ohftT{ whfNzr w[Zy wzsoh ih d/ Bkb f;js ns/ gfotko GbkJh ftGkr gzikp f;js ns/ gfotko GbkJh ftGkr gzikp

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

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 dh nkpkdh fgS/)  pbke b?tb T[s/  ns/ j'o efwT{fBNh f;js e/Ado (jo fJZe dh nkpkdh fgS/)  ghHn?uHn?;H;ha (PHSC) tZb'A ubkJhnK ik ojhnK  vhHn?uHn?;H tZb'A ubkJhnK ik ojhnK 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

BUDGET FY ( ) PLAN NON PLAN GOI/CSSOTHERSTotalDHS DFW PHSC AYURVEDA HOMOEPATHY ESI AIDS NRHM TOTAL 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

SUMMARY STAFF Sr. NoCategorySanctionFilledVacantRemarks 1Medical Drug and Food Nursing Laboratory Paramedical Diminishing Cadre for Pharmacists 6IEC

SUMMARY STAFF Sr. NoCategorySanctionFilledVacantRemarks 7Malaria Section Technician Statistical Ministerial /Class IV Diminishing Cadre for Class IV 11 Paramedical (TB and Leprosy) Total

STAFF (Medical) Sr. NoCategorySanctionFilledVacant Medical 1Director321 2 Additional Director202 3Joint Director110 4 Deputy Director Deputy Director (Dental) Senior Medical Officer Medical Officer Medical Officer (Dental)

STAFF (Drug and Food) Sr. NoCategorySanctionFilledVacant 1 Assistant Drug Controller330 2 Drug Inspector Food Inspector23 -

STAFF (Nursing) Sr. NoCategorySanctionFilledVacant 1 Superintendent Punjab Health School Amritsar at Mohali1-1 2Nursing Superintendent5-5 3Principal Tutor1082 4Matron District Public Health Nurse12- 6Public Health Nurse (Teaching) Sister Tutor Nursing Sister Staff Nurse Lady House Keeper24159

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

STAFF (Paramedical) Sr. NoCategorySanctionFilledVacant 1 Multipurpose Health Worker (Female) Multipurpose Health Worker (Male) Multipurpose Health Supervisor (Female) Trained Dai Ophthalmic Officer Senior Radiographer Radiographer Radiographer (Contract Basis) Pharmacist

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

STAFF (Malaria Section) Sr. NoCategorySanctionFilledVacant 1 Assistant Malaria Officer14- 2Assistant Unit Officer Entomologist-cum- Parasitamologist1-1 4 Entomologist Assistant514 5Insect Setter11- 6Insect Collector Draftsman11- 8 Superior Field Worker Biologist13-

STAFF (Technician) Sr. NoCategorySanctionFilledVacant 1 Refrigerator Mechanic Assistant Dental Mechanic835 3Dental Mechanic Dental Hygienist Dental Electrician101 6 Dark Room Assistant E.C.G. Technician Operation Theatre Assistant Pump Mechanic Field Assistant11-

Sr. NoCategorySanctionFilledVacant 11 Sanitary Supervisor (Health Core) Microscope Mechanic11- 13Artist Projectionist Developer101 16Machine Operator Tradonal Machine Operator101 18Senior Compositor101 19Compositor101 20Copy Holder110 21Proof Assistant Manager off-set Press101 23Cold Chain Officer110 STAFF Cont.. (Technician)

STAFF (Statistical) Sr. NoCategorySanctionFilledVacant 1 Joint Director(Evaluation)101 2 Deputy Director(Statistics)101 3 Senior Research Officer211 4Statistical Officer Superintendent (Statistics) Statistical Assistant Junior Statistical Assistant25 0 8Computor

STAFF (Ministerial) Sr. NoCategorySanctionFilledVacant 1Administrative Officer101 2 Registrar (Budget) DRME101 3Superintendent Grade Superintendent Grade Senior Assistant Junior Assistant/Clerk Personal Assistant422 8 Junior Scale Stenographer44- 9 Senior Scale Stenographer Steno-Typist (Head Quarter)990

Sr. NoCategorySanctionFilledVacant 11Steno-Typist (Field) Superintendent Grade Senior Assistant Clerk Librarian11- 16Home Science Assistant1-1 17Senior Scale Stenographer Junior Scale Stenographer22- 19Packer / Sweeper541 20Class IV ( Head Quarter) Sweeper (Head Quarter)55- 22Chowkidar88- 23Class IV (Field) (Total Posts) STAFF Cont.. (Ministerial)

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)

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)

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) ( )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

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.

Shortage of Staff Contd.. Sr. No. Name of PostScale Requirement of Posts Remarks 1District Immunization Officer District Dental Health Officer Epidemiologist Deputy Medical Commissioner Distt. Mass Media & Information Officer Deputy Mass Media & Information Officer Artist Cum Photographer District Public Health Nurse Food Inspector Assistant Malaria Officer Multipurpose Health Worker(M) Superintendent Grade-II Superintendent Statistics Senior Assistant Statistical Assistant Details of posts required at Newly created districts

Details of posts required at Newly created districts Contd.. Shortage of Staff Contd.. Sr. No. Name of PostScale Requirement of Posts Remarks 16Steno Typist Clerk Computer/ Statistical Clerk Multi Purpose Supervisor (M)/ Health Supervisor Driver Senior Lab. Technician For District Malaria Laboratory 22Medical Laboratory Technician Grade II Lab. Attendant District TB Officer For TB Clinics 25Medical Laboratory Technician Grade I Medical Officers For School Health Clinics 27Medical Officer (Dental) Public Health Nurse Class IV (Helper/ Watchman/ Sweeper) Steno Typist

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 shops.  38 posts of Drug Inspectors are more required so as to have one Drug Inspector for every 600 chemist shop.

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.

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.

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

Requirement of Equipments SNInstitutionRequirement (Cr.) ProvisionGap Rs(Cr.)Source 1SHC (1187)11.87NilNon-Plan (RDP) SC (2950)2.90 NRHM Untied fundsNil 3PHC (394) NRHM (3.25), Non-Plan (2.33) CHC/SDH/DH NRHM (13.24), Plan (1.00) TOTAL

Requirement for Infrastructure [As per 2011 Estimates] SNInstitutionRequirement (Cr.) ProvisionGap Rs(Cr.)Source 1SC (2950) per year NRHM PHC (394) per year NRHM CHC/SDH/DH per year NRHM Cr. State Plan TOTAL

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 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

CANCER CONTROL India – 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, Bathinda12,00, Faridkot5,85, Mansa7,31,

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.

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..

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.

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 Lac from Govt. of Punjab.

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 Crore for machinery and equipment. Simulator and Treatment Planning system for Govt. Medical College Patiala. Government of India has provided Rs 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 Crore have been provided by Govt. of India for machinery and equipment and construction.

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.

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.

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.

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 The study will be completed by March There are many steps being taken to establish de-addiction centers like DHS (16):- Annual Plan Rs lakh, Total Plan Outlay =Rs lakh DHS (17) State Level Drug Dependence Treatment Center (SDDTC), Govt. Medical College, Amritsar (Swami Viveka Nand Drug Dependence Treatment Center ):-Annual Plan Rs lakh, Total Plan Outlay =Rs lakh, Preparedness to Combat Drug Abuse In The State.. Contd..

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

 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 crore have been seized during the year 2008 and action taken against the defaulters.  Drugs worth Rs 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..

 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

Code No. Sub-Head/Name of the Scheme 11th Plan ( ) Approved Outlay Annual Plan ( ) Expenditure Annual Plan ( ) Annual Plan ( ) 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) DHS 2 National Malaria Eradication Programme (Urban) - (50:50) DHS 3Punjab Nirogi Yojana- (33:67) DHS 4Integrated Disease Surveillance Project(IDSP), Punjab -(70:30) State Funded Schemes DHS 5Implementation of Tele-medicine Application in the State of Punjab DHS 9Balri Rakshak Yojana DHS 10 Construction of new hospitals (PAP Jalandhar and Nangal) DHS 11 Upgradation and expansion of existing Health Institutions DHS 12National Rural Health Mission (NRHM) (85:15) New Scheme DHS 12(i)National Urban Health Mission (NUHM) (85:15) Scheme Wise Outlay & Expenditure

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

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

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 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 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.

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

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 for sale of cheaper generic medicines manufactured mostly by CPSUs. Summary – Issues and Challenges

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

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 deliveries in Govt. Hospitals). Need for more incentives for poor people. Provision of delivery kit of Rs. 1500/- per child during 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

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

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

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

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