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Facility Report

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									                                                       Facility Report
                                                                Kashmir Division



Introduction:
All twelve district of Kashmir region have undertaken for facility Survey to assess the availability of infrastructure, manpower, equipment and
medicine at the health care facilities in the Sub Centres, Primary Health Centres, Community Health Centres and District Hospitals. The
present Regional report is based on the data collected during the block consultation facility Survey in July 2007 covering 1249 sub centre, 345
primary health centre, 44 community health centres and 8 district hospital.


A general observation from infrastructure table is that all the facilities are mostly available at the District Hospital level and some facilities are
lacking in the case of community health centres. Facilities are found unsatisfactory at PHC level and alarming situation is observed at (SC)
grass root level facilities.


Infrastructure refers to the basic support system in the form of ownership and condition of the building, and the basic facilities available within
the building for the smooth functioning of the health care establishments. Some of the facilities included are supply of water, electricity,
separate toilet with running water, furniture, number of beds for indoor patients, standby facility in the form of a generator, operation theatre,
labour room, laboratory facility for testing blood, urine etc., telephone, functional vehicle, investigative facility (ECG, X-ray, USG & Cardiac
monitor etc) and whether the health care establishment is linked with the district blood bank.
Fifty-nine percent of the district hospitals have pipe water facility and in the case of first referral units and community health centre, the supply
of water from this source is 49 percent and 44 percent of district hospitals, 81 percent of first referral units and 70 percent of community health
centres.


More than 90 percent of the district hospitals have electricity (in all parts of the hospitals) and tap water supply. Seventy one percent and forty
three percent have telephone and computer facility respectively. The availability of ECG, X-ray, USG, cardiac monitor for OT and blood Bank
facility were found in all district hospital. Though other investigative facilities as per IPHS norms was only 57%. The facility of quarters for
medical staff and the availability of computer at DHs is not satisfactory


The overall staff situation in DH prevailing in the region is some what satisfactory except in the case of gynaecologist/obstetrician, paediatrician
and hospitals having such specialists general duty doctors, Staff Nurse, and laboratory technician.


In general, most of the CHCs (88 %) have electricity in all parts of the health centre. Operation theatre and aseptic labour room facilities are
available in 53 and 41 percent of the CHCs in that order. Around 77 percent of the CHCs have a telephone, and 72 percent have vehicle. While
75 percent of the CHCs got water from tap. Thus nearly 92 percent have water facility.


The availability of specialist physicians in the CHCs is much below the prescribed IPHS standard. There is a shortage of 33 gynaecologist/
obstetrician, 37 paediatricians,. 154 Staff Nurse, and 28 public health nurse.


In the region 345 surveyed PHCs, 37 percent are functioning in rented building, but only 18% percent have separate toilet, Forty one percent
and Fifty three percent of the PHCs respectively have tap water and electricity, while 30% have a labour room. Telephone facility (5%) and
computer (2%) are not very common.


At present 276 post of MO,s , which also include the position of AYUSH staff, 849 posts of ANM, 201 posts of lab technician are lying vacant.
Over all required availability of equipment at PHC level was foun only 26%.The situation is still not better in the case of emergency obstetric
cue drug kit with only 30 percent at PHC. Overall 16% required medicine was found available at PHC.


Out of the total (1249) SCs, 73 percent function from a rented building and 82 percent SC,s are functioning without proper water supply Nine
percent and five percent of the SCs have an electricity connection and separate toilet facility respectively and only 2 percent sub centre have
labour room facility. Only 5% SC,s have residential facility for ANM


As per IPHS norms 1511 post of ANM,s at sub Centre levels are lying vacant.


The availability of kit C at the national level as well as state level is quite unsatisfactory. Only 20% equipments was found available at SC,s
level. Supply of contraceptives is more than thirty eight percent at SCs. Overall supply of medicine including contraceptive is found 23.7%.


1.1    Background
India is a signatory to the Alma Ata Declaration of 1978 and had committed to attaining “Health for All” by 2010 AD through the primary health
care approach. The establishment of primary health centres in India started as early as in 1952, and over the last five decades it has
undergone several changes to meet the increasing demand for health care services. Until the eighth five year plan, the emphasis was on the
expansion of the health care establishment. However, during the Eighth and subsequent plans the emphasis was mainly on consolidation of
existing health infrastructure rather than on expansion. “The thrust has been on qualitative improvement in the health services through
strengthening of physical facilities like provision of essential equipment, supply of essential drugs and consumables, construction
of building and staff quarters, filling up of vacant posts of medical and paramedical staff and in-service training of staff.” In line with
this, the Ministry of health and family welfare (MoHFW), Government of India (Gol) is implementing it under the NRHM umbrella. It may also be
mentioned here that Allopathic Dispensary (AD) is treated as PHC and Medical Aid Centre (MAC) is treated as Sub centre.
The population norms for all the facilities are given below:
            Centre                                   Population Norm (GOI)                           Norms considered for Kashmir region
                                Plain area                          Hilly/Tribal area
 Sub-Centre                     5,000                               3,000                            4000
 PHC                            30,000                              20,000                           25,000
 CHC                            120,000                             80,000                           1,00,000




Sub- centres are peripheral contact point between the primary health care system and the community. Two ANMs are recommended by IPHS
at each facility. A PHC, on the other hand, is the first contact point between the village community and the medical officer. A PHC is expected
to have a 2 Medical officer (One from AYUSH) and 6 paramedical and other staff. It acts as a referral unit for 5-6 sub-centres. It should have 4-
6 beds for indoor patients. The activities of the PHCs involve curative, preventive, Promotive and family welfare services.


CHCs are basically referral centres for PHCs approximately at the rate of 1:4. Its manpower strength includes seven medical specialists
(General Surgeon, physician, gynaecologist, paediatrician, anaesthetist, eye surgeon and public health program Manager) supported by 21
paramedical and other staff. There is a provision of contractual staff also as per need. It also should have 30 in-door beds with one OT, X-ray,
labour room and laboratory facilities.


1.2     Objectives
The primary objective of the facility survey is to assess the existing situation of the health care facilities available in the government health care
establishments at different levels in terms of infrastructure, staff, equipments and drugs.


The main objectives of the facility survey are to assess
       i.     Percent of Infrastructure facilities as per the IPHS norms.
      ii.     To identify the gaps of manpower as per IPHS norms.
       iii.     Percentage availability of equipments as per IPHS norms.
       iv.      Percentage availability of Drugs as per IPHS norms.


1.3           Methodology
All district hospitals, community health centres, Primary Health centre and sub centre are included in the facility survey. The following critical
input has been considered in this report:
•     Infrastructure: Ownership of the building, water supply, electricity, Separate toilet, generator, vehicle, phone, laboratory, no. of beds,
      labour room, waste disposal and blood bank facility.
•     Staff: All type of staff are considered as per IPHS norms.
•     Equipment: IPHS list of equipment for different facilities are used.
•     Medicine: IPHS list of medicines for different facilities are used.


Selection of District Srinagar for District Action Plan Under NRHM:


Srinagar city being the summer capital of J&K is considered an urban area. But after deliberations with the officials at the district level and
verification of revenue records, it was decided in the meeting to take the DAP for the Peripheral, Slum and rural areas existing in the different
zones and blocks, that forms appox. 70% area of the District.


Block Hazratbal: The only medical block of Srinagar district is almost 95% rural. With only 1 SC at Hazratbal locality, and PHC Hazratbal in
urban settings. The rest of the SC’s are located in hilly areas including tribal ones.


Zone Batmaloo: The Zone includes areas like Gangbuk, Khanmoh, Maloora, Zainakot. Bemina, Gund Hassi Bhat, which are purely rural and
are situated in peripheral areas of Srinagar, intermingling with other rural districts like Budgam, Bandipora and such. Batmaloo zone also has a
large rural population, to whom health facilities are provided.
Zone Khanyar: This medical block though located centrally in the Srinagar district has to cater to large population living in the peripheries of
Dal lake and also includes slum areas like interior parts of Rainawari area, Abi dal etc.


Zone Zadibal & S.R . Gunj: These two zones also cater to large rural areas that are attached with these two zones and also provides health
facilities to people of old city where a large population lives in slum conditions.


Process Adopted:
Health Facility Survey basically offers assessment of the functioning of health facilities at all levels and focuses specifically on existing status
and identified gaps in infrastructure, human resources, equipments and drugs. Health Facility Survey was conducted in all districts falling under
Kashmir Region including Leh and Ladakah at block level under the guidance and support of Block Medical Officers of the respective blocks,
Concerned CMOs facilitated the whole process in organizing the said meetings on the given dates and venues. The rationale behind it was
certainly the identification of the actual need and gaps in context with the health facilities and its determinants.


Facility survey was done in all medical blocks of Kashmir Region including Leh and Kargil wherein facility incharges (ANMs, MPFHWs,
Parrmacists and Medical Officers) have been called from the respective subcentres, Allopathic dispensaries, PHCs, Ayurvedic Dispensaries
etc.). Briefing was given to them for filling of facility survey formats based on IPHS Standards in presence of respective BMOs. EPOS team
facilitated the whole process in filling the correct facility formats which are one of the key component under DAP.


All facility formats were then tabulated, compiled and analyzed by using Microsoft excel and results are summarized herewith.




1.4 Data Collection Tools and Techniques


(a) Questionnaires and Field Work
There are four types of questionnaires that were provided by government of India for Facility Survey. One questionnaire each was for District
Hospital, Community Health Centre/Sub-divisional hospital, Primary Health Centres and Sub Centres. The overall content of the questionnaire
and the format was discussed with concerned head of the blocks health facility. This activity was completed in the month of July - August 07.


(b) Coverage
All government facilities were covered. The Facility Survey covered a total of 8 district hospitals, 47 CHCs, 345 PHCs and 1249 SCs.


(c) Information covered in this report
The Facility Survey covered a lot of information regarding the health care facilities available at different levels of health care establishments of
the Government. The reports covered most of the information collected though not all.


The information which is included in this report for infrastructure in form of ownership and condition of the building, and the basic facilities
available within the building for the smooth functioning of the health care establishments. Some of the facilities included are supply of water,
electricity, separate toilet with running water, furniture, number of beds for indoor patients, standby facility in the form of a generator, operation
theatre, labour room, laboratory facility for testing blood, urine etc., waste disposal, telephone, functional vehicle, investigative facility (ECG, X-
ray, USG & Cardiac monitor etc) and whether the health care establishment is linked with the district blood bank.


For staff, all type of staff recommended by IPHS are taken, A complete list of equipments at all facilities ( SC,s: Equipment Kit- C. PHC:
suggested Equip., Labour room equip., Pap smear, laboratory equip. CHC: Standard surgical set- 1, II, III, IV, V and VI, IUD insertion kit,
normal delivery kit,, equip for anaesthesia, equip for neo natal Resuscitation, kit for blood transfusion,, equip. for operation theatre and
equipment for radiology), are included.
As far as drugs is concerned, IPHS recommended list of drugs (SC,s : Kit-A, Kit-B, other drug & vaccines, NDCP medicine, contraceptives and
drugs required by Anganwari centre. PHC: Anti DOTs, anti infective medicine, antifilarials, anti bacterials, anti fungal, anti protozoal, antiseptic,
disinfectant, contraceptives, med. For psychotic disorder, vitamins & minerals and RTI/ STI drugs. CHC: A essential drug list of 70 medicine.) is
considered.
       .


DISTRICT HOSPITAL


Introduction
In the hierarchical health care system of the Government of India in a district, the district hospital is the apex body, which provides specialized
health care services to people on subsidized costs. Every district is expected to have a District Hospital (DH). But in some cases sub-divisional
hospital is found to serve as a DH where DH as such has not yet been established. Such hospitals are treated as not included in the DH list in
this report as they are categorized as a different level of health care establishment. The districts without a DH are Kulgam, Shopiyan,
Ganderbal and Bandipora. Thus the information collected and analysed in this chapter relates to a total of 8 district hospital covered.


Infrastructure (Table -1)
•   On the whole, excluding four or five items of infrastructure, the situation is fairly satisfactory in Kashmir region.
•   More than 90 percent of the district hospitals have electricity (in all parts of the hospitals) and tap water supply. Thus standby facility in the
    form of a generator is also available in all hospital. Seventy one percent and forty three percent have telephone and computer facility
    respectively. The availability of ECG, X-ray, USG, cardiac monitor for OT and blood Bank facility were found in all district hospital. Though
    other investigative facilities as per IPHS norms was only 57%. The facility of quarters for medical staff and the availability of computer at
    DHs is not satisfactory
•   A separate aseptic labour room is found in all district hospitals. The available labour room may not be clean, may be having seepage, or
    may be kept open for other purposes when not used for delivery, thereby defying the definition of aseptic. In some cases the deliveries are
    conducted in the operation theatre.


Staff Position (Table 2 A)
All the staff positions are taken as per IPHS norms. We have taken existing staff against IPHS norms to identify the gap of manpower. The
overall situation prevailing in the region is some what satisfactory except in the case of gynaecologist/obstetrician, paediatrician and hospitals
having such specialists general duty doctors, Staff Nurse, and laboratory technician.


•     For the provision of reproductive health particularly for females a gynaecologist/obstetrician is essential. But most of the hospital faces
      acute shortage (75%) of gynaecologist/ obstetrician. However Kargil DH runs without gynaecologist/obstetrician. This reflects the poor
      availability of staff in DHs
•     The importance of paediatrician cannot be underestimated for childcare. But the data shows that 50 percent of the DHs don’t have a doctor
      specialized in paediatrics.
•     Eighty-Seven percent of the total DHs have at least one Anaesthetist. But all the DH have shortage of casualty doctor/ general duty doctor.
      Anantnag and Kupwara don’t have a single general duty doctor.
•     There is a shortage of 84 percent staff Nurse at DH. A laboratory technician is also not at 37 % of the DHs and a total shortage of lab
      technician is 75 % at district hospital.


COMMUNITY HEALTH CENTRE


4.1       Introduction
Though not designated as such, community health centres are also first referral units where referral cases from lower level health care
establishments are sent. The CHCs have to take care of these cases besides their usual health care activities, while there are 47CHCs in the
region.




Infrastructure (Table:1)
In general, most of the CHCs (88 %) have electricity in all parts of the health centre. Operation theatre and aseptic labour room facilities are
available in 53 and 41 percent of the CHCs in that order. Around 77 percent of the CHCs have a telephone, and 72 percent have vehicle. While
75 percent of the CHCs got water from tap. thus nearly 92 percent have water facility.


•   A higher proportion of CHCs (75%) got water from taps. Though there are only very few CHCs without electricity, electricity in all parts of
    the hospitals is noted only in 88 percent of the CHCs. Seventy five percent CHCs have electricity as well as generator.
•   At least 77 percent of the CHCs have a telephone facility in the region. Availability of a functional vehicle is 72%.
•   All CHC,s have laboratory facility.
•   Only 53% CHCs in the region have OT facility.
•   A separate aseptic labour room is found only in 41 percent of the CHCs. However, this should not be misconstrued as an absence of
    delivery facility. There may be various reasons whereby the labour room defies the definition of aseptic, for instance, it may be used for
    other purposes, or it may be unclean and damp.
•   Only a miniscule proportion of CHCs (2 %) have linkage with district blood banks.
•   Most of the CHCs have X-ray machine (91%) ECG (86%) and USG (84%).


Staff Position (Table -2)
•   The availability of specialist physicians in the CHCs is much below the prescribed IPHS standard. There is a shortage of 33 gynaecologist/
    obstetrician. Thirty seven paediatricians are also required.
•   In .respect to the shortage of Staff Nurse (154) and public health nurse (28) is alarming. CHCs also are referral centres, though they may
    not designated as such, and should have a gynaecologist/obstetrician and paediatrician to take care of RCH needs.
•   Overall, the situation of staff nurse and ANM at the regional level is quite un satisfactory.


Equipment (Table-3)
•   Availability of complete standard surgical set I, II, III, IV, V, VI is les than 50 % at CHC level. Overall availability of equipments is only 30 %.
Medicine
•   As per the list of IPHS medicine list only 46% medicine was found available.


PRIMARY HEALTH CENTRE
The primary health centres have the major responsibility of providing both preventive and curative health care services in the area. This
includes delivery of reproductive and child health set-vices, such as, antenatal care and immunization in addition to routine inpatient and out
patient services. Compared to District Hospitals Or sub-divisional Hospitals, PHCs are accessible to a larger population, as one PHC is
expected to serve 30,000 populations. However, just the availability of PHCS is not sufficient for the effective delivery of these services. They
should also have essential infrastructure, staff, equipment and supplies.


Infrastructure (Table 1)
Table 1 presents the percentage of PHCs with selected infrastructure facilities much as own building, toilet facility, continuous supply of tap
water, electricity, labour room, laboratory, telephone, functional vehicle and beds for in-patients in each state. In the region 345 surveyed
PHCs, 37 percent are functioning in rented building, but only 18% percent have separate toilet, Forty one percent and Fifty three percent of the
PHCs respectively have tap water and electricity, while 30% have a labour room. Telephone facility (5%) and computer (2%) are not very
common.


•   In the region 63 % PHCs function from their own building. It means 37 % are running in rented building.
•   Only 18 % of the PHCs have separate toilet facilities.
•   In any health facility, continuous supply of water is a critical input. However, less than fifty percent have tap water supply..
•   Provision of immunization to children and pregnant women is one of the important functions of the PHC. PHCs need electricity for purposes
    of lighting. Operating equipment and for storage of vaccines at specified temperatures in a refrigerator/ freezer. Forty seven percent of the
    PHCs function without electricity.
•   In the context of the National population policy, 2000 goal of eighty percent institutional deliveries, the availability of a labour room is a
    critical facility for a PHC. However, only 30 percent of the PHCs in the region have a labour room.
•   In the context of provision of RCH services, the availability of laboratory in PHC to test blood and urine of the women seeking amenatal cue
    as well as for the diagnosis of RTI/STI among men and women is critical. Out of the 345 PHCs surveyed only 39 percent have laboratory
    facilities.
•   For communication purposes, especially as the PHCs are supposed to refer the complicated cases to higher health facilities, the telephone
    facility in PHC is very important, but it is a scare facility in a PHC. Only 5% PHCs have a telephone connection.
•   In the context of the out-reach programme of the PHCs and referral of the complicated cases to higher health facilities, the availability of a
    vehicle in running condition becomes a critical input. Forty seven percent PHCs have a functional vehicle.
•   Average no. of bed per PHC is 4.


Staff Position (Table 2)
•   The availability of at least one Medical Officer MO) on the role of PHC is absolutely essential. At present 276 post of MO,s , which also
    include the position of AYUSH staff, are vacant. The identified gaps of ANM at PHC level is 849.
•   Along with the laboratory for pathological tests the availability of a Laboratory Technician on the PHC staff is necessary. In the region, as
    per IPHS norms, 201 posts of lab technician are lying vacant.


Equipment (Table-3)
•   In the context of provision of services of institutional deliveries, the availability of equipment in PHCs is essential. Over all required
    availability of equipment at PHC level was foun only 26%.


Medicine (Table-4)
•   The situation is still not better in the case of emergency obstetric cue drug kit with only 30 percent at PHC
•   Overall 16% required medicine was found available at PHC.


SUB - CENTRE
Sub-Centres (SCs) are the most peripheral health institutions catering to the health care needs of the rural population. It is the most peripheral
contact point between the Primary Health Cue system and the community. It is manned by two ANM per Sub Centre. Under the Facility Survey
all 1249 SC,s were covered.


Infrastructure (Table-1)
•   Seventy three percent of SCs run in rented building.
•   At the regional level 82 percent SC,s are functioning without proper water supply.
•   More than Ninety percent of the SC,s are functioning without any electricity facility.
•   The facility Survey also collected information on the availability of separate toilets facilities in the SCs. Only 5 % of the SCs have this facility.
•   The presence of the ANM all 24 hours at the SCs is essential for the people to avail the health services. That is why the government has
    focused on providing quarters to the ANM at SCs. If the SC is not having any quarter’s facility, the ANM may stay somewhere else. Only 5%
    SC,s have residential facility for ANM.


Staff (Table 2)
As per IPHS norms 1511 post of ANM,s at sub Centre levels are lying vacant.


Equipments: (Table-3)
The availability of kit C at the national level as well as state level is quite unsatisfactory. Only 20% equipments was found available at SC,s
level.


Medicine: (Table-4)
Supply of contraceptives is more than thirty eight percent at SCs. Overall supply of medicine including contraceptive is found 23.7%.
Table:1                                      Percentage Availability of Infrastructure
                                                 Kashmir Region
                                             Total SCs      Total PHCs    Total CHCs     Total DHs
                     Indicators
                                                 1249            345             47                  8
     1    Building (Govnt. + Donated)             27             63              96                  100
     2    Building (Rented)                       73             37              4                   0
          Condition of Building (Good +
                                                  40             NA              NA                  NA
     3    Fair)
          Water Supply (Tap, borewell/
                                                  18             53              92                  100
     4    handpump/tubewell, well)
    4.1   Tap water supply                        NA             41              75                  100

     5    Electricity                              9             53              99                  100
    5.1   In all parts of hospital                NA             29              88                  93
          Elertic supply (power generation
                                                  NA             NA              50                  100
    5.2   stablization)
     6    Separate Toilet                          5             18              48                  67

    6.1   Sep.Toilet with running water           NA             NA              27                  71
     7    Furniture                               21             44              66                  55
     8    Labor Room                               2             30              85                  100
    8.1   Aseptic labor room                      NA             NA              41                  100
     9    Avail.of Quater for staff                5             14              24                  70
          Number of beds available
                                                                  4              24                  106
     10   (Average)
     11   Laboratory                                             39              99                  100
     12   Operation Theatare                                     13              53                  100
     13   Waste Disposal (Burnt+Dump)                            62              66                  86
     14   Availability of incenator                              0               11                  50
15   Telephone                        5    77    71
16   Computer                         2    29    43
17   Generator/Invertor               16   75    100
18   Vehicle                          47   72    86
19   Emergency Room / Casualty             55    75
     Separate wards for males and
                                           57    67
20   females (Yes/No)
21   No. of beds : Male Total              799   20
22   No. of beds : Female                  705   47
23   Availability of ECG facilities         86   100
24   X-Ray facility                        91    100
25   Ultrasound facility                   84    100
26   Cardiac Monitor for OT                39    100
27   Blood Storage Unit available          2     100
28   Blood Bank Facility                         100
29   Other Investigative Facility                57
     Heating ventilatoin & air
                                                 14
30   conditioning
31   Lift & vertical transport                   36
32   Refrigeration                               100
     NA = Not applicable
Table: 2                                                                       Identified Gaps of Manpower

                                                                Kashmir Region




                                                                                                                                                              No. 0f Required


                                                                                                                                                                                No. of Existing


                                                                                                                                                                                                   Total Gaps
                                              Bandipora




                                                                                 Ganderbal
                                                          Baramulla
                                   Anantnag




                                                                                                                               Pulwama
                                                                                                               Kupwara




                                                                                                                                                   Srinagar
                                                                      Budgam




                                                                                                                                         Shopian
                                                                                                      Kulgam
                                                                                             Kargil




                                                                                                                                                                   Staff


                                                                                                                                                                                     Staff
                                                                                                                         Leh
Name of Blocks




                            IPHS
No. of Sub- Centres                129        51          168         134        44          131      82       205 121         76        58        50                                             1249
                            Norm

ANM                          2     148        74          208         143        56          180      79       299 140         90        82        12         2498              987               1511
N0. Of PHC's                       47         12          48          47         20          17       23       37        17    33        15        29                                             345
MO                           2     27         11          44          29         25          27       15       18        20    29        16        15         690               414               276
Pharmacist                   1     -18        2           1            0         1           2        -3       -2        1     3         1         -8         345               365               -20
Nurse                        3     111        29          117         121        51          47       58       91        31    77        34        82         1035              186               849
Female Health Worker         1     9          7           16          19         7           4        4        9         -4    4                   -4         345               274               71
Health Educator              1     24         10          44          36         15          14       17       31        12    28        12        21         345                 81              264
Health Assistant
                             2     82         19          93          85         37          31       42       63        31    61        24        50         690                 72              618
(one male and one Female)
Clerks                       2     78         15          88          82         34          33       34       57        26    61        30        46         690               106               584
LT                           1     26         9           28          31         10          12       20       14        3     16        12        20         345               144               201
Driver                       _                7           16          33         10          11                0         -13   0                   25                            -89              89
Class lV                       4   100   16    107   62    35   19   29   68   31   77   30   38   1380   768   612
Total                              439   125   554   498   225 200 216 349 138 356 159 285 5865 2321            3544
No. of CHC's                       6      3    6      7    2    3    4    7    2    2    4    1                 47
A. CLINICAL
MANPOWER
General Surgeon                1   3      1    2      1    0    2    3    4    1    0    3    -3   47     30    17
Physician                      1   4      1    2      3    1    2    3    7    2    0    3    0    47     19    28
Obstetrician / Gynaecologist   1   4      1    5      4    1    3    4    4    2    1    3    1     47    14    33
Paediatrics                    1   3      1    6      4    1    2    4    7    2    2    4    1    47     10    37
Anaesthetist                   1   4      1    4      2    0    2    4    5    1    1    3    0     47    20    27
Public Health Programme
                               1   4      1    5      4    2    2    4    6    2    2    4    0     47    11    36
Manager
Eye Surgeon                    1   5      1    6      4    1    2    3    6    1    2    4    0    47     12    35
Other specialists (if any)
General duty officers
(Medical Officer)
B. SUPPORT
MANPOWER
Public Health Nurse            1   5      1    2      6    2    1    3    2    2    2    1    1    47     19    28
ANM                            1   1      1    1     -2    1    1    2    -3   -1   0    -1   0     47    47     0
Staff Nurse
                               7   7      4    17    25    0    10   16   33   6    3    33   0    329    175   154
Nurse/Midwife
Dresser                        1   4      1    2      5    0    2    3    7    1    2    7    0     47    13    34
Pharmacist / compounder        1   -10   -3    -21   -6    0    0    -3   -8   0    -5   -8   -6    47    117   -70
Lab. Technician                1   -3     1    -21    1    -3   2    2    2    -1   0    2    -2   47     67    -20
Radiographer                   1   4      1    2      5    2    0    1    4    1    0    4    -1    47    24    23
Ophthalmic Assistant           1   1    1    1     1    1    1    1    4    1    0    4    0    47    31    16
Ward boys / nursing orderly    2   -5   -2   -47   -5   -6   -1   4    -7   1    0    -7   2    94    167   -73
Sweepers                       3   -5   -3   -17   -2   -5   2    -1   4    1    1    4    0    141   162   -21
Chowkidar                      1   3    -1   -3    4    2    1    1    2    1    2    2    1    47    32    15
OPD Attendant                  1   1    1    0     4    0    2    3    5    1    2    5    1    47    22    25
Statistical Assistant / Data
                               1   5    1    3     1    2    2    4    4    2    2    4    1    47    16    31
entry operator
OT Attendant                   1   3    0    -2    3    2    1    4    6    2    2    6    1    47    19    28
Registration Clerk             1   4    0    0     3    2    3    4    5    2    2    5    0    47    17    30
Any other staff (specify)
Total                              42   10   -53   65   6    42   69   99   30   21   85   -3   1457 1044   413
Note: ( - ) Surplus staff
TABLE 3                                                                             Percentage Availability of Equipment

                                                                                                                Kashmir Region




                                                                                          Ganderbal
                                                      Bandipora


                                                                   Baramulla
                                          Anantnag




                                                                                                                                               Pulwama
                                                                                                                             Kupwara




                                                                                                                                                                     Srinagar
                                                                                Budgam




                                                                                                                                                          Shopian
                                                                                                                   Kulgam
                                                                                                       Kargil
                                                                                                                                                                                   Average




                                                                                                                                        Leh
Name of the block
                                                                                                                                                                                % of the Region



                                  IPHS
NO OF SC                          Norm   129         51           168          134       44           131         82        205        121    76         58          50              1249

Equipment kit
                                   55    10.6        21.0         19.5         22.3      20.4         22.2        20.7      12.9       41.0   17.6       8.8        22.2              20
( kit- C )
NO OF PHC                                47          12           48           47        20           17          23        37         17     33         15          29              345
Suggested equipments               36    17.4        16.7         19.2         37.6      20.0         21.2        26.4      19.1       43.5   16.4       10.8       24.5              23
Operational labour room            10    7.1         10.0         42.0         49.4      10.0         23.8        65.0      20.6       60.6   12.1       18.0       22.0              28
Pap Smear                          11    5.6         52.3         34.9         51.8      28.6         29.4        40.9      14.9       63.1   5.3        18.2       38.2              32
Laboratory Reagents                10    7.1         21.0         16.5         33.6      3.3          8.9         15.0      14.1       49.1   4.1        2.1        14.0              16
Glassware & other equip.           7     16.0        54.0         42.9         49.6      4.8          32.6        32.1      23.7       89.1   20.9       0.0        42.9              34
Furniture                          25    12.1        21.3         29.3         46.9      14.8         23.2        10.0      13.3       46.4   18.4       8.6        20.0              22
TOTAL                              99    10.9        29.2         30.8         44.8      13.6         23.2        31.6      17.6       58.6   12.9       9.6        26.9              26
NO OF CHC                                 6           3            6            7         2            3           4         7          2      2          4          1                47
Standard Surgical Set-1 FRU        32    40.0        41.7         59.9         37.8      89.1         5.2         43.8      23.3       51.6   59.4       75.0       81.3              51
Standard Surgical Set - II         33    38.0        21.2         26.8         28.4      97.0         15.2        19.7      9.9        42.4   54.4       10.6       78.8              37
IUD Insertion Kit                  19    20.0        7.0          47.4         45.2      44.8         21.1        10.5      13.7       79.0   63.2       52.6       63.2              39
CHC Standard Surgical Set - III    17    19.0        15.7         34.3         28.2      100          33.3        17.6      2.0        23.5   79.4       14.7       41.2              34
Normal Delivery                    12    32.0        30.6         31.9         55.0      96           80.6        8.3       6.8        45.8   62.5       33.4       83.3              47
Standard Surgical Set - IV         16    19.0        18.8         33.3         30.0      100          10.4        9.4       3.2        56.3   62.5       32.9       100.0             40
Standard Surgical Set - V          21    5.0         9.5          25.4         21.0      0.0          17.5        2.4       4.0        4.8    35.8       8.4        42.9              15
Standard Surgical Set - VI        11    20.0   12.1   30.3   21.8   0.0    39.4   0.0    3.0    4.6    72.8   11.4   100    26
Equipment for Anaesthesia         17    11.0   19.6   20.6   37.6   8.9    0.0    1.5    5.9    14.7   50.0   10.3   64.7   20
Equip. for Neo-natal
                                  10    12.0   0.0    0.0    20.8   0.0    0.0    0.0    5.0    46.0   20.0   10.0   50.0   14
Resuscitation
Materials Kit for Blood
                                  15    21.0   2.2    1.1    20.0   0.0    0.0    0.0    5.5    3.3    36.7   18.4   0.0    9
tranfusion
Equipment for Operation theatre   11    4.0    30.3   46.8   43.4   77.3   0.0    9.1    17.4   68.2   50.0   29.6   72.7   37
Equipment for Labour room         13    9.0    25.9   33.4   41.6   92.3   46.2   11.5   26.4   65.4   50.0   26.9   69.2   41
Equipment for Radiology           9     58.0   14.8   48.1   44.3   88.9   70.4   5.6    36.7   77.8   50.0   50.0   100    54
TOTAL NO.%                        236   22.0   17.8   31.4   33.9   56.7   24.2   10.0   11.6   41.7   53.3   27.4   67.7   33
TABLE 4                                                                     Percentage Availability of Medicines
                                                                                                            Kashmir Region




                                                  Bandipora




                                                                                      Ganderbal
                                                               Baramulla
                                      Anantnag




                                                                                                                                         Pulwama
                                                                                                                       Kupwara




                                                                                                                                                               Srinagar
                                                                            Budgam




                                                                                                                                                    Shopian
                                                                                                             Kulgam
                                                                                                   Kargil
                                                                                                                                                                             Average




                                                                                                                                  Leh
Name of the block
                                                                                                                                                                          % of the Region



                              IPHS
NO OF SC                             129         51           168          134       44           131        82       205        121    76         58         50               1249
                              Norm

 Kit- A                        5     0.1         0.0          11.5         8.9        1.0         27.3       0.2      18.6       37.3    4.2       17.1       0.0              10.5
Kit- B                         9     1.4         5.7          29.0         34.4      36.9         59.9       1.0      15.1       76.2   12.7       13.7       35.5             26.8
Drugs Req. by ANMs and
                               6     0.6         16.7          6.8         22.4      19.9         48.7       0.0      15.7       46.0   5.8        0.0        3.3              15.5
LHVs
Other Drugs & Vacci.           8     3.7         21.3          20.8        24.1      37.5         67.6       0.8      16.1       92.0   16.7       19.7       35.0             29.6
Med. Req.for NDCP              7     1.3         15.0         145.6        22.1      12.9         20.4       0.8      10.6       26.0    5.7       5.2        2.9              22.4
Contracep. Req.for
                               4     2.3         32.3         45.7         47.2      37.8         63.3       1.6      37.6       40.7   49.0       40.9       60.0             38.2
F.Plang.
Drug List for AWC              12    1.7         34.0         21.2         18.3      21.8         33.4       0.4      19.2       71.7   14.2       17.6       23.3             23.1
Total                          51    1.6         17.9         40.1         25.3      24.0         45.8       0.7      19.0       55.7   15.5       16.3       22.9             23.7
TOTAL NO OF PHC                      47           12           48           47        20           17        23        37         17     33         15         29              345
Essen. & emerg.
                               38    13.8        34.0         10.8         43.1      18.4         41.5      13.0      28.9       77.4   17.0       32.9       35.3             30.5
obstetrics care drugs
Antidots                       4     22.1        33.3         17.3         30.6       0.0         18.2       0.3      19.0       27.5   12.8       3.2        5.0              15.8
Anticonvul./ Antiepileptics    4      3.6        0.0           0.5         19.4       0.0         14.3       0.0       9.4       33.8    9.8       1.8        0.0               7.7
Antiinfective Medicines        5      9.5        20.0         20.3         34.0      10.0         38.8       1.2      23.9       52.9   17.8       23.2       28.0             23.3
Antifilarials                  1      5.9        0.0          10.0         21.1       0.0         21.6       0.0      9.2        17.6    2.3       0.0        0.0               7.3
Antibacterials                 16     7.5        8.7          17.7         36.1       6.3         20.4       2.1      15.9       56.6   17.2       19.2       15.0             18.6
Dermatological medicine        14     8.8        2.3          11.3         30.8       2.4         14.7       0.8      14.5       42.4   15.9       11.3       11.4             13.9
Antilep.& Antitubercullar      2      6.8        50.0          2.5         22.2       0.0         29.8       0.0       0.0       8.8     9.3       3.0        30.0             13.5
Antifungal medicine            4      0.6        8.3           1.0         19.7       0.0          4.8       0.0       2.9       2.5    14.7       8.9        0.0               5.3
Antiprotozoal medicine         5      4.6        15.7          2.9         26.7       3.3         18.2       0.0      17.1       44.7   17.3       4.0        12.0             13.9
Blood Products and
                               13    5.3         0.0           9.9         21.9      1.3          10.7       0.6      10.1       30.7   9.6        3.0        3.1               8.8
Plasma Substitutes
Antiseptics                  6     10.0   2.0     6.9   24.7   5.0    31.3   0.0    15.1   50.0   11.1   13.4   0.0    14.1
Disinfectants                3      3.9   11.0    3.7   20.3   0.0     6.6   0.0    14.5   41.1   10.2   0.0    0.0     9.3
Diuretics                    2      5.4   33.3    8.5   22.2   0.0    44.4   0.0    15.8   73.5    5.3   10.0   20.0   19.9
Gastrointestinal             22     8.5   1.7    10.7   38.9   7.2    35.8   3.0    15.2   65.2   15.3   20.0   21.8   20.3
Hormones, Endocrine &
                             10    12.5   0.0    1.6    26.1   2.0    5.8    0.6    12.7   19.4   7.3    4.2    8.0    8.3
Contraceptives
Ophthalm. preparation        12    6.8    11.0   1.6    24.6   1.9    15.2   0.0    11.1   40.2   8.2    0.0    3.3    10.3
Psychotic Disorders          15    8.9    6.7    7.8    26.9   2.4    21.0   1.0    10.9   32.5   7.4    5.1    6.7    11.4
Solutions correcting water
Electrolyte and Acid-        9     14.4   3.7    26.4   41.3   20.0   38.2   2.1    27.6   76.4   19.8   33.5   26.6   27.5
Base Disturbances
Vitamins & Minerals          3     11.3   0.0    17.4   46.8   13.3   36.8   0.5    21.0   78.4   18.7   34.5   26.7   25.4
Drugs under RCH              1      5.1   0.0    0.0    28.9    0.0   19.9   2.5    0.0    17.6    0.0   14.0   0.0     7.3
Product Strength
                             31    11.5   6.3    14.9   36.7   5.9    31.1   5.6    22.7   53.1   15.7   17.3   23.9   20.4
formulation Units
RTI / STI Drugs              10    20.8   23.3   10.7   37.9   12.0   18.4   1.4    18.6   57.0   13.3   13.6   20.0   20.6
Drugs & Consumable for
                             6     10.3   5.7    4.5    25.0   8.3    6.1    1.0    23.6   75.4   9.7    15.2   6.7    15.9
MVA
TOTAL                        236    9.1   11.5    9.1   29.4    5.0   22.6   1.5    15.0   44.8   11.9   12.1   12.6   15.4
CHC                                  6     3       6     7       2     3      4      7      2      2      4      1      47
Essential drugs              70    23.0   33.0   44.3   56.9   37.9   34.7   67.0   38.0   76.4   40.0   49.0   51.4   46.0
District Srinagar:


 Infrastructure: Table:1
       Out of 50 SC’s in the District, 69% SC`s and 41% PHC’s run in rented buildings. As far as condition of SC building`s is concerned 11% are in
       poor condition.
       Only 52% SC’s are getting water supply through tap, bore well, hand pump, tube well and well. and 79% PHC’s have tap water supply.
       Sixty eight percent SC’s and 4% PHC’s are functioning without electric facility . only 52 % PHC’s and 50% of District Hospital have electric
       facility in all parts of the health centre.
       Facility survey also revealed that availability of separate toilet facility at SC is 2% and PHC is 25% . Though CHC has this facility but only 32%
       are without water.
       The availability of laboratory in PHC is to test blood & urine of the women seeking antenatal care as well as for the diagnosis of RTI/STI
       among men and women is critical. Only 52% have laboratory facility.
       The availability of a labor room, to achieve NRHM Goal of maximum institutional delivery, is important facility for a SC and PHC. However 0%
       SC’s and 4% PHC’s have this critical facility. Which is almost negligible .
       For communication purposes the telephone facility at PHC and District Hospital is very important. Telephone Facility is not available at PHC
       and District Hospital .
       To attend emergency cases, it is necessary to have staff quarters in the compound. Only 2% SC`s, 7% PHC and 27% of CHC have quarter
       for staff.
       A separate aseptic labor room is critical in reducing the chances of infection during delivery. Neither a separate aseptic labor room nor blood
       storage unit is available at CHC.
       Facility of ECG, X Ray, and ultra sound was available at CHC .
       The investigative facility is only 59% available at DH. Air condition, lift and vertical transport is not available in district hospital .



 Manpower: Table:2
       The health assistant (Female) also known as ANM has a key role to play in the implementation of RCH programme at grass root level.
       Seventy eight ANM’s are looking after the work of 50 SC’s. There is a gap of 12 ANM’s as per IPHS norms.
       Total requirement of staff at PHC’s is 285 and only 237 staff are in position, which reflects the shortage of more than 54 % staff. There is
       especially a shortage of, Nurses (82), Health assistants (50), clerks (46) and class IV (38).
       In CHC there is non availability of Physician ,Eye surgeon and other staff members . Vacant post of specialists make CHC virtually non-
       functional. There is an urgent need to recruit professionals as soon as possible that will help to reduce the load of district hospital.
       In DH there is non availability Phychiatrist, radiologist, Microbiologist, public health manager and pathologists doctors.In para medicals there is
       only 38% of available staff.
Equipments: Table:3
     Certain equipment is essential for the delivery of RCH services at SC. Out of 55 (recommended list of) equipment for SC on an average only
     11 (22.2 %) equipment was available at the centre.
     As far as availability of equipments at PHC is concerned only 25.2 equipments were available.
     Miserable condition of CHC is remarkable in respect of availability of equipment. Non availability of kit for blood transfusion was reported.

Medicines:Table:4
     The Supply of Kit-A for SC was found unsatisfactory (0 %). Though Kit-B was found available 35.5% at sub centres and availability of
     contraceptives was 60 %.
     About 17.5 % medicines were reported available out of total medicines recommended for PHC. Availability of Antifilarials (0%),
     dermatological medicine (11.4 %), vitamins & minerals (26.7%), Antidots (5 %), Anti infective medicine (28%), Anti bacterial (15%) was noticed
     and remaining 18 category of medicines fall between 0- 8 % availability.
     Supply of essential drugs at CHC was found satisfactory (51.4).




  Table:1                                                Percentage Availability of Infrastructure
                                                            District: Srinagar
                          Indicators                     SC (50)                PHC (29)                 CHC (1)                   DH(1)

     1           Building (Govnt. + Donated)               31                       41                     100                       100
     2           Building (Rented)                         69                       59                      0                         0
                 Condition of Building (Good +
                                                           89
     3           Fair)
                  Water Supply (Tap, borewell/
                                                           52                       91                     100                       100
     4           handpump/tubewell, well)
    4.1          Tap water supply                                                   79                     100                       100
     5           Electricity                               32                       96                     100                       100
    5.1          In all parts of hospital                                           52                     100                        50
                 Elertic supply (power
                                                                                                                                     100
                 generation stablization)
     6           Separate Toilet                           21                       25                     100                        0
6.1       Sep.Toilet with running water                                  68               0
 7        Furniture                         25               45         100
 8        Labor Room                        0                 4         100              100
8.1       Aseptic labor room                                             0
 9        Avail.of Quater for staff          2               7           27              100
          Number of beds available
                                                             52         100              110
10        (Average)
11        Laboratory                                         34         100              100
12        Operation Theatare                                  5          0               100
13        Waste Disposal (Burnt+Dump)                        34          0               100
14        Availability of incenator                                      0
15        Telephone                                           0         100               0
16        Computer                                            0         100               0
17        Generator/Invertor                                  6          0               100
18        Vhiecle                                            10          67              100
19        Emergency Room / Casualty                                      0
          Separate wards for males and
                                                                        100
20        females (Yes/No)
21        No. of beds : Male                                             14
22        No. of beds : Female                                           12
23        Availability of ECG facilities                                100              100
24        X-Ray facility                                                100              100
25        Ultrasound facility                                           100              100
26        Cardiac Monitor for OT                                        100              100
27        Blood Storage Unit available                                   0               100
28        Blood Bank Facility                                                            100
29        Other Investigative Facility                                                    59
          Heating ventilatoin & air
30        conditioning
                                                                                         50
31        Lift & vertical transport                                                       0
32        Refrigeration                                                                  100




      Table: 2                             Identified Gaps of Manpower in The District
                                            District- Srinagar
                                                                                                                      Existing Staff
                                                              batamaloo



                                                                          hazratbal




                                                                                                           Required
                                                                                      s.r gung
                                                    khanyar




                                                                                                 zadibal




                                                                                                                         No. of
                                                                                                            No. 0f

                                                                                                             Staff
                   Name of Blocks                                                                                                      Total



                                        IPHS Norm
No. of Sub- Centres                     Recommend   7         13          13          9          8                                      50
                                        ed

ANM                                         2        0        1           11          0           0         100        88               12
N0. Of PHC's                                         4        7            5          6           7                     0
MO                                          2        2         3           4          4           2          58        43               15
Pharmacist                                  1        0        -1          -2          -1         -4          29        37               -8
Nurse                                       3       12        20          14          17         19          87         5               82
Female Health Worker                        1       -2        0            1          -5          2          29        33               -4
Health Educator                             1        4        5            3          5           4          29         8               21
Health Assistant                                     8        14           8
                                            2                                         10         10          58           8             50
(one male and one Female)
Clerks                                      2       8         12           9          10          7          58       12                46
LT                                          1       3         5            3          5           4          29        9                20
Driver                                      _       4         6            3          6           6                   -25               25
Class lV                                    4       8                     11          8          11         116       78                38
Tota
                                                                                                            493       208              285
l
No. of CHC's                                        1         NA          NA          NA         NA
A.    CLINICAL MANPOWER
1      General Surgeon                      1       -3                                                       1            4             -3
2      Physician                            1        0                                                       1            1             0
3      Obstetrician / Gynaecologist         1        1                                                       1            0             1
4      Paediatrics                          1        1                                                       1            0             1
5      Anaesthetist                         1        0                                                       1            1             0
       Public Health Programme
6                                           1       0                                                        1            1             0
       Manager
7      Eye Surgeon                          1       0                                                        1            1             0
8      Other specialists (if any)                                                                                                       -1
       General duty officers (Medical
9
       Officer)
B. SUPPORT MANPOWER
1    Nursing Staff                        7+2
a    Public Health Nurse                   1    1                   1             0               1
b    ANM                                   1    0                   1             1               0
c.   Staff Nurse
                                          7     0                   7             7               0
d.   Nurse/Midwife
6    Dresser                              1      0                  1             1              0
7    Pharmacist / compounder              1     -6                  1             7              -6
8    Lab. Technician                      1     -2                  1             3              -2
9    Radiographer                         1     -1                  1             2              -1
10   Ophthalmic Assistant                 1      0                  1             1              0
11   Ward boys / nursing orderly          2      2                  2             0              2
12   Sweepers                             3      0                  3             3              0
13   Chowkidar                            1      1                  1             0              1
14   OPD Attendant                        1      0                  1             0              1
     Statistical Assistant / Data entry
15                                        1     1                   1             0               1
     operator
16   OT Attendant                         1     1                   1             0               1
17   Registration Clerk                   1     0                   1             1               0
18   Any other staff (specify)
                                Total                              31             34             -3
        Note: ( - ) Surplus staff




 A.      Doctors

S.No.                         Personnel              IPHS Norm   Existing Staff            Identified Gaps


  1                                                                          1         0
         Hospital Superintendent                         1

  2                                                                          1         2
         Medical Specialist                              3
  3                                                                          2         0
         Surgery Specialists                             2
4                                                   1    3
     O&G specialist                            4
5                                                   0    1
     Psychiatrist                              1
6                                                   1    0
     Dermatologist / Venereologist             1
7                                                   1    1
     Paediatrician                             2
8                                                   2    0
     Anesthetist (Regular / trained)           2
                                                         0
9                                                   1
     ENT Surgeon                               1

10                                                  1    0
     Opthalmologist                            1

11                                                  1    0
     Orthopedician                             1
                                                         1
12                                                  0
     Radiologist                               1
13                                                  0    1
     Microbiologist                            1
14                                                  0    6
     Casualty Doctors / General Duty Doctors   6
                                                         -1
15                                                  2
     Dental Surgeon                            1
16                                                  0    1
     Forensic Expert                           1
17                           1                      0    1
     Public Health Manager                     1

18                     2
                                                    0    2
     AYUSH Physician                           2
19                                                  0    2
     Pathologists                              2
                                                    14   20
     Total                                     34
 B.     Para-Medicals

S.No.                      Personnel                IPHS Norm   Existing Status   Identified Gaps


 1                                                                    15                60
        Staff Nurse*                                75 to 100

 2                                                                    20                0
        Hospital worker (OP/ward +OT+ blood bank)      20
 3                                                                    15                0
        Sanitary Worker                                15
 4                                                                    1                 0
        Ophthalmic Assistant / Refractionist            1
 5                                                                    0                 1
        Social Worker / Counsellor                      1
 6                                                                    0                 1
        Cytotechnician                                  1
 7                                                                    0                 1
        ECG Technician                                  1
 8                                                                    0                 1
        ECHO Technician                                 1
 9      Audiometrician                                                0                 0

 10                                                                   6                 6
        Laboratory Technician ( Lab + Blood Bank)      12

 11                                                                   0                 4
        Laboratory Attendant (Hospital Worker)          4
 12     Dietician                                       1             0                 1
 13                                                                   0
        PFT Technician                                  -
 14                                                                   3                 3
        Maternity assistant (ANM)                       6
 15     Radiographer                                    2           2              0
 16                                                                 0              1
        Dark Room Assistant                             1
 17                   1                                             5              0
        Pharmacist                                      5
 18                                                                 0              1
        Matron                                          1
 19                                                                 0              2
        Assistant Matron                                2

 20                                                                 0              1
        Physiotherapist                                 1

 21                                                                 0              1
        Statistical Assistant                           1

 22                                                                 0              1
        Medical Records Officer / Technician            1
 23                                                                 1              0
        Electrician                                     1

 24                                                                 1              0
        Plumber                                         1

 B.
        Para-Medicals

S.No.                                                           EXIS, staf   Identified Gaps
        Personnel                                   IPHS Norm

 1                                                                 15              60
        Staff Nurse*                                75 to 100

 2                                                                 20              0
        Hospital worker (OP/ward +OT+ blood bank)      20

 3                                                                 15              0
        Sanitary Worker                                15
4                                                     1   0
     Ophthalmic Assistant / Refractionist        1

5                                                     0   1
     Social Worker / Counsellor                  1

6                                                     0   1
     Cytotechnician                              1

7                                                     0   1
     ECG Technician                              1

8                                                     0   1
     ECHO Technician                             1

9                                                     0   0
     Audiometrician

10                                                    6   6
     Laboratory Technician ( Lab + Blood Bank)   12

11                                                    0   4
     Laboratory Attendant (Hospital Worker)      4

12                                                    0   1
     Dietician                                   1

13                                                    0
     PFT Technician                              -

14                                                    3   3
     Maternity assistant (ANM)                   6

15                                                    2   0
     Radiographer                                2
16                                              0   1
     Dark Room Assistant                    1

17                                              5   0
     Pharmacist1                            5

18                                              0   1
     Matron                                 1

19                                              0   2
     Assistant Matron                       2

20                                              0   1
     Physiotherapist                        1
21                                              0   1
     Statistical Assistant                  1

22                                              0   1
     Medical Records Officer / Technician   1
23                                              1   0
     Electrician                            1

24                                              1   0
     Plumber                                1
            TABLE 3                                   AVERAGE AVAILABLE PERCENTAGE OF EQUEMENTS
                                                DISTRICT – Srinagar




                                                           BATAMALOO



                                                                       HAZRATBAL
                                                 KHANYAR




                                                                                   S.R.GUNG




                                                                                              ZADIBAL
                                                                                                           Average
         NAME OF BLOCKS-                                                                                % of the District
NO OFSC(50)              IPHS Norm                7        13          13          9          8
Equipment kit
                                      55         21        27          20          24         20               22
( kit- C )
                                   IPHS Norm
                                                  4        7           5           6          7
NO OF PHCs(29)                    Recommended
Suggested equipments                   36        17               22   25          31         28               24
Operational labour room                10        40               10   20          0          40               22
Pap Smear                              11        64               27   46          27         27               38
Laboratory Reagents                    10        10                0   30          10         20               14
Glassware and other                                                                                            43
equipment                              7         29               29   71          14         71
Furniture                              25        12               12   32          20         24               20
TOTAL                                  99        23               18   33          21         30               25
                                   IPHS Norm
NO OF CHC(1)                      Recommended     1        0           0           0          0                1
Standard Surgical Set-1 FRU            32        81                                                            81
Standard Surgical Set - II            33         79                                                            79
IUD Insertion Kit                     19         63                                                            63
CHC Standard Surgical Set - III       17         41                                                            41
Normal Delivery                       12         83                                                            83
Standard Surgical Set - IV            16         100                                                          100
Standard Surgical Set - V             21         43                                                            43
Standard Surgical Set - VI            11         100                                                          100
Equipment for Anaesthesia             17         65                                                            65
Equipment for Neo-natal
                                     10
Resuscitation                              50    50
Materials Kit for Blood tranfusion   15    0      0
Equipment for Operation theatre      11    73    73
Equipment for Labour room            13    69    69
Equipment for Radiology              9     100   100
TOTAL NO.                            236   67    67
               TABLE 4                                           AVARAGE AVAILABLE PERCENTAGE OF MEDICINE

                                                     DISTRICT - SRINAGAR




                                                                     BATAMALOO



                                                                                      HAZRATBAL




                                                                                                   S.R.GUNG
                                                       KHANYAR




                                                                                                               ZADIBAL
                                                                                                                            Average
                NAME OF BLOCKS-                                                                                          % of the District
                                        IPHS Norm      7             13              13            9           8
NO OF SC(50)                           Recommended
Name of Drug
                                            5                                                                                  0.0
Quantity ( Kit- A )                                    0.0                 0.0       0.0          0.0         0.0
Name of Drug
                                            9                                                                                  35.5
Quantity ( Kit- B )                                   22.2            33.3           44.4         33.3        44.4
Drugs required by
                                            6                                                                                  3.3
ANMs and LHVs                                          0.0                 0.0       0.0          16.7        0.0
Other Drugs and
                                            8                                                                                  35.0
Vaccines                                              37.5            25.0           50.0         37.5        25.0
Medicines required
                                            7                                                                                  2.9
for NDCP                                              14.3                 0.0       0.0          0.0         0.0
Contraceptives required for F.Plang.        4         75.0            75.0           50.0         50.0        50.0             60.0
Proposed Drug List for
                                           12                                                                                  23.3
A.Wadi Centres                                        33.3            16.7           25.0         16.7        25.0
Total                                      51         25.5            19.6           47.1         47.1        21.6             32.2
                                        IPHS Norm      4             7                5            6           7
TOTAL NO OF PHCs(29)                   Recommended
DRUGS
Essential & emergecy
obstetrics care drugs                      38                                                                                  35.3
                                                      47.4            23.7           31.6         39.5        34.2
Antidots                                    4         25.0               0           0.0           0.0        0.0              5.0
Anticonvulsant /
Antiepileptics                              4                                                                                  0.0
                                                       0.0                       0   0.0          0.0         0.0
Antiinfective Medicines          5       40.0     20   0.0    60.0   20.0   28.0
Antifilarials                    1        0.0      0   0.0     0.0   0.0    0.0
Antibacterials                  16       18.8   18.8   6.3    18.8   12.5   15.0
Dermatological medicine         14       14.3    7.1   7.1    21.4   7.1    11.4
Antileprosy &
Antitubercullar                 2                                           30.0
                                         50.0     0    50.0   50.0   0.0
Antifungal medicine             4         0.0     0    0.0     0.0   0.0    0.0
Antiprotozoal medicine          5        20.0     0    20.0    0.0   20.0   12.0
Blood Products and
Plasma Substitutes              13                                          3.1
                                          7.7      0   0.0     0.0   7.7
Antiseptics                      6        0.0      0   0.0     0.0   0.0    0.0
Disinfectants                    3        0.0      0   0.0     0.0   0.0    0.0
Diuretics                        2        0.0      0   50.0    0.0   50.0   20.0
Gastrointestinal                22       31.8   13.6   18.2   27.3   18.2   21.8
Hormones, Endocrine &
Contraceptives                  10                                          8.0
                                         10.0    10    10.0   10.0   0.0
Ophthalmological
preparation                     12                                          3.3
                                         8.3     8.3   0.0     0.0   0.0
Psychotic Disorders             15       6.7     6.7   0.0    13.3   6.7    6.7
Solutions correcting water
Electrolyte and Acid-           9                                           26.6
Base Disturbances                        22.2   22.2   22.2   44.4   22.2
Vitamins & Minerals             3        33.3   33.3   0.0    66.7   0.0    26.7
Drugs under RCH                 1         0.0      0   0.0     0.0   0.0    0.0
Product Strength
formulation Units               31                                          23.9
                                         29.0   12.9   12.9   41.9   22.6
RTI / STI Drugs                 10       30.0      0   10.0   30.0   30.0   20.0
Drugs and Consumable
for MVA                         6                                           6.7
                                         16.7      0   16.7    0.0   0.0
TOTAL                          236       22.5   11.9   13.1   23.7   16.1   17.5
DRUGS                        Total No.
Essential drugs                 70       51.4                               51.4
District Anantnag

  Infrastructure: Table:1
          Out of 129 SC’s in the District, 120 Sc’s (93%) and 49% PHC’s are running in rented buildings. As far as condition of SC’s
          building is concerned. 86% are in poor condition.
          Only 6% SC’s are getting water supply through tap, bore well, hand pump, tube well and well. Out of total 6% SC’s and 47%
          PHC’s have tap water supply.
          Ninety Nine percent SC’s and 36% PHC’s are functioning without electric facility and only 47 % PHC’s have electric facility in
          all parts of the health centre.
          Facility survey also revealed that availability of separate toilet at SC and PHC is almost negligible. Though CHC has this
          facility but without water.
          The availability of laboratory in PHC is only 38%.
          The availability of a labor room, to achieve NRHM Goal of maximum institutional delivery, is important facility for SC and PHC.
          This facility is not available at SC’s and only 21% PHC’s have this critical facility.
          For communication purposes, only 11% PHCs and 33% CHC’s are having telephone facility.
          To attend emergency cases, it is necessary to have staff quarters in the compound. Neither single SC nor CHC have quarter
          for staff. Only 23% PHC’s are having residential facility for the staff.
          A separate aseptic labor room is critical in reducing the chances of infection during delivery. 33% separate aseptic labor
          rooms are available at CHC’s and blood storage units are unavailable at CHC’s.
          (67%) EC, (67%) X Ray, and (67%) ultra sound are available at CHC’s and only 33% of cardiac monitor for OT were noticed.
  Manpower: Table:2
          The health assistant (Female) also known as ANM has a key role to play in the implementation of RCH programme at grass
          root level. 110 ANM’s are looking after the work of 129 SC’s. There is a gap of 19 ANM’s as per IPHS norms.
          Total requirement of staff at 47 PHC’s is 841 and only 402 staff are in position, which reflects the shortage of more than 52 %
          staff. There is, especially, a shortage of Nurses (111), health assistants (82), and clerks (78).
          Situation of CHC is alarming where only23% of the clinical manpower is available. Vacant post of specialists makes CHC
          virtually non-functional. There is an urgent need to recruit professionals as soon as possible that will help to reduce the load
          on district hospital.
  Equipments: Table:3
          Certain equipment is essential for the delivery of RCH services at SC. Out of 56 (recommended list of) equipment for SC an
          average of only ( 9.%) equipment were available at the centres.
          As far as availability of equipments at PHC is concerned, only 17 % equipments were found available.
          In CHC availability of equipment is 23%.There is availability of standard surgical set-II(38)%, standard surgical set-III (19%),
          standard surgical set IV (19) ,standard surgical set-V (5), standard surgical set-VI (20%), normal delivery set (32%),
          equipment for anaesthesia (11%), equipment for neo natal resuscitation (12%) and kit for blood transfusion was reported
          (21%) and rest of the equipment is 4-9%..
Medicines:Table:4
       The Supply of Kit-A for SC was found unsatisfactory (0 %) .(1%) Kit-B was found available at sub centres and availability of
       contraceptives was 0nly 2 %.
       About 21 % medicines were reported available out of total medicines recommended for PHC.s Availability of Antifilarials (6%),
       dermatological medicine (9 %), vitamins & minerals (11%), Antidots (22 %), Anti infective medicine (10%), Anti bacterial (8%)
       was noticed.
       Supply of essential drugs at CHC was found unsatisfactory .(23%)
Table:1                                         Percentage Availability of Infrastructure


                                                District: ANANTNAG


                            Indicators                  SC (129)       PHC (47)         CHC (6)   DH



          Building (Govt. + Donated)                        3             45                83    100
    1
                                                           93             49                17    0
    2     Building (Rented)

          Condition of Building (Good + Fair)              14             Na                Na    Na
    3

          Water Supply (Tap, borewell/
                                                            6             64                100   100
          handpump/tubewell, well)
    4

          Tap water supply                                 Na             47                83    100
   4.1

          Electricity                                       1             49                83    100
    5

          In all parts of hospital                         Na             26                55    100
   5.1
      Elertic supply (power generation
                                           Na   Na   50    100
      stablization)
5.2

      Separate Toilet                      0    15   50    100
6

      Sep.Toilet with running water        Na   Na   60    100
6.1
      Furniture                            16   38   55    50
7

      Labor Room                           0    21   67    100
8

      Aseptic labor room                   Na   Na   33    100
8.1

      Avail.of Quater for staff            0    23   0     0
9
      Number of beds available (Average)        5    14    100
10
      Laboratory                                38   83    100
11

      Operation Theatare                        11   33    100
12

      Waste Disposal (Burnt+Dump)               51   100   0
13

      Availability of incenator                 Na   0     0
14

      Telephone                                 11   33    100
15
     Computer                                 0    17   0
16
     Generator/Invertor                       21   83   100
17
     Vhiecle                                  47   28   100
18

     Emergency Room / Casualty                     50   100
19

     Separate wards for males and females
                                                   40
     (Yes/No)
20
21   No. of beds : Male                            25   0

     No. of beds : Female                          15   100
22

     Availability of ECG facilities                67   100
23

24   X-Ray facility                                67   100

     Ultrasound facility                           67   100
25
     Cardiac Monitor for OT                        33   100
26
     Blood Storage Unit available                  0    100
27
     Blood Bank Facility                                100
28
     Other Investigative Facility                       50
29
     Heating ventilatoin & air conditioning             0
30
     Lift & vertical transport   0
31

32   Refrigeration               100

     Na = Not Applicable
Table:2                                      Identified Gaps of Manpower
                                                                 District Anantang

                                                                                                                                                GAP of




                                                                                                                                No. of Exis.
                                                                                                                  No. of Req.
                                                                                                       Qazigund
                                Bijbihaira


                                              Shangus




                                                                                             Verinag
                                                                                   Achabal
                                                                 Larnoo
                                                                                                                                                 Man




                                                        Mattan




                                                                          Sallar




                                                                                                                     Staff


                                                                                                                                   Staff
                                                                                                                                               power in
Name of Blocks
                                                                                                                                                  the
                                                                                                                                                district

                         IPHS
Total No. of SCs (129)   Norm   12            10        18       23       15       25        18        8

ANM                       2     12            10        23       29       17       27        21        9          258           110              148
Total No. of PHC (47)           5             5         8        7        6        8         4         4
MO                        2     6             6          4        1       4        6          0         0           94            67              27
Pharmacist                1     0             0         -3       -4       -5       1         -2        -5           47            65             -18
Nurse                     3     12            14        19       18       13       17        11        7          141             30             111
Female Health Worker      1     1             -2        -1       5        5        1         1         -1           47            38              9

Health Educator           1     5             2         5        6        5        4         1         -2           47            23              24
Health Assistant
(one male and one         2     10            10        16       12       11       13        4         6            94            12              82
Female)
Clerks                    2     10            10        14       12       9        14        6         3            94            16              78
LT                           1     4    5   6    4   2    5    0   0    47    21    26
Driver                       _                                                0
Class lV                     4     15   9   15   8   15   21   8   9    188   88    100

TOTAL                                                                   799   360   439

Total No. of CHC (5)
                                   1    1   1    1   NA   Na   1   NA
A. CLINICAL
MANPOWER
General Surgeon              1     0    1   1    1             0         5    2     3
Physician                    1     0    1   1    1             1         5    1     4
Obstetrician /
                             1     0    1   1    1             1         5    1     4
Gynaecologist
Paediatrics                  1     0    1   1    1             0         5    2     3
Anaesthetist                 1     1    1   1    1             0         5    1     4
Public Health
                             1     1    0   1    1             1         5    1     4
Programme Manager
Eye Surgeon                  1     1    1   1    1             1         5    0     5
Other specialists (if any)
General duty officers
(Medical Officer)
B. SUPPORT
MANPOWER
Nursing Staff                7+2
Public Health Nurse          1     1    1   1    1             1         5    0     5
ANM                          1     -1   0   0    0             0         5    6     -1
Staff Nurse                  7     0    4   3    6             4        35    18    17
Nurse/Midwife                                                   0
Dresser                      1   1    0    1    1    1     5    1     4
Pharmacist /
                             1   -2   -2   -2   -3   -1    5    15    -10
compounder
Lab. Technician              1   0    -2   0    0    -1    5    8     -3

Radiographer                 1   0    1    1    1    1     5    1     4
Ophthalmic Assistant         1   0    0    1    0    0     5    4     1
Ward boys / nursing
                             2   0    -1   -2   -1   -1   10    15    -5
orderly
Sweepers                     3   0    1    0    -1   -5   15    20    -5
Chowkidar                    1   0    0    1    1    1     5    2     3
OPD Attendant                1   -2   0    1    1    1     5    4     1
Statistical Assistant /
                             1   1    1    1    1    1     5    0     5
Data entry operator
OT Attendant                 1   0    1    1    1    0     5    2     3

Registration Clerk           1   0    1    1    1    1     5    1     4

Any other staff (specify)
TOTAL                                                     155   105   50

 Note: ( - ) Surplus staff
DISTRICT HOSPITAL ANANTNAG – Availability of Manpower and Identified Gaps



Doctors

               Personnel                    IPHS Norm             Existing Staff   Identified Gaps


Hospital Superintendent                          1                      1                0

Medical Specialist                               3                      2                1

Surgery Specialists                              2                      2                0

O&G specialist                                   4                      1                3

Psychiatrist                                     1                      0                1

Dermatologist / Venereologist                    1                      1                0

Paediatrician                                    2                      2                0

Anesthetist (Regular / trained)                  2                      1                1
ENT Surgeon                       1    1    0

Opthalmologist                    1    1    0

Orthopedician                     1    1    0

Radiologist                       1    1    0

Microbiologist                    1    0    1
Casualty Doctors / General Duty
                                  6    0    6
Doctors
Dental Surgeon                    1    1    0

Forensic Expert                   1    0    1

Public Health Manager1            1    0    1

AYUSH Physician2                  2    0    2

Pathologists                      2    0    2

Total                             34   15   19
Para-Medicals

           Personnel            IPHS Norm   Existing Staff   Identified Gaps


Staff Nurse*                    75 to 100        21                54

Hospital worker (OP/ward +OT+
                                   20            22                -2
blood bank)

Sanitary Worker                    15             1                14

Ophthalmic Assistant /
                                   1              1                0
Refractionist

Social Worker / Counsellor         1              0                1

Cytotechnician                     1              0                1

ECG Technician                     1              0                1

ECHO Technician                    1              0                1

Audiometrician                                    0                0
Lab.Tech. ( Lab +BB)        12   0    12

Lab. Atten. (Hos.Worker)    4    3    1

Dietician                   1    2    -1

PFT Technician              -    0    0

Maternity assistant (ANM)   6    0    6

Radiographer                2    3    -1

Dark Room Assistant         1    0    1

Pharmacist1                 5    11   -6

Matron                      1    0    1

Assistant Matron            2    0    2

Physiotherapist             1    0    1
Statistical Assistant       1    0    1
Medical Records Officer /
                            1    0    1
Technician
Electrician                         1                  1                0
Plumber                             1                  1                0
Total                               154                45             109



    Administrative Staff


          Personnel         IPHS Norm     Current Availability   Identified Gaps


Manager (Administration)        -
Junior Admin. Officer           1                  0                   1

Office Superintendent           1                  1                   0

Assistant                       2                  2                   0
Junior Assistant / Typist       2                  0                   2

Accountant                      2                  0                   2

Record Clerk                    1                  0                   1
Office Assistant            1              0                   1
Computer Operator           1              0                   1
Driver                      2              0                   2
Peon                        2              0                   2
Security Staff*             2              0                   2



    Operation Theatre

                                    Gen.    Current
                         Emer. OT                         Identified Gaps
                                     OT    Availability

Staff Nurse                 8        1          0                  9
OT Assistant                4        2          2                  4

Sweeper                     3        1          1                  3

Total                      15        4          3               16
    Blood Bank / Blood
         Storage
                                 Blood
                   Blood Bank
                                Storage

Staff Nurse            3          1       0   4
MNA / FNA              1          1       0   2
Lab Technician         1           -      1   0
Safai Karamchari       1          1       1   1
Total                  6          5       2   9
    TABLE : 3                                Percentage Availability of Equipments


                                                              DISTRICT –Anantnag




    Total no. of SC (129)        IPHS Norm
                                             12    10    18      23    18     25     15   8
1                                   56       17    7     5        0           24     11   10   11
     kit- C
    Total no. of PHCs (31)                   4      3    6       4     4       3      4    3
1   Suggested equipments            36       13     0    17      19           20     10   43   17
2   Operational labour room         10       10     0    0       0            0       0   40    7
3   Pap Smear                       11       0      0    0       0             0      0   39    6
4   Laboratory Reagents             10       0      0    4       3            13      0   30    7
5   Glassware & other equip.         7       0      0    4       2            48     25   33   16
6   Furniture                       25       7      0    6       13           20      2   37   12
    TOTAL                           99       6      0    30      38           17      6   39   19
    Total no. of CHCs (5)                    1      1    1       1     1                   1    6
1   Standard Surgical Set-1         32       31    14    2       0                        17   40
    FRU
2   Standard Surgical Set - II      33       25    21    8        0                       8    38
3   IUD Insertion Kit               19       14     0    5        0                       0    20
4   CHC Standard Surgical           17       13     0    3        0                       0    19
    Set - III
5   Normal Delivery                 12       12    0     7        0                       0    32
6   Standard Surgical Set - IV      16       13    0     2        0                       0    19
7   Standard Surgical Set - V       21       5     0     0        0                       0     5
8   Standard Surgical Set - VI      11       11    0     0        0                       0    20
9 Equipment for                  17     9            0          0        0                                        0                11
     Anaesthesia
10   Equip. for Neo-natal        10     6            0          0        0                                        0                12
     Resuscitation
11   Materials Kit for Blood     15     1           15          0        0                                        0                21
     tranfusion
12   Equipment for Operation     11     2            0          0        0                                        0                 4
     theatre
13   Equipment for Labour        13     6            0          0        0                                        0                 9
     room
14   Equipment for Radiology     9      26           0         0        0                                         0                58
     TOTAL NO.                  236    12.4         3.6       1.9      0.0                                       1.8                4




TABLE : 4                                                              Percentage Availability of Medicines

                                                                       District – Anantnag




                                                                                                                 Qazigund
                                        Bijbehara


                                                    Shangus




                                                                                             Achabal
                                                                                 Verinag
                                                                        Larnoo




                                                                                                       Salllar
                                                              Mattan
                                                                                                                                  Avg
     Nameof Blocks
                                                                                                                            % of the District


     Total no. of Sub           IPHS
                                        12          10        18       23        18          25        15        8
     Centres(129)              Norms
1     Kit- A                     5      0           0         0         0                    0         1         0                 0

2    Kit- B                      9      2           1         0         0                    3         2         2                 1
     Drugs required by
3                                6      0           0         1         0                    2         0         1                 1
     ANMs and LHVs
                                                                                 NA




4    Other Drugs & Vacci.        8      18          1         1.0       0                    3         1         2                 4
5    Med. Req.for NDCP           7     `12          1         0.0       0                    5         2         0                 1
     Contracep. Req.for
6                                4      2           4         1         0                    6         2         1                 2
     F.Plang.
7    Drug List for AWC         12    1     1    2    0        7    1    0    2
     Total                     106   11    14   11   1   0    50   19   17   15
     Total no. of PHCs(31)           4     3    6    4   4    3    4    3
     Essen. & emerg.
1                              38    0     0    7    0   19   40   14   30   14
     obstetrics care drugs
2    Antidots                  4     100   0    1    0   3    25   6    42   22
     Anticonvul./
3                              4     11    0    0    0   1    0    0    17   4
     Antiepileptics
4    Antiinfective Medicines   5     11    0    2    0   3    27   0    33   10

5    Antifilarials             1     13    0    0    0   1    0    0    33   6

6    Antibacterials            16    3     0    2    0   4    27   3    21   8
     Dermatological
7                              14    42    0    1    0   3    12   0    12   9
     medicine
     Antilep.&
8                              2     37    0    0    0   0    17   0    0    7
     Antitubercullar
9    Antifungal medicine       4     5     0    0    0   0    0    0    0    1
10   Antiprotozoal medicine    5     11    0    0    0   0    13   0    13   5
     Blood Products and
11                             13    13    0    1    0   2    8    0    18   5
     Plasma Substitutes
12   Antiseptics               6     34    0    0    0   2    22   0    22   10

13   Disinfectants             3     16    0    1    0   3    0    0    11   4
14   Diuretics                 2     8     0    0    0   2    33   0    0    5
15   Gastrointestinal          22    5     0    2    0   5    23   0    33   9
     Hormones, Endocrine
16   & Contraceptives          10    58    0    2    0   3    7    0    30   13

17   Ophthalm. preparation     12    26    0    0    0   0    0    0    28   7
18   Psychotic Disorders       15    32    0    0    0   3    16   0    20   9
     Solutions correcting
19   water                     9     39    0    2    0   5    44   14   11   14
     Electrolyte and Acid-
     Base Disturbances


20   Vitamins & Minerals   3     24   0   0    0   2    56   8   0    11

21   Drugs under RCH       1     8    0   0    0   0    0    0   33   5
     Product Strength
22                         31    3    0   5    0   10   26   6   42   12
     formulation Units
23   RTI / STI Drugs       10    82   0   0    0   3    30   8   43   21
     Drugs & Consumable
24                         6     26   0   0    0   1    22   0   33   10
     for MVA
     TOTAL                 236   16   0   27   0   76   23   4   27   22
     CHCs (5)                    1    1   1    1   1             1

1    Essential drugs       70    26   0   22   0                 32   23
DISTRICT BUDGAM


Infrastructure: Table:1
    Out of 134S/C’s in the District, 106 Sc’s (79%) and out of 47 PHC’s 20 (42% ) PHC’s are running in rented buildings. .
    Only 16% SC’s and 41% PHC’s are getting tap water supply
    97% SC’s and 42% PHC’s are functioning without electric facility and only 38 % PHC’s have electric facility in all parts of the health centre.
    Facility survey also revealed that availability of separate toilet at SC’s and at PHC’s is almost negligible. Though CHC’s have this facility but have
    no water supply.
    The availability of laboratory in PHC’s is only 43.3% for test purposes.
    The availability of a labor room, to achieve NRHM Goal of maximum institutional delivery, is important facility for a SC’s and PHC’s. However only
    0% SC’s and 67% PHC’s have this critical facility.
    For communication purposes the telephone facility at PHC’s is very important. Telephone Facility is available 0% at PHC and 90% at CHC’s.
    To attend emergency cases, it is necessary to have staff quarters in the compound. Neither a single SC nor a CHC have quarter for staff.
    A separate aseptic labor room is critical in reducing the chances of infection during delivery. Neither a separate aseptic labor room nor blood
    storage unit is available at CHC.
    Facility of ECG, X Ray, and ultra sound is available at CHC but non availability of cardiac monitor for OT was noticed.
    Only 48% Investigative facilities is available at DH.
    Lift and vertical transport is not available
Manpower: Table:2
    The health assistant (Female) also known as ANM has a key role to play in the implementation of RCH programme at grass root level. 125n
    ANM’s are looking after the work of 134 SC’s. There is a gap of143 ANM’s as per IPHS norms.
    Total requirement of staff at 47 PHC’s is 188 and only 126 staff are in position, which indicates the shortage of more than 62(33%)staff. There is
    especially a shortage of MO`s(29) Nurses (121), health assistants (85), and clerks (82).
    Situation of CHC’s is alarming where none of the clinical manpower is available. Vacant posts of specialists make CHC’s virtually non-functional.
    There is an urgent need to recruit professionals as soon as possible.
    Non availability of recommended Staff as per IPHS norms is the hindrance for the smooth functioning of DH .There is a shortage of both
    medical and Para medical Staff.
Equipments: Table:3
    Certain equipment is essential for the delivery of RCH services at SC’s. Out of 56 (recommended list of) equipment for SC’s an average of only
    22% equipment were available at the centres.
     Only 45 % equipments were available at PHC’s..
    Miserable condition of CHC’s is remarkable in respect of availability of equipment. Non availability of standard surgical set-II, standard surgical
    set-III, standard surgical set-V, standard surgical set-VI, normal delivery set, and equipment for anesthesia, equipment for neo natal resuscitation
    and kit for blood transfusion was reported.
Medicines:Table:4
   The Supply of Kit-A for SC’s was found unsatisfactory (9 %). Though Kit-B was found available at 34% sub centres and availability of
   contraceptives was 47 %.
   About 29 % medicines were reported available out of total medicines recommended for PHC’s. Availability of Antifilarials (21%), dermatological
   medicine (31 %), vitamins & minerals (47%), Antidots (31 %), Anti infective medicine (34%), Anti bacterial (36%) was noticed and remaining 18
   categories of medicines fall between 0- 41% availability.
   Supply of essential drugs at CHC’s was found (57%). Which is satisfactory.




Table:1                                              Percentage Availability of Infrastructure

                                                            District: Budgam

                             Indicators                    SC (134)              PHC (47)               CHC (7)                    DH

     1         Building (Govnt. + Donated)                    21                    42                     100                     100
     2         Building (Rented)                              79                    58                      0                       0
     3         Condition of Building (Good + Fair)            72                   100                     100                     100
               Water Supply (Tap, borewell/
                                                              16                    41                     100                     100
     4         handpump/tubewell, well)

     4.1       Tap water supply                               14                    33                     50                      100

     5         Electricity                                    3                     58                     100                     100

     5.1       In all parts of hospital                      Na                     38                     100                     100
               Elertic supply (power generation
                                                             Na                     Na                     Na                      100
     5.2       stablization)
     6         Separate Toilet                               Na                     Na                     100                     100
     6.1       Sep.Toilet with running water                 Na                     Na                     Na                      100
     7         Furniture                                      11                    48                     48                       58
     8         Labor Room                                     0                     67                     100                     100
     8.1       Aseptic labor room                            Na                     Na                     Na                      100

     9         Avail.of Quater for staff                     Na                     Na                     Na
     10        Number of beds available (Average)   6     NA

     11        Laboratory                           43    100   100

     12        Operation Theatare                   50    100   100

     13        Waste Disposal (Burnt+Dump)          100   100   100

     14        Availability of incenator            Na    0     0

     15        Telephone                            0     100   100
     16        Computer                             0     0     100
     17        Generator/Invertor                   0     100   100
     18        Vhiecle                              67    100   100
     19        Emergency Room / Casualty                  39    NA
               Separate wards for males and
                                                          100   100
     20        females (Yes/No)
     21        No. of beds : Male                         12    NA

     22        No. of beds : Female                       13    NA
     23        Availability of ECG facilities             100   100
     24        X-Ray facility                             100   100
     25        Ultrasound facility                        85    100
     26        Cardiac Monitor for OT                     57    100
     27        Blood Storage Unit available               0     100

     28        Blood Bank Facility                              100

     29        Other Investigative Facility                     48
               Heating ventilatoin & air
                                                                0
     30        conditioning
     31        Lift & vertical transport                        100
     32        Refrigeration                                    100
Na = Not Applicable
Table: 2                                                                 Identified Gaps of Manpower

                                                                 District- Budgam




                                                                                      Charershari
                                                    Chattergam



                                                                          Khansihab




                                                                                                                                               No.of Exis
                                                                                                              Soibuigh




                                                                                                                                   Req.Staff
                                                                                                    Chadora



                                                                                                                         Beerwah
                                   Budgam




                                                                 Magam
                                            Nagam




                                                                                                                                    No. 0f




                                                                                                                                                 Staff
                                                                                                                                                            Total




                                                                                          ef
Name of Blocks
                                                                                                                                                            Gap


                            IPHS
No. of Sub- Centres (134)          19       8       17           14       16            14          17        6          23
                            Norm
ANM                          2     20       10      18           14       16            15          22        5          23        268         125          143

N0. Of PHC's(47)                   7        2       5            1        9              4          6         2          11

MO                           2     -1       2       5            0         7             2           5        -4         13         94          65           29
Pharmacist                   1      0       0       0            0        0              0           0        0           0        47           47           0
Nurse                        3     18       4       12           0        22            12          18        4          31        141          20          121
Female Health Worker         1     -2       0       2            0        9              1           0        0           9        47           28           19
Health Educator              1     5        2       2            0        7              4          3         2          11         47          11           36
Health Assistant
                             2     9        3       10           2        18             8          12        3          20         94            9          85
(one male and one Female)
Clerks                       2     13        3      5            2        17             8          11        1          22  94                 12           82
LT                           1      4        2      2            0         6             4           4        0           9   47                16           31
Driver                       1      6        2      2            1         9             3           6        0           4   47                14           33
Class lV                     4      9        6      5            2        14            -2           7        1          20 188                126           62
Total                              61       24      45           7        109           40          66        7          139 846               348          498
No. of CHC's (7)
                                   NA       1       NA           1        2              1          1         NA         1
A. CLINICAL MANPOWER
General Surgeon              1              0                    0        2             -1          0                    0           7            6          1
Physician                    1              1                    0        1              0          0                    1           7            4          3
Obstetrician / Gynaecologist               1    1        1    0    1    0        1    7    3          4
Paediatrics                                1    1        1    0    0    1        1    7    3          4
Anaesthetist                               1    1        0    0    1    0        0    7    5          2
Public Health Programme Manager            1    1        1    0    1    1        0    7    3          4
Eye Surgeon                                1    1        1    0    1    0        1    7    3          4
Other specialists (if any)                                                                            0
General duty officers (Medical Officer)                                                               0
B. SUPPORT MANPOWER
Nursing Staff                             7+2
Public Health Nurse                        1    1        1    2    1    1         0   7    1          6
ANM                                        1    0        0    0    1    0        -3   7    9          -2
Staff Nurse
                                           7    5        4    14   3    0        -1   49   24         25
Nurse/Midwife
Dresser                                    1     1        0   2    1     1        0    7   2          5
Pharmacist / compounder                    1     0       -5   0    1    -1       -1   7    13         -6
Lab. Technician                            1     1       -1   2    1     0       -2    7   6          1
Radiographer                               1     1        1   2    0     0        1   7    2          5
Ophthalmic Assistant                       1     0        0   1    0     0        0    7   6          1
Ward boys / nursing orderly                2    -1       -6   2    2     0       -2   14   19         -5
Sweepers                                   3     1       -1   0    3     0       -5   21   23         -2
Chowkidar                                  1     1        1   2    1     0       -1   7    3          4
OPD Attendant                              1     1        1   2    1     0       -1    7   3          4
Statistical Assistant / Data entry
                                           1    0        0    0    1    0        0    7    6          1
operator
OT Attendant                               1    1        1    1    0    0        0    7    4          3
Registration Clerk                         1    1        0    2    0    0        0    7    4          3
Any other staff (specify)
Total                                           19   0    6   35   19    3   0   -11 217        152   65
   Note: ( - ) Surplus staff
DH – Availability of Manpower
Doctors

Personnel                         IPHS Norm   Current Avail.   Identified Gaps

Hospital Superintendent               1             1                0

Medical Specialist                    3             1                2

Surgery Specialists                   2             2                0
O&G specialist                        4             1                3

Psychiatrist                          1             0                1
Dermatologist / Venereologist         1             0                1
Paediatrician                         2             0                2
Anesthetist (Regular / trained)       2             2                0
ENT Surgeon                           1             1                0
Opthalmologist                        1             1                0
Orthopedician                         1             1                0
Radiologist                           1             0                1
Microbiologist                        1             0                1
Casualty Doctors / General
                                      6             6                0
Duty Doctors
Dental Surgeon                        1             2                -1
Forensic Expert                       1             0                1
                         1
Public Health Manager                 1             0                1
                     2
AYUSH Physician                       2             0                2
Pathologists                          2             1                1
Total                                34            19                15
Para-Medicals

Personnel                     IPHS Norm    Current Avail.   Identified Gaps

Staff Nurse*                   75 to 100         0                75
Hospital worker (OP/ward
                                  20            15                5
+OT+ blood bank)
Sanitary Worker                   15             6                9
Ophthalmic Assistant /
                                  1              1                0
Refractionist
Social Worker / Counsellor        1              0                1
Cytotechnician                    1              0                1
ECG Technician                    1              1                0
ECHO Technician                   1              0                1
Audiometrician                                   0                0
Laboratory Technician ( Lab
                                  12             0                12
+ Blood Bank)
Laboratory Attendant
                                  4              0                4
(Hospital Worker)
Dietician                         1              0                1
PFT Technician                     -             0                0

Maternity assistant (ANM)         6              1                5

Radiographer                      2              0                2
Dark Room Assistant               1              0                1
             1
Pharmacist                        5              5                0
Matron                            1              0                1
Assistant Matron                  2              0                2
Physiotherapist                   1              0                1
Statistical Assistant             1              0                1
Medical Records Officer /
                                  1              0                1
Technician
Electrician                        1              1                0
Plumber                            1              1                0
Total                             154            31               123




Administrative Staff


Personnel                       IPHS Norm   Current Avail.   Identified Gaps


Manager (Administration)               -          .                 -
Junior Administrative Officer       1             0                1
Office Superintendent               1             0                1
Assistant                           2             0                2
Junior Assistant / Typist           2             0                2
Accountant                          2             0                2
Record Clerk                        1             0                1
Office Assistant                    1             0                1
Computer Operator                   1             0                1

Driver                              2             2                0

Peon                                2             0                2
Security Staff*                     2             0                2
Total                              17             2                15
Operation Theatre

Staff                          IPHS Norm
                                                 Current Avail    Identified Gaps
                             Emergency / FW OT

Staff Nurse                          8                 0                 9
OT Assistant                         4                 1                 5
Sweeper                              3                 1                 3
Total                               15                 2                17



Blood Bank / Blood Storage
Staff                          IPHS Norm
                                                 Current Avail.   Identified Gaps
                              Blood Bank

Staff Nurse                         3                  1                3
MNA / FNA                           1                  0                2
Lab Technician                      1                  0                1
Safai Karamchari                    1                  1                1
Total                               6                  2                7
Table:3                                                        Percentage Availability of Equipments
                                                       District:Budgam




                                                                                     Charersharief
                                                  Chattergam




                                                                         Khansihab




                                                                                                               Soibuigh
                                                                                                     Chadora




                                                                                                                          Beerwah
                                 Budgam




                                                                 Magam
                                          Nagam
                                                                                                                                    Avg.% in
Name of Blocks
                                                                                                                                     District



No. of SC's (134)         IPHS   19       14      17            16       14          17              6         8          24
                          Norm
                           56    89       25      16            11       11          13              16        7          13          22
kit- C
No. of PHC's (47)                7        1       5              9       4            6              2         2          11           5

Suggested equipments       36    23       22      31            52       31          11              67        49         52          38

Operational labour room    10    30       50      10            90       10          20              70        75         90          49

Pap Smear                  11    36       36      36            67       36          36              82        70         67          52

Laboratory Reagents        10    10       10      10            80       10          10              80        12         80          34
Glassware and other
                           7     90       14      7             100      7           28              100       0          100         50
equipment

Furniture                  25    60       40      44            60       44          12              58        44         60          47

TOTAL                      99    42       29      23            75       23          20              76        42         75          45

No. of CHC's (7)                 NA       1       NA             2       1            1              NA        1          NA

Standard Surgical Set-1    32             16                     0       41          94                        38                     38
Standard Surgical Set - II       33    6    0   33   91    12   28

IUD Insertion Kit                19    0    0   89   100   37   45

Standard Surgical Set - III      17    41   0   0    88    12   28

Normal Delivery                  12    75   0   67   100   33   55

Standard Surgical Set - IV       16    50   0   0    100   0    30

Standard Surgical Set - V        21    5    0   0    100   0    21

Standard Surgical Set - VI       11    0    0   0    100   9    22

Equip. for Anaesthesia           17    35   0   59   88    6    38
Equip.for Neo-natal
                                 10    4    0   0    100   0    21
Resuscitation
Materials Kit for Blood trans.   15    0    0   0    100   0    20
Equip. for OT                    11    81   0   36   82    18   43
Equip. for Labour room           13    85   0   62   15    46   42

Equip. for Radiology              9    78   0   44   67    33   44

TOTAL                            236   34   0   31   87    17   34
Table: 4                                                       Percentage Availability of Medicine

                                                        District: Budgam




                                                                                   Charersharief
                                                  Chattergam




                                                                       Khansihab




                                                                                                             Soibuigh
                                                                                                   Chadora




                                                                                                                        Beerwah
                                 Budgam




                                                               Magam
                                          Nagam
                                                                                                                                     Average
Name of Blocks                                                                                                                    % of the District
                          IPHS   19       14      17           16      14          17              6         8          23
Sc's                      Norm
Kit- A                     5     60        0       0            0      0            0               0        0          20               9
Kit- B                     9     89       33      11           44      11          44              44        0          33               34
Drugs required by
                           6     100      17      17           17      0           17              17        0          17               22
ANMs and LHVs
Other Drug&Vacci.          8     90       38      13           13      13          25              12         0         13               24
0                          7     90       14      14           14      11          14              14        14         14               22
Contracep. Req.for
                           4     100      75      50           25      50          25              25        50         25               47
F.Plang.
Drug List for AWC          12    90       42       0            8      0            0               8        0          17               18
Total                      51    88       31      15           16      12          18              17        9          20               25
PHC's                             7        1       5            9      4            6               2        2          11
Essen. & emerg.
                           38    21       55      34           21      34          18              60        84         61               43
obstetrics care drugs
Antidots                   4     25       25      25           25      25          25              62        0          63               31
Anticonvul./
                           4     25       0       0            50      0            0              50        0          50               19
Antiepileptics
Antiinfective Medicines    5     20       40      28           0       28          20              50        70         50               34
Antifilarials              1     90        0       0           0       0            0              50         0         50               21
Antibacterials           16    25    25      19   30    19   19   66   66   56   36
Dermatological
                         14    21    29      1    16    0    21   57   75   57   31
medicine
Antilep.&
                         2     50    0       0    0     0    50   50   0    50   22
Antitubercullar
Antifungal medicine      4     0     25      0    0     0    0    50   52   50   20
Antiprotozoal medicine   5     0     40      20   0     20   0    50   60   50   27
Blood Products and
                         13    0     8       6    0     6    0    50   77   50   22
Plasma Substitutes
Antiseptics              6     33        0   7     0    7    0    50   75   50   25
Disinfectants            3      0    0       0     0    0    0    50   83   50   20
Diuretics                2      0    0       0    50    0    0    50   50   50   22
Gastrointestinal         22    18    27      16   60    16   18   68   77   50   39
Hormones, Endocrine
& Contraceptives         10    10    0       10   10    10   10   55   80   50   26

Ophthalm. preparation    12     0    50       0   0     0     0   50   71   50   25
Psychotic Disorders      15    13    40      13   0     13   13   50   50   50   27
Sol. correcting water
                         9     44    44      39   0     39   44   56   50   56   41
 Electrolyte and Acid-
Vitamins & Minerals      3     67    0       43    0    43   67   67   67   67   47
Drugs under RCH          1     0     0        0   100   0     0   50   60   50   29
Product Strength
                         31    10    55      32   2     32   13   60   68   58   37
formulation Units
RTI / STI Drugs          10    20    60      15   30    15   20   60   63   58   38
Drugs & Consumable
                         6     50    0       0    17    0    0    58   42   58   25
for MVA
TOTAL                    236    23    22 13       17    13   14   55   55   54   29
CHC's                          NA     1  NA        2    1     1    ]    1   1    1
Essential drugs          70          41           39    85   90        47   39   57
DISTRICT KARGIL


Infrastructure: Table:1
     Out of 131 SC’s in the District, 52% of SC’s and 5% PHC’s are running in rented buildings. In which 52% SC’s are in poor
     condition.
     Only 4% SC’s are getting water supply through tap, bore well, hand pump, tube well and well. And 22% PHC’s have tap water
     supply.
     There is non availability of electricity in SC’s and 94% PHC’s are functioning without electric facility.
     Facility survey also revealed that availability of separate toilet at SC’s is 5% and PHC’s is 33% . In CHC availability of separate
     toilets is not present.
     The availability of laboratory in PHC’s is only 24% have laboratory facility.
     The availability of a labor room, to achieve NRHM Goal of maximum institutional delivery, is important facility for a SC and PHC.
     However 11% SC’s and 54% PHC’s have this critical facility.
     For communication purposes, the telephone facility at PHC’s is only 11%. And 33% CHC’s have computer facility.
     To attend emergency cases, it is necessary to have staff quarters in the compound. Only 19% SC’s, 14% PHC’s and 50% CHC’s
     have quarters for staff.
     There is non availability blood storage unit CHC.
     Facility of ECG, X Ray, and ultra sound is available at CHC’s, but non availability of cardiac monitor for O.T .
     In District hospital, there is a non availability of Air condition & lift .



Manpower: Table:2
     The health assistants (Female) also known as ANM’s has a key role to play in the implementation of RCH programme at grass root
     level. 82 ANM’s are looking after the work of 131 SC’s. There is a gap of 180 ANM’s as per IPHS norms.
     Total requirement of staff at PHC’s is 306 and only 106 staff are in position, which reflects the shortage of more than 65 % staff.
     There is, specially, a shortage of MO (27), Nurse (47), health assistant (31), clerks (33) and clas IV (19).
     In CHC there is non availability of,Gynacologist and There is a Vacancy of 44 posts which makes CHC’s almost non-functional.
     There is an urgent need to recruit professionals as soon as possible .
     In DH there is non availability of Psychiatrist, Radiologist, Microbiologist, Public Health Manager ,Medical specialist, O & G
     specialist, and Forensic expert. The Para- Medical staff is available at 38%.

Equipments: Table:3
     Certain equipment are essential for the delivery of RCH services at SC’s. Out of 55 (recommended list of) equipment an average
     of only 22% equipment was found available at the Sub-Centers
     As far as availability of equipments at PHC’s is concerned, only 23% equipments were available.
     The availability of the equipment at the CHC’s only 70%
Medicines:Table:4
     The Supply of Kit-A for SC was found unsatisfactory (27 %). Though Kit-B was found available 60% at sub centres and availability
     of contraceptives was 63.3 %.
     About 22.6. % medicines were reported available out of total medicines recommended for PHC’s. Availability of , dermatological
     medicine (14.7 %), vitamins & minerals (36.8%), Antidots (18.2 %), Anti infective medicine (21.6%), Anti bacterial (20.4%) was
     noticed.
     Supply of essential drugs at CHC’s was found unsatisfactory at (34.7%).




  Table:1                                          Percentage Availability of Infrastructure
                                                        District: Kargil

                          Indicators                 SC (131)           PHC (17)              CHC (3)                   DH


                 Building (Govnt. + Donated)            48                 95                    100                    100
     1
                 Building (Rented)                      52                  5                     0                      0
     2
                 Condition of Building (Good +
                                                        48                  .
     3           Fair)
                  Water Supply (Tap, borewell/
                                                         4                 22                    50                     100
     4           handpump/tubewell, well)
    4.1          Tap water supply                                           0                     0
     5           Electricity                             0                  6                    100                    100
    5.1          In all parts of hospital                                   6                    100                    100
                 Elertic supply (power
                                                                                                                        100
                 generation stablization)
     6           Separate Toilet                         5                 33                     0                      0
    6.1          Sep.Toilet with running water                                                    0                      0
     7           Furniture                              20                 41                    76
     8           Labor Room                             11                 54                    100                    100
    8.1          Aseptic labor room                                                              100
     9           Avail.of Quater for staff              19                 14                    50                     100
     Number of beds available
                                      1    8     100
10   (Average)
11   Laboratory                       24   100   100
12   Operation Theatare               13    0    100
13   Waste Disposal (Burnt+Dump)      29    0    100
14   Availability of incenator              0     0
15   Telephone                        11   100   100
16   Computer                         6    33    100
17   Generator/Invertor               17   100   100
18   Vhiecle                          33   33    100
19   Emergency Room / Casualty              0     0
     Separate wards for males and
                                           0      0
20   females (Yes/No)
21   No. of beds : Male                    7
22   No. of beds : Female                  7

23   Availability of ECG facilities        100   100

24   X-Ray facility                        100   100

25   Ultrasound facility                   100   100

26   Cardiac Monitor for OT                0     100

27   Blood Storage Unit available          0     100

28   Blood Bank Facility                         100

29   Other Investigative Facility
     Heating ventilatoin & air
30   conditioning
                                                 50

     Lift & vertical transport                   50
31

32
     Refrigeration                               100
                 Table: 2                                   Identified Gaps of Manpower in The District
                                                 District- : Kargil




                                                                                                                                         No. of Existing
                                                                                                                        Required Staff
                                                                                          PANIKHAR


                                                                                                     ZANSKAR
                                                                                CHIKTAN




                                                                                                               SANKOO
                                                              SHARGOL
                                                   KARGIL




                                                                        DRASS




                                                                                                                           No. 0f
                                                                                                                                                           Total




                                                                                                                                              Staff
                    Name of Blocks                                                                                                                         GAP


No. of Sub- Centres                  IPHS Norm                                                                                                             131
                                                  31          13        13      16        14         20        24
ANM                                      2        35          14        21      21        21         24        44       262                82              180
N0. Of PHC's                                       5          3         3       1         1          1         3                                            17
MO                                       2        10          5         4       2         1          0         5         34                  7              27
Pharmacist                               1         1          0         1       0         1          -1        0         17                15               2
Nurse                                    3        15          9         8       3         1          2         9         51                  4              47
Female Health Worker                     1         5          0         0       0         1          -2        0         17                13               4
Health Educator                          1         5          3         2       1         0          0         3         17                  3              14
Health Assistant
                                         2                                                                               34                  3              31
(one male and one Female)                         10          5         6       2         0          2         6
Clerks                                   2        10          4         8       2         2          1         6         34                  1              33
LT                                       1         5          2         2       0         1          0         2         17                  5              12
Driver                                   1         4          2         2       -1        1          1         1         17                  6              11
Class lV                                 4         8          5         7       -4        _          -1        4         68                49               19
                   Total                                                                                                306              106               200
No. of CHC's(3)
                                                        0     0         0       1                    1         1                                            3
A.    CLINICAL MANPOWER
1    General Surgeon                         1                                  0                    1         1            3                1              2
2    Physician                               1                                  0                    1         1            3                1              2
3    Obstetrician / Gynaecologist            1                                  1                    1         1            3                0              3
4    Paediatrics                          1     0   1    1    3    1    2
5    Anaesthetist                         1     0   1    1    3    1    2
6    Public Health Programme Manager      1     0   1    1    3    1    2
7    Eye Surgeon                          1     0   1    1    3    1    2
8    Other specialists (if any)                 0   1    1    3    1    2
     General duty officers (Medical
9
     Officer)
                    Total
B.   SUPPORT MANPOWER
1    Nursing Staff                        7+2
a    Public Health Nurse                  1     0   1    0    3    2    1
b    ANM                                  1     2   0    -1   3    2    1
c.   Staff Nurse
                                          7     0             21   11   10
d.   Nurse/Midwife                                  5    5
6    Dresser                              1     0   1    1    3    1    2
7    Pharmacist / compounder              1     1   0    -1   3    3    0
8    Lab. Technician                      1     1   0    1    3    1    2
9    Radiographer                         1     0   -1   1    3    3    0
10   Ophthalmic Assistant                 1     0   1    0    3    2    1
11   Ward boys / nursing orderly          2     0   0    -1   6    7    -1
12   Sweepers                             3     1   1    0    9    7    2
13   Chowkidar                            1     0   0    1    3    2    1
14   OPD Attendant                        1     0   1    1    3    1    2
     Statistical Assistant / Data entry
15                                        1     0             3    1    2
     operator                                       1    1
16   OT Attendant                         1     0   0    1    3    2    1
17   Registration Clerk                   1     1   1    1    3    0    3
18   Any other staff (specify)
                                 Total                        96   52   44
     Note: ( - ) Surplus staff
 A.     Doctors
S.No.          Personnel          IPHS Norm   Existing staf   Identified Gaps


 1                                                 1                0
        Hospital Superintendent       1
 2                                                 0                3
        Medical Specialist            3
 3      Surgery Specialists           2            2                0
 4      O&G specialist                4            0                4

 5      Psychiatrist                  1            0                1
        Dermatologist /
 6                                                 0                1
        Venereologist                 1
 7      Paediatrician                 2            1                1
        Anesthetist (Regular /
 8                                                 0                2
        trained)                      2
 9      ENT Surgeon                   1            1                0
 10                                                1                0
        Opthalmologist                1
 11                                                1                0
        Orthopedician                 1
 12     Radiologist                   1            0                1
 13     Microbiologist                1            0                1
        Casualty Doctors /
 14                                                10               -4
        General Duty Doctors          6
 15     Dental Surgeon                1            2                -1
 16     Forensic Expert               1            0                 1
                              1
 17     Public Health Manager         1            0                 1
 18                       2                        0                2
        AYUSH Physician               2
 19     Pathologists                  2            1                1
                  Total              34            20               14
 B.     Para-Medicals
S.No.         Personnel          IPHS Norm   Existing staf   Identified Gaps


 1                                                19               56
        Staff Nurse*             75 to 100
        Hospital worker
 2      (OP/ward +OT+ blood                       7                13
        bank)                       20
 3      Sanitary Worker             15            2                13
        Ophthalmic Assistant /
 4                                                2                -1
        Refractionist                1
        Social Worker /
 5                                                0                1
        Counsellor                   1
 6      Cytotechnician               1            0                1
 7      ECG Technician               1            2                -1
 8      ECHO Technician              1            0                1
 9      Audiometrician                            0                0
        Laboratory Technician
 10                                               6                6
        ( Lab + Blood Bank)         12
        Laboratory Attendant
 11                                               1                3
        (Hospital Worker)            4
 12     Dietician                    1            0                1
 13     PFT Technician               -            0
        Maternity assistant
 14                                               3                3
        (ANM)                        6
 15     Radiographer                 2            0                 2
 16     Dark Room Assistant          1            4                -3
                   1
 17     Pharmacist                   5            9                -4
 18     Matron                       1            0                1
 19     Assistant Matron             2            1                1
 20     Physiotherapist              1            1                0
 21     Statistical Assistant        1            0                1
        Medical Records
 22                                               0           1
        Officer / Technician          1
 23     Electrician                   1           1           0
 24     Plumber                       1           0           1
                  Total              154          58          96




 C.
         Administrative Staff

S.No.          Personnel             IPHS Norm   Exist staf        gap

         Manager (Administration)          -           .            -
         Junior Administrative
                                                       1
         Officer                           1                        0
         Office Superintendent             1           0            1
         Assistant                         2           3           -1
         Junior Assistant / Typist         2           1            1
         Accountant                        2           0            2
         Record Clerk                      1           0            1
         Office Assistant                  1           3           -2
         Computer Operator                 1           0            1
                                                       3
         Driver                             2                      -1
         Peon                               2          0            2
         Security Staff*                    2          0            2
                   Total                   17          11           6
 D.     Operation Theatre


S.No.           Staff          IPHS Norm                  Exist staff                       gaps

                             Emergency / FW OT
  1     Staff Nurse                 8                           0                              9
  2     OT Assistant                4                           5                              1
  3     Sweeper                     3                           0                              4
        Total                       15                          5                             14


        Blood Bank / Blood
 E.
        Storage
S.No.           Staff           IPHS Norm
                                                 Current Availability at Hospital   Remarks / Suggestions /
                                Blood Bank            (Indicate Numbers)               Identified Gaps
  1     Staff Nurse                 3                           0                             4
  2     MNA / FNA                   1                           0                             2
  3     Lab Technician              1                           0                             1
  4     Safai Karamchari            1                           1                             1
        Total                       6                           1                             8
TABLE 3                                                    AVAILABLE PERCENTAGE OF EQUEMENTS

                                              DISTRICT -KARGIL




                                                                                             PANIKHAR



                                                                                                         ZANSKAR
                                                                                  CHIKTAN




                                                                                                                    SANKOO
                                                              SHARGOL
                                                  KARGIL




                                                                         DRASS
                                                                                                                                Average
                NAME OF BLOCKS-                                                                                              % of the District
                                  IPHS Norm                                                                                        131
NO OFSC(131)                                      31          13        13       16         14          20         24
Equipment kit
                                     56          31.0        25.1       24.8     15.0       31.0        8.2        20.6            22.2
( kit- C )
                               IPHS Norm
                              Recommended                                                                                           17
NO OF PHCs(16)                                    5           3          3        1          1           1          3
                                                                                                                                   21.2
Suggested equipments                 36          13.4        34.3       21.2     22.2       22.2        11.1       24.0
                                                                                                                                   23.8
Operational labour room              10          10.0        70.0       30.0     0.0        0.0         0.0        56.6
                                                                                                                                   29.4
Pap Smear                            11          25.5        75.7       29.2     0.0        0.0         0.0        75.7

Laboratory Reagents                  10          6.0         6.6        0.0      20.0       20.0        0.0        10.0            8.9

Glassware and other                                                                                                                32.6
equipment                             7          0.0         33.3       0.0      85.7       85.7        0.0        23.8

                                                                                                                                   23.2
Furniture                            25          6.4         14.6       8.0      52.0       52.0        0.0        29.3
                                                                                                                                   23.2
TOTAL                                 99         10.2        39.1       14.7     30.0       30.0        1.9        36.6
                                  IPHS Norm
                                                  0           0          0        1          0           1          1               3
NO OF CHC(3)
                                     32                                          3.1                    6.3        6.3             5.2
Standard Surgical Set-1 FRU
                                     33    33.3    6.1    6.1    15.2
Standard Surgical Set - II
IUD Insertion Kit                    19    21.1    21.1   21.1   21.1

                                     17    52.9    23.5   23.5   33.3
CHC Standard Surgical Set - III
Normal Delivery                      12    58.3    91.7   91.7   80.6

                                     16    31.3    0.0    0.0    10.4
Standard Surgical Set - IV
                                     21    42.9    4.8    4.8    17.5
Standard Surgical Set - V
                                     11    118.2   0.0    0.0    39.4
Standard Surgical Set - VI
                                     17     0.0    0.0    0.0    0.0
Equipment for Anaesthesia
Equipment for Neo-natal              10     0.0    0.0    0.0    0.0
Resuscitation
                                     15     0.0    0.0    0.0    0.0
Materials Kit for Blood tranfusion
                                     11     0.0    0.0    0.0    0.0
Equipment for Operation theatre
Equipment for Labour room            13    15.4    61.5   61.5   46.2

                                     9     55.6    77.8   77.8   70.4
Equipment for Radiology
                                     236   94.3    47.1   47.1   62.9
TOTAL NO.
    TABLE 4                                             AVARAGE AVAILABLE PERCENTAGE OF MEDICINE
                                                                      DISTRICT -KARGIL




                                                                                           PANIKHAR
                                                            SHARGOL




                                                                                                       ZANSKAR
                                                                                CHIKTAN




                                                                                                                  SANKOO
                                               KARGIL




                                                                       DRASS
                                                                                                                           Average
                                                                                                                           % of the
                NAME OF BLOCKS-                                                                                            District
                              IPHS Norm
                                              31            13        13       16         14          20          24         131
    NO OFSC
    Name of Drug
                                      5                                                                                      27.3
1   Quantity ( Kit- A )                       44.3         10.8       36.9     10.0       44.3        27.6       17.3
    Name of Drug
                                      9                                                                                      59.9
2   Quantity ( Kit- B )                       61.1         60.7       65.8     41.0       61.1        46.0       83.7
    Drugs required by
                                      6                                                                                      48.7
3   ANMs and LHVs                             51.2         30.8       55.1     32.3       51.2        44.4       75.8
    Other Drugs and
                                      8                                                                                      67.6
4   Vaccines                                  75.9         52.9       83.7     47.7       75.9        59.5       77.6
    Medicines required
                                      7                                                                                      20.4
5   for NDCP                                  20.4         17.6       17.6     13.4       20.4        17.7       35.4
    Contraceptives required for
                                      4                                                                                      63.3
6   F.Plang.                                  46.4         57.7       55.8     71.9       46.4        33.3       131.8
    Proposed Drug List for
                                     12                                                                                      33.4
7   A.Wadi Centres                            32.1         37.8       55.1     31.3       32.1        31.7       13.3

    Total                            51                                                                                      45.8
                                              47.4         38.3       52.9     35.3       47.4        37.2       62.1

                                                                                                                             17
    NO OF PHCs                    IPHS Norm    5            3          3        1          1           1          3
1    Essential & emergecy
     obstetrics care drugs     38   60.5   46.6   31.6   78.9    10.5   15.8    46.5   41.5

2    Antidots
                               4    31.3   21.4   0.0    25.0    25.0   25.0    0.0    18.2

3    Anticonvulsant /
     Antiepileptics            4    0.0    0.0    0.0    50.0    25.0   25.0    0.0    14.3

4    Antiinfective Medicines
                               5    30.0   28.6   80.0   40.0    20.0   60.0    13.3   38.8

5    Antifilarials
                               1    75.0   42.9   0.0     0.0    0.0     0.0    33.3   21.6

6    Antibacterials
                               16   18.8   17.9   18.8   56.3    12.5    0.0    18.8   20.4

7    Dermatological medicine
                               14   25.0   20.4   0.0    28.6    7.1     7.1    14.3   14.7

8    Antileprosy &
     Antitubercullar           2    37.5   21.4   0.0    100.0   0.0    50.0    0.0    29.8

9    Antifungal medicine
                               4    0.0    0.0    0.0    25.0    0.0     0.0    8.3    4.8

10   Antiprotozoal medicine
                               5    35.0   25.7   0.0    40.0    0.0     0.0    26.7   18.2

11   Blood Products and
     Plasma Substitutes        13   13.5   9.9    0.0    38.5    0.0     0.0    12.8   10.7

12   Antiseptics
                               6    12.5   11.9   0.0    83.3    0.0    100.0   11.1   31.3

13   Disinfectants
                               3    8.3    4.8    0.0     0.0    33.3    0.0    0.0    6.6

14   Diuretics
                               2    25.0   35.7   0.0    100.0   0.0    100.0   50.0   44.4
15   Gastrointestinal
                                     22       47.7   39.0    22.7   63.6    0.0    27.3   50.0   35.8

16   Hormones, Endocrine &
     Contraceptives                  10       2.5     1.4    0.0    20.0    0.0    10.0   6.7    5.8

17   Ophthalmological
     preparation                     12       39.6   25.0    0.0    25.0    0.0    8.3    8.3    15.2

18   Psychotic Disorders
                                     15       40.0   24.8    0.0    40.0    20.0   13.3   8.9    21.0

19   Solutions correcting water
     Electrolyte and Acid-            9       36.1   34.9    22.2   44.4    22.2   55.6   51.9   38.2
     Base Disturbances
20   Vitamins & Minerals
                                      3       41.7   38.1    33.3   100.0   0.0    0.0    44.4   36.8

21   Drugs under RCH
                                      1       25.0   114.3   0.0     0.0    0.0    0.0    0.0    19.9

22   Product Strength
     formulation Units               31       38.7   35.9    19.4   90.3    6.5    0.0    26.9   31.1

23   RTI / STI Drugs
                                     10       55.0   37.1    30.0    0.0    0.0    0.0    6.7    18.4

24   Drugs and Consumable
     for MVA                          6       8.3    11.9    16.7    0.0    0.0    0.0    5.6    6.1

                                     236                                                         22.6
     TOTAL                                    29.5    27.1   11.4   43.7    7.6    20.7   18.5

     CHC                          IPHS Norm

                                                                                          33.0   34.7
1    Essential drugs                 70                             33.0           38.1
DISTRICT LEH
Infrastructure: Table:1
       Out of 121 SC’s in the District, 14% of sub-centers and 0% PHC’s are running in rented buildings, in which 25% SC’s are in poor
       condition.
       Only 32% SC’s and 59% of PHC’s are getting water supply through tap, bore well, hand pump, tube well and wells and 24% PHC’s
       have tap water supply.
       61% SC’s and 59% of PHC’s have no electricity and 29 % PHC’s have electric facility in all parts of health centre.
       Facility survey also indicated that availability of separate toilet is only in 16% of SC’s, 35% PHC’s and 50 % of CHC’s are available.
       Only 76% PHC’s have laboratory facilities.
       The availability of a labor room, to achieve NRHM Goal of maximum institutional delivery, is important facility for a SC and PHC.
       However, only 4% SC’s, 65% PHC’s and 100% CHC’s have this important facility.
       For communication purposes, telephone facility is only 12% in PHC’s .
       To attend emergency cases, it is necessary to have staff quarters in the compound. Only 18% of sub-center’s’, 53% of PHC’s and
       0% CHC’s have quarters for staff.
       There is no blood storage unit available at CHC.
       Facility of ECG, x ray, and ultra sound was available at CHC. Only 50% of Cardiac Monitor for OT is present.

Manpower: Table:2
     The health assistant (Female) also known as ANM has a key role to play in the implementation of RCH programme at grass root
     level. 138 ANM’s are looking after the work of 121 SC’s. There is a gap of 104 ANM’s as per IPHS norms.
     Total requirement of staff at 17 PHC’s is 306 and only 147 staff are in position, which reflects the shortage of 52 % staff. There is,
     Specially, a shortage of M.O’s (20) ,Nurse (30), health assistant (28), and clerks (27).
     In D.H there is a shortage of 14 medical staff and 96 Para-medical staff.
Equipments: Table:3
       Certain equipment is essential for the delivery of RCH services at SC. Out of 55 (recommended list of) equipment for SC on an
       average only 41 % equipment was available at the SC’s.
       As far as availability of equipments at PHC is concerned only 59.2 % equipments were available.
       There is availability of standard surgical set-I 53.9%, standard surgical set II 37.9%, standard surgical set-III 35.3%, standard
       surgical set-IV 34.4, of standard surgical set-V 4.7%, standard surgical set VI 6.8%, normal delivery set 68.7%, equipment for
       anaesthesia 19.1% ,equipment for neo natal resuscitation 40% and kit for blood transfusion was reported 1.7% are avilable.On an
       average 43.1% of equipments are available at CHC.
Medicines:Table:4
        The Supply of Kit-A for SC was unsatisfactory (37.2 %). Though Kit-B was found available at 76.1% at sub centres and availability of
        contraceptives was 40.7 %.
        About 44.8 % medicines were reported available out of total medicine recommended for PHC. Availability of Antifilarials (17.6%),
        dermatological medicine (42.4 %), vitamins & minerals (78.4%), Antidots (27.5 %), Anti infective medicine (52.9%), Anti bacterial (56.6%) was
        noticed and remaining 18 category of medicines fall between 2.5-41 % availability.
        Supply of essential drugs at CHC was found satisfactory (76.4%).



Table:1                                                 Percentage Availability of Infrastructure
                                                                  District: Leh

                       Indicators                     SC (121)               PHC (17)                CHC (2)                        DH


              Building (Govnt. + Donated)                 86                    100                     100                         100
   1
              Building (Rented)                           14                     0                       0                           0
   2
              Condition of Building (Good +
                                                          75
   3          Fair)
               Water Supply (Tap, borewell/
                                                          32                    59                      100
   4          handpump/tubewell, well)
  4.1         Tap water supply                                                  24                      50
   5          Electricity                                 39                    41                      100
  5.1         In all parts of hospital                                          29                      50
              Elertic supply (power
              generation stablization)
   6          Separate Toilet                             16                    35                      50
  6.1         Sep.Toilet with running water                                                             50
   7          Furniture                                   39                    66
   8          Labor Room                                  4                     65                      100                         100
  8.1         Aseptic labor room                                                                        100
   9          Avail.of Quater for staff                   18                    53                       0                          100
              Number of beds available
                                                                                 6                       3                          130
  10          (Average)
  11          Laboratory                                                        76                      100                         100
  12          Operation Theatare                                                6                       50                          100
13   Waste Disposal (Burnt+Dump)      65   50
14   Availability of incenator             50
15   Telephone                        12   100
16   Computer                         12   100
17   Generator/Invertor               24   100
18   Vhiecle                          65   67
19   Emergency Room / Casualty             50
     Separate wards for males and
                                           50
20   females (Yes/No)
21   No. of beds : Male                    3
22   No. of beds : Female                  3

23   Availability of ECG facilities        50    100

24   X-Ray facility                        100   100

25   Ultrasound facility                   50    100

26   Cardiac Monitor for OT                50    100

27   Blood Storage Unit available          0

28   Blood Bank Facility

29   Other Investigative Facility                59
     Heating ventilatoin & air
30   conditioning
     Lift & vertical transport
31
     Refrigeration
32
           Table: 2                               Identified Gaps of Manpower in The District
                                                  District- : Leh




                                                                                                             No. of Existing
                                                                                            Required Staff
                                                                                               No. 0f




                                                                                                                  Staff
             Name of Blocks                                                                                                    Total GAP

                                         Leh    Kharu   Nubra     Khaltsi   Nyoma Tangtsi
                              IPHS
No. of Sub- Centres           Norm                                                                                                     121
                                           26    11      23         28        21     12
ANM                              2         26    11      23         28        4      12     242              138                 104
N0. Of PHC's                               3      1       4          5        2      2                                                  17
MO                               2         4      1       5          5        2      3       34                14                 20
Pharmacist                       1         1      0       0          0        0      0       17                16                  1
Nurse                            3         3      2       9          9        3      4       51                21                 30
Female Health Worker             1         0      0       0          -2       1      2       17                16                  1
Health Educator                  1         2      1       2          4        2      3       17                  3                14
Health Assistant
                                 2                                                           34                  6                28
(one male and one Female)                  6      2       7          9        2      2
Clerks                           2         6      2       8          6        2      3       34                  7                27
LT                               1         0      0       0          2        0      1       17                14                  3
Driver                           1         1      0       1          2        0      0       17                13                  4
Class lV                         4         6      2       7          7        6      3       68                37                 31
             Total                                                                          306              147                 159
No. of CHC's(2)
                                                              1
A.    CLINICAL MANPOWER
1    General Surgeon                 1                        0      1                          2                1                 1
2    Physician                       1                        1      1                          2                0                 2
     Obstetrician /
3                                    1                        1      1                          2                0                 2
     Gynaecologist
4    Paediatrics                      1    1   1    2    0    2
5    Anaesthetist                     1    0   1    2    1    1
     Public Health Programme
6                                     1    1   1    2    0    2
     Manager
7    Eye Surgeon                      1    0   1    2    1    1
8    Other specialists (if any)
     General duty officers
9
     (Medical Officer)
               Total
B.   SUPPORT MANPOWER
1    Nursing Staff                   7+2
a    Public Health Nurse              1        1    2    1     1
b    ANM                              1    0   -1   2    3    -1
c.   Staff Nurse
                                      7    0   6    14   8    6
d.   Nurse/Midwife
6    Dresser                          1    0   1    2    1     1
7    Pharmacist / compounder          1    0   0    2    2     0
8    Lab. Technician                  1    0   -1   2    3    -1
9    Radiographer                     1    0   1    2    1    1
10   Ophthalmic Assistant             1    0   1    2    1    1
     Ward boys / nursing
11                                    2    0   1    4    3    1
     orderly
12   Sweepers                         3    0   1    6    5    1
13   Chowkidar                        1    0   1    2    1    1
14   OPD Attendant                    1    0   1    2    1    1
     Statistical Assistant / Data
15                                    1        1    2    1    1
     entry operator
16   OT Attendant                     1        1    2    1    1
17   Registration Clerk               1        1    2    1    1
18   Any other staff (specify)
                             Total                  62   36   26
     Note: ( - ) Surplus staff
DH – AVAILABILITY OF MANPOWER & IDENTIFIED GAPS:
 A.     Doctors

S.No.         Personnel           IPHS Norm        Existing staf   Identified Gaps


  1                                                     1                 0
        Hospital Superintendent       1
  2                                                     0                 3
        Medical Specialist            3
  3     Surgery Specialists           2                 2                 0
  4     O&G specialist                4                 0                 4

  5     Psychiatrist                  1                 0                 1
        Dermatologist /
  6                                                     0                 1
        Venereologist                 1
  7     Paediatrician                 2                 1                 1
        Anesthetist (Regular /
  8                                                     0                 2
        trained)                      2
  9     ENT Surgeon                   1                 1                 0
 10                                                     1                 0
        Opthalmologist                1
 11                                                     1                 0
        Orthopedician                 1
 12     Radiologist                   1                 0                 1
 13     Microbiologist                1                 0                 1
        Casualty Doctors /
 14                                                     10               -4
        General Duty Doctors          6
 15     Dental Surgeon                1                 2                -1
 16     Forensic Expert               1                 0                 1
                              1
 17     Public Health Manager         1                 0                 1
 18                       2                             0                 2
        AYUSH Physician               2
 19     Pathologists                 2                  1                 1
                  Total              34                 20               14
 B.     Para-Medicals

S.No.        Personnel           IPHS Norm    Existing staf   Identified Gaps

  1                                                19               56
        Staff Nurse*              75 to 100
        Hospital worker
  2     (OP/ward +OT+ blood                        7                13
        bank)                        20
  3     Sanitary Worker              15            2                13
        Ophthalmic Assistant /
  4                                                2                -1
        Refractionist                1
        Social Worker /
  5                                                0                 1
        Counsellor                   1
  6     Cytotechnician               1             0                 1
  7     ECG Technician               1             2                -1
  8     ECHO Technician              1             0                 1
  9     Audiometrician                             0                 0
        Laboratory Technician
 10                                                6                 6
        ( Lab + Blood Bank)          12
        Laboratory Attendant
 11                                                1                 3
        (Hospital Worker)            4
 12     Dietician                    1             0                 1
 13     PFT Technician               -             0
        Maternity assistant
 14                                                3                 3
        (ANM)                        6
 15     Radiographer                 2             0                2
 16     Dark Room Assistant          1             4                -3
                   1
 17     Pharmacist                   5             9                -4
 18     Matron                       1             0                 1
 19     Assistant Matron             2             1                 1
 20     Physiotherapist              1             1                 0
 21     Statistical Assistant        1             0                 1
        Medical Records
 22                                              0           1
        Officer / Technician          1
 23     Electrician                   1           1          0
 24     Plumber                       1           0          1
                  Total              154         58          96




 C.     Administrative Staff


S.No.         Personnel             IPHS Norm   Exist staf       gap


        Manager (Administration)           -          .           -
        Junior Administrative
                                                      1
        Officer                            1                       0
        Office Superintendent              1          0            1
        Assistant                          2          3           -1
        Junior Assistant / Typist          2          1            1
        Accountant                         2          0            2
        Record Clerk                       1          0            1
        Office Assistant                   1          3           -2
        Computer Operator                  1          0            1
                                                      3
        Driver                             2                      -1
        Peon                               2           0           2
        Security Staff*                    2           0           2
                  Total                    17         11           6
 D.      Operation Theatre




                                    Norm
 S.No.




                                                               Exist
                                    IPHS




                                                                                                     gaps
                   Staff




                                                               staff
                              Emergency / FW OT
 1       Staff Nurse                 8                           0                                  9
 2       OT Assistant                4                           5                                  1
 3       Sweeper                     3                           0                                  4
         Total                       15                          5                                  14


         Blood Bank / Blood
 E.
         Storage
S.No.            Staff           IPHS Norm
                                                  Current Availability at Hospital   Remarks / Suggestions / Identified
                                 Blood Bank            (Indicate Numbers)                         Gaps
 1       Staff Nurse                 3                           0                                   4
 2       MNA / FNA                   1                           0                                   2
 3       Lab Technician              1                           0                                   1
 4       Safai Karamchari            1                           1                                   1
         Total                       6                           1                                   8
TABLE 3                                       AVAILABLE PERCENTAGE OF EQUEMENTS

                                                               DISTRICT –Leh

      NAME OF BLOCKS-                 Leh       Kharu   Nubra     khaltsi   Nyoma     Tangtsi      Average
                                                                                                % of the District

NO OFSC(121)              IPHS Norm      26      11      23         28         21       12

Equipment kit                56       41.0       40.4   46.8       33.1        43.3    41.4           41.0
( kit- C )
NO OF PHCs(17)        IPHS Norm   3               1       4         5           2       2
                     Recommend
                          ed
Suggested equipments      36     54.6            38.8   31.9       40.0        58.3    50.3           45.7
Operational labour        10     86.6            90.0   52.5       48.0        60.0    96.2           72.2
room
Pap Smear                 11     81.8           18.1    70.4       72.7        0.0     99.5           57.1
Laboratory Reagents       10     66.6           20.0    22.5       52.0        85.0    47.4           48.9
Glassware and other        7    100.0           100.0   96.4       77.1        92.8    16.9           80.5
equipment
Furniture                 25     41.3            60.0   28.0       59.2        78.0    39.7           51.0
TOTAL                     99     71.8            54.5   50.3       58.2        62.4    58.3           59.2
NO OF CHC(2)                 IPHS Norm                    1         1

Standard Surgical Set-       32                           56.2     51.5                               53.9
1 FRU
Standard Surgical Set -      33                         33.3       42.4                               37.9
II
IUD Insertion Kit            19                         78.9       78.9                               78.9
CHC Standard Surgical        17                          47        23.5                               35.3
Set - III
Normal Delivery              12                         91.6       45.8                               68.7
Standard Surgical Set -      16                         12.5       56.2                               34.4
IV
Standard Surgical Set -      21                          4.7        4.7                               4.7
V
Standard Surgical Set -      11                    9          4.5                                         6.8
VI
Equipment for                17                   23.5        14.7                                        19.1
Anaesthesia
Equipment for Neo-           10                   40          40.0                                        40.0
natal Resuscitation
Materials Kit for Blood      15                    0          3.3                                         1.7
tranfusion
Equipment for                11                   81.8        68.1                                        75.0
Operation theatre
Equipment for Labour         13                   61.5        65.3                                        63.4
room
Equipment for                9                    88.8        77.7                                        83.3
Radiology
TOTAL NO.                    236               44.9           41.2                                        43.1




       TABLE 4                                AVARAGE AVAILABLE PERCENTAGE OF MEDICINE

                                                         DISTRICT -LEH
                                                                                                                 Average
                                                                                                                 % of the
                    NAME OF BLOCKS-                    Leh    Kharu   Nubra   khaltsi   Nyoma   Tangtsi          District

                                      IPHS Norm                                                                    121
        NO OF SC                                         26     11     23       28        21       12
       Name of Drug
                                          5                                                                        37.2
  1    Quantity ( Kit- A )                             37.2    34.5    79.1     15.5     33.0     24.0
       Name of Drug
                                          9                                                                        76.1
  2    Quantity ( Kit- B )                             76.2    90.1    87.9     50.6     91.6     60.0
       Drugs required by
                                          6                                                                        45.9
  3    ANMs and LHVs                                   45.9    48.5    60.1     53.7     35.8     31.5
     Other Drugs and
                                       8                                                   91.1
4    Vaccines                                  91.1    97.7    95.6   85.6   99.3   77.5
     Medicines required
                                       7                                                   25.8
5    for NDCP                                  25.0    18.2    32.2   17.9   35.7   25.7
     Contraceptives required for
                                       4                                                   40.7
6    F.Plang.                                  40.7    50.0    39.1   30.5   33.7   50.0
     Proposed Drug List for
                                      12                                                   41.7
7    A.Wadi Centres                            41.7    36.3    56.8   40.4   60.0   15.0
     Total                            51       51.1    53.6    64.4   42.0   55.6   40.5   51.2


     NO OF PHCs                    IPHS Norm    3       1       4      5      2      2
1    Essential & emergecy
     obstetrics care drugs            38       84.2    81.5    89.4   61.1   85.5   63.0   77.4

2    Antidots                          4       25.0    25.0    25.0   30.0   25.0   35.0   27.5
3    Anticonvulsant /
     Antiepileptics                    4       66.6    50.0    37.5   10.0   12.5   26.0   33.8
4    Antiinfective Medicines          5        53.3    60.0    60.0   36.0   30.0   78.0   52.9
5    Antifilarials                    1         0.0     0.0    50.0    0.0   0.0    56.0   17.6
6    Antibacterials                   16       64.5    50.0    78.1   40.0   34.3   73.0   56.6
7    Dermatological medicine          14       45.2    35.7    66.1   20.0   67.8   20.0   42.4
8    Antileprosy &
     Antitubercullar                   2        0.0     0.0    25.0   10.0   0.0    18.0   8.8
 9   Antifungal medicine               4        0.0     0.0     0.0   15.0   10.0   0.0     2.5
10   Antiprotozoal medicine            5       46.6    60.0    45.0   32.0   40.0   44.0   44.7
11   Blood Products and
     Plasma Substitutes               13       51.2    38.4    21.1   26.2   46.1   2.0    30.7

12   Antiseptics                      6         38.8    66.6   75.0   30.0   58.3   32.0   50.0
13   Disinfectants                    3         33.3     0.0   66.6   26.7   33.3   86.0   41.1
14   Diuretics                        2        100.0   100.0   75.0   50.0   50.0   65.0   73.5
15   Gastrointestinal                 22        72.7    81.8   59.1   51.8   56.8   69.0   65.2
16   Hormones, Endocrine &
     Contraceptives                   10       23.3    30.0    10.0   12.0   40.0   3.0    19.4
17   Ophthalmological
     preparation                     12       38.6   58.3     37.5    28.3   41.6   37.0   40.2

18   Psychotic Disorders             15       40.0   53.3     18.3    32.0   13.3   37.0   32.5
19   Solutions correcting water
      Electrolyte and Acid-           9       77.7   88.8     86.1    57.8   88.8   59.0   76.4
     Base Disturbances
20   Vitamins & Minerals              3       88.8   100.0    100.0   53.3   50.0   78.0   78.4
21   Drugs under RCH                  1        0.0    0.0      25.0   20.0   0.0    60.0   17.6
22   Product Strength
     formulation Units               31       70.9   74.2     14.5    52.9   70.9   36.0   53.1

23   RTI / STI Drugs                 10       53.3   40.0     45.0    62.0   60.0   84.0   57.0
24   Drugs and Consumable
     for MVA                          6       72.2   83.3     58.3    93.3   41.6   95.0   75.4

     TOTAL                           236      47.8     49.0    49     35     39.8   48.2   44.8


     CHC                          NRHM Norm

                                                                                           76.4
1    Essential drugs                 70                       71.4    81.4
DISTRICT BANDIPORA


 Infrastructure: Table:1
         Out of 51 SC’s in the District 84% and 45% PHC’s are running in rented buildings. As far as condition of SC’s building is
         concerned. 67% are in poor condition.
         Only 34% SC’s and 40% PHC’s are getting water supply through tap, bore well, hand pump, tube well and well. Out of total,
         36% PHC’s have tap water supply.
         Ninety seven percent SC’s and 50% PHC’s are functioning without electric facility and only 30 % PHC’s have electric facility
         in all parts of the health centre.
         Facility survey also revealed that availability of separate toilet at SC,s is 0% and PHC’s is 40% . Though CHC has this facility
         but 67% of CHC’s are without running water.
         The availability of laboratory in PHC is Only 9%.
         The availability of a labor room, to achieve NRHM Goal of maximum institutional delivery, is important facility for SC and
         PHC. This facility is not available at SC’s and only 30% PHC’s have this critical facility.
         For communication purposes, only 9% PHCs have telephone facility.
         To attend emergency cases, it is necessary to have staff quarters in the compound. There is only 22% staff quarters for
         PHC’s , 33% at CHC’s and 0% in SC’s.
         A separate aseptic labor room is critical in reducing the chances of infection during delivery. 66% separate aseptic labor
         rooms are available at CHC’s and blood storage units are unavailable at CHC’s.
 Manpower: Table:2
         The health assistant (Female) also known as ANM has a key role to play in the implementation of RCH programme at grass
         root level. 28 ANM’s are looking after the work of 51 SC’s. There is a gap of 74 ANM’s as per IPHS norm.
         Total requirement of staff at 12 PHC’s is 212 and only 87 staff are in position, which reflects the shortage of more than 60 %
         staff. There is, especially, a shortage of Nurses (29), health assistants (19), and clerks (15).
          Only 12% of the clinical manpower is not available at CHC’s.

 Equipments: Table:3
       Certain equipment is essential for the delivery of RCH services at SC. Out of 56 (recommended list of) equipment for SC
       0% equipment were not available at SC’s.
       As far as availability of equipments at PHC is concerned, only 21 % equipments were found available.
       In CHC availability of equipment is 17.8%.There is availability of standard surgical set-I 41.7%, standard surgical set-
       II(21)%, standard surgical set-III (15.7%), standard surgical set IV (18.8) ,standard surgical set-V (9.5), standard surgical set-
       VI (12%), normal delivery set (30%), equipment for anesthesia (19.6%), and rest of the equipment is 4-17%..
Medicines:Table:4
      The Supply of Kit-A for SC was found unsatisfactory (0 %) .(6%) Kit-B was found available at sub centres and availability of
      contraceptives was 0nly 32 %.
      About 11 % medicines were reported available out of total medicines recommended for PHC’s Availability of Antifilarials
      (6%), dermatological medicine (9 %), vitamins & minerals (11%), Antidots (33 %), Anti infective medicine (12%), Anti bacterial
      (8%) emergency drugs (34%) ,antilipracy (50%), Diuretics (33%) ,RTI/STI (33%) was noticed and remaining 0-16%.
      Supply of essential drugs at CHC was found unsatisfactory. (33%)
Table:1                                   Percentage Availability of Infrastructure

                                               District: Bandipora
                        Indicators               SC (51)       PHC (12)        CHC( 3 )   DH (0)

   1      Building (Govnt. + Donated)              16             55             100
   2      Building (Rented)                        84             45              0
          Condition of Building (Good +
                                                   38             NA             Na
   3      Fair)
          Water Supply (Tap, borewell/
                                                   34             40             100
   4      handpump/tubewell, well)
   4.1    Tap water supply                         Na             36             100
   5      Electricity                               3             50             100
   5.1    In all parts of hospital                 Na             30             100
          Elertic supply (power generation
                                                   Na             NA             Na
   5.2    stablization)
    6     Separate Toilet                          0              40             100
   6.1    Sep.Toilet with running water            Na             NA              33
    7     Furniture                                22             45              80
    8     Labor Room                               0              30             100
   8.1    Aseptic labor room                       Na             NA              66
    9     Avail.of Quater for staff                0              22              33
          Number of beds available
                                                                     7           23
   10     (Average)
   11     Laboratory                                                 9           100
   12     Operation Theatare                                         0           100
   13     Waste Disposal (Burnt+Dump)                             64             66
14   Availability of incenator        NA    33
15   Telephone                         9   100
16   Computer                          0    0
17   Generator/Invertor               27   100
18   Vhiecle                          27    33
19   Emergency Room / Casualty             100
     Separate wards for males and
                                           66
20   females (Yes/No)
21   No. of beds : Male                    13
22   No. of beds : Female                  10
23   Availability of ECG facilities        100
24   X-Ray facility                        100
25   Ultrasound facility                   100
26   Cardiac Monitor for OT                100

27   Blood Storage Unit available          0
28   Blood Bank Facility
29   Other Investigative Facility
     Heating ventilatoin & air
30   conditioning
31   Lift & vertical transport
32   Refrigeration
     Na = Not applicable
Table: 2                                         Identified Gaps of Manpower
                                  District- Bandipora




                                                Bandipora




                                                                    Required




                                                                               Existing
                                       Hajjan




                                                                                No. of
                                                            Gurez

                                                                     No. 0f




                                                                                          Gaps
                                                                                          Total
                                                                      Staff




                                                                                Staff
Name of Blocks


                            IPHS
No. of Sub- Centres (51)               24       15          12
                             Norm
ANM                           2        35       20          20       102         28       74
N0. Of PHC's(12)                       5        3           4                     0
MO                            2         3       5            4        24         13       11
Pharmacist                    1        -1       0           -1        12         10        2
Nurse                         3        12       8           12        44         15       29
Female Health Worker          1         2       2            4        12         5         7
Health Educator               1         4       3            4        12         2        10
Health Assistant                        7       6            8
                              2                                       24          5       19
(one male and one Female)
Clerks                        2        6        4           7         24         9        15
LT                            1        3        3           3         12         3         9
Driver                        _        2        3           2                    -7        7
Class lV                      4        6        4           7         48         32       16
TOTAL                                                                                     125
No. of CHC's(3)
                                       1        1           1
A. CLINICAL MANPOWER
General Surgeon               1        1        0           0          3          2        1
Physician                     1        1        0           1          3          2        1
Obstetrician / Gynaecologist                   1    1    1    0    3    2    1
Paediatrics                                    1    1    1    1    3    2    1
Anaesthetist                                   1    1    0    0    3    2    1
Public Health Programme Manager                1    1    1    1    3    2    1
Eye Surgeon                                    1    1    1    1    3    2    1
Other specialists (if any)
General duty officers (Medical Officer)
B. SUPPORT MANPOWER
Nursing Staff                                 7+2
Public Health Nurse                            1    0    0    1    3    2    1
ANM                                            1    0    0    0    3    2    1
Staff Nurse
                                               7    3    3    6    21   17   4
Nurse/Midwife
Dresser                                        1    0     1    1   3    2    1
Pharmacist / compounder                        1    -3    1   -3   3    6    -3
Lab. Technician                                1    0     0   -1   3    2    1
Radiographer                                   1    0    -1   -1   3    2    1
Ophthalmic Assistant                           1    1     0    1   3    2    1
Ward boys / nursing orderly                    2    -2   -3   -7   6    8    -2
Sweepers                                       3    -3    1    1   9    12   -3
Chowkidar                                      1    -1    0    1   3    4    -1
OPD Attendant                                  1    1     1    0   3    2    1
Statistical Assistant / Data entry operator    1    1     1    1   3    2    1
OT Attendant                                   1    0     0    1   3    3    0
Registration Clerk                             1    0          0   3    3    0
Any other staff (specify)
TOTAL
  Note: ( - ) Surplus staff
Table:3                                      Percentage Availability of Equipments

                                                   District: Bandipora




                                                           Bandipora
                                          Hajjan




                                                                          Gurez
                                                                                     Avg. %age
Name of Blocks
                                                                                     of District


                             IPHS Norm
No. of SC's (51)                         24                15             11

kit- C                          56       15.0             15.0           33.0          21.0

No. of PHC's (12)                         5                3              4
Suggested equipments            36       25.0             17.0            8.0          16.7
Operational labour room         10       0.0              0.0            30.0          10.0
Pap Smear                       11       55.0             36.0           66.0          52.3
Laboratory Reagents             10       3.0              0.0            60.0          21.0

Glassware and other
                                 7       33.0             29.0           100.0         54.0
equipment
Furniture                       25       0.0              2.0            62.0          21.3
TOTAL                           99
No. of CHC's(3)                           1                1              1
Standard Surgical Set-1         32       59               18.8           46.9          41.7
Standard Surgical Set - II      33       33               15.2           15.2          21.2
IUD Insertion Kit               19       16               5.3             0.0           7.0
Standard Surgical Set - III      17    6    17.6   23.5   15.7
Normal Delivery                  12    58   33.3   0.0    30.6
Standard Surgical Set - IV       16    25   18.8   12.5   18.8
Standard Surgical Set - V        21    0    9.5    19.0   9.5
Standard Surgical Set - VI       11    0    18.2   18.2   12.1
Equip. for Anaesthesia           17    35   17.6   5.9    19.6
Equip.for Neo-natal
                                 10         0.0    0.0    0.0
Resuscitation                          0
Materials Kit for Blood trans.   15    0    0.0    6.7    2.2
Equip. for OT                    11    18   18.2   54.5   30.3
Equip. for Labour room           13    8    46.2   23.1   25.9
Equip. for Radiology             9     44   0.0    0.0    14.8
TOTAL                            236   22   15.6   16.1   17.8
Table: 4                                Percentage Availability of Medicine

                                            District: Bandipora




                                                           Bandipora
                                              Hajjan




                                                                         Gurez
                                                                                    Average
                Name of Blocks
                                                                                 % of the District


                                 IPHS
Sc's                             Norm         24           15           12
Kit- A                            5           0             0            0              0
Kit- B                            9           6             0           11              6
Drugs required byANMs and
                                  6           0             0           50              17
LHVs
Other Drugs & Vacci.              8           15           36           13              21
Med. Req.for NDCP                 7            2            0           43              15
Contracep. Req.for F.Plang.       4           12           10           75              32
Drug List for AWC                 12          13           39           50              34
Total                            51           7           12.1          34.6          17.86
PHC's                                         5            3             4
Blood Products and Plasma
                                  38          0            7.0          95              34
Substitutes
Antidots                          4           0            0.0          100             33
Anticonvul./ Antiepileptics       4           0            0.0           0              0
Antiinfective Medicines           5           20          20.0          20              20
Antifilarials                     1           0            0.0           0              0
Antibacterials                        16    0     13.0   13      9
Dermatological medicine               14    0     7.0     0      2
Antilep.& Antitubercullar             2     100   50.0    0     50
Antifungal medicine                   4     0     0.0    25      8
Antiprotozoal medicine                5     7     20.0   20     16
Blood Products and Plasma
                                      13     0    0.0     0      0
Substitutes
Antiseptics                           6      6    0.0     0      2
Disinfectants                         3      0    0.0    33     11
Diuretics                             2     0     50.0   50     33
Gastrointestinal                      22    0     0.0     5      2
Hormones, Endocrine &
                                      10     0    0.0     0      0
Contraceptives
Ophthalm. preparation                 12    33    0.0     0     11
Psychotic Disorders                   15    0     0.0    20      7
Solns. correcting water Electrolyte
                                      9      0    11.0    0      4
             & Acid-
Vitamins & Minerals                   3     0     0.0     0      0
Drugs under RCH                       1     0     0.0     0      0
Product Strength formulation
                                      31     0    13.0    6      6
Units
RTI / STI Drugs                       10     0    10.0   60     23
Drugs & Consumable for MVA            6     0     17.0    0      6
TOTAL                                 236   6.9   9.1    18.6   11.5
CHC's(3)
Essential drugs                       70    22     0     77     33
DISTRICT KULGAM:
Infrastructure: Table:1
     Out of 82 SC’s in the District, 77 SC’c (77%) and 30% PHC’s are running in rented buildings. As far as condition of SC’s is concerned 100% are
     in poor condition.
     Only 61% PHC’s have tap water supply and 100% SCs are without any water facility.
     90% SC’s and 35% PHC’s are functioning without electric facility and only 20 % PHC’s have electric facility in all parts of the health centre.
     Facility survey also revealed that availability of separate toilet at SC is nil and 35% PHCs have this facility This facility at CHC is almost negligible.
     The availability of laboratory in PHC is to test blood & urine of the women seeking antenatal care as well as for the diagnosis of RTI/STI among
     men and women is critical. Only 48% have laboratory facility.
     The availability of a labor room, to achieve NRHM Goal of maximum institutional delivery, is important facility for a SC and PHC. 2% SC’s and
     22% PHC’s have this critical facility.
     For communication purposes, the telephone facility at PHC is not available and 50% CHCs have this facility..
     To attend emergency cases, it is necessary to have staff quarters in the compound.Out of 4 CHCs only 1 CHC has quarter for staff. 30% PHC’s
     have residential facility for the staff.There is not a single SC with the facility of staff quarter.
     A separate aseptic labor room is critical in reducing the chances of infection during delivery. 50% separate aseptic labor rooms are available at
     CHCs ,PHCs (0%) and blood storage units are unavailable at CHCs.
     Out of total CHCs only 1 CHC has the facility of ECG, X Ray, ultra sound and cardiac monitor for OT.
Manpower: Table:2
     The health assistant (Female) also known as ANM has a key role to play in the implementation of RCH programme at grass root level. 85 ANM’s
     are looking after the work of 82 SC’s.
     Total requirement of staff at 23 PHC’s is 416 and only 197 staff are in position, which reflects the shortage of more than 51 % staff. There is,
     especially, a shortage of Nurses (58), health assistant (42), and clerks (34).
     Situation of CHC is alarming, where only10% of the clinical manpower is available. Vacant post of specialists make CHC virtually non-functional.
     There is an urgent need to recruit professionals as soon as possible that will help to reduce the load of district hospital.

Equipments: Table:3
     Certain equipment is essential for the delivery of RCH services at SC. Out of 56 (recommended list of) equipment for SC on an average only (
     12.%) equipment were available at the centres.
     As far as availability of equipments at PHC is concerned, only 27 % equipments was found available.
     Miserable condition of CHC is remarkable in respect of availability of equipment. Non availability of standard surgical set-II, standard surgical set-
     III, standard surgical set-V, standard surgical set-VI, normal delivery set, equipment for anaesthesia, equipment for neo natal resuscitation and kit
     for blood transfusion was reported.
Medicines:Table:4
        The Supply of Kit-A for SC was found unsatisfactory (0 %) .Kit-B was found available (1%) at sub centres and availability of contraceptives was
        0nly 2 %.
        About 33 % medicines were reported available out of total medicines recommended for PHC. Availability of Antifilarials (0%), dermatological
        medicine (1 %), vitamins & minerals (1%), Antidots (0%), Anti infective medicine (1%), Anti bacterial was noticed (2%).
        Supply of essential drugs at CHC was found.(67%)




 Table:1                                               Percentage Availability of Infrastructure

                                                               District: kulgam

                          Indicators                    SC (82)             PHC (23)             CHC (4)                       DH


                Building (Govt. + Donated)                21                    77                 100
    1
                Building (Rented)                         77                    30                  0
    2
                Condition of Building (Good +
                                                           0                   NA                  NA
    3           Fair)
                Water Supply (Tap, borewell/
                                                           0                    61                  50
    4           handpump/tubewell, well)
   4.1          Tap water supply                                                61                  50

    5           Electricity                               10                    65                 100
   5.1          In all parts of hospital                  NA                    20                  50
                Elertic supply (power
                                                          NA                   NA                  NA
                generation stablization)
    6           Separate Toilet                            0                   35                   25
   6.1          Sep.Toilet with running water             NA                   NA                   50
    7           Furniture                                 20                   41                   52
    8           Labor Room                                 2                    22                  50
8.1   Aseptic labor room               NA   NA   50
 9    Avail.of Quater for staff         0   30   25
      Number of beds available
                                            4    4
10    (Average)
11    Laboratory                            48   100

12    Operation Theatare                    13   25
13    Waste Disposal (Burnt+Dump)           91   100
14    Availability of incenator             0     0
15    Telephone                             0    50

16    Computer                              0    25

17    Generator/Invertor                    17   75
18    Vhiecle                               57   100
19    Emergency Room / Casualty                  25
      Separate wards for males and
                                                 50
20    females (Yes/No)
21    No. of beds : Male                         10
22    No. of beds : Female                        4
23    Availability of ECG facilities             25
24    X-Ray facility                             25
25    Ultrasound facility                        25
26    Cardiac Monitor for OT                     25
27    Blood Storage Unit available                0
28    Blood Bank Facility
29    Other Investigative Facility
      Heating ventilatoin & air
30    conditioning
31    Lift & vertical transport
32    Refrigeration
             TABLE : 2                                                  MANPOWER AND IDENTIFIED GAPS
                                                    DISTRICT kulgam




                                                                                                          ExistingSt
                                                                                    Qazigund




                                                                                               Required
                                                                         D.H Pora
                                                             Yaripora
                                                    Qaimoh
                                           kulgam




                                                                                                No. of




                                                                                                            No. of
                                                                                                 Staff




                                                                                                              aff
                                                                                                                       TOTAL GAP of Man
                                                                                                                         power in the
           NAME OF BLOCKS-                                                                                                 district
                                    IPHS
     TOTAL NO OF SUB CENTRE         Norm   19       11       18         15          19
                                                                                                164          85
ANM                                   2    19       10       20         13          17                                       79
                                    IPHS
                                    Norm
        TOTAL NO OF PHC                    9        4        1           5          4
MO                                   2     6        4        0           5          0            46          31              15
Pharmacist                           1     -4        0       0          -1          -3           23          26              -3
Nurse                                3     22       12       3          13          8            69          11              58
Female Health Worker                 1     1        1        0           2          0            23          19               4
Health Educator                      1     6        2        1           5          3            23          6               17
Health Assistant                     2
                                           17       6        2          10          7            46          4               42
(one male and one Female)
Clerks                               2     18       6        2                      8            46          12              34
LT                                   1      6       2        1          10          1            23           3              20
Driver                               _                                   3                                    0
                                     4     -3       8        2          14          5            92          63              29

              TOTAL
        TOTAL NO OF CHC             IPHS
                                    Norm   1        NA       1           1          1
A.   CLINICAL MANPOWER
1    General Surgeon                 1     0                 1           1          1             4          1                3
2    Physician                       1     0                 1           1          1             4          1                3
3    Obstetrician / Gynaecologist    1     1                 1           1          1             4          0                4
4    Paediatrics                     1     1                 1           1          1             4          0                4
5    Anaesthetist                     1     1    1    1    1   4     0    4
     Public Health Programme
                                      1
6    Manager                                1    1    1    1   4     0    4
7    Eye Surgeon                      1     0    1    1    1   4     1    3
8    Other specialists (if any)
     General duty officers (Medical
 9   Officer)
B.   SUPPORT MANPOWER
 1   Nursing Staff                    7+2
 a   Public Health Nurse               1    1    0    1    1   4      1    3
b    ANM                               1    1    0    1    0   4      2    2
c.   Staff Nurse                                           5         12   16
                                      7     0    7    4        28
d.   Nurse/Midwife                                                    0
 6   Dresser                          1     1     0    1   1   4      1    3
 7   Pharmacist / compounder          1     -1   -1   -2   1   4      7   -3
 8   Lab. Technician                  1     0     1    0   1   4      2    2
 9   Radiographer                     1     1     0    0   0   4      3    1
10   Ophthalmic Assistant             1     0     1    0   0   4      3    1
11   Ward boys / nursing orderly      2     1     0    1   2   8      4    4
12   Sweepers                         3     -1    0   -1   3   12    13   -1
13   Chowkidar                        1     0     0    0   1   4      3    1
14   OPD Attendant                    1     1     0    1   1   4      1    3
     Statistical Assistant / Data
                                      1     1
15   entry operator                              1    1    1   4     0    4
16   OT Attendant                     1     1    1    1    1   4     0    4
17   Registration Clerk               1     1    1    1    1   4     0    4
18   Any other staff (specify)
                 TOTAL                                         124   55   69
     Note: ( - ) Surplus staff
                                              AVILABLE PERCENTAGE OF EQUIPMENT
             TABLE : 3

                                                DISTRICT - kulgam




                                                                                         QAZIGUND
                                                                   YARIPORA




                                                                              D.H PORA
                                                 KULGAM



                                                          QAIMOH
                                                                                                       Average
                NAME OF BLOCKS-                                                                     % of the District

    NO OF Sc (82)                 IPHS Norm     19        10       20         13         17
    Equipment kit
                                     56         15        5        16         14         8
1   ( kit- C )                                                                                             21
                                  IPHS Norm      9        4        1          5          4
    TOTAL NO OF PHCs(23)
1   Suggested equipments             36         12        0                   15         11                26
2   Operational labour room          10          6        0                   11          9                65
3   Pap Smear                        11          4        0                    8          6                41
4   Laboratory Reagents              10          2        0                    0          4                15
    Glassware and other                          3        0                   0          6
5   equipment                         7                                                                    32
6   Furniture                         25         3        0                    0          7                10
    TOTAL                             99        28        0                   35         44                27
                                  IPHS Norm
    TOTAL NO OF CHCs (4)                         1        NA       1          1          1                 4
    Standard Surgical Set-1
                                     32
1   FRU                                         21                 12         6          17                44
2   Standard Surgical Set - II       33         13                 3          2          8                 20
3   IUD Insertion Kit                19          5                 1          2          0                 11
    CHC Standard Surgical Set -
                                     17
4   III                                          6                 6          0          0                 18
5   Normal Delivery                  12          1                 0          3          0                 8
6   Standard Surgical Set - IV       16          1                 4          1          0                 9
7   Standard Surgical Set - V        21          0                 2          0          0                 2
8   Standard Surgical Set - VI       11          0                 0          0          0                 0
9    Equipment for Anaesthesia   17    0    1    0    0    1
     Equipment for Neo-natal
                                 10
10   Resuscitation                     0    0    0    0    0
     Materials Kit for Blood
                                 15
11   tranfusion                        0    0    0    0    0
     Equipment for Operation
                                 11
12   theatre                           0    2    2    0    9
13   Equipment for Labour room   13    0    3    3    0    12
14   Equipment for Radiology     9      0   2     0    0   6
     TOTAL NO.                   236   47   36   19   25   32
DISTRICT PULWAMA:
 Infrastructure: Table:1
      Out of 82 SC’s in the District, 77 SC’c (77%) and 30% PHC’s are running in rented buildings. As far as condition of SC’s is concerned
      100% are in poor condition.
      Only 61% PHC’s have tap water supply and 100% SCs are without any water facility.
      90% SC’s and 35% PHC’s are functioning without electric facility and only 20 % PHC’s have electric facility in all parts of the health centre.
      Facility survey also revealed that availability of separate toilet at SC is nil and 35% PHCs have this facility This facility at CHC is almost
      negligible.
      The availability of laboratory in PHC is to test blood & urine of the women seeking antenatal care as well as for the diagnosis of RTI/STI
      among men and women is critical. Only 48% have laboratory facility.
      The availability of a labor room, to achieve NRHM Goal of maximum institutional delivery, is important facility for a SC and PHC. 2% SC’s
      and 22% PHC’s have this critical facility.
      For communication purposes, the telephone facility at PHC is not available and 50% CHCs have this facility..
      To attend emergency cases, it is necessary to have staff quarters in the compound.Out of 4 CHCs only 1 CHC has quarter for staff. 30%
      PHC’s have residential facility for the staff.There is not a single SC with the facility of staff quarter.
      A separate aseptic labor room is critical in reducing the chances of infection during delivery. 50% separate aseptic labor rooms are
      available at CHCs ,PHCs (0%) and blood storage units are unavailable at CHCs.
      Out of total CHCs only 1 CHC has the facility of ECG, X Ray, ultra sound and cardiac monitor for OT.
 Manpower: Table:2
      The health assistant (Female) also known as ANM has a key role to play in the implementation of RCH programme at grass root level. 85
      ANM’s are looking after the work of 82 SC’s.
      Total requirement of staff at 23 PHC’s is 416 and only 197 staff are in position, which reflects the shortage of more than 51 % staff. There
      is, especially, a shortage of Nurses (58), health assistant (42), and clerks (34).
      Situation of CHC is alarming, where only10% of the clinical manpower is available. Vacant post of specialists make CHC virtually non-
      functional. There is an urgent need to recruit professionals as soon as possible that will help to reduce the load of district hospital.

 Equipments: Table:3
      Certain equipment is essential for the delivery of RCH services at SC. Out of 56 (recommended list of) equipment for SC on an average
      only ( 12.%) equipment were available at the centres.
      As far as availability of equipments at PHC is concerned, only 27 % equipments was found available.
      Miserable condition of CHC is remarkable in respect of availability of equipment. Non availability of standard surgical set-II, standard
      surgical set-III, standard surgical set-V, standard surgical set-VI, normal delivery set, equipment for anaesthesia, equipment for neo natal
      resuscitation and kit for blood transfusion was reported.
Medicines:Table:4
         The Supply of Kit-A for SC was found unsatisfactory (0 %) .Kit-B was found available (1%) at sub centres and availability of
         contraceptives was 0nly 2 %.
         About 33 % medicines were reported available out of total medicines recommended for PHC. Availability of Antifilarials (0%),
         dermatological medicine (1 %), vitamins & minerals (1%), Antidots (0%), Anti infective medicine (1%), Anti bacterial was noticed (2%).
         Supply of essential drugs at CHC was found.(67%)



Table:1                                           Percentage Availability of Infrastructure

                                                            District: Pulwama
                         Indicators                 SC (76)              PHC (33)                 CHC (2)                       DH
               Building (Govnt. + Donated)             15                   45                      100                        100
    1
               Building (Rented)                       85                   55                       NA                         NA
    2
               Condition of Building (Good +
                                                       40                   NA                       NA                        100
    3          Fair)
               Water Supply (Tap, borewell/
                                                       10                   50                      100                        100
    4          handpump/tubewell, well)
   4.1         Tap water supply                       NA                    29                      100                        100

    5          Electricity                             7                    30                      100                        100

   5.1         In all parts of hospital               NA                    18                      100                        100
               Elertic supply (power
                                                      NA                    NA                       NA                        100
   5.2         generation stablization)
    6          Separate Toilet                         7                     8                       50
   6.1         Sep.Toilet with running water          NA                    NA                        0                        100
    7          Furniture                              24                    38                       73                        58
    8          Labor Room                              0                    14                      100                        100
   8.1         Aseptic labor room                     NA                    NA                        0                        100
    9          Avail.of Quater for staff               0                     2                        0                          _
               Number of beds available
                                                                             3                       24                        100
    10         (Average)
11        Laboratory                       36   100   100

12        Operation Theatare               0    50    100

13        Waste Disposal (Burnt+Dump)      43   100   100

14        Availability of incenator        NA    0    100
15        Telephone                        9    100   100
16        Computer                         0     0    100
17        Generator/Invertor               NA   100   100
18        Vhiecle                          41   100   100

19        Emergency Room / Casualty             100   100
          Separate wards for males and
                                                50    100
20        females (Yes/No)
21        No. of beds : Male                    13    60

22        No. of beds : Female                  12    40

23        Availability of ECG facilities        100   100

24        X-Ray facility                        100   100

25        Ultrasound facility                   100   100
26        Cardiac Monitor for OT                 0    100

27        Blood Storage Unit available           0    100

28        Blood Bank Facility                         100

29        Other Investigative Facility                73
          Heating ventilatoin & air
 30       conditioning
                                                      0
 31       Lift & vertical transport                   100
 32       Refrigeration                               100
NA=Not applicable
Table: 2                                                    Identified Gaps of Manpower

                                      District- Pulwama




                                                                                                    Total Gaps
                                                                                       Exis.Staff
                                                                           Req.Staff
                                       Pulwama


                                                  Pampore




                                                                                        No. of
                                                                            No. 0f
                                                                Tral
Name of Blocks


                               IPHS
No. of Sub- Centres (76)                    23          23         30
                               Norm
ANM                             2           25          27         38      152           62         90
N0. Of PHC's   (33)                         12          14             7
MO                              2           13          12          4       66           37         29
Pharmacist                      1            0           2          1       33           30         3
Nurse                           3           28          33         16       99           22         77
Female Health Worker            1            1           2          1       33           29         4
Health Educator                 1           10          12          6       33           5          28
Health Assistant
                                2           22          26         13       66            5         61
(one male and one Female)
Clerks                          2           22          27         12       66          5            61
LT                              1            5           7          4       33          17           16
Driver                          _                                                       0            0
Class lV                        4           21          39         17      132          55           77
TOTAL                                                                      561         205          356
No. of CHC's      (2)
                                      NA         1                     1
A. CLINICAL MANPOWER
General Surgeon                 1                -1                    0     2            2          0
Physician                       1                -1                    0     2            2          0
Obstetrician / Gynaecologist    1                 0                    1     2            1          1
Paediatrics                                   1     1    1    2    0    2
Anaesthetist                                  1     0    1    2    1    1
Public Health Programme Manager               1     1    1    2    0    2
Eye Surgeon                                   1     1    1    2    0    2
Other specialists (if any)                                              0
General duty officers (Medical Officer)                                 0
B. SUPPORT MANPOWER
Nursing Staff                                 7+2
Public Health Nurse                            1     1   1    2    0    2
ANM                                            1    -1   0    2    2    0
Staff Nurse
                                              7     1    2    14   11   3
Nurse/Midwife
Dresser                                       1      1    1   2    0     2
Pharmacist / compounder                       1     -2   -3   2    7    -5
Lab. Technician                               1      0    0   2    2     0
Radiographer                                  1      0    0   2    2     0
Ophthalmic Assistant                          1      0    0   2    2     0
Ward boys / nursing orderly                   2      0    0   4    4     0
Sweepers                                      3      1    0   6    5     1
Chowkidar                                     1      1    1   2    0     2
OPD Attendant                                 1      1    1   2    0     2
Statistical Assistant / Data entry operator   1      1    1   2    0     2
OT Attendant                                  1      1    1   2    0     2
Registration Clerk                            1      1    1   2    0     2
Any other staff (specify)
   TOTAL                                                      62   41   21
   Note: ( - ) Surplus staff
DISTRICT HOSPITAL – AVAILABILITY OF MANPOWER AND IDENTIFIED GAPS



Doctors

Personnel                          IPHS Norm             Exis. Staff   Ident. Gaps


Hospital Superintendent                1                     1             0

Medical Specialist                     3                     1             2

Surgery Specialists                    2                     1             1

O&G specialist                         4                     1             3

Psychiatrist                           1                     0             1

Dermatologist / Venereologist          1                     0             1

Paediatrician                          2                     0             2

Anesthetist (Regular / trained)        2                     1             1

ENT Surgeon                            1                     0             1
Opthalmologist                         1                     1             0
Orthopedician                          1                     0             1
Radiologist                            1                     0             1
Microbiologist                         1                     0             1
Casualty Doctors / General Duty
                                       6                     6             0
Doctors
Dental Surgeon                         1                     1             0
Forensic Expert                     1           0             1
Public Healt Manager1               1           0             1
                  2
AYUSH Physician                     2            0             2
Pathologists                        2            0             2
Total                              34           13            21




Para-Medicals

Personnel                       IPHS Norm   Exis. Staff   Ident. Gaps


Staff Nurse3                    75 to 100       0             70
Hospital worker (OP/ward +OT+
                                   20           0             20
blood bank)
Sanitary Worker                    15           0             15
Ophthalmic Assistant /
                                    1           1             0
Refractionist
Social Worker / Counsellor          1           0             1

Cytotechnician                      1           0             1

ECG Technician                      1           0             1

ECHO Technician                     1           0             1

Audiometrician                                  0             0
Lab.Tech. ( Lab +BB)        12    0   12
Lab. Atten. (Hos.Worker)     4    0    4
Dietician                    1    0    1
PFT Technician               -    0

Maternity assistant (ANM)    6    2    4
Radiographer                 2    0    2
Dark Room Assistant          1    0    1
Pharmacist4                  5    2    3
Matron                       1    0    1
Assistant Matron             2    0    2
Physiotherapist              1    0    1
                             1    0    1
                             1    0    1
                             1    1    0
                             1    1    0
Total                       154   7   147
Administrative Staff

                                IPHS   Exis.   Iden.
Personnel
                                Norm   Staff   Gaps

Manager (Administration)         -      0       0

Junior Administrative Officer    1      0       1

Office Superintendent            1      0       1

Assistant                        2      2       0
Junior Assistant / Typist        2      0       2

Accountant                       2      1       1

Record Clerk                     1      0        1
Office Assistant                 1      0        1
Computer Operator                1      0        1
Driver                           2      2        0
Peon                             2      0        2
Security Staff*                  2      0        2
Total                            17     5       12
Operation Theatre




                     Emer.




                             Gen.
                      OT




                              OT
Staff Nurse           8       1      0   8

OT Assistant          4       2      1   3

Sweeper               3       1      2   1

Total                15       4      3   12
Blood Bank / Blood
                                         0
Storage
                     Blood




                             Blood
                             Stora
                     Bank




                              ge
Staff Nurse           3       1      0   3
MNA / FNA             1       1      0   1
Lab Technician        1       -      1   0
Safai Karamchari      1       1      0   1
Total                 6       4      1   5
Table:3                       Percentage Availability of Equipments
                                           District: Pulwama


Name of Blocks                                   Pulwama        Pampore     Tral    Total Avg.


                               IPHS Norm
No. of SC's (76)                                    23                23     30        76

kit- C                             55               14.1          13.6      25.05      18
No. of PHC's (33)                                   12                14     7

Suggested equipments               36               26.4              8.9   13.9       16

Operational labour room            10               15.0          15.7       5.7       12

Pap Smear                          11               6.2               4.5    5.2        5

Laboratory Reagents                10               2.5               8.5    1.4        4
Glassware and other
                                   7                35.7          27.1       0.0       21
equipment
Furniture                          25               24.0          16.0      15.2       18

TOTAL                              99               21.3          12.3      10.2       15

No. of CHC's (2)                                     0                1      1

Standard Surgical Set-1            32               0.0           71.9      46.9       59

Standard Surgical Set - II         33               0.0           81.8      27.0       54

IUD Insertion Kit                  19               0.0           94.7      31.6       63

Standard Surgical Set - III        17               0.0           94.1      64.7       79

Normal Delivery                    12               0.0           75.0      50.0       63
Standard Surgical Set - IV       16    0.0   87.5    37.5   63

Standard Surgical Set - V        21    0.0   42.9    28.6   36

Standard Surgical Set - VI       11    0.0   100.0   45.5   73

Equip. for Anaesthesia           17    0.0   76.5    23.5   50
Equip.for Neo-natal
                                 10    0.0   40.0    0.0    20
Resuscitation
Materials Kit for Blood trans.   15    0.0   73.3    0.0    37

Equip. for OT                    11    0.0   72.7    27.3   50

Equip. for Labour room           13    0.0   53.8    46.2   50

Equip. for Radiology             9     0.0   66.7    33.3   50

TOTAL                            236   0.0   74.6    33.9   54
Table: 4                                            Percentage Availability of Medicine
                                                  District: Pulwama

                                                                                                Avg.
Name of Blocks                            Pulwama          Pampore           Tral
                                                                                          % of the District

                              IPHS Norm
Sc's                                        23                23             30

Kit- A                            5         12.0              0.0            0.6                 4
Kit- B                            9         14.0              4.8            19.4                13
Drugs required by
                                  6         10.0              0.7            6.8                 6
ANMs and LHVs
Other Drugs & Vacci.              8         13.0             14.6            22.5                17
Med. Req.for NDCP                 7         10.0              4.3            2.9                 6
Contracep. Req.for F.Plang.       4         38.0             82.5            26.5                49
Drug List for AWC                12         22.0              4.3            16.3                14
Total                            51         16.5             11.3            6.80                12
PHC's                                       12                14              7
Essen. & emerg.
                                 38         26.1             18.2            6.6                 17
obstetrics care drugs
Antidots                          4         8.3               8.8            21.3                13
Anticonvul./ Antiepileptics       4         8.3                0             21.3                10
Antiinfective Medicines           5         25.0             25.6            2.8                 18
Antifilarials                     1         0.0                7              0                  2
Antibacterials                   16         25.0             15.1            11.6                17
Dermatological medicine          14         26.8              7.6            13.2                16
Antilep.& Antitubercullar         2         0.0               14              14                 9
Antifungal medicine               4         22.8              3.5            17.8                15
Antiprotozoal medicine   5     25.0   1.4    25.6   17
Blood Products and
                         13    13.5   3.2    12.1   10
Plasma Substitutes
Antiseptics              6     16.7   4.7    11.8   11
Disinfectants            3     16.7    0     14     10
Diuretics                2     12.5   3.5     0     5
Gastrointestinal         22    22.5   14.3   9.1    15
Hormones, Endocrine &
                         10    13.3   5.7    2.8    7
Contraceptives
Ophthalm. preparation    12    18.8    0     5.9    8
Psychotic Disorders      15    18.3   1.9    1.9    7
Soln. correcting water
Electrolyte& Acid-       9     38.9   19     1.6    20

Vitamins & Minerals      3     44.3   11.7    0     19
Drugs under RCH          1     0.0     0      0     0
Product Strength
                         31    31.2   13.5   2.3    16
formulation Units
RTI / STI Drugs          10    30.0   8.5    1.4    13
Drugs & Consumable for
                         6     29.0    0      0     10
MVA
TOTAL                    236   22.9   10.4   8.2    14
CHC's                           0      1      1
Essential drugs          70     0     45.7   34.3   40
DISTRICT BARAMULLA:



Table:1                                   Percentage Availability of Infrastructure

                                                District: Baramulla
                      Indicators                SC (168)    PHC (48)     CHC (6)      DH

    1     Building (Govnt. + Donated)              17          73          100        100
    2     Building (Rented)                        83          25           0         0

          Condition of Building (Good + Fair)      32          NA          NA         NA
    3
           Water Supply (Tap, borewell/
                                                   21          60          100        100
    4     handpump/tubewell, well)
   4.1    Tap water supply                         NA          60          100        100
    5     Electricity                               3          62          100        100
   5.1    In all parts of hospital                 NA          35          100        100
          Elertic supply (power generation
                                                   NA          NA          NA         100
   5.2    stablization)
    6     Separate Toilet                           2           8           17        100
   6.1    Sep.Toilet with running water            NA          NA           67        100
    7     Furniture                                12          39           59
    8     Labor Room                                2          25           83        100
   8.1    Aseptic labor room                       NA          NA           33        100
    9     Avail.of Quater for staff                 3          14           33
   10     Number of beds available (Avg.)                       5           15        100
   11     Laboratory                                           35          100        100
    12    Operation Theatare                                   23          100        100

          Waste Disposal (Burnt+Dump)                          52           50        100
    13
14   Availability of incenator        NA   17    100
15   Telephone                         2   17     0
16   Computer                          0   17     0
17   Generator/Invertor               2    100   100
18   Vhiecle                          50   87    0
19   Emergency Room / Casualty             67
     Separate wards for males and
                                           83
20   females (Yes/No)
21   No. of beds : Male                    15
22   No. of beds : Female                  14

23   Availability of ECG facilities        100   100

24   X-Ray facility                        100   100

25   Ultrasound facility                   100   100

26   Cardiac Monitor for OT                50    100

27   Blood Storage Unit available          0     100

28   Blood Bank Facility                         100

29   Other Investigative Facility                61
     Heating ventilatoin & air
                                                 0
30   conditioning
31   Lift & vertical transport                   0

32   Refrigeration                               100
     NA=Not applicable
Table: 2                                                      Identified Gaps of Manpower
                                                               District- Baramulla




                                                                                                                     Dangiwacha



                                                                                                                                  No. of Exis
                                                                                        Tangmarg




                                                                                                                                  No. 0f Req
                                                                                                            Rohama
                                                                     Boniyar
                                   Sopore

                                            Kunzer

                                                     Pattan




                                                                               Sheeri



                                                                                                   Kreeri




                                                                                                                                    Staff

                                                                                                                                    Staff
                                                                                                                                                Total




                                                               Uri
Name of Blocks
                                                                                                                                                Gaps


                            IPHS
No. of Sub- Centres         Norm   14       15       23       14     11        20       10         22       24       15

ANM                          2     12       19       11       28     17        23       16         36       35       21           336 118       218

N0. Of PHC's                       11       6        5         5     4         6        3          4        3        1

MO                           2     12       5         5        5     4          4        3          3       3        0             96    52     44
Pharmacist                   1     0        0         0        0     0          0       -1          2       0        0             48    47      1
Nurse                        3     27       13       12       15     10        11        9         10       9        1            144    27     117
Female Health Worker         1     3        0         1        4     2          2        0          3       1        0             48    32     16
Health Educator              1     10       5        3         5     4         6        3          4        3        1            48     4       44
Health Assistant
                             2     21       11       9        10     8         12       6          8        6        2            96     3       93
(one male and one Female)
Clerks                       2     22       10       10       10     6         11       6          8        4        1            96   8        88
LT                           1      6       3         3        4     2          4       3          2        1        0            48  20        28
Driver                       _      9       3         4                                                                               -16       16
Class lV                     4     29       8        11       19     9         7         4         11       5        4            192 85        107
TOTAL                              139      58       58       72     45        57       33         51       32       9            816 262       554
No. of CHC's
                                   1        NA       1         1     NA        1        1          NA NA NA
A. CLINICAL MANPOWER
General Surgeon              1     1                 0         0               1        -1         1                               6     4       2

Physician                    1     1                 -1        0               1        0          1                               6     4       2
Obstetrician / Gynaecologist               1    1     0    1    1    1    1     6    1    5

Paediatrics                                1    1     1    1    1    1    1     6    0    6

Anaesthetist                               1    0     1    1    1    0    1     6    2    4

Public Health Programme Manager            1    1     0    1    1    1    1     6    1    5

Eye Surgeon                                1    1     1    1    1    1    1     6    0    6

Other specialists (if any)                      1     0

General duty officers (Medical Officer)         1     0              0
B. SUPPORT MANPOWER
Nursing Staff                             7+2
Public Health Nurse                        1    -3    1    1    1    1    1     6    4    2
ANM                                        1    -3    -1   -2   0    0    7     6    5    1
Staff Nurse
                                           7    -6    7    6    4    3    3     42   25   17
Nurse/Midwife
Dresser                                    1    -3    1    1    1    1    1     6    4    2
Pharmacist / compounder                    1    -2    -3   -2   0    -6   -8    6    27   -21
Lab. Technician                            1    -10   0    -3   -1   -4   -3    6    27   -21
Radiographer                               1    1     0    1    0    0    0     6    4    2
Ophthalmic Assistant                       1    0     0    1    1    0    -1    6    5    1
                                                                      -
Ward boys / nursing orderly                2    -19   0    -4   0         -12   12   59   -47
                                                                     12
Sweepers                                   3    -1    -1   -1   2    -4   -12   18   35   -17
Chowkidar                                  1    -2    0    0    1    1    -3    6    9    -3
OPD Attendant                              1    -3    1    1    1    1    -1    6    6    0
Statistical Assistant / Data entry         1    -1    1    1    1    1          6    3    3
operator

OT Attendant                1   -5    1    0   1    1    0     6    8    -2
Registration Clerk          1   -3    1    0   1    1    0     6    6    0
Any other staff (specify)
                                                     -
Total                           -52   10   5   20        -21   186 239   -53
                                                    13
DISTRICT HOSPITAL- AVAILABILITY OF MANPOWER AND IDENTIFIED GAPS


Doctors


          Personnel               IPHS Norm            Exis Staff   Ident. Gaps


Hospital Superintendent               1                    1            0
Medical Specialist                    3                    2            1
Surgery Specialists                   2                    2            0
O&G specialist                        4                    1            3
Psychiatrist                          1                    0            1
Dermatologist / Venereologist         1                    0            1
Paediatrician                         2                    1            1
Anesthetist (Regular / trained)       2                    2            0
ENT Surgeon                           1                    1            0
Opthalmologist                        1                    1            0
Orthopedician                         1                    1            0
Radiologist                           1                    2            -1
Microbiologist                        1                    0            1
Casualty Doctors / General
                                                           2            4
Duty Doctors                          6
Dental Surgeon                        1                    2            -1
Forensic Expert                       1                    0            1
Public Health Manager1                1                    0            1
AYUSH Physician2                      2                    0            2
Pathologists                          2                    0            2
Total                                34                   18            16
Para-Medicals

     Personnel         IPHS Norm   Exis. Staff   Ident. Gaps

Staff Nurse*           75 to 100       5             70
Hospital worker
(OP/ward +OT+                          0             20
blood bank)               20
Sanitary Worker           15           15            0
Ophthalmic
Assistant /                            0             1
Refractionist              1
Social Worker /
                                       1             0
Counsellor                 1
Cytotechnician             1           0             1
ECG Technician             1           0             1
ECHO Technician            1           0             1
Audiometrician                         0             0
Lab.Tech. ( Lab +BB)      12           6             6
Lab. Atten.
                                       1             3
(Hos.Worker)               4
Dietician                  1           0             1
PFT Technician             -           0             0
Maternity assistant
                                       5             1
(ANM)                      6
Radiographer               2           0             2
Dark Room
                                       0             1
Assistant                  1
Pharmacist1                5           10            -5
Matron                     1            0            1
Assistant Matron           2            0            2
Physiotherapist            1            0            1
Statistical Assistant         1                        0                    1
Medical Records
                                                       0                    1
Officer / Technician          1
Electrician                   1                         1                   0
Plumber                       1                         1                   0
Total                        154                       40                  114


Administrative Staff
                                        Current Availability at Hospital
        Personnel           IPHS Norm                                      Gaps
                                             (Indicate Numbers)
Manager (Administration)           -
Junior Administrative
                                                       0                    1
Officer                           1
Office Superintendent             1                    1                    0
Assistant                         2                    2                    0
Junior Assistant / Typist         2                    1                    1

Accountant                         2                   0                    2
Record Clerk                       1                   0                    1
Office Assistant                   1                   0                    1
Computer Operator                  1                   0                    1
Driver                             2                   0                    2
Peon                               2                   0                    2
Security Staff*                    2                   0                    2
Total                             17                   4                    13
Operation Theatre
                      Emer.OT       Gen. OT


Staff Nurse              8             1          0   9
OT Assistant            4              2          3   3
Sweeper                 3              1          0   4
Total                   15             4          3   16
Blood Bank / Blood
Storage
                     Blood Bank   Blood Storage

Staff Nurse              3             1          0   4
MNA / FNA                1             1          0   2
Lab Technician           1             -          1   0
Safai Karamchari         1             1          0   2
Total                    6             4          1   9
Table:3                   Percentage Availability of Equipments
                                           District: Baramulla




                                                                                                                   Dangiwacha
                                                                                     Tangmarg




                                                                                                                                Avg.% in
                                                                                                         Rohama
                                                                  Boniyar
                                 Sopore




                                                                                                                                District
                                          Kunzer

                                                   Pattan




                                                                            Sheeri




                                                                                                Kreeri
                                                            Uri
Name of Blocks



                          IPHS
No. of SC's (168)         Norm   14       15       23       14    11        20       10         22       24       15

kit- C                     55    31       20       14       0     0         7        22         11       62       29            19.5

No. of PHC's (48)                11       6        5        5     4         6        3          4        3         1

Suggested equipments       36    14       32       20       7     29        11       11         7        32       28            19.2

Operational labour room    10    100      0        23       2     60        40       30         55       50       60            42.0

Pap Smear                  11    100      0        17       15    55        27       36         27       64        9            34.9

Laboratory Reagents        10    100      0        30       20    5         0        0          0        10        0            16.5

Glassware & equipment      7     100      0        91       17    100       14       0          50       57        0            42.9

Furniture                  25    100      0        15       20    34        20       22         2        32       48            29.3

TOTAL                      99    86       5        33       13    47        19       17         24       41       24.1          26.7

No. of CHC's (6)                 1        NA       1        1     NA        1        1          1        NA       NA
Standard Surgical Set-1          32    100   63   88   19    41   50   60   59.9

Standard Surgical Set - II       33    100   15   0    0     30   15   27   26.8

IUD Insertion Kit                19    100   47   0    100   21   16   47   47.4

Standard Surgical Set - III      17    100   24   0    0     71   12   34   34.3

Normal Delivery                  12    100   50   0    0     25   17   32   31.9

Standard Surgical Set - IV       16    100   25   0    6     50   19   33   33.3

Standard Surgical Set - V        21    100   10   0    0     43   0    25   25.4

Standard Surgical Set - VI       11    100   27   0    0     55   0    30   30.3

Equip. for Anaesthesia           17    100   12   0    0     12   0    21   20.6

Equip.for Neo-natal
                                 10    0     0    0    0     0    0    0    0.0
Resuscitation

Materials Kit for Blood trans.   15     0    0    0    0     0    7    1    1.1

Equip. for OT                    11    90    45   36   18    64   27   47   46.8

Equip. for Labour room           13    62    31   46   15    23   23   33   33.4

Equip. for Radiology             9     100   22   78   67    11   11   48   48.1

TOTAL                            236   82    26   18   16    32   14   31   31.4
Table: 4                      Percentage Availability of Medicine
                                                                              District: Baramulla




                                                                                                                                               DANGIWACHA
                                                                                                      TANGMARG
                                                                               BONIYAR




                                                                                                                                 ROHAMA
                                       SOPORE


                                                  KUNZER

                                                             PATTAN




                                                                                                                   KREERI
                                                                                           SHEERI
                                                                       URI
                                                                                                                                                               Average
Name of Blocks                                                                                                                                              % of the District
                              IPHS
Sc's (168)                    Norm   14         15         23         14     11          20         10           22          24           15
Kit- A                         5     20         0.0        0.0        0.0    0.0         0.0        0.0          0.0        41.7          53.3                    11.5
Kit- B                         9     78         18.5       11.1       0.0    0.0         44.4       0.0          11.1       73.6          53.3                    29.0
Drugs Req. by ANMs&
                               6      0         0.0        0.0        0.0    0.0         16.7       0.0          0.0        51.4          0.0                     6.8
LHVs
Other Drugs & Vacci.           8     13         15.0       13.0       0.0    12.5        12.5       45.0         0.0        95.3          0.8                     20.8
Med. Req.for NDCP              7      0         32.4       14.9       2.0    0.0         14.3       25.4         0.0        13.5          9.5                     11.2
Contracep. Req.for F.Plang.    4     50         50.0       50.0       7.1    0.0         25.0       66.7         47.7       100.0         60.0                    45.7
Drug List for AWC              12    34         38.9       0.0        7.1    0.0         8.3        0.0          32.2       92.0          0.0                     21.2
Total                          51    30.0       3.0        1.7        1.2    0.9         2.4        18.6         12.0       68.3          25.2                    16.0
PHC's (48)                           11          6          5         5       4           6          3            4          3             1

Essen. & emerg. Obstetrics     38     0          0         34.9       2.6    43.4        5.3        4.7          7.0         8.7          1.0                     10.8
Antidots                       4      0          0         33.3 10.0         25.0        25.0       25.0         25.0       25.0          5.0                     17.3
Anticonvul./ Antiepileptics    4      0          0          0         5.0    0.0         0.0        0.0          0.0         0.0          0.0                     0.5
Antiinfective Medicines         5     0          0         66.7 12.0         20.0        20.0       20.0         0.0        60.0          4.0                     20.3
Antifilarials                   1     0          0          0   0.0           0.0        100        0.0           0.0        0.0          0.0                     10.0
Antibacterials                 16     0          0         29.2 15.0         21.9        18.8       18.8         25.0       43.8          5.0                     17.7
Dermatological medicine        14     0          0         14.3 17.1         14.3        42.9       14.3         0.0         7.1          2.9                     11.3
Antilep.& Antitubercullar    2     0       0    0   0.0      25.0   0.0    0.0    0.0    0.0    0.0   2.5
Antifungal medicine          4     0       0    0   10.0     0.0    0.0    0.0    0.0    0.0    0.0   1.0
Antiprotozoal medicine       5     0       0   13.3 16.0     0.0    0.0    0.0    0.0    0.0    0.0   2.9
Blood Products and
                            13    0        0    51    15.4   11.5   0.0    3.8    3.8    11.5   1.5   9.9
Plasma Substitutes

Antiseptics                 6     0             0     20.0   0.0    0.0    8.3    0.0    33.3   0.0   6.9
Disinfectants               3     0        0    0     20.0   0.0    0.0    0.0    0.0    16.7   0.0   3.7
Diuretics                   2     0        0    0     10.0   25.0   0.0    50.0   0.0    0.0    0.0   8.5
Gastrointestinal            22    0        0   13.6   9.1    13.6   13.6   0.0    31.8   22.7   2.7   10.7
Hormones,Endocrine &
Contraceptives              10    0        0    0     6.0    0.0    0.0    0.0    0.0    10.0   0.0   1.6

Ophthalm. preparation       12     0       0    0     11.7   0.0    0.0    4.2    0.0    0.0    0.0   1.6
Psychotic Disorders         15    0        0   22.3   5.3    10.0   6.7    23.3   3.3    6.7    0.0   7.8
Sols. correcting water
Electrolyte and Acid-       9     0        0   29.6 13.3     44.4   11.1   38.9   66.7   55.6   4.4   26.4

Vitamins & Minerals         3     0        0   44.4 13.3     0.0    33.3   16.7   33.3   33.3   0.0   17.4
Drugs under RCH             1     0        0    0     0.0    0.0    0.0    0.0    0.0    0.0    0.0   0.0

Product Strength
                            31    0        0   33.3 18.1     0.0    6.5    8.1    45.2   32.3   5.8   14.9
formulation Units

RTI / STI Drugs             10     0       0    10    20.0   0.0    0.0    5.0    25.0   45.0   2.0   10.7
Drugs & Consumable for
                            6     0        0    0     20.0   0.0    0.0    0.0    0.0    25.0   0.0   4.5
MVA

Total                       236        0     0 16.5 11.2     10.6   11.8   10.0   11.1   18.2   1.4   9.1
CHC's                              1       NA   1    1       NA      1      1      1     NA     NA
Essential drugs             70    100           30 0.00             46     42.9   47.1                       44.3

								
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