1. ohftT{ whfNzr w[Zy wzsoh ih d/ Bkb f;js ns/ gfotko GbkJh ftGkr gzikp 4-9-2009 f;js ns/ gfotko GbkJh ftGkr gzikp 4-9-2009

2. HEALTH DEPARTMENT Wings – Director Health Services Director Health Services PHSC – Secondary level hospitals PHSC – Secondary level hospitals Drug Controller Drug Controller Food Safety – PFA Food Safety – PFA Employee State Insurance Employee State Insurance Ayurveda & Homeopathy Ayurveda & Homeopathy NRHM NRHM PSACS PSACS

3. Health Institutions - f;js ;z;EktK ;z;EktKfrDsh ;p ;?ANo (jo fJZe 5000 dh nkpkdh fgZS/) 2950 w[ZYbk f;js e/Ado (jo fJZe 30000 dh nkpkdh fgS/)  pbke b?tb T[s/  ns/ j'o 39441353 efwT{fBNh f;js e/Ado (jo fJZe 120000 dh nkpkdh fgS/)  ghHn?uHn?;H;ha (PHSC) tZb'A ubkJhnK ik ojhnK  vhHn?uHn?;H tZb'A ubkJhnK ik ojhnK 12911415 fdjksh j;gskb 45 ;p vthiBb j;gskb 36 fibQk j;gskb 21 ôfjoh fv;g?A;ohnK$;e{b j?bE $NhHphH ebhfBe j'o ;z;EktK JhHn?;HnkJhH j;gskb JhHn?;HnkJhH fv;g?A;oh 134670

4. BUDGET FY (2009-10) PLAN NON PLAN GOI/CSSOTHERSTotalDHS38.29576.986.70- 621.97 DFW-22.7817.38- 40.16 PHSC43.0015.407.5020.00 85.90 AYURVEDA0.2035.826.98- 43.00 HOMOEPATHY0.139.211.02- 10.36 ESI-47.50-- 47.50 AIDS--18.15- 18.15 NRHM32.71-218.052.14 252.90 TOTAL 114.33707.69275.7822.141119.94 HSE (Excluding Medical Education) is 0.79% of the GDP against desired 2 – 3%. Per Capita Public Expenditure of Health – Rs. 448/- per year. Amount in Crores

5. SUMMARY STAFF Sr. NoCategorySanctionFilledVacantRemarks 1Medical 38643272592 2Drug and Food45423 3Nursing 31042502602 4Laboratory 1065840225 5Paramedical981093311324 Diminishing Cadre for Pharmacists 6IEC207104103

6. SUMMARY STAFF Sr. NoCategorySanctionFilledVacantRemarks 7Malaria Section254149105 8Technician20212280 9Statistical387272115 10Ministerial /Class IV 94518547904 Diminishing Cadre for Class IV 11 Paramedical (TB and Leprosy)281612 Total28427251974065

7. STAFF (Medical) Sr. NoCategorySanctionFilledVacant Medical 1Director321 2 Additional Director202 3Joint Director110 4 Deputy Director342410 5 Deputy Director (Dental)18144 6 Senior Medical Officer37932158 7 Medical Officer 31422752390 8 Medical Officer (Dental)285158127

8. STAFF (Drug and Food) Sr. NoCategorySanctionFilledVacant 1 Assistant Drug Controller330 2 Drug Inspector19163 3 Food Inspector23 -

9. STAFF (Nursing) Sr. NoCategorySanctionFilledVacant 1 Superintendent Punjab Health School Amritsar at Mohali1-1 2Nursing Superintendent5-5 3Principal Tutor1082 4Matron442816 5District Public Health Nurse12- 6Public Health Nurse (Teaching)42348 7Sister Tutor503713 8Nursing Sister41037040 9Staff Nurse25062010496 10Lady House Keeper24159

10. STAFF (Laboratory- Food & Chemical) Sr. NoCategorySanctionFilledVacant 1Bio Chemist11- 2Junior Analytical Assistant5-5 3Senior Analytical Assistant3-3 4Analyst31292 5Public Analyst1-1 6Deputy District Public Analyst321 7Deputy Chemical Examiner2-2 8Assistant Chemical Examiner321 9Government Analyst1-1 10Bio Chemist110 11 Senior Medical Laboratory Technician574314 12 Senior Medical Laboratory Technician Grade-151247735 13 Medical Laboratory Technician Grade-2445285160

11. STAFF (Paramedical) Sr. NoCategorySanctionFilledVacant 1 Multipurpose Health Worker (Female)3631355972 2 Multipurpose Health Worker (Male)29582153805 3 Multipurpose Health Supervisor (Female)750537213 4Trained Dai376233143 5Ophthalmic Officer1991945 6Senior Radiographer40337 7Radiographer22014377 8 Radiographer (Contract Basis)1151132 9Pharmacist153123900

12. STAFF (IEC) Sr. NoCategorySanctionFilledVacant 1 State Mass Media and Information Officer1-1 2 District Mass Media and Information Officer18162 3Deputy MEIO422913 4Assistant Editor1-1 5B.E.E1425686 6Photographer110 7 Technical Officer/ Audio Visual110 8Publicity Supervisor110

13. STAFF (Malaria Section) Sr. NoCategorySanctionFilledVacant 1 Assistant Malaria Officer14- 2Assistant Unit Officer391029 3 Entomologist-cum- Parasitamologist1-1 4 Entomologist Assistant514 5Insect Setter11- 6Insect Collector291811 7Draftsman11- 8 Superior Field Worker15111833 9Biologist13-

14. STAFF (Technician) Sr. NoCategorySanctionFilledVacant 1 Refrigerator Mechanic16151 2 Assistant Dental Mechanic835 3Dental Mechanic18216 4Dental Hygienist20155 5Dental Electrician101 6 Dark Room Assistant21183 7E.C.G. Technician1394 8 Operation Theatre Assistant41347 9Pump Mechanic1284 10Field Assistant11-

15. Sr. NoCategorySanctionFilledVacant 11 Sanitary Supervisor (Health Core)1156 12 Microscope Mechanic11- 13Artist1376 14Projectionist17116 15Developer101 16Machine Operator101 17 Tradonal Machine Operator101 18Senior Compositor101 19Compositor101 20Copy Holder110 21Proof Assistant110 22 Manager off-set Press101 23Cold Chain Officer110 STAFF Cont.. (Technician)

16. STAFF (Statistical) Sr. NoCategorySanctionFilledVacant 1 Joint Director(Evaluation)101 2 Deputy Director(Statistics)101 3 Senior Research Officer211 4Statistical Officer1129 5 Superintendent (Statistics)22193 6Statistical Assistant612536 7 Junior Statistical Assistant25 0 8Computor26420064

17. STAFF (Ministerial) Sr. NoCategorySanctionFilledVacant 1Administrative Officer101 2 Registrar (Budget) DRME101 3Superintendent Grade-118153 4Superintendent Grade-214 - 5Senior Assistant135 - 6Junior Assistant/Clerk1299633 7Personal Assistant422 8 Junior Scale Stenographer44- 9 Senior Scale Stenographer66- 10 Steno-Typist (Head Quarter)990

18. Sr. NoCategorySanctionFilledVacant 11Steno-Typist (Field)23116665 12Superintendent Grade-268599 13Senior Assistant2982926 14Clerk11101033110 15Librarian11- 16Home Science Assistant1-1 17Senior Scale Stenographer16133 18Junior Scale Stenographer22- 19Packer / Sweeper541 20Class IV ( Head Quarter)86842 21Sweeper (Head Quarter)55- 22Chowkidar88- 23Class IV (Field) (Total Posts) 729965991193 STAFF Cont.. (Ministerial)

19. Requirement of New Health Institutions – Sub Centers  2950 Sub- centers are functioning.  Shortage of 289 Sub Centers as per census 2001 and 687 Sub Centers as per estimates of 2011 population, as per norm of 1 sub centre for every 5000 population. Cost of new Sub Center is Rs. 7 lac. YearExistingRequired as per Norms Additions Required Fund Required (Rs. in Crore) 20012950323928920.00 20112950363768748.00

20. Requirement of New Health Institutions – PHCs  394 PHCs are functioning.  Shortage of 146 as per census 2001 and 212 PHC’c as per 2011 estimated population. Rs. 1 crore per PHC. YearExistingRequired as per Norms Additions Required Fund Required (Rs. in Crore) 2001394540146146.00 2011394606212212.00

21. Requirement of New Health Institutions – CHCs  142 Administrative Blocks in the State.  One CHC is to be provided in each block. Number of Administrative Block142 Number of CHC Required as per norms(1 per block +2 for Block with population more than 1.50 lac) 165 Number of CHCs already functioning under PHSC114 No of blocks were no CHC Exists (108 out of 142 ok)34 Number of CHCs more required (6 double) (165-114+6)57 Number of CHCs under DHS which needs to be strengthen15 Number of CHCs to be constructed at new places42 Funds Required for 57 CHCs including CHCs under DHS (Rs. in Crores) (In the first phase 34 CHCs would suffice) 171

22. Staff and Building for New Districts  Posts - 8 New districts i.e. Mansa, Moga, Muktsar, SBS Nagar, SAS Nagar, Barnala, F.G.Sahib and Tarn Taran were created after 1992 but all the required posts for the office of Civil Surgeons have not been sanctioned. In all 274 new posts of other than Class-IV are required.  Office - There is no office accommodation for the office of Civil Surgeons in these 8 districts. The office of Civil Surgeon at Amritsar, Ludhiana, Patiala, Gurdaspur and Hoshiarpur required to be constructed at proper place. The total requirement of funds would be about Rs. 26 crore.  Residence - Civil Surgeons of districts Amritsar, Barnala, F.G.Sahib, Hoshiarpur, Kapurthala, Mansa, Moga & SBS Nagar do not have residential accommodation earmarked. They are staying in the premises of Senior Medical Officers or in Private Accommodation.

23. Shortage of Staff Contd.. Sr. No. Name of PostScale Requirement of Posts Remarks 1District Immunization Officer10025-151005 2District Dental Health Officer10025-151003 3Epidemiologist7880-135005 4Deputy Medical Commissioner10025-151005 5 Distt. Mass Media & Information Officer 6400-106406 6 Deputy Mass Media & Information Officer 5800-92006 7Artist Cum Photographer5800-92008 8District Public Health Nurse6400-106408 9Food Inspector4550-72206 10Assistant Malaria Officer5800-92006 11Multipurpose Health Worker(M)4550-720048 12Superintendent Grade-II6400-1064012 13Superintendent Statistics6400-106408 14Senior Assistant5800-920022 15Statistical Assistant5800-920011 Details of posts required at Newly created districts

24. Details of posts required at Newly created districts Contd.. Shortage of Staff Contd.. Sr. No. Name of PostScale Requirement of Posts Remarks 16Steno Typist3330-620016 17Clerk3120-516060 18Computer/ Statistical Clerk3120-51606 19 Multi Purpose Supervisor (M)/ Health Supervisor 4550-72205 20Driver3330-620064 21Senior Lab. Technician5000-81008 For District Malaria Laboratory 22Medical Laboratory Technician Grade II3330-62008 23Lab. Attendant3120-51608 24District TB Officer7880-135008For TB Clinics 25Medical Laboratory Technician Grade I4020-62008 26Medical Officers7880-135008 For School Health Clinics 27Medical Officer (Dental)7880-135008 28Public Health Nurse5000-81008 29 Class IV (Helper/ Watchman/ Sweeper) 2520-4140128 16Steno Typist3330-620016

25. Food and Drug Control Drug Inspectors  19 posts of Drug Inspectors are sanctioned in the state. 1 Inspector for 1 district.  Present strength is grossly inadequate for about 22000 shops.  38 posts of Drug Inspectors are more required so as to have one Drug Inspector for every 600 chemist shop.

26. Food and Drug Control Food Inspectors  23 Food Inspectors – sanctioned. Only 1 inspector for a district.  There should be at least 1 Food Inspector in every Sub-Division.  53 more Posts of Food Inspectors are required.

27. Requirement of funds for existing Health Institutions Sub-Centres – Out of 2950 Sub-Centres 1030 are functioning from Dharmshalas etc. New buildings would require Rs. 60 crore. PHCs - 80 PHCs out of 394 PHCs are similarly situated. A sum of Rs. 80 crore is required for these new buildings.

28. Requirement of Medicines SNInstitutionRequirement (Cr.) ProvisionGap Rs.Source 1SHC (1187)10.6811.79Non-Plan (RDP)Nil 2SC (2950)1.00 GoI in KindNil 3PHC (394)8.0011.00NRHM (1.00), Non-Plan (10.00) Nil 4CHC/SDH/DH19.0014.00NRHM (6.00), Non-Plan (2.50), User Charges (5.50) 5.00 TOTAL38.6837.795.00

29. Requirement of Equipments SNInstitutionRequirement (Cr.) ProvisionGap Rs(Cr.)Source 1SHC (1187)11.87NilNon-Plan (RDP)11.87 2SC (2950)2.90 NRHM Untied fundsNil 3PHC (394)10.005.58NRHM (3.25), Non-Plan (2.33) 4.41 4CHC/SDH/DH80.0014.24NRHM (13.24), Plan (1.00) 65.76 TOTAL104.7722.7282.04

30. Requirement for Infrastructure [As per 2011 Estimates] SNInstitutionRequirement (Cr.) ProvisionGap Rs(Cr.)Source 1SC (2950)48.0010.00 per year NRHM18.00 2PHC (394)212.005.00 per year NRHM200.00 3CHC/SDH/DH153.005.00 per year NRHM + 25.00 Cr. State Plan 113.00 TOTAL413.0060.0025.00328.00

31. Shortage of Vehicles/ Ambulances  Ambulances were procured more than 10 years back and majority of them are not road worthy.  172 vehicles (Ambassador (27), Gypsy(26), Trucks(10), Buses(39), Jeep(59) and Ambulances(11) were condemned and Rs.95.47 lacs was deposited in the State Treasury.  Due to its condemnation and auction there is huge shortage of vehicles. Type of Vehicles RequiredQtyPlace Ambulances50 for district hospitals, sub division hospitals and community health centers Ambassadors25 The offices of Civil Surgeons and Head Office Tata Sumo, Gypsy etc85district and state head quarters More Vehicles Required

32. CANCER CONTROL India – 200- 250 cases per one lakh population. Punjab - As per survey conducted by Health Department in Districts Mukatsar, Bathinda, Faridkot and Mansa the prevalence of cancer patients is 52.2 per lakh population (2005 survey). SNDistrictPopulationNo. of cancer patients No. of cancer patients per lakh population 1Muktsar8,27,90645356.6 2Bathinda12,00,73671159.3 3Faridkot5,85,50016428.0 4Mansa7,31,53542057.5

33. CANCER CONTROL Contd.. The number of deaths because of Cancer in 2007 in Bathinda, Faridkot, Mansa, Muktsar, Sangrur, Barnala, Patiala, Ludhiana and Ferozepur (Malwa districts) was 591. The number of Cancer patients in whole of Punjab in Government Institutions was 2300.

34. Detection of Cancer Imaging: oX-Ray: CHC, SDH, DH and Medical College Hospitals. oUltrasound: Sub-Divisional, District and Govt. Medical College Hospitals oCT Scan: All Govt. Medical College Hospitals. Biopsy: CH Jalandhar and Govt. Medical College Hospitals. Mammography: CH Bathinda and Mata Kaushalya Hospital, Patiala Laboratory : Fine Needle Aspiration Cytology, Peripheral Blood Smear examination available at District Hospitals and Medical College Hospitals CANCER CONTROL...Contd..

35. Cancer Control.. Contd.. Treatment : Surgery : Sub-Divisional, District and Medical College Hospitals. Chemotherapy : Medical College Hospitals. Radiotherapy : Medical College Patiala. PGIMER, Chandigarh has been approved as Regional Cancer Centre for Punjab by Govt.of India. Regional Cancer Centre provides comprehensive cancer treatment services and training to Medical & Para-medical staff for detection & prevention of cancer and supportive care to patients. It is also a referral centre for other hospitals. Palliative Care: It is provided at all levels. It includes relief of pain and symptomatic treatment of terminally ill patients. It also includes provision of psychosocial support and aims at improving quality of life of patients.

36. Cancer Control.. Contd.. Projects completed: Mammography unit at Civil Hospital Bathinda and Mata Kaushalya Hospital Patiala. Brachytherapy Machine costing Rs 70 lacs for the treatment of cancer patients has been installed at Govt. Medical College Patiala. Cobalt Source for the treatment of cancer patients has been installed at Sri Guru Ram Dass Institute of Medical Sciences and Research with assistance of Rs. 25.00 Lac from Govt. of Punjab.

37. Cancer Control.. Contd.. Ongoing Projects: Multispecialty & Cancer Hospitals are being setup at Mohali and Bathinda in Public Private Partnership mode in collaboration with M/S Max Health Care India. Regional Cancer Centre at Medical College Amritsar: Government of India has provided Rs. 2.00 Crore for machinery and equipment. Simulator and Treatment Planning system for Govt. Medical College Patiala. Government of India has provided Rs. 2.00 Crore for this purpose. Mammography unit is to be installed at Medical College Patiala. Rs. 30 lacs have been provided for this. Radiotherapy unit at Sri Guru Gobind Singh Medical College Faridkot. Rs. 3.00 Crore have been provided by Govt. of India for machinery and equipment and construction.

38. Cancer Control.. Contd.. Projects under consideration of Govt. of India : Onconet Service- A Tele Medicine Service is to be established by Govt. of India. Regional Cancer Centre PGI will be connected to four district Hospitals namely Hoshiarpur, Sangrur, Bathinda and Muktsar for this service. Setting up of a Cancer Registry in Districts Bathinda & Muktsar. District Cancer Control Programme for districts Hoshiarpur and Patiala. This programme is to be implemented by PGI Chandigarh.

39. Cancer Control.. Contd.. Other facilities to cancer patients: Financial assistance under State Illness fund to cancer patients belong in to below poverty line families up to the tune of Rs. 1.5 Lacs. School children suffering from cancer are provided free treatment by Punjab Government. Punjab Government provides free travel facility to cancer patient and one attendant. Health Education activities are under taken to make people aware about the causes signs and symptoms and prevention of cancer.

40. Preparedness to Combat Drug Abuse In The State There are 12 De-addiction Centers functional, 3 in State medical Colleges i.e. Patiala, Amritsar and Faridkot and 9 in Govt. Hospitals Tarn Taran, Pathankot, Kapurthala, Jullandhar, Bathinda, Faridkot, Muktsar, Hoshiarpur and Badal. 2 De- Addiction Centers at Civil Hospitals Talwandi Saboo and Ferozpur are in the process of being established. A state level 50 bedded Drug Dependence Treatment Center is being set up at Government Medical College, Amritsar. 22 De-addiction Centers/Counseling Centers in Punjab are being run under the control of Ministry of Social Welfare, Govt. of India. Out of this 13 centres are run by Indian Red Cross Society and 09 by Non-Govt. Organizations. 37 such centers in Punjab (33 functional and 4 under construction) is insufficient to handle the drug abuse problem in the State. In 33 functional DDTCs there are 142 beds out of which 30 beds are with State Medical Colleges and 112 are with the Department of Health and Family Welfare, Punjab in various Civil Hospitals.

41. There are 26 Psychiatrists within the department working at different health institutions of the state and are providing services in drug abuse prevention at their place of postings. All of them can be judiciously and optimally utilized to manage/advisor to DDDAC/any drug de-addiction centers in every district.) The NDDTC, AIIMS has already trained 20 psychiatrists as Master Trainers in Drug Abuse Prevention. It has also trained 10 health personnel from four districts of the state (4 psychiatrists, 3 staff nurses, 3 laboratory technicians) for Opioid Substitution Clinics which are going to be established by GOI to prevent IDU in collaboration with NACO. Health department has already commissioned a study on “Drug abuse in the border districts of Punjab” funded by National Rural Health Mission, (NRHM), Punjab at the cost of Rs. 5.0 lakh in 2009. The study will be completed by March 2010. There are many steps being taken to establish de-addiction centers like DHS (16):- Annual Plan 2009-10- Rs. 200.0 lakh, Total Plan Outlay =Rs. 330.0 lakh DHS (17) State Level Drug Dependence Treatment Center (SDDTC), Govt. Medical College, Amritsar (Swami Viveka Nand Drug Dependence Treatment Center ):-Annual Plan2009-10 Rs. 200.0 lakh, Total Plan Outlay =Rs. 334.0 lakh, Preparedness to Combat Drug Abuse In The State.. Contd..

42. Trained Manpower: - S.No.ItemNumber 1 Total Districts20 2 Psychiatrist in State Health Services26 3 Districts with a Psychiatrist18 4 Districts without a Psychiatrist02 (Fatehgarh Sahib, SBS Nagar) 5 Psychiatrists Trained as Master Trainer20 6 Health employees Trained in Opioid Substitution Therapy 10

43.  Drug Menace: During the year 2008, 617 Joint raids were conducted by the Drug Inspectors with the help of police department to check the menace of drug addiction.  37 licenses of chemist shops have been cancelled and licenses of 294 chemists were suspended due to various contraventions of drug and cosmetics Act.  Drugs worth Rs. 3.18 crore have been seized during the year 2008 and action taken against the defaulters.  Drugs worth Rs. 1.34 crore have been seized during the year 2009 (upto July) and action taken against the defaulters.  329 Joint raids were conducted and 119 licenses of chemist shops have been cancelled and 244 chemist's licences were suspended during 2009(upto July). Drug De-Addiction Program Contd..

44.  During 2008, 290 samples out of 3520 samples were found to be adulterated.  During 2009 (upto July) 183 samples out of 1981 samples were found to be adulterated. Prevention of Food Adulteration

45. Code No. Sub-Head/Name of the Scheme 11th Plan (2007-12) Approved Outlay Annual Plan (2007-08) Expenditure Annual Plan (2008-09) Annual Plan (2009-10) Approved Outlay Revised Outlay Expenditure Approved Outlay DIRECTORATE OF HEALTH SERVICES(DHS) Department of Health and Family Welfare Centrally Sponsored/Funded Schemes DHS 1 National Malaria Eradication Programme (Rural)- (50:50) 200.0029.6640.00 21.1945.00 DHS 2 National Malaria Eradication Programme (Urban) - (50:50) 100.003.3420.00 15.7225.00 DHS 3Punjab Nirogi Yojana- (33:67)200.00100.00 200.00 DHS 4Integrated Disease Surveillance Project(IDSP), Punjab -(70:30) 57.520.0034.50 0.0034.50 State Funded Schemes DHS 5Implementation of Tele-medicine Application in the State of Punjab 147.000.00150.00 0.00 DHS 9Balri Rakshak Yojana300.008.72100.0050.0026.0460.00 DHS 10 Construction of new hospitals (PAP Jalandhar and Nangal) 1000.000.00837.00 500.00300.00 DHS 11 Upgradation and expansion of existing Health Institutions 0.00 250.000.002500.00 DHS 12National Rural Health Mission (NRHM) (85:15)19567.100.003000.002884.00 4125.00 New Scheme DHS 12(i)National Urban Health Mission (NUHM) (85:15)0.00 100.00 Scheme Wise Outlay & Expenditure

46. Code No. Sub-Head/Name of the Scheme 11th Plan (2007-12) Approved Outlay Annual Plan (2007-08) Expenditure Annual Plan (2008-09) Annual Plan (2009-10) Approved Outlay Revised Outlay Expenditure Approved Outlay State Funded Schemes DHS 13 Medical Equipment/Diagnostic Services in the hospitals 500.0013.16165.00210.00206.15100.00 DHS 15 Setting up of Urban Healthcare Centres in Muncipal Corporation Town, Bathinda (ACA- 2008-09) 5000.000.001000.00 0.00500.00 DHS 16 Establishment of De-addiction Centres in the State 330.000.00165.0040.000.00200.00 DHS 17 Establishment of State Level Drug Dependence Treatment Centre 383.000.00200.000.100.00200.00 DHS 18 Specialized Healthcare Services in the Rural areas of the State and Continuing Medical Education through tele-medicine 1000.000.000.100.00 DHS 19 Assistance to NGOs/District Administration for enforcement of PNDT Act, monitoring of pregnancies, helpline etc. 500.000.00100.000.00 Centrally Sponsored/Funded Scheme DHS 20 Rashtriya Swasthya Bima Yojana for workers covered under BPL (75:25) 0.00 200.00100.00 200.00 New Schemes State Funded Scheme DHS 21 Implementation of Emergency Response Services in the State 0.00 100.00 Scheme Wise Outlay & Expenditure

47. Code No. Sub-Head/Name of the Scheme 11th Plan (2007-12) Approved Outlay Annual Plan (2007-08) Expenditure Annual Plan (2008-09) Annual Plan (2009-10) Approved Outlay Revised Outlay Expenditure Approved Outlay DHS 22 Assistance for Institutional deliveries to poor families 0.00 1000.00 DHS 23 Providing hotline facilities in the district as well as sub-divisional hospitals (more than 100 beds) for maintaining emergency services. 0.00 200.00 DHS 24 Setting up of mobile cancer detection units in the State. 0.00 1.00 DHS 25 Setting up of Urban Healthcare Centres in Jalandhar, Ludhiana and Malerkotla for urban poor and slum dwellers 0.00 1500.00 Total (DHS)29284.62154.886111.605715.604003.1011390.50 AYURVEDA Department of Health & Family Welfare State Funded Schemes AY 1 Upgradation and Extension of Govt. Ayurvedic Pharmacy and Stores, Patiala 50.000.0020.00 9.0010.00 Total(Ayurveda)50.000.0020.00 9.0010.00 HOMOEOPATHY Department of Health & Family Welfare State Funded Schemes HM 1 Strengthening of Existing Govt. Homoeopathic Dispensaries 65.000.0013.00 11.9813.00 Total (Homoeopathy)65.000.0013.00 11.9813.00 Grand Total (Medical & Public Health)40621.00324.409544.609614.974423.7416938.92 Scheme Wise Outlay & Expenditure

48. Summary – Issues and Challenges 1.Food Adulteration – Significant seizures but requirement for extra enforcement staff – 53 Food Inspectors (One per Sub- Division). 2.Drug Menace – Campaign launched and habit forming drugs worth more than Rs. 6.00 Cr. seized during last 2½ years. Need for increasing the strength of Drug Inspectors from 19 to 57 so as to have 1 Drug Inspector per every 600 Chemist Shops. 3.Sex Ratio – Latest data shows an improvement from 796 in 2001 to 838 in 2006 as per SRS 2007. Need for strengthening the schemes for girl child. Some States are depositing upto Rs. 30,000/- per girl child at birth to enable her to receive staggered payment through academic career.

49. 4.Access to Health Care – Free delivery, free referral for school students, free treatment for BPL families in Govt. Hospitals. Implementation of RSBY for BPL families in all the districts for cashless treatment upto Rs. 30,000/-. Implementation of Bhai Kanhaya by Cooperation Deptt. for cashless treatment upto Rs. 2,00,000/- for members of Co-op. Societies. State illness fund for BPL families. Need – Definition of BPL families restrictive and need for enlarging the scope of insurance scheme for greater number of poor people. Supply of free medicines – more medicines should be added. Summary – Issues and Challenges

50. 5.Telemedicine – Made functional but needs to be strengthened. Greater involvement of medical colleges. 6.PPP Projects – Two Hospitals awarded. Case of 3 Hospitals – Mother and Child Hospital, FGH Sahib, SDH Nangal and Nabha being referred to PIDB. 7.Jan Aushadhi Stores – 8 opened and remaining 12 would be opened by 30-11-2009 for sale of cheaper generic medicines manufactured mostly by CPSUs. Summary – Issues and Challenges

51. 8.EMRI – Emergency Medical Response System needs to be made functional. 16 States have already undertaken this work and GoI is encouraging it under NRHM. 9.Recruitment of Staff – After many years Govt. has allowed recruitment of MOs, MO Dental and Specialists which needs to be continued on regular basis. 191 more Ayurvedic Doctors needs to be recruited. 10.ESI – Recruitment of Doctors on contract basis. ESI willing to set up a Medical College provided State Govt. arranges 30 acres of land. Summary – Issues and Challenges

52. 11.Institutional Deliveries – Significant increase but still deliveries in Govt. Institutions account for about 15% of all births and 23% of total institutional deliveries. (5 lakh birth, 62% institutional deliveries and 70000 deliveries in Govt. Hospitals). Need for more incentives for poor people. Provision of delivery kit of Rs. 1500/- per child during 2009-10. Need for strengthening the community monitoring system specially at PHCs and SCs level. Involvement of private parties in under served pockets. Summary – Issues and Challenges

53. 12.Work of ANMs – Hardly any vacancy of ANMs in 2950 SCs. Bigger SCs have 2 ANMs. They are being provided mobiles and an application based on mobiles for online monitoring of their performance. 13.ASHAs – Proper selection and weeding out of non- performers. 14.Community Monitoring – Payment of allowances and incentives to ANMs/Staff Nurses and other Doctors enganged under NRHM through the Planning and Monitoring Committees. Summary – Issues and Challenges

54. 15.Monitoring of Staff – A website of NRHM, Computerization of service particulars and administrative maps by PRSC, Ludhiana. Involvement of District Administration and PRIs in District Health Societies and Missions. Need for greater accountability on the part of the staff in the field. 16.Staff and Buildings in New Districts – New 24 Health Blocks. 17.Upgradation of DH/SDH/CHCs and new constructions as per norms. Summary – Issues and Challenges

55. 18.Funds for equipments for PHSC. 19.HMIS in all Hospitals for effective monitoring of service delivery. Summary – Issues and Challenges

56. 20.Rationalization of postings and transfers – End to irrational deployment of Doctors and Other Paramedical Staff for the first time. Need to continue this. Deputation- 82 doctors on deputation with UT and many for more than 25 years. Doctors should return after completion of their tenure of 3-5 years after replacement. Similarly about 45 doctors are with Medical Colleges. These doctors did not return after completion of SR and PG and were adjusted in an irregular manner by the Medical Education Department against the post of Teaching faculty. Summary – Issues and Challenges