Presentation to National Program Coordination Committee

Presentation to National Program Coordination Committee
State PIP of Uttar Pradesh for 4th May, 2011

REPRODUCTIVE AND CHILD HEALTH (RCH Flexi-pool)
Part - A REPRODUCTIVE AND CHILD HEALTH (RCH Flexi-pool)

BUDGET OVERVIEW (Rs. in Lacs)
Sl. BUDGET HEAD Budget Expenditure Up to March -11 % Expen- diture ( ) % Change Over 1 MATERNAL HEALTH 76% -46% 2 CHILD HEALTH 973.25 84% 667.47 (- S.H.P.) -42% 3 FAMILY PLANNING 53% 8029.3 -4% 4 ADOLSCENT HEALTH (ARSH) 311 261.25 556.86 79% 5 URBAN RCH 64% 23% 6 INNOVATIONS/ PPP/ NGO 791.97 277.08 35% In MFP - 7 INFRASTRUCTURE & HR+ INCENTIVES/AWARDS 65% 105% 8 INSTITUTIONAL STRENGTHENING 546.29 46% ------ 9 TRAINING 31% 10 IEC/ BCC 61% 11 PROCUREMENT 476.44 22.66 5% 12 PROGRAMME MANAGEMENT 2210.1 71% 120% 13 JSY 113% 19% 14 Other RCH Activities- Guaranteed Cashless Delivery Services. 2840 New Activity TOTAL RCH II 86% 28% Maternal health – Last year we had asked for establishment of 908 RTI/STI clinics at Block CHC/PHC level, budget was Rs Lacs. This year, for these established RTI/STI Clinics, budget for medicines and consumables only has been asked under procurement head. Last year, Up-gradation of 3000 Sub Centres accredited under JSY of Rs Lacs was asked, this year only 1000 sub centres are being upgraded. Child Health – The budget proposed this year is low because it does not include budget for school health programme. Last year budget for school health programme was Rs Lacs, this year, as per GOI guidelines, School health programme has been reflected in Mission flexi pool with the budget of Rs Lacs. Family Planning – Budget proposed is slightly less because target for sterilization has been kept for 6 Lacs beneficiaries because achievement in last 3-4 years is less than 4 lacs and with best efforts, the state shall try to achieve the target of 6 Lacs. Additionally some new innovative projects like accreditation of private providers for family planning (Rs. 75 Rs per case for 5000 beneficiaries), pilot on injectable contraceptives worth Rs Lacs 500 per beneficiary * ); incentives to institutions and providers for family planning services worth Rs Lacs have been included. Additionally training of 810 doctors in Minilap and refresher training of 288 doctors has been included. ARSH – The budget increased because of AFHS clinics are being established at 36 sites, a project of menstrual hygiene has been included for 13 districts, and ARSH training upto block level has been included. Urban RCH – Budget has increased slightly due to innovative project of establishing urban health post (150 total) near residential colonies built by state for poorest of poor in urban slums. Innovations/PPP/NGO- The budget proposed is less because last year PCPNDT & Sex ratio activities are included in this head, but this year this chapter is separate and the budget is not included and reflected in Mission Flexipool for Rs Lacs. Further, some innovations like Accreditation of private providers for IUD insertion services (Rs. 75 Lacs for 1 lac ben. ) is included in this. Infrastructure, HR, Incentives/Awards – this year MCH centre operationalization plans have been prepared for every district and actual need based calculations have been given by the districts. The requirement of ANM, Staff Nurses & paramedical staff has been raised from these plans. Further, As per GOI suggestions during sub group meeting on PIP on 7th march 2010, the efforts are being made to strengthen existing FRUs at District woman hospitals and selected CHCs by providing MBBS lady doctors and specialists on performance basis. This year HR for govt. Blood banks and Routine Immunization support (which was previously included in Mission Flexipool) has also been included in this. Incentives for ANMs have been included to promote institutional deliveries at sub centres and incentives to teams of low performing FRUs on better performance have also been included. Institutional Strengthening – Last year under this head Logistic management/improvement, M&E, HMIS and Sub centre rent was proposed but this year, the line items having separate heads/chapters (i.e. Planning, Implementation and Monitoring, Operationalization of health facilities, etc.) and are reflected under Mission Flexipool. Training- The budget has increased because this year some activities like strengthening of SIHFW and renovation of Rs Lacs, Development of training packages for various training programmes of Rs Lacs, Strengthening of existing nursing schools of Rs Lacs & Other trainings like Family welfare counsellors and Minilap training for doctors of Rs Lacs have been included in this chapter. Other trainings being conducted at SIHFW worth Rs Lacs, which were reflected in Mission Flexipool last year, have also been included in this chapter as all trainings are reflected in RCH Flexipool under Training Chapter as per GOI guidelines. IEC/BCC – this year reflected in mission Flexipool for Rs Lacs. Procurement- This year total procurement is in mission Flexipool for Rs. 4, Lacs. Programme Management – This year, total programme management proposal has come in RCH Flexipool. Last year only SPMU & DPMU were included in RCH flexipool, where as Divisional and Block PMUs were budgeted in Mission Flexipool. Further, 10% increment to all the functionaries working optimally has been included. JSY – The increase due to increased targets. This year the state’s efforts will be to increase JSY deliveries upto 30 Lacs. Other RCH Activities – New proposal for guaranteed cashless delivery services, which includes diet provisions, medicines, blood transfusion facilities and consumables for caesarean sections. 3

Institutional delivery
SERVICES OVERVIEW Sl. Indicator Expected / Planned Reported March 11 % Achievement 1 Institutional delivery 21 Lacs 23.39 Lacs >100% 2 Full immunisation 56 Lacs 45.42 Lacs 81% 3 Sterilisation 7.45 Lacs 3.80 Lacs 51% 4 IUD insertion 22 Lacs 15.43 Lacs 70% The target under JSY was 21 Lacs for year The state has achieved Lacs under the head. As per information received from the districts, the number of deliveries conducted at district hospitals is 4.37 Lacs, at CHCs 8.04 Lacs, at PHCs 6.84 Lacs and at sub centres 3.99 Lacs. Home deliveries were only 20124, where JSY benefits have been paid. 92% of ASHAs escorted the pregnant ladies to the health facilities for delivery. The state has been reporting more than 95% immunization during the last few years but as per CES-2009, the percentage of full immunization is only 40.9%. This year, special efforts have been made to monitor the sessions, to ensure that sessions are held. As per information received from the districts, 81% children below 1 year have been immunised fully. Sterilization target for year was 7 lacs for female and for males. The achievement however is not up to the mark and the efforts are being made to increase the awareness in the community and reduce unmet need through fix day approach, sterilization camps, involvement of private providers and incentive schemes. IUD insertion targets could also not been achieved fully. This year private providers are being involved for IUD insertions, IUD camps will be organized at sub centres and proposal for ASHAs being incentivized for follow up of IUCD beneficiaries has been included. Further, post partum IUCD activities are also been promoted this year in identified centres.

MATERNAL HEALTH First Referral Units (FRUs)
(Figures in number) Facility Cum. target (2012) Cum. Progress till Mar ‘10 Incre. Target (10-11) Progress 10-11 till Mar’11 till Mar ‘11 Incre. Target (11-12) Comments FRUs –District Women Hospitals 53 48 5 4 1 All FRUs to be strengthened this year with adequate HR & Blood provision FRUs – District Combined & other Hospitals 20+6 8 18 13 21 Existing FRUs to be strengthened this year FRUs – CHCs 121 72 14 86 - 10 partially functional, 1-2 CS/month, to be strengthened this year Total 200 128 37 31 160 6 There are 53 district women hospitals in the state and all are functional as FRUs. Most of them are performing very well, conducting more than 3000 deliveries and more than 1000 cesarean sections every year. There are a few district woman hospitals/district combined hospitals, which are not performing well and efforts are being made to fill up the gaps identified. Some CHC- FRUs and few sub district hospitals are also functioning well performing more than 1000 deliveries and more 500 cesarean per year. This year, efforts are being made to concentrate on these units to perform optimally. There are 908 block level CHCs and PHCs, which have to function as 24*7 units and around 192 additional PHCs, where round the clock normal delivery services are to be provided this year. At present, 830 such units are functional as 24*7 units. In these units, provision of 1 ISM lady doctor and 3-5 staff nurse/ANM is being made according to number of deliveries being conducted. Sub centres with adequate infrastructure are also conducting deliveries and these sub centres are being strengthened so that ANM can stay at the facility and provide services to the community sub centres have been accredited under JSY and out of these, 3000 are being strengthened as per gap analysis made. These subcentres are being provided with labour table, privacy curtain, strengthening of overhead tanks, toilet repairs, provision of invertors if power supply is adequte to charge it, cooking gas and consumables like Macintosh, gloves, instruments for delivery, BP instrument, foeto-scope,etc. Safe abortion services are being provided at all district woman/combined hospitals. The efforts are being made to provide the services upto all FRU CHCs this year. At present, 100 CHCs are providing the services. RTI/STI services are being provided at all DWH/DCH and CHCs.

MATERNAL HEALTH Facility Cum. target (2012) Cum. Progress till Mar’ 10
(Figures in number) Facility Cum. target (2012) Cum. Progress till Mar’ 10 Incre. Target (10-11) Progress 10-11 till Mar’11 till Mar ‘11 Incre. Target (11-12) Comments 24x7 Facilities 1100 712 138 118 830 270 All 24*7 facilities to be strengthened Sub-centres conducting deliveries with adequate infrastructure incl. Labour Room 4000 1800 700 600 2400 1600 3000 sub centres being strengthened ( ); 1000 proposed to be strengthened ( ) Sub-district facilities providing safe abortion services 15 SDH + 107 CHC 4 SDH+ 80 CHC 4 SDH + 20 CHC 2SDH + 6 SDH + 100 CHC 9 SDH + 7 CHC All district woman hospitals & FRU CHCs providing safe MTP services Sub-district facilities providing RTI/ STI services 15 5 10 All DWH & CHCs providing RTI/STI services There are 53 district women hospitals in the state and all are functional as FRUs. Most of them are performing very well, conducting more than 3000 deliveries and more than 1000 cesarean sections every year. There are a few district woman hospitals/district combined hospitals, which are not performing well and efforts are being made to fill up the gaps identified. Some CHC- FRUs and few sub district hospitals are also functioning well performing more than 1000 deliveries and more 500 cesarean per year. This year, efforts are being made to concentrate on these units to perform optimally. There are 908 block level CHCs and PHCs, which have to function as 24*7 units and around 192 additional PHCs, where round the clock normal delivery services are to be provided this year. At present, 830 such units are functional as 24*7 units. In these units, provision of 1 ISM lady doctor and 3-5 staff nurse/ANM is being made according to number of deliveries being conducted. Sub centres with adequate infrastructure are also conducting deliveries and these sub centres are being strengthened so that ANM can stay at the facility and provide services to the community sub centres have been accredited under JSY and out of these, 3000 are being strengthened as per gap analysis made. These subcentres are being provided with labour table, privacy curtain, strengthening of overhead tanks, toilet repairs, provision of invertors if power supply is adequte to charge it, cooking gas and consumables like Macintosh, gloves, instruments for delivery, BP instrument, foeto-scope,etc. Safe abortion services are being provided at all district woman/combined hospitals. The efforts are being made to provide the services upto all FRU CHCs this year. At present, 100 CHCs are providing the services. RTI/STI services are being provided at all DWH/DCH and CHCs.

JANANI SURAKSHA YOJANA
JSY Target 10-11 (No.) Achv. 10-11 (No.) Proposed * 11-12 Budget (Rs. Lacs) Exp.10-11 Budget Proposed Home Deliveries 42000 20124 30000 210.00 250.00 Inst. Deliveries – Rural Inst. Deliveries – Urban 252000 323114 370000 ASHA -escorting pregnant woman 14.45 lac 19.32 lacs 20 lacs Admin. Costs - Total The target for was 21 Lacs against which state has performed Lacs deliveries. This year, the state proposes to conduct 30 Lacs deliveries under JSY, though the budget proposed is for 25 Lacs beneficiaries. *This year, the efforts will be to conduct 30 Lacs deliveries under JSY, though the budget proposed is for 25 Lacs beneficiaries. An additional budget of Rs Crores will be required for 30 lac beneficiaries under JSY

Other information under JSY
Sl Particulars Status 1 No. of beneficiaries verified by officers at various levels State officers and functionaries verify beneficiaries during field visits CMOs/CMS (F)/ACMOs/DPMs verify on regular basis in districts State quality monitors verify the beneficiaries during visits in districts allotted to them 2 Mode of payment to beneficiaries (cash/ cheque) Bearer cheque 3 What grievance redressal mechanisms are in place Grievance Redressal system at Tehsil level during Tehsil diwas, At Distt. Level with CMO & CMS of the facility 4 No. of private facilities accredited – current and planned 17 accredited under JSY Planned 140 for year 5 No. of deliveries in private accredited facilities (till March11 ) 3417

Issues identified & steps proposed by the State in JSY
1. District Woman Hospitals are overloaded and staff is overworked. Recruitment of more MBBS/specialist doctors and staff nurses proposed on contractual basis. To address complaints of delayed payments, maintain transparency in systems and better monitoring of the programme, JSY is being computerized with development of website, where data from districts will be uploaded on daily basis with details of clients and payments. The development of software and monitoring systems are being supported by NIC. A call centre (grievance redressal cell ) is being established in the secretariat with existing computer cell where on a toll free number, the caller from any where in the state will be able to register complaints/get information/solution of query will be available on 24*7 basis.

MATERNAL DEATH REVIEW Sl Particulars Status 1
Whether training completed up to block level State and district level training is complete. Block level training is in progress and will be completed by July 2011. 2 No. of maternal deaths reported in 10-11 551 (report received from District Women Hospitals between November, 2010 to March, 2011 ) 3 No. of maternal deaths analysed in 10-11 431 4 Major causes of death Anaemia is the most common cause (43%) Sepsis (28%) Post Partum Haemorrhage (4%) Obstructed Labor (7%) Ecclempsia (5%) Others (13%) includes abortions & APH

Key bottlenecks & steps proposed for improvement
Acute shortage of Specialist Doctors in FRUs- Anaesthetists, Gynaecologists, Paediatricians & Pathologists, Ultrasonologists etc. Shortage of Staff Nurses & other paramedical staff. Due to shortage of Doctors adequate numbers are not available for long term training courses like EmOC & Anaesthesia training. Steps for Improvement- 191 specialists are working on contract & 470 specialists are working on-call basis. This year proposal for around 400 MBBS doctors and 330 specialists on contract to work in district woman/ combined hospitals, CHCs and blood banks has been made. 1484 staff nurses & 239 paramedical staff are working on contractual basis and this year the proposal for 2500 staff nurses and 700 paramedical has been made. Incentives for better performing ANMs has been proposed this year. To operationalize FRUs, it has been proposed to incentivize the teams performing well against set norms and standards. Proposal to increase in monthly honoraria of the contractual staff working in rural and backward areas has been included.

FREE & ASSURED REFERRAL TRANSPORT
Facility Status Proposed No. Of districts having referral transport / EMRI Planned for 71 72 No. of high focus districts having referral transport / EMRI Planned for 45 45 Call centre at State/ district level (give nos) - 1 at State No. of ambulances (including for EMRI) 988 (EMTS) 1012 (EMTS) Whether ambulances fitted with GPS (Y/N) N Y Total no. of patients using referral transport Data NA No. of pregnant women using referral transport No. of sick newborns using referral transport Number of Calls received Not yet functional Number of calls attended Number of pregnancy related calls attended Total monthly running cost 1.28lacs (estimated) 1.28 lacs Average cost per trip

FREE & ASSURED REFERRAL
Planned for Year Comments Whether it is free for PW and sick newborns - Yes Whether second referral and drop back facility is being provided Budgetary provision for the above, including basics Procurement of 1012 new Lacs Establishment of Call centre Lacs Operational cost (8 months) Lacs Steps to widely disseminate above services- Through Print & Electronic media, IPC, Messages on Ambulances etc. Source of funds for the budget 60% from NRHM GoI & 40 % from State

PROVISION OF FREE SERVICES FOR DELIVERY & NEWBORN CARE FOR ALL CASES
Facility Current Status Plan for Provision of free drugs From State Budget per beneficiary x 25 lacs PW, Rs.200 for consumable per beneficiary of CS x 0.90 lacs PW Provision of free blood during complications Yes, from RKS or JSY Admin head Rs 800 per beneficiary for 0.25 lacs PW Provision of free diet Yes, up to Distt. Woman Hospital Rs.100 per beneficiary x 15 lacs PW Provision of free diagnostics Yes, from State Budget

PROVISION OF FREE SERVICES FOR DELIVERY & NEWBORN CARE FOR ALL CASES
Unit cost per delivery, per c-section, per day for diet, etc. Total budgetary provision made Sources of funds (e.g. NRHM, State budget) Plan (IEC etc.) for putting the above entitlements in the public domain Provision of Rs.100 for medicines in normal delivery, Rs.200 additional in case of C-section & Rs.50 for diet per day has been made in PIP . Rs lacs for medicines, Rs. 180 lacs for consumables, Rs. 160 lacs for blood transfusion arrangement & Rs lacs for diet Consumables & routine medicines are solely from State budget. For C-section cases, 50% of budget is from NRHM & 50% from State budget. IEC through print & electronic media is being planned.

Incremental Target (10-11) Incremental Target (11-12)
CHILD HEALTH Facility Cum. target (2012) Cum. progress till Mar’ 10 Incremental Target (10-11) Progress till Mar’11 Cum. progress till Mar’11 Incremental Target (11-12) *Sick New Born Units – DH 30 7 5 5 ( Under Establishment) 12 10 DWH+ 8 Med Colleges New Born Stabilization Unit – SDH, CHC, etc. 180 25 155 85 110 70 New Born care corner – DH, SDH, CHC, PHC, etc. 1100 240 610 525 765 335 Nutritional Rehabilitation Centre 26 13 8 18 During , total admissions in SNCUs were 9762, out of which 7828 were cured, 992 new born expired and 679 either referred to higher centre or left.

CHILD HEALTH Steps proposed- Key bottlenecks -
Non availability of paediatricians & staff nurses to operationalize SNCUs. In community a few behaviours are not suitable for new born care (delaying colostrums, giving honey/ghutti after birth, bathing new born just after delivery and putting local medicines/mud on umbilical cord ) and they need to be addressed urgently Steps proposed- This year it has been proposed to establish/strengthen SNCUs in govt. Medical colleges, where adequate faculty/resident paediatricians are available. Training of MBBS doctors in facility based new born care, so that they may work as paediatrician. Comprehensive Child Survival Programme (CCSP) which includes behaviour change communication strategies for community and ASHA is being trained as key person in this programme, is to be implemented with full efforts in whole of the state.

CHILD HEALTH No. of districts implementing IMNCI (CCSP in UP)– current and planned 36 Districts are implementing Comprehensive Child Survival Programme (CCSP) In remaining 35 districts, TOT being conducted, ASHA/ANM will be trained from April onwards . No. of districts where training is saturated- - 10 districts (Aligarh, Banda Bulandshahar, Gorakhpur, Jhansi, Lakhimpur Kheri, Mirzapur, Pratapgarh, Saharanpur & Varanasi) Plan for Home based newborn care ( HBNC), including incentives to ASHAs- Home based newborn care is an essential part of CCSP training. Trained ASHAs are making 3 to 6 Home visits and getting incentives of Rs. 50 for 3 visits and Rs. 100 for 6 visits. Status of implementation of Joint MCH cards Being implemented with ICDS jointly in all Districts.

Fixed Day Static FP Services
FAMILY PLANNING Fixed Day Static FP Services Cum. target (2012) Cum. progress till Mar ’11 Increment. Target (10-11) Progress till Mar’11 Increment. Target (11-12) DH & SDH providing Laparoscopic /Minilap sterilization services 53 DWH/ 20 DCH + 15 SDH 53 DWH/11 DCH +12 SDH 5DCH + 7 SDH 5DCH +7SDH 9DCH + 3 SDH DH & SDH providing Non scalpel vasectomy services 61 DH + 20 DCH 50 DH+12 DCH 6DH + 5DCH 6DH + 5DCH 11DH+ 8DCH CHC & PHC providing Minilap/Laproscopic services At all 820 block CHC/PHC in camp mode - CHC & PHC providing NSV services NSV camps organized at CHCs

Steps proposed for improving female sterilization services
53 District Women Hospitals are providing FP services on daily basis (6 days/week) 20 District combined hospitals/ 120 CHCs will provide fix day services twice/ week. Facility based monitoring of sterilization cases performed at these facilities will be done. Details of clients will include - type of family planning services opted, parity and method of sterilization. Districts are instructed to maintain detailed records as per guidelines. Wide IEC activities in the form of wall writings, leaflets, brochure etc. will be carried out to create awareness in the community about fixed days.

Steps to promote post partum FP services
At present, small number of PP ligation is being done. This year, it has been planned to increase the number of post partum ligations by – Provision of Family Welfare Counsellors at every FRU to counsel the client to adopt post partum family planning services. Abdominal tubectomy (Minilap) induction training for 12 days is planned for 810 medical officers (MBBS). These trained service providers will be able to provide post partum abdominal ligation on day to day basis. In identified divisional district hospitals, 9 batches of 5 trainees each will be trained for the purpose during the year In addition, abdominal tubectomy refresher training will be given to 288 medical officers, who need to refresh their skills.

Steps to promote family planning services
Steps for scaling-up IUD services IUD trainings is planned for 688 doctors, 1376 staff nurses and ANMs through SIFPSA in the year Training will be conducted in 43 identified districts at DWHs and 2 CHCs, having good client load. In addition, 3 districts (Lucknow, Jhansi and Allahabad) are also providing post partum IUCD services on pilot basis. This year it is planned to expand these services to 20 more districts.

Steps to promote family planning services
Family Planning services through private providers- At present, the number of accredited private and NGO facilities providing FP services is very low. FPAI, some other institutions are providing quality family planning services consistently. This year special initiative of providing compensation package of Rs Lacs as an advance for 100 cases to 50 identified private providers, who will perform 5000 cases of sterilization in the year. These private provider will also be given an additional incentive of Rs per case, if the centre conducts more than 30 operations at a time on a pre-fix day. This year, provision of accreditation of private providers for quality IUD services is also proposed and expected that 1 lac IUDs would be inserted for which Rs Lacs have been proposed 75/- per client) Apart from this, through FOGSI initiative some more NGOs (PSI/Jhiepgo) are linked in for IUD services and training of private providers is being planned.

Steps proposed for NSV services
District Male/Combined hospitals /FRUs are providing fixed day NSV services. There is provision to train young male doctors (MBBS) on NSV skills during existing NSV camps, wherever there is sufficient client load. The extra technical support for training will be provided through NGOs (Engender health). Provision for sufficient NSV kits/sets is being made accordingly. Wide publicity for NSV on fixed days is being planned by wall writing, leaflets, brochure, etc.

ADOLESCENT HEALTH PROGRAMME
Facility Target Progress Adolescent Friendly health services (AFHS) clinic – DH - 1 AFHS clinic in Divisional level male & female district hospitals (36) AFHS clinic – SDH, etc. AFHS clinic – CHC AFHS clinic – PHC Districts covered under Adolescent Health Programme 71 Schools covered 8200 5733 Students covered 12 lacs 11.92 lacs Students given IFA/ de-worming tablets 10.75 lacs

SCHOOL HEALTH PROGRAMME (SHP)
Facility Target (No.) Progress (No.) Districts covered under SHP 71 72 Schools covered 49200 (32800 in 1st year in 2nd Year new) 38618 57400 Students covered Lacs 43.09 Lacs 84 Lacs Students given IFA/ de-worming tablets 73 Lacs 42.52 lac (IFA) 41.87 lac (De-worming)

SCHOOL HEALTH PROGRAMME (SHP)
Issues/steps proposed in the programme No. of enrolled children in primary schools is much more than the actual presence in the schools. Acceptance for de-worming tablets is less than that for IFA. Counseling to students and parents for the same is being incorporated in teachers training. Elaborated teachers training programme is underway for which training modules have been developed in Hindi. Trained teachers will be able to screen the students on 6 monthly interval and refer as per need to relevant health facility.

URBAN RCH Due to increase in urbanization existing health facilities can not provide quality RCH services in the slums and Peri-urban areas. To fulfill the gaps New Urban Health Posts were established under European Commission, are now being funded with NRHM. These are in rented building, located near slum areas and having contractual staff. These Health Posts are providing Primary Medical care, MCH, Family Planning and referral services. 128 Urban Health Posts are functional in 67 Districts and additional Human resource, ambulances, drugs support to Bal Mahila Chikitsalaya in district Lucknow has been proposed for Other than above activities, 150 New Urban Health Posts are proposed in newly established colonies to provide health services to poorest of poor .

Proposed under Programme Management head
URBAN RCH Rs. in lacs Sl. Budget Head Budget Expenditure 1 Sustaining of Urban Cell at Directorate Proposed under Programme Management head 2 Lucknow Urban RCH Programme 432.75 281.26 3 Urban RCH activities in 13 big cities 611.82 531.68 4 Urban RCH activities in 53 big cities 547.79 452.10 5 Baseline survey, Health facility survey and sensitization workshop for 14 cities under NUHM 81.90 6 Urban Health Posts in residential areas –Poorest of poor - 789.00 Total Budget

GENDER & SEX RATIO Year Sex ratio Child sex ratio 2001 898 916 2011
908 899 10 Districts with poor sex ratio Agra 835 Baghpat 837 Bulandshaher 844 G.B.Nagar 845 Ghaziabad 850 Meerut Muzaffar Nagar 858 Jhansi 859 Hathras 862 Hardoi 863

Steps taken to monitor sex ratio
District appropriate authorities are instructed to increase the frequency of surprise inspections of ultrasound units/places They are also advised to discuss the issue of PC&PNDT Act during monthly monitoring meeting held under the chairmanship District Magistrate. Information about Male/ Female child is also to be collected through other programmes routine immunization/ Jachcha Bachcha Surakhsha Abhiyan. This will help in knowing the trends of sex ratio in particular area and taking steps accordingly.

Steps taken to Improve sex ratio
Steps are taken to monitor and prevent second trimester abortions (unauthorized) Districts are instructed to monitor MTP Act closely. Updated report of all the MTP cases done by registered providers at registered places is to be made available at Districts and sent to State along with quarterly report.

Steps taken to enforce PC&PNDT Act
Ensure building up strong court cases for those violating the PC&PNDT Act and seek the required legal assistance for the same. Legal action is to be taken (as per act) for not keeping the proper records and unregistered ultrasound machine /centres /mobile centres (units). A total of 39 cases have been filled under PC&PNDT Act till date. Out of which 8 cases have been dropped, rest are under trial.

TRAININGS MATERNAL HEALTH TRAINING 1
Unit in No. Sl. Training Target Achievement MATERNAL HEALTH TRAINING 1 21 days Skill Birth Attendant (SBA) for Staff Nurses / ANM/ LHV 3000 1867 2 12 days Basic Emergency Obstetric Care (BEmOC ) training - (SBA for Medical Officers) 336 327 288 3 16 weeks Comprehensive Emergency Obstetric Care (CEmOC) incl. c-section – MO 64 48 4 18 weeks Life Saving Anaesthesia Skills (LSAS) – MO 72 62 84 5 Medical Termination of Pregnancy (MTP) – MO 120 150 6 Reproductive Tract Infections/ Sexually Transmitted Infections (RTI/STI) – MO (District Trainers) 200 162 1650 7 Reproductive Tract Infections/ Sexually Transmitted Infections (RTI/STI) - MO 75 46 8 Reproductive Tract Infections/ Sexually Transmitted Infections (RTI/STI) – LT 50 45

TRAINING CHILD HEALTH TRAININGS 10
Unit in No. Sl. Training Target Achievement CHILD HEALTH TRAININGS 10 Comprehensive Child Survival Programme (CCSP) – ANM/LHV 6320 1861 5305 11 Comprehensive Child Survival Programme (CCSP) - ASHA 32180 11759 32585 12 Facility based Integrated Management of Childhood Illnesses (F-IMNCI) – Medical Officers 142 89 1495 13 Facility based Integrated Management of Childhood Illnesses (F-IMNCI) – Staff Nurses 2745 14 Navjat Sishu Suraksha Karyakram (NSSK) – M O 1382 587 1622 15 Navjat Sishu Suraksha Karyakram (NSSK)– Staff Nurse 1033 586 1199 16 Navjat Sishu Suraksha Karyakram (NSSK) – ANM/ LHV 1040 735 1234

TRAINING Sl. Training Target 2010-11 Achievement 2011-12
Unit in No. Sl. Training Target Achievement FAMILY PLANNING 17 Laparoscopic Sterilisation 240 54MO, 31 SN 18 Minilap Sterilisation 144 45MO, 22SN 135 19 Non- scalpel Vasectomy(NSV) 282 105 294 20 IUD (Copper –T) – MO 688 21 IUD (Copper –T)– SN 1376 22 IUD(Copper –T) – ANM/ LHV 3870 23 Post Partum IUCD-MO 27 27MO,17SN 100 ADOLSCENT REPRODUCTIVE & SEXUAL HEALTH (ARSH) TRAINING 24 ARSH –State Trainer 25 - ARSH –Regional Trainer 55 26 ARSH – MO/PHN 1816 1360 2640 ARSH – HV/ANM 4263 1711 12000

OTHER TRAININGS Unit in No. Sl. Training Target 2010-11 Achievement
1 NRHM Programme Management training- ACMOs/Dy.CMOs 200 143 50 2 NRHM Programme Management training- Sr. MOs 131 3 BCC training for DPMU (TOT) 30 22 100 4 Disaster management Training 105 150 5 Hospital waste management 210 169 75 MOs Workers 6 Administrative management training for CMS 59 7 Rogi Kalyan Samiti (RKS) – ToT (CMS & MS) 300 256 - 8 Rogi Kalyan Samiti (RKS) – ToT (CMO/Div. PM/DPM) 160 133 9 Family life education 91 10 Hospital Administration Course for CMS– NIHFW 40 39 11 Logistic Management & HMIS (trainers of RFWTCs) 47

Availability of State and District training sites
TRAINING (Contd...) Availability of State and District training sites State Institute of Health and Family Welfare – 1 Regional Health and Family Welfare Training Centres -11 PHN Training Centre - 1 LHV Training Centres - 4 ANM Training Centres - 40 District Training Centres – 30 Availability of Trainers for various trainings State/Regional and District trainers are available for various trainings. Trainers at pre service training sites are not available in adequate numbers. Therefore, proposed in PIP

TRAINING (Contd...) Key Issues in Training -
Due to non availability of adequate number of medical and paramedical staff in the districts, usually attendance in training sessions is poor. The CMS/MS do not allow the doctors and nurses to go for long term trainings. Steps proposed to address the above, and to enhance training capacity to meet targets for year : Proposal for establishment of district training labs for refresher trainings. Proposal for establishment of mobile training labs for onsite trainings and quality issues has been included in PIP. Efforts are being made to provide doctors on make shift arrangement basis for the facility, from where doctor is being sent for training.

TRAINING (Contd...) Steps taken to monitor quality of training and post-training skills utilisation Qualified and dedicated personnel are being identified as trainers along with additional responsibility of monitoring the quality of trainings and ensuring post training skill utilization. Training modules material and availability of teaching aids is being ensured. Regular monitoring during training sessions and in the field by identified monitors and state officers as per the training calendar. Data base for all the trainees is being maintained to rationalize the postings for proper utilization of the skills obtained in the training. Independent evaluation of the training programme is being proposed.

TRAINING (Contd...) Strengthening of Training Institute Sl.
Training Institutes Proposed to be Strengthened Nos. Amount requested for Strengthening Training Institutes 1 State Institute of Health and Family Welfare (SIHFW) Rs lacs 2 State Nursing Colleges -4 4 Rs lacs 3 ANM Training centres -36 36 Rs Lacs District Training Centres - 30 30 Rs lacs Total Lacs

Part - B MISSION FLEXIPOOL

Infrastructure Progress (2009-10)
Sl. Name of work Physical Target Amount Sanctioned (in lacs) Expenditure (in lacs) Physical Progress (till March-11) 1 Construction District drug ware house 30 All completed 2 Strengthening of hospital facilities 134 3 Facility surveys for strengthening district hospitals and CHCs to IPHS 134+ 100 300.00 4 Construction of Sub centre 2908 2808 completed, 77 under progress, 23 land not available 5 Construction of CHCs 33 1 complete, 30 in progress, 2 land not available 6 Up-gradation of CHCs to IPHS 50 9 completed , 41 in progress

Infrastructure Progress (2009-10) Continued...
Sl. Name of work Physical Target Amount Sanctioned (in lacs) Expenditure (in lacs) Physical Progress (till March-11) 7 Up-gradation of district hospitals to IPHS 40 >75%-4 50-75%-7 25-50%-21 <25%-8 8 Strengthening of RFWPTCs 11 916.50 >75%-2 50-75%-6 25-50%-1 <25%-2 9 Strengthening of ANMTCs 4 495.64 333.50 50-75%-1 10 Construction of JSY wards at PHCs 942 858 completed, 74 in progress, land required for 10

Infrastructure Progress (2010-11)
Sl. Name of work Physical Target Amount Sanctioned (in lacs) Expenditure Physical Progress (till March-11) 1 Up-gradation of district hospitals to IPHS 89 71 in progress (25%), rest to be started soon 2 Construction of regional drug ware houses 7 74.68 3 in progress, rest to be started soon 3 Construction of Sub centres 1756 886.54 472 in progress, rest to be started soon.

Infrastructure Proposed 2011-12
Activity Sub Centers District Hospital Others No Amount Unit in No. Amount in lacs New Construction 710 - 61 (18 District Drug ware houses & 32 Waiting homes for pregnant ladies ) Up-gradation 1000 300.00 89 Strengthening/Renovation 11 Regional drug ware houses Strengthening Gyn/obs. Department -CSMMU, Lucknow 8 SNCUs in Paediatric Departments of govt. Medical colleges 110.00 105.40 537.38 Infrastructure budget as % of total budget- 9% Amt. for block and below level facilities (as % of Infra Budget)- 22%

Infrastructure Proposed 2011-12
Sub-Centre rent No. of SC Rs 250/SC Amt proposed in 8106 243.18 Amount proposed for other activities Hospital Strengthening Mobility Support for transportation of supplies Others (pl specify) - Rs Rs (operationalization of 53 District drug ware houses)

HUMAN RESOURCE (Medical)
Rs. in Lacs Human Resources Existing (in ) Proposed (in ) Unit cost proposed Total Amount in lacs Specialists Contract for whole month 191 800 4,764.00 On call 14782 calls 30000 510.00 Doctors MBBS/BDS 523 1250 5,179.80 ISM Male 1126 - ISM Female 802 1100 3,960.00 Nurses 1484 2500 4,980.00 ANMs 807 3,252.00 Para medicals - Lab tech/ ECG Tech/X-ray Tech/ Physio, Opto/etc 239 700 972.00 Data Entry Operators 129 138 10000 165.60 ISM Pharmacists 813 PHNs/ Tutors /Others as teaching faculty at RHFWTs/ANMTCs/DPTCs, etc. 100 20000 200.00 Total 3,983.40

Human Resource (Programme Management Staff - SPMU)
Category Sanctioned (in ) Working (in ) Proposed (in ) Unit Cost Proposed Total Amount in lacs GMs 8 6 100,000.00 96.00 DGMs 2 5 75,000.00 45.00 FC 1 12.00 Senior Finance and Accounts Manager - 60,000.00 7.20 Senior Accounts Manager 50,000.00 6.00 Managers-Finance 4 3 45,000.00 21.60 Consultants (Nonmedical) 7 33,000.00 27.72 Consultants (medical) 35,000.00 12.60 Regional Managers-/Accountants -/Data Analysts/Sect.Steno/Office Coordinator Reg.Mana-4/Account-3/Data Ana-5 /Sect.-4 /Office Coordinator-1 Accountants-1, Data Analyst-5, 15 21,000.00 37.80 Data Assistant/Programme Assistant- 17 DA -4, PA-7 20 17,000.00 40.80 Internal Auditors 14,000.00 6.72 Typists/Computer Operators-/Guards Guards-3 Guard-3 10,000.00 9.60 Electrician 7,000.00 0.84 Office Attendants 13 6,500.00 10.14 Sweeper 4,500.00 1.62 Sub Total 335.64 Increment (10%) 33.56 Total 369.20

Human Resource (Programme Management Staff - DPMU)
Category Existing (in ) Proposed (in ) Unit Cost Proposed Total Amount in lacs DPMs 60 72 27,000.00 233.28 DCMs (budgeted in Asha Support System in Mission Flexi pool) 64 22,000.00 - DAMs 49 190.08 Data Cum Account Assistants 71 17,000.00 146.88 Class-IV 6,500.00 56.16 Sub Total 626.40 Increment (10%) 62.64 Total 689.04

ASHAs Total Number of ASHAs in the State – 136183
Population Per ASHA – Approx population Drug Kits (Norm: Rs 600/Kit) – Amount proposed per kit = Rs. 500/- Total Number of Kits to be procured = ( *2 times) Total Amount proposed = Lacs Expenditure on Selection, Training (Norm: Rs 10,000 per ASHA) Total amount proposed = Lacs Amount proposed per ASHA = Rs (Approx.) Total amount proposed for paying incentives – Rs.10, Lacs Incentive to ASHAs under Child Health - Home Visits New Borns (56580)= Rs. 1, Lacs Other Incentives to ASHAs (122565) = Rs. 8, Lacs ASHA Award Scheme (820) = Rs Lacs Incentive to ASHA for complete ANC (136183) = Rs. 1, Lacs Non monetary incentives (like uniforms, Umbrella etc) proposed for ASHA - None

Untied Funds/ AMG/ RKS/ VHSC
Facility Type / No. of facilities Norm/Total Amount Proposed (in Lacs) Total (As per RHS/No. Proposed in PIP) Untied funds AMG Corpus Grant HMS/RKS VHSC District Hospitals (DHM, DWH, DHC, T.B. and Mental Hospital) - Rs. 5,00,000 152 760.00 CHCs (block + Non block) Rs.50,000 Rs. 1,00,000 466 233.00 466.00 1,165.00 Sub District Woman Hospitals 15 7.50 15.00 37.50 Block PHCs 460 230.00 460.00 1,150.00 PHCs (30,000 Population or 2294 APHCs-Government building) Rs.25,000 Rs. 50,000 2,661 665.25 1,147.00 2,661.00 4,473.25 Sub Centre (12413 Government building) Rs.10,000 20,521 2,052.10 1,241.30 3,293.40 VHSCs - 51,914 5,191.40 8,379.25 3,329.30 4,362.00 16,070.55

Capital Cost (per unit)
MOBILE MEDICAL UNIT Rs. In Lacs Category No. of Districts Existing number New Proposed Capital Cost (per unit) Operational Cost Total 0 MMU 1 MMU >1 MMU Units 57 - 15 133 2,779.70 615 28.00 Tender/Prebid/Hiring Consultant and other related expenditure 90.00 Sub Total 30,372.50 Deduction - Committed liabilities ( only for operational cost) 850.64 Cost of MMU (per unit per month) = Approx. Rs.1.98 Lac Cases per MMU per month = cases are being attended in every session by these MMUs.

Name of Study tours & research Estimated Cost (in Lacs)
Proposed Institute Study tours of state, district, facility doctors and programme managers 120.00 Nutrition and Rehabilitation Centres – Madhya Pradesh SNCU- West Bengal (Purulia) and Gujarat Family Planning Services – Tamilnadu Procurement Systems and mechanism - Tamilnadu Adolescent (ARSH) – Karnataka and Maharashtra MCTS – Gujarat Communitization Processes – Chhattisgarh, Maharashtra and Rajasthan Concurrent evaluation of various programmes like CCSP, SHP, etc. 25.00 PRC Lucknow/reputed Medical Colleges

IEC/BCC Main Activities Amount Proposed Expected output
Rs. In Lacs Main Activities Amount Proposed Expected output Strengthening of BCC/IEC Cell (state) 5.00 Better performance Development of State BCC/IEC strategy 1.00 Better implementation BCC/IEC activities for MH 440.42 Reduction in maternal mortality and morbidity BCC/IEC activities for CH 164.46 Reduction in IMR BCC/IEC activities for FP 676.81 Better acceptance of FP services BCC/IEC activities for ARSH 42.26 Better acceptance of youth friendly services Other activities Urban RCH 82.80 Improvement in urban slums health indicators Radio Drama Series for general Public 120.00 Increasing awareness VHSC Advocacy Booklet 22.50 Better utilization of VHSC funds Republic day Celebration 1.50 Routine Immunization 353.75 Reduction in Vaccine preventable diseases BCC/IEC activities for School Health 80.93 Improvement in health status of school going children. Total 1,991.43

Saubhagyawati Scheme – A PPP initiative by GO-UP
The scheme was initiated in year with a package of 1.85 Lacs to private provider for 100 deliveries (including caesarean section). In the first year, overwhelming response was received when 158 nursing homes got accredited and in 8 months time, reported normal deliveries, 597 complicated deliveries and performed 1252 caesareans. From the year , due to withdrawal of benefits to the beneficiary and ASHA, the number reaching in these centres reduced to 5754 normal delivery, 166 complicated and 693 caesarean sections, which further reduced to 493 normal deliveries, 27 complicated cases and 70 caesarean in At present only 111 nursing homes are accredited and that too are not enthusiastic or very responsive.

Alternative proposal under Saubhagyawati Scheme
GOI is requested to either reinstate the same benefits as earlier to beneficiaries and ASHAs or an alternative proposal given in PIP, as per below: Alternately it is proposed to pay Rs. 2000/- in case of normal delivery and Rs. 7000/- in case of caesarean section to the private hospital, accredited under the scheme in line with RSBY. As per initial discussion with private hospitals, they are agreeable to this preposition. For normal deliveries, an amount of Rs. 200 Lacs and for approx caesarean sections, an amount of Rs Lacs is being proposed under the scheme (Totalling Rs Lacs)

No of Beneficiary Targeted
NGO/PPP/Innovations Name of Initiative Amount Proposed No of Beneficiary Targeted Accreditation of private providers for sterilization Services 1500/case) 75.00 5000 Promoting FP through private 500/ case if more than 30 cases in one setting 12.50 2500 Family Friendly Hospitals (FFHs) 59.50 50 districts Performance based rewards- Institutions & Providers for FP Rs. 1 Lac/ district 72.00 72 Accreditation of private providers for IUD insertion Rs. 75/- per case 100000

DECENTRALIZED HEALTH PLANNING
Issues Comments No. of districts in the State 72 No. of DHAP prepared and sent to Ministry 72 prepared. No. of high focus districts 45 Has resource envelop indicated to all districts Yes Is higher weightage of 1:1.3 given to high focus districts No. of blocks where Block Plan made 410 No of Villages 104022 No of villages with VHSCs 51943 (at Gram Panchayat level) No. of villages where Village Plan made 1400

PROCUREMENT OF EQUIPMENTS & DRUGS
Others Units Amount (in Lacs) Maternal Health 2000 Medical Abortion drug 100 Consumable for RTI/STI 2.00 14.40 100 Colour 16 Lacs 100 Foetal Rs Lacs 433 MVA Rs. 2000/- 820 Rs. 4500/- 20 Blood storage Rs /- 316 Blood transportation 15000/- 110.00 866.00 36.90 18.00 47.40 - Child Health 20585 new Rs. 1000/kit 35287 kit 535/ kit 205.85 188.79 Equipment for 6 SNCUs at District Women Hospitals 40.00

Others Units Amount (in Lacs) Family Planning 1000 NSV Rs. 700/- , 5000 IUD Rs. 3000/- & 160 Minilap Rs. 3000/- 161.80 AMRC for 400 laparoscopes 24.00 School Health Lac IFA paediatric Rs. 14/- for 100 tablets Lacs deworming Rs. 2/- for Lac children *2 tablets 344.40 75000 Rs. 200/- 150.00 -

Others Units Amount (in Lacs) ARSH IFA tablets for Lacs Rs per girl Deworming tablets for Rs. 4/- per girl Deworming tablets for lac non school going girls under in districts of menstrual hygiene. 82.66 49.20 61.01 Urban RCH (Drugs & consumables 8 BMCs in Lucknow UHPs+ 150 New UHPs proposed 243.60 Dental 350 Facilities 175.00 Total (Rs Lacs) 2,569.30 - 2,199.76 24.00

Monitoring & Evaluation (M&E)
HMIS Computer systems and related hardware have been supplied and installed up to the block level facilities. Financial provision for internet connectivity has been made. Block data assistants have been posted and training has been planned. It is expected to start the facility based reporting on HMIS portal from September 2011 onwards.

2. Mother & Child Tracking System (MCTS)
Presently data from community is being collected by ANMs on prescribed format. Offline data entry is being done at the block level. Import of offline data on web portal of MCTS is not smooth. Retrieval of data and generation of work plans from the MCTS portal is difficult. To avoid the above problems, it has been plan to upload MCTS data directly from block level on the web portal from September 2011.

3. Capacity Building Training has been planned for HMIS and MCTS and analytical skills. District level trainers will be trained at the state level, as master trainers. District level master trainers will conduct the block level training at the district head quarter or at a place, where well equipped computer lab is available. All the trainings will be explanatory as well as hands-on skills on web portal. It is expected that the whole training programme will be completed by month of July-August 2011. Skills and Knowledge of faculties from NIC, PRC, SIHFW, SPMU other eminent institutions will be utilized for training of Master Trainers.

Details (including cost per unit)
Major Head Minor Head Budget (in Lacs) Details (including cost per unit) Remarks 1.Strengthening of M&E/ HMIS/ MCH Tracking Salaries of M&E, MIS & Data Entry Consultants 235.00 195 Rs /month /operator Mobility for M & E Officers 150.00 State, district and block level officials Workshops/Training on M & E 5.00 State level training M&E Studies 2.50 For research agency for HMIS Others (specify) 15.00 Hiring of IT related services from external agency 2. Procurement of HW/SW and other equipments Hardware/Software Procurement 195.00 90 90 computers with all accessories Internet connectivity 60.00 Rs. 400/month per unit Annual Maintenance 25.00 AMC for already procured H/W and equipments during Operational Costs (consumables etc) Rs. 400/ month per unit for computers, printers, stationery at state, district & block level Others (Specify) Wireless internet access – data cards for remote health facilities

Major Head Minor Head Budget (in Lacs) Details (including cost per unit) Remarks 3.Operationalising HMIS at Sub District level Review of existing registers – to make them compatible with National HMIS 10.00 Review of existing registers/formats and redesign in order to make compatible with national HMIS Printing of new registers/Forms 15.00 Printing of registers/input formats for health facilities Training of staff 75.00 Training on M&E at division, district and block level 4. Computeri- zation of CMSD in directorate of Medical and Health- U.P, Lucknow 25.00 Procurement of server unit, 10 computer sets, internet connection, outsourcing of data entry work and web based software, etc. Total 897.50

Major Head Minor Head Budget (in Lacs) Details (including cost per unit) Remarks 5.Operationalising MCH tracking Printing and reproducing Registers/ Forms 72.00 Rs per unit tracking formats Capacity building of teams State level 10.00 Rs Lacs For state level (4 times) District level Rs Lacs For 72 districts (4 times) Block level 41.00 Rs Lacs For 820 Blocks (1 time) Ongoing review of MCH tracking activities 17.28 Rs Lacs 4 review meetings at state, 3 participants per district (total 216) Monitoring data collection and data quality 123.00 Rs Lacs / month 25% of blocks, MCTS data will outsourced Others (Specify) 82.00 Rs Lacs Contingency for 820 Blocks Total 417.28

OTHERS ACTIVITIES Activity Amount Proposed ( In Lacs) Expected Output
SL. Activity Amount Proposed ( In Lacs) Expected Output B7 District Action Plans (Including Block, Village) 200.00 1 State PIP, 72 DAPs, 820 Block PIPs and 10% Village plans to be developed B 8.3a Tehsil Level Pradhan Sammelan 124.80 312 sammelans will be organized B9 Mainstreaming of AYUSH SBA Training of ISM Lady Doctors (4 doctors per batch) 135.00 125 Batches (500 ISM doctors will be trained) B.10.4 Grameen Swasthya Melas (Health Melas) 2,087.28 820 Melas per month will be organized B.10.5 Creating awareness on declining sex ratio issues 158.20 Activities in 72 Districts and state level B.10.6 Other activities Saas Bahu Sammelans 108.00 In 72 Districts

Referral Transport (EMTS)
B12 Referral Transport (EMTS) B12.1 Ambulance - New (1012) with Equipments and accessories 10,879.00 1012 new ambulances with equipments and accessories will be procured Equipment and accessories for 590 ambulances purchased in 2,065.00 Equipments and accessories for 590 (already procured) Cost of 398 ambulances of along with equipments and accessories 4,278.50 Cost of 398 ambulances alongwith equipments and accessories 4 Operational Cost of1012 Ambulances( from Oct. 11- March 12) 7,772.16 Operationalization of 1012 ambulances for 6 months 5 Operational Cost of 988 Ambulances( from Sept.11 to March 2012) 8,852.48 Operationalization of 988 ambulances for 7 months Establishment of Call Centre and Procurement of Toll free number 1,800.00 1 call centre will be established to manage issues related referral and transport with toll free number Hiring consultant for selection of service provider, expenses of tender and related activities 50.00 1 agency will be hired for selection of service provider and processing of tender, etc. Sub Total 35,697.14 Deduction of - a. 40% (Rs lacs) of operational cost of Rs Lacs to be borne by State Govt.-UP (item no. 4 & 5) and b. Committed liability of Rs Lacs from last year 18,254.32 17,442.82

Activity Amount Proposed ( In Lacs) Expected Output
SL. Activity Amount Proposed ( In Lacs) Expected Output B13 School Health Programme 729.36 Health status of Lacs school going children to be improved. B15 Planning, Implementation and Monitoring B15.1 Community Monitoring B15.1.1 State level 20.00 1 state level Visioning workshop will be organized a State Q.A.Cell 14.93 1 cell will be established to ensure quality assurance b State Quality Monitors 89.64 Better monitoring of activities in districts B15.3 Monitoring and Evaluation B15.3.3 Other M & E Activities Village Health Index Register 112.00 VHI registers will be printed c ANM Supervision and Monitoring Systems 820.00 Monitoring through Block CHCs d Mobility support to ANM to conduct VHND sessions 794.64 session will be monitored by ANMs during VHNDs e Mobility Support to DWH & DCH Staff for supervision and monitoring activity 187.50 Verification and follow-up of JSY and FP beneficiaries through hospital staff f Mobility Support for Monitoring & Supervision – DCM and DAM 120.96 For supervision and monitoring of various activities and accounts

CCSP Programme Monitoring 368.14
SL. Activity Amount Proposed ( In Lacs) Expected Output g CCSP Programme Monitoring 368.14 Handholding of ASHAs and better implementation of the programme h Hospital Information System (HIS) in hospitals 2,665.00 Establishment of Hospital Information Systems in Hospitals, Medical colleges (total 127units) i State level Call centre/Grievance redressal cell 30.00 1 State level Call centre/ Grievance redressal cell will be established to address field level problems, complaints, grievances and queries related health services B.17 PNDT Activities 41.23 At state and district level B.18 Regional drugs warehouses 120.33 1state +11 regional B.19 New Initiatives/ Strategic Interventions a MCH Centres Operationalization (other than HR) Partial Construction (MCH Centre Level – I,II & III) 3,840.50 Repair of residences of level –I, 1100 (24*7) +126 FRUs Equipments(MCH Centre Level – I &II) 900.00 72 districts One room set for 2nd ANM(MCH Centre Level – I) 250.00 100 one room set

Backward Districts Interventions 247.60
SL. Activity Amount Proposed ( In Lacs) Expected Output b Backward Districts Interventions 247.60 20 district mobile team & 10 district static labs B.22 State level health resources centre (SHSRC) 115.00 Development of 200 model villages B23 Support Services Hospital Waste Management System 1,300.00 For all districts upto block level Support to ANMs at Accredited Sub Centres 120.00 2000 sub centres performing good number of Rs. 100 per delivery Outsourcing of cleaning, upkeep & laundry services in DH and CHCs 3,744.00 @ Rs per bed for 134 DH and 200 CHCs B23.3 Support Strengthening NVBDCP BRD Medical College, Gorkhapur (Paediatrics Department) 359.15 Critical care unit for JE/AES cases

Total Mission Flexi pool
SL. Activity Amount Proposed ( In Lacs) Expected Output B.24 Other Expenditures (Power Backup, Convergence etc) I Diesel for generators For District Hospitals 912.00 Uninterrupted power supply for 152 Rs /month For fully Functional CHCs 1,957.20 Uninterrupted power supply for 466 Rs /- month For CHCs which are functional in Block PHC building 1,932.00 Uninterrupted power supply for /- month Ii POL for generator at District H.Q.Cold chain 216.00 Uninterrupted power supply for cold chain maintenance in 72 districts H.Q. Iii Provision of Food for JSY beneficiaries 1,500.00 Availability of fresh food for 15 Lacs beneficiaries iv Refrigerators (CHCs & BPHCs) 73.80 Provision of proper emergency drug storage in 820 Blocks facilities. Total Mission Flexi pool

Part - C IMMUNISATION

BUDGET OVERVIEW (Rs. Lacs)
Budget head Budget Expenditure % Change Over 1 RI strengthening project (Review meeting, Mobility support, Outreach services etc) +9.36% 2 Salary of Contractual Staff 269.90 101.60 295.24 +9.38% 3 Training under Immunisation 543.77 124.47 267.37 -50.8% 4 Cold chain maintenance 220.15 114.84 393.40 +78.6% Sub Total +6.5% In , Rs Lacs in Part C and Rs Lacs in Mission Flexi pool. In , Rs Lacs in Part C and Rs Lacs in Mission Flexi pool and Rs Lacs in RCH Flexi pool. In , Expenditure of Rs Lacs in Part-C and Rs Lacs in Mission Flexipool. 5 Pulse Polio operating costs -16% 76

IMMUNISATION Indicators Target 2010-11 Progress 2011-12
No. of immunisation sessions (88 %) Training of MOs 3223 1362 Training of HW 7680 2490 3547 Training of cold chain handlers 900 111 1000 Review meetings 4 3

Strengthening Routine immunization
1. Alternate Vaccine Delivery : Alternate vaccine delivery is as per GOI norm Rs.50/- per session in rural and urban slum areas. Rs. 1000/- for 4 sessions to cover vacant sub-centre and hard to reach areas. 2. Status of alternate vaccinators in urban slums: In Urban slum areas of 11 big cities ,along with regular vaccinator , provision of hired vaccinator has been made session were planned in out of that sessions were held with hired vaccinators. 3. Status of cold chain maintenance: Human resource: Contractual manpower hired at State, Divisional and District level Equipments: 4 WIF and 18 WIC are functional. New WIC/WIF are being installed . 20 Solar refrigerators have been supplied from GOI and are in process of installation . Old/CFC equipments (ILRs/DFs) need to be replaced .

Strengthening Routine immunization…
4. Systems for supervision and monitoring : AD UIP is Nodal Officer for implementing and monitoring of immunization activities. District Immunization Officer is nodal officer at District level Monitoring of RI sessions are taking place by Govt. Officers and partners NPSP/WHO and UNICEF RI revised Monitoring formats are being used and are compiling at District NPSP office and after analysis compilation at State level for feedback. No. of supervisory visit by State: 108 by the State Officers and State Quality Monitor on a regular basis (average 8-10/ per month/SQM) No of report submitted : Sessions were monitored in year as per their monitoring formats.

National Disease Control Programmes
Part - D National Disease Control Programmes

Revised National Tuberculosis Control Programme (RNTCP)
Major Interventions & plan for : Diagnosis and treatment for MDR cases: two Dots plus sites developed at Agra & Lucknow. Agra has started implementation & Lucknow is almost ready to deliver services. Plan for expansion of DOTS plus services in phased manner in 7 more DOTS Plus sites in Intensified TB HIV package under TB HIV coordination program: Initiated in 5 high prevalence districts- Deoria, Mau, Allahabad, Banda and Etawah; to be extended to entire state by “Universal access to TB care”- intensified case finding by contact tracing of Sm positive patients and for vulnerable groups Strengthening of Basic DOTS by intensive supervision & monitoring Strengthening collaboration between partners from Global funds through– UNION (International Union Against TB & Lung Diseases- IUTALD) by MAMTA, Mahila Samajik Sansthan, CHAI. etc

Districts with poor to moderate performance
State - Uttar Pradesh RNTCP Performance Indicators- NSP CDR /TSR Name of the district NSP CDR /Treatment Success Rate Reasons for poor performance Proposed solutions /Activities in PIP Constraints Cure rate 1 a) Further improvement in referral of TB suspects from PHIs to DMCs by strengthening of health system, Encourage referral of TB suspects through ASHA 1 b) Awareness about free diagnostic & treatment services by effective *ACSM activities. Thrust on involving more NGO & PPs in revised schemes under the programme 1 c)Further improving quality of microscopy services by monitoring under EQA by both IRLs ( Lucknow & Agra ) 1 d) Further strengthening & monitoring of other sectors: , ESI, Railway, Corporate, CGHS Low awareness level for free TB diagnostic & treatment services in communityLow referral by PHIs (including Distt. Hospitals) Deoria 38% 81% Low CDR & cure rate Mau 42% 89% Low CDR (< 50%) Azamgarh 43% 82% Mainpuri 46% 88% Banda 47% 87% Kushinagar 48% 90% Siddharthnagar Ghazipur 50% 79% Maharajganj *Advocacy, Communication and Social Mobilization

Districts with poor to moderate performance – contd..
Name of the district NSP CDR /Treatment Success Rate Reasons for poor performance Proposed solutions /Activities in PIP Constraints 1 e) Support to IMA-GFATM-RNTCP-PPM partnership project under IMA 1 f) Support to Global Round partners “G R- 9” Akshya Project, financially supported by Global funds 1 g) Implementation of TB-HIV collaborative activities in all districts & monitoring referral of chest symptomatic from ICTC & vice versa. 1 h) Strengthening inter district/inter state referral feedback mechanism 1 g) Opening new TU s/DMCs to meet population norms 2 a) Further strengthening of DOT network by involvement of ASHA, AWW and general health staff. 2 b) Retrieval of defaulting patients by general health staff & ASHA ; Monitoring by MO- PHIs. 2 c)Thrust on involvement of NGOs in DOTS adherence schemes under the programme. 2 d) Emphasis on patient provider & community meetings Low awareness level for free TB diagnostic & treatment services in community, Low referral by PHIs (including Distt. Hospitals) Cure rate Sitapur 52% 83% Moderate CDR (50-59%) & low cure rates < 85% Chandauli 53% Ballia 55% Sant Kabir Nagar 56% Kanpur Nagar 80% Firozabad 58% 84% Kheri 59% 82% Allahabad Fatehpur 70%

Status of IRL and DOTS Plus
Districts Implementing DOTS Plus/Proposed Status of IRL and services offered DOTS Plus Site No of Patients proposed to Put on DOTS Plus ( ) Human Resource status for DOTS Plus Districts already implementing Districts proposed Solid Culture Liquid culture *LPA 1 implementing, 1 near completion, 7 planned in 300 Contractual staff for DOTS Plus was appointed on 1st March 2011 till 31st March 2011 for Two DP sites, Renewal of contract pending awaiting approval of PIP 1 23 in phased manner Yes, by IRL Lucknow Planned in FY 11-12 *Line, Probe, Assay

Budget heads and Amount proposed
Sl. Budget heads Amount proposed (in lacs) Amount approved (in lacs) Remarks 1 Civil works 182.94 As communicated by Central TB Division by E mail dated 6th March 2011 2 Laboratory materials 341.87 331.30 3 Honorarium 585.67 292.84 4 IEC/ Publicity 257.16 102.87 5 Equipment maintenance 93.90 54.35 6 Training 291.22 116.49 7 Vehicle maintenance 107.20 99.70 8 Vehicle hiring 398.00 220.09 9 NGO/PP support 741.87 259.65 10 Miscellaneous 324.29 224.29 11 Contractual services 12 Printing 335.44 117.40 13 Research and studies 0.00 14 Medical Colleges 114.47 112.91 15 Procurement –vehicles 68.50 16 Procurement – equipment 22.00 21.60 17 Tribal Action Plan Total(A) Additionality funds from NRHM (B) 116.60 101.60 Total (A+B)

Additionality Funds from NRHM
Details of the activities for which Additionality Funds are proposed to be sought. Sl. Budget heads Amount proposed Amount approved Remarks (As communicated by CTD, GoI) 1 Additional Instruments for Intermediate Reference Lab (IRL) Lucknow for LPA of MDR suspects under DOTS Plus-for additional 100 KVA generator for LPA May be approved 2 Rooms for Hostel facility at Thakurganj TB hospital, Lucknow, being developed as State training centre for TB 3 Repair of Drain, furnishing of hostel rooms, minor repair in IRL at STDC Agra 660000 4 CUG mobile connection for Programme officers & supervisory staff Detailed proposal required. 5. Intensified monitoring activities and MIS to be developed for 13 identified low performing district in the state Details to be shared with CTD may be approved 6 Silico- tuberculosis project Detail project to be shared with CTD, may be approved Total

National Vector Borne Disease Control Programme (NVBDC)
MALARIA Key achievements Key Interventions & Strategy- By Active & Passive surveillance Malaria positive including Pf cases were diagnosed and treated. Involved ASHAs of 10 districts in surveillance work after providing training skill. IRS with DDT50% conducted in high risk areas of 39 districts covering lakhs population. Special provision of antilarval activities in 40 flood affected districts and 42 urban areas covered under U.M.U.& F.C.U. Special surveys involving ASHAs, science teachers, science students & private doctors with incentives. Reorientation of LTs for parasite identification. IRS in high risk areas of 41 districts. Involvement of village health & sanitation committees. To abide civic bye-laws for not creating mosquito-genic conditions and prevention for mosquito-bite.

Key Interventions & Strategy-
Lymphatic Filariasis Key achievements Key Interventions & Strategy- MDA observed on 27th Dec.2010 with mop-up rounds on 28th and 29th Dec.2010 in 50 Filaria endemic districts covering lakhs population. Updated Lymphoedema and Hydrocel cases. 3559 Hydrocelectomy operations under taken. MDA observing with high coverage in 50 endemic districts. Hydrocelectomy operation of at least 50% of existing line listed Hydrocel cases. 34 clinics to be activated for diagnosis of Mf as per norms & night blood surveys to be done as per norms.

Dengue/ Chikungunya Key achievements – Key Interventions & Strategy- 22 Sentinel & 1 Apex lab strengthened. 702 cases of Dengue were confirmed by Eliza IgM technique. Source reduction & vector surveillance in 54 districts together with fogging, space spray anti larval operations was done. Identified 8-10 beds as isolation ward in all districts hospitals Activation of sentinel surveillance units where blood banks exists and have Eliza readers in addition to existing sentinel labs. Source reduction, Antilarval measures/ IEC/ BCC to be done as per norms. Space spray/ fogging in case of exigency.

Kala-azar Key achievements- Key Interventions & Strategy- Fortnight observed in Feb./March, in Deoria, Ballia, Kushi Nagar and Varanasi. Surveillance activities could trace only 14 cases which were 100% treated. 1.70 lakhs population covered under IRS with DDT 50% Special surveys to be carried out in addition to fortnight, preferring village hot days (market days) and ensuring complete treatment. 10 affected villages of 4 endemic districts together with adjoining 60 villages to be surveyed and all Kala-azar to be treated completely to rule out their presence in future. IRS to be conducted to protect 8.66 lakh population.

JAPANESE ENCEPHALITIS /AES
Key achievements – Key Interventions & Strategy- In the year 2005, the disease was prevalent in 34 district of UP, whereas in the beginning of 2010, 20 districts were affected and at the end of 2010 only 13 districts are found to be affected. Year No. of District Affected A.E.S. JE Confirmation Cases Deaths Confirmed cases Death % of JE +vity 2005 34 5581 1593 1042 18.67 2006 22 2075 476 170 8.19 2007 24 2675 577 235 29 8.78 2008 23 2730 486 168 36 6.15 2009 26 3073 556 328 50 10.67 2010 20 3548 498 344 59 9.69

AES/JE Status in UP at a Glance
In year 2006, 22 districts (Cases- 2075, Deaths-476, CFR- 23) Districts of U.P. Highly affected by J.E. Dec. 2010 Azamgarh Gazipur Lucknow Saharanpur Behraich Gonda Maharajganj Siddarth Nagar Balia Gorakhpur Mau Sitapur Balrampur Kausambi Muzaffar Nagar Sarawasti Basti Khiri Raibareli Deoria Kushi Nagar Sant Kabir Nagar Gorakhpur (56) Sant Kabir Nagar (51) Maharajganj (52) Siddarth Nagar (45) Kushinagar (58) Balrampur (70) Deoria (57) Behraich (25) Basti (44)

Key achievements- Special campaign of JE vaccination conducted at 7 Districts of Gorakhpur and Basti division with good results, as shown bellow :- AES detected Cases 2009 2010 No. Detected (AES) 3073 3548 No. Investigated (AES) 2802 2965 JE Outbreaks 328 344 Other Outbreaks (Non JE) 2745 3204 Year Districts Target Children (1-15 Yrs) Vaccinated Children (1-15Yrs) Vacci nated % 2006 7 99.97 2007 11 96.7 2008 9 100.95 2009 84.7 2010 97.5 Out of the total cases of AES detected only aprox. 10% is of JE Note: J.E. Vaccination programme was extended for another 26 days in Jan and 99% vaccination was achieved.

Key Interventions & Strategy-2011-12
Targets for – Key Interventions & Strategy Upgrading of PHCs and CHCs for admitting mild and moderately sick patients Strengthening of district hospitals – with ventilators and fully trained medical staff. Strengthening and upgradation of JE Epidemic ward of BRD Medical college Gorakhpur. Strengthening of diagnostic facilities at District lab of sensitive Districts. Vector surveillance of the sensitive districts to be improved by training of malaria and filaria workers. Sampling and examination of water sources in AES/JE sensitive areas. Training of HEO/ANMs/AWW/WARD boys and ASHAs – for dissemination of information to the community for AES/JE prevention and control Training of traditional healers - guiding sick patients for early treatment at PHC / CHS. /Distt. Hospital. To improve the Vector and Disease Surveillance of Epidemic Prone Diseases. Strengthening of Regional Lab Swasthya Bhawan, Lucknow and other 15 identified sentinel Labs. JE vaccination already included in the routine immunization of the age group 1 – 2 years, to be continued in the sensitive Districts. Private sector Hospitals and Nursing Homes are to be involved in disease surveillance. Appointment of vacant posts of Data Entry Operators.

Budget Heads & Amount Proposed
Sl. Activity Amount (in Lacs) 1 MALARIA 178.00 2 FILARIA 911.94 3 DENGUE 87.30 4 KALA AZAR 37.00 5 JE/AES 757.75 TOTAL 1,971.99

National Blindness Control Programme (NBCP)
Key Achievements ( ) Total Cataract Operations during NRHM period are 40,40,338 against target of 42 lacs. School Eye Screening Programme NRHM Period are lacs against target of lacs. Out of Which 4.32 lacs Free Spectacles were distributed against the target of 5.48 lacs In Cornea Collection NRHM Period are 1988 against target of 8100 cornea. Management of other Eye diseases( New Activity from ) - achievements against target of 23570 230 Vision Centers have been developed so far.

Proposed Interventions(2011-2012)
Phaco Surgeries will be added. Training of Eye Surgeons and Staff Nurses and Ophthalmic Assistants. Strengthening of IOL Centres at CHCs New Eye Banks will be stabilized. Encouragement to New NGO Hospitals. Sl. Intervention Targets 1 Cataract Operation 7,70,000 2 School eye Screening 33,00,000 3 Free Spectacles for Poor Children 70000 4 Corneal Collection 500 5 Vision Centre 50 6 Other Eye Desases 15000

Budgetary Provisions (2011-12)
Rs. In Lacs Activities Physical Targets Budget Proposed 1 Cataract Operation 770000 2 Other Eye Diseases 15000 150.00 3 Purchase of Equipments 10 Pheco, 10 Microscope, 50 Appl. Tonometer, 50 Flash Autoclave 365.00 4 School Eye Screening 70000 140.00 5 Corneal Transplantation 500 7.50 6 Vision Centre 50 25.00 7 Repair and Maintenance of Ophthalmic Equipments 1 lacs for 88 district Hospitals 88.00 8 Training of Surgeons/PMOA and Staff Nurse 50 eye Surgeons and other 78.00 9 IEC(World Sight Day) 72 dist and 10 lacs for State level 82.00 10 Office Expenses and Contract Staff Salary State level 14.00 11 Office Expenses at District level and Honorarium District level 2 lacs each district. 144.00 12 Recurring GIA to EDC 100 EDC 1000 each 1.00 13 Non Recurring Grant to 2 eye bank 15 lacs each eye bank 30.00 14 Non Recurring Grant NGO Hospital 2 30 lacs each NGO Hospital 60.00 15 Non Recurring Grant 5 EDC 1.00 lacs each for 5 EDC 5.00 Total PIP for

National Iodine Deficiency Disorder Control Programme (NIDDCP)
Key achievements- Key Interventions & Strategy Goiter rate came down below 10% in children aged years. Availability & consumption of Iodized salt by the community is on increase. U.S.I. Cell has been constructed by UNICEF in 4 Medical Colleges namely Gorakhpur, Meerut, Agra & Allahabad Regular mass awareness activities through radio and doordarshan. Establishment of IDD Control Cell Establishment of IDD Monitoring Lab Conduction of surveys in 5 districts by medical colleges. Community level IEC activities Testing of iodine in salt at the consumer level through FTK. Skill development of PRI and Grassroot level workers

Sl. Activity Amount (in Lacs) 1 IDD Cell 6.50 2 Establishment & Maintenance of IDD Lab 4.00 3 Survey 2.50 4 Health Education & Publicity 13.00 Total 26.00

integrated disease surveillance project (IDSP)
Achievements ( ) – Epidemiologists are posted in 46 districts and are trained. Microbiologist posted at regional lab, at Lucknow . IDSP played an important role in monitoring, testing and evaluating in case of an outbreak. IDSP collects information from all the districts on S, P and L formats which is then complied and sent weekly to NCDC, New Delhi. Data Manager posted State Surveillance Unit has undergone TOT Training, at NCDC New Delhi for online portal Entry. Online data reporting is being done from all districts. Swine flu vaccination completed in all the districts in two phases. IDSP has played a remarkable role in prevention and treatment of Swine Flu.

Targets For Covering communicable and other vaccine preventable diseases like Measles, Pertussis, Diphtheria, Influenza A, H1N1 and Malaria under IDSP Surveillance. One model lab per district for diagnosis of epidemic prone to be established. Involvement of all Medical Colleges of the state for data collection and disease surveillance. Involvement of private sector hospitals and nursing homes. Strengthening of State Priority Labs of IDSP (Regional Lab -Lucknow and district Lab Ghazi bad). The call centre 1075 will be activated in all the districts for the outbreak information. Ensuring collaboration between epidemiologists, microbiologists / state lab coordinators at all levels.

Proposed Interventions
District outbreak investigation team in each district - Epidemiologist as the nodal officer Rapid response team in each district under the district surveillance officer / ACMO. Strengthening of data quality analysis and linkages to action – online entry and analysis, reporting, services, health alerts to public health staff and lab information. Training of District Surveillance Officers.

Sl. Activity Amount (in Lacs) 1 Operational Cost 163.42 2 Human Resources 585.96 3 Training 3.14 4 Procurements - 5 ASHA Incentives 8.64 6 Referral Services 7 Innovations/PPP 8 IEC-BCC Activities 38.60 9 Financial aid to medical institution Grand Total 799.76

National Leprosy Eradication Programme (NLEP)
Key achievements-NLEP Year 2007 2011(Jan) Annual New Case Detection Rate 17 12.7 Districts that have achieved elimination 36 51 Blocks that have achieved elimination 427 555

Key Interventions & Strategy-2011-12
Prevention of Deformity (POD) initiatives for early detection and management of nerve damage & self care training Medical Rehabilitation by screening of disabled cases for Reconstructive surgery Implementation of awareness programmes at Block level & ASHA sensitization workshops Intensive Awareness Campaign in 453 high endemic blocks Active Search in 50 highest endemic blocks ASHA and Health Staff sensitization and active search in high endemic villages Screening of disabled leprosy affected persons fit for Reconstructive surgery Self Care training and supportive medicines for affected persons of 72 Leprosy Colonies Urban Leprosy Control (PPP) activities in 52 urban areas

Sl Activity Amount (in Lacs) 1 Mobility Support 105.7 2 Office expenses 54.73 3 Urban Leprosy Control 18.84 4 Human Resource 56.04 5 Training 45.08 6 Procurement of Drugs 32.0 7 ASHA Incentive 16.12 8 Disability Prevention & Rehab 60.0 9 NGO Support 51.0 10 IEC BCC 258.12 11 Monitoring Supervision 10.44 12 Additionalities 19.52 Total 727.59

National Mental Health Programme (NMHP)
Key Interventions & Strategy Status & Key achievements- Currently being implemented in 4 districts Construction of Centre of excellence in Psychiatry Deptt. Of CSSMU, Lucknow is being done. Financial Support to all medical colleges for upgradation of building and equipments. Initiation of Diploma courses in clinical psychology, psychiatric social work and psychiatric nursing through state medical faculty involving public and private sector hospitals. Training of physicians working in district hospitals in psychiatry to ensure detection and treatment in early state. Initiatives for execute Life skill education and counselling in schools, counselling services in colleges, work place stress management and district counselling centres in 4 districts. Convergence with NGOs (MSJE supported) and department of health. Development of Independent psychiatry department as per MCI norms.

Sl Budget Heads Amount (in Lacs) 1 Operational Cost 3.64 2 Human Resource 37.46 3 Training 21.92 4 Procurement 27.90 5 ASHA Incentive - 6 Referral Services 7 Innovation PPP 8 IEC 8.00 Grand Total 98.92

National Programme for Prevention and Control of Deafness (NPPCD)
Key achievements till Key Interventions & Strategy Construction of sound proof rooms in 3 districts of 3rd phase. Capacity building and Training of doctors and para-medicals upto CHCs and school teachers. Recruitment of human resources (Audio logical assistant, speech trainers, etc.) Procurement of equipments & hearing aids. Strengthening of state & district nodal offices. IEC/BCC activities in all the 8 districts Identification and capacity building of district hospitals and facilities to provide preventive/screening/curative services on daily basis. Strengthening of district hospitals with equipments, infrastructure and manpower Sound proof rooms constructed in 4 districts and construction is in progress in one more district. Training of personnel up to PHC/CHCs level is completed in 2 districts (Ist phase). 18 medical doctors trained in 3 districts (2nd phase). 5 districts selected in 1st & 2nd phase are delivering patient care services. 1st phase - Gorkhapur & Barabanki; 2nd phase- Banda, Varanasi, Lucknow; 3rd phase- Agra, Moradaba, Saharanpur

Sl Budget Heads Amount (in Lacs) A Establishment of State Nodal Officers Officer 17.69 B District Hospital Capacity Building 59.44 C Three New District Hospital Staff 5.40 D Establishment of District Nodal Officer at three new districts 7.50 E Training of three new districts 48.73 F Capacity Building of continuous phase of old 5 districts 89.10 G Continuous phase of 5 districts hospital staff expenses 9.00 H Continuous phase of 5 districts nodal officer expenses 12.50 Grand Total 249.36

National Tobacco Control Programme (NTCP)
Key Interventions & Strategy Setting up of TCC’s in Districts. Training of School teachers, health workers, health professionals, law enforcers, NGO’s, women SHG’s. IEC activities at the regional languages at grass root level. Awareness programs by the trained Women SHG/ NGO’s. School Programme for Govt. Schools (50 per district) with the help of NGOs. Regular meetings with religious leaders to drum up support for Tobacco Control Program. Monitoring enforcement of tobacco control laws

Sl. Activity Amount (in Lacs) 1 Operational cost 36.50 2 Manpower for 12 months 209.28 3 Training 72.50 4 Procurement 43.20 5 ASHA Incentive 6 Referral Services 7 Innovations/PPP/NGO 8 IEC/BCC 217.50 9 Financial aid to institutions 10 Monitoring for Tobacco Control Laws & reporting (lumpsum) 36.00 Grand Total 614.98

Budget Summary – National Disease Control Programmes
(Rs. in Crores) Sl. Scheme/ Programme Approved amount ( ) Amount Proposed ( ) 1. NVBDCP 10.22 19.72 2. RNTCP 45.96 67.81 3. NPCB 35.00 40.57 4. NIDDCP 0.24 0.26 5. IDSP 5.1 8.00 6. NLEP 5.72 7.28 7. NTCP - 6.15 8. MHP 0.99 9. NPPCD 2.50 Total 102.24 153.28

Infrastructure Maintenance**
BUDGET SUMMARY – PIP (Rs. In Crores) Sl. Scheme/ Programme Approved Amount ( ) Amount Proposed ( ) 1 RCH Flexi-Pool 761.49 972.09 2 NRHM Flexi-Pool 1,495.66 3 Immunization 50.03 60.77 4 NVBDCP 10.22 19.72 5 RNTCP 45.96 67.81 6 NPCB 35.00 40.57 7 NIDDCP 0.24 0.26 8 IDSP 5.10 8.00 9 NLEP 5.72 7.28 10 NTCP - 6.15 11 MHP 0.99 12 NPPCD 2.49 13 PPI Operation Cost 178.58 100.00 14 Infrastructure Maintenance** 465.60 529.07 Total 3,309.87 ** The amount of Rs Crores has been included as per GOI allocation sheet for the year If the state requires additional amount, separate requisition letter will be submitted accordingly.

Thanking You...

Presentation to National Program Coordination Committee

Similar presentations

Presentation on theme: "Presentation to National Program Coordination Committee"— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

Presentation to National Program Coordination Committee

Similar presentations

Presentation on theme: "Presentation to National Program Coordination Committee"— Presentation transcript:

Similar presentations

About project

Feedback