condition of
                                                         running                                No. of                 Functional                  Condition of
      Total No Of PHC         water         power                      Labour       of labour            No. of beds                 OT (Good
                                                          water                                 rooms                     OT                          ward
                          supply in the     supply                      room          room                                           Condition)
                                                          supply
                             facility


 Total Available               3              1             2             1                       2          0             0

 Total Not Available           8              9             9            10                                               11

 Total Irregular Supply        0              1

 Total Good Condition                                                                   0                                                0              0
 Total Needs Major                                                                      1                                                1              2
 Repair
 Total Needs Minor                                                                      0                                                0              0
 Repair
 Total Needs New                                                                        10                                              10              9
 Building

There are 11 PHCs exists in Seraikella Khjarsawan District, out all these PHCs only in 03 PHCs Water Supply Facilities is available which there is a
need to make water facility available in rest 8 PHCs. Similarly there are 01 PHCs which have the continues Supply of power , in 01 PHCs there is
irregular power supply while in 09 PHC there is no power supply . Toilet facility is available in two PHCs. In only one PHC Labour Rooms is
functional But out of Eleven PHCs ony three have building and rest working without building or in HSC building.



                                                                                   28
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12


                                          Health Sub- Centre
HSC Infrastructure (Building) Progress & Plan (New Building)
Upgraded HSC Status

                                           Amount
                           Total Amount
                   sanctioned              received   Financial
                           sanctioned (in
Total HSC                                     till    Progress                                      Financial
                     HSCs

                            lacs) (Under                         Physical
Sanctioned                                Sept,2010 (expenditure             Plan for 2011-2012      Target
                           Departmental                          Progress
   Yes                                     (include   till Sept,                                   (2011-2012)
                            or NRHM or
                                          07,08, 09     2010)
                             any other)
                                              etc)
                                                                          Handover and provide
                                                                  work
Barasegoi           1           1419000   1419000     1419000               service through
                                                                Completed
                                                                            Upgraded HSC.
                                                                          Handover and provide
                                                                  work      service through
Baghraidih          1           1633300   1633300     1633300               Upgraded HSC.
                                                                Completed

                                                                            Handover and provide
                                                                              service through
                                                                  work
Sukhsari            1           1853000   1853000     1853000                 Upgraded HSC.
                                                                Completed

                                                                            Handover and provide
                                                                  work
Kukaru              1           1853000   1853000     1853000                 service through
                                                                Completed
                                                                              Upgraded HSC.
                                                                            Handover and provide
                                                                              service through
                                                                  work        Upgraded HSC.
Jhimri              1           1853000   1853000     1853000
                                                                Completed


                                                                          Handover and provide
                                                                  work
Patahesal           1           1693400   1693400     1693400               service through
                                                                Completed
                                                                            Upgraded HSC.
                                                                          Handover and provide
                                                                  work
Jhalak              1           1598000   1598000     1598000               service through
                                                                Completed
                                                                            Upgraded HSC.
                                                                          Handover and provide
                                                                  work
Kandra              1           1853000   1853000     1853000               service through
                                                                Completed
                                                                            Upgraded HSC.
                                                                          Handover and provide
                                                                  work      service through
Hudwa               1           1853000   1853000     1853000
                                                                Completed   Upgraded HSC.
                                                                            Handover and provide
                                                                  work        service through
Riding              1           1853000   1853000     1853000
                                                                Completed     Upgraded HSC.
                                                                            Handover and provide
                                                                  work        service through
Gopinathpur         1           1853000   1853000     1853000
                                                                Completed     Upgraded HSC.
*Data Source- District Administration.




                                                                                                        29
                                                                                                                                                            SARAIKELA-KHARSAWAN,DHAP 2011-12

In above upgraded HSCs need fund to provide facilities to conduct the deliveries . The plan
for the year 2011-2012 is as follows :-

                                                                                                                                                     Unit Cost & total
 Total HSC     Names / No. of HSCs                                                   Name of Block                                                                                                                              Justification
                                                                                                                                                         Amount
      1       Barasegoi                                                              Kuchai                                                               100000
      2       Baghraidih                                                             Kharsawan                                                            100000
      3       Sukhsari                                                               Nimdih                                                               100000
      4       Kukaru                                                                 Ichagarh                                                             100000                                                             In all these new
      5       Jhimri                                                                  Rajnagar                                                            100000                                                            upgraded centers
                                                                                                                                                                                                                               delivery will
      6       Patahesal                                                              Seraikella                                                           100000
                                                                                                                                                                                                                              conducted and
      7       Jhalak                                                                 Rajnagar                                                             100000                                                          therefore these need
      8       Kandra                                                                 Gamharia                                                             100000                                                           to be strengthened.
      9       Hudwa                                                                  Seraikella                                                           100000
     10       Riding                                                                 Kharsawan                                                            100000
     11       Gopinathpur                                                            Rajnagar                                                             100000
              Total                                                                                                                                      1100000

Budget – The total of Rs 1100000 (Eleven lakh) is budgeted in the Infrastructure Upgradation.


CONDITION OF HSC
                            Assured running water supply




                                                                                                                          Condition of labour room
                                                           Continuous power supply




                                                                                                 Functional Labour room




                                                                                                                                                                                  Residential Facility for


                                                                                                                                                                                                             Condition of ANM


                                                                                                                                                                                                                                 Status of HSC
                                                                                                                                                     No. of rooms
                                                                                                                                                                    No. of beds




                                                                                                                                                                                                                 residence
                                                                                       Toilets




                                                                                                                                                                                          ANM

   Total No Of HSC




Total Available               3                              6  0                                 24                                                                                   8
Total Not Available         170                            165 194                               170                                                    0              0              186
Total Irregular Supply       21                             23
Total Good Condition                                                                                                       8                                                                                     1                31
Total Needs Major Repair                                                                                                   7                                                                                     2                 8
Total Needs Minor Repair                                                                                                   9                                                                                     2                12
Total Needs New Building                                                                                                  170                                                                                   189              143

There are 194 HSCs exists in Saraikela-Kharsawan District, out all these HSCs only in 03 HSCs
Water Supply Facilities is available which there is a need to make water facility available in rest
191 HSCs. Similarly there are 06 HSCs which have the continues Supply of power , in 23 HSC
there is irregular power supply while in 165 HSC there is no power supply . Toilet facility is not
available in any HSCs. 08 Labour Rooms are functional, 07needs major repair, 09 needs minor
repair and rest require new building.. Out of these Labour rooms none are in Good condition.
                                                                                                                                                                                                                                                 30
                                                                                                                                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12




                                                                                      HUMAN RESOURCE
                                                                                      HUMAN RESOURCE

                                                                                   District Hospital, Saraikela
                                                                                                    Doctors
                  District                                                            Regular                 Contractual                      On Deputation                  Total               Total Gap
Sl no.
                  Hospital         Requirement as per IPHS (1)         Sanctioned    In position    Vacant
                                                                           2              3            4             5                                    6                    7(3+5+6)                 8 (1-7)
      1      Saraikela                           9                         9              7            2             1                                    0                           8                    1
            Total                                9                         9              7            2             1                                    0                           8                    1


                                                                                    Community Health Centre
                                                                       Doctors
                                                                                                                                                                    Status of Medical Officer in CHCs
                             Requir              Regular                 Contract                             Total
                                                                                        On          Total
Sl                           ement                                          ual                               Gap                              7
          CHC Name                     Sanctio          In      Vaca                  Deputati
no.                          as per                                                     on
                                         ned         position    nt                                                                            6
                             IPHS
                              (1)         2             3        4             5          6        7(3+5+6)   8 (1-7)                          5

1         Gamharia             6          4             4        0             2          0           6         0




                                                                                                                            Gaps as per IPHS
                                                                                                                                               4

2         Kharsawan            6          4             4        0             1          0           5         1
                                                                                                                                               3
3         Chandil              6          4             4        0             1          0           5         1
4         Kuchai               6          4             2        2             1          0           3         3                              2


5         Nimdih               6          4             4        0             2          0           6         0                              1


6         Seraikella           6          3             1        2             0          0           1         5                              0

7         Rajnagar             6          4             4        0             1          0           5         1                                  Gamharia   Kharsawan     Chandil   Kuchai     Nimdih
                                                                                                                                                                                          Name of CHC
                                                                                                                                                                                                            Seraikella   Rajnagar   Ichagarh



8         Ichagarh             6          4             4        0             1          0           5         1
                                                                                                                                                                          Requirement as per IPHS         In position     Total Gap
          Total               48         31            27        4             9          0          36         12




                                                                                                                                                                                                                                               31
                                                                                                                                      SARAIKELA-KHARSAWAN,DHAP 2011-12


                                                                 Staff Nurse
                                                                                   On
                                                                    Contractu      Deputat
Sl      CHC         Require
                                             Regular                al             ion        Total        Total Gap
                    ment as
no.     Name                   Sanctio       In         Vaca
                   per IPHS
                               ned           position   nt
                      (1)
                                                                                              7(3+5+
                                   2              3         4              5           6        6)          8 (1-7)
1     Gamharia        2            2              0         2              2           0         2             0
2     Kharsawan       2            2              0         2              2           0         2             0
3     Chandil         2            2              0         2              2           0         2             0
4     Kuchai          2            2              0         2              0           0         0             2
5     Nimdih          2            2              0         2              2           0         2             0
6     Seraikella      0            0              0         0              0           0         0             0
7     Rajnagar        2            2              0         2              1           0         1             1
8     Ichagarh        2            2              0         2              0           0         0             2
      Total           14           14             0         14             9           0         9             5

                                                                           ANM
                                                                                             On
Sl      CHC        Requirement                Regular                          Contractual   Deputation     Total        Total Gap
no.     Name       as per IPHS
                                   Sanctioned In position           Vacant
                        (1)
                                       2           3                  4            5             6          7(3+5+6)      8 (1-7)
1     Gamharia            4            2           2                   0           7             0              9           -5
2     Kharsawan           4              2              2              0           0             0              2            2
3     Chandil             4              2              0              2           0             0              0            4
4     Kuchai              4              2              0              2           5             0              5           -1
5     Nimdih              4              2              0              2           0             0              0            4
6     Seraikella          4              2              1              1           7             2             10           -6
7     Rajnagar            4              2              4             -2           3             0              7           -3
8     Ichagarh            4              2              0              2           2             0              2            2
      Total                   32             16                 9          7           24              2            35           -3


                                                                                                                                                                    32
                                                                                                                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                                               Primary Health Centre
                                                                                                                                                                                  Status of Medical Officer in PHCs
                                                                        Doctors
                   Total                           Regular                         On                                                               6
                                                                                                                  Total
Sl       CHC        No.      Requirem                                 Contractua Deputatio          Total
                                                                                                                  Gap                               5
No.      Name       of       ent as per Sanctioned In position Vacant     l         n
                   PHC       IPHS (1)




                                                                                                                           Gaps as per IPHS
                                                                                                                                                    4
                                            2           3        4        5         6              7(3+5+6)      8 (1-7)
                                                                                                                                                    3
 1    Gamharia      2           8           3           3         0            2           0             5           3
 2    Kharsawan     0           0           0           0         0            0           0             0           0                              2

 3    Chandil       2           8           4           2         2            2           1             5           3                              1

 4    Kuchai        0           0           0           0         0            0           0             0           0                              0
 5    Nimdih        1           4           2           1         1            0           0             1           3                                      ria             an             nd
                                                                                                                                                                                             i   l
                                                                                                                                                                                                         ha
                                                                                                                                                                                                           i
                                                                                                                                                                                                                         di
                                                                                                                                                                                                                           h            l la              ar           ar
                                                                                                                                                                                                                                                                          h
                                                                                                                                                          ha            w                ha           uc            im                ke                ag           ag
                                                                                                                                                                      sa                                                           ai                 jn
 6    Seraikella    2           8           4           1         3            2           0             3           5                                  am          ar
                                                                                                                                                                                     C               K          N               er               R
                                                                                                                                                                                                                                                     a            Ich
                                                                                                                                                    G                                                                          S
                                                                                                                                                                  Kh
 7    Rajnagar      3           12          6           2         4            1           0             3           9                                                                                    Nam e of CHC
 8    Ichagarh       1           4          2            1         1           0           0            1             3
                                                                                                                                                                                 Requirement as per IPHS                   In position           Total Gap
       Total        11          44         21           10        11           7           1           18            26

                                                                   ANM                                                                                                                   S t at us of A NM i n P CHs


                                           Regular                                    On
                    Require                                                                                                                   20
                                                                      Contractual   Deputatio    Total       Total Gap
Sl       CHC        ment as
                                                                                       n
No.      Name         per                                                                                                                     15

                                Sanctio
                     IPHS
                                ned       In position    Vacant                                                                               10
                      (1)
                                    2          3            4             5            6        7(3+5+6)      8 (1-7)




                                                                                                                           Gaps as per IPHS
                                                                                                                                               5
1     Gamharia           4           4          2            2            12           0          14           -10
2     Kharsawan          4           4          0            4            0            0          0             4                              0
                                                                                                                                                         Gamharia     Kharsawan          Chandil       Kuchai       Nimdih          Seraikella         Rajnagar      Ichagarh

3     Chandil            4           4          0            4            0            0          0             4                              -5


4     Kuchai             4           4          0            4            0            0          0             4
                                                                                                                                              -10

5     Nimdih             4           4          0            4            0            0          0             4
6     Seraikella         4           4          0            4            1            0          1             3                             -15

                                                                                                                                                                                                          Name of CHC

7     Rajnagar           4           4          2            2            1            0          3             1
                                                                                                                                                                                     Requirement as per IPHS        In position       Total Gap

8     Ichagarh           4            4         0            4             0           0          0             4
      Total             32           32         4            28           14           0          18            14

                                                                                                                                                                                                                                                                              33
                                                                                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                                      Health Sub – Centre
                    Total                                                      ANM
                     No.    Requirement              Regular
                                                                                                  On                     Total
Sl       CHC          of    as per IPHS               In                         Contractual                   Total
                                          Sanctioned                 Vacant                    Deputation                Gap
no.      Name       HSC         (1)                   position
                                                                                                                          8 (1-
                                 1                2           3            4             5         6         7(3+5+6)
                                                                                                                           7)
 1    Gamharia       21          42               40          15          25          32           0            47         -5
 2    Kharsawan      21          42               42          13          29          28           0            41          1
 3    Chandil        25          50               50          17          33          24           0            41          9
 4    Kuchai         14          28               28           2          26          21           0            23          5
 5    Nimdih         28          56               58          15          43          17           0            32         24
 6    Seraikella     25          50               46          14          32          22           3            39         11
 7    Rajnagar       32          64               31          12          19          37           2            51         13
 8    Ichagarh       28          56               52           9          43          26           0            35         21
      Total         194         388              347          97          250        207           5           309         79


                                                                   Male Health Worker
                   Total
                                       Regular                                                   On
                   No. of    Require
Sl      CHC                                            In                       Contractual    Deputatio     Total     Total Gap
                   HSC      ment as    Sanctioned                  Vacant
No.     Name                                           position                                   n
                               per
                                                                                                               7
                            IPHS (1)        2             3           4              5            6                     8 (1-7)
                                                                                                            (3+5+6)
1     Gamharia       21        40          20             1          19              0            0            1          39
2     Kharsawan      21        42          21             2          19              0            0            2          40
3     Chandil        25        50          25             1          24              0            0            1          49
4     Kuchai         14        28          14             1          13              0            0            1          27
5     Nimdih         28        58          29             4          25              3            0            7          51
6     Seraikella     25        46          23             4          19              0            0            4          42
7     Rajnagar       32        62          31            11          20              0            0           11          51
8     Ichagarh       28        52          26             0          26              0            0            0          52
       Total        194       378         189            24         165              3            0           27         351



                                                                                                                                                                 34
                                                                                                                        SARAIKELA-KHARSAWAN,DHAP 2011-12


                                                         Multi - Purpose Health Worker
                            Requir      Regular                                            On
                                                                                                            Total
Sl                          ement                    In                    Contractual   Deputa    Total
                  Total                 Sanctioned                Vacant                                    Gap
       CHC                  as per                   position                             tion
No                No. of
       Name       HSC
                            IPHS
 .                           (1)                                                                  7(3+5+
                                               2         3           4          5           6              8 (1-7)
                                                                                                  6)

1    Gamharia       21          21          21           0           21          9          0       9        12
2    Kharsawan      21          21          21           0           21          5          0       5        16
3    Chandil        25          25          25           0           25          5          0       5        20
4    Kuchai         14          14          14           0           14          2          0       2        12
5    Nimdih         28          28          28           0           28          4          0       4        24
6    Seraikella     25          25          25           0           25          7          0       7        18
7    Rajnagar       32          32          32           0           32          8          0       8        24
8    Ichagarh       28          28          28           0           28          4          0       4        24
     Total         194         194         194           0          194         44          0       44       150


                                               Proposal for construction New HSCs in PTG area in year 2011-12
                         Sl.No           Name of CHCs           Area Proposed        PTG area       Amount           Remarks
                           1         Kuchai                     Jilingda               PTG          2500000
                                                                kandarbera             PTG          2500000
                                                                Hesakocha              PTG          2500000
                           2         Chandil                    Matkamdih              PTG          2500000
                                                                Dhunaburu              PTG          2500000
                                                                Chilgu                 PTG          2500000
                                                                Samanpur               PTG          2500000
                           3         Nimdih                     Tengadih               PTG          2500000
                                                                Bareda                 PTG          2500000
                                                                                          Total    22500000
      Note : Our district have 3 PTG block. Above mentioned PTG area are situated far from HSC so we planned for new HSC construction.


                                                                                                                                                      35
                                                                          SARAIKELA-KHARSAWAN,DHAP 2011-12


                                               MATERNAL HEALTH
                                               MATERNAL HEALTH
          Objectives and Targets

                                                                                                       Target
                                                                                      Current Level
              Objective(s)                                                                              for
                                                                                       (2010-11)
                                                                                                      2011-12

       1         Ensuring registration of pregnant women for ANC                      49%             60 %

       2         Increase in the % of pregnant women registered in the first          50%             75%
                 trimester

       3         Increase in the % of pregnant women with full ANC                    48%             60%

       4         Ensuring that % of pregnant women receive at least one TT            49%             60%
                 injections & consume 100 IFA tablets.

       5         Increase in skilled attendance during delivery from to               33%             50%

       6         Increase in institutional delivery                                   28%             40%

       7         Increase in the % of mothers receiving postnatal care within 48hrs   51%             70%
                 of delivery

       8         Increase in % of neonates breastfed within 1 hour of birth           61%             75%

       9         Ensuring that all newborns are weighed within 48 hrs of birth        86%             95%


  *   Data Source- Internal MIS.


       Situational Analysis

Antenatal Care

The situation analysis shows that there the health services are still not able to trace pregnant women in their
first trimester and therefore only 50% women are registered then. However around 87% pregnant women are
registered for ANC but out of this only 48% are given services of ANC check up(as per HMIS – 2010) . This
is very near to the DLHS analysis which shows that 50.9 % pregnant women are rendered ANC check up
services .
In most of the blocks the all women registered under ANC are not being delivered 3 ANC check up services .
The situation in CHC Chandil needs to be addressed because CHC Chandil is covering a large population
strategies need to be devised to improve the ANC services of CHC Chandil and also where the coverage is
only 30%.
Anaemia and IFA
The health services in the district is able to reach out to 49% pregnant women for distributing 100 IFA while
only 15% women are reported as Anaemic.
 More pregnant women should be tested of hemoglobin which can be done either by the ANMs or in the
    Laboratory. Therefore the ANMs should be well equipped with hemoglobin meter. The CHC and
    laboratory services should also be improved. The stated will be monitored closely for ensuring the
    coverage.




                                                                                                             36
                                                                                                                                        SARAIKELA-KHARSAWAN,DHAP 2011-12

PHYSICAL ACHEIVEMENT OF THE YEAR 2009-10 AND 2010-11 (Till Sep10)

                                                                                           Ante Natal Checkup                                      Anemia                IFA
                                                                                                                                                                              % of
                                                                          No. of     % of      No. of        % of      No. of       % of    No. of      % of     No. of    pregnant
SL.   Name of                                                  Pregnant Women      Women     pregnant     pregnant    pregnant    pregnant pregnant   pregnant pregnant     women
                    Population            Achievement
No    the CHC                                                  Women registered registered women           women women with women with women           women women who       who
                                                              Population for 1st   for 1st  registered   registered 3 ANC check 3 ANC check  with       with  received 100 received
                                                                        Trimester Trimester   for ANC      for ANC       up          up     anemia     anemia IFA tablets 100 IFA
                                                                                                                                                                            tablets
                POP of 2009
                              24194   Achievement April '09
                 April 09 -                                     2255       953       42        2067         92        1876         83        358            17    1098         53
                                5      - March '10 (Actual)
 1 Gamharia      March 10
                              29276   Achievement April '10     3756      1654       44        3232         86        1576         42        257            8     1290         40
                Present POP
                                9       - Sep '10 (Actual)
                POP of 2009
                                      Achievement April '09
                 April 09 -   73454                             2101       860       41        1654         79        1554         74        604            37     654         40
                                       - March '10 (Actual)
 2 Kharsawan     March 10
                                      Achievement April '10     1271       578       45        1113         88         786         62        336            30     342         31
                Present POP   88884
                                        - Sep '10 (Actual)
                POP of 2009
                              12195   Achievement April '09
                 April 09 -                                     3488      1749       50        1749         50        1800         52        365            21     861         49
                                9      - March '10 (Actual)
 3 Chandil       March 10
                              14725   Achievement April '10     2106       932       44        1796         85         642         30        189            11     587         33
                Present POP
                                0       - Sep '10 (Actual)
                POP of 2009
                                      Achievement April '09
                 April 09 -   53692                             1856       754       41        1856        100        1369         74        210            11     980         53
                                       - March '10 (Actual)
 4 Kuchai        March 10
                                      Achievement April '10      971       389       40         971        100         526         54        541            56     354         36
                Present POP   64972
                                        - Sep '10 (Actual)
                POP of 2009
                                      Achievement April '09
                 April 09 -   94205                             2694       843       31        2473         92        1800         67        186            8      483         20
                                       - March '10 (Actual)
 5 Nimdih        March 10
                              11399   Achievement April '10     1630       900       55        1412         87        1265         78        154            11     635         45
                Present POP
                                4       - Sep '10 (Actual)




                                                                                                                                                                                    37
                                                                                                           SARAIKELA-KHARSAWAN,DHAP 2011-12

               POP of 2009
                                     Achievement April '09
                April 09 -   83586                           1195    194    16    940    79    819    69        210    22      412     44
                                      - March '10 (Actual)
6 Seraikella    March 10
                             10114   Achievement April '10   1446    857    59   1019    70    717    50        189    19      530     52
               Present POP
                               4       - Sep '10 (Actual)
               POP of 2009
                             12251   Achievement April '09
                April 09 -                                   3504    1387   40   2683    77    401    11        100     4      640     24
                               4      - March '10 (Actual)
7 Rajnagar      March 10
                             14825   Achievement April '10   2120    1108   52   1939    91    879    41        10      1     1453     75
               Present POP
                               0       - Sep '10 (Actual)
               POP of 2009
                                     Achievement April '09
                April 09 -   98422                           2815    142    5    1800    64   1460    52        98      5      867     48
                                      - March '10 (Actual)
8 Ichagarh      March 10
                             11909   Achievement April '10   1703    1139   67   1510    89    864    51        225    15     1213     80
               Present POP
                               7       - Sep '10 (Actual)
               POP of 2009
                                     Achievement April '09
                April 09 -                                   19908   6882   35   15222   76   11079   56       2131    14     5995     39
                                      - March '10 (Actual)
      Total     March 10
                                     Achievement April '10   15003   7557   50   12992   87   7255    48       1901    15     6404     49
               Present POP
                                       - Sep '10 (Actual)




                                                                                                                                            38
                                                             SARAIKELA-KHARSAWAN,DHAP 2011-12

Institutional Delivery
The HMIS data indicates that out of the total deliveries conducted in the district 38.72 %
HMIS 09-10 while 18.72% (HMIS10-11)are conducted in the CHCs. However only % of these
deliveries were given JSY incentive.

CHC /Block              No. of Pregnant Women     Case load for referral (2011-2012)
Seraikella                        2388                                   238

Kharsawan                         2388                                  238

Kuchai                            1948                                  194

Rajnagar                          3955                                  395

Gamharia                          8575                                  857

Nimdih                            2868                                  286

Chandil                           3856                                  385

Ichagarh                          3352                                  335

Total                            29330                                 2928


Referral Transport
The situation analysis indicates that in the year 2009-2010 , 160 cases were referred from CHC to
higher institution. In the year 2010-11 only 271 cases referred from CHC to higher institution.

 CHC /Block      No.of           Ambulance                            Refferal     TOTAL
                                           Case load for referral
                 Pregnant        maintain                             transport
                                              ((2011-2012)
                 Women           costs                                cost
 Seraikella           2388          25000              238               71400          96400

 Kharsawan            2388          25000              238               71400          96400

 Kuchai               1948          25000              194               58200          83200

 Rajnagar             3955          25000              395              118500         143500

 Gamharia             8575          25000              857              257100         282100

 Nimdih               2868          25000              286               85800         110800

 Chandil              3856          25000              385              115500         140500

 Ichagarh             3352          25000              335              100500         125500

 Total               29330         200000              2928             878400         1078400



                                                                                                 39
                                                                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12


Status of Ambulance:–

Situational analysis-
In the District Saraikela-Kharsawan out of eight CHC and one Sadar Hospital , there are only two CHC and Sadar Hosoital have ambulance .
Strategy-
    1. We are laisoning with the district administration to provide ambulance and also insert in the integrated district action plan for the 2011 -2012.
    2. We also request to State Rural Health Society to provide at least 4 ambulance for this district to manage the referral services from Hard to reach
        areas.


REFFERAL FACILITY




                                                                                                                                                      40
                                                                                                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12

  Table representing the status of Institutional Delivery and JSY


                                                                                       Institutional Delivery and JSY                                                 Referral
                                                  Total no.
                                                      of                             No. of           % of                                                               No. of
                                                Instituional                      institutional   institutional                                                        deliveries
       Name of the                               deliveries    No. of     % of    deliveries in   deliveries in                                                      referred due
S.No                      Achievement
          CHC                                    (including deliveries deliveries   which JSY       which JSY       Inst.      Budget for                                  to
                                                   all the   conducted conducted incentive to     incentive to    Delivery         JSY         Sahiyya    JSY Total complications
                                                institutions   at CHC    at CHC    beneficiary     beneficiary     target     Beneficiaries   Incentive    budget       through
                                                 govt./pvt.)    only      only     were given      were given      for JSY       (in Rs)        (in Rs)    (in Rs ) HSC/PHC/CHC
                     Achievement April '09
 1     Gamharia      - March '10 (Actual)             442         223          51          442             100       5145          618800      265200      884000                74
                     Achievement April '10
                     - Sep '10 (Actual)               320         122          38          320             100       3001          448000      192000      640000                96
                     Achievement April '09
 2     Kharsawan     - March '10 (Actual)             636         359          56          559              88       1576          890400      381600 1272000                    44
                     Achievement April '10
                     - Sep '10 (Actual)               514         358          70          451              88          919        719600      308400 1028000                    43
                     Achievement April '09
                     - March '10 (Actual)             356         321          90          356             100       2314          498400      213600      712000                37
 3     Chandil       Achievement April '10
                     - Sep '10 (Actual)
                                                      545         459          84          512              94       1350          763000      327000 1090000                    50
                     Achievement April '09
 4     Kuchai        - March '10 (Actual)             203         203         100          203             100       1286          284200      121800      406000                12
                       Achievement April
                       '10 - Sep '10 (Actual)         339         332          98          339             100          750        474600      203400      678000                23




                                                                                                                                                                        41
                     Achievement April                                                SARAIKELA-KHARSAWAN,DHAP 2011-12
                     '09 - March '10
  5     Nimdih       (Actual)                  476    412   86    476   100    1704    666400   285600   952000           53
                     Achievement April
                     '10 - Sep '10 (Actual)    469    389   83    469   100     994    656600   281400   938000            2
                     Achievement April
                     '09 - March '10
  6     Seraikella   (Actual)                  821    769   94    821   100    1414   1149400   492600 1642000            18
                     Achievement April
                     '10 - Sep '10 (Actual)    640    584   91    640   100     825    896000   384000 1280000             6
                     Achievement April
                     '09 - March '10
  7     Rajnagar     (Actual)                  233    208   89    233   100    2296    326200   139800   466000           21
                     Achievement April
                     '10 - Sep '10 (Actual)    186    154   83    186   100    1339    260400   111600   372000           46
                     Achievement April
                     '09 - March '10
  8     Ichagarh     (Actual)                  150     42   28    127    85    2234    210000    90000   300000            1
                     Achievement April
                     '10 - Sep '10 (Actual)    141     87   62    141   100    1303    197400    84600   282000            5
                     Achievement April
                     '09 - March '10
                     (Actual)                 3317   2537   76   3217    97   17969   4643800   1990200 6634000          260
Total
                     Achievement April
                     '10 - Sep '10 (Actual)   3154   2485   79   3058    97   10482   4415600   1892400 6308000          271




                                                                                                                    42
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12

 MUKHYA MANTRI JANANI SISHU SWASTH ABIHYAAN


MMJSY Planning

The year 10-11 the total institutional delivery is 3154 till sep.2010. And the Sixty Three Lakhs and eight
Thousand rupees has been paid to beneficiary. In the financial year 11-12 we target 10482 women to
provide better health institutional and safe delivery system. The budget is given for the year 2011-12 in the
table forms above.

Provision for FY 11-12 for promoting institutional delivery:


Voucher                                          Denomination

Institutional delivery                           Rs1400.00 (Rural Area)

                                                 Rs.1000.00(Urban Area)

To Pregnant women / Sahiyya / Health link        Rs. 250.00
worker (who arranges transport to the
institution during labour)

Foe post natal visit & after BCG injection       Rs. 200.00
(within. 7 days)

Sahiyya /Health link worker during her           Rs 150.00
stay in the Institution




                                                                                                          43
                                                                                                                         SARAIKELA-KHARSAWAN,DHAP 2011-12


Table representing the status of Home Delivery

                                                                                                               Home Delivery
                                                                                                            No. of home % of home
                                                                     Pregnant
                                                                                               No. of       deliveries in deliveries in
Sl.                                                                  Women
      Name of the CHC                                                           No. of         home         which JSY      which JSY
No                                                                   Populati
                                                                                deliveries     deliveries   incentive to incentive to
                                                                        on
                                                                                conducted      conducte     beneficiary    beneficiary   Home delivery
                                                                                at Home        d by SBA     were given     were given    target 2011-12
  1 Gamharia            Achievement April '09 - March '10 (Actual)      8575             23            23               23          100            3430
                        Achievement April '10 - Sep '10 (Actual)        5002               8            8                8          100            2001
  2 Kharsawan           Achievement April '09 - March '10 (Actual)      2627             17            17               17          100            1051
                        Achievement April '10 - Sep '10 (Actual)        1532             42            42               42          100             613
  3 Chandil             Achievement April '09 - March '10 (Actual)      3856             10            10               10          100            1542
                        Achievement April '10 - Sep '10 (Actual)        2249             15            15               15          100             900
  4 Kuchai              Achievement April '09 - March '10 (Actual)      2143             12            12               12          100             857
                        Achievement April '10 - Sep '10 (Actual)        1250             16            16               16          100             500
  5 Nimdih              Achievement April '09 - March '10 (Actual)      2840               0            0                0             0           1136
                        Achievement April '10 - Sep '10 (Actual)        1657               0            0                0             0            663
  6 Seraikella          Achievement April '09 - March '10 (Actual)      2357               8            8                8          100             943
                        Achievement April '10 - Sep '10 (Actual)        1375             12            12               12          100             550
  7 Rajnagar            Achievement April '09 - March '10 (Actual)      3827               0            0                0          100            1531
                        Achievement April '10 - Sep '10 (Actual)        2232               0            0                0          100             893
  8 Ichagarh            Achievement April '09 - March '10 (Actual)      3724             42            42               42          100            1490
                        Achievement April '10 - Sep '10 (Actual)        2172             38            38               38          100             869
      Total             Achievement April '09 - March '10 (Actual)     29949            112           112             112           100           11980
                        Achievement April '10 - Sep '10 (Actual)       17470            131           131             131           100            6988

                    The table depicts that on an average 4% women have home deliveries.

                    Regarding caesarean section in none of the blocks the Govt. facility is equipped to conduct C Section.



                                                                                                                                                          44
                                                              SARAIKELA-KHARSAWAN,DHAP 2011-12




a. Antenatal care

Strategies :-
 Increasing early registration through counseling of eligible couples by Sahiyyas and ANMs and
  distribution of IEC materials.
 Case management of pregnant women to ensure that they receive all relevant services by Sahiyyas
  and ANMs
 Involvement of VHCs to aware the community
 Providing ANC along with Immunization services on Immunization days or VHND
 Strengthening ANC services at the Sub centre level by ensuring availability of appropriate
  infrastructure equipment and supplies
 Functionalizing the VHND
 Setting up of referral transport system at every PHC level.
 Effective monitoring and support to HSCs for ANC by PHCs and CHCs.
 Ensuring quality ANC through appropriate training of the ANM


Activities :-
 Training of Sahiyas for counseling of eligible couples for early registration and the importance of
  ANC.
 Regular updating of the ANC register and MCH tracking by ANM with the help of Sahiya and AWW.
 Preparation of the due list with the dates for Ante Natal Checkups for every pregnant woman in the
  Sub centre area and informed to Sahiyyas & VHCs.
 Training to Sahiyas and AWWs to fill and update due list and ANC schedule list for every pregnant
  woman in their work area during House visit and Active involvement of VHSC.
 Organizing Antenatal checkups on immunization days or VHND focus a special day at the sub centre
  level for anti-natal check up.
 Sahiyyas and AWWs to coordinate with ANM to provide Antenatal care according to the ANC
  schedule maintained in the register for every expectant mother.
 Sahiyyas and AWWs to track left outs and drop outs before every ANC & immunization day and
  ensure their participation for the coming day.
 Participation of Sahiyya and AWW in VHSC meeting and sharing the ANC status and Due list with all
  the members of VHCs.
 Wide publicity through IEC Materials and IPC.
 Organizating VHND on monthly bases per village and scheduling by ANM on Sub-Center level
 Ensuring the house hold visiting of ANM and Sahiyyas

 Training to ANMs to provide complete Ante natal care and identify high risk pregnancies.
 Strengthening of Sub centre in terms of equipments to conduct ANC services.

 Ensuring the display of Educative posters in villages at important Place.
 Ensuring regular supply of TT& IFA tablets at each sub centre level.

 Setting up Helpline with referral transpotation at every CHC and PHCs
 Ensuring appropriate referral facility for risky pregnancies/deliveries
 Ensuring the quality of ANC by involvement of Medical officers in ANC at HSC as well as AWC time
  to time.
 Ensuring the availability of Fund and distribution of Incentive to Sahiyyas/ health workers
                                                                                                  45
                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12




   b.   Natal, neo-natal and postnatal care


Strategies :-
       Strengthening facilities for institutional deliveries
       Ambulance services (see the facility section)
       Developing a pool of Skilled Birth Attendants for each block
       Counseling and support to new mothers
       Sick Newborn Care Unit
       Other services

Activities :-

    Equipping PHCs and CHCs to provide minimum 24 hours post delivery stay to mothers and
     newborns by setting on maternal and neonatal wards
    Equipping CHCs, and DH to enable 48 hrs of post delivery stay for mothers and new born by setting
     up maternal and neonatal wards
    Ensuring availability of required medical officers, nurses and ANMs at all facilities
    Appointment of Pediatricians and Gynecologists and anesthetic at every CHCs.
    Regular stocks of emergency medicine include the PPH controlling drugs.
    Identifying ambulance service providers for PHCs, CHCs, and DH and signing contracts for services
    Focus on increasing exemption to BPL patients in the utilization of ambulance services and use of
     RKS fund
    Regular rounds of SBA training for ANMs, LHVs and Nurses
    Sahiyyas to have the names and numbers of skilled birth attendants for every block
    Stabling the Helpline
    Ensuring mother to receive a post natal check up before discharge
    IMNCI training for all Sahiyyas, AWW and ANMs
    EmOC training for Seven MOs and at least one medical officer of DH.
    Streamlining JSY money from district to CHC to provide timely payment to beneficiaries and
     Sahiyyas.
    Established special counter for JSY incentive payment
    Ensuring the frequent visit of Sahiyyas' to new born baby in first 48 hours and also ensure exclusive
     breast feeding, counsel the families about new born care and post natal care.
    ANM and staff at facility to provide counseling and support for exclusive breast feeding.
    Ensuring the family planning Counselling and telling them about importants of spacing between the
     two children
    Proper implementation of VHND and use this plateform for counseling
    Postnatal follow up by Sahiyyas and ANMs at the village level
    Oparationalised of Sick Newborn Care Unit at the District Hospital
    Weekly RTI/STI clinics to be held at all CHCs
    Tag of VHND Monthly with RCH camps .




                                                                                                       46
                                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                             A 2. Child Health
       Immunization is the most effective service to the community to reduce IMR. The recent
DLHS-3 data shows that total 69.3 % children are receiving BCG vaccine, three doses of DPT
vaccine, three doses of OPV vaccine and measles before their first birthday. The trend of
Immunization in the district is as follows:
The graphical representation of performance of district till October 2010

                        95

                               92                     91

                        90
                                               88                   88
                                                                              86
  Percentage Coverage




                                                                                                     85
                        85



                        80                                                                   78



                        75



                        70
                              BCG          OPV       DPT1          DPT3     Measles     Full Imm.   Vit. A
                                                                  Antegen




The above table depicts that :-
                        Approx 8% of Children are not receiving BCG vaccine which shows the poor mobilization
                         activity, poor availability and accessibility. This also indicates that there is some problem in
                         geographical coverage and certain areas are still untouched from immunization services.
                        Average dropped out rate is below 10 but CHC, Chandil dropout rate is 10.57 which indicate
                         that there is need to improve mobilization and quality of services.

                                                        DLHS 3                                            Target
                                 Indicators                                    HMIS 2009-10                 for
                                                      ( Jharkhand)                                        2011-12

                              Fully Immunized              61.6%                      95 %                    98

                             Dropped Out BCG-
                                                            15%                       2%                     1%
                                  Measles

                             Dropped Out DPT1-
                                                           36.4%                      2%                     1%
                                   DPT3

                                    Left Out               12.8%                      10%                    5%

                               BCG Coverage                85 %                       85%                    95 %

* Data Source- DLHS , HMIS and District Data.
                                                                                                                      47
                                                                       SARAIKELA-KHARSAWAN,DHAP 2011-12

Following data shows that in the year 09-10 the BCG coverage was the 85% (HMIS 09-10) .we
effort to increase it to at least 95% BCG coverage.

Now it is clear from the data that the coverage of fully immunization is 83% (09-10) and we plan to
increase it to 95% in the financial year 2011-12

Block wise achievements

                                                                                                            Fully
                                                                BCG      DPT -I        DPT-    Measles
                      Name of the CHC                                                                    Immunization
                                                                 %        %            III %     %
                                                                                                             %
                Achievement April '09 - March '10 (Actual)        95      102          102       87           87
 Gamharia       Achievement April '10 - Sep '10 (Actual)          52       51           52       50           50
                             Target 2011-2012                    100      100          100      100          100
                Achievement April '09 - March '10 (Actual)        87       89           94       90           87
 Kharsawan      Achievement April '10 - Sep '10 (Actual)          58       61           57       58           57
                             Target 2011-2012                    100      100          100      100          100
                Achievement April '09 - March '10 (Actual)        96       97           95       79           79
  Chandil       Achievement April '10 - Sep '10 (Actual)          59       62           55       49           45
                             Target 2011-2012                    100      100          100      100          100
                Achievement April '09 - March '10 (Actual)        87       92           90       90           87
   Kuchai       Achievement April '10 - Sep '10 (Actual)          55       56           52       53           52
                             Target 2011-2012                    100      100          100      100          100
                Achievement April '09 - March '10 (Actual)        81       86           85       79           79
   Nimdih       Achievement April '10 - Sep '10 (Actual)          54       53           49       51           49
                             Target 2011-2012                    100      100          100      100          100
                Achievement April '09 - March '10 (Actual)        93       92           91       93           91
 Seraikella     Achievement April '10 - Sep '10 (Actual)          54       54           51       52           51
                             Target 2011-2012                    100      100          100      100          100
                Achievement April '09 - March '10 (Actual)        56       73           89       79           66
  Rajnagar      Achievement April '10 - Sep '10 (Actual)          47       44           45       48           41
                             Target 2011-2012                    100      100          100      100          100
                Achievement April '09 - March '10 (Actual)        66       68           72       74           66
  Ichagarh      Achievement April '10 - Sep '10 (Actual)          52       51           48       47           46
                             Target 2011-2012                    100      100          100      100          100
                Achievement April '09 - March '10 (Actual)        85       90           92       83           83
   District     Achievement April '10 - Sep '10 (Actual)          53       53           51       50           46
                             Target 2011-2012                    100      100          100      100          100
Nutrition:-
Strategies :-

       Promote cholestrom feeding and exclusive breast feeding through mother group , sahiya , and
        other CBOs.
       Setting up of Second MTC center at Chandil for savior malnourished children.
       Conduct VHND in every session site.
Activities :-

     Identification of severely undernourished children (Grade III & Grade IV) in AWC and share the list
      with health.
                                                                                                                48
                                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12

     Preliminary monthly health checkups at AWC by the ANM and refer to MTC center for severe
      malnourished children.
     Ensuring the Nutrition awareness in VHND.
     Ensure Block Level Monitoring committee / Hospital Management Society meeting .

Health Services :-
Strategies :-

     Promotion of health seeking behaviour for sick children through BCC campaigns.
     BCC for pregnant women and mothers to regarding feeding practices, immunisation, and other
      aspects of child care.
     Capacity building of ASHA, AWW and ANM for the management of common childhood diseases and
      identification of serious cases for referral.
Activities :-

     Training of ANM and AWW for IMNCI
     Training Sahiyyas to refer sick child to facility in case of serious illness.
     Sahiyyas equipped to provide ORS to children with diarrhea and suggest referral in case of
      emergency.
     Regular stock up of Sahiyya drug kits.
     Providing weighing machines to every AWC to ensure monthly weighing
     Sahiyyas to support AWWs in monthly weighing
     Ensuring Health Check up in VHND


Health Services – Immunizations
Strategies :-

     Immunization services through awareness generation by Sahiyyas and AWWs.
     Ensuring continued tracking of pregnant women and children for full immunization
     Improving timely supply of the vaccines
     Improving timely supply of the vaccines Improving availability and maintaining quality of cold chain
      equipments
     Adopting safe disposal policies for needles and syringes
Activities :-

     Organising regular routine immunisation training for ANM and AWW and IPC/IEC/BCC trainings for
      Sahiyyas and AWWs
     Organising immunisation camps at every sub centre level on every VHND.
     Regular house to house visits for registration of pregnant women for ANC and children for
      immunization
     Developing tour plan schedule of ANM with the help of MOIC.
     Timely payment to MOICs to arrange transportation of vaccines from district to CHCs.
     Regular disbursement of funds from District to MOs for providing incentives to Sahiya.
     Regular disbursement of funds for ANMs to provide incentives to Sahiyyas workers
     Visits by MOIC, CDPO, LHV and health educator to monitor the progress of immunization schedule
      and prepare report.
     School Health programmes to be conducted through partnership with NGOs
     One day Health camps with the help of Child cabinet
     One day Quiz on Health issues
     Providing an award for the ‘Healthiest’ school in the block

                                                                                                         49
                                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12

    Requisition to be sent the state health society for expanding the school health programme to high
     school of government schools.


    To ensure the availability of vaccines in the district, CHCs and Immunization Sites following
   actions can be taken:

           Cold Chain maintenance,
           Arrangement of Electricity Back up- Repairing of Generators at Kuchai, Rajnagar,
           Chandil, Seraikella and Nimdih.
           Arrangement of vaccine movement from state to district, district to CHCs and and
            CHCs to R I session sites.
           Strengthening existing Alternate Vaccine Delivery System
           Appointment of Cold Chain mechanics at District.

To accessibility we need to focus on the following activities;

      Revising R I Microplan on regular interval
      Identification of Hard to Reach areas and incorporating them in R I microplan and
       organizing R I sessions in these areas. At present there are 39 villages/ Hamlets in the district
       which are hard to Reach.
      To increase accessibility of Routine Immunization services Village Health and Nutrition Day
       can be operationalzed . The VHND micro plan will be based on the Routine Immunization
       plans with addition of other services once in a month at the villages. This will provide an
       opportunity to receive multiple services at one point of contact every month.
      Review of RI activities at Health Sub center, CHC level and district level
      Proper functioning of RI monitoring cell at district level.
      The SARAIKELA-KHARSAWAN district in eight CHC and one District hospital we need
       to POL cost @10,000/- per month per CHC / DH.Total Budget require are 90,000/-.

       The above mentioned activities also ensure the utilization and adequate coverage status of
   the district. We can add the following activities to ensure utilization and adequate coverage

      Construction/ renovation of Safety pits
      Safe disposal of Immunization wastes

       To ensure effective coverage of the district we need to focus on capacity building activities
    for the service providers like

       Cold Chain training for Cold Chain handlers
       RI handbook training for front line workers
       Training on Injection safety and Waste management




                                                                                                     50
                                                              SARAIKELA-KHARSAWAN,DHAP 2011-12

Strengthening of the existing Malnutrition Treatment Centres (MTCs) Operationalization of
new MTCs, improving the quality of implementation, equipping the MTCs, training the staff was
the main focus in 2010-11.

Plan for MTC in 2011-12: A new MTC is required in CHC Chandil..

Budgetary Provision for MTC

                          Particulars                         Unit     Unit Cost   Total Cost

  Operationalization of MTC                                    2        491000       982000




Total Budget for Cold Chain Expenses


                                                                                       Total
  Particular                                          Unit             Unit cost
                                                                                      Budget
  Refrigerator Mechanic                                   1               10000       120000
  proMIS Operator/ Store Keeper for
                                                          1               12000       144000
  District Warehouse
  Cold Chain Handler                                      9               10000        90000
  POL for Cold Chain                                      9                5000        45000
  Total                                                                               399000



    INTEGRATED MANAGEMENT OF NEONATAL AND CHILDHOOD ILLNESSES
     (IMNCI)

   IMNCI is an evidence-based syndromic approach to case management. It has three main
   components :
    (1) Improvement in the case management skills of health staff,
    (2) Improvement in the overall health system for effective management of neonatal and
       childhood illness and
    (3) Improvement in family and community healthcare practices. Under NRHM the IMNCI
       strategy is visualized as key input in the child survival programme.
    REFERRAL TRANSPORT

   IMNCI leads to an increase in referrals for sick newborns and children. The state has provided
   Rs. 500/- for referral transport to the family for referral of each sick new born and severely
   malnourished child.




                                                                                                51
                                                                       SARAIKELA-KHARSAWAN,DHAP 2011-12

                                             A3. FAMILY PLANNING

 Situation Analysis:
         The utilization of any method of contraception is 37.4%, out of this; nearly 22.6% is contributed by
 female sterilization. Male sterilization is a low 0.3%. Other spacing methods are equally low with the use of
 IUD a mere 0.4%, pills 6.5% and condoms 3.3%. A significant unmet need for family planning services has
 been recorded at 34% which importantly comprises of a 12.4% need for spacing and 21.6% for limiting
 methods.

 Objectives and Targets

                                                                                              Current          Target
                                                                            Jharkhand
                                   Objective                                                   Level            for
                                                                              DLHS 3
                                                                                                              2011-12
      1       Fulfilling unmet need of 34% for family planning services
              at the community level                                           34.7              34%             60%

      2       Increasing the use of any modern method of family
              planning                                                         34.9              31%             50%

      3       Increasing male sterilization rates
                                                                                 0.4             0.3             20
      4       Increasing the utilization of condoms as the preferred
              choice of contraception                                            2.0             3.3%            12%


 (Source: DLHS-03 Internal MIS data)

Current users of Family Planning


                                                                                       Total no. of     Total      Total
                                                                       No. of oral
    Name of                                                                              Female         No. of     No. of
                        Achievement and Target for 2011 -12             pills cycle
     CHC                                                                               Sterilization    NSV        IUD
                                                                       distributed
                                                                                           done         done     Insertion

                 Achievement April '09 - March '10 (Actual)               10928            736            46        736
   Gamharia      Achievement April '10 - Sep '10 (Actual)                 72696            211           202       1007
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                            2440           1050           81        1181
            Achievement April '09 - March '10 (Actual)                     4828            108           30         398
  Kharsawan Achievement April '10 - Sep '10 (Actual)                      16049            125           28         300
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                            625             456           38           625
                 Achievement April '09 - March '10 (Actual)               4218             327           60           311
    Chandil      Achievement April '10 - Sep '10 (Actual)                 6179             116           34           520
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                           1254             703           56           895




                                                                                                                        52
                                                                       SARAIKELA-KHARSAWAN,DHAP 2011-12

                 Achievement April '09 - March '10 (Actual)                  3298         60       5       200
   Kuchai        Achievement April '10 - Sep '10 (Actual)                    5206        100       7       430
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                               1925       603       38      688
                 Achievement April '09 - March '10 (Actual)                   5017       349       42      292
   Nimdih        Achievement April '10 - Sep '10 (Actual)                    13788        77       15      392
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                                934       585       44      668
                 Achievement April '09 - March '10 (Actual)                   2626       194       11      475
  Seraikella     Achievement April '10 - Sep '10 (Actual)                    26373       132        7      292
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                               2440       730       56      625
                 Achievement April '09 - March '10 (Actual)                   5472        96       28      239
  Rajnagar       Achievement April '10 - Sep '10 (Actual)                    36083       276      104      441
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                              2956        914       75      906
                 Achievement April '09 - March '10 (Actual)                  1000        288       12       36
   Ichagarh      Achievement April '10 - Sep '10 (Actual)                    2275         52        8      271
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                           492.5          365       25      312
                 Achievement April '09 - March '10 (Actual)               37387         2220      219     2687
   District      Achievement April '10 - Sep '10 (Actual)                178649         1123      394     3653
                   Target for 2011-2012 (Increase 25 % of Last years
                                        target)                              13933      5406       413     5900
                                                                                          Source: Internal MIS

The given table shows that the 2220 Tubectomy and 219 NSV has done in the financial year 09-10.

We have plan to increase it at least 5406 tubectomy and 413 NSV to be done in the in the financial year
2011-12. The budget for the plan has been given below.

PLAN FOR 2011 – 12

                               Target    Fund       Target for     Fund                 Fund
  Sl.No.         Blocks                                                         IUD
                              for NSV   Required    Tubectomy     Required             Required

     1        Gamharia          81       121500        1050      1050000        1181   23620

     2        Kharsawan         38       57000         456        456000        625    12500

     3        Chandil           56       84000         703        703000        895    17900
     4        Kuchai            38       57000         603        603000        688    13760
     5        Nimdih            44       66000         585        585000        668    13360
     6        Saraikela         56       84000         730        730000        625    12500
     7        Rajnagar          75       112500        914        914000        906    18120
     8        Ichagarh          25        37500        365        365000        312     6240
     9        District          413      619500        5406      5406000        5900   118000


                                                                                                            53
                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12




 Fund require for Family Planning Camp :-

                                       FUND                         FUND               FUND
                                                 TUBECTOMY
                             NSV                    CAMP                     IUD                  Fund
 Sl.No.         Blocks      CAMP     REQUIRE                      REQUIRE   CAMPS    REQUIRE     Required
   1      Gamharia             2       20000            2           20000      1       10000      50000
   2      Kharsawan            2       20000            2           20000      1       10000      50000
   3      Chandil              2       20000            2           20000      1       10000      50000
   4      Kuchai               2       20000            2           20000      1       10000      50000
   5      Nimdih               2       20000            2           20000      1       10000      50000
   6      Saraikela            2       20000            2           20000      1       10000      50000
   7      Rajnagar             2       20000            2           20000      1       10000      50000
   8      Ichagarh             2       20000            2           20000      1       10000      50000
          District            16       160000          16          160000      8       80000      400000


Strategies :-

     IEC/BCC at community level with the help of Sahiyyas, AWW

     Addressing complications and failures of family planning operations

     Ensuring the Referral services Streamlining compensation channels

     Streamlining incentives for MOs

     Interpersonal counseling of eligible couples on family planning choices by Sahiyyas and male peer
      educators

Activities :-

     ANM and Sahiyya to report complications and failure cases at community to facility.

     Quick facility level action to address complications and failures.

     Training Sahiyya to increase awareness amongst men about the importance of contraception and
      the ease of spacing methods

     ANM to have a stock of contraceptives for distribution

     MTP services to be provided at all CHCs.

     Training of MOs for conducting tubectomy and vasectomies




                                                                                                          54
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12

                A4. ARSH (Adolescent Reproductive & Sexual Health)
Objective

                                                                                  Current     Target for
                                     Objective
                                                                                   Level      2011-12
     1      Reducing the % births to women during age 15-19 years                  15.2%         10%

     2      Reducing anemia levels in adolescent girls and boys


Situation analysis:
Nearly 15.2% of births are to girls in the age group of 15-19 years. This is a very vulnerable age group
deserving of special attention and support.


Strategies :-

     Upgradation o f ARSH Clinin at District level and establishment of ARSH clinic at CHC level
     Providing life skills education to married and un-married adolescent girls by Sahiyyas and AWWs

Activities :-
     Treating anemia among adolescent girls and boys.
     Training of MO and Counselor
     Training of Sahiyyas and AWWs on providing life skills education to adolescent girls
     Screening of all adolescents especially girls for anemia during the monthly health checkups/VHND
         of children at AWC
     Screening of all adolescents for RTIs and STIs
     Providing IFA supplementation to adolescents
     Requisition to state for providing spectacles for refractive corrections
     Convergence with VHC, VEC and ICDS
Budget for strengthening ARSH Clinics

                    Number of ARSH Clinics           Fund Required @ Rs 5000 p.a

                                03                                15000




                                                                                                        55
                                                                SARAIKELA-KHARSAWAN,DHAP 2011-12

                                    A 5. TRIBAL HEALTH


       1. RCH & OUT Reach Camp


                                                          RCH/Out Reach Camps
                                              RCH Camps                    Out reach Camps
         Name of the Blocks         Held ( Apr to   TARGET           Held ( Apr to      TARGET
                                      Dec 10)       (2011-12)         Dec 2010)         (2011-12)
                                         13                               0
                Seraikella                                24                                  0
                                         15                               0
             Kharsawan                                    24                                  0
                                         16                               3
                 Kuchai                                   24                                  3
                                         15                               0
                Rajnagar                                  24                                  0
                                         12                               0
                Gamharia                                  24                                  0
                                         11                               10
                 Nimdih                                   24                               10
                                         10                               10
                 Chandil                                  24                               12
                                         14                               0
                Ichagarh                                  24                                  0
                                        106                               23
                  Total                                   192                              25


                                   RCH/ PTG camps
                      RCH Camps                 PTG camps
  Name of the       Held (             FUND       Held (                  FUND
                           TARGET                         TARGET                     TOTAL
    Blocks          Apr to           REQUIRE      Apr to                 REQUIRE
                            (2011-                         (2011-
                     Sep                           Sep
                              12)                            12)
                    2010)                         2010)
Seraikella            13       24      120000         0          0           0       120000
Kharsawan             15       24      120000         0          0           0       120000
Kuchai                16       24      120000         3          3         15000     135000
Rajnagar              12       24      120000         0          0           0       120000
Gamharia              12       24      120000         0          0           0       120000
Nimdih                11       24      120000        10         10         50000     170000
Chandil               10       24      120000        10         12         60000     180000
Ichagarh              14       24      120000         0          0           0       120000
Total                106      196      980000        23         25        125000     1105000


Monthly RCH camps will be organized in all blocks in hard to reach and underserved areas. These
underserved areas will be covered through the Camp mode. Camp will be organized twice a month
in remote villages of every CHCs.




                                                                                                    56
                                                              SARAIKELA-KHARSAWAN,DHAP 2011-12

Plans for FY 11-12 :

RCH camps will be organized on a monthly basis. For these districts detailed action plan shall be
made in advance. The outlay per camp is Rs.5,000/-per camp. The services provided during the
RCH camps will be Basket of RCH services.
PTG Camps :

Special PTG camps for the tribal as well as hard to reach area also planned. Camp will be organized
once in a month in remote villages in three CHCs in which cover 25 villages in rotational wise to
provide the health services to the PTG community.
Plan of FY 11-12 :

      The reporting along with record keeping of the deaths.
      The Sahiyyas and the AWW are trained for the reporting of the deaths.
   The facility level deaths will also be given top priority and recorded for dissemination.




                                                                                                57
                                                              SARAIKELA-KHARSAWAN,DHAP 2011-12

                            B. NRHM ADDITIONALITIES

B 1. HOSPITAL MANAGEMENT SOCIETY :-

                                      Rogi Kalyan Samiti
        Rogi Kalyan Samiti / Hospital Management Society is a simple yet effective management
structure. This committee, which would be a registered society, acts as a group of trustees for the
hospitals to manage the affairs of the hospital. It consists of officials from Government sector and
members from NGOs, local elected representatives and who are responsible for proper functioning
and management of the hospital / PHC. Each HMS has one Governing Board for policy decisions
and one Executive Committee for execution of the functioning of HMS. HMS can accept funds
from NRHM and other sources including the donations from private parties. Each district hospital
would get a grant of Rs 5 lakhs, each CHC (existing PHC), PHC (existing APHC), Sub Divisional
Hospital (SDH), Refferal Hospital, and Urban Family Welfare Centre would get a grant of Rs 1
lakhs each from NRHM flexi-pool. The RKS/ HMS is free to prescribe, generate and use the funds
placed with it, as per its best judgment for smooth functioning and maintaining the quality of
services.
        Objectives the RKS (Hospital Management Society)
        Upgrade and modernize the health services provided by the hospital and any associated
         outreach services.
        Organize outreach services/ health camps at facilities under the jurisdiction of the hospital
        Display a Citizens’ Charter in the Health facility.
        Generate resources locally through donations, user fees and other means
        Undertake construction and expansion in the hospital building
        Ensure optimal use of hospital land as per govt. guidelines
        Ensure subsidized food, medicines and drinking water and cleanliness to the patients and
         their attendants.
        Ensure proper use, timely maintenance and repair of hospital building equipment and
         machinery.
        Acquiring equipment, furniture, ambulance (through purchase, donation, rental, or any
         other means, including loans, from banks) for the hospital
        Making arrangements for the maintenance of hospital building (including residential
         buildings), vehicles and equipment available with the hospital.
        Improving boarding/ lodging arrangements for the patients and their attendants
        Progress and target for FY 11 -12
        In District Saraikela- Kharsawan there are 20 HMS/RKS among them 1 for district, 08 for
        CHCs and 11for PHCs. All the 19 RKS/HMS are applied for registration .




                                                                                                   58
                                                                      SARAIKELA-KHARSAWAN,DHAP 2011-12

          HOSPITAL MANAGEMENT SOCIETY FOR CHC

                                                                                                 % Fund
                                                                                                               Fund
                             Registration                   No. of                               Utilised
     Name         Date of                                              Fund                                  required
                                Status      Bank A/c no.   Meetings              Fund Utilized
                 Formation                                            Received                   till Sep   For 2011-
                              (Yes/ No)                      held
                                                                                                                12
                                                                                                  2010

Saraikela        10.07.10        No           103890          4       166847        97075          58       100000

                                              8628
Gamharia        07.08.2010       No          GRAMIN           5       130000        63500          49       100000
                                              BANK

Rajnagar         05.08.10        No            6048           5       394916        49304          12       100000

Chandil         01.09.2010       No                           6       188346       123153          65       100000

Nimdih          17.07.2006       Yes         SB-6138          6       100000        79905          80       100000

Ichagarh        12.08.2010       No                           4       100255        11400          11       100000

Kuchai          07.08.2006       No            9659           7       123132        40372          33       100000

Kharsawan       15.07.2010       No            3441           6       100000        45299          45       100000

Sadar
Hospital/                        No                           4       520232       101422          19       500000
DHQ/Others

    Total                                                             1823728      611429          34       1300000




The given table shows that the total amount in financial year 10-11 is 1823728/-. In which the
611429/- rupees 34 % has been utilized. The financial year 2011-12 we need 24 LAKH rupees for
HMS.




                                                                                                                 59
                                                                        SARAIKELA-KHARSAWAN,DHAP 2011-12

                       B 2. Untied Funds and Annual Maintenance Grant

Objective
        To increase functional, administrative and financial resources and autonomy to the field units.
        To develop the physical infrastructure and centre specific activities for PHCs.
Strategy
        Provide Untied Funds to Village Health Committees @ Rs. 10,000 each
        Provide Untied Funds to Health Sub centres @ Rs. 10,000 each
        Provide Untied Funds to Primary Health Centers @ Rs. 25,000 each
        Provide Untied Funds to Community Health Centers @ Rs. 50,000 each
        Provide Annual Maintenance Grant to Health Sub centres @ Rs. 10,000 each
        Provide Annual Maintenance Grant to Primary Health Centers @ Rs. 50,000 each
        Provide Annual Maintenance Grant to Community Health Centers @ Rs. 1,00,000

Progress So far
                                                   Untied fund

          Facilities                                                                                    Fund
                                                         Fund Utilized till
                                 Fund Received                                   SoE Submitted        required
                                                           Oct - 2010
                                                                                                     For 2011-12


                                                     CHC-08
Chandil                               53466                    32061                  60%                  50000

Gamharia                              52998                    12994                  25%                  50000

                                      50000                      2200                  4%                  50000
Ichagarh
                                      51096                       0                    0%                  50000
Kharsawan
                                      59220                    22150                  37%                  50000
Kuchai
                                      50093                    32299                  64%                  50000
Nimdih
                                      51014                      9920                 19%                  50000
Rajnagar
                                     50000                        0                    0                   50000
Seraikella
                                     417887                   111624                  27%              400000
Total
                                                     PHC-11
Chandil                              59700                    34700                   58%                  50000

Gamharia                             60290                    38930                   65%                  50000

                                     25000                    24872                   99%                  25000
Ichagarh
                                       0                          0                    0                     0
Kharsawan
                                       0                          0                    0                     0
Kuchai
                                       0                          0                    0                   25000
Nimdih
                                                                                                                 60
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12

                                  21400                   13700                 64%             75000
Rajnagar
                                   1813                   1804                 100%             50000
Seraikella
Total                            168203                  114006                 68%            275000

                                      HSC (Total no. of HSC - 194 )
 FOR TOTAL HSC(194)              2701887                 1258283                 47%            1940000
       TOTAL                     2701887                 1258283                 47%            1940000


Following data shows that the total untied fund expenditure 1483913/- out of 3287977/- that is
45.1% . In the financial year 2011-12 we need to 2565000/- in the coming financial year the detail
of the budget has been given in table form.

Village Health Committee :

Situational Anlysis :-
After the Sahiya training and VHC members the expenditure of the VHC fund enhanced but still it
not as per the expectation. The another challenges to updated the expenditure report in monthly or
quarterly basis. The VHC expenditure is till now in this year is 5812380/- and in the financial year
we need 1crore 16 lakh 570 thousand rupees only.

Strategy-

       Any village level public health activity like cleanliness drive, sanitation drive, school health
        activities, ICDS, Anganwadi level activities, household surveys etc.
       Health care need of the poor household.
       Community activities that involve and benefit more than one household. Nutrition,
        Education & Sanitation, Environmental Protection, Public Health Measures shall be key
        areas.
Activity-
       Orientation of PRI members on VHC and VHC untied fund.
       Regular meeting at cluster and PHC level with the VHC memnbers.
       Regular follow up strategy of Village by the Sahiya, Sahiya Sathi and BTT.
       Addressed the problems in BLMC.




                                                                                                     61
                                                                        SARAIKELA-KHARSAWAN,DHAP 2011-12

                                       Village Health Committee - Total VHC -1165

                                                         Amount
                                                      received under                  Expenditure           Fund
                  Total
                            Total     Total No. of      VHC Untied     Untied fund      Amount           required (in
                  No. of
                            No. of     VHC A/c         fund inluding   Disbursed to (submitted % fund Rs. '000) for
CHC Name         Revenue
                            VHC         Opened            opening     VHCs Accounts SoE) (in Rs. Utilised 2011-12
                 Villages
                                      (till Sep 10)     balance(till   (in Rs. '000) '000) (till Sep
                                                      Sep 10) (in Rs.                     10)
                                                           '000)
Seraikella            174    174             169         2378497         2378497        950616       40%    1740000

Kharsawan             134    134             131         1860000         1860000         751950    40%         1340000

Kuchai                101     99             97          1367250         1367250         390382    29%          990000

Rajnagar              254    254             247         3249650         3249650         974300    30%         2540000

Gamharia              200    187             177         2590000         2590000         1222946   47%         1870000

Chandil               137    137             132         1570000         1570000         560000    36%         1370000

Nimdih                84      81             78          1161300         1161300         405859    35%          810000

Ichagarh              106     99             94          2030000         2030000         556327    27%          990000

Total               1190    1165            1125        16206697        16206697         5812380   36%      11650000



                            Annual Maintenance Grant FOR CHC
                              Fund Received
        CHC Name            (including opening                                                     Fund required
                                                        Fund Utilized        SoE Submitted
                            balance) till Sep in                                                    For 2011-12
                                  Rs '000
          Chandil                 137683                   73856                   54%                100000

         Gamharia                  105290                  13990                   13%                100000

                                   149580                  45337                   30%                100000
         Ichagarh
                                   125000                  72176                   58%                100000
        Kharsawan
                                   126442                  39442                   31%                100000
          Kuchai
                                   127220                  37260                   29%                100000
          Nimdih
                                   101755                   6755                    7%                100000
         Rajnagar
                                   127553                  11225                    9%                100000
         Seraikella
           Total                   1000523                 300041                  30%                800000




                                                                                                               62
                                                             SARAIKELA-KHARSAWAN,DHAP 2011-12

                              Annual Maintenance Grant for PHC
                        Fund Received
    CHC Name          (including opening                                          Fund required For
                                             Fund Utilized     SoE Submitted
                      balance) till Sep in                                            2011-12
                            Rs '000
       Chandil               65176              15176               23%                100000

      Gamharia              90332               43782               48%                100000

                               0                  0                  0                  50000
      Ichagarh
                               0                  0                  0                    0
     Kharsawan
                               0                  0                  0                    0
       Kuchai
                               0                  0                  0                  50000
       Nimdih
                            154650              35312               23%                150000
      Rajnagar
                            30502               30502               100%               100000
      Seraikella
        Total               340660              124772              37%                550000

In the financial year the current expenditure has been made in the AMG is approx 31.67% of the
total given budget . Now in this year we need to total 12 lakh rupees only. The detail of the budget
has been given to the above list.




                                                                                                 63
                                                                       SARAIKELA-KHARSAWAN,DHAP 2011-12

                                 B 3. COMMUNITY MOBILIZATION


B-1. Sahiyya:

     1. Situation analysis:

Sl          Block         No. of Villages    No. of Sahiyyas                No. of Sahyyas trained
                                                selected          I         II        III       IV          V
1        Chandil                137                249           219       239       234       236         220
2        Nimdih                  84                178           165       164       163       162         166
3        Saraikela              174                221           171       212       204       208         194
4        Rajnagar               254                264           255       158       244       254         252
5        Kharsawan              134                256           221       213       208       235         245
6        Kuchai                 101                211           192       197       211       214         200
7        Ichagarh               106                261           232       245       239       247         242
8        Gamhariya              200                224           224       253       230       264         196
             Total             1190               1864          1679      1681      1733      1820        1715


          The selected sahiyya are frequently dropped out because they are either from economically sound
           or they had a attractive figure under government par roll. The negative approach of working is not
           favoring to play actual role of sahiyya. On the other hand still the selection of sahiyya is not as per
           the requirement of the community i.e. tola or hamlets wise. Sahiyyas go through the drug kit
           training but still need refresher training.
          The total number of sahiyya i.e. 1820 has been under gone up to 4th module.
          In the ongoing program the sahiyya has been not provided any incentives except their performance
           under JSY. Even they are unable to know the incentive packages in the different programs under
           NRHM. For energizes & motivated them the award or incentive should be given through various
           activities or program.
Objective:
          To Ensure fully operationalisation of Shaiya programme and empowering them for better
           implementation of health activities for communit.
Strategies and Activities

             Community Perticepation Budget for Saraikela-Kharaswan.

                                    A. Establishmnet of VHRC at DPMU unit.


Sl.No.      Budget Heads                      Description.                             Value (Rs)
            Furniture for the
     1      District Program         Table, Chair, Almirah etc.                                          100000
            Cord.
                             Sub-Total=(A)                                                              100000

                                                                                                               64
                                                                       SARAIKELA-KHARSAWAN,DHAP 2011-12

                               B. Training of Sahiya on Moudle 6th and 7th.

Sl.No.     Budget Heads                      Description.                         Value (Rs)
  1        Venue
  2        Fooding.
  3        Staisneries.
                                 Rs.300/- X 12 days X 1864 No.                                   67,10,400
  4        Travelling Cost.
  5        Hon. Of BTT.
  6        Miscellaneous
                   C. Training of Sahiya Sathi. (Total Number of Sahiya Sathi - 110.)
Sl.
           Budget Heads                      Description                         Value in (Rs)
No.
                                 4 Batch X 4days X Rs.500/ Per
  1        Venue                                                                                       8000
                                 day.
                                 110 Nos X 4 days X Rs.100/ Per
  2        Fooding.                                                                                   44000
                                 day.
                                 110 Nos X Rs.50/- per
  3        Staisneries.                                                                                5500
                                 participants.
                                 110 Nos X Rs.50 /- Per
  4        Travelling Cost.                                                                            5500
                                 participants.
                                 2 BTT X 4 days X 4 batch X
  5        Hon. Of BTT.                                                                                4800
                                 Rs.150/ BTT.
           Miscellaneous
  6        (Banner, Training     Rs. 1000/- per batch X 4 batch.                                       4000
           Materials).
                           Sub-Total = (c)                                                            71800
D. Training of Sahiya on Sahiya Help Desk in four bock of Hard to reach area. (Nimdih,
Chnadil, Ichagarh & Kuchai) i,e 12 Nos of Sahiya in Each Block .Total number of Sahiya 48
in round 50 in case of drop out.
Sl.
            Budget Heads                            Description.                         Value (Rs)
No.
   1       Venue                 2 Batch X 2days X Rs.500/-per batch                                   2000
  2        Fooding.              50 NosX 2days X 100 /- per perticepents.                             10000
  3        Staisneries.          50 NosX Rs.50/- per perticepents.                                     2500
  4        Travelling Cost.      50 Nos X Rs.50 /- Per perticepents.                                   2500
  5        Hon. Of BTT.          2 BTT X 2 days X 2 batch X Rs.150/ BTT.                               1200
           Mislaneous,
  6        (Banner, Training     Rs. 1000/- per batch X 2 batch.                                       2000
           Materilas)
                                  Sub-Total=( D )                                                     20200
E. Follow up by the Sahiya Sathi in the cluster.( Each and every sahiya sathi will be
 ssigned the cluster to visit their respective cluster villages and support to sahiya. (Total
number of Sahiya Sathi -110)

Sl.
                      Budget Heads                          Description.                 Value (Rs)
No.
                                                  Rs2000/ X 110 Nos X 12
       1   Honourarium of Sahiya Sathi .                                                          2640000.
                                                  months

                                   Sub-Total =(E)                                                2640000
F. Cluste level meeting of Sahiya , Sahiya Sathi, AWW, ANM & other VHC members.( Total
no. of Cluster- 110)
                                                                                                         65
                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12

Sl. No.             Budget Heads                           Description.              Value (Rs)

          Organizing the cluster level            110 cluster X Rs.250/ per
      1                                                                                       330000
          meeting.                                cluster X 12 months.
                                 Sub-Total =( F )                                             330000

G. Monthly meeting of Sahiya at PHC level for reporting & convergence with other sectors.

Sl.
                    Budget Heads                           Description.              Value (Rs)
No.
          Organizing the Block Level              8 Blocks X Rs. 1000/- per block
  1                                                                                               96000
          meeting.                                X 12 months.
                                 Sub- Total=( G )                                 96000
H. Establishment & operation of Sahiya Help Desk in Four Hard to reach blocks ( Nimdih,
Chandil, Ichagarh & Kuchai) & District Hospital.
Sl.No.              Budget Heads                           Description.              Value (Rs)
                                                  Rs. 5000/- each block X 4
  1       Establishment Cost in 4 Blocks.                                                         20000
                                                  Blocks.
          Honourarium os Sahiya at Sahiya         Rs.100/ per sahiya X 60 sahiya
  2                                                                                           288000
          Help Desk or resource center.           X 4days in month X 12 months.
                                 Sub- Total=(H)                                               308000
I. Supportive Supervision of the Program. (Apart from Training Program of BTT, it assumed to
avail the service of BTT as supportive supervision in the Block ,like Support to sahiya sathi in the
field durring follow up, conducting cluster and block level meeting, Report compilation , Laisoning
with other Govt. sectors like DWSD, ICDS, Panchayat Samiite etc.

Sl.No.              Budget Heads                           Description.              Value (Rs)
                                                  4 BTT X 8 Blocks X 7 days X
      1   Honorarium of BTT.                                                                  806400
                                                  Rs.300 /-X 12 months.
                                  Sub Total=(I)                                               806400
J. Block Level Sahiya Sammelam ( The vision behind it is to share the good practices done by
the sahiya. To highlight their best achievement & honour for the same. Inter & intra sectoral
convergence at block level.It will be conduct once in a year in each block)
Sl.No.              Budget Heads                           Description.              Value (Rs)
     1    Logostic Arrangement                    Rs.2000/block X 8 blocks.                       16000
      2   Fooding                                 Rs.15000/-per block X 8 blocks.             120000
      3   IEC materials                           Rs.5000/- per block X 8 blocks.                 40000
      4   Misleneous                              Rs.1000/ per block X 8 blocks.                   8000
                                  Sub- Total=(J)                                              184000

K. District Level Seminar ( The objective is to facilitate the community worker a big platform to
share the achievement in one hand. On the other hand directly interaction of higher govt. officials
with the community)

Sl.No.              Budget Heads                           Description.              Value (Rs)
     1    Logostic Arrangement                    Rs. 8000/-                                       8000
      2   Fooding                                 Rs.30000/-                                      30000
      3   IEC materials                           Rs.10000/-                                      10000
      4   Misslaneous-                            Rs. 2000/-                                       2000
                                  Sub-Total=(K)                                                   50000


                                                                                                     66
                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12

L. Pear group visit of Sahiya in the inter district-
The objective is to learn and increase the motivational level of Sahiya. From each block 9 sahiya will be
selected as per their performance and they will be visit one day in the nearest district I,e East. Singbhum or
West Singbhum. The experience will be shared with rest of the sahiya of the block.

Sl.No               Budget Heads                         Description.                   Value (Rs)

1        Traveling Expenses                     Rs.2000/-per group X 8                               16000
                                                groups.

2        Food ( Break fast, lunch etc. during   Rs. 150 per participants X 92(                       13800
         visit)                                 72 sahiya and 2 Guide )

3.       Honorarium of Sahiya for one day,      Rs.100/- X 72 Sahiya.                                 7200

4        Documentation                          Rs.2000/-                                            2000.

                                           Sub-Total=(L)                                           39000


M. Training of VHC members
For the capacity building of VHC member should under go regular training.
Sl.No               Budget Heads                         Description.                   Value (Rs)

1        Venue

2        Fooding.

3        Staisneries.
                                                 Rs. 130 x 3 members x 1190
                                                                                         464100
                                                             VHC
4        Travelling Cost.

5        Hon. Of BTT.

6        Mislaneous.

         Subtotal (M)                                                                    464100

             Total Budget = A+B+C+D+E+F+G+H+I+J+K+L+M                                    5109500




                                                                                                             67
                                                         SARAIKELA-KHARSAWAN,DHAP 2011-12


                       B.4 PUBLIC PRIVATE PARTNARSHIP


One of the major component of NRHM to strengthen the health system with the support of
PPP mode Jharkhand one of the state who is taking        some CHC, PHC to strengthen the
facility. And to provide better health care to rural people especially women and children.


In the Saraikela-Kharsawan district one PHC has been taken for the purpose which is PHC
HUDU. PHC HUDU situated in hard to reach area having new building, two Medical
Officer ( One Regular + One Contract ) and ANM. But PHC require resident facility for
medical Officer and Other Para Medical Staff.


. The budget require at least 5 lakh rupees.




                                                                                             68
                                                               SARAIKELA-KHARSAWAN,DHAP 2011-12



                          B 5. MOBILE MEDICAL UNIT (MMU)

Objective
To provide mobile health care services having curative, preventive and rehabilitative nature, to be
provided by the service provider along with all primary health care services for the hard-to-reach
areas of SARAIKELA-KHARSAWAN.
Mechanism for coverage:
               Route planning for the placement of mobile health units will be done after the
                mapping and demarcation of the outreach areas.
               Cluster of 5-6 surrounding villages will be formed and camps will be organized at
                cluster level to cover maximum number of patients.
               Frequency of the visit will be finalized based on area mapping. It would also
                prioritize the need of the community.
               In order to mobilize patients and to deliver health services to the last household, the
                active involvement of key stakeholders like ANM, AWW, Sahhiya, Village Health
                Committees and Gram Pradhan will be ensured.
               To ensure the regular service and for supportive supervision a copy of detailed plan
                and schedule of placement will be shared with these stakeholders.
Range of services:
The fully equipped mobile medical van will provide a wide range of quality health care services.
               Preventive services will be provided for diarrhea, malaria and other communicable
                diseases.
               Clinical services will be ensured on maternal health, ANC, child health, family
                planning and reproductive health, first aid .
               Behavior Change Communication (BCC) activities will be conducted to inculcate
                health seeking practices among the community.
               Need based Information Education and Communication (IEC) materials will be
                shared among the communities.
               Referral transportation facilities will be ensured to District Hospitals and Medical
                colleges in emergency and critical cases.
               Diagnostic and pharmacy services are the integral part of the whole range of
                services.

The following NGOs are serving with MMU in hard to reach , unsaved , under served area in
Saraikela-Kharsawan.
              1. VIKAS BHARTI
              2. I.C.E.R.T
              3. T.S.R.D.S
              4. One at District Health Society.

The budget for the four mobile medical Unit is 125000/ per month per mobile medical unit .
Approx = 4 x Rs.125000 x 12 = 6000000 rupees is required it .


                                                                                                    69
                                                               SARAIKELA-KHARSAWAN,DHAP 2011-12




                           B. 6 SCHOOL HEALTH PROGRAMME
8.3.2 Convergence with Education department :
        One of the most powerful social determinants of health status and of utilization of health
services is education. Education acts in many ways. At present both departments are converging at
primary level health check of school going children. The term school health is usually limited to areas
of health care provided to school children through institution of the school. Under the existing school
health programme all primary schools are visited by PHC doctors on a monthly basis for check-up
relating to refractive error correction, hearing, oral hygiene, basic medicine for some common
problems like deworming, iron supplements and skin diseases. Drug Kits are also supplied to each
primary level school. There is clearly a need for more intensive interaction between the schools and
the health authorities. Existing services of Mobile Medical Unit (MMU) will also be extending to
different educational institutions in rural as well as urban areas.
1.      An annual health checks with follow up and remedial action on illnesses identified.
2.      At least one annual dental check up with follow up and remedial action on illnesses identified.
3.      At least one annual eye check up including for refractive errors with follow up and remedial
        action and where needed giving the spectacles.
4.      progress status of Saraikela-Kharsawan in convergence with Education department

                                                                        HEALTH CHECK UP
         NAME OF CHC          NO. OF SCHOOL       NO. OF STUDENT
                                                                             HELD

Gamharia                            122                 5620                   4368

Kharsawan                           63                  5487                   5483

Chandil                             101                 2774                   2749

Kuchai                              57                  1296                   1292

Nimdih                              32                  1491                   1475

Saraikela                           67                  3485                   3480

Rajnagar                            12                  2927                   2912

Ichagarh                            24                  1830                   1814

District                            478                24910                  23573




In District Searaikella-Kharsawan CHC / HSC wise        School health programme conducted as per
microplan. During School Health Programme total Student registered was 24910 from 478 school and
health checkup done 23573 out of 23910.




                                                                                                    70
                                                             SARAIKELA-KHARSAWAN,DHAP 2011-12

            5. The budget require for financial year 2011-12 is as follow-

                                                          BUDGET FOR FOLLOW UP
  NAME OF         NO. OF          NO. OF                          LUNCH
    CHC          SCHOOL          STUDENT         MOBILITY FOR   SNACK AND
                                                                               TOTAL
                                                    TEAM          OTHER
                                                               CONITGENCY
Gamharia           235            36223            117500        117500       235000
Kharsawan          169            19480             84500        84500        169000
Chandil            204            24355            102000        102000       204000
Kuchai             155            15037             77500        77500        155000
Nimdih             195            20147             97500        97500        195000
Saraikela          177            17686             88500        88500        177000
Rajnagar           247            27926            123500        123500       247000
Ichagarh           213            17544            106500        106500       213000
District           1595          178398            797500        797500      1595000


In Saraikela-Kharsawan District total number of Schools are 1595 in which 178398 student
study under class five .In these School the team has to do health checkup in the phase wise
according to the action plan made by CHC. These school will be covered by HSc wise. The
require budget for the activity is 500 rupees.

For the mobility of team for visit per school and other contingency expenditure like banner,
lunch and small snakes for children is 500 rupees per school has been listed above.




                                                                                           71
                                                             SARAIKELA-KHARSAWAN,DHAP 2011-12


                          B. 7 IEC AND BCC ACITIVITY
Use media and other IEC/IPC strategies to enable individuals, families and communities to
recognize signs of obstetric emergencies, maternal and child health related issues. Educate
communities about danger signs of pregnancy, labor and post-partum period. Launch a
sustained social mobilization effort for institutional deliveries with the help of community
level motivators and self help groups.

1. Nukad Natak program will be organized at rural areas for awareness generation
2. Wall writing on different healthy behavior
3. Miking at Local market for awareness generation
4. Health camp at Primary and Middle school
5. Preparation of posters, pamphlets and flash board etc
6. Spreading messages through Village level Women Self Help Group meeting
7. Printing of IEC material as a guide book on messages related to child & maternal health for
   counseling to target population by frontline worker
8. Village Health Nutrition Day will be used for information sharing and dissemination of
   messages with community at AWC level every Thursday and Saturday
9. The district has done good BCC and IEC activity. The Signage activity done in all HSC, PHC,
   CHC and District Hospital as per guideline provided by State . Under the JSY the banner
   and flex board has been placed to every HSC and aganwari centre, under kisore saptah
   the wall writing have been made for all HSC respectively.

     10. The budget for the coming financial year related to IEC and BCC is required as below.
                                   BUDGET FOR IEC/BCC FOR 2011-12

                                                                SCHOOL
                                                                             NUKKAT
                                                                HEALTH
NAME OF                  RSBY WALL      JSY WALL    AIDS                    AND NATAK
             NO OF HSC                                        PROGRAMME                   TOTAL
  CHC                     WRITING       WRITING    AND HIV                   FOR ALL
                                                                 WALL
                                                                           PROGRAMME
                                                                WRITING
Saraikela        24         12000        12000      24000        12000        72000       132000
Gamharia         20         10000        10000      20000        10000        60000       110000
Rajnagar         32         16000        16000      32000        16000        96000       176000
Chandil          26         13000        13000      26000        13000        78000       143000
Nimdih           30         15000        15000      30000        15000        90000       165000
Ichagarh         27         13500        13500      27000        13500        81000       148500
Kuchai           14         7000         7000       14000        7000         42000       77000
Kharsawan        21         10500        10500      21000        10500        63000       115500
Total           194         97000        97000      194000       97000        582000     1067000
        Approx Ten lakh and Sixty Seven thousand is need for the purpose of the same .




                                                                                                 72
                                                               SARAIKELA-KHARSAWAN,DHAP 2011-12


                         B. 8 Mainstreaming of AYUSH
Mapping and Setting up of AYUSH health facilities.
       The AYUSH health facilities will work under one roof and separate space would be
allocated exclusively for it in the same building. In case, separate space is not available at the
PHCs/CHCs civil works will be undertaken from the funds provided to AYUSH Department for
this purpose.

AYUSH Existing Infrastructure Status:

           Districts                     No. of Dispensaries        No. of Joint Dispensary
  SARAIKELA-KHARSAWAN                             18                           01



Filling up the HR positions under AYUSH

                   Existing HR Status of AYUSH (As per the State AYUSH Dept. MIS)
                   Districts                    No. of Doctors         No. of Compounders
           SARAIKELA-KHARSAWAN                        14                        01
Capacity Building- The AYUSH is one of the best component of under NRHM . In SARAIKELA-
KHARSAWAN distict the medicine is require for the AYUSH .In Every CHC and District Hospital the
doctor and compunder is require as per listed below.

                                                                                   AYUSH
  NAME OF
              DOCTOR                   COMPOUNDER                  MEDICINE        UNTIED
   CHC/                    BUDGET                       BUDGET                                    TOTAL
              REQUIRE                    REQUIRE                   REQUIRE          FUND
  DISTICT
                                                                                   OTHERS
Saraikela         1        360000            1          120000      100000          25000         605000
Gamharia          1        360000            1          120000      100000          25000         605000
Rajnagar          1        360000            1          120000      100000          25000         605000
Chandil           1        360000            1          120000      100000          25000         605000
Nimdih            1        360000            1          120000      100000          25000         605000
Ichagarh          1        360000            1          120000      100000          25000         605000
Kuchai            1        360000            1          120000      100000          25000         605000
Kharsawan         1        360000            1          120000      100000          25000         605000
District
Hospital          3        1080000           2          240000      100000          25000     1445000
Total            11        3960000          10          1200000     900000         225000     6285000


In Saraikela-Kharsawan district we have need of 11 AYUSH Doctor and 10 compounder is
require as well as the medicine is require for the community health centre for the AYUSH
treatment approx Sixty Two lakh Eighty Five thousand require for it.




                                                                                                   73
                                                                                                                                     SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                                                    B. 9 TRAINING
                                                                        STATUS OF TRAINING AT DISTRICT LEVEL
                                                                      (RCH, NRHM Additionalities & Routine Immunization )
 Reporting Month:            October 2010
                                                              Fund Status                                       Expenditure                  Closing Balance with District
                         No. of Trainig                                                                                                                                            % of
                          Completed        Opening       Fund         Fund return               Expenditure                   Total               Balance in        Total
                                                                                                            Expenditure                Advance to                                 Fund
Sl.      Name of                          Balance as   received        to State    Total Fund     till last             Expenditure                District        Balance
                                                                                                              during                    PHCs &                                    Utilize
No.    Programmes                           on 1st      during          Head      with District reporting               till reporting              Head            with
                                                                                                             reporting                   Others                                     d
                                           April'10    2010-11         Quarter                    Month                      Month                 Quarter         District
                                                                                                               Month
                                                                                                                                                                                   13=
                                                                                   (6 )= (3)+(4)-                                                                    12=
 1           2                                3           4               5                           7             8         9= (7+8)        10          11                      9/6*1
                                                                                         (5)                                                                       (10+11)
                                                                                                                                                                                    00
 a     SBA Training              5          233,909      829,320               -     1,063,229       170,942       18,134       189,076            -    874,153     874,153          18
       Child Health
 b                               1           82,000      138,200               -       220,200       115,692            -       115,692            -    104,508     104,508          53
      Activities
 c     IYCF                  1               25,100      256,163               -       281,263        13,450       23,662         37,112      11,750     232,401     244,151         13
 d     NSV Training          -                    -       47,500               -        47,500             -            -              -           -      47,500      47,500          -
 e     MTP Training          1                6,075       55,430               -        61,505             -       11,800         11,800           -      49,705      49,705         19
 f     IMNCI TOT            10              869,300    1,938,700               -     2,808,000       390,272      728,161      1,118,433     188,600   1,500,967   1,689,567         40
       ANM Training
 g                                -         795,200               -      795,200               -            -           -                -         -           -             -         -
      (ISDT)
 h     Aneamia Control            -          60,000            -               -        60,000              -           -             -            -     60,000      60,000           -
 i     IUCD-TOT                   -          40,458      339,020               -       379,478            472           -           472            -    379,006     379,006           0
       Sel. & Training
  j                         48            2,986,253               -            -     2,986,253      1,986,672           -      1,986,672      30,596    968,985     999,581          67
      of Sahiyya,VHC
 k     HMIS Training              -          12,480               -            -        12,480              -           -                -         -     12,480      12,480            -
 l     MTC Training               -          68,800               -       68,800             -              -           -                -    68,800     68,800           -            -
      R I Training                -           9,315               -                       9,315                         -                -                            9,315            -
 m
           Total                          5,188,890    3,604,333         864,000     7,929,223      2,677,500     781,757      3,459,257     299,746   4,298,505   4,469,966         44


Above table shows that fund available with district is 79,29,223 (Seventy Nine Lakhs Twenty Nine Thousand Two Hundred and Twenty Three) and Total expenditure till
October 2010 is 34,59,257 (Thirty Four Lakhs Fifty Nine Thousand Two Hundred and Fifty Seven), total fund utilized percentage is 44%.


                                                                                                                                                                             74
                                                         SARAIKELA-KHARSAWAN,DHAP 2011-12




        BUDGET REQUIRMENT FOR TRAINING DISTRICT & BLOCK LEVEL 2011-12

                                               Unit
                        No. of Batches Plan
        Budget Head                           Cost (in             Amount in Rs.
                            for 2011-12
                                               Rs.)
SBA                             6             138220                  829320
ARSH (Dist)                     1             138368                  138368
ARSH (Block)                    4              35208                  140832
HMIS (Dist)                     1              23310                  23310
HMIS (Block)                    8              37778                  302224
School Health Program           8              25185                  201480
MTP                             2              27715                  55430
NSSK                            2              48300                  96600
F-IMNCI                         1              55000                  55000
IMNCI                           13            144900                 1883700
New Born Care                   1              39330                  39330
MTC                             4              20815                  83260
NSV                             1              47500                  47500
IUCD (MO)                       2              98555                  197110
IUCD (ANM)                      2              70095                  140190
IYCF (Refreser)                 1              26738                  26738
IYCF (Block)                    5              45885                  229425
Total                                         1022902                4489817




                                                                                       75
                                                              SARAIKELA-KHARSAWAN,DHAP 2011-12




              B. 10 Programme Management Unit
        To strengthen the Block program management unit in all Blocks
        Regular training of DPMU and BPMU
        Establishment of district monitoring team
        Regular meeting at block and district level to review the progress and planning for
        next month.
        Need of vehicle for DPMU for regular monitoring of the program
        Inter coordination between departments within health sector
        Convergence between Health and ICDS department right from village to district level
        for better service delivery and improvement in outreach
        The Budget is need under DPMU AND BPMU is as listed below .


             CAPACITY
NAME OF      BUILDING       HMIS AND                  PRINITING                   POSTAGE
                                          MOBILITY                  FURNITURE
  CHC/        UNDER        SUPERVISION                   AND                        AND          TOTAL
                                          SUPPORT                    FOR BPMU
DISTRICT       NRHM         TRAINING                 STATIONARY                  TELEGRAPH
            PROGRAMME
Saraikela        0            25000        36000        60000         25000        36000        182000
Gamharia         0            25000        36000        60000         25000        36000        182000
Rajnagar         0            25000        36000        60000         25000        36000        182000
Chandil          0            25000        36000        60000         25000        36000        182000
Nimdih           0            25000        36000        60000         25000        36000        182000
Ichagarh         0            25000        36000        60000         25000        36000        182000
Kuchai           0            25000        36000        60000         25000        36000        182000
Kharsawan        0            25000        36000        60000         25000        36000        182000
District      100000          25000        60000        60000           0          60000        305000
Total         100000          225000       348000       540000        200000       348000      1761000

        For strengthen of DPMU And BPMU the one lakh rupees is need to capacity building training for
BPMU in the coming financial year. Hmis training is need for all ANMs the CHC wise budget is Two
Lakh twenty five thousand rupees only. Morever the mobility support for field visit and supervision is
reqire three thousand for CHC and Six Thousand for District per month. printing, furniture and
postage and telegraph budget is required. Total approx seventeen lakh sixty one thousand is required
for the strengthen of DPMU as well as BPMU.

                              DISTRICT HEALTH ACTION PLAN
District health action plan is a major component of NRHM. It shows the community demand and need
According to the need of villages through village health committee come to the point of action. The
block CHC generate the demand to the district though their village health plan and according to it
The district generates demand though DHAP from the state.




                                                                                                   76
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12

It shows the district activity for the beneficiary and the last person of the Community. It is also a part
of plan and strategy , in the SARAIKELA-KHARSAWAN district the planning team effort for their Better
dhap though the participation of community members . the budget for it require is as follow.

                                                   TRAINING                                VHAP COST
                                                                       SAHIYA
  Name of the        Total number of                      VHC           HELP        VHC
    Blocks           Sahiyyas selected     Module 5     MEMBER                                 VHAP COST
                                                                        DESK      FORMED
                                                        TRAINED

Seraikella                 221                194          194            1          169         16900

Kharsawan                  256                245          245            1          131         13100

Kuchai                     211                200          200            1           97          9700

Rajnagar                   264                252          252            1          247         24700

Gamharia                   224                196          196            1          177         17700

Chandil                    249                220          220            1          132         13200

Nimdih                     178                166          166            1           78          7800

Ichagarh                   261                242          242            1           94          9400

District Hospital           0                  0              0           1           0            0
Total                      1864              1715          1715           9         1125         112500




                                                                                                          77
                  SARAIKELA-KHARSAWAN,DHAP 2011-12




C. Disease Control Programmes




                                                78
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12



                                         C-1. RNTCP

   ANNUAL PLAN FOR PROGRAMME PERFORMANCE & BUDGET FOR THE YEAR
                   1ST APRIL 2011 TO 31ST MARCH 2012


This action plan and budget have been approved by the DTCS.

Section-A – General Information about the District



 1 Population (in lakh) please give projected population 2011-12                              10,76,668

 2 Urban population                                                                           2,02,417

 3 Tribal population                                                                          3,86,531


(These population statistics may be obtained from Census data /District Statistical Office)



ORGANIZATION OF SERVICES IN THE DISTRICT:


                                                Please indicate if the TU is-          No. of MCs
                               Population (in
S. No.       Name of the TU
                                  Lakhs)
                                                    Govt              NGO       Govt    NGO         Private

  1      Seraikela-TU             3,56,247            1                0         4        0           0

  2      Chandil-TU               5,22,094            1                0         5        0           0

         District                 8,78,341            2                0         9        0           0




                                                                                                          79
                                                                         SARAIKELA-KHARSAWAN,DHAP 2011-12



RNTCP performance indicators:

                                               Annualized
                                        No of
                  Total                             New    Cure rate for Plan for the next year
                         Annualized new                                                                  Proportion
                number                             smear      cases
                          total case smear                                                                 of TB
                   of                             positive detected in
 TB Unit                  detection positive                                                              patients
                patients                            case    the last 4                Cure rate
                           rate (per cases put                                                           tested for
                 put on                         detection corresponding Annualized
                          lakh pop)      on                               NSP CDR                           HIV
               treatment                         rate (per   quarters                   (85%)
                                     treatment
                                                lakh pop)

                                                                                                To
                                                                                Continue    improve
                              186                      78         204/232
                                                                               to sustain    in cure
Seraikela.        668                     280                                                                   8:1
                             (91%)                   (104%)        88%          N.S.P &        rate
                                                                                 C.D.R       atleast
                                                                                              90%

                                                                                                To
                                                                                 Focus to   improve
                              107                      56                        increase
                                                                  243/273                    in cure
Chandil.          563                     294                                    ACDR &                     19:1
                                                                   89%                         rate
                             (53%)                   (74%)
                                                                                  N.S.P      atleast
                                                                                              90%

                                                                                                To
                                                                                 Focus to   improve
                                                       65                        increase
                              138                                 447/505                    in cure
Total            1231                     574                                    ACDR &                     11:1
                             (68%)                                 89%                         rate
                                                     (86%)
                                                                                  N.S.P      atleast
                                                                                              90%


Section B – List Priority areas for achieving the objectives planned:


S.No.              Priority areas          Activity planned under each priority area

   1                                            a.   Enhance the IEC activity.
           To increase the total ACDR
                                                b.   Training all MOs.

   2                                            a)   Increase the no. of home visit by all supervisory staff.
           Increase the Cure rate >90%
                                                b)   Increase the supervision and monitoring by MOTC & DTO.

   3                                            a.   Enhance the supervision and monitoring by supervision staff.
           Minimise the default rate of
           CAT – II                             b.   Training all Sahiya and Savika.

   4                                            a)   Early case detection and treatment.
           Minimise the death rate
                                                b)   Increase the IEC activities.




                                                                                                                      80
                                                                                SARAIKELA-KHARSAWAN,DHAP 2011-12

Section C – Plan for Performance and Expenditure under each head:


Civil Works


                      No.                                                                                    Quarter in
                                                                                              Estimated
                   required      No.                          Pl provide justification                       which the
                                               No.                                           Expenditure
                    as per     actually                          if an increase is                            planned
                                            planned                                            on the
                       the     present                             planned (use                                activity
                                             for this                                          activity
        Activity    norms       in the                           separate sheet if                            expected
                                              year
                     in the    district                              required)                                  to be
                    district                                                                                 completed

                       (a)        (b)          (c)                      (d)                      (e)             (f)

      DTC                1        1             0                                             10,000=00          1st
                                                                                                              Qtr.2011
                                                                                                                1st
      TUs                2        2             0                                             10,000=00      Qtr.2011

                                                                                                                1st
      DMC                9        9             1                                             30,000=00      Qtr.2011


                                                                                    Total     50,000=00


Laboratory Materials




                                                                                  Estimated
                                                        Procurement             Expenditure
                     Amount              Amount           planned                for the next
                   permissible           actually        during the            financial year
                                                                                                        Justification/
                    as per the           spent in          current            for which plan
                                                                                                       Remarks for (d)
        Activity   norms in the         the last 4        financial                is being
                      district           quarters          year (in               submitted
                                                          Rupees)
                                                                                     (Rs.)

                   (a)                (b)               (c)                   (d)                 (e)

     Purchase of   1,35,000=00                                                                    10% may be
     Lab                              91,975=00         1,50,000=00            1,65,000=00        increase due to
     Materials                                                                                    price raising




                                                                                                                          81
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12



Honorarium


                                                                    Estimated
                                                Expenditure
                      Amount        Amount                     Expenditure for the
                                                   (in Rs)
                    permissible     actually                  next financial year for
                                                planned for                              Justification/
                     as per the     spent in                   which plan is being
                                                   current                              Remarks for (d)
        Activity      norms in     the last 4                        submitted
                                                  financial
                    the district    quarters
                                                     year
                                                                      (Rs.)

                        (a)           (b)           (c)                 (d)                   (e)

     Honorarium                                                                            Due to
     for DOT                                                                             increase in
     providers                                                     80,000=00              number of
     (both tribal   25,200=00      76,500=00    35,000=00                               cure patients.
     and non
     tribal
     districts)

     Honorarium
     for DOT
     providers of
     Cat IV
     patients




Annual Action Plan Format Advocacy, Communication and Social Mobilization (ACSM) for
RNTCP

1) Information on previous year’s Annual Action Plan
   a) Budget proposed in last Annual Action Plan: Rs. 1,20,000=00
   b) Amount released by the state: Rs. 45,618=00
   c) Amount Spent by the district- Rs. 34,833=00
2) Permissible budget as per norm : Rs. 67,500=00
3) Budget for next financial year for the district as per action plan detailed below: 2011-12




                                                                                                          82
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12




Equipment Maintenance:


                                                                              Estimated
                                                                            Expenditure
                                                             Amount
                                   No.       Amount                          for the next
                                                         Proposed for
                                 actually    actually                      financial year
                                                         Maintenance                         Justification/
                                 present     spent in                     for which plan
                                                              during                        Remarks for (d)
              Item                in the    the last 4                         is being
                                                             current
                                 district    quarters                         submitted
                                                          financial yr.
                                                                                (Rs.)

                                 (a)        (b)          (c)              (d)               (e)

 Office Equipment                1          8,720=00      30,000=00             33,000=00

 (Maintenance includes
 computer software and
 hardware upgrades, repairs of
 photocopier, fax, OHP etc)

 Binocular Microscopes (               9          Nil     12,000=00             12,000=00
 RNTCP)

                                                                                45,000=00




                                                                                                              83
                                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12

Section D: Summary of proposed budget for the district –

                                                   Budget estimate for the coming FY 2011- 12
 Sl. No.   Category of Expenditure           (To be based on the planned activities and expenditure in
                                                                    Section C

    1      Civil works                                                                       50,000=00

    2      Laboratory materials                                                           1,65,000=00

    3      Honorarium                                                                        80,000=00

    4      IEC/ Publicity                                                                 1,29,000=00

    5      Equipment maintenance                                                             45,000=00

    6      Training                                                                       1,81,000=00

    7      Vehicle maintenance                                                            1,92,500=00

    8      Vehicle hiring                                                                    65,000=00

    9      NGO/PP support                                                                 1,00,000=00

   10      Miscellaneous                                                                  1,60,000=00

   11      Contractual services                                                          13,25,400=00

   12      Procurement – equipment                                                           15,000=00

                      TOTAL                                                              25,07,900=00




                                                                                                         84
                                                                     SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                  C-2 NVBDCP

         NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME

                                        District Annual Action Plan

                                                  Year: 2011-12
A. Population:          1076688

B. Status of Health facilities :-


Sl.
                               Health facility                                 No
No.

1        District Hospital                                                     01

2        CHC (Block PHC/)                                                      08

3        PHC (APHC)                                                            11

4        Sub centre (HSCs)                                                     194

5        Revenue Villages                                                     1190

6        Rapid response team                                                   01

7        District /Block Task Force (Dengue)                                   1/8



C. Human Resource:

Sl no                Designation             Sanction          In Position      To be trained

    1       Dist Malaria Officer             1          Nominated by govt.1    Untrained

    2       Medical officer (Regular)        58         33                     Untrained

    3       Medical Officer(Contract)        80         34                     Untrained

    4       Asst. Malaria Officer            1          0                      ---------

    5       Dist. VBD Consultant             1          1                      Untrained

    6       MI                               3          3                      Trained

    7       MTS                              5          1                      Trained

    8       MPW                              105        44                     44 Trained

    9       Lab Technician                   2          2                      Trained

    10      ANM                              -          345                    Untrained

    11      SAHIYA                           1850       1773                   1773Trained


                                                                                                   85
                                                           SARAIKELA-KHARSAWAN,DHAP 2011-12

12    Financial & Logistic Assistant   1       0                     ---------

13    Data Entry Operator              1       0                     ---------

14    S.W.                             67      2                     Trained

15    S.I.                             16      3                     Trained




     Status of health facilities:-

        Sl. No          Resources/facilities       Existing

             1    Laboratory infrastructure          10

             2    Laboratory technician              02

             4    Binocular Microscope               10

             5    Vehicle                            01

             6    Motor Cycle                         0

             7    Computer                           01

             8    Lapatop                             0

             9    Inverter                            0

             10   Table/Chair                        4/6

             11   Almirah                             3

             12   Xerox Machine                      01

             13   Fax Machine                        01




                                                                                         86
                                                                                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12

1.     Malaria Situation analysis of the disease:

(C). Epidemiological data for last five years indicating BS/RDT examined, malaria positive, Pf positive, number of deaths, ABER, API, Pf %, SPR and
SFR.

          Name of                          BSC/            Positive Cases                                                                 Death
                       Year     Popu.                                               PF%   ABER   API    SPR     AFI     SFR       RT      Due to
           PHC                             BSE       PV       PF    Mixe    Total                                                         Malaria


                       2006     84185     10436     257      240     0      497     48    12.4   5.9     4.8    0.3     2.3       497       0

                       2007     85903      8386     169      562     0      731     77    9.8    8.5     8.7    0.7     6.7       731       0

         Seraikella    2008     87656      9181     220      691     0      911     76    10.5   10.4    9.9    0.8     7.5       911       0

                       2009     89409     12831     309      578     0      887     65    14.4   9.9     6.9    0.6     4.5       887       0

                       2010     91644     10436     115      276     0      391     71    11.4   4.3     3.7    0.3     2.6       391       0

                       2006     74095     11266     798      454     0      1252    36    15.2   16.9   11.1    0.6     4.0      1252       0

                       2007     75607      9829     1064      95     0      1159     8    13.0   15.3   11.8    0.1     1.0      1159       0

         Kharsawan     2008     77150      9527     968      494     0      1462    34    12.3   19.0   15.3    0.6     5.2      1462       0

                       2009     78693     12499     518      622     0      1140    55    15.9   14.5    9.1    0.8     5.0      1140       0

                       2010     80660     12920     245      383     0      628     61    16.0   7.8     4.9    0.5     3.0       628       0

                       2006     53968      8960     552      225     0      777     29    16.6   14.4    8.7    0.4     2.5       777       0

           Kuchai      2007     55069      7092     527      147     0      674     22    12.9   12.2    9.5    0.3     2.1       674       0

                       2008     56193      6784     241      112     0      353     32    12.1   6.3     5.2    0.2     1.7       353       0



                                                                                                                                                      87
                                                                                       SARAIKELA-KHARSAWAN,DHAP 2011-12

            2009   57317    8498    234   137    0   371    37   14.8   6.5    4.4    0.2   1.6     371      0

            2010   58749    6722    253   244    0   497    49   11.4   8.5    7.4    0.4   3.6     497      0

            2006   123836   11080   294   175    0   469    37   8.9    3.8    4.2    0.1   1.6     469      0

            2007   126363   8248    218   441    0   659    67   6.5    5.2    8.0    0.3   5.3     659      0

Rajnagar    2008   128942   9030    83    715    0   798    90   7.0    6.2    8.8    0.6   7.9     798      0

            2009   131521   15459   372   659    0   1031   64   11.8   7.8    6.7    0.5   4.3     1031     0

            2010   134809   12056   111   197    0   308    64   8.9    2.3    2.6    0.1   1.6     308      0

                                                                                                              3
            2006   245297   13036   51    286    0   337    85   5.3    1.4    2.6    0.1   2.2     337    (Susp.)

            2007   250305   11734   43     94    0   137    69   4.7    0.5    1.2    0.0   0.8     137      0
Gamhariya
            2008   255413   18405   69    264    0   333    79   7.2    1.3    1.8    0.1   1.4     333      0

            2009   260521   24344   162   395    0   557    71   9.3    2.1    2.3    0.2   1.6     557      0

            2010   267034   23108   134   341    0   475    72   8.7    1.8    2.1    0.1   1.5     475      0

            2006   123310   11587   269   1082   0   1351   80   9.4    11.0   11.7   0.9   9.3     1351     5

            2007   125826   12892   35    1214   0   1249   97   10.2   9.9    9.7    1.0   9.4     1249     0

 Chandil    2008   128394   12966   21    1417   0   1438   99   10.1   11.2   11.1   1.1   10.9    1438     0

            2009   130962   13465   23    1224   0   1247   98   10.3   9.5    9.3    0.9   9.1     1247     0

            2010   134236   12817   161   504    0   665    76   9.5    5.0    5.2    0.4   3.9     665      0



                                                                                                                     88
                                                                                               SARAIKELA-KHARSAWAN,DHAP 2011-12

              2006     95119      14389     418     448    0   866    52   15.1   9.1   6.0   0.5   3.1     866      0

              2007     97060      9045       89     354    0   443    80   9.3    4.6   4.9   0.4   3.9     443      0

  Nimdih      2008     99041      9202       90     501    0   591    85   9.3    6.0   6.4   0.5   5.4     591      0

              2009    101022      10721     348     446    0   794    56   10.6   7.9   7.4   0.4   4.2     794      0

              2010    103547      8446      114     257    0   371    69   8.2    3.6   4.4   0.2   3.0     371      0

              2006     99470      7621      291     192    0   483    40   7.7    4.9   6.3   0.2   2.5     483      0

              2007    101500      6392      215     136    0   351    39   6.3    3.5   5.5   0.1   2.1     351      0

 Ichagrah     2008    103571      8230      153     262    0   415    63   7.9    4.0   5.0   0.3   3.2     415      0

              2009    105642      9470      109     357    0   466    77   9.0    4.4   4.9   0.3   3.8     466      0

              2010    108283      10004     242     226    0   468    48   9.2    4.3   4.7   0.2   2.3     468      0

              2006    899280      88375     2930    3102   0   6032   51   9.8    6.7   6.8   0.3   3.5     6032     8

              2007    917633      73618     2360    3043   0   5403   56   8.0    5.9   7.3   0.3   4.1     5403     0

Dist Total    2008    936360      83325     1845    4456   0   6301   71   8.9    6.7   7.6   0.5   5.3     6301     0

              2009    955087     107287     2075    4418   0   6493   68   11.2   6.8   6.1   0.5   4.1     6493     0

              2010    978962      96509     1375    2428       3803   64   9.9    3.9   3.9   0.2   2.5     3803     0

Note: Up to Sept.10 Epidemiological Situation Report.




                                                                                                                             89
                                                                                                               SARAIKELA-KHARSAWAN,DHAP 2011-12

2. PRIORITIES, CONSTRAINS AND REQUIRED ACTIONS:-

PRIORITIES,                       CONSTRAINS                                     REQUIRED ACTIONS

Functional Facilities                   Non functional equipments                     Pooling of staffs
                                                                                       Purchase of equipments
Increase and imparting Human            Lack of training of LTs, MPWs, ANMs,          Contractual appointment of LTs, Driver .
resources                                SAHIYA                                        Training

Inaccessible areas                      Absence of Paramedical staffs                 Weekly/Fortnightly arrangement of Paramedical staffs
                                                                                       Involvement of SAHIYA
Malaria Surveillance                    Vertical programme                            Decentralization of the programme
                                        No periodic Data Collection                   Developing a system for periodic Data Collection,
                                        Lack of required amount of Diagnostic          (Sending Report via ANM through PHC and monthly
                                         centre                                         meeting)
                                                                                       Microscopic centre at sector level
Proper Diagnosis                       Irregular supply of Logistics                  Regular Supply of Logistics.
                                       Burden of slides                               Provide RD kits up to village level
                                       Inefficient technician                         Orientation Training
                                       Improper slide making at village level
EDCT( Microscopy and RDK)              In accessibility                               Involvement of AWWs and Sahiyas for slide collection
                                       Early Diagnosis                                 and Complete treatment.
                                       Not consuming complete dose by the             Sahiyas to ensure for complete drug consumption
                                        patient                                        Total involvement of SAHIYA.
                                     SAHIYA not yet completely involved.

Personal Protection                     Lack of Bed nets.                             Distribution of LLIN
                                        Improper use of Bed nets                      To ensure the community for proper use of LLIN
Vector Control                          Lack of awareness.                            IEC/BCC/IPC
                                        Non acceptance of IRS by the                  Well Advance information to the community
                                         community
Use of Bed Nets by the Pregnant         Inadequate supply of Bed nets                 Priority should be given to the Pregnant women and
women and infants                       Improper use of Bed Nets                       infants and ensure proper use.
                                                                                       Procurement of Bed nets


                                                                                                                                               90
                                                                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12

Planning and Monitoring                   Lack of Local Planning                          Involvement of VHSCs members/ PRI Members
                                          Lack of involvement of PRI, NGO,                Coordination with Health and other department.
                                           VHSC
Disease Surveillance                      Vertical Programme for all vector               Horizontal integration of programme through VHSC,
                                           born and common disease                          PHC, CHC, HSC
                                          No co-ordination for disease                    Initiation and integration with IDSP at HSC level
                                           surveillance at various level.
Management of severe and                  MO not trained.                                 Training according to approved guideline
complicated malaria cases                 MO not follow proper guideline for
                                           Drugs



High Risk Areas: Based on the epidemiological data

                                High risk             High risk Sub         High risk Village        High risk              Tribal
   S. No               Blocks   PHCs (No)              centre (no)                (no)             Population (no)      Population (no)

      1       Kharsawan                1                     7                     35                    32685               19805

      2       Kuchai                   1                    10                     28                    39140               21742

      3       Saraikela                1                    13                     85                    33953               10186

      4       Rajnagar                 1                    11                     89                    39130               11739

      5       Gamharia                 1                     5                     32                   133523               20140

      6       Chandil                  1                    12                     45                    39192               11758

      7       Nimdih                   1                    14                     32                    35906               10772

      8       Ichagarh                 1                    11                     25                    36093               10828

              Total                    8                    83                    371                   389622               116969



                                                                                                                                                 91
                                                                                                                            SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                     Classify the areas as per following API ranges

                 S. No     API         Blocks (No)      PHCs (No)       Sub centre (No)             Villages (No)    Population @ Village (No)

                 1         <1                 8               8                     21                   131                    252201

                 2         1–2                8               8                     29                   177                    129898

                 3         2–5                8               8                     57                   311                    242943

                 4         5 – 10             8               8                     53                   317                    213478

                 5         > 10               8               8                     34                   206                    155152

                                        Total                                   194                      1142                   993671


3.     Prioritization of the areas including the criteria of prioritization
(a)    SWOT ANALYSIS

STRENGTH                                                                                 WEAKNESS

     Formation of Dist Malaria Society.                                                  Non availability of motorcycle to MTS for supervision.
     Available of required no of PHC and HSC scattered in all over the district.         Delayed receiving of funds
     Available of Dedicated workers                                                      Tribal people believe in Quakes.
     MTS and MPW are working                                                             Poor Hygiene and sanitation facility.
     SAHIYA are trained for BS collection and RDK test.                                  No inter sectoral co-ordination.
     RRT formed in dist and PHC level for Control of Epidemic situation.                 Health seeking behavior of People in Government facility is very poor.
     Good communication facility to PHC HQ                                               No separate Logistic asst and data entry operator for the program.
                                                                                          Reporting system is very poor in PHC level
OPPORTUNITY                                                                              THREATS

     Involvement of NGO in Spray work and LLIN Distribution.                             Low literacy Rate.
     Involvement of Village Health & Sanitation committee.                                  Lack of transport connectivity
     Use of Untied fund (PHC/HSC)                                                           Irregular Monsoon
                                                                                            Communication facility from PHC HQ to Village is not good.

                                                                                                                                                                    92
                                                                                                                               SARAIKELA-KHARSAWAN,DHAP 2011-12

(b) Specific activities like

                a) RD Kits (selected Pf endemic blocks only)

                                 A. of Rapid Diagnostic Kits for the plan year based on epidemiological and operational data

                                                                                                                  RDTs for buffer
                                                                                               Expected RDT
                                                      No. sub-centre          No. blood                             stock and             Total
                                                                                               requirement in
                                No. PHCs where        areas with Pf >     examinations in                         distribution to        annual
     Sl.                                                                                       remote high Pf                                              Nos to be
                                RDTs are to be        30% & SFR>2%           those sub-                            other areas:
     No         Blocks                                                                        areas and PHCs                                            distributed in
                                    used in               and no            centre/ PHC                                               RDT supply
      .                                                                                           [Ax 1.25]                                            prioritized areas
                               emergency hours          microscopy         areas last year                            [B x 0.20]
                                                     result within 24h           (A)                                                     [B+C]
                                                                                                     (B)                 (C)

      1    Kharsawan           Kharsawan                     -                 12920               16150                3230             19380              38896

      2    Kuchai              Kuchai                        -                  6722                8403                1681             10083              27604

      3    Gamharia            Gamharia                      -                 23108               28885                5777             34662              27088

      4    Saraikela           Saraikela                     -                 10436               13045                2609             15654              27542

      5    Rajnagar            Rajnagar                      -                 12056               15070                3014             18084              28578

      6    Chandil             Chandil                       -                 12817               16021                3204             19226              55228

      7    Nimdih              Nimdih                        -                  8446               10558                2112             12669              20352

      8    Ichagarh            Ichagarh                      -                 10004               12505                2501             15006              24688

                                   Total                                       96509               120636              24127             144764             249976

     * Planning for RDTs is based on annual blood examinations in areas and health facilities, where it is n ot possible to obtain a microscopy result within 24 hours (no
     later than day after slide is taken and where the risk of P. falciparum rate is >2%.

     * Villages planned to be equipped with RDTs should have trained ASHA/ CHVs ( including A W W)



                                                                                                                                                                       93
                                                                                                                        SARAIKELA-KHARSAWAN,DHAP 2011-12

* In the above, sub-centre area means the sub-centre and the villages under it, while PHC means the PHC health facility, e.g. " PHC (new). The distinction is made,
because in some cases, the PHC has microscopy, but many of the sub-centre areas under it do not.

* In general, it should be assured that as a minimum. RDTs are supplied to cover all blood examinations in the eligible PHCs and sub-centre areas. The number of
blood examinations is estimate by adding 25% to the number of blood examinations during the last complete calendar year, because RDTs may attract additional
patients.

* If possible, a buffer stock of approximately 20%, depending on the availability of supplies is added, to cover needs in other areas and health facilities, where
individual patients may be considered highly suspect of falciparum malaria on account of symptoms or travel history, or where microscopy may be temporarily
unavailable and to provide a reserve for supplies to the eligible areas.




                        B.    Requirement of Rapid Diagnostic Kits based on epidemiological data for next Plan Year

                                                                              Sub
                       S.                                      Slide                       Village        Total            Tribal
                                        Details                              centre
                       No.                                   Collection                     (no)        Population       Population
                                                                              (no)

                                                              96509 till
                        1     Areas with high Pf %                             194          1142           998533          353820
                                                              Sept-10

                              Of the above prioritized to
                        2     be equipped with RDT              33148          194          1142           998533          353820
                              during the year

                              No of RDTs Required for
                        3                                      200000          194          1142           998533          353820
                              Next Plan Year




                                                                                                                                                                94
                                                                                                                              SARAIKELA-KHARSAWAN,DHAP 2011-12

Areas for supply of ACT

    A. Allocation of ACTs and quinine for a plan year based on epidemiological and operational data

    Data latest complete year                                                             Allocation for plan year

                                                                                             Adults, not
                                                                   Pf cases reported in                                     Children            Pregnant Women
                                                                                              pregnant
                                                                    previous year till
                                           Name         Total
                 Details                                                  Oct-10
                                           block      Population                             ACT Blister        AS Tabs           SP Tabs        Quinine Tablets

                                                                            A               A x1.5 x 0.67      A x 1.5 x 2      A x 1.5 x 0.5   A x 1.5 x 0.02 x 21

                                         Kharsawan        80660            419                   421                 1257              314             264

                                         Kuchai           58749            274                   275                 822               206             173

                                         Gamhariya       267034            375                   377                 1125              281             236

                                         Seraikella       91644            311                   313                 933               233             196
     Blocks identified for roll out of
                  ACT
                                         Rajnagar        134809            218                   219                 654               164             137

                                         Chandil         134236            609                   612                 1827              457             384

                                         Nimdih          103548            273                   274                 819               205             172

                                         Ichagrah        108283            262                   263                 786               197             165

     PHCs around Pf resistance foci      Chandil       134236              609                   612                 1827              457             384




                                                                                                                                                                      95
                                                                                                                                                                                                                                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12

c) BednetsAll planning should be based on enumeration of bednets in households by Bednet Survey. (Use the IVM Annual Plan Format for
detailed planning)

                                                         Revised Microplan Format For Distribution of LLINs Requirements(PHC wise)

                                                                                                            High risk Sub-centre with API 2-5                                                                                                                        High risk Subcentre with API >5




                                                                                                                                                                                                                                                                                                                                                                                 Total bednet required for the districts
                                                                                                                                                                       No of Bed Nets required to saturate




                                                                                                                                                                                                                                                                                                                                           No of Bed Nets required to saturate
                                                                                                                                                                                                             No of House Hold already covered
                                                                                                                                     Total No of Bed Net Required to




                                                                                                                                                                                                                                                                                                         Total No of Bed Net Required to
                                                                                                                                                                         80% of the API 2-5 population




                                                                                                                                                                                                                                                                                                                                              80% of the API>5 population
                                      No of House Hold



                                                           Total Population
                    No of Subcentre




                                                                                                                                            cover Population




                                                                                                                                                                                                                                                                                                                cover Population
                                                                              No of Sub-center




                                                                                                                  Total Population




                                                                                                                                                                                                                                                                                    Total Population
                                                                                                                                                                                                                                                No of Subcenter
 S.
      Name of PHC




                                                                                                                                                                                                                        with LLIN
                                                                                                 No of HD




                                                                                                                                                                                                                                                                  No of HD
 No




 1    Kharsawan              20       16131                80655                        15         10447                 52234               20894                              16715                                     0                                 2                923                  4617              1847                                1477                      22740

 2    Kuchai                 14       11749                58745                        10            7823               39114               15646                              12516                                     0                                 3          1166                       5829              2332                                1865                      17977

 3    Seraikella             23       18326                91630                        10            5756               28780               11512                                  9210                                  0                                 8          5859                29294                 11718                                  9374                      23230

 4    Rajnagar               33       26969               134846                           6          2429               12145                  4858                                3886                                  0                                 2          1165                       5823              2329                                1863                              7187

 5    Gamhariya              22       53406               267029                           6          6383               31917               12767                              10213                                     0                                 2          2291                11456                    4582                                3666                      17349

 6    Chandil                25       26846               134231                        11         14735                 73676               29470                              23576                                     0                              17        13432                   67161                 26864                              21492                         56335

 7    Nimdih                 29       20708               103542                        21         14107                 70534           28213.6                                22571                                     0                                 6          6847                19151                 13694                              10956                         41908

 8    Ichagarh               28       21656               108278                        15         16184                 80921               32368                              25895                                     0                                 6          8515                42575                 17030                              13624                         49398

      Total               194         195791              978956                        94       77864            389321                  155728                             124583                                       0                              46       40198             185906                       80396                              64317                        236125


                                                                                                                                                                                                                                                                                                                                                                                                                           96
                                                                                                                                SARAIKELA-KHARSAWAN,DHAP 2011-12

d) Planning for IRS: Please specify criteria for selection of areas for IRS:-

       (Specify whether the unit of planning is village / sub centre. Mention the cut off used for API, Pf% deaths for selection of areas; whether
       MAP criteria has been applied)(1) Pf > 30% (2) API > 2-10% (3) SPR > 5%

   (Base the planning for IRS on epidemiological data)

   (A) IRS Plan:-

                                                           PHC WISE FOR IRS ACTIVITIES YEAR 2011
                                                                                       Date of Spray ( 1st Round)   Date of Spray (2nd Round)      SP      Ammount
        Sl     Name of     No of     No. of                                                                                                     consume   Required for
        No     thePHC      Village    HSC     Population   House Hold   No of Squard    From            To             From           To         in MT      2 Round

         1   Kharsawan      125       20         49986       9997            4         15-May        45 days          1st Aug     45 days         0.9         0.9

         2   Kuchai         100       14         36904       7381            3         15-May        45 days          1st Aug     45 days         0.7         0.7

         3   Seraikella     167       23         56544       11309           5         15-May        45 days          1st Aug     45 days         1.1         1.1

         4   Rajnagar       245       34         82317       16463           7         15-May        45 days          1st Aug     45 days         1.5         1.5

         5   Gamharia       186       32        161265       32253          14         15-May        45 days          1st Aug     45 days         3.0         3.0

         6   Chandil        103       24         81975       16395           7         15-May        45 days          1st Aug     45 days         1.5         1.5

         7   Nimdih          83       23         63651       12730           6         15-May        45 days          1st Aug     45 days         1.2         1.2

         8   Ichagarh       133       27         66479       13296           6         15-May        45 days          1st Aug     45 days         1.2         1.2

             Total         1142       197       599120        119824        53                                                                   11.2        11.2




                                                                                                                                                                     97
                                                                     SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                 Planning of IRS

         A.    (a) High Risk Area as per guideline:-

S.                          High risk            High risk Sub             High risk Village       High risk
No            Blocks        PHCs (No)             centre (no)                    (no)            Population (no)

 1       Kharsawan               1                        7                       35                    32685

 2       Kuchai                  1                       10                       28                    39140

 3       Saraikela               1                       13                       85                    33953

 4       Rajnagar                1                       11                       89                    39130

 5       Gamharia                1                        5                       32                 133523

 6       Chandil                 1                       12                       45                    39192

 7       Nimdih                  1                       14                       32                    35906

 8       Ichagarh                1                       11                       25                    36093

          Total                  8                       83                      371                 389622



                  (b) Spray equipment Status:-

Sl. No.         Name of PHC          Pump        Balti- 15L        Balti- 5L       Napna       Damage Pump

     1        Kharsawan               5             10                5                5            2

     2        Kuchai                  40            70                52               57          30

     3        Seraikella              66            115               73               75          45

     4        Rajnagar                78            136               78               78          50

     5        Gamhariya               60            93                66               68          40

     6        Chandil                 71            115               75               73          45

     7        Nimdih                  47            65                50               50          25

     8        Ichagarh                50            85                50               60          30

               Total                 417            689              449            466            267




                                                                                                            98
                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12



          (c) Insecticide status:

  Sl.      Name of           Previous Balance          Received          Total     Expenditure        Balance
  No.      PHC                    (In KG)               (In KG)        (In KG)       (In KG)          (In KG)

    1      Kharsawan                2,570                  0            2,570           0               2,570

    2      Kuchai                   1,717                  0            1,717          350              1,367

    3      Seraikella               1,881                  0            1,881          600              1,281

    4      Rajnagar                 5,722                  0            5,722          500              5,222

    5      Gamhariya                3,696                  0            3,696          550              3,146

    6      Chandil                  6,965                  0            6,965          550              6,415

    7      Nimdih                   2,182                  0            2,182          350              1,832

    8      Ichagarh                 1,811                  0            1,811          150              1,661

           Total                    26,543                 0           26,543          3,050           23,493



          (d) Training of Spray Worker (i.e. 1Vill X 2 Spray Workers)

  Sl.No                          Name of PHC                            No. of Spray workers

                        (Training given at sector level)

    1      Kharsawan                                                              75

    2      Kuchai                                                                 84

    3      Seraikella                                                             83

    4      Rajnagar                                                               33

    5      Gamhariya                                                              65

    6      Chandil                                                               150

    7      Ichagarh                                                              106

    8      Nimdih                                                                 85

                                 Total                                           681



 Total 681 (Six Hundred Eighty One) number of spray workers trained. Under District Malaria Office, Seraikella
– Kharsawan .




                                                                                                           99
                                                                SARAIKELA-KHARSAWAN,DHAP 2011-12

      (e) General Training


                Name of
                               Total Strength    Trained        Untrained     Remarks
                the Post

                MO                   67              0             67

                MI                    3              3             0

                MPW                  44             44             0

                ANM                  345             0            345

                MTS                   1              1             0

                VBD                   1              0             1

                DMO             1 (Nominated)        0             1




4.   Strategy & innovations proposed:-

                     District Plan
        Sl No                                                    Strategies
                      Objectives

                                     Patient referral e.g. Like use of NRHM funds for transport of
          1     EDCT                 severe cases. Referral system, Identification of High risk area,
                                     Active surveillance, Passive surveillance, Treatment Policy

                                     Office equipments like:-

                Development of            a. Laser Printer, Scanner, Fax machine, Computer Table
          2
                Infra structure              and Chair
                                       b.    MTS Vehicle
                                       c.    Chair, Table and Almirah for DMO, DMC, Logistic
                                             Asst. and DEO.
                Human                Appointment of LTs for Six PHCs and Fourth Grade Staff
          3     Resource             and Driver for HQr Office.
                Development

                                     Community mobilization
          3     IEC/BCC              eg. Mobilizing using street plays, puppet plays, self help
                                     groups, Poster, Pamphlets, flex etc

                Inter sectoral co    NGO/ CBO involvement
          4
                ordination           Co ordination with Fishery, Education, Forest Deptt.




                                                                                                  100
                                                         SARAIKELA-KHARSAWAN,DHAP 2011-12

5. Requirement for commodity as per technical norms and considering balance of stores,
consumption capacity and justification.

                                Previous Year's   Requirement for the   Balance         Net
             Items                utilization        current year       available   requirement

Choloroquine Tab. (no)             167800               328716            650         328066

Primaquine 2.5 mg Tab. (no.)        70000               47128            18000        29128

Primaquine 7.5 mg Tab. (no.)         3900               54983             2000        52983

ACT Comb. (Artemisinine+SP)          4900               15078             1050        14028

Artesunate Tab. (no.)               36100               15350             800         14550

Arteether Inj (no.)                  1269                9498             801          8697

Quinine Sulphate Tab. (no.)           0                 57561              0          57561

Quinine Injection (no.)               0                 19187              0          19187

S+P Comb. Tab. (no.)                10000               16000             2000        14000

R.D. Kits (no.)                     43100               98177            11625        86552

DDT 50% ( in Kg)                    34582                  0             23993           0

Malathion 25% wdp (in ltrs.)          0                  50 ltr            0           50 ltr

Malathion Technical (in ltrs)         0                    0               0             0

Temephos 50% (in ltrs.)               0                  50 ltr            0           50 ltr

Pyrethrum Extt. 2%                    0                  40 ltr            0          40 Lit.

Primiphos methyl (in ltrs)            0                    0               0             0

Synthetic Pyrethroid for IRS          0                11000 kg            0         11000kg

SP for ITNs in litre                  0                    0               0             0

ITNs (no)                             0                    0               0             0

LLINs (no)                            0                 236125             0          236125

Micro Slides (No.)                 106802               115000             0          115000

Stirrup Pumps (No.)                  417                 267               0           267

Bucktet 15 Litre                     689                 212               0           212

Bucket 10 litre                      473                  53               0            53



                                                                                              101
                                                                                                            SARAIKELA-KHARSAWAN,DHAP 2011-12

6. Cash assistance required from Centre and unspent balance available with State

                             RECEIPT & EXPENDITURE REPORT                                     Month of Oct-10
                                                       FINANCIAL YEAR 2010-11
                                                   Recd. From       Total                       Expenditure        Total       Closing
Sl.                          Alloted     Opening                               Expenditure
          Alloted Head                             SMCS/Misc./    Amount                         in current     Expenditure    Balance
No.                          Amount      Balance                              till last month
                                                     Interest    (Colm.4+5)                        month        (Colm.7+8)    (Colm.6-8)
 1             2                3           4            5            6               7               8              9            10
 1    V.B.D Consultant       360000.00   181000.00         0.00    181000.00        179000.00       30000.00      209000.00     151000.00
 2    Salary of MTS           247000.00    208217.00         0.00    208217.00       38783.00        6500.00       45283.00    201717.00
 3    DA for MTS               36000.00     30033.00         0.00     30033.00        5967.00        1000.00        6967.00     29033.00
 4    POL for MTS              90000.00     75083.00         0.00     75083.00       14917.00        2500.00       17417.00     72583.00
 5    Salary of LT            156000.00     72400.00         0.00     72400.00       83600.00       12000.00       95600.00     60400.00
 6    Salary of MPW          3900000.00   2324800.00         0.00   2324800.00     1575200.00      264000.00     1839200.00   2060800.00
 7    Hon. for Acctt.           3000.00         0.00         0.00          0.00       3000.00           0.00        3000.00          0.00
 8    Training of MPW          40000.00     40000.00         0.00     40000.00            0.00          0.00           0.00     40000.00
 9    Hon. of Sahiya           24000.00      4740.00         0.00      4740.00       19260.00           0.00       19260.00      4740.00
 10   POL. & Maintenance       55000.00     11635.00         0.00     11635.00       43365.00        2150.00       45515.00      9485.00
 11   TA/DA                    20000.00         0.00         0.00          0.00      20000.00           0.00       20000.00          0.00
 12   NAMMIS                   10000.00         0.00         0.00          0.00      10000.00           0.00       10000.00          0.00
 13   Salary for DEO           52000.00     52000.00         0.00     52000.00            0.00          0.00           0.00     52000.00
 14   Salary for F & LA        64000.00     64000.00         0.00     64000.00            0.00          0.00           0.00     64000.00
 15   Training of Sahiya -     74000.00      4000.00         0.00      4000.00       70000.00           0.00       70000.00      4000.00
 16   Without head             74282.00     21531.00         0.00     21531.00       52751.00           0.00       52751.00     21531.00
 17   Printing                149600.00         0.00   149600.00     149600.00            0.00          0.00           0.00    149600.00
 18   Bank Interest            22427.00     15705.00         0.00     15705.00        6722.00        3198.00        9920.00     12507.00
           Total             5377309.00   3105144.00   149600.00    3254744.00     2122565.00      321348.00     2443913.00   2933396.00




                                                                                                                                            102
                                                                                                                SARAIKELA-KHARSAWAN,DHAP 2011-12

NB:- Funds required under the following heads as       1. Office Contingency                        – 100000.00
                                                       2. Consumable                                – 150000.00
                                                       3. POL                                       – 80000.00
                                                       4. Assets (Table/ Chair/Almirah etc)         – 100000.00
                                                       5. Office building/Store house               –
                                                       6. MTS Vehicles (5 Nos)                      – 250000.00
                                                       7. VBD Consultant four wheeler (1 No.s)      – 700000.00
                                                       8. MI Vehicles (3 Nos)                       – 150000.00
                                                       6. Mobile Set (115 Nos)                      –
                                                       7. Laptop for DMC                            – 39000.00



            7. Assistance for Capacity Building and IEC/BCC activities may be incorporated.

               Training: mention number of batches to be trained.

                                                    Trained                     To be Trained in year 2011-12
                                          Cost
       Sl.                                             in
                      Trainings            per                                                                       Total Cost
       No                                          Previous    Q1 (no)   Q2 (no)   Q3 (no)   Q4 (no)   Total (no)
                                          Batch                                                                         (Rs)
                                                   year (no)
              Medical specialists at
        1                                 60000       0          2                   0         0           2
              District Hospital
        2     Medical Officers            60000       0          25        25                  17         67
              Laboratory Technicians
        3                                             2          0         0         0         0           0
              (induction)
              Laboratory Technicians                                                                                As per State
        4                                 50000       0          2         0         0         0           2
              (reorientation)                                                                                         decision
        5     Health Supervisors (M)                  3          0         0         0         0           0
        6     Health Supervisors (F)      25000       0          0         0         0         0           0
        7     Health Workers (M)          25000       44         25        25        25        30         105
        8     Health Workers (F)          25000       0          86        86        87        86         345



                                                                                                                                             103
                                                                                                       SARAIKELA-KHARSAWAN,DHAP 2011-12

IEC/BCC activities:-

 Sl No         District Plan Objectives                                 Strategies                             Required Funds in Rs.

                                                        Patient referral e.g. Like use of NRHM
                                                        funds for transport of severe cases.                         444000
      1        EDCT                                     Referral system, Identification of High risk
                                                        area, Active surveillance, Passive
                                                        surveillance, Treatment Policy

                                                        Office equipments like:-

                                                        a. Laser Printer, Scanner, Fax machine,                      2030000
      2        Development of Infra structure               Computer Table and Chair
                                                        b. MTS Vehicle
                                                        c. Chair, Table and Almirah for DMO,
                                                            DMC, Logistic Asst. and DEO.
                                                        d. Laptop for DMC.

                                                        Appointment of LTs for Six PHCs and
      3        Human Resource Development               Fourth Grade Staff and Driver for HQr                           0
                                                        Office.

                                                        Community mobilization

      3        IEC/BCC                                  eg. Mobilizing using street plays, puppet                    500000
                                                        plays, self help groups, Poster,
                                                        Pamphlets, flex etc

                                                        NGO/ CBO involvement
      4        Inter sectoral co ordination             Co ordination with Fishery, Education,                       100000
                                                        Forest Deptt.

                                                TOTAL                                                                2574000


                                                                                                                                       104
                                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12


                                           FILARIA
1.   Situation analysis of the disease:
     Filariasis (Philariasis) is a parasitic disease and is considered an infectious tropical disease,
that is caused by thread-like filarial nematodes (roundworms) in the superfamily Filarioidea, also
known as "filariae". In humans There are 8 known filarial nematodes which use humans as the
host. These are divided into 3 groups according to the niche within the body that they occupy:
'lymphatic filariasis', 'subcutaneous filariasis', and 'serous cavity filariasis'. Lymphatic filariasis is
caused by the worms Wuchereria bancrofti, Brugia malayi, and Brugia timori. These worms occupy
the lymphatic system, including the lymph nodes, and in chronic cases these worms lead to the
disease elephantiasis. These worms occupy the subcutaneous layer of the skin, in the fat layer.
Serous cavity filariasis is caused by the worms Mansonella perstans and Mansonella ozzardi,
which occupy the serous cavity of the abdomen. In all cases, the transmitting vectors are either
blood sucking insects .

NB:- Filariasis survey is   in initial stage at Saraikela-Kharsawan District. We are reporting earlier
to State.




                                                                                                      105
                                                             SARAIKELA-KHARSAWAN,DHAP 2011-12




          Monitoring of Parameters for elimination oh Lymphatic Filariasis:
MDA Coverage -:         More than 85%

Micro filaria Rate :    Less than 1%

                            MDA Coverage                              Hydrocele           Hydrocele
                                             Microfilaria Rate
Sl. No.    Name of CHC        of eligible                                               Operation done
                                                   (%)
                            population (%)                                             against line-listed
                                                                  number line-listed

                                                                                               0
   1       Kuchai                  0                0                    107


                                                                                               0
   2       Kharsawan               0                0                    143


   3       Seraikella              0                0                    174                   0

   4       Rajnagar                0                0                    150                   0

   5       Gamhariya               0                0                    140                   0

   6       Chandil                 0                0                    92                    0

   7       Nimdih                  0                0                    169                   0

   8       Icahgarh                0                0                    559                   0

                                Total                                   1534




                                                                                                106
                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12


2. Specific Constraints for implementation of the programme


             PRIORITIES                      CONSTRAINS                      REQUIRED ACTIONS

Functional Facilities                      Non functional                  Pooling of staffs
                                            equipments                      Purchase of equipments


Increase and imparting Human               Lack of training of
resources                                   LTs, MPWs, ANMs,                Training
                                            SAHIYA
Filaria Surveillance                                 -                   Initial Stage

Proper Diagnosis                                     -                      Required action on
                                                                             Reporting.
Vector Control                             Lack of awareness.              IEC/BCC/IPC
                                                                            Well Advance information
                                                                             to the community
Planning and Monitoring                    Lack of Local                   Involvement of VHSCs
                                            Planning                         members/ PRI Members
                                         Lack of involvement               Coordination with Health
                                            of PRI, NGO, VHSC                and other department.
Management of severe and                 MO not trained.                   Training according to
complicated Filaria cases               MO not follow proper                 approved guideline
                                        guideline for Drugs


                  (a) Prioritization of the areas including the criteria of prioritization

STRENGTH                                                 WEAKNESS

                                                              Non availability of motorcycle to MTS for
         Available of required no of PHC and HSC              supervision.
          scattered in all over the district.                Tribal people believe in Quakes.
         Available of Dedicated workers                     Poor Hygiene and sanitation facility.
         MTS and MPW are working                            No inter sectoral co-ordination.
         Good communication facility to PHC HQ              Health seeking behavior of People in
                                                               Government facility is very poor.
                                                             No separate Logistic asst and data entry
                                                               operator for the program.
                                                             Reporting system is very poor in PHC
                                                               level
OPPORTUNITY                                              THREATS

         Involvement of NGO .                               Low literacy Rate.
         Involvement of Village Health &                    Lack of transport connectivity
          Sanitation committee.                              Irregular Monsoon
         Use of Untied fund (PHC/HSC)                      Communication facility from PHC HQ to
                                                            Village is not good.

b)       Strategy & innovations proposed: The strategy for Elimination of Lymphatic Filariasis (ELF)
         need to be described in this section. The preparatory activities are described below :

                                                                                                      107
                                                            SARAIKELA-KHARSAWAN,DHAP 2011-12

   a) IEC activities at local level:-


The social mobilisation programme by means of the IEC campaign about the MDA had been
transmitted to the population by four media sources, television, radio, banners and leaflets. While
the television and radio conveyed the message to most people in all PHCs, banners and leaflets
were the most widely viewed message in Saraikela-Kharsawan district. Loudspeakers , Dugdugi,
Chow dance and Puppet Show had also been popular in Seraikella-Kharsawan districts.

i) Requirement for commodity as per technical norms and considering balance of stores,
consumption capacity and justification.:- NIL

ii) Cash assistance required from Centre and unspent balance available with State:- NIL

iii) Assistance for Capacity Building and IEC/BCC activities may be incorporated:- As per State
Malaria Office Decision.




                                                                                               108
                                                        SARAIKELA-KHARSAWAN,DHAP 2011-12


                          Dengue/Chikungunya
     Situation analysis of the disease:-

     Dengue is transmitted by the bite of an Aedes mosquito infected with any one of
the four dengue viruses. It occurs in tropical and sub-tropical areas of the world.
Symptoms appear 3—14 days after the infective bite. Dengue fever is a febrile illness
that affects infants, young children and adults.


Symptoms range from a mild fever, to incapacitating high fever, with severe
headache, pain behind the eyes, muscle and joint pain, and rash. There are no specific
antiviral medicines for dengue. It is important to maintain hydration. Use of
acetylsalicylic acid (e.g. aspirin) and non steroidal anti-inflammatory drugs (e.g.
Ibuprofen) is not recommended.


Dengue haemorrhagic fever (fever, abdominal pain, vomiting, bleeding) is a
potentially lethal complication, affecting mainly children. Early clinical diagnosis and
careful clinical management by experienced physicians and nurses increase survival of
patients.
    Name of the PHC           Year         Population      No. of Patients     Death
                              2009           89409                0              0
  Seraikella
                              2010           94240                1              0
                              2009           78693                0              0
  Kharsawan
                              2010           83310                0              0
                              2009           57317                0              0
  Kuchai
                              2010           61506                1              0
                              2009          131521                0              0
  Rajnagar
                              2010          137194                1              1
                              2009          260521                0              0
  Gamhariya
                              2010          268774               17              0
                              2009          130962                0              0
  Chandil
                              2010          136624                6              0
                              2009          101022                0              0
  Nimdih
                              2010          106085                1              1
                              2009          105642                0              0
  Ichagarh
                              2010          110798                0              0
                              2009          955087                0              0
            Total
                              2010          998531               27              2

 1. No any case reported in 2009.
  2. 27 cases reported from TMH Jamshedpur of Saraikela-Kharsawan dist. in 2010.
 Lab. Facility is not available.
 Coordination process is going on with NGOs.



                                                                                       109
                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12

    Priorities, Constraints and Required actions :-

Sl.No                    Priorities                           Constraints                  Required action
1         Increase and imparting Human resources              Lack of training of
                                                               MO and                        Training
                                                               Paramedical staff
2         Dengue Surveillance                                Vertical                       Decentralization of
                                                               programme                      the programme
                                                             No periodic Data               Developing a
                                                               Collection                     system for periodic
                                                             Lack of required                Data Collection.
                                                               amount of
                                                               Diagnostic centre
3         Personal protection                           Improper use of bed Nets      .Distribution of LLIN.
                                                        and Domestic Container
                                                        etc                           .To ensure the community
                                                                                      for proper use of LLIN

4         Vector Control                                .No antilarval measures in    .IEC/BCC/IPC
                                                        remote areas etc

5         planning and Monitoring                       .Lack of proper planning      .Involvement of VHSC and
                                                        and monitoring                PRI members


 In case of epidemic, Rapid Response Team is available under IDSP and VBDCP.
 Strategy for Case Reduction – Intensified entomological surveillance work will be done in
    affected areas. Vector control strategies will also be done for transmission risk reduction and
    prevention of occurrence of outbreak. Rapid Response Team will be accelerated for elimination
    of the foci to interrupt the transmission.

Training Status:-

                                         Total No. In
         S.N.       Category of Staff                       Total No. Trained        Total No. Untrained
                                          Position

          1      Dy.Supritendent                 01                 0                         01

          2      PHC-MO                          67                 01                        66

          3      DMO                             01                 0                         01

          4      VBD Consultants                 01                 0                         01

          5      MTS                             01                 0                         01

          6      LT-Regular/Cont.            0/10                   0                         0




                                                                                                               110
                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12


Specific Constraints for implementation of the programme

IEC activities in the campaign

• Publicity should be more intense and done at least one month before the campaign.

• IEC material should be supplied well in advance. Panchayats should be fully involved in such activities.

• People should be contacted and reminded about the place and dates of vaccination about two to three days
before actual vaccination activity.

• Since IEC is very important, it was essential that IEC activities should be closely monitored and made more
effective and comprehensive.

• More funds needed to be allocated for IEC activities.

• To create awareness, meetings should be organized between Gram Pradhans, ANMs, AWWs, leaders and
villagers.

• Emphasis should also be on inter-personal communication through AWWs/ASHAs/ANMs as well as school
teachers as they lived in the village and were close to the community. They also had greater acceptance
within the community. This will also reduce the gap between awareness and coverage of children immunized.

• In addition to current modes of publicity, it is necessary to use other modes like rallies by school children,
publicity during weekly haats/bazaars, etc.

• The publicity about the campaign should also include information about risks of Dengue disease and its
effects.

Prioritization of the areas including the criteria of prioritization

STRENGTH                                                  WEAKNESS

                                                               Non availability of motorcycle to MTS for
          Available of required no of PHC and HSC              supervision.
           scattered in all over the district.                Tribal people believe in Quakes.
          Available of Dedicated workers                     Poor Hygiene and sanitation facility.
          MTS and MPW are working                            No inter sectoral co-ordination.
          Good communication facility to PHC HQ              Health seeking behavior of People in
                                                                Government facility is very poor.
                                                              No separate Logistic asst and data entry
                                                                operator for the program.
                                                              Reporting system is very poor in PHC
                                                                level
OPPORTUNITY                                               THREATS

          Involvement of NGO .                               Low literacy Rate.
          Involvement of Village Health &                    Lack of transport connectivity
           Sanitation committee.                              Irregular Monsoon
          Use of Untied fund (PHC/HSC)                      Communication facility from PHC HQ to
                                                             Village is not good.


                                                                                                             111
                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12

i) Strategy & innovations proposed: The strategy for Elimination of Lymphatic Filariasis (ELF)
need to be described in this section. The preparatory activities are described below :

                (a) IEC activities at local level:-

   The social mobilisation programme by means of the IEC campaign about Dengue had been
transmitted to the population by four media sources, television, radio, banners and leaflets. While
the television and radio conveyed the message to most people in all PHCs, banners and leaflets
were the most widely viewed message in Saraikela-Kharsawan district. Loudspeakers, Dugdugi,
Chow dance and Puppet Show had also been popular in Saraikela-Kharsawan districts.

ii)  Requirement for commodity as per technical norms and considering balance of stores,
consumption capacity and justification.:- NIL

iii) Cash assistance required from Centre and unspent balance available with State:-

   Fund and Commodity Requirement
                                                                                      2011-12
                                                                   2010-11
     Dengue/Chikungunya
                                                                (Expenditure)       (Proposed)*

     Grant in respect of Dengue and Chikungunya

     Strengthening surveillance (As per GOI approval)

                Apex Referral Labs recurrent @ Rs/ 1.00
                 lakh
                                                                                Rs. 1.00 lakhs
                Sentinel surveillance Hospital recurrent @
                                                                                Rs. 0.50 lakhs
                 Rs. 0.50 lakhs
                Test kits (Nos.) to be supplied by State/GoI


                                                                 No any fund
                                                                    recd.


     One time Grant @ Rs. 25.0 lakhs per SSH (RIMS &
     Sadar Hospital)                                                            Rs. 50.0 lakhs

     Monitoring/Supervision and Rapid Response                                  Rs. 0.50 lakhs

     Epidemic Preparedness                                                      Rs. 0.50 lakhs

     IEC/BCC/Social Mobilization                                                Rs. 1.50 lakhs

     Training/Workshop                                                          Rs. 1.00 lakhs

                                                        Total                   Rs. 54.00 lakhs




                                                                                                  112
                                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12

7. Assistance for Capacity Building and IEC/BCC activities may be incorporated:- As per
State Malaria Office decision.

                                             PART-III
                    Expenditure ( Financial Performance)- Budget Proposal
                                        (Rs. in lakhs)
                                                                                      Support to
                                                                           2011-12   be met from
                                                                                     NVBDCP/GoI
                                                          2010-11
                                                                                        or state
                                                       (Expenditure)
                                                                                     resources or
                                                                       (Proposed)*    NRHM flexi
                                                                                         fund

Malaria

DBS

MPW                                                    1839200         7560000

SAHIYA                                                 19260           4440000

Operational Cost including spray wages                 0               3205917

NAMMIS                                                 10000           35000

IEC,BCC &PPP                                           3500            500000

Training                                               0               200000

Additional support under World Bank (if applicable)

Human Resource                                         358383          1050000

Capacity building in project areas                     70000           200000

Mobility support                                       86399           500000

Additional support under GFATM       (if applicable)

Capacity Building                                      0               0

Establishment State Society                            0               0

Human Resource                                         0               0

Monitoring & Evaluation                                0               0

BCC/PPP/Soc.Mkt.                                       0               0




                                                                                                    113
                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12

Drugs                                      In Quantity       In Quantity

Chloroquine phosphate tablets          167000            600000

Primaquine tablets                     67750             117453

Quinine sulphate tablets               0                 102900

Quinine Injections (E- Mal)            1269              16000

Sulphadoxine + Pyremethamine tablets   10000             15000

Diagnostics

IRS

Wages                                  0                 3205917

Human resource                         0                 318 (Staff)

Monitoring & Evaluation                0                 500000

Bednet

Impregnated mosquito nets              0                 275000

LLIN                                   0                 255200 (net)

Insecticides

DDT 50% wdp                            34.582 MT         0

Synthetic Pyrethroid                   0                 11.25 MT

Malathion 25%/Technical                0                 0

UMS – Larvicides

For polluted water (Abat)              0                 200 lt

For non-polluted water (Malathion)     0                 100 lt

Pyrethrum extract 2%                   0                 100 lt

Total Malaria                          2632761           22523187


Filaria
Drugs (by GoI)                         0                 100000

Training                               0                 500000

BCC                                    0                 100000




                                                                                114
                                                               SARAIKELA-KHARSAWAN,DHAP 2011-12

Preparatory activity (may be shown activity-wise
                                                    0               200000
including hydrocelectomy)

Drug distributor’s including ASHA and supervisors
                                                    0               400000
honorarium

Total (Filaria)                                     0               1300000

Dengue/Chikungunya                                                             0

Grant in respect of Dengue and Chikungunya

Strengthening surveillance (As per GOI approval)

   Apex Referral Labs recurrent @ Rs/ 1.00 lakh           0        100000

 Sentinel surveillance Hospital recurrent @ Rs.
                                                                    50000
0.50 lakhs                                                 0

   Test kits (Nos.) to be supplied by GoI                 0        200000

Monitoring/Supervision and Rapid Response                  0        300000

Epidemic Preparedness                                      0        200000


IEC/BCC/Social Mobilization                                0        100000


Training/Workshop                                          0        100000

Total Dengue/Chikungunya                                            1050000

AES/JE

Diagnostics and Management                                 0        50000

Elisa Kits                                                 0        1000

IEC/BCC                                                    0        100000

Training                                                   0        100000

Monitoring and Supervision                                 0        50000

Technical Malathion                                        0        100 lt

Total AES/JE                                                        301000

Grand Total                                             2632761     25174187




                                                                                            115
                                                         SARAIKELA-KHARSAWAN,DHAP 2011-12

   The requirement for programme implementation has been indicated in detail and the
  summary is indicated below :

                                      Balance
                            Cash
                                        from     Committed                         State
        Disease          assistance                            Net requirement
                                      previous   expenditure                     resources
                          from GoI
                                       years

Malaria

     a. DBS                                                       22523187
                             0        2933396     2933396                            0
     b. World Bank for
        project states
     c. GFATM for
        project states
Filaria                      0           0           0             1300000           0

Kala-azar                    0           0           0                0              0

Kala-azar World Bank                                                  0
                             0           0           0                               0
Project assistance

AES including JE             0           0           0             301000            0

Dengue                       0           0           0             1050000           0

Chikungunya                  0           0           0                0              0

Total                        0        2933396     2933396         25174187           0




                                                                                         116
                                                             SARAIKELA-KHARSAWAN,DHAP 2011-12

       C-3 NLEP (National Leprosy Eradication Programme)

Objective :-
To reduce the leprosy disease prevalence rate to <1/10,000

Situational Analysis :-

Performance under NLEP at District Saraikela-Kharsawan

                                                                                      2010-11
                     Indicators                              2008-09     2009-10      (Till Oct
                                                                                       2010)
No. of New Cases detected ANCDR                               381          395          279

No. of Cases on record at year end (PR)                       1.50        1.65         2.08

No. of Grade II Disability among new cases (%)                2.62         4.3          Nil
                                                        MB-95.72        MB-94.07
Treatment Completion Rate
                                                        PB-98.64        PB-97.15

Reconstructive Surgery Conducted                               06          06            02




                                                                                           117
                                                             SARAIKELA-KHARSAWAN,DHAP 2011-12

                         CHC wise performance record
Performance Under NLEP

I. No. of new cases detected

                                                                          2010-11
 Sl. No.     Name of CHC          2008-09            2009-10
                                                                      (Till Oct 2010)
    1      Saraikela                 53                 63                  24
    2      Kharsawan                 39                 47                  42
    3      Kuchai                     5                 11                   9
    4      Chandil                   32                 21                  27
    5      Ichagarh                  58                 41                  39
    6      Nimdih                    35                 32                  21
    7      Gamharia                  85                124                  67
    8      Rajnagar                  74                 56                  50
           Total                    381                395                 279


II. No. of Cases on Record (At Year End. (PR) till OCT-10

                                                                          2010-11
 Sl. No.     Name of CHC          2008-09            2009-10
                                                                      (Till Oct 2010)
    1      Saraikela               1.75               2.12                 1.94
    2      Kharsawan               1.38               3.06                 3.27
    3      Kuchai                                     0.47                 0.83
    4      Chandil                 0.83               0.55                 1.72
    5      Ichagarh                2.58               1.39                 2.24
    6      Nimdih                  1.41               1.52                 1.35
    7      Gamharia                1.44               2.11                 2.28
    8      Rajnagar                2.12               1.59                 2.41
           Total                   1.50               1.65                 2.08


III. No. of GR II Disability among new cases (%) till OCT-10



                                                                          2010-11
 Sl. No.     Name of CHC          2008-09            2009-10
                                                                      (Till Oct 2010)
    1      Saraikela                                                      25%
    2      Kharsawan               2.56               4.25                30.95
    3      Kuchai
    4      Chandil                                                        14.81
    5      Ichagarh
    6      Nimdih                  2.85               6.25                 9.52
    7      Gamharia                5.88               8.06                29.85
    8      Rajnagar                4.05                 0                  18%
           Total                   2.62               4.30                19.35




                                                                                          118
                                                                      SARAIKELA-KHARSAWAN,DHAP 2011-12

IV. Treatment Completion Rate

               Name of               2008-09                2008-09               2009-10
 Sl. No.
                PHC              PB         MB        PB             MB         PB              MB

                            97.95         87.09     77.77       90          -           -
      1       Saraikela
                            97.29         100       100         84.6        -           -
      2       Kharsawan
                            100           100       100         100         -           -
      3       Kuchai
                            100           95.23     100         100         -           -
      4       Chandil
                            100           97.14     100         100         -           -
      5       Ichagarh
                            100           96.15     100         94.7        -           -
      6       Nimdih
                            100           99.23     100         93.02       -           -
      7       Gamharia
                            96.66         88.4      100         94.2        -           -
      8       Rajnagar
                            100           98.03     100         96.4        -           -
9             Urban
                            98.64         95.72     97.15       94.1        -           -
10            Total

V. Re-Constructive Surgery Conducted Till Oct-10

                                                                                      2010-11
    Sl. No.      Name of CHC              2008-09              2009-10
                                                                                  (Till Oct 2010)
      1       Saraikela                        -                  -                       -
      2       Kharsawan                        2                  4                       -
      3       Kuchai                           1                  1                       -
      4       Chandil                          -                  -                      1
      5       Ichagarh                         -                  -                      1
      6       Nimdih                           -                  -                       -
      7       Gamharia                         -                  2                       -
      8       Rajnagar                         3                  5                       -
              Total                            6                 12                      2

SWOT ANALYSIS

    Sl no                       Desig.                       Sanction                In Position

      1       Dist Leprosy Officer                               1              Nominated by govt.1

      2       Medical officer (Regular)                         01                       01

      4       NMA                                                -                       02

      5       Clerk                                              1                          1

      6       Psychotherapist                                    1                          0

      7       Driver                                             1                          1

      8       Peon                                               1                          0

                                                                                                      119
                                                              SARAIKELA-KHARSAWAN,DHAP 2011-12

Objectives :-

          To achieve the PR less than 1 per 10,000 population by the middle of 2011-12.

          To increase the TCR for MB and PB from 94 and 97% to 100 % by the end of 2011-12.

          To bring down the Grade II deformity to zero by the end of 2011-12.

          To increase the number of SAHIYA from present -% to 50% by the end of 2011-12.

          To increase the number of CHC, managing difficult reaction cases and refer timely to
           DNT or Sadar Hospital from present 03 to 8 by the end of 2011-12.

          To cover all the CHCs in a month during 2011-12.

          To involve maximum number of private hospitals and practitioner for regularly reporting.


Currently disease prevalence rate per 10,000 population is 2.08
Disease detection rate per 10,000 population is 0.66
Number of cases under treatment is 270
No. of patients RFT – 178
% of children in new cases – 7.77
% of deformity – 4181
% of Female – 38.51
No. of cases referred – 10
Total treated patients treated Up to 31-10-09 – 270


Infrastructure and Human Resources: The district has an District Leprosy Society, under the
Chairman of Deputy commission and CS as a vice chairman. It has a district nucleus team, which
include the DLO, MO, NMA/MSW, clerk, physiotherapist, driver and peon. NGO supporting Leprosy
work are CSWA, AMDA, SPARSH (Jharkhand).




                                                                                                120
                                                                                                                      SARAIKELA-KHARSAWAN,DHAP 2011-12

 Strategies and Activities
                                                                                     Timeline
                                                                       Indica
            Strategies                           Activities                                              Budget         Responsibility   Remarks
                                                                        tors    Q1   Q2    Q3   Q4

Capacity building                 Two day training of MO
                                                                                      1    1         Rs 106,000               DLO

                                  Two day training of ANM, Health                                    Rs. 12,000 x 6
                                  workers for 6 session 30 ANMs each                  1    1    1    = Rs 72,000              DLO

                                  one day training of LHV and                                        Rs 15,000 x 1 =    DLO
                                  supervisors                                   1                    Rs 15000

                                  half day training to Sahiyyas                                      Rs 50 x 1600 =     DLO
                                                                                1     1    1    1    Rs 80,000
Sustaining that case management
                                  one day training to AWW                                            Rs 25000           DLO
                                                                                1          1
                                  one day training to Private                                        Rs 2000            DLO
                                  Practitioners, Dermatologist, labs
                                                                                      1
                                  technicians & pharmacist

                                  Five day training of Lab Tech for                                  -                  SLO
                                  Smear Examination (Dist Level-2 &
                                                                                1     1
                                  CHC Level-1)

                                                                                                     Rs 3000 x 8        DLO
Ensuring DPMR activities          POD training                                                       blocks x2 = Rs
                                                                                1     1    1    1
                                                                                                     48,000

                                  MCR Chappels procurement                                           Rs 250 x 100 =     DLO
                                                                                      1              Rs 25000

                                  Patients Welfare                                                   Rs 200 x 50        DLO
                                                                                                1    =10,000




                                                                                                                                                   121
                                                                                                           SARAIKELA-KHARSAWAN,DHAP 2011-12

IEC activities                      School Quiz                                           Rs 5000 x 8        DLO
                                                                                          blocks = Rs
                                                                      2    2    2    2
                                                                                          40000

                                    Rallies                                               Rs 3000 x 8 =      DLO
                                                                                     1    Rs 24000

                                    Hoarding Chhau Dance Mahotsau                         Rs 5000 x 1 =      DLO
                                                                      1                   Rs 5000

                                    IPC through Community Listening                       Rs 500 x 100 =     DLO
                                                                      25   25   25   25   Rs 50,000

                                    Advertisement in Media                                Rs 5000 x 4 x 2    DLO
                                                                           4         4    = Rs 40000

Meeting                             Review meeting at HQ                                  Rs 9000            DLO
                                                                      3    3    3    3
                                    Joint Meeting with NGO's                              Rs. 500 x 2 =      DLO
                                                                           1         1    Rs. 1000

                                    Supervision & Monitoring                              Rs. 15000          DLO
                                                                      1    1    1    1
                                    Procurement of Supplementary                                             DLO
Ensuring Supplementary medicine     Medicines                                             Rs 25,000

Urban Leprosy unit                  Urban Leprosy Unit, Adityapur                         Rs 10,000
                                                                                1
Miscellaneous                       Office expenditure                                    Rs 30000

                                    Drug Management                                       Rs 25,000

                                    Appointment of one driver on                          Rs 6200 x 12 =
                                    contract                          1                   74,400

                                    POL for Vehicle                                       Rs 75,000

                                                                                            Rs 671400
                                  Total




                                                                                                                                        122
                                                                                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12


                                                            Summary of proposed budget for the district
                                                                                                                             Budget estimate for the coming FY
S.No.                                              Category of Expenditure                                                               2011-12
 1      Contractual Services                                                                                                                       74,400=00
 2      Services and sensitization through Sahiya                                                                                                  67,200=00
 3      Office expenses & Consumables
        4 days training of newly appointment MO ( Rural & Urban)
        3 days training of newly appointment health workers & health supervisor.                                                                   75,000=00
        2 days refresher training of MO
        5 days training of newly appointment Lab. Technicial
 4      Behavioral Change Communication ( IEC )
                                                                                                                                                1,64,000=00
        Mass media, Outdoor media, rural media and advocacy
 5      POL / Vehicle operation and hiring
                                                                                                                                                   75,000=00
        2 Vehicles at state level & 1 vehicle at district level
 6      DPMR
                                                                                                                                                   91,000=00
        MCR footwear, Aids and appliances, welfare allowance to BPL patients for RCS, Support to govt. institution for RCS

 7      Materials & Suppliers
                                                                                                                                                   25,000=00
        Supportive drugs, lab, reagent , equipment and printing.
 8      Urban Leprosy Control
                                                                                                                                                   65,000=00
        Township, Medium Cities – 1,Medium Cities – II & Mega Cities
 9      NGO – SET Scheme
 10     Supervision, Monitoring and Review
                                                                                                                                                   24,000=00
        Review meeting and travel expenses
 11     Cash Assistance                                                                                                                            18,000=00
                                                              TOTAL                                                                             8,56,600=00



                                                                                                                                                                 123
                                                                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12


                                     C-4. National Blindness -Control Programme
 Situation analysis:
              Eye surgeon not in position along with assistant and lack of equipment as well as infrastructure.
            Strategies                        Activities                Indicators        Timeline                 Responsibili
                                                                                                                       ty
                                                                                                         Budget                   Remarks
                                                                                                Q    Q
                                                                                     Q1    Q2
                                                                                                3    4

Prompt detection refraction     School eye screening                                                                DBC Officer
                                                                                     1      1   1    1
                                No. of Teachers trained in screening                                                DBC Officer
                                for refraction errors.                                      1        1

Ensuring proper treatment       No. of School going children provided                                               DBC Officer
                                free glass

Recruitment of Staff            Cataract operation camp                                                             DBC Officer
                                                                                     3      3   3    3
                                Contracting-in of ophthalmologist                                                   DBC Officer
                                services                                             1

     Survey of Blind Cases      Survey through sahiya, and                                                          DBC Officer
                                maintaining Blind report register on
                                                                                     8      8   8    8
                                CHC level.

         Cataract Survey        Screening eye patients.                                                             DBC Officer   Through
                                                                                     3      3   3    3
                                                                                                                                   Camp
   Promotion of eye donation    Organizing Seminar at CHC level two                                                 DBC Officer
                                unit in each quarter.                                2      2   2    2




                                                                                                                                               124
                                                                                                          SARAIKELA-KHARSAWAN,DHAP 2011-12


                                 Budget for National Blindness -Control Programme

                                                      Physical                  Time Line
    Sl.No.                  Budget Head                                                                    Budget      Resposibility   Remarks
                                                       Target    Q1        Q2               Q3      Q4

1            GIS for SES                                         8330   8330         8330        8330    62475/-

2            Free Spectacles                                                                             1000x200/-
                                                       1000      350      350           300         0
                                                                                                         =2,00,000/-

3            TA / DA                                                                                     01x25,000/-   DBCS
                                                        01        01       0                0       0
                                                                                                         = 25,000/-

             Remuneration Opthalmic Assistant                                                            =8000x12=     DBCS
                                                         1        3        3                3       3
                                                                                                         96000/-

4            DBCS 1                                                                                      =2000x12=
                                                         1        3        3                3       3    24000/-
                                      1. ACMO
                                                         1        0        0                0       0    =500/-
                                      2. Stationary
                                                         1        0        0                0       0    =330/-
                                      3. Review
                                         Meeting         1        0        0                0       0    =500/-

                                      4. TA/DA

                                IEC                      1        1        1                1       1    =20800/-

                    Total                                                                                429605/-




                                                                                                                                            125
                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12



                                Innovation
1. Establishment of regional cold chain Depo at Chandil, Saraikela-
Kharsawan

Situational Analysis

The district saraikela-Kharsawan have eight blocks. In which four situated at NH-
33 near Jamshedpur city and another four are in remote area towards Chaibasa
district. In our last experience we felt too much problem in regular supply of
vaccine as a result our regular immunization as well as Pulse Polio effected.

Suggestions
 We are looking established a regional cold chain depo at Chandil from which not
only our district but also regular supply of Jamshedpur and Chaibasa district.
The chadil is situated at NH-33 as well as having good railway communications.
In Chandil we have existing a govt. building which requires some constructions
work to start the cold chain depo.

Budget
For upgradation of existing building is aaporiximately around 3 Lakhs.
For new building – State Concern
For manpower and equipment – State Concern

2. Counseling center for the vulnerable group.

            Situational Analysis-
                  In the Adityapur Industrial area , there are more than 500
            factories where many low paid daily earner are living in unhygienic
            slums .They are also living apart from their family members for long
            period. In such a situation they are very much porn to HIV infection
            as well as various vector born diseases.
            Strategy-
                  To set up counseling center at various targeted places to
            educate the vulnerable group against the ailments so that at one
            front they can adopt a healthy living style and n another front they
            could get proper treatment if they got the ailment.




                                                                              126
                                               SARAIKELA-KHARSAWAN,DHAP 2011-12

           Activities-
Sl.No   Activity                Numbers      Budget             Remark
                                               Rs.200000 x
        Set up of Counseling
  1                                03             3nos=
        Center / Kiosk.
                                               Rs.600000/-
                                                                  *Counseling
                                                                   should be
                                                                  done by the
                                                                 staff of ICTC
                                                                    center of
        Operationalisation of
  2.                               03              Nil          Gamharia PHC.
        the center.
                                                                * Other staff of
                                                                   concerned
                                                                SHC /PHC will
                                                                    train for
                                                                  counseling.
                                 Around
        IEC and BCC among the                Rs.500 x 500 Nos
  3.                               500
        vulnerable group.                      =Rs.250000.
                                factories.
                                                                   It will be
                                                                 linked with
        Help Desk at district                                      the ARSH
  4                                01
        level.                                                  clinic of Sadar
                                                                  Hospital –
                                                                   Saraikela.




                                                                             127
                                                                                                             SARAIKELA-KHARSAWAN,DHAP 2011-12

                         SUMMARY OF MISSION FLEXIBLE POOL (MFP) PIP 2011-12 (DISTRICT )

                                                       Phsyical       Financial    Proposed
                                                                                                             Budget
                                                     Achievement    Expenditure     Physical
S. No                      Item                                                                Unit Cost   required for   Remarks
                                                      as on 30th       on 30th     Target FY
                                                                                                             2011-12
                                                     October 2010   October 2010    2011-12

 1.1                                                         Human Resource
1.1.1           Remuneration & Allowance
          Remuneration of contractual ANM (
1.1.1.1                                                       229       3330072          229      64000     21024000
          ANMs recruited under NRHM)
          Hardship & Mobility Allowance for
1.1.1.2   already recruited ANMs (ANMs for                      0              0           0           0              0
          LWE)
          Remuneration of contractual Staff Nurse/
1.1.1.3                                                        14       1008000           14      96000       2016000
          A Grade Nurse
1.1.1.4   Remuneration of contractual LT                        9        444000            9      76500        918000
1.1.1.5   Remuneration of contractual Radiologist               5        280000            7      70000        840000
1.1.1.6   Remuneration of contractual Pharmacist                0              0           2      20000        240000
1.1.2                   Recruitment
1.1.2.1   Recruitment of ANM for LWE                            0              0           0           0              0
1.1.2.2   Recruitment of Staff Nurse for LWE                    0              0           0           0              0
          Recruitment Male Health Workers for
1.1.2.3                                                         0              0           0           0              0
          LWE
          Recruitment of contractual Medical
1.1.2.4                                                         2        280000           13    200000        6240000
          Officer
          Rrecruitment of Specialist (Gynae.,                   0              0           5    100000       3000000
1.1.2.5
          Padiat., Ansth., Surgery, Medicine)                   0              0          20    300000      12000000
        Total for Health Human Resources                      259       5342072          299    926500      46278000




                                                                                                                                          128
                                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12

             Provision for Mobile to HSCs & PHCs in
 1.1.12       Hard to reach area/ Naxal effected Ares
                            & DRCHOs
1.1.12.1     ANM                                         0        0    0        0         0
1.1.12.2     MO                                          0        0    0        0         0
1.1.12.3     DRCHO                                       0        0   12      750      9000
        Total for mobiles to service providers           0        0   12      750      9000
 1.1.15                  Hospital Manager
1.1.15.1     Consultant Hospital Manager                 0        0    1    22000    264000
             Support for establishment of Hospital
1.1.15.2                                                 0        0    1   100000    100000
             Manager
               Total Hospital Managers                   0        0    2   122000    364000
 1.1.16                   COLD CHAIN
1.1.16.6     Refrigerator Mechanic                       1        0    1    10000    120000
             proMIS Operator/ Store Keeper for
1.1.16.7.3                                               0        0    1    12000    144000
             District Warehouse
             Cold Chain Handler                          0        0    9    10000   1080000
1.1.16.8     POL for Cold Chain                          0        0    9     5000    540000
             Total Cold Chain augmentation               1        0   52   186000   2232000
 1.1.17         Block Programme Management Unit
1.1.17.1     Block Programme Manager                     8   560000    8    13000   1248000
1.1.17.2     Block Account Manager                       7   490000    8    12000   1152000
             Mobility support for Monitoring &
1.1.17.3                                                 3        0    8     3000    288000
             Monthly Meeting at Dist level
             Training on new MIS formats & Forms
1.1.17.5                                                 0        0    9    25000    225000
             District level
                 Total Block level PMU                  12   510000   47   247000   1964000



                                                                                                                 129
                                                                                      SARAIKELA-KHARSAWAN,DHAP 2011-12

 1.2              Infrastructure Upgradation
1.2.1      New HSC construction                        0         0      9    250000    2250000
           Malnutrition treatment Corners (MTC)
1.2.4                                                  0         0      2    491000     982000
           Block level
           Strengthening of 9 Pahariya/PTG Health
1.2.5                                                  0         0      0         0          0
           Subcentre
          Total Infrastructure Upgradation             0         0     11    741000    3232000
 1.4                Community Mobilization
1.4.1.1    ASHA                                        0         0      0         0          0
1.4.1.2    VHC                                         0         0   1165     10000   11650000
1.4.1.3    Beneficiary enlisting for RI                0         0      0         0          0
          Total Community Mobilization                 0         0   1165     10000   11650000
 1.7                  Rogi Kalyan Samiti
1.7.2      Sub- Divisional Hospital                    1    101422      1    500000     500000
1.7.3      CHC (Presently Primary Health Centres)      8    498607      8    100000     800000
           PHC (Presently Addl. Primary Health
1.7.4                                                 11         0     11    600000    1100000
           Centres)
1.7.5      Referral Hospital                           0         0      0         0          0
             Total Rogi Kalyan Samiti                 20    600029     20   1200000    2400000
 1.8                      Untied Fund
1.8.1      CHC (Presently Primary Health Centres)      8    109424      8     50000     400000
           PHC (Presently Addl. Primary Health
1.8.2                                                 11     89134     11     25000     275000
           Centres)
1.8.3      Health Sub Centres                        194   1103557    194     10000    1940000
1.8.4      Village Health Committee                 1125   5256053   1165     10000   11650000
                 Total Untied Fund                  1338   6558168   1378     95000   14265000




                                                                                                                   130
                                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12

  1.9              Annual Maintenance Grant
 1.9.1      Sub Divisional Hospital                    0        0     0        0         0
 1.9.2      CHC (Presently Primary Health Centres)     8   262577     8   100000    800000
            PHC (Presently Addl. Primary Health
 1.9.3                                                 9   124772    11    50000    550000
            Centres) - Govt. Building
 1.9.4      Health Sub Centres - Govt. Building        0   118306   194    10000   1940000
           Total Annual Maintenance Grant             17   505655   213   160000   3290000
  1.1                   CONVERGENCE
1.10.1.3    Convergence meeting at block level         0        0     8     2000     64000
            Mapping of different stakeholder
1.10.2                                                 0        0     1     4000     16000
            working on health and nutrition
1.10.3.1    Convergence meeting at District level      0        0     1     5000     20000
1.10.3.2    Resource book on convergence (printing)    0        0     0        0         0
1.10.4      Drop-in centre under HIV programme         0        0     0        0         0
                 Total Convergence                     0        0    10    11000    100000
 1.11       Conflict area plan
1.11.1      Lab Strengthening with consumables         0        0     0        0         0
1.11.2      Additional POL for Genset                  0        0     7    35000     35000
            Additional POL and maintenance for
1.11.3                                                 0        0     8    75000    240000
            Ambulance
1.11.4      Establishment cost of Sahiyya help desk    0        0     9    45000    155000
1.11.5      Sahiyya help desk at all CHCs              0        0    24    26000    604000
1.11.6      Food for in patients in CHC                0        0     0        0         0
            Upgrading 5 HSCs (Swasth guarantee
1.11.7                                                 0        0     0        0         0
            upkendra) per block as per IPHS
1.11.8      TA for ANMs                                0        0     0        0         0




                                                                                                                131
                                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12

           Holding health camps twice a year in
1.11.9     each HSC with compulsory drugs and          0        0     30     5000    150000
           supplies.
           Provisioning of incentive for Sahiyya for
1.11.10    referral of malnourished children with      0        0      0        0         0
           follow up
1.11.11    Issuing referral cards to Sahiyyas          0        0   1800      300    540000
1.11.12    Training on life saving skills to ANMS      0        0      0        0         0
           Social Audit and Public hearing for
1.11.13                                                0        0      0        0         0
           measure entitlements
           Development of Social Audit and Public
1.11.14    hearing tools and dissemination of the      0        0      0        0         0
           same
           Outsourcing of services like Diating etc.
 1.13                                                  0        0      5    50000    160000
           (RS. 10000 per CHC/FRU per month)
             Total Conflict Area Plan                  0        0   1883   236300   1884000
 1.15        Management Cost & Contingencies
 1.15                        DPM                       1   196000      1    30000    360000
 1.15                        DAM                       1   154000      1    25000    300000
 1.15                         DPC                      1   175000      1    27500    300000
 1.15                        DDM                       1   117600      1    22000    264000
1.15.1      Stationary & Printing & Office expenses    9    13084      9    10000    540000
1.15.1.2                    District                   1        0      1     5000     60000
1.15.1.3                     Block                     8    13084      8     5000    480000
           Postage & Telegraph/TeleFax / Mobile /
1.15.2                                                 3     7000     19    13400    451200
                      Internet /datacard
1.15.2.2                    District                   1        0      1     5000     60000
1.15.2.3                     Block                     2     7000      8     3000    288000
1.15.3             News Paper & Periodicals            0        0      9      400     43200

                                                                                                                 132
                                                                                   SARAIKELA-KHARSAWAN,DHAP 2011-12

                DPMU Management Cost (Security,
 1.15.4                                                0        0     1     5000     60000
                   Cleaning, Gardining etc.)
               Total Management Costs                 16   662684    32   125400   2215200
  1.16           Monitoring & Evaluation / HMIS
 1.16.1             Strengthening of M&E Cell          1     2500     9     7500    300000
             Establishment of Internet & Telephone
1.16.1.1.4   Connectivity to District Programme        0        0     1     5000     60000
             Managemnt Unit for HMIS (Yearly)
             Internet & Telephone Connectivity to
1.16.1.1.5   Block Programme Management Unit for       1     2500     8     2500    240000
             HMIS (Yearly)
                 AMC for Block & District level
1.16.1.1.6                                             0        0     0        0         0
                Computer and allied infrastructure
 1.16.2      Operationalising the new MIES format      1        0   194     2400    465600
1.16.2.1     Printing of new forms                     0        0   194     2400    465600
             Total Monitoring & Evaluation             1     2500   203     9900    765600
  1.17    Preparation of Annual Plan
          Preparation of Annual District Health
1.17.2.2                                               1    20000     1    20000     20000
          Action Plan
          Preparation of Annual Block Health
1.17.2.3                                               7    15000     8     5000     40000
          Action Plan
         Total preparation of Annual Plan              8    35000     9    25000     60000
  1.22         Routine Immunisation Additionalities

 1.22.1      POL for Genset                            0        0     2     5000    120000

1.22.4.4     Mobility Support for PTG Group            0        0    25     5000   1500000
1.22.4.5     JMSSPM                                    0        0    16     1000    192000




                                                                                                                133
                                                                                                                            SARAIKELA-KHARSAWAN,DHAP 2011-12

           Cold Chain Additionality - Maintainance
1.22.4.6                                                                 0                 0         15          10000       1800000
           of ILR and DF etc.
   Total Routine Immunisation Additionalities                            0                 0         33          16000       2112000
                   G.TOTAL                                         1672            14216108        5369        4111850      92820800



                                                  RCH FLEXIBLE POOL PIP 2011-12
                                          Phsyical         Financial
                                                                                Proposed                           Budget for
 FMR                                   Achievement as   Expenditure on
                  ACTIVITY                                                   Physical Target   Unit Cost         required 2011-        Remarks
 Code                                      on 30th       30th October
                                                                               FY 2011-12                              12
                                        October 2010         2010

  A.1                                                          MATERNAL HEALTH

 A.1.1     Operationalise facilities               0                 0                  252        610000                1200000

A.1.1.1    Operationalise FRUs                     0                 0                     3       800000                 600000
           MTP services at health
A.1.1.3                                            1                 0                  308          18000                616000
           facilities
 A.1.2       Referral Transport                    4           135700                  2924            300                877200
            Integrated outreach
 A.1.3                                             8           301623                    96           1000                 96000
                RCH services
A.1.3.1    RCH Outreach Camps                      5            25000                    96          10000                960000
           Janani Suraksha Yojana
 A.1.4                                          4865          5566000                 29330           2500            41062000
                    / JSY
A.1.4.1    Home Deliveries                      2082                 0                11732            500               5866000
A.1.4.2    Institutional Deliveries             2783          5566000                 17598           2000            35196000

A.1.4.2.1 Rural                                    0                 0                     0               0                   0


                                                                                                                                                         134
                                                                                 SARAIKELA-KHARSAWAN,DHAP 2011-12


A.1.4.2.2 Urban                       0         0            0         0            0


A.1.4.2.3 Caesarean Deliveries        0         0            0         0            0

A.1.4.3   Other activities (JSY)      0         0           36      1200       43200
           Sub-total Maternal
                                     18    462323       3679     1439300     4349200
          Health (excluding JSY)
               Sub-total JSY       4865   5566000      29330        2500    41062000
  A.2                                        CHILD HEALTH
          Integrated
          Management of
 A.2.1                               10         0           13    144900     1883700
          Neonatal & Childhood
          Illness/ IMNCI

          Facility Based
 A.2.2                                0         0            1     55000       55000
          Newborn Care/ FBNC
          School Health
 A.2.4                                0         0        319        5000      1595000
          Programme
 A.2.8    Other                       0         0            1     39330        39330
          Sub-total Child Health     10         0        334      244230     3573030
  A.3                                      FAMILY PLANNING
            Terminal/Limiting
 A.3.1                             1613   1913000       6330      182500   1155225000
                Methods
          Female Sterilisation
A.3.1.2                               0         0           16     10000       160000
          camps
A.3.1.3   NSV camps                   0         0           16     10000       160000
          Compensation for
A.3.1.4                            1202   1202000       5406        1000      5406000
          female sterilisation


                                                                                                              135
                                                                              SARAIKELA-KHARSAWAN,DHAP 2011-12

          Compensation for male
A.3.1.5                             432    711000            413    1500    619500
          sterilisation
A.3.2       Spacing Methods        3707     71420           5908   10020    198000
A.3.2.1   IUD camps                   0         0              8   10000     80000
          IUD services at health
A.3.2.2   facilities /             3707     71420           5900      20    118000
          compensation
          Other
A.3.5.                                0         0              0       0         0
          strategies/activities
             Sub-total Family
           Planning (excluding        0         0             40   30000    400000
              compensation)
                 Sub-total
             compensation of
                                   9048   2055840          17627   12540   6341500
           Sterilisation , IUD &
                NSV camps
 A.4                                                ARSH
          ARSH clinics at health
A.4.1                                 1         0              3    5000     15000
          facilities
A.4.2                                 0         0              0       0         0
             Sub-total ARSH           1         0              3    5000     15000
A.5                                            URBAN RCH
A.5.1     Urban RCH Services          0         0              0       0         0
          Other
A.5.2                                 0         0              0       0         0
          strategies/activities
          Sub-total Urban RCH         0         0              0       0         0
 A.6                                           TRIBAL RCH



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                                                                            SARAIKELA-KHARSAWAN,DHAP 2011-12

          Tribal RCH services -
A.6.1.                              15     35000         196       5000   980000
          Out reach camps etc.
          Other
A.6.2                                0         0           0          0        0
          strategies/activities
          Sub-total Tribal RCH      15     35000         196       5000   980000
              VULNERABLE
 A.7                                 0         0          25       5000   125000
                GROUPS
          Sub-total Vulnerable
                                     0         0          25       5000   125000
                Groups

 A.8                                     INNOVATIONS/ PPP/ NGO

A.8.1     PNDT and Sex Ratio         0         0           0          0        0
          Public Private
A.8.2                                0         0           1     500000   500000
          Partnerships
          Other innovations (if
A.8.4                                0         0           0          0        0
          any)

                Sub-total
                                     0         0           1     500000   500000
          Innovations/PPP/NGO

 A.9                                     INFRASTRUCTURE & HR

           Contractual Staff &
A.9.1                                0         0           0          0        0
                Services
          Other contractual staff
A.9.1.5                              0         0           0          0        0
          - ANM
          Other contractual staff
A.9.1.6                              0         0           0          0        0
          - MPW
A.9.3       Minor civil works        0         0          14     250000   700000


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                                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12

                  Sub-total
                                      0             0          14       250000    700000
            Infrastructure & HR

 A.10                                     INSTITUTIONAL STRENGTHENING

           Logistics
A.10.2     management/                0             0           5        50000    250000
           improvement
           Monitoring &
A.10.3                                0             0         100         1000    100000
           Evaluation / HMIS

           Sub-total Institutional
                                      0             0         105        51000    350000
              Strengthening

 A.11                                              TRAINING
             Strengthening of
A.11.1                                0             0           0            0         0
           Training Institutions
              Maternal Health
A.11.3                               17             0          14       188245   1229520
                 Training
           Skilled Birth
A.11.3.1                              9             0           6       138220    829320
           Attendance / SBA
           Other MH Training
A.11.3.7                              8             0           8        50025    400200
           CORE SKILL

A.11.5     Child Health Training     25        190740          21       258345   2107890

A.11.5.1   IMNCI                      0             0          13       144900   1883700
           Facility Based
A.11.5.2                              0             0           1        39330     39330
           Newborn Care




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                                                                           SARAIKELA-KHARSAWAN,DHAP 2011-12

           Care of Sick Children
A.11.5.4   and severe               24     7200            1     5000      5000
           malnutrition
                                     1   183540            2    48300     96600
A.11.5.5   Other CH Training
                                     0        0            4    20815     83260
              Family Planning
A.11.6                               0        0            4   198895    397790
                 Training
A.11.6.4   IUD Insertion Training    0        0            2   168650    337300
           Contraceptive Update
A.11.6.5                             0        0            2    30245     60490
           Training
A.11.7        ARSH Training          0        0            5   173576    279200
           ARSH training (
A.11.9                               0        0            1   138368    138368
           District Level )
           ARSH Training ( Block
                                     0        0            4    35208    140832
           Level )
             Sub-total Training     42   190740           44   819061   4014400
 A.12                                         BCC / IEC
             Strengthening of
A.12.1                               0        0            0        0         0
             BCC/IEC Bureaus
             Implementation of
A.12.3                               0        0            0        0         0
              BCC/IEC strategy
           BCC/IEC activities for
A.12.3.1                             0        0           24    10000    240000
           MH
           BCC/IEC activities for
A.12.3.2                             0        0           12    10000    120000
           CH
           BCC/IEC activities for
A.12.3.3                             0        0           12     5000     60000
           FP



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                                                                         SARAIKELA-KHARSAWAN,DHAP 2011-12

           BCC/IEC activities for
A.12.3.4                            0        0        12      10000    120000
           ARSH
A.12.4        Other activities      0        0         2      15000     30000
           BCC/IEC activities for
                                    0        0        12       8000     96000
           Tribal Health
            Sub-total BCC/ IEC      0        0        74      58000    666000

 A.13                                   PROGRAM MANAGEMENT

           Strengthening of State
A.13.1                              0        0         0          0         0
           society/ DPMU

           Strengthening of
A.13.2                              0        0         0          0         0
           District society/ BPMU

           Strengthening of
A.13.3     Financial Management     0        0         0          0         0
           systems

           Other activities
           (Program mgmt.
A.13.4                              0        0        45     144750   1761000
           expenses, mobility
           support)

             CAPACITY BUILDING
A.13.4         UNDER NRHM           0        0         1     100000    100000
                PROGRAMME
           HMIS AND SUPERVISION     0        0         1       6250     25000
            TRAINING ( District )
           HMIS AND SUPERVISION     0        0         8       6250    200000
             TRAINING ( Block )
             MOBILITY SUPPORT       0        0         1       5000     60000
                ( District )


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                                                                  SARAIKELA-KHARSAWAN,DHAP 2011-12

 MOBILITY SUPPORT             0         0       8      3000     288000
     ( Block )
FURNITURE FOR BPMU            0         0       8      6250     200000
   PRINITING AND              0         0       1      5000      60000
STATIONARY ( District )
   PriNITING AND              0         0       8      5000     480000
 STATIONARY ( Block )
   POSTAGE AND                0         0       1      5000      60000
TELEGRAPH ( District )
    POSTAGE AND               0         0       8      3000     288000
 TELEGRAPH ( Block )
 Sub-total Program
                              0         0      45    144750    1761000
   Management
   Total RCH II Base
                          13981   7847580   47798   2097081   60087930
           Flexi Pool
Total RCH II Demand
                Side
GRAND TOTAL RCH
              II




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                                                                                                     SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                                  Annexure – I

                                                         List of Private Hospital and NGO
1. Siddhesh Nursing Home, Adityapur                            21. Tata Main Hospital, Kamshedpur.
2. Well View, Adityapur.                                       22. Bikash Bharti
3. Shahay Nursing Home, Adityapur                              23. K.G.V.K
4. Surya Clinic, Near Adityapur Bridge.                        24. T.S.R.D.S
5. Brahmanand Sewa Sadan, Tamuliya.
6. Gurunank Nursing Home, Mango.
7. Tinplate Hospital.
8. Sai Policlinic, Rajnagar
9. New Life Marcy Hospital, Adityapur
10. Marcy Hospital, Jamshedpur
11. Saroj Sewa Sadan, Adityapur
12. Well Care (Lal Building) Nursing Home, Gamhariya.
13. Van Guard Nursing Home, Gamhariya.
14. M/s Sai Nursing Home, Kharsawan
15. I.C.E.R.T, Kuchai
16. Tara Seva Sadan, Potka
17. Ganga Memorial Nursing Home,
18. Life Line, Sakshi, Jamshedpur
19. Purnima Netralaya, Tamoliya Chandil
20. Bramhananda Narayan Herdyalaya, Tamoli Jamshedpur.



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                                                                              Annexure – II

                                                             Malaria Surveillance
                                                        District Malaria Office, Saraikela-Kharsawan

Surveillance - at present Annual Blood Examination Rate (ABER) is being considered as physical target for monitoring performance. Around 16% of the population in
                                       remote and inaccessible areas should be diagnosed with RDT in PF Predominant areas.

                                        ABER ( BSE + RDT) - During Previous           ABER ( BSE + RDT) - During            Surveillance by Using RDT during
                                                       Year                                  Current Year                             previous year
Sl.No.         Name of PHC                                                                            Acheivement
                                           Target                                   Target per                             During Previous       During Current
                                                              Achievement                             upto Sept-10
                                         Minimum 10                                  Month                                      year                  year
                                                                                                         Month

  1      Kuchai                              5732                 8498                 587                        6722             0                   3871

  2      Kharsawan                           7869                 12499                807                       12920             0                   8795

  3      Seraikella                          8941                 12831                916                       10436             0                   965

  4      Rajnagar                           13152                 15459                1348                      12056             0                   4919

  5      Gamhariya                          26052                 24344                2670                      23108             0                   4399

  6      Chandil                            13096                 13465                1342                      12817             0                   3251

  7      Nimdih                             10102                 10721                1035                       8446             0                   3260

  8      Icahgarh                           10564                 9470                 1083                      10004             0                   3688

              Total                         95509                107287                9790               96509                    0                  33148




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                                                                                                    SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                                Annexure-III

                                          District Malaria Office, Seraikella-Kharsawan

Indicators for monitoring of malaria

Impact Indicator - Annual Parasite incidence (API) - i.e. cases per thousand population per year, is considerred as
impact indicator. By the year 2012, the overall country's API has to be brought down to 1.3. The States who has
already achieved API 1.3 or less should maintain while other States should bring down API, year by year to achieve the
taget of 1.3 API by 2012. This indicator has to be monitored district wise.

 Sl.                                                              2008                    2009            2010
            Name of PHC         Base year 2006 API
 No.
                                                             Achievement              Achievement     Achievement

  1     Kuchai                            3.8                       6.3                   6.5               8.5

  2     Kharsawan                        16.2                      19.0                   14.5              7.8

  3     Seraikella                        5.6                      10.4                   9.9               4.3

  4     Rajnagar                          3.6                       6.2                   7.8               2.3

  5     Gamhariya                         4.3                       1.3                   2.1               1.8

  6     Chandil                          10.5                      11.2                   9.5               5.0

  7     Nimdih                            8.7                       6.0                   7.9               3.6

  8     Icahgarh                          4.6                       4.0                   4.4               4.3

             Total                       6.44                      6.7                    6.8              4.7




                                                                                                                                 144
                                                                                                                         SARAIKELA-KHARSAWAN,DHAP 2011-12

                                                                           Annexure-IV

                  Indoor Residual Spray ( For Malaria) : To achieve desirable impact, minimum 80% coverage of Population as well as rooms is must.

                                                During Current Year Round-1                                         During Current Year Round-2


                                                                Numbers        No. of                                          Numbers Numbers
                              Targetted     Pop.      %                                     %     Targetted    Pop.      %                          %
    PHC         Insecticide                                     of Rooms       Rooms                                           of Rooms of Rooms
                                Pop.       Covered Coverage                              Coverage   Pop.      Covered Coverage                   Coverage
                                                                targeted      covered                                          targetted covered

                DDT             31829       26681       84        29090       27864         96      37940       30332       80      20084      19600   98
                SP                0           0          0          0           0            0        0          0           0        0          0      0
A. Kuchai
                Malathion         0           0          0          0           0            0        0          0           0        0          0      0
                Total           31829       26681       84        29090       27864         96      37940      30332        80      20084      19600   98
                DDT               0           0          0          0           0            0        0          0           0        0          0      0
B.              SP                0           0          0          0           0            0        0          0           0        0          0      0
Kharsawan       Malathion         0           0          0          0           0            0        0          0           0        0          0      0
                Total             0           0          0          0           0            0        0          0           0        0          0      0
                DDT             62408       44454       71        44329       39712         90      69284      52649        76      44336      43850   99
                SP                0           0          0          0           0            0        0          0           0        0          0      0
C. Seraikella
                Malathion         0           0          0          0           0            0        0          0           0        0          0      0
                Total           62408       44454       71        44329       39712         90      69284      52649         0      44336      43850   99
                DDT             31354       24219       77        16726       14288         85      31913      22761        71      22711      22216   98
                SP                0           0          0          0           0            0        0          0           0        0          0      0
D. Rajnagar
                Malathion         0           0          0          0           0            0        0          0           0        0          0      0
                Total           31354       24219       77        16726       14288         85      31913      22761         0      22711      22216   98
                DDT             16522       12741       77        13537       11507         85      37618      27478        73      19883      19545   98
E.              SP                0           0          0          0           0            0        0          0           0        0          0      0
Gamhariya       Malathion         0           0          0          0           0            0        0          0           0        0          0      0
                Total           16522       12741       77        13537       11507         85      37618      27478        73      19883      19545   98



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                                                                                                                       SARAIKELA-KHARSAWAN,DHAP 2011-12




                                                                          Annexure-V

                                                  District Malaria Office, Saraikela-Kharsawan

            Monitoring of Functioning of Sentinel surveillance Hospital separately for Japanese Encephalitis, Dengue and Chikungunya

         No. of sentinel surveillance                            No SSH                                          No. of SSH

             hospital established                               functional                                        reporting

1 Sadar Hospital Seraikella                                        Yes                                               Yes

2. ICERT, Kuchai                                                   Yes                                               Yes




                                                                                                                                                    146

				
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