Transcript pipnrhm-mohfw.nic.in

Presentation to National Program
Coordination Committee
On
State PIP of Madhya Pradesh for 2011-12
18 March, 2011
1
MADHYA PRADESH - Demographic Profile
Area (in sq.kms.)
3,08,000
Estimated Population (2011)
7,50,86,196
Male
3,91,11,879
Female
3,89,73,317
Scheduled Tribes
1,52,19,769 (20.27%)
Scheduled Castes
1,13,97,932 (15.18%)
Development Blocks
313 (Tribal blocks - 89)
Populated villages
52,117
Gram Panchayats
23,040
Literacy
64.1 percent
Male
76.5 percent
Female
50.6 percent
Density of Population
196 per sq. kms.
Sex Ratio
920 : 1000
Child Sex Ratio
919
2
Goals- 2012
Madhya Pradesh
Current status
INDIA
Target
Current status
2012
Target
2012
MMR
335
(SRS 2006)
220
254
(SRS 2006)
<100
IMR
67
(SRS 2009)
60
50
(SRS 2009)
<30
TFR
3.3
(SRS 2008)
3.0
2.6
(SRS 2008)
2.1
3
Financial Status : 2010-11
Rs. In crores
S.
N0
Scheme/ Programme
ROP
2010-11
Fund Received
from GoI and
State Government
Expenditure
Up to Feb 2011
325.51
1
RCH Flexible Pool
392.04
220.34
2
NRHM Flexible Pool
321.20
259.86
3
AYUSH
4
Routine Immunization
20.32
10.86
11.35
5
Pulse Polio
15.06
15.00
0.95
6
National Programs
41.59
26.38
25.44
7
Treasury Transfer (Family Welfare Establishment)
220.27
220.27
218.57
8
Total
1010.48
-
740.30
158.48
(73.26%)
9
State Share
127.08
10
Unspent balance under NRHM as on 01.04.2010
148.58
Total
1010.48
1028.37
Overall expenditure expected by March 2011 - 95%
740.30
4
State Share
Year
PIP
GOI Release
State Share
(RCH/NRHM/Immu.)
2007-08
552.50
472.79
-
2008-09
554.31
478.94
90.00
2009-10
659.20
361.10
113.00
2010-11
733.56
491.06
127.08
Total
2499.57
1803.89
330.08
• State has contributed Rs. 330.08 Cr. as against the requirement of Rs. 318.33 Cr.
5
Comparative Budget Provision :
2010-11 & 2011-12
S.
N
0
Scheme/ Programme
Rs. In crores
Approved Budget
2010-11
Amount Proposed
2011-12
1
RCH Flexible Pool
392.04
392.03
2
NRHM Flexible Pool
321.20
303.09
3
AYUSH
4
Routine Immunization
20.32
21.52
Sub Total
733.56
734.87
5
Pulse Polio
15.06
17.28
6
National Disease Control Programs
41.59
104.34
7
Treasury Transfer (Family Planning Establishment)
220.27
260.00
Total
1010.48
1116.49
18.23
6
BUDGET OVERVIEW: RCH flexi pool
(Rs. Lakhs)
Sr.
No.
BUDGET HEAD
2010-11
BUDGET
2010-11
EXPENDITURE
Up to Feb
2011
2011-12
BUDGET
% CHANGE
OVER 2010-11
1.
MATERNAL HEALTH
2263.84
1262.93
2275.09
0.50
2.
CHILD HEALTH
1763.38
2008.79
1812.30
2.77
3.
FAMILY PLANNING
196.99
193.26
874.50
343.93
4.
ARSH
114.76
56.62
107.83
-6.04
5.
URBAN RCH
153.32
55.64
236.00
53.93
6.
TRIBAL RCH
24.00
11.85
0.00
-100.00
7.
VULNERABLE GROUPS
200.07
0.22
100.00
-50.02
8.
Gender/PC&PNDT/Studies
128.24
106.75
260.51
103.14
9.
Human Resource
3738.13
2299.46
2581.90
-30.93
BUDGET OVERVIEW: RCH flexi pool
Sr.
No.
BUDGET HEAD
2010-11
BUDGET
2010-11
EXPENDITURE
2011-12
BUDGET
% CHANGE
OVER 2010-11
10.
INSTITUTIONAL STRENGTHENING
620.76
358.38
558.83
-9.98
11.
TRAINING
1362.77
987.40
1238.85
-9.09
12.
IEC/ BCC
919.52
682.20
972.50
5.76
13.
FINANCIAL MANAGEMENT
-
-
42.00
100.0
14.
PROGRAMME MANAGEMENT
1907.98
1251.88
2146.26
12.49
15.
JSY
20077.58
18241.51
18808.48
-6.32
16.
STERILISATION, IUD COMPENSATIONS
& NSV CAMPS
5730.00
5033.99
7187.50
34.22
39204.05
32550.87
39202.54
0.00
TOTAL RCH FLEXI POOL
BUDGET OVERVIEW: NRHM flexi pool
Sr.
No.
BUDGET HEAD
2010-11
BUDGET
2010-11
EXPENDITURE
2011-12
BUDGET
% CHANGE
OVER 201011
1.
ASHA
3464.06
1248.43
4460.70
28.77
2.
VILLAGE HEALTH & SANITATION
COMMITTEE (VHSC)
5539.30
1939.02
4996.58
-9.80
3.
STRENGTHENING OF SHCs
4158.32
2143.19
4105.20
-1.28
4.
STRENGTHENING OF PHCs
1979.75
637.68
1580.50
-20.17
5.
STRENGTHENING OF CHCs
1351.00
415.52
1164.50
-13.80
6.
ROGI KALYAN SAMITI
1519.00
584.09
1684.00
10.86
7.
PREPARATION OF DISTRICT PLAN
50.00
13.60
48.74
-2.52
8.
STRENGTHENING OF ANM, MPW,
LHV TRAINING CENTRES
288.00
168.10
201.50
-30.03
9.
SWABLAMBAN YOJANA
504.80
343.30
648.50
28.47
10.
STRENGTHENING OF IN-SERVICE
TRAINING FACILITIES
430.00
39.24
205.00
-52.33
11.
HEALTH MELA
218.40
96.37
249.00
14.01
BUDGET OVERVIEW: NRHM flexi pool
Sr.
No.
BUDGET HEAD
2010-11
BUDGET
2010-11
EXPENDITURE
2011-12
BUDGET
% CHANGE
OVER 201011
12.
MOBILITY SUPPORT FOR
SPECIALISTS, MEDICAL, PARAMEDICAL & PROGRAMME STAFF
871.20
530.09
871.20
0.00
13.
LOGISTICS
500.00
9.61
300.00
-40.00
14.
PROCUREMENT
1117.56
1901.21
2073.11
85.50
15.
QUALITY ASSURANCE
207.00
13.94
330.75
59.78
16.
DIFFICULT AREA PERFORMANCE
BASED ALLOWANCE
1000.00
-
200.00
(Rs. 300 lakhs
under MCH
Sub-plan)
-80.00
17.
UP-GRADATION OF HEALTH
FACILITIES AS PER IPHS
3774.47
1561.53
2082.00
-44.84
18.
MOBILE MEDICAL UNIT
1006.00
1490.50
895.02
-11.03
BUDGET OVERVIEW: NRHM flexi pool
Sr.
No.
BUDGET HEAD
2010-11
BUDGET
2010-11
EXPENDITUR
E
2011-12
BUDGET
% CHANGE
OVER 201011
19.
EMERGENCY MANAGEMENT
SERVICES SYSTEM
1118.50
1411.46
1485.00
32.77
20.
COMMUNITY MONITORING
20.00
0.67
95.14
375.70
21.
IMPROVING ACCESS TO MDR-TB
SERVICES UNDER RNTCP
-
-
101.92
-
22.
OPERATING COST FOR
RCH/NRHM INTERVENTIONS
-
-
715.40
-
23.
DISTRICT SPECIFIC
INTERVENTIONS
350.00
93.89
100.00
-71.43
24.
NRHM MANAGEMENT COST @
6% OF SANCTIONED ACTIVITIES
1212.02
616.31
1715.63
41.55
30719.38
15257.83
30309.38
-1.33
TOTAL NRHM FLEXI POOL
DIFFERENTIAL FINANCING FOR HIGH FOCUS DISTRICTS
S. NO.
STATE
HIGH FOCUS
DISTRICTS
% OF
TOTAL
50
34
68
750.86
485.13
64.6
1.
NO. OF DISTRICTS
2.
POPULATION
3.
PROPOSED RCH II BUDGET FOR
2011-12
(Rs. Lakhs)
39204.05
26914.82
68.6
4.
PROPOSED NRHM BUDGET FOR
2011-12
(Rs. Lakhs)
30309.38
19223.98
63.4
(in lakhs)
SERVICES OVERVIEW
S.
No.
INDICATOR
EXPECTED
Planned
REPORTED
Up to Feb
2011
%
ACHIEV.
1
Institutional delivery
2066120
1549590
1194183
77.06
2
Full immunisation
1928314
1542652
1378073
89.33
3
Sterilisation
700000
550000
599461
109.00
(upto 17.03.2011)
4
IUD insertion
620300
516917
325250
62.92
Maternal Health
14
Impact of Interventions
in reduction of MMR
MMR
600
500
498
400
408
300
Average 23.8 points
decline per annum
379
301
335
Average 8.8 points
decline per annum
220
254
200
India
Required average 19.2
points decline per annum
MP
100
100
0
1998
2003
Years
2006
2012
15
Maternal Health - Challenges
• Service Delivery
• Percentage of ANC registration in First Trimester – 33.8% (DLHS
III), 41.43% (JSY 2008)
• Percentage of PW with 3 ANC - 34.3% (DLHS), 60% (CES 2009)
• Institutional Delivery – 47.1% (DLHS III), 80.28% (JSY 2008) , 81%
(CES 2009)
• Quality
• Percentage of Birth Assisted by SBA – 52.8% (DLHS III), 82.9%
(CES 2009)
• Percentage of C-section – 3% (JSY 2008) 4.1% (HMIS)
• Percentage of Still Birth – 18 per thousand total birth (HMIS)
• Output
• Percentage of 24x7 operationalized – 86%
• Percentage of CEmONC operationalized – 65%
16
Reporting of deliveries – Bottlenecks and steps initiated
MP- Performance against estimated targets
April-Feb.'11
25.00
20.00
15.00
10.00
5.00
0.00
20.83
18.18
18.93
14.26
78.27%
Estimated PW
PW regd. for
ANC
75.33%
Estimated
Deliveries
reported
Deliveries
75.33%
1. Implementation of pregnancy tracking mechanism
2. Reporting of Home deliveries by ASHA
3. Co-relating JSY beneficiaries with institutional and home deliveries.
Status of Deliveries
MP-Deliveries
performance
April-Feb. '11
Deliveries at
Pvt.Inst., 110381,
6%
unreported
deliveries, 467418,
25%
Deliveries at
Pub.Inst., 1083802,
57%
Home Deliveries
232342
12%
Non SBA, 159790,
8%
SBA, 72552, 4%
1. SBA training of ANMs for ensuring safe delivery at home
2. Strengthening referral transport facilities for institution deliveries
MATERNAL HEALTH
Facility
Cumulative
Cum.
Incremental
target
Progress
Target
(2012) Till Mar. 2011
(10-11)
Progress
10-11
till Mar’11
Incr.
Target
(11-12)
FRU – DH
50
45
6
1
5
FRU – SDH - CH
35
20
10
3
8
FRU – CHC
35
19
6
1
3
24x7 FACILITIES
500
430
82
12
70
Sub-centres conducting deliveries,
with adequate infrastructure, incl. LR
300
189
250
189
111
Sub-district facilities providing safe
abortion services
389
169
50
25
220
Sub-district facilities providing RTI/
STI services
389
244
145
46
145
Bottlenecks in operationalizing EmONC Services
• Shortage of Specialist and Staff Nurses in proportion to
case load and bed strength of hospitals.
• Inadequate residential accommodation for service
providers.
• Maternity wing ill-equipped to provide quality services.
• Poor utilization of Blood Storage facilities.
• Scarcity of HIV testing kit at field level.
• All service providers at sub district level not trained for
provision of RTI/STI services.
• Skill based trainings not taken on priority.
• Post training follow up needs strengthening.
Steps initiated for strengthening EmONC service
Category
Medical
Officer
Specialists
Staff Nurse
Sanctioned
3790
Available
3583
Gap (%)
5
3057
7309
1177
3603
61
51
LHV
ANM
1973
10492
1680
12183
15
Surplus 16%
Lab Technician
1415
1058
25
Radiographer
667
427
36
Steps initiated for strengthening EmONC service
•
HR issue addressed by planning increase salary
package for staff Nurses and Specialist.
• Performance based management system will be
introduced.
• Hiring of Private Sector specialists.
• 72 MOs are trained in EmOC and 40 in LSAS.
• No. of ANM and GNM Schools are being Increased
Steps initiated for strengthening EmONC service
• 690 Compulsory Rural Posting of Graduates and PG Doctors
under Bond being intensively pursued
• 442 Doctors appointed under RCH with provision of 2-4 LMO
and 6-8 SNs in maternity wing of DH.
• 571 Doctors Recruited through PSC. Posting being done in
accordance with facility specific vacancy information
• 1810 ANMs Recruited under RCH and 1100 ANMs on
Regular basis
• 347 Staff Nurses under RCH and 1026 on Regular Basis
Recruited
Strengthening infrastructure
• Model maternity wing proposed in all DH with
support from 13th finance commission.
• Extension of maternity ward and upgradation
of labour room and provision of residential
quarters, proposed in MCH sub plan.
• Provision of construction of prefabricated
Level 1 MCH centers SHC.
• Provision of solar volotike power backup
system in 128 level 3 MCH centers.
INITIATIVES FOR STRENGTHENING OF CAC SERVICES
• GoMP extended its MoU with IPAS for another 4
years.
• Refresher TOTs Master trainers (76 Doctors and 39
nursing staff reoriented)
• 774 doctors and 650 nursing staff trained as certified
providers.
25
BLOOD SAFETY PROGRAM
• Coordination with MPSACS for establishing and
optimum utilization of BB and BSUs.
• Total Blood Bank
–
127
• Govt. Blood Bank
• GOI/PSU Blood Bank
• IRCS Blood Bank
• Private Blood Bank
• Blood Storage Centers – 61
–
–
–
–
47
07
04
69
26
Expansion of quality PPTCT services
• Total ICTC – 159
• Medical Colleges
–
11
• District Hospitals
–
50
• CH/CHC
–
79
• Other Hospital
–
03
• PPP ICTC
16
• FICTC (Level II & Level III ) – 195
• Provision of HIV testing kits for FICTCs, consumables
and one time grant for FICTCs and support to quality
assurance for 4 SRL made in PIP.
27
Maternal Death Review
Implementation Process…….
• District MCH Officers designated as district nodal
officer for maternal death review
• FBMDR committees constituted in all 50 DH and 5 MCs
• State Level Orientation of Gynecologists and MCH
Officers completed.
• Orientation of field staff at block level in process.
• Total No. of maternal deaths reported – 639
• MDR conducted - 179
– FBMDR – 179
– CBMDR – 163
28
Maternal Death Review – Causes of MD
Year 2010-11
Pulmonary
Unsafe Abortion
Embolism
2%
2%
Others
Hapatities
10%
2% APH
3%
Malaria
3%
Eclampsia
23%
Sepsis
7%
PPH
20%
Rapture Uterus
12%
Anemia
16%
CAUSES OF MATERNAL DEATHS
APRIL – Jan 2011 (HMIS)
Abortion
4%
Other Causes
(including causes
not known)
48%
Obstructed/prolo
nged labour
9%
Severe
hypertesnion/fits
12%
Bleeding
21%
High fever
6%
30
FREE & ASSURED REFERRAL TRANSPORT
Facility
Status 2010-11
(till Feb 2011)
Proposed
2011-12
No. of high focus districts having referral
transport / EMRI
34 (33 Janani Express and
1 EMRI)
-
Call centre at State/ district level
45 (44 at District level
for Janani Express & 1 for
EMRI at State level)
-
No. of EMRI ambulances
87 in 6 dist.
13 in 3 districts planned
Total - 100
50 in 4 districts
40 small ambulances
in 6 districts
No. of Ambulances in Govt. Institutions
531
108-type
from state budget
Whether ambulances fitted with GPS (Y/N)
No
Being Planned
Total no. of patients using referral transport
430551
850000
No. of pregnant women using referral transport
357154
650000
8863
32500
No. of sick newborns using referral transport
FREE & ASSURED REFERRAL TRANSPORT
Janani Express Yojana and EMRI-108
•
•
•
•
•
•
JEY linked with call center in 44 districts
Remaining 6 districts covered under EMS
Free Transport to All from home to facility and facility to higher facility in case of
referral
Drop back facility for pregnant women not being provided.
IEC activities being carried out
Budget provision for operationalizing call center @ Rs. 30000 PM and running cost of
JEY vehicles @ Rs. 18000-22000 PM under JSY fund.
32
FREE & ASSURED REFERRAL TRANSPORT – EMRI 108
• Operational with 87 ambulances in 6 districts, being expanded in 3
more adjoining districts with 13 ambulances.
• Provision of 40 small ambulances in 6 EMRI districts @ Rs. 7.00 lacs
and operating cost @ Rs. 12.00 lacs per annum
• Strengthening of EMRI-108 Call center for JEY ambulances @ Rs.
10.00 lacs
Highlights :•
35%. Pregnancy related cases
•
549 Deliveries in Ambulance
•
Average reach time 19 minutes
PROVISION OF FREE SERVICES FOR DELIVERY & NEWBORN
CARE FOR ALL CASES
Facility
Current Status
(Y/ N)
Plan for 2011-12
(Y/ N)
Provision of free drugs
Yes
Yes
Provision of free blood during complications
Yes
Yes
DH and CH
150 MCH-L3 centres
Free for BPL,
Subsidised charges
through RKS for APL
Free specialized
diagnostics services
through PPP or through
hospital strengthening in
MCH centres
Provision of free diet
Provision of free diagnostics
• Free delivery services including C-Sections in all Government institutions
for BPL
• Subsidized charges through RKS for admission, diagnostic services,
surgery for APL.
• Rs. 30 for diet for Indoor patients from State Budget.
• Provision of modular kitchen from NRHM budget made in PIP.
• IEC activities through wall writing, posters, hoardings and local IEC being
done.
JANANI SURAKSHA YOJANA
Target
‘10-11
Achv.
‘10-11
(till Jan
2011)
Proposed
‘11-12
Budget
‘10-11
(Rs. lakh)
Exp. ‘1011
(till Jan
2011)
Budget ‘1112
(Rs. lakh)
Home Deliv.
40000
14226
80000
200.00
68.82
400.00
Inst. Deliv. –
Rural
905328
809179
952000
15843.24
14475.94
13325.00
Inst. Deliv. –
Urban
279616
152472
179827
5355.39
1883.90
1798.27
C-sections
ASHA
incentive
Admin.
Costs
Included in HR
1184944
-
1052000
-
-
2699.00
678.95
359.59
583.21
Janani Suraksha Yojana
• Directives issued for verifications of 2% cases at divisional and 5%
district level.
• Total 46635 beneficiaries of JSY verified at various level and corrective
measures taken accordingly.
• Payment to beneficiaries by bearer cheques.
• Payment to ASHAs through e-transfer/ account payee cheques.
• Grievance redressel mechanisms at State/Division and District level.
• 31 private institutions accredited under Janani Sehyogi Yojana .
• BPL beneficiaries are given free treatment but JSY benefit is not
extended under janani Sehyogi .
• Payment to BPL home delivery beneficiaries through bearer
cheque/Cash is a matter of concern.
• Proposal of Cash assistance under JSY to motivators and beneficiaries
after 3 ANC check-up under consideration.
Child Health
Shift in IMR
India Vs MP
120
100
101
80
80
98
98
85
74
82
72
70
64
60
60
55
67
50
40
57
39
34
26
20
0
1990
1994
1998
2002
Projected Path India
Source : SRS Data
2005
2008
Projected Path MP
2009
2015
CHILD HEALTH
Facility
Cumulative
target (2012)
Cum.
progress till
Mar ‘11
Incremental
Target (1011)
Progress 1011 till Mar’11
Incremental
Target (1112)
SNCU – DH
45
23
21
10
22
NBSU – SDH, CHC,
etc.
70
24
50
24
46
NBCC – DH, SDH,
CHC, PHC, etc.
965
620
200
120
345
NBCC – Sub-centre
623
-
50
-
55
NRC
277
234
47
32
28
Status of Newborn treated in SNCU
22274
25000
20000
16019
15000
Admission
Death
10000
12.3%
2751
12.6%
2012
5000
0
2009-10
13 SNCU
2010-11 Till Jan. 2011
23 SNCU
Neonates Treated : Inborn v/s Outborn
22274
April 2010 - Jan. 2011
13572
8702
61%
Total Admission
Inborn
39%
Outborn
NBSU
At CEmONC CHC Beenagaj, District Guna
20 NBSU functional and 1100 Newborns Treated
NBCC
• New Born Care Corners planned at all delivery points (CEmONC & BEmONC)
• 620 New Born Care Corners operational & 345 planned in 2011-12
New Born Care Corner, CHC Tendukheda, Dist. Damoh
Status of IMNCI
•
•
IMNCI programme in 18 district scale up planned in 7 high focus district
Training completed in 12 districts
989
24956
942
805
81%
Total
Trained
871
795
17803
92%
16199
569
72%
71%
47094262
4592
88%
Medical Officer

Health
Supervisor
ICDS
Supervisor
Now ASHAs will be trained in module 6 & 7
ANM & MPW
28%
AWW
ASHA
IMNCI implementation status: (Till Jan. 2011)
Total
IMNCI Implementation
%age
District
18
18
100
Block
103
93
90
Sector
588
442
75
SHC
2903
2137
74
Village
18186
11119
61
60000
50000
40000
30000
20000
10000
0
54688
47636
0-2 month
Assessed
10.35 %
11.53 %
4934
6307
0-2 month
Referred
2 month-5 year 2 month-5 year
Assessed
Referred
IYCN Indicators
Breastfed within 1 hr of birth
43.1%
0-5m EBF
51.5%
6-9m receiving CF
Source : DLHS -3
39.6%
<3y with anaemia
82.3%
Source : NFHS-3
Severe wasted (W/H <-3SD)
12.6%
Existing Interventions under IYCN
 Management of SAM children through NRC
 Strengthening IYCF practices
– Training of frontline workers (ANM/AWW) on IYCF
practices
– Accreditation of DHs as Baby Friendly Hospitals
 Micronutrient supplementation to 9m-5y children
– Bal Suraksha Maah (BSM)
• Vitamin A supplementation
• Deworming
– IFA supplementation
47
Bal Shakti Yojna –
The Flagship Programme
NRC Dist. Hoshangabad
48
Scaling up of NRCs
234
202
100
47
8
2006
2007
2008
2009
Till Feb. 2011
Technical & Gap filling support by UNICEF
Management of <6m SAM children in NRCs
 Counseling mothers for correct
positioning and attachment to achieve
successful lactation
 Supplementary suckling technique (SST)
for mothers with lactation failure
(insufficient or no milk output)
234
93 (40%)
Total NRCs
NRCs practicing SST
SAM Children Managed in NRCs
46836
34369
24614
7182
2006-07
11953
2007-08
2008-09
2009-10
2010-11
(Till Feb. '11)
Establishment of 28 additional NRCs planned with 21 in High Focus districts in 2011-12
Proposed Financial Guidelines Under
Bal Shakti Yojna (2011-12)
NRHM fund
Establishment
Cost of NRC
Rs. 1,50,000/-
Running Cost of
NRC including
Follow Up
• Wage loss compensation
to mother Rs. 100/day
• Rs. 50/day spent on child’s
food as per protocols
Rs. 3000/- per SAM Child
HR Cost in
NRC (Paramedical Staff)
• Female Feeding
Demonstrator, Cook &
Caretaker
• Approx. Rs. 20,700/for 10 bedded NRC &
Rs. 30,000/- for 20
bedded NRC
Mother-Baby Friendly Hospital Initiative
Lancet series on Child survival, India analysis, 2004: Early childhood nutrition is
the single most important child survival intervention
Intervention




Child survival rate (%)
Breastfeeding
15.6
Complementary feeding
5.0
Newborn temperature management
2.4
Clean delivery
4.8
Zinc
4.1
Vitamin A
3.4
Measles vaccine
0.6
District level committees for M-BFHI formed
IYCN Cell operational since 2009 in Rewa Division with UNICEF support
10 breastfeeding counsellors appointed in 10 districts with NIPI & UNICEF support
>80% newborns initiated breastfeeding within 1 hr of birth in these districts
HBNC
• ASHAs will be trained in module 6 & 7 across the state for provision of
home based newborn care
• 19 Master trainers trained at Gardhchiroli
• 419 district level trainers trained
• 162 training sites identified
• Incentives to ASHA for provision of HBNC planned under ASHA
programme
Bottle Necks
SNCU & NBSU
• Lack of suitable space within DH/ SDH/ CHC adjoining
LR/MW
• Slow progress of civil works
• Crunch of Staff Nurses and Paediatricians for SNCU &
NBSU placement
• High drop-out rates of trained manpower
• Procuremental delays
Bottle Necks
NRC
• Delay in civil works
• Poor identification, mobilization and referral of SUW
to NRCs by AWW
• Necessitation of long stay in NRC causes de-motivation
in parents/ guardians
• High drop-out rates of trained manpower
• Poor quality of locally available milk and lack of
micronutrients causes less than expected weight gain
in SAM children
• Absence of community & facility based linkages in
management of SAM
Corrective measures
• Site selection for SNCU in existing DH
• Proposition of new buildings adjoining to MMW, where space is unavailable
• Pre- fabricated buildings under consideration for expediting civil works
• Out of state & private colleges staff nurses allowed
• Salary package of contractual personnels (SN/ PGMO/ FD) made more attractive
• De-centreralized procurement policy and enhancement of financial powers of CM&HOs
for addressing procurement delays
• Training & usage MUAC tool by AWW for early & correct identification of SAM
• Proposal of hike in wage loss compensation for mothers of SAM children
• Procurement procedures for therapeutic F-75 & F-100 initiated
• IMSAM programme to be piloted in 2 select districts for linking community & facility
m/m of SAM children
Child Health Plan 2011-12
Child Health
(Rs, In lakhs)
Nutrition
(Rs. In lakhs)
Total
CH
99.00
1713.00
1812.00
HR
501.24
704.84
1206.08
Training
258.34
56.32
314.66
Procurement
133.50
200.00
333.50
Civil
100.00
382.00
482.00
1092.08
3056.16
4148.24
Activity
Total CH
Family Planning
Family Welfare
S.N
Indicators
Madhya Pradesh
India
3.3
2.6
52.8%
48.5%
Male Sterilization
1.3%
1%
Female Sterilization
44.3%
37.3%
Oral Pills
1.7%
3.1%
IUDs
0.7%
1.8%
Condoms
4.9%
5.3%
5.
Unmet need for spacing
5.5%
6.3%
6.
Unmet need for terminal
methods
6.3%
6.8%
1.
Total Fertility Rate ( SRS 2008)
2
CPR (any modern method)
3.
CPR (limiting methods)
4.
CPR (spacing methods)
60
Source – NFHS-III
FAMILY PLANNING
Fixed Day Static FP
Services
Cum. target
(2012)
Cum.
progress till
Feb. 2011
Incremental
Target (1011)
Progress 1011
till Mar’11
Incr.
Target
(11-12)
DH & SDH providing Lap
ster. services
106
82
25
30
24
DH & SDH providing
Minilap ster. services
66
46
25
9
20
DH & SDH providing NSV
services
80
60
25
6
20
CHC & PHC providing
Minilap services
200
150
25
9
50
CHC & PHC providing
NSV services
240
200
25
6
40
Family Planning Achievement
STERILISATION BY METHOD
APRIL-MARCH
2005-2010
Sr.No.
Year
LTT
TT
NSVT
Total
1
2005-06
272,268
64,037
30,625
366,930
2
2006-07
300,515
54,758
11,569
366,842
3
2007-08
367,843
59,537
30,816
458,196
4
2008-09
348,606
62,034
29,891
440,531
5
2009-10
332,281
54,100
18,607
404,988
6
2010-11
479,518
80,187
35,568
5,95,273
Family Planning Achievement
STERILISATION BY METHOD
APRIL-15 MARCH 2011
Sr.No.
Year
LTT
TT
NSVT
Total
1
Gwalior
70,857
4,299
2,578
77,734
2
Ujjain
39,549
31,601
5,951
77,101
3
Bhopal
72,547
9,934
4,288
86,769
4
Rewa
55,276
1,695
8,587
65,558
5
Indore
85,881
21,513
2,794
110,188
6
Jabalpur
89,580
9,079
7,295
105,954
Sagar
59,487
1885
1776
63,148
TOTAL
473,177
80,006
33,269
586,452
FAMILY PLANNING
Key issues in operationalisation of FDS services and steps proposed:


Irrational placement of trained providers.
Reluctance of trained providers and lack of confidence.
Strategy:





Strong political commitment and interdepartmental
coordination.
Rational posting of trained providers.
Re-orientation and training to regain confidence.
Focus on minilap and NSV through training to MBBS doctors.
No. of training sites for minilap and NSV increased.
FAMILY PLANNING
Post-partum FP services:

Post-partum sterilisation (Feb 2011) – 27773 (5.8%), planned to
achieve 30% PP sterilization to take leverage of increasing ID.

Accredited private institutions/NGOs providing FP services - 84
Total sterilisations conducted - 9053 (1.9%) (Feb 2011)

Training to field workers, counsellors and ASHAs/AWWs on
counselling skills.
-
FAMILY PLANNING
IUD Services:

257 Master Trainers (MO, SNs, DPHNs, Sister Tutors, LHVs)
trained

438 (43.8%) MOs/SNs trained against the target of 1000

1722 (68.9%) ANMs trained against the target of 2500

Close monitoring & supportive supervision to facilitate
insertions

Compensation to acceptors for IUD acceptance proposed in
plan 2011-12.
ARSH & SCHOOL HEALTH (SHP)
Facility
Target
10-11
Progress
10-11
Target
11-12
32
27
18
-
-
-
AFHS clinic – CHC
54
40
-
AFHS clinic – PHC
-
-
-
50
50
50
Schools covered
106315
102850
110495
Students covered
9750000
3726967
10407306
Students given IFA/ deworming tablets
9750000
2720650
10407306
AFHS clinic – DH
AFHS clinic – SDH, etc.
Districts covered under SHP
ARSH & SCHOOL HEALTH (SHP)
• Lack of separate space in hospitals for ensuring
privacy for providing ARSH services
• Regular orientation needed for district level officers
regarding ARSH program
• Distribution of IFA & de-worming tablets through
school teachers, consumption is difficult to monitor
• Additional Rs. 10 cr. would be required to cover all
children Under mid-day meal scheme
ARSH 2011-12
Activity
Budget in lac
Formation of ARSH Club and Orientation and incentive to
members
43.50
Adolescent clinic in 18 districts hospital
9.00
Awareness creation of adolescents by NGO in 2 identified
districts
25.00
Promotion of Menstrual hygiene in Adol. girls of 1
identified district ( for Production centres)
9.00
Telecast of weekly Phone-in Programme on All India Radio
for orientation of youth on ARSH issues and addressing
their queries across the state
21.33
107.83
69
URBAN RCH Health
•
•
•
GIS mapping of health facility in public and private along with
AWCs in 8 identified districts.
Fixed day health activities in urban slums in 14 identified cities
with referral mechanism for seriously ill patients and for NCDs.
Capacity building of link worker (USHA & CBOs)
Activity
Budget in lac
GIS Mapping of health facilities in identified 8 cities
9.00
and situation analysis
Capacity Building of USHAs and CBOs
37.50
186.00
Organization of bi monthly health camp in
urban slums and provision of vouchers
Exposure visits for observation on Best Practices
3.50
Total
236.00
GENDER & SEX RATIO
• Nodal officer designated for gender equity at state
and district level.
• PNDT cell functional at state and district level
• Monitoring of Sex ratio at birth is being done. Sex
ratio at birth showing increasing trend (HMIS Data)
• Focused IEC interventions being implemented to
"Save the girl child"  Bitiya Campaign launched at State and district level.
 Parents with one and only daughter club formed
 Awareness generation workshops held.
GENDER & SEX RATIO
 Regular monitoring and review meetings held involving
member of district level supervisory committee.
 Meetings and consultations with various stake holders
held and review of enforcement of PC&PNDT act at
district level through Video Conferencing.
 Regular meetings of supervisory and advisory boards at
state and district level are ensured.
 Regular inspections of USG centres as per provision in
the Act.
Status of Implementation of PC&PNDT
No.
Activities
Achievements
1
No. of registered bodies
1424
2
No. of court cases
3
Inspection up to September 2010
4
Cancellation
26
5
Suspension
7
15
549 institutions
73
Activities & Budget for 2011-12
Activities
Budget (Rs.
in lacs)
State level workshop of Club of parents only daughter
5.00
Divisional level Workshop for media personnel and service
providers
14.00
Hiring services(contractual staff)
6.30
4.96
PC & PNDT supervisory and advisory board meetings
Awareness generation on PC & PNDT Act among common
people and inspection of USG centers.
160.25
Other Activities (Evaluation of JEY & Impact assessment of
NRC)
70.00
Total
260.51
74
Facility based reporting in HMIS portal
• Online data entry for monthly report being done for all
313 Blocks & 50 Districts
• Facility master data base created in web portal for all
the districts.
• Training workshop of District and Block Level Health
officials regarding online uploading of facility based
HMIS Data will be planned in April 2011
• Online facility based HMIS Data uploading in web Portal
process will be piloted in 2 districts from April 2011
• Online facility based HMIS Data uploading in web Portal
process will be started from All districts after the
successful implementation of pilot in 2 districts.
• Printed formats made available at all levels.
Plan for roll-out of MCTS and uploading data
•
Training
of
district
and
block
level
health
funtonaries/managers conducted.
•
Master data base created for all the facilities.
•
Data entry started from December 2010. so far more than
23000 records entered.
Capacity Building
•
HMIS data for 2008-09 & 2009-10 have been validated
•
Quaterly review meetings are held at State/Divisional level
to review the Physical & Financial progress using HMIS data.
•
Regular release of monthly health bulletin on various key
process indicators is being done and also uploaded on
departmental website along with graphical analysis.
•
Consultants visiting districts and blocks frequently to
ascertain consistency and quality of data.
•
Training of DPMU/BPMUs staff will be planned in April-May
2011
Proposed Activities 2011-12
• To strengthen Maternal Child Tracking System - post of MCTS
consultant
• Laptops for all 313 BPMUs
• For customization of MCTS and maintenance of website- post of
Programmer cum web manager
Budget Head
Budget
(Rs. in lakhs)
Strengthening of M & E/HMIS
136.59
Procurement of Hardware (Laptops & Desktops)and
Software and other equipments
330.30
Workshops/Training on M & E/HMIS
Printing of Formats
86.94
5.00
Total
558.83
78
Training
TRAINING
S.
No.
TRAINING
10-11
Target
10-11
Achiev.
11-12
Target
1
SBA - SN
400
196
336
2
SBA – ANM/ LHV
600
588
536
3
BEmOC – MO
400
121
40
4
BEmONC Foundation
128
87
-
5
EmOC, incl. c-section – MO
32
13
32
6
LSAS – MO
16
17
16
7
MTP – MO
150
101
160
8
RTI/ STI – MO
631
101
150
9
RTI/ STI – SN
90
83
75
10
RTI/ STI – LT
11
IMNCI – ANM/ Supervisor
3840
724
1536
12
IMNCI – AWW/ ASHA
13
F-IMNCI – MO/MC Faculty/PGMO
730
202
528
14
F-IMNCI – SN
360
81
192
15
NSSK – MO
1193
980
213
NSSK – SN
1124
920
204
4706
TRAINING
S.
No.
TRAINING
10-11
Target
10-11
Achiev.
11-12
Target
2022
1800
222
16
NSSK – ANM/ LHV
17
Lap Ster.
50
31
50
18
Minilap Ster.
100
42
100
19
NSV
100
17
100
20
IUD – MO
21
IUD – SN
22
IUD – ANM/ LHV
2500
1722
1500
23
ARSH – MO
400
97
200
24
ARSH – SN
400
263
200
25
ARSH – ANM
26
ARSH - Counsellor
44
44
-
27
ARSH – Prog. Mgr.
26 distt.
26 distt.
24 distt.
205
1000
233
250
Training Budget -: 2011-12
Activities
Budget (Rs.
in lacs)
Maternal Health Training
461.14
Child Health Training
314.66
Family Planning Training
70.01
38.80
ARSH
Public Health & Other Health Management Training
including Financial Management
CME for doctors and Nurses
Total
349.25
5.00
1238.86
82
TRAINING
•
•
•
•
•
5 Government Medical College, SIHMC, 3 RHFWTCs and 47
district hospitals have been identified as training site for skilled
based health trainings.
Master trainers available in adequate numbers.
Shortage of faculty in training centres
To monitor quality of training and post training skills utilization
training coordinators have been positioned under MH, CH and
FW program.
32 ANMTC, 3 RHFWTC, 1 SIHMC and 34 DTC will be
strengthened and Rs. 4.06 Cr. have been proposed in PIP
TRAINING
•
•
•
•
Quality assurance committee has also been assigned
responsibility for monitoring of trainings
Due to Shortage of manpower (Medical officers, Staff Nurse &
ANM) in the district, nominated candidate are not relieved for
the training for CMHO/BMO
Post training placement of EmONC and LSAS trained doctors is
being ensured.
SIHMC and RHFWTC faculty also involved in follow up of
training.
IEC/BCC
Main Activities
Amount
Proposed
Implementation of specific interventions
including innovations on BCC strategies/plans
at district level
125.00
Implementation of specific interventions
including innovations on BCC strategies/plans
at block level
469.50
Implementation of specific IEC activities at
state level (Maternal health/JSY/Child
health/FP/ARSH & others) including printing,
hoardings, wall paintings, news paper
advertisements etc.
Capacity building of state IEC bureau staff &
distt./block/field level functionaries
300.00
Total
35.00
929.5
Expected output
Change in health seeking
behavior of people i.e. rise in
demand for services.
IEC functionaries at state/
dist./block level become
more capable.
MCH CENTERS
PLANNING & OPERATIONALIZATION
86
Differential Planning –
Focus on 34 High Focus Districts
*
B HD
MR N
Tribal Districts
GL R
*
DTA
S OP
S VP
TK M
NMC
GUN
AK N
PAN
*
R TM
*
JBA
DHR
DMH
UMR
K TN
B PL
UJ N
*
IDR
*
* *
BRW
VDS
RJG
S TN
S DH
N
S AG
MDS
SJP
R WA
C TP
KRG
S HE
DEW
DWS
*
K ND
JBP
RS
NS P
HS B
HR D
*
B TL
*
CD
*
S DL
**
*
*
*
DDR
*
*
ANP
MDL
S NI
BLG
*
High focus Districts
Non High focus Dist.
B HP
87
Total MCH Centers
Sr.
No.
Type of Health
Institution
Total Inst.
Level III
Level II
Level I
Total
1.
Medical College
5 Govt.
5 Pvt.
10
0
0
10
2.
District Hospital
50
50
0
0
50
3.
Civil Hospital
56
36
13
0
49
4.
CHCs
333
64
243
0
307
5.
PHCs
1156
0
558
0
558
6.
SHCs
8659
0
0
623
623
7.
PPP
-
24
0
0
24
10263
184
814
623
1621
Total
88
MCH Centre in 34 High Focus Districts
Sr. No.
Type of Health
Institution
Level III
Level II
Level I
Total
1.
Medical College
1
0
0
1
2.
District Hospital
34
0
0
34
3.
Civil Hospital
16
05
0
21
4.
CHCs
48
179
0
227
5.
PHCs
0
395
0
395
6.
SHCs
0
0
455
455
7.
PPP
15
0
0
15
114
579
455
1148
Total
89
Infrastructure Upgradation: MCH Centers
• Construction of Model Maternity wings in DH: Budget
support through 13th Finance Commission
• Upgradation of other Infrastructure under NRHM (MCH Sub
Plan)
• Phasing of infrastructure upgradation for MCH centers in HFD
 Level-I (SHCs)
–
2 years
 Level-II PHCs
–
2 Years
 Level-II CHCs
–
3 Years
 Level-III CHCs
–
3 Years
 Level-III DHs
–
3 Years
• Provision of essential equipments in MCH centers on need
basis.
90
Budget Provisions in MCH Sub Plan: Civil Work
In Crores.
MCH Center
Financial Requirement
2011-12
Level – 1 (SHCs)
56.97
Level – 2 (PHCs)
79.00
Level – 2 (CHCs)
35.80
Level-3 (DH/CH/CHC)
34.00
Level-3 (Medical College)
3.84
Total Infrastructure
209. 61
91
Budget Summary Sub Plan MCH Year 2011-12
In Crores.
MCH Center
Level 1 MCH centers equipments 111 @1.37Lac per
centre
Level 2 MCH centers equipments -288 @12.25 Lac
per centre
Level 3 MCH centers equipments - 100 @24.22 Lac
per centre (DH being equipped by 13th finance
commission)
Total Equipment
Difficult area allowance for staff posted in difficult
Level - 3 MCH centers
Grand Total
Financial
Requirement
2011-12
1.52
35.28
24.22
61.02
3.00
273.64
92
MISSION FLEXIPOOL
ASHA -Selection & Training Status
Physical
Activity
Target
Achiev.
%
Selection of ASHA
52117
50113
96.15
Training on Module 1
50113
49041
97.86
Training on Module 2
50113
46180
92.15
Training on Module 3
50113
46009
91.81
Training on Module 4
50113
44223
88.25
Training on Module 5
Refresher training (Module 1-4)
50113
50113
10570
18992
21.09
37.90
Training of ASHA - Module 6 &7
• Training of state level trainers
• Identification of State training sites
Training started at 4 places
• No. of State level ToT batches planned
• No. of State level ToT batches completed
• Identification of District training sites
• No. of district level trainers trained
• ASHA Kit procurement
• ASHA Module and Manual printing
• Reporting Formats
– 19
- 5
-
16
16
160
419
– Tender floated.
- in process
- finalized by Technical
committee
ASHAs
Activity
Status
Total Number of ASHAs in the State
50,113
Population Per ASHA
Appx. 1,000
Drug Kits (Norm: Rs 600/Kit)
• Amount proposed per kit
• Total Number of Kits to be procured• Total Amount proposed
Rs. 600/Kit
45552
Rs. 273.31 lacs
Expenditure on Selection, Training
• Total amount proposed
• Amount proposed per ASHA
Rs 2150.19 lacs
Rs 10069
Total amount proposed for paying incentives
Rs 1874.35 lacs
Non monetary incentives
Provision of Rs. 100.00 lacs
VHSC Plan -2011-12
• Constitution of VHSCs
as Swastha Gram Samiti
-
44438
• Untied fund to SGSs
-
44438
• Development of Training Module for SGS members
• TOT for SGS trainers
-
450
• SGS Training batches
-
1017
• Development of integrated village health plan
Untied Fund
Facility Type /
CHC
PHC
SC
Villages
No. of facilities
(As per
RHS/No.
Proposed in
PIP)
Norm ( Rs. in lacs)
Untied funds
to Facilities
Total
( Rs. in lacs)
VHSC
333 / 333
0.50
166.50
1156 / 1156
0.25
289.00
8869 / 8869
0.10
886.90
521117 / 44438
Total
0.10
4438.00
5780.40
AMG
Facility Type /
No. of facilities
(As per RHS/No.
Proposed in PIP)
Norm
Total
( Rs. in lacs)
CHC
333 / 333
1.00
333.00
1156 / 961
0.50
480.50
8869 / 6926
0.10
692.60
PHC
SC
Total
1506.10
RKS - Corpus Grant
No. of facilities
(As per RHS/No.
Proposed in PIP)
Norm
Total
( Rs. in lacs)
50
5.00
250.00
CH
CHC
56
1.00
56.00
333 / 328
1.00
328.00
PHC
1156 / 1050
1.00
1050.00
Facility Type /
DH
Total
1684.00
INFRASTRUCTURE
Type of
Health
Institution
Total No.
Functioning
Available
Buildings
as per
norms
Functioning
in buildings
less than
norms
Buildings
Under
Constructi
on
No. of
Buildings
Required to
be
Constructed
District
Hospitals
50
41
9
5
4
CHC
333
190
143
71
72
PHC
1156
994
162
97
65
SHC
8869
6443
2426
912
1514
Infrastructure Development
2010-11
Particular of Work
District Hospitals (Total 50)
Upgradation of District Hospital Building as
per IPHS (ongoing)
Construction of level II SNCU at DH
Construction of 20 Bedded Maternity
Wards at DH
Construction of 20 Bedded Paediatric
Wards at DH
Construction of Blood Bank Building at
DH
Construction of Drug store cum CMHO
office Building at DH (ongoing since
2009-10)
Construction of Model Labour Room at
DH
No. Of Works Completed
Sanctioned
Under
Progress
5
1
4
17
17
12
4
5
13
7
0
7
1
0
1
14
(ongoing)
7
7
4
3
1
Infrastructure Development
2010-11
Particular of Work
No. Of Works
Sanctioned
Completed
Under
Progress
Upgradation works as per IPHS in
CHC/CH (ongoing)
40
4
36
Construction of CHC Buildings
6
(ongoing)
2
4
Construction of Labour Rooms at FRU
(CHC level)
40
(ongoing)
13
27
Construction of Staff Duty Room with
Female Toilet in 60 FRU (CHC level)
20
(ongoing)
14
6
Construction pf PHC Building
61
31
30
Construction of SHC Building
484 (ongoing)
328
156
INFRASTRUCTURE
Amt. in lacs
Activity
SC
No
PHC
Amt.
No
Amt.
CHC
No
DH
Amt.
No
Amt.
Others
No
Amt.
New
Const.
156
150
26
411
3
245
-
-
-
-
Upgradation
34
901
10
400
47
620
50
1282
43
877.50
•
•
Infrastructure budget as % of total budget- 17.93%
Amt. for block and below level facilities (as % of Infra Budget)- 53.20%
INFRASTRUCTURE
Amt. in lacs
Sub-Centre rent
No. of SC
Amt @ Rs 250/SC
Amt proposed in PIP
1035
31.05
From untied fund
Amount proposed for other activities
Hospital Strengthening
Mobility Support
Others (pl specify)
300
From NRHM Mgt. cost
Nil
Procurement of Equipments & Drugs
Category
Drugs
Equipment
Others
Total
(In
Lakhs)
Units Amount Units Amount Units Amount
MH
CH
10.00
62.55
200.00
133.50
ARSH
Infrastructure
Strengthening
ASHA
273.31
38.76
Warehouse racks/
Vacc. Cleaner
273.00
Total
376.49
--
333.50
217.16
217.16
255.00
21.60
294.91
4.28
43.04
255.00
PROMIS
Small Ambulances
for Janani Exp
303.94
273.00
280.00
280.00
2073.10
MMU
Category
MMU
•
•
No. of Districts
0
MMU
1
>1
MMU MMU
28
07
15
Existing
number
91
New
Proposed
32
Total 123
Capital
Cost
(per
unit)
Nil
Operational Cost
(In Lakh)
Unit Cost
(Annual)
Total
16.66
(Revised)
2049.88
Cost of MMU (per unit per month) – Rs1.39 Lakh (revised)
Cases per MMU per month – 2158 (current)
Amount
Propose
d (In
Lakh)
895.02
MMU
•
Being upscaled to areas with high % of SC population & LWE area – work
orders issued, services expected to start by end of April 2011
•
Total 122 blocks covered through 123 MMUs • Tribal blocks
- 90 MMUs in 89 blocks
• Blocks with high SC pop.
- 31 MMUs in 31 blocks
• LWE blocks
- 02 MMUs in 02 blocks
•
Blocks divided into Clusters; Pathology services added.
•
Effective monitoring through GPS and Bio-metric attendance.
•
Provision of Rs. 7 Cr. in State budget for SC blocks.
MMU
Activity
Physical
Target
Budget
(Rs in Lakhs)
MMUs in 89 tribal, 02 LWE affected blocks and 01
for Primitive Baiga tribe
92
863.04
MMUs in SC blocks
31
State Budget
State monitoring unit for Mobile Medical units
01
06.98
GPS Monitoring of MMUs
--
25.00
Total MMU
895.02
HUMAN RESOURCE
Category
Medical
Officer
Sanctioned
3790
Available
3583
Gap (%)
5
Specialists
Staff Nurse
LHV
3057
7309
1973
1177
3603
1680
61
51
15
ANM
10492
12183
Surplus 16%
Lab Technician
1415
1058
25
Radiographer
667
427
36
HUMAN RESOURCE
Category
SpecialistsPG’S
Existing (in 2010- Proposed (in
11)
2011-12)
150
100
Diploma
Unit cost
proposed
40,000
Total Amount (in
lacs)
100.00
37500
Doctors
292
170
30,000
138.60
Ayush Doctors
164
600
18000
137.52
Nurses
347
315
15000
99.30
ANMs
1810
520
6000
139.80
Lab Tech
106
30
7000
9.52
Ayush
Pharmacist
Others (specify)
164
-
8000
13.12
Total
3033
1735
637.86
HR Initiatives
• HR Database for Doctors Created
• HR Deployment in terms of Graduates and PG being
Rationalized, Specialists being relocated as per institutional
requirements
• 950 posts of M.O.’s being created for Deputation and Training
Reserve
• Contractual Doctors are being Progressively Regularised
• Cadres Reforms: Clinical/Public Health in Progress
• One Year Diploma Course in Public Health Management
Initiated in Collaboration with PHFI
112
HR Initiatives
•
•
•
•
•
•
•
•
Increased Honorarium for all cadres.
Hiring of Private Sector specialists.
72 MOs are trained in EmOC and 40 in LSAS.
Provision of performance based incentives for EmOC and
LSAS trained Doctors.
No. of ANM Schools Increased from 29 to 32
Additional 18 ANM Schools planned so as to reach target of
one ANM School per district
Two B.Sc. Nursing Schools added to take the total to three,
next year four more are to be added
Seven G.N.M. Schools to be added next year to take the
total to twenty
113
Programme Management Staff
Category
Existing (in
2010-11)
Proposed (in
2011-12)
Unit cost
proposed
Total Amount
(in lacs)
12000-30000
346.56
6000-14000
1277.04
DPMU
DPM, DAM,DA
95
150
BPMU
BPM, Block &
PHC BeMONC
Accountant,
Data Entry
Operator
996
1189
DECENTRALIZED HEALTH PLANNING
•
•
•
•
•
•
•
•
No. of districts in the State
No. of high focus districts
No. of DHAP prepared and sent
to Ministry
Has resource envelop indicated to
all districts
Is higher weightage of 1:1.3 given
to high focus districts
No. of blocks where Block Plan
made
No. of Villages
No. of villages with VHSCs
- 50
- 34
- 50
- Yes
- No
- 313
- 52117
- 44437
NRHM Part – C
IMMUNIZATION
BUDGET OVERVIEW
S.
NO.
BUDGET HEAD
2010-11
BUDGET
2010-11
EXPENDITUR
E
1
RI strengthening project (Review
meeting, Mobility support,
Outreach services etc)
1619.9
997.89
1631.94
0.74
2
Salary of Contractual Staff
52.8
34.64
52.8
0.00
3
Training under Immunisation
342.9
79.35
257.96
- 24.77
4
Cold chain maintenance
12.71
14.12
259.71 *
1943.35
5
Pulse Polio operating costs
1500.08
187.61
1728.35
15
3528.39
1313.61
3930.7
6
11.40
TOTAL IMMUNISATION
2011-12
% CHANGE
BUDGET OVER 2010-11
* Rs 240 lacs for POL for Gen sets have been included Under cold chain maintenance head
for the year 2011-12
IMMUNISATION - Training
Indicators
Target (1011)
Progress 1011
Target
(11-12)
No. of immunisation
sessions
Training of MOs
600000
568000
700000
2500
756
1800
Training of HW
6500
4618
4250
Training of cold chain
handlers
1450
1450
1450
Review meetings
1456
1038
1456
IMMUNISATION - AVD
• Mechanism for alternate vaccine delivery
– Partially operationalized, tenders invited – rates
were 3 to 4 times higher.
– AVD is done by JSRs, ANMs / ASHA relative, few NGO
volunteers.
• Status of alternate vaccinators in urban slum
– Retired ANM/LHV/SN/Pharmacist are designated,
but consistency & accountability lacks.
IMMUNISATION – Cold Chain
Status of cold chain maintenance
• Sickness rate is below 2%.
• NRHM funds insufficient, State resources were
utilized.
• Funds for WIC/WIF maintenance have been
provisioned in addition to district budget.
• EVM recommendations have been incorporated
in relevant sections of State PIP.
IMMUNISATION
supervision & Monitoring
Systems for supervision and monitoring
• Comprehensive VHND monitoring plan has
been implemented, wherein state, divisional,
district & block officers were given minimum
targets to supervise sessions.
• Revised checklist, with modifications to suit
state needs is being used.
National Disease Control Program
Part - D
RNTCP
RNTCP Performance Indicators
RNTCP Performance Indicators :- NSP CDR /TSR – 59%/88%
Name of the
district/districts
NSP
CDR/Treatm
ent Success
Rate (TSR)
Reasons for poor
performance
Proposed
solutions
/Activities in
PIP
Constraints
-Suboptimal Priority to
RNTCP
-Low referral
-Suboptimal S&M
-Suboptimal ACSM
-Suboptimal Community
Involvement
- Strengthening
referrals and S&M
-Designation of OICc
for Intensive S & M
-Contact Tracing
-Involvement of
ASHAs, Community,
NGOs and PPs
-Strengthening
ACSM activities
- Involvement of
NRCs
-Suboptimal
Involvement of
Medical Colleges
and PPs
-Suboptimal
Involvement of
General Health
System
Poor Performing Districts
Betul
35/87
Bhind
34/85
Bhopal
76/76
Chindwara
41/86
Dindori
48/84
Harda
37/80
Morena
32/85
Raisen
35/88
Rajgarh
42/87
Ratlam
47/87
*Poor performing Districts are Districts with Case Detection rate < 50% and Treatment Success rate < 80%
Moderate performing Districts are Districts with Case Detection 50 – 59% and Treatment Success rate 80 – 85%
RNTCP Performance Indicators
RNTCP Performance Indicators :- NSP CDR /TSR – 59%/88%
Name of the
district/districts
NSP
CDR/Treatm
ent Success
Rate (TSR)
Reasons for poor
performance
Proposed
solutions
/Activities in
PIP
Constraints
-Suboptimal Priority to
RNTCP
-Low referral
-Suboptimal S&M
-Suboptimal ACSM
-Suboptimal Community
Involvement
- Strengthening
referrals and S&M
-Designation of OICc
for Intensive S & M
-Contact Tracing
-Involvement of
ASHAs, Community,
NGOs and PPs
-Strengthening
ACSM activities
- Involvement of
NRCs
-Suboptimal
Involvement of
Medical Colleges
and PPs
-Suboptimal
Involvement of
General Health
System
Poor Performing Districts
Sehore
39/87
Seoni
37/86
Tikamgarh
35/84
Ujjain
49/88
Umaria
41/90
*Poor performing Districts are Districts with Case Detection rate < 50% and Treatment Success rate < 80%
Moderate performing Districts are Districts with Case Detection 50 – 59% and Treatment Success rate 80 – 85%
RNTCP Performance Indicators
RNTCP Performance Indicators :- NSP CDR /TSR - 59%/88%
Name of the
district/districts
NSP
CDR/Treatm
ent Success
Rate (TSR)
Reasons for poor
performance
Proposed
solutions
/Activities in
PIP
Constraints
-Suboptimal Priority to
RNTCP
-Low referral
-Suboptimal S&M
-Suboptimal ACSM
-Suboptimal Community
Involvement
- Strengthening
referrals and S&M
-Designation of
OICc for Intensive S
&M
-Contact Tracing
-Involvement of
ASHAs, Community,
NGOs and PPs
-Strengthening
ACSM activities
- Involvement of
NRCs
-Suboptimal
Involvement of
Medical Colleges
and PPs
-Suboptimal
Involvement of
General Health
System
Moderate Performing Districts
Balaghat
52/90
Barwani
56/86
Dewas
57/86
Guna
55/89
Narsingpur
53/88
Rewa
57/88
Shahdol
56/89
Sidhi
53/88
Vidisha
55/89
*Poor performing Districts are Districts with Case Detection rate < 50% and Treatment Success rate < 80%
Moderate performing Districts are Districts with Case Detection 50 – 59% and Treatment Success rate 80 – 85%
Status of IRL and DOTS Plus
Districts
Implementing
DOTS
Plus/Proposed
Status of IRL and
services offered
Districts
already
implemen
ting
District
s
propos
ed for
201112
Solid Liquid
Cultur culture
e
LPA
0
25
_
_
_
DOTS Plus
Site
No of
Patients
proposed
to Put on
DOTS Plus
( 2011-12)
IndoreUpgraded.
Bhopal-Under
up gradation
process
ProposedJabalpur, Ujjain
and Gwaliar
125
Human
Resource
status for
DOTS Plus
Sr.DOTS Plus &
TB-HIV
Supervisor
appointed at
Indore.
Recruitment of
DPS-Sr.MO,
Supervisors,
DPS-SAs, in
process
Mycobacterial Culture and DST Laboratory at Jabalpur (RMRCT) accredited. Two more
C/DST labs – CHRC, Indore and BMHRC, Bhopal to be accredited on 18th and 19th March,
2011
Budget heads and Amount proposed
Sr. No.
Budget heads
Amount proposed (INR in lacs)
1
2
3
4
5
Civil works
Laboratory materials
Honorarium
IEC/ Publicity
Equipment maintenance
125.14
112.05
116.30
89.4
48.70
6
7
8
9
10
11
12
13
14
15
16
Training
Vehicle maintenance
Vehicle hiring
NGO/PP support
Miscellaneous
Contractual services
Printing
Research and studies
Medical Colleges
Procurement –vehicles
Procurement – equipment
96.30
54.66
167.36
197.66
95.81
906.97
100.00
1.00
85.61
63.00
15.60
17
Tribal Action Plan
Total
Included in respective heads
2275.56
National Vector Born
Disease Control
Programme
NVBDCP
Component
Human Resource
Training
Infrastructure
Procurement
IEC
Untied funds
Honorarium & incentives
RKS
Other Mission
PPP/NGO
Operating Cost
Financial aid/grant to
institutions
Grand Total ( A)
NRHM Management Operational Cost
Grand Total ( B )
Provision for
2010-11
519.98
141.70
0.00
1471.37
168.00
0.00
160.00
0
0
0
217.40
Sanction for
2010-11
655.30
66.70
0.00
176.87
65.00
0.00
55.00
0
0
0
200.25
Proposed for
2011-12
903.33
123.10
0.00
972.30
168.14
3.00
2681.45
3.00
1222.12
8.00
2823.01
2681.45
42.62
1264.74
2823.01
127.50
0
0
10.00
510.64
NVBDCP
Component
Provision Sanction for
for 2010-11
2010-11
Proposed for
2011-12
Human Resource
519.98
655.30
903.33
Honorarium and Incentive
Operating cost
100.00
55.00
55.00
93.00
85.00
375.04
IEC/BCC
56.00
35.00
73.12
10.00
PPP/NGO
Training
Procurement
66.70
66.70
77.00
1436.37
176.87
854.00
Total Malaria (DBS + EAC)
2272.05
1073.87
2347.49
NVBDCP
FILARIA
Provision for Sanction for
2010-11
2010-11
Proposed for
2011-12
Component
Operating Cost
104.15
100.00
80.35
Training
71.00
42.10
44.00
42.90
60.00
279.15
72.50
237.85
IEC
Honorarium & Incentives
Total Filaria elimination
100.00
NVBDCP
DENGUE & CHIKUNGUNYA
Provision for
2010-11
Sanction for
2010-11
Proposed for
2011-12
3.00
3.00
8.00
20.25
15.25
55.25
68.00
30.00
52.12
4.00
0.00
4.00
35.00
0.00
118.30
130.25
48.25
237.67
Component
Financial aid/grant to
institutions
Operating cost
IEC
Training
Fogging machine
Total
Dengue/Chikungunya
National Programme for
Control of Blindness
NPCB
Cataract Operation in Madhya Pradesh
Year
Target
Achievement
Percentage
IOL
Percentage
2010-2011
(Up to February)
450000
(387000)
364204
94.11%
98.67%
School Screening in Madhya Pradesh
Year
2010-11
(Up to
February)
Target
4100000
No. of
School
examined
No. of
student
examined
37854
3452041
Achievement
Percent
No. of
Student with
refractive
errors
No. of
Student given
Free
Spectacles
84.19%
84045
31303
NPCB
In Lacs
S.
N.
1
Components
3
Grant in aid for Cataract Operations
(for Govt. Sector+NGO's Sector)
(3,00,000 @ Rs 750/-)
Free Spectacles for School Children
(73,800X200)
Infrastructure Strengthening
4
Maintenance of Ophthalmic Equipment
5
Human Resources
Total
2
Proposed budget
2011-12
2250.00
160.00
858.00
84.00
57.60
3409.60
Integrated Disease
Surveillance Programme
Integrated Disease Surveillance Project (IDSP)
PHYSICAL ACHIEVEMENTS 2010-11
Weeks
S units
P units
L units
Number
of
Reporti
ng Unit
Reporti
ng unit
%
Number
of
Reporting
Unit
Reporting
unit
%
Number
of
Reportin
g Unit
Report
ing
unit
%
Week
01
8546
4015
47
1636
596
36
898
397
44
Week
50
8981
5610
62
1825
857
47
899
519
57
1. Actual number of existing S,P and L units is stabilized and upgraded quarterly, as we are
including private units as well.
2. Number and percent of units reporting regularly has also increased.
3. Regular& timely report of weekly report to CSU. Analyzed regularly & action taken
accordingly.
Integrated Disease Surveillance Project (IDSP)
OUTBREAK 2009-10
No. of District
No. of Outbreaks
2009
2010
2009
2010
30
41
141
163
Integrated Disease Surveillance Project (IDSP)
OUTBREAKS REPORTED IN YEAR 2010
Sr.
no.
Name of Outbreak
No. of
Outbreak
No. of
Cases
No. of
Death
1
Measles
62
439
11
2
Fever
9
283
0
3
Malaria
7
189
0
4
Chicken pox
3
26
0
5
Diarrhoea & Vomiting,
Loose Motion
57
2606
26
6
Food Poisoning
4
171
1
7
Cholera
2
3
0
8
Gastroenteritis
8
176
3
9
Chikungunya
11
13
0
10
Total
163
3467
30
IDSP
(In lacs)
S.
N.
Activity proposed
Budget
2010-11
1 Surveilance preparedness
Training & Staff Salary
2 Outbreak Investigtion
337.58
Budget
2011-12
2011-12
508.77
11.00
5.00
3 Analysis & use of data
12.74
34.84
4 New innovation
Total
0.00
361.32
4.60
553.21
National Leprosy Eradication Programme
COMPARISION OF NLEP INDICATORS
S.
N.
Component
INDIA
(2009-10)
MADHYA
PRADESH
(2009-10)
2010-11
(Nov' 2010)
133717 - 10.93
5592 - 7.8
5670-7.73
87190 - 0.71
4589 - 0.64
4864-0.66
1
ANCDR /100,000
population
2
PR /10,000 population
3
MB Proportion
50162 (48.5%)
3436 (61.6%)
2545 (62.18%)
4
Child Proportion
10532 (9.97%)
288 (5.16%)
214 (5.23%)
5
Female Proportion
36723 (35.14%)
1818 (32.59%)
1428 (34.89%)
6
Deformity Grade-I among
NCD
4202 (4.02%)
950 (17.03%)
493 (12.04%)
7
Deformity Grade-II among
NCD
3105 (3.1%)
294 (5.27%)
245 (5.99%)
8
Otherwise Deletion
7246 (6.93%)
319 (5.7%)
355 (8.66%)
9
SC among New cases
24789 (18.54%)
855(15.29%)
656 (16.03%)
10
ST among New cases
17818 (13.33%)
1666(29.79%)
1183 (28.90%)
NLEP
(Rs. in lakhs)
S.
No.
Activity proposed
1) Contractual Services
2) Services through ASHA/USHA
Honararium to ASHA, sensitization of
ASHA
3) Office expenses & Consumables
4) Capacity building
MO, Health Workers, Supervisors, Lab
Technicians & Refresher Training of
MO's
5) Behavioral Change Communication
Budget Budget
2010-11 2011-12
2011-12
17.40
26.82
26.00
8.19
16.30
16.96
21.00
62.33
40.00
12.43
NLEP
(Rs. in lakhs)
S.
No.
Activity proposed
Budget Budget
2010-11 2011-12
6) POL/Vehicle operation & hiring
7) DPMR
8) Material & Supplies
37.50
38.00
25.00
38.35
23.75
23.00
9) Urban Leprosy Control
16.80
16.79
10) Supervision, Monitoring & Review
4.00
3.20
11) Cash assistance
15.00
24.00
12) Special Activity in High Endemic
Districts
TOTAL
41.79
257.00
297.61
Non Communicable Disease
Control Programmes
National Iodine Deficiency Disorder Control
Programme
Key activities carried out in year 2010-11 –
• Urinal Iodine extraction survey of school children was
conducted in Sidhi, Shahdole, Badwani, Mandla and Chattarpur
District by Gandhi Medical College, Bhopal.
• Message was published in leading news papers of the State on
Global IDD Day on 21st October 2010.
• IEC Activities were conducted by Districts on Global IDD Day.
NIDDCP
S.
N.
Proposed PIP
2010-12
Sanctioned
PIP 2010-11
Allotment
2010-11
Proposed Budget
2011-12
1
17.40
20
0.00
17.40
Note :- Rs. 7 Lacs were released by GOI from 2002-07.
Mental Health
This programme is being conducted by Medical
Education Dept. In our State at present programme is
being run through 5 Medical Colleges in 5 Districts.
 Medical College Bhopal
 Medical College Indore
 Medical College Jabalpur
 Medical College Gwalior
 Medical College Rewa
-
District Sehore.
District Dewas.
District Mandla.
District Shivpuri.
District Satna.
Mental Health
(Rs. in lakhs)
S.N.
Districts
Budget for
District
Total
1 5 Existing Districts
26.37
131.85
2 22 New District
26.37
580.14
3 State Cell at DHS
20.39
Total
732.38
National Programme
for Prevention and Control of Deafness - Progress
1 Districts Nodal officers have been nominated.
2 Audiological Assistants posted in 1. Bhopal
2. Indore
3. Gwalior
3 Recruitment of Audiological Assistants for
Jabalpur, Rewa and Khargone is under process.
4 Recruitment of Instructors is under process.
National Programme for Prevention
and Control of Deafness– Progress
5 Awareness generation at dissability camps –
Districts
Camps Held
1. Bhopal
-
62
2. Indore
-
59
3. Gwalior
-
89
4. Jabalpur
-
187
5. Rewa
-
206
6. Khargone
-
43
National programme for
prevention and control of deafness (NPPCD)
(Rs. in lakhs)
S.
N.
1
Proposed PIP Sanctioned Allotment Proposed Budget
2010-11
PIP 2010-11 2010-11
2011-12
92.62
Nil
Nil
92.62
Programme is being run in 6 Districts, Indore, Bhopal, Gwalior,
Khargone, Rewa & Jabalpur.
Note :- Rs. 61.42 were released in 2008-09. Expenditure till
December 2010 Rs. 2 Lacs.
National Tobacco Control Programme
Key Activities done under the programme • Enforcement of Smoke Free Rules and display of no smoking
signage.
• Universities requested to make their universities and affiliated
colleges free from tobacco smoke and also make the Tobacco
Control Policy of the University.
• State has notified additional officers to enforce the provisions of
the Tobacco Control Act
• Flying squads in all the districts to monitor the enforcement and
compliance of COTPA 03.
National Tobacco Control Programme
Key Activities done under the programme • Mechanism for compounding of offence has been established.
• State Level Task Force and District Level Task force in all the
Districts have been constituted
• The State of MP was first among all States to draft Tobacco Free
School guidelines on 20 June 2008.
• All IG of IG zones of Madhya Pradesh have been asked for strict
enforcement of section 6 (a) and 6 (b) (Prohibition of sale to
minors and prohibition of sale of tobacco products in 100 yards
of educational institution.
National Tobacco Control Programme
Key Activities done under the programme -
• IEC –
– World No Tobacco Day 31st May observed through out
the State in year 2008-09 and 2010.
– Documentary on Tobacco Free Village Chinchgohan
produced and telecasted by Doordarshan Indore and
Bhopal.
– Different IEC materials (like posters, pamphlets) on
tobacco control
– Religious leaders were sensitized at Indore,
Omkareshwar and Haridwar.
National Tobacco Control Programme
Key Activities done under the programme -
• Capacity building and training activities:
− Training of school teachers was organized in
Khandwa and Gwalior Districts.
− Orientation meeting with Administrative and
Police officials organized at Khandwa and
Gwalior Districts.
− Students of different Government Schools
educated about ill effects of tobacco use at
Khandwa & Gwalior Districts.
National tobacco control programme (NTCP)
S.
N.
1
Proposed PIP Sanctioned Allotment Proposed Budget
2010-11
PIP 2010-11 2010-11
2011-12
7988000
Nil
Nil
7988000
Programme is being run in 2 Districts Khandwa & Gwalior.
Note :- Rs. 1724000 were released in 2008-09. Expenditure till
December Rs. 9.00 lacs
THANKS
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