Transcript Slide 1

PRESENTATION
NATIONAL RURAL HEALTH MISSION
FOR
HON’BLE HEALTH MINISTER
13TH DECEMBER 2008
NATIONAL RURAL HEALTH MISSION (2005-2012)
• NRHM launched by Hon’ble Prime Minister on 12/4/2005. As of now to
conclude in 2012.
• Aimed to ensure affordable, quality health care to the poorest house holds in
remotest areas.
• Special focus on 18 low performing States which have weak public health
indicators and weak infrastructure.
• Punjab is among the nine high performing States- Punjab, Haryana, Gujarat,
Maharashtra, Karnataka, Kerala, Tamil Nadu, Andhra Pradesh, West
Bengal.
2
HISTORICAL PROSPECTIVE
• RCH-II (2005-2010) aimed at reducing IMR and MMR was already in
progress.
• Programme for control of various diseases were already in progress for the
last more than 15-20 years.
• Government felt the need to integrate all ongoing health programme into
one programme and consolidate the work being done by other departments.
• NRHM encompasses –
– RCH – II including immunization
– All individual disease control programme
– Flexi-pool as per requirement of the State
– Convergence with other departments like AYUSH, Water Supply and
Sanitation, Nutrition, Woman and Child Development, Rural
Development and Panchayats
• NRHM can be summarized as : Reducing IMR and MMR through
institutional deliveries, involvement of Panchayati Raj institutions and
convergence with other departments.
NRHM OBJECTIVES
• Universalized access to quality health care especially to rural poor
with focus on women and children.
• Reduced Infant Mortality Rate and Maternal Mortality Rate.
• Ensuring population stabilization & gender equity.
• Prevention and control of communicable and non-communicable
diseases.
• Access to integrated comprehensive primary health care.
• Mainstream AYUSH- Integration of AYUSH with mainstream health
institutions .
• Promotion of Healthy life style.
• Emphasis on potable drinking water, hygiene, sanitation and
nutrition.
4
KEY COMPONENTS OF NRHM
System strengthening
Community Partnership
Improved services
Infrastructure development
Village level planning
Monitoring through
computerisation
ASHA
Improved financial
management &
Human Resource
Village Health &
Nutrition Days
Specialist Services – On
call/contract
Public Private Partnership
Village Health &
Sanitation Committees
Immunization
strengthening
Telemedicine
Mobile Medical Units
Intra & inter sectoral
convergence
Increased involvement of
PRIs
24-Hour- delivery
services
Emergency Obstetric
Services
IMNCI
Adolescent health
Family welfare services
Accessibility, Approachability and Quality
NRHM STRATEGIES
•
Decentralization of the process of health planning and management from Village to
District level.
•
Involvement of PRIs and Village Health & Sanitation Committees.
•
Up-gradation of existing health institutions from Sub Centres to District Hospitals as
per Indian Public Health Standards (IPHS).
•
Flexible financing- untied funds for filling up the gaps in infrastructure and other
related activities.
•
Manpower requirement- recruitment of doctors, and paramedical staff in relation to
Woman & Child Health.
•
Improved management through capacity building- provision of computers, computer
operators, establishment of State, District and Block Programme Management Units
(PMUs).
•
Integration of AYUSH with the mainstream health institutions including recruitment
of Ayurvedic/Homeopathy doctors at PHC and CHC level.
•
Intersectoral Convergence with Nutrition, water and sanitation programmes.
•
Promotion of Public Private Partnership for achieving public health goals.
NRHM – ILLUSTRATIVE STRUCTURE
Health Manager
BLOCK LEVEL HEALTH OFFICE –---------------
Accountant
Store Keeper
Accredit private
providers for public
health goals
100,000
Population
100 Villages
BLOCK
LEVEL
HOSPITAL
Ambulance
Telephone
Obstetric/Surgical Medical
Emergencies 24 X 7
Round the Clock Services;
30-40 Villages
Strengthen Ambulance/
transport Services
Increase availability of Nurses
Provide Telephones
Encourage fixed day clinics
CLUSTER OF GPs – PHC LEVEL
3 Staff Nurses; 1 LHV for 4-5 SHCs;
Ambulance/hired vehicle; Fixed Day MCH/Immunization
Clinics; Telephone; MO i/c; Ayush Doctor;
Emergencies that can be handled by Nurses – 24 X 7;
Round the Clock Services; Drugs; TB / Malaria etc. tests
5-6 Villages
GRAM PANCHAYAT – SUB HEALTH CENTRE LEVEL
Skill up-gradation of educated RMPs / 2 ANMs, 1 male MPW FOR 5-6 Villages;
Telephone Link; MCH/Immunization Days; Drugs; MCH Clinic
VILLAGE LEVEL – ASHA, AWW, VH & SC
ASHAs, AWWs in every village; Village Health & Nutrition Day
Drug Kit, Referral chains
NRHM FIVE COMPONENTS
(PART- A)
(PART- B)
(PART- C)
RCH AND RELATED
ACTIVITIES
(RCH FLEXI POOL)
INITIATIVES UNDER NRHM
OTHER THAN RCH
(MISSION FLEXI POOL)
IMMUNIZATION
STRENGTHENING
PROGRAMME
(PART- D)
(PART- E)
NATIONAL DISEASE
CONTROL PROGRAMMES
INTER SECTORAL
CONVERGENCE
SCHEMES
INSTITUTIONAL ARRANGEMETS UNDER NRHM
STATE LEVEL
• State Health Mission chaired by Hon’ble Chief Minister.
• State Health Society chaired by Chief Secretary.
• Merger of all vertical societies into State Health Society.
• Signing of MoU with GoI.
• State Level Planning and Monitoring Committee headed by
Hon’ble Health Minister
INSTITUTIONAL ARRANGEMETS UNDER NRHM
DISTRICT LEVEL
• District Health Mission chaired by Chairman Zila Parishad.
• District Health Society chaired by Deputy Commissioner.
• District Planning and Monitoring Committee headed by Zila
Parishad Chairman.
• Rogi Kalyan Samities in District/Sub Divisional Hospitals.
• Merger of all vertical societies into District Health Society.
..contd.. INSTITUTIONAL ARRANGEMETS UNDER NRHM
BLOCK LEVEL
• Block Planning and Monitoring Committees at Block PHC.
• PHC Planning and Monitoring Committees at PHC level.
• Rogi Kalyan Samities for CHCs
VILLAGE LEVEL
• Village Health & Sanitation Committees in each village.
• Accredited Social Health Activist (ASHA) for every 1000
population.
HEALTH INDICATORS
India
Punjab
23.1
17.6
14.6
14.7
Manipur
Kerala
7.4
7.0
4.4
4.8
Manipur
Delhi
62.15
68.25
73.5
Kerala
933
876
1001
1058
Pondicherry
Kerala
55
43
12
13
Manipur
Kerala
TFR (SRS 2005)
2.9
2.1
1.7
Kerala
Maternal Mortality Ratio (SRS 2005)
301
178
110
Kerala
50.7
72.5
96.5
T.Nadu
Institution Delivery (%) (NFHS III)
41
53
100
Kerala
Contraceptive Use (%)
56
63.3
73
HP
44
60
81
T.Nadu
Birth Rate
(SRS 2007)
Death Rate
(SRS 2007)
Life Expectancy at birth
Sex Ratio
(Census 2001)
IMR
(SRS 2007)
Ante Natal Care (at least 3 checkup)
(%)
(NFHS III)
(NFHS III)
Vaccine coverage (%)
(NFHS III)
Best State
TARGETS FOR PUNJAB UNDER NRHM
At the start of RCH
SRS 1998-1999
Present
Status
2007-2008
Target by
2009-2010
Total Fertility Rate
2.5
2.1
1.8
Infant Mortality Rate
49
44
<30
199
178
<100
Institutional Deliveries
37.5%
(NFHS II)
52.5
80%
ANC Check-up with 03
contacts
58.4%
(NFHS II)
72.5
100%
Indicators
(per 1000 live births)
Maternal Mortality Ratio
(per 100000 live births)
HEALTH INSTITUTIONS
PUBLIC
SECTOR
PRIVATE
SECTOR
MEDICAL COLLEGES
3
5
DISTRICT HOPITALS
20
SUB DIVSIONAL HOSPITALS (Total no. of Sub
Divisions 78)
38
COMMUNITY HEALTH CENTRES
127
INSTITUTIONS
BLOCK PHCs
(112 PHSC, 15 DHS)
118
BLOCK PHCs AND SDH
6
BLOCK PHCs AND CHCs
70
ONLY (EXCLUSIVE) BLOCK PHCs
42
983
HEALTH INSTITUTIONS
INSTITUTIONS
PUBLIC
SECTOR
PHCs (MINI PHCs) – EXCLUSIVE
352
PHCs BLOCK – EXCLUSIVE
42
TOTAL PHCs – EXCLUSIVE
TOTAL PHCs – EXCLUSIVE + AT CHC/SDH
394
394 + 76 = 470
SUBSIDIARY HEALTH CENTERS
1187
SUB-CENTRES AT VILLAGE LEVEL
2858
CLINICS /DISPENSARIES
PRIVATE
SECTOR
3046
NRHM
BUDGET
OVER THE YEARS
PROGRAMME IMPLEMENTATION PLAN
•
•
•
•
•
NRHM is a centrally sponsored scheme. For Year 2005-06 and 200607, GoI contribution was 100%, & from Year 2007-08, GoI
contribution is 85% and state contribution is 15%.
Every year State Health allocation to increase at least 10% of the
previous year.
State Govt. is required to prepare a Programme Implementation Plan
(SPIP). It is discussed with Ministry of Health, GoI and then
approved by it.
After approval of SPIP the funds are released by GoI and the Sate
Govt.
Minor changes in PIP can be made and major changes are allowed
only with the approval of GoI.
FINANCIAL REPORT FOR THE YEAR 2005-09
Rs. in lakhs
Approved Plan
Releases
Expendit % of Unspent
Funds
Funds
Total
ure
Utilizati Balance
released released Funds Incurred
on
by GOI by State Available
GOI
State
Share 15%
from 200708
Total
2
3
4
5
6
7
8 (2+6+7)
9
10
11 (8-9)
283.20
9820.78
Not
Required
9820.78
8103.25
0.00
8386.45
5971.37
61%
2415.08
2006-07 2415.08 16271.85
Not
Required
16271.85 14194.06
0.00
16609.14 8326.24
46%
8282.90
2007-08 8282.90 16196.72
2841.00
19037.72 11516.27
705.00
20504.17 16657.93
84%
3846.24
2008-09
(Up to Oct 3846.24 19923.00
08)
3000.00
22923.00
9138.75
79%
2005.91
Year
Op
Balance
1
2005-06
5292.51
0.00
7132.84
FINANCIAL STATUS UPTO OCTOBER 2008
(DISTRICT LEVEL)
Rs. in lakhs
SN
Component
Releases
Expenditure
1
RCH II
1968.24
1133.70
2
NRHM Additionalities
1790.21
1183.95
3
Immunization & PP
164.05
91.63
4
NDCP
366.61
366.61
5
Inter Sectoral Convergence
0.00
0.00
6
CSS Family Welfare Head 2211
2540.13
2540.13
TOTAL
6829.20
5316.02
STATE OBLIGATIONS UNDER NRHM
State signed MoU with Govt. of India in December 2005 for implementation of NRHM
SN
INITIATIVES
STATE LEVEL
DISTRICT
BLOCK LEVEL /
LEVEL
VILLAGE LEVEL
th
On 17 August
2005
Not applicable
constituted.
Block Health
Committees notified
on 11/12/2007
Incorporated
th
from 26
Village Health
August 2005 to
Sanitation
January 2006
Committees
constituted on
21/10/2007.
REMARKS
Setting up of the Health Missions
On 26th
October 2005
constituted.
2
Incorporation of Health Societies
Incorporated on
26th February
2007
3
Integration of all vertical programmes of
Health & Family Welfare Department.
Already
Integrated
Already
Integrated
Already Integrated
Completed
4
Merger of different societies with State
Health Society.
Done on
21/12/2007
Being Done
Not required
Yet to be
completed
Already
notified and are
operational
At Block Level
Community Health
Centres already
notified and are
operational.
Completed upto
CHC but yet to be
done in 484 PHCs
1
5
Constitution of Rogi Kalyan Samities in
all Health Institutions upto PHCs
Not required
Completed
Completed
…contd. STATE OBLIGATIONS UNDER NRHM
SN
INITIATIVES
6
Recruitment of staff for
Programme Management
Units.
7
State and District Health
Plans
STATE LEVEL
Recruitment completed
2007-08:
th
PIP submitted on 10 July 07
PIP approved on 25/9/07
Outlay-Rs.16196 lacs
2008-09:
th
PIP submitted on 27 Feb 08
Approval of PIP received
Outlay- Rs. 22923 lacs
DISTRICT LEVEL
BLOCK
LEVEL /
VILLAGE
LEVEL
REMARKS
Recruitment
completed
Recruitment
under
process at
block level.
Being
discussed
separately
Facility Survey
completed.
Integrated
District Health
Action Plan
ready for 20
districts.
Facility
survey upto
Sub centre
level
completed.
District
Action Plans
completed in
all 20
districts
The Department has decided in principle to out source the setting up of State Health System
Resource Centre (SHSRC), Price Water House Bangalore has been selected. Contract is
being signed..
WORK DONE - FUNDS
Component
Untied Funds
IPHS
Annual
Maintenance Grant
Rogi Kalyan
Samitis
Mobile Phones for
ANMs
Amount/Scope
2007-08
2008-09
Remarks
Rs. 10,000
2858 SCs
2858 SCs
Funds Released
Rs. 25,000
484 PHCs
484 PHCs
Funds Released
Rs. 50,000
Nil
128 CHCs
Funds Released
Rs. 20 Lacs
20 DHs
Nil
Funds Released
Rs. 20 Lacs
116 CHCs
Nil
Funds Released
Rs. 50,000
484 PHCs
100 PHCs
Funds Released
Rs. 1 Lac
Nil
112 CHCs
Funds Released
Rs.5 Lac
20 DHs
Nil
One Time Grant
1 Lac
36 SDHs
Nil
One Time Grant
1 Lac
110 CHCs
Nil
One Time Grant
4000
In Process
134 Lacs
Application Solution for on line data transfer
from ANMs to State
In Process
WORK DONE– MCH – 24x7 PHCs
• 75 PHCs upgraded to 24x7 PHCs in 2007-08 and 26 PHCs in
2008-09 for 24 hrs. delivery.
• 24x7 PHC – 1 MO (F) and 3 Staff Nurses on contract basis.
• Out of 101 MO(F), 60 posts filled up leaving 41 posts vacant.
• 34 Staff Nurses yet to be appointed.
• Posts advertised. Last date 20/12/2008
• Generator set provided at 75 and for remaining 26 in process.
• Labour room etc. constructed
WORK DONE – MCH - FRUs
• 50 CHCs in 2007-08 and 10 in 2008-09 upgraded to
FirstReferral Units (FRUs). Facility for a complicated delivery
including blood transfusion.
• 1 Gynaecologist, 1 Paediatrics and 5 Staff Nurses to be
appointed.
• So far 21 Gynaecologist, 22 Paediatrics in position and
advertisement for remaining 39 and 38 given. Last date
20/12/2008.
• Advertisement for remaining Staff Nurses 13 given.
• Through rationalization of posting of Gynaecologist, 21
regular Gynaecologists posted in the FRUs i.e. 42 FRUs are
having Gynaecologist and only 18 are without Gynaecologist.
WORK DONE – 24 x7 PHCs and FRUs
•
Signages for these 101 and 60 institutions being developed.
Tender floated
•
On line monitoring of performance of these institutions through
PEC, work given.
•
Biometric based on-line attendance system. Tender already
received.
WORK DONE - MMUs
• 20 MMUs deployed in districts. 4 districts – Amritsar, Jalandhar, Ludhiana
and Mohali not provided with MMUs. 4 districts Faridkot, Bathinda,
Mansa and Barnala have one additional MMUs.
• Cost of each MMU Rs. 36.00 lacks. Full Bus chassis used for MMUs. Has
the facility of ECG, X-Ray and Lab.
• 1 MO(F), 1 MO(M), 1 Radiographer, 1 Lab Technician, 1 Staff Nurse, 1
Pharmacist (Regular) and 1 Driver and 1 Helper provided.
• 12 posts of MO(F) and 10 MO(M) vacant. Advertisement given.
• Instruction issued for free treatment and medicine (Rs. 7500 per month)
issued.
• Tenders for GPS enabled tracking system invited and last date 15/12/2008.
• Decision regarding MMUs for the remaining 4 districts yet to be taken.
WORK DONE - VHSCs
• NRHM implementation planned within the frame work of PRIs at different
levels.
• Village Health & Sanitation Committees formed in coordination with PRIs at
each village level.The committee consists of ideally 11 member under the chair
of Sarpanch/Panchayat Member and ANM or AWW as Member Secretary with
50% representation of women and due representation from weaker sections.
• 11418 VHSCs formed and remaining 1161 yet to be formed.
• Committee provided with annual grant of Rs 10,000/- to be used as untied grant
to meet village level public health activities. Funds already released to VHSCs
(Total – Rs. 11.31 Cr. In 2007-08)
• Headed by Panch / Sarpanch.
WORK DONE - ASHA
•
•
•
•
•
•
•
15400 ASHAs selected in the State, 2356 yet to be selected
ASHA - a female health activist in the community to create awareness on
health and mobilize the community for utilization of the existing health
services.
One ASHA to cover 1000 population.
ASHA to be a woman resident of the village-Married/Widow/Divorced
preferably in the age group of 25 to 45 years with the formal education up to
eighth class.
Selection of ASHA to be made by the District Health Society under the
supervision of Deputy Commissioner, and Civil Surgeon to be as District
Nodal Officer.
SMO at block level to be the Block Nodal Officer.
Performance based incentive money of Rs. 3.96 crore has already been
released to District Health Societies for ASHAs for the year 2008-09 & Rs.
1.3 crore in 2007-08.
WORK DONE - TRAINING OF ASHAs
•
•
•
•
•
•
Training of ASHAs in Module 1 is scheduled to be conducted during the current
financial year.
Training at the State Level for District Trainer completed in July 2008.
Training at the District Level for Block Level Trainers completed in August 2008.
Training at the Block Level for ASHAs to be taken up now. ASHA books have been
translated and are under print.
Training of ASHA for 6 districts being given to NGO. Matter under process
Tenders for ASHA kit have been received and would be made available by
31/12/2008.
WORK DONE – RECRUITMENT
• No recruitment done in 2005-06, 2006-07.
• Fresh recruitment at the State Level made in November 2007 and
State Programme Management Unit set up.
• Fresh recruitment of doctors and nurses started in March 2008.
• Great emphasis given on recruitment of Staff in the Hospitals and
Sub-Centres.
• 3 recruitment drives launched – July 2008, October 2008 and
December 2008. Recruitment has been made a monthly features.
• All vacant posts of ANMs for last 5-6 years at Sub-Centres (514)
filled up under 2211 scheme. 2nd ANM provided at 954 bigger SubCenters.
• For Gynaecologist and MO(F), advertisement given for increased
pay packages. Basic pay increased from 15,000/- and 20,000/- to
20,000/- and 25,000/-.
WORK DONE – RECRUITMENT
• Letter written to Civil Surgeons on 8/12/2008 for identifying
remote/extremely remote areas. We will give the regular and
contractual lady doctor special incentive during 2009-10.
• Recruitment at 4 levels –
• State Programme Management Unit
• District Programme Management Unit
• Block Programme Management Unit
• Doctors, Nurses, ANMs etc. in the Health Institutions
• 1 Medical Officer appointed in PHCs in the Malwa Districts of the
State where there was no doctors. Against 95 posts, 59 posts filled
up. Remaining posts advertised. We should try to provide at least one
doctor in each PHC in the PIP 2009-10.
RECRUITMENT STATE PROGRAMME MANAGEMENT UNIT
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
Remarks
1
Director Finance
1
1
0
On Deputation
2
State Programme
Manager
1
1
0
From State Govt.
3
Maternal Health
Specialist
1
0
1
4
Family Welfare Specialist
1
1
0
5
Procurement Manager
1
0
1
40,000
Rs 30,000/- from Dec
Services have been
terminated
40,000
Rs 30,000/- from Dec
25,000
6
Manager (HRD)
1
0
1
20,000
7
Manager (F&A)
1
1
0
25,000
8
Manager (M&E)
1
1
0
20,000
9
State NGO Coordinator
1
1
0
30,000
10
Programme Coordinator
(ARSH & Gender)
1
1
0
20,000
Advertisement for recruitment
issued on 1/12/2008
Officer Resigned
Advertisement for recruitment
issued on 1/12/2008
…contd…
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
11
Programme Coordinator
(BCC)
1
1
0
20,000
12
Consultant (Admn)
1
0
1
20,000
13
Consultant (M&E)
1
1
0
20,000
14
System Analyst
1
0
1
15,000
15
Accounts Officer
2
2
0
15,000
16
Statistical Assistant
4
4
0
10,000
17
Hardware Supervisor
1
1
0
10,000
19
Accountant-cum-Cashier
2
2
0
10,000
Remarks
Candidate resigned
Officer Resigned
Advertisement for
recruitment issued on
1/12/2008
…contd…
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
Remarks
Selection has been done for
the vacant position candidate
is yet to join
20
Computer Assistant
4
4
0
8,000
21
Office Assistant
9
9
0
7,000
23
Graphic Designer
1
1
0
10,000
24
Procurement Assistant
2
1
1
8,000
Candidates have been adjusted
at State HQ from the districts
25
Drivers
2
0
2
5,000
Action is being initiated
26
Class-IV
3
2
1
3,000
44
35
9
Total
Action is being initiated
RECRUITMENT DISTRICT PROGRAMME MANAGEMENT UNITS
SN
Name of the Post
Sanctioned
Post
Filled
Vacant
Consolidated
Salary PM
Remarks
1
District Programme
Manager
20
18
2
20,000
Selection has been Done.
2
District Accounts Officer
20
17
3
15,000
Advertisement for recruitment
issued on 1/12/2008
3
District Monitoring &
Evaluation Officer
20
20
0
15,000
4
Procurement Officer
20
4
16
15,000
5
Maintenance Engineer
20
17
3
12,000
6
Statistical Assistant
20
18
2
8,000
Advertisement for recruitment
issued on 1/12/2008
7
Procurement Assistant
20
0
20
8,000
No further recruitment to be
made. Procurement Assistant
have been adjusted as
Statistical Assistant or
accountant as per their
qualification
8
Accountant-cum-Cashier
20
17
3
8,000
Advertisement for recruitment
issued on 1/12/2008
9
BCC Facilitator
20
20
0
8,000
Total
180
RECRUITMENT BLOCK PROGRAMME MANAGEMENT UNITS
SN
Name of the Post
1
Block Statistical
Assistant
2
Block Accountant cum
Cashier
3.
Sanctioned
Post
118
118
Filled
98
93
Vacant
20
25
Computer Operator
173
155
18
Total
409
346
63
Consolidated
Salary PM
Remarks
8,000
Advertisement for
recruitment issued on
1/12/2008
8,000
Advertisement for
recruitment issued on
1/12/2008
5,000
Advertisement for
recruitment issued on
1/12/2008
RECRUITMENT - FRUs
SN
1
2
3
4
5
Name of the Post
Obstetricians
Paediatricians
Anaesthesia
Staff Nurses
OT Assistant
Sanctioned Post
60
60
60
300
60
Filled
21+21
22+3
Vacant
Consolidated
Salary PM
39
Rs. 25000/- +
Rs. 3000/- HRA+
Rs. 1000/ EmOC +
Rs. 500/- per
delivery conducted
+ Rs. 200/ MTP
35
Rs. 25000/- +
Rs. 200/- per
Emergency Case
during off duty
hours + Rs. 3000/HRA
Remarks
28 Recruited, 7 resigned.
Advertisement issued for
39 posts on 1/12/2008
31 Recruited, 9 resigned.
Advertisement issued for
35 posts on 1/12/2008
60
Rs. 1500/- on call
per case + TA Rs.
6/KM upto 50 KM
Empanelment for CHCs at
District level
287
13
Rs. 8500/- + Rs.
1500/- (if
accommodation is
not provided)
Advertisement for
recruitment issued on
1/12/2008
50
Rs. 4000/- + 300/evey Major OT
Case + Rs. 1500/HRA
Not required to recruit
10
RECRUITMENT PHCs 24x7
SN
1
2
Name of the Post
Female Medical Officer
Staff Nurses
Sanctioned
Post
101
303
Filled
50
269
Vacant
Consolidated
Salary PM
51*
Rs. 20000 PM +
Rs. 500 per
Delivery+ Rs.
200/ MTP + Rs.
3000/- HRA
34*
Rs. 5000/- + Rs.
500/- per delivery
conducted + Rs.
100/- per delivery
assisted and Rs.
1500/- HRA (if
accommodation
is not provided)
Remarks
*Advertisement for recruitment
issued on 1/12/2008
*Advertisement for recruitment
issued on 1/12/2008
RECRUITMENT Mobile Medical Unit (MMU)
SN
Name of the Post
Sanctioned
Post
20
Filled
10
Vacant
10
Consolidated
Salary PM
Remarks
22,000
20 recruited 10 resigned/ not joined
Advertisement issued for 10 posts
on 1/12/2008
1
Medical Officer (Male)
2
Medical Officer
(Female)
20
8
12
22,000
20 recruited 12 resigned/ not joined
Advertisement issued for 12 posts
on 1/12/2008
3
Nurses
20
17
3
8,000
Advertisement for recruitment
issued on 1/12/2008
4
Radiographer
20
12
8
8,000
Advertisement for recruitment
issued on 1/12/2008
5
Lab Technician
20
17
3
8,000
Advertisement for recruitment
issued on 1/12/2008
6
Driver
20
20
0
7,000
*Placement agency hired
7
Helper
20
20
0
4,000
*Placement agency hired
RECRUITMENT – MO (Mini PHC) &
ANM for Urban Slum Area & Sub-Centres
SN
Name of the Post
Sanctione
d Post
Filled
Vacant
Consolidated
Salary PM
1
Medical Officer for
Mini PHC
95
61
34
20,000
1
MPHW (Female) for
urban slums
230
230
*0
6,000
2
ANM for vacant subcentres (2211)
514
6,000
1265
3
2nd ANM for 954 subcentres
954
203
6,000
Remarks
Advertisement issued for
the recruitment on
1/12/2008
Mainly reserved posts
Advertisement for
recruitment issued on
1/12/2008
WORK DONE - SCHOOL HEALTH
•
32,64,926 of students are in Primary and Secondary level
School
•
No. of Students
Primary
7,09,747
6,29,510
13,39,257
Middle-Secondary
10,39,509
8,86,160
19,25,679
Total
17,49,256
15,15,670
32,64,926
Special Campaigns under School Health Programme held
– 13th August (held in slum areas of key districts)
– 14th August (held in CHCs and SDHs)
– 2nd October (held in CHCs, SDHs, & DHs)
•
Requirement of Drugs :– IFA TabletsPediatric with2 0 mg elementary iron
Adult with60 mg elementary iron 60mg
– Deworming Tablets
Procured and distributed
12356 person examined
110888 school children examined
Eye checkup camps under which
free spectacles distributed to school
children
7 Crore Tabs
3 Crore Tabs
32.64 lakh Tabs
WORK DONE - SCHOOL HEALTH
Free Treatment of School Students for CHD &
RHD
•Decision taken on 4/11/2008 for free treatment of students (upto +2 level)
studying in Govt. & Govt. aided schools suffering from Congenital Heart Disease
(CHD) and Rheumatic Heart Disease (RHD) in PGI Chandigarh. So far 16
students referred to PGI and Rs. 10.00 lacks deposited.
•Directions given to heads of PHCs, CHCs and dispensaries to diagnose school
students suffering from RHD and CHD and refer to PGI.
•Work of examination of School Children – not so systematic. Students cards are
under print and would be supplied to the Schools.
•Civil Surgeons have been directed to fix the target and show achievement
alongwith certificates from the School Headmaster that the health team has visited
the school and examined the children.
WORK DONE - COMMUNITY MONITORING &
PLANNING COMMITTEES
• To involve the community in the decision making
and monitoring of initiatives and ongoing health
programmes, Health Monitoring & Planning
Committees are being constituted at Village, PHC,
Block, District and State level with the following
objectives
– provide systematic info about community needs
– provide feedback according to
• locally developed yardsticks
• key indicators.
– increase involvement and participation of community
– Validate sector wide data from other sources
– Triangulation
WORK DONE – SEX RATIO
• Survey for sex ratio commissioned in September
2008. Report likely to be received by 28/2/2009.
STATE
PROGRAMME
IMPLEMENTATION PLAN
2008-09
PIP 2008-2009
COMPONENTS
DESCRIPTION
OUTLAY
(Rs. In crores)
PART A
RCH
56.95
PART B
NRHM ADDITIONALITIES
80.80
PART C
IMMUNIZATION & PPI
12.34
PART D
NATIONAL DISEASE ONTROL
PROGRAMME
14.73
PART E
INTERSECTORAL CONVERGENCE
5.33
TOTAL
NRHM
170.15
CENTRALLY SPONSORED SCHEMES
(Already under Implementation but now
merged with NRHM)
59.34
GRAND TOTAL
229.49
PIP 2008-2009
• GoI contribution Rs. 180 Cr., GoP contribution
Rs. 30 Cr.
• Previous funds available – GoI- Rs. 31.41 Cr.;
GoP – Rs. 7.05 Cr. = TOTAL – Rs. 38.43Cr.
• TOTAL FUNDS AVAILABLE FOR 2008-09
Rs. 210 Cr. + Rs. 38 Cr.= Rs. 248 Cr.
PART A- RCH FLEXI POOL
Rs. In lakhs
Allocation
SN
1
2
3
4
5
6
7
Sub Components
Releases/ Expenditure
2008-092008-09
Maternal Health
Janani Suraksha Yojna
ASHA
Child Health & IMNCI
Family Planning
ARSH
Urban RCH
PNDT Sex Ratio
Innovations / PPP/NGO
235.00
186.00
334.50
86.15
920.60
27.07
135.60
64.84
442.50
52.50
171.50
440.00
.67
937.71
10.02
32.90
21.57
0
Infrastructure & Human Development
1558.50
221.87
323.34
95.35
461.88
276.70
9
Logistic Management
Quality Assurance and Infection Control
Programme
HMIS Monitoring and Evaluation
Training
10
Behaviour Change Communications
291.76
40.75
11
Procurement
Programme management Units SPMU and
DPMUs
Flexi pool
Total A (RCH II)
122.50
125.91
347.26
264.35
157.50
5695.00
11.70
2703.50
8
13
12
..contd.. PART A
•
Digitization of Civil Registration Systems (CRS). RFP under preparation.
Under e-Governance Project of the State on pilot basis CRS is being
implemented in district Kapurthala & Nawanshahar. Work has been allotted to
WIPRO. Work allotment for digitization of CRS for whole Punjab is under
process.
•
Sex Ratio Survey. The work has been allotted to AMS, Luckhnow. First
inception report of the survey submitted.
•
City Specific GIS mapping for Urban Health Mission for three cities i.e.
Amritsar, Jalandhar and Ludhiana which was assigned to Punjab Engineering
College, Chandigarh has been completed
•
To ensure dissemination of information relating to NRHM to field level
functionaries and to ensure immediate reporting, steps have been taken to
finalize website of the NRHM. The work will be completed by the end of this
month.
PART B- NRHM ADDITIONALITIES
Allocation
SN
B
a
b
c
d
e
f
g
h
I
j
k
l
m
n
o
p
q
r
s
Sub Components
Rs. In lakhs
Releases/ Expenditure
2008-09
NRHM Additionalties
Village Health & Sanitation Committees
1230.00
0.00
ASHA - proposed under RCH II
SC Untied Fund & Maintenance
286.20
285.80
CHC Untied Fund & Maintenance
Annual Maintenance Grant
121.00
64.00
162.00
121.00
64.00
655.80
Mobile Medical/ Health Units
397.40
111.20
Upgradation of CHC
1091.80
0.00
Upgradation of PHC
821.43
0.00
Upgradation of SC
725.38
0.00
Upgradation of SHC
600.00
0.00
Upgradation on SDH/ FRUs
Upgradation of DH
School Health
100.00
370.00
500.00
100.00
0.00
12.45
Strengthening of Programme Management
476.56
0.00
Strenthning of Logistics Management
50.00
0.00
Rogi Kalyan Samitiis
12.33
0.00
937.50
134.00
8079.60
0.00
0.00
1350.30
PHC Untied Fund & Maintenance
Emergency Response Services
Mobile Phones for ANMs
Total B
..contd.. PART B
Extension of New Institutions
•
•
•
•
•
•
•
40 New Sub Centre's is to be constructed at a cost of Rs. 2.5 crore.
One new CHC to be constructed at Zirakpur at a cost of Rs. 2.5 crore
Up-gradation of Institutions
77 Sub Centres to be renovated at a cost of Rs. 1.00 Lakh each
10 PHCs to be repaired / renovated at cost of rs. 60.00 Lakh.
PHC at Adampur and Rural Hospital Morinda to be completely renovated.
Following Sub Divisional Hospitals to be upgraded with an outlay of Rs.6.00
Crore
– Batala (50 to 80 beds) ...
Rs. 1.5 crore
– Patti (50 to 80 beds) ...
Rs. 1.5 crore
– Nabha (100 to 130 beds) ………
Rs. 1.5 crore
– Pathankot (100 to 130 beds) ……
Rs. 1.5 crore
..contd.. PART B
•
Following District Hospitals to be upgraded
– Mohali (70 to 120 beds) …
– Mata Kaushalya Hospital Patiala …
(154 to 250 beds)
– Gurdaspur (100 to 150 beds) …
– Ludhiana (addition of 30 beds burnh Unit)…
– Bathinda (Renovation) ...
Rs. 3.00 Crore
Rs.2.00 Crore
Rs.2.50 Crore
Rs. 1.00 Crore
Rs.0.50 Crore
• Equipment and furniture worth Rs.6.50 Crore to be provided in CHCs as per IPHS
Norms
• Equipment and furniture worth Rs.1.83 Crore to be provided in the PHCs as per
IPHS norms
• Drugs and consumables as per following details to be given:
- CHCs …
Rs. 3.60 Crore
- PHCs …
Rs.4.84 Crore
- SHCs …
Rs.6.00 Crore
PART C- IMMUNIZATION
Rs. In lakhs
Allocation
SN
Sub Components
a
Alternative vaccine Delivery
b
Mobilization of Children by
AWW/TBA/ASHA
Strengthening of Monitoring
and Supervision
Computer Assistant to DIO,
Provision for Additional
Support, Slums and underserved
area
Total C
c
d
Releases/
Expenditure
2008-09
103.34
68.59
9.18
79.58
260.69
91.63
PART DNATIONAL DISEASE CONTROL PROGRAMME
Rs. In lakhs
Allocation
SN
Sub Components
Releases/
Expenditure
2008-09
a
RNTCP
522.16
201.52
b
Leprosy
0.76
26.35
c
IDSP
79.91
43.86
d
20
0.00
e
National Iodine Deficiency
Disorder Control Programme. NIDDCP
Malaria & Vector Borne
212.36
19.88
f
Blindness Control
637.5
75.00
1472.69
366.61
Total D
PART EINTERSECTORAL CONVERGENCE
Rs. In lakhs
Allocation
SN
Sub Components
a
Convergence with AYUSH
b
Co ordination & Orientation with PRIs
c
Releases/
Expenditure
2008-09
424.80
0.00
75.15
0.00
33.45
0.00
533.40
0.00
5934.00
2540.13
Special innovation for Minorities
Total E
Part II
CSS Family Welfare Head 2211
•
•
•
Appointment of one Ayurveda MO & one Homeopathy MO in 121 PHCs & 112 CHCs
respectively.
99 Ayurveda MOs already recruited. 22 MOs of reserved categories (9 SC, 1 FF, 2 Sports,
3 Handicapped, 6 Exn, 1 General)
Written test & Counseling for appointment of 112 Homeopathy MOs done. Appointment
letters being issued
DRINKING WATER SUPPLY
There are numerous schemes for providing clean drinking water in rural and
urban areas :
• Under JNNURM, UIDSSMT and BSUP high priority has been given to
providing drinking water supply. The total allocation for current year is Rs.
350 crore.
• Under Municipal Development Fund a sum of Rs. 1 crore is to be spent in
various towns.
• For Rural Areas, there are various schemes – Accelerated Rural Water
Supply Scheme (Rs. 110 crore), NABARD (Rs. 70 crore), World Bank (Rs.
132 crore), Rajiv Gandhi National Drinking Water Mission (Rs. 10 crore),
RO Process (Rs. 25 crore) for clean drinking water.
• Under SSA, funds can be provided for drinking water in elementary schools
in the State.
SANITATION
• Sewerage works will be executed in urban areas under JNNURM
and JBIC Projects.
• For Rural Areas there is a State Government schemes for
providing individual toilets (Rs. 5 crore).
• Under Total Sanitation Programme of GoI we have Rs. 77 crore
project for providing toilets in schools, Aanganwadi Centers,
Community toilets and individual toilets.
• Under World Bank Project, there is a provision for laying
underground sewer in 1000 villages and cleaning of village
ponds.
• For cleaning of village ponds we have a State Scheme (Rs. 5
crore). NREGA funds can also be used for this purpose in all the
districts without any limit.
SCHOOLS – WATER & TOILETS
• Schools not having Water & Toilet facilities have been
identified by a survey.
• 480 Schools are without drinking water facilities Water &
Sanitation Department would provide these facilities from
their regular schemes like ARWSP.
• 4447 schools are without Toilet facilities Water & Sanitation
Department has been asked to prepare estimates.
• Funds to the extent Rs. 40000.00 per school will be provided
from Total Sanitation Campaign (TSC) & above Rs.
40000.00 from 12th Finance Commission of Rural
Development Department.
NUTRITION
• Under ICDS Programme (50:50) the State
Government will be spending Rs. 55 crore in 2008-09.
• Under Kishori Shakti Yojana (Nutrition for adolescent
girls) will spent Rs. 2.50 crore through Woman and Child
Development.
• Under these 2 programmes a total of 13.52 lakh children
and mothers were provided nutrition.
VILLAGE HEALTH COMMITTES
• The Village Health & Sanitation Committees has been
constituted in all the villages. These committees are
headed by Sarpanch/ Panches.
• The new Panches and Sarpanches have been inducted
in the already constituted VHSCs and the Health
Department would thereafter coordinate these 3
programmes – Water Supply, Sanitation and Nutrition
at block level.
• The Agriculture Department would also be involved.
COORDINATION WITH OTHER DEPARTMENTS
• We are holding regular meetings with WSS, Rural
Development, Woman and Child Development
Departments.
• We are going to constitute Coordination Committees
with these departments for greater synergy.
OTHER
INITIATIVES
NATIONAL URBAN HEALTH MISSION
•
GoI proposes to launch NUHM from 2008-09 to 2011-12 (4 years). Current year allocation is
likely to be Rs. 1012 crore and Punjab would get about Rs. 25 crore.
•
The target population would be urban poor living in slum areas, homeless poor and construction
workers.
•
3 towns - Amritsar, Jalandhar and Ludhiana will be taken up from 2008-09 and the remaining 10
towns – Patiala, Abohar, Batala, Bathinda, Moga, Malerkotla, Khanna, Pathankot, Hoshiarpur
and Mohali from 2009-10.
•
The programmes aims at upgradation of Primary Urban Health Centers in terms of infrastructure
and man power. Urban Social Health Activist (USHA) will be provided for every 1000
population.
•
Private hospitals would be empanelled in case there are no government institutions in the slum
areas.
•
There would be a separate Health Insurance Scheme for Urban Slum Poor's and they would be
free to seek treatment from Government and Private referral hospitals.
•
State has already initiated the process for GIS mapping of the urban slums (notified & non
notified) and health facilities (Private & public) in three cities, work has been allotted to Punjab
Engineering College Chandigarh. The work will be completed in the first week of September 08.
EMERGENCY RESPONSE SERVICE IN THE STATE
• 240 Ambulances equipped with medical facilities and medical
technicians to be deployed.
• 60 ambulances will have advance life saving equipment
(cardiac care, highway trauma care, EmOC)
• 180 ambulances will have basic life saving equipment
(EmOC, highway trauma etc.).
• Patient to be shifted to nearest centre through the ambulance positioned
with trained medical technician and expert driver.
• Capital cost of the ambulances will be Rs.29 crore and for establishing
IT infrastructure and Emergency Response Centre the capital cost will be
Rs. 12 crore. Total initial cost will be Rs. 41 crore. Recurring cost will be
Rs. 25 cr. per annum
• Emergency Call Centre with a common three digit toll free number.
• Tenders have been received and work is being allotted.
OTHER INITIATIVES
• Web Site of Punjab NRHM – www.pbnrhm.org prepared and hosted
• Service particulars of MOs – Service particulars with complete details
including postings computerized and placed on the website for final checkup by
Civil Surgeons. It would be easy to determine the status of postings, transfers
and vacancies in the health institutions. Would be ready by 25/12/2008.
• Administrative Maps – Maps being developed with the help of Punjab Remote
Sensing Agency at Ludhiana. All details received except from District
Gurdaspur, Jalandhar and Mohali. These maps are necessary for depiction of
information on GIS, Tracking of MMUs and EMRI Ambulances.
• Pregnancy Tracking – Pilot project being developed for Mohali and Ropar
district for online registration of pregnancies. Tender for allotment of work
being invited.
• Mobiles phones for ANMs – Continuous contacts and information.
• Special incentives for Remote and Extremely Remote Areas to MO(F) and
Gynecologist.
MONITORING AND STATUS (31/10/2008)
Institutional Deliveries
• Annual pregnancies – 4,80,000
• Deliveries in health department institutions in 2007-08 –
25269
• Total institutional deliveries – About 52%
• Performance upto October 2008 (Health Department
Institutions) –
2007-08
2008-09
25269
31357
Increase of 24.10%
• 4 Excel Sheets
INSTITUTIONAL DELIVERIES
Institutional births (%age)
60
52.5
50
40
37.5
30
24.8
20
10
0
NFHS I
NFHS II
1992-93
INSTITUTIONAL DELIVERIES
1997-98
NFHS III
2005-06
Year 2007-08 & 2008-09 (Up to October 08)
Trend of Institutional Deliveries – Month wise
(Health Department Institutions)
24%
6000
5390
5373
5248
4923
5000
3959
4396
4000
3459
4171
3995
4132
2998
3000
3131
2915
2628
2000
1000
0
April
May
June
July
2007-08
August
2008-09
September
October
500
0
1102
1420
2269
2262
3295
3500
865
944
1068
2144
2569
3641
2008-09
599
470
652
1791
1755
2000
934
1206
1009
1163
1549
2500
2109
2185
2007-08
600
755
1636
1438
1302
1239
2051
1999
4000
344
510
1582
1459
1324
1029
1164
1500
298
1000
895
District wise Institutional Deliveries2007-08 & 2008-09 (till Oct 08)
3000
Institutional Deliveries- District Hospitals
2007-08 & 2008-09 (till Oct 08)
2600
2007-08
(12261)
2008-09 (12485)
2486
2750
( % : 1.83)
2252
2450
2300
2150
2000
1850
1550
1176
1105
1400
1250
716
717
Districts
108
117
203
196
367
459
440
463
277
264
241
382
603
548
617
509
50
190
247
200
90
157
500
350
739
813
821
402
376
650
618
800
901
890
820
814
950
785
743
1100
513
581
No. of Deliveries
1700
2008-09 (7649)
(% :0.46)
766
766
806
356
393
413
442
1032
1101
617
725
765
769
1108
2007-08 (7614)
490
530
573
245
68
58
22
3
12
Districts
238
105
213
244
65
246
105
417
558
250
296
223
1100
1075
1050
1025
1000
975
950
925
900
875
850
825
800
775
750
725
700
675
650
625
600
575
550
525
500
475
450
425
400
375
350
325
300
275
250
225
200
175
150
125
100
75
50
25
0
243
No. of Deliveries
Institutional Deliveries- Sub Divisional Hospitals
2007-08 & 2008-09 (till Oct 08)
500
2008-09
346
363
400
252
174
172
0
Districts
118
125
75
52
59
70
12
0
0
20
23
77
76
100
193
219
241
205
144
143
98
122
150
141
147
200
245
293
182
209
225
250
264
286
300
288
292
350
No. of Deliveries
: 68.11)
150
450
50
(%
(4401)
441
2007-08 (2618)
477
Institutional Deliveries- FRUs
2007-08 & 2008-09 (till Oct 08)
Institutional Deliveries- 24x7 PHCs
2007-08 & 2008-09 (till Oct 08)
2007-08 (463)
(% : 570 )
568
600
2008-09 (3102)
550
431
500
450
350
185
194
101
120
63
0
Districts
0
0
0
0
5
0
0
0
0
0
0
21
24
72
21
34
0
0
0
50
0
77
104
108
61
100
85
150
115
138
200
106
194
205
250
209
252
300
72
No. of Deliveries
400
Institutional Deliveries- CHCs other than FRUs
2007-08 & 2008-09 (till Oct 08)
2007-08 (2960)
(% : 30.10)
2008-09 (3851)
633
670
620
570
486
520
353
254
Districts
55
90
89
55
20
108
116
119
163
167
115
123
144
153
95
79
79
49
70
67
120
123
133
170
143
220
209
209
270
250
235
255
320
259
278
302
370
44
No. of Deliveries
420
374
396
470
JANANI SURAKSHA YOJNA
Cash assistance scheme for BPL and SCs/STs mothers (age 19 and above
upto 2 living children) on birth in Public or Private accredited health units.
Rural area
Rs.700/Urban area
Rs. 600/Non Institutional delivery Rs.500/Rs.1500/- to be provided for hiring the services of specialists to carry out the
caesarean in a Govt. Institution
•
2007-08 – 29256 beneficiaries covered against the
target of 90,000 per annum.
•
2008-09 – Till October 19,949 beneficiaries
covered constituting 22.17% of the annual target. It
should have been 60% at the end of October
JSY Performance
District wise Beneficiaries covered (till Oct 08)
100%
Moga, 78.86
Moga, 44.84
90%
Nawanshaher, 72.16
Percentages
80%
70%
60%
50%
40%
Mansa, 59.18
Mansa, 17.97
Ferozpur, 55.51
Ferozpur, 34.62
Bathinda, 53.26
Bathinda, 25.13
Ropar, 53.22
Ropar, 23.78
Sangrur, 51.37
Sangrur, 12.35
F.G. Sahib, 14.74
F.G. Sahib, 46.37
Kapurthala, 45.08
Barnala, 44.84
30%
Mohali, 44.16
Muktsar, 42.61
20%
10%
0%
Nawanshaher, 26.88
Kapurthala, 33.78
Barnala, 8.93
Mohali, 25.58
Muktsar, 19.84
Hoshiarpur, 13.03
Hoshiarpur, 37.46
Amritsar, 32.12
Ludhiana, 30.96
Faridkot, 30.29
Tarn Taran, 25.49
Jalandhar, 24.09
Patiala, 16.34
Gurdaspur, 11.11
Tarn Taran, 15.82
Jalandhar,
Patiala,13.10
6.80
Gurdaspur, 2.12
% Beneficiaries covered
% Institutional Deliveries
Amritsar, 24.55
Ludhiana, 7.53
Faridkot, 24.98
UTILIZATION OF FUNDS
• As per GOI condition funds upto 2006-07 to be
utilized and UC sent for further release of GOI funds
during 2008-09.
• Similarly funds upto 2007-08 to be utilized for
release of funds during 2009-10.
• UCs to be sent for 2006-07.
• Utilization during 2008-09 Rs. 68.29 cr. was given to
districts and various agencies.
100.00
0.00
84.82
51.57
215.47
193.10
199.80
196.03
375.11
327.31
281.12
229.16
441.66
408.36
Total Funds Available
73.02
56.46
93.51
56.82
33.33
164.63
128.36
215.61
300.00
87.92
49.19
68.58
334.42
500.00
140.88
123.56
111.53
226.63
194.12
143.51
142.98
566.38
541.57
600.00
47.31
32.44
41.93
83.33
51.65
200.00
353.78
400.00
195.96
District wise utilization of funds (till Oct 08)
Rs. in lakhs
Utilization
Ranking of the districts
To achieve more and to strengthen the NRHM
programme the districts have been ranked on
performance basis on different health parameters
Ranking of the districts-
THANK YOU