1. Sikar District Tour (23-27,Oct 2013) Poonam Shrivastava Co. Yashoda /HBNC Room No. 212, DMHS Jaipur

2. District Information 8 Blocks DH-1, CHC-31, PHC-101, SC-649 TargetAchivem ent Sept 13 (pcts) % achiv. Till sept.13 ANC735273168743.10 ID661741227918.56 Live Birth 668432349935.16 Full immu nizati on 630992771543.92 PIP 2013-141866.29 Fund received 2013-14 1271.15 Balance fund 2012-13 452.23 Total fund available 1723.38 Expenditure till 31 sept. 811.51 % utilisation agnst PIP 43.48 %utilsation agnst fund available 47.09

3. Fund utilization at all levels Fund utilisation till Sept 13 against total fund received from 2005-06 to 2013-14 Untied Fund % utilisation AMG% utilisation Corpus Grant% utilisation Branding % utilisation 2013-14 cleanliness% utilisation 2013-14 SC73.4527.08 (BPMs, BCMOs, PHC incharge may make institution wise plan) - Tenders are in process.It is decided in DRHS meeting that work order for Branding activity will be issued after approval of election commission a letter with this regard is written to MD NRHM Funds /guidelines not received. Funds can easily be utilised at SC level PHC71.1869.5150.72 Tenders are in process but will issue work order after elections CHC91.1739.75 (BPMs, BCMOs, PHC incharge may make institution wise plan) 57.02 Tenders are in process but will issue work order after elections DH- - 47.71 UC not received work order issued

4. ASHA Component Only 19% funds are utilized till Sept. 13 under ASHA Incentive Rs 300 incentive for ANC is not given to ASHA Incentive for complete immunization Rs. 100 and booster dose Rs. 50 is not given to ASHAs Incentive under child health 250 for HBNC,150 for follow up of discharge SNCU/MTC children, Rs 50 infant death information, 100+200 MTC referral+ transport are also not given to ASHAs. Also there was a considerable gap between JSY beneficiary payment and ASHA incentive for ID DAC could not provide block wise and activity wise targets achievement and incentive payment status. 6&7 module ASHA trainings were organized at blocks and will complete all trainings till November. Mobility support for PHC supervisors is not utilized

5. Findings during visits Only one DP PHC Shishu did not had SBA trained staff at LR. CHC palsana had 5 staff trained in SBA. NBCC all delivery points other than SC has required equipment but equipment were not clean staff is not trained in NSSK. NBSU at CHC fatehpur was locked CHC incharge said additional staff is required for round the clock services in NBSU. Radiant warmers are supplied to DPs but not installed Cold chain maintenance issues no wooden platforms at some institutions ILR/DF were directly plugged in without stablizer, opv was found in DF at rural institutes, temperature record did not show any fluctuation equipment were not defrost funds like AMG /Corpus grant may be utilized for rectification of electric fitting and minor repair or renovation in cold chain. BCG vaccine was not found at some places. CTF agreement done at most of CHCs and some PHCs but CTF agency did not render frequent services.

6. Findings under JSSK,shubhlakshmi,ANC Payment and services(transport, hot food, drugs,lab test) under JSSK programme was quit appropriate. Payment under shubhlakshmi yojana were given to all female birth. Most of institution/health worker hesitate to report sever anemia in pregnant women. Their was a considerable difference in ANC registration and complete ANC Funds required for upgraded and New sanctioned institutions 33 PHCs,14 CHCs,113 SCs. MTC at Srimadhopur CHC was not functional inspite of trained nursing staff due to un availability of required equipment. CHC Srimadhopur ANC record is not maintained in prescribed ANC register