1. NATIONAL RURAL HEALTH MISSION HON’BLE HEALTH MINISTER
FOR
HON’BLE HEALTH MINISTER
13TH DECEMBER 2008
PRESENTATION

2. NATIONAL RURAL HEALTH MISSION (2005-2012)
NRHM launched by Hon’ble Prime Minister on 12/4/2005. As of now to conclude in 2012.
Aimed to ensure affordable, quality health care to the poorest house holds in remotest areas.
Special focus on 18 low performing States which have weak public health indicators and weak infrastructure.
Punjab is among the nine high performing States- Punjab, Haryana, Gujarat, Maharashtra, Karnataka, Kerala, Tamil Nadu, Andhra Pradesh, West Bengal.

3. HISTORICAL PROSPECTIVE
RCH-II ( ) aimed at reducing IMR and MMR was already in progress.
Programme for control of various diseases were already in progress for the last more than years.
Government felt the need to integrate all ongoing health programme into one programme and consolidate the work being done by other departments.
NRHM encompasses –
RCH – II including immunization
All individual disease control programme
Flexi-pool as per requirement of the State
Convergence with other departments like AYUSH, Water Supply and Sanitation, Nutrition, Woman and Child Development, Rural Development and Panchayats
NRHM can be summarized as : Reducing IMR and MMR through institutional deliveries, involvement of Panchayati Raj institutions and convergence with other departments.

4. NRHM OBJECTIVES
Universalized access to quality health care especially to rural poor with focus on women and children.
Reduced Infant Mortality Rate and Maternal Mortality Rate.
Ensuring population stabilization & gender equity.
Prevention and control of communicable and non-communicable diseases.
Access to integrated comprehensive primary health care.
Mainstream AYUSH- Integration of AYUSH with mainstream health institutions .
Promotion of Healthy life style.
Emphasis on potable drinking water, hygiene, sanitation and nutrition.

5. Accessibility, Approachability and Quality
KEY COMPONENTS OF NRHM
Community Partnership Village level planning ASHA Village Health & Nutrition Days Village Health & Sanitation Committees Increased involvement of PRIs
Improved services
System strengthening
Infrastructure development
Monitoring through computerisation
Improved financial management &
Human Resource
Public Private Partnership
Telemedicine
Mobile Medical Units
Intra & inter sectoral convergence
24-Hour- delivery services
Emergency Obstetric Services
Specialist Services – On call/contract
Immunization strengthening
IMNCI
Adolescent health
Family welfare services
Accessibility, Approachability and Quality

6. NRHM STRATEGIES
Decentralization of the process of health planning and management from Village to District level.
Involvement of PRIs and Village Health & Sanitation Committees.
Up-gradation of existing health institutions from Sub Centres to District Hospitals as per Indian Public Health Standards (IPHS).
Flexible financing- untied funds for filling up the gaps in infrastructure and other related activities.
Manpower requirement- recruitment of doctors, and paramedical staff in relation to Woman & Child Health.
Improved management through capacity building- provision of computers, computer operators, establishment of State, District and Block Programme Management Units (PMUs).
Integration of AYUSH with the mainstream health institutions including recruitment of Ayurvedic/Homeopathy doctors at PHC and CHC level.
Intersectoral Convergence with Nutrition, water and sanitation programmes.
Promotion of Public Private Partnership for achieving public health goals.

7. NRHM – ILLUSTRATIVE STRUCTURE
Health Manager
BLOCK LEVEL HEALTH OFFICE – Accountant
Store Keeper
Accredit private providers for public health goals
100,000 Population
100 Villages
BLOCK
LEVEL
HOSPITAL
Strengthen Ambulance/
transport Services
Increase availability of Nurses
Provide Telephones
Encourage fixed day clinics
Ambulance
Telephone
Obstetric/Surgical Medical
Emergencies 24 X 7
Round the Clock Services;
30-40 Villages
CLUSTER OF GPs – PHC LEVEL
3 Staff Nurses; 1 LHV for 4-5 SHCs;
Ambulance/hired vehicle; Fixed Day MCH/Immunization
Clinics; Telephone; MO i/c; Ayush Doctor;
Emergencies that can be handled by Nurses – 24 X 7;
Round the Clock Services; Drugs; TB / Malaria etc. tests
5-6 Villages
GRAM PANCHAYAT – SUB HEALTH CENTRE LEVEL
Skill up-gradation of educated RMPs / 2 ANMs, 1 male MPW FOR 5-6 Villages;
Telephone Link; MCH/Immunization Days; Drugs; MCH Clinic
VILLAGE LEVEL – ASHA, AWW, VH & SC
ASHAs, AWWs in every village; Village Health & Nutrition Day
Drug Kit, Referral chains

8. NRHM FIVE COMPONENTS RCH AND RELATED ACTIVITIES
(PART- A)
RCH AND RELATED ACTIVITIES
(RCH FLEXI POOL)
(PART- B)
INITIATIVES UNDER NRHM OTHER THAN RCH
(MISSION FLEXI POOL)
(PART- C)
IMMUNIZATION STRENGTHENING PROGRAMME
(PART- D)
NATIONAL DISEASE CONTROL PROGRAMMES
(PART- E)
INTER SECTORAL CONVERGENCE SCHEMES

9. INSTITUTIONAL ARRANGEMETS UNDER NRHM
STATE LEVEL
State Health Mission chaired by Hon’ble Chief Minister.
State Health Society chaired by Chief Secretary.
Merger of all vertical societies into State Health Society.
Signing of MoU with GoI.
State Level Planning and Monitoring Committee headed by Hon’ble Health Minister

10. INSTITUTIONAL ARRANGEMETS UNDER NRHM
DISTRICT LEVEL
District Health Mission chaired by Chairman Zila Parishad.
District Health Society chaired by Deputy Commissioner.
District Planning and Monitoring Committee headed by Zila Parishad Chairman.
Rogi Kalyan Samities in District/Sub Divisional Hospitals.
Merger of all vertical societies into District Health Society.

11. ..contd.. INSTITUTIONAL ARRANGEMETS UNDER NRHM
BLOCK LEVEL
Block Planning and Monitoring Committees at Block PHC.
PHC Planning and Monitoring Committees at PHC level.
Rogi Kalyan Samities for CHCs
VILLAGE LEVEL
Village Health & Sanitation Committees in each village.
Accredited Social Health Activist (ASHA) for every 1000 population.

12. HEALTH INDICATORS India Punjab Best State Birth Rate Death Rate
(SRS 2007)
23.1
17.6
14.6
14.7
Manipur
Kerala
Death Rate
7.4
7.0
4.4
4.8
Delhi
Life Expectancy at birth
62.15
68.25
73.5
Sex Ratio
(Census 2001)
933
876
1001
1058
Pondicherry
IMR 55 43 12 13
TFR (SRS 2005)
2.9
2.1
1.7
Maternal Mortality Ratio (SRS 2005)
301
178
110
Ante Natal Care (at least 3 checkup) (%) (NFHS III)
50.7
72.5
96.5
T.Nadu
Institution Delivery (%) (NFHS III) 41 53
100
Contraceptive Use (%)
(NFHS III) 56
63.3 73 HP
Vaccine coverage (%) 44 60 81

13. TARGETS FOR PUNJAB UNDER NRHM
Indicators
At the start of RCH
SRS
Present Status
Target by
Total Fertility Rate
2.5
2.1
1.8
Infant Mortality Rate
(per 1000 live births) 49 44
<30
Maternal Mortality Ratio
(per live births)
199
178
<100
Institutional Deliveries
37.5%
(NFHS II)
52.5
80%
ANC Check-up with 03 contacts
58.4%
72.5
100%

14. HEALTH INSTITUTIONS INSTITUTIONS PUBLIC SECTOR PRIVATE SECTOR
MEDICAL COLLEGES 3 5
DISTRICT HOPITALS 20
983
SUB DIVSIONAL HOSPITALS (Total no. of Sub Divisions 78) 38
COMMUNITY HEALTH CENTRES
127
(112 PHSC, 15 DHS)
BLOCK PHCs
118
BLOCK PHCs AND SDH 6
BLOCK PHCs AND CHCs 70
ONLY (EXCLUSIVE) BLOCK PHCs 42

15. HEALTH INSTITUTIONS INSTITUTIONS PUBLIC SECTOR PRIVATE SECTOR
PHCs (MINI PHCs) – EXCLUSIVE
352
PHCs BLOCK – EXCLUSIVE 42
TOTAL PHCs – EXCLUSIVE
394
TOTAL PHCs – EXCLUSIVE + AT CHC/SDH
= 470
SUBSIDIARY HEALTH CENTERS
1187
SUB-CENTRES AT VILLAGE LEVEL
2858
CLINICS /DISPENSARIES
3046

16. NRHM
BUDGET
OVER THE YEARS

17. PROGRAMME IMPLEMENTATION PLAN
NRHM is a centrally sponsored scheme. For Year and , GoI contribution was 100%, & from Year , GoI contribution is 85% and state contribution is 15%.
Every year State Health allocation to increase at least 10% of the previous year.
State Govt. is required to prepare a Programme Implementation Plan (SPIP). It is discussed with Ministry of Health, GoI and then approved by it.
After approval of SPIP the funds are released by GoI and the Sate Govt.
Minor changes in PIP can be made and major changes are allowed only with the approval of GoI.

18. Funds released by State
FINANCIAL REPORT FOR THE YEAR
Rs. in lakhs
Year
Op Balance
Approved Plan
Releases
Expenditure Incurred
% of Utilization
Unspent Balance
GOI
State Share 15% from
Total
Funds released by GOI
Funds released by State
Total Funds Available 1 2 3 4 5 6 7
8 (2+6+7) 9 10
11 (8-9)
283.20
Not Required
0.00
61%
46%
705.00
84%
(Up to Oct 08)
79%

19. FINANCIAL STATUS UPTO OCTOBER 2008 (DISTRICT LEVEL)
Rs. in lakhs SN
Component
Releases
Expenditure 1
RCH II 2
NRHM Additionalities 3
Immunization & PP
164.05
91.63 4
NDCP
366.61 5
Inter Sectoral Convergence
0.00 6
CSS Family Welfare Head 2211
 TOTAL

20. STATE OBLIGATIONS UNDER NRHM
State signed MoU with Govt. of India in December 2005 for implementation of NRHM SN
INITIATIVES
STATE LEVEL
DISTRICT LEVEL
BLOCK LEVEL / VILLAGE LEVEL
REMARKS 1
Setting up of the Health Missions
On 26th October 2005 constituted.
On 17th August 2005 constituted.
Not applicable
Completed 2
Incorporation of Health Societies
Incorporated on 26th February 2007
Incorporated from 26th August 2005 to January 2006
Block Health Committees notified on 11/12/2007
Village Health Sanitation Committees constituted on 21/10/2007. 3
Integration of all vertical programmes of Health & Family Welfare Department.
Already Integrated 4
Merger of different societies with State Health Society.
Done on 21/12/2007
Being Done
Not required
Yet to be completed 5
Constitution of Rogi Kalyan Samities in all Health Institutions upto PHCs
Already notified and are operational
At Block Level Community Health Centres already notified and are operational.
Completed upto CHC but yet to be done in 484 PHCs

21. BLOCK LEVEL / VILLAGE LEVEL
…contd. STATE OBLIGATIONS UNDER NRHM SN
INITIATIVES
STATE LEVEL
DISTRICT LEVEL
BLOCK LEVEL / VILLAGE LEVEL
REMARKS 6
Recruitment of staff for Programme Management Units.
Recruitment completed
Recruitment under process at block level.
Being discussed separately 7
State and District Health Plans :
PIP submitted on 10th July 07
PIP approved on 25/9/07
Outlay-Rs lacs :
PIP submitted on 27th Feb 08
Approval of PIP received
Outlay- Rs lacs
Facility Survey completed. Integrated District Health Action Plan ready for 20 districts.
Facility survey upto Sub centre level completed.
District Action Plans completed in all 20 districts
The Department has decided in principle to out source the setting up of State Health System Resource Centre (SHSRC), Price Water House Bangalore has been selected. Contract is being signed..

22. WORK DONE - FUNDS Component Amount/Scope 2007-08 2008-09 Remarks
Untied Funds
Rs. 10,000
2858 SCs
Funds Released
Rs. 25,000
484 PHCs
Rs. 50,000
Nil
128 CHCs
IPHS
Rs. 20 Lacs
20 DHs
116 CHCs
Annual Maintenance Grant
100 PHCs
Rs. 1 Lac
112 CHCs
Rogi Kalyan Samitis
Rs.5 Lac
One Time Grant
1 Lac
36 SDHs 
110 CHCs 
Mobile Phones for ANMs
134 Lacs
4000
In Process
Application Solution for on line data transfer from ANMs to State

23. WORK DONE– MCH – 24x7 PHCs
75 PHCs upgraded to 24x7 PHCs in and 26 PHCs in for 24 hrs. delivery.
24x7 PHC – 1 MO (F) and 3 Staff Nurses on contract basis.
Out of 101 MO(F), 60 posts filled up leaving 41 posts vacant.
34 Staff Nurses yet to be appointed.
Posts advertised. Last date 20/12/2008
Generator set provided at 75 and for remaining 26 in process.
Labour room etc. constructed

24. WORK DONE – MCH - FRUs
50 CHCs in and 10 in upgraded to FirstReferral Units (FRUs). Facility for a complicated delivery including blood transfusion.
1 Gynaecologist, 1 Paediatrics and 5 Staff Nurses to be appointed.
So far 21 Gynaecologist, 22 Paediatrics in position and advertisement for remaining 39 and 38 given. Last date 20/12/2008.
Advertisement for remaining Staff Nurses 13 given.
Through rationalization of posting of Gynaecologist, 21 regular Gynaecologists posted in the FRUs i.e. 42 FRUs are having Gynaecologist and only 18 are without Gynaecologist.

25. WORK DONE – 24 x7 PHCs and FRUs
Signages for these 101 and 60 institutions being developed. Tender floated
On line monitoring of performance of these institutions through PEC, work given.
Biometric based on-line attendance system. Tender already received.

26. WORK DONE - MMUs
20 MMUs deployed in districts. 4 districts – Amritsar, Jalandhar, Ludhiana and Mohali not provided with MMUs. 4 districts Faridkot, Bathinda, Mansa and Barnala have one additional MMUs.
Cost of each MMU Rs lacks. Full Bus chassis used for MMUs. Has the facility of ECG, X-Ray and Lab.
1 MO(F), 1 MO(M), 1 Radiographer, 1 Lab Technician, 1 Staff Nurse, 1 Pharmacist (Regular) and 1 Driver and 1 Helper provided.
12 posts of MO(F) and 10 MO(M) vacant. Advertisement given.
Instruction issued for free treatment and medicine (Rs per month) issued.
Tenders for GPS enabled tracking system invited and last date 15/12/2008.
Decision regarding MMUs for the remaining 4 districts yet to be taken.

27. WORK DONE - VHSCs
NRHM implementation planned within the frame work of PRIs at different levels.
Village Health & Sanitation Committees formed in coordination with PRIs at each village level.The committee consists of ideally 11 member under the chair of Sarpanch/Panchayat Member and ANM or AWW as Member Secretary with 50% representation of women and due representation from weaker sections.
11418 VHSCs formed and remaining 1161 yet to be formed.
Committee provided with annual grant of Rs 10,000/- to be used as untied grant to meet village level public health activities. Funds already released to VHSCs (Total – Rs Cr. In )
Headed by Panch / Sarpanch.

28. WORK DONE - ASHA
15400 ASHAs selected in the State, 2356 yet to be selected
ASHA - a female health activist in the community to create awareness on health and mobilize the community for utilization of the existing health services.
One ASHA to cover 1000 population.
ASHA to be a woman resident of the village-Married/Widow/Divorced preferably in the age group of 25 to 45 years with the formal education up to eighth class.
Selection of ASHA to be made by the District Health Society under the supervision of Deputy Commissioner, and Civil Surgeon to be as District Nodal Officer.
SMO at block level to be the Block Nodal Officer.
Performance based incentive money of Rs crore has already been released to District Health Societies for ASHAs for the year & Rs. 1.3 crore in

29. WORK DONE - TRAINING OF ASHAs
Training of ASHAs in Module 1 is scheduled to be conducted during the current financial year.
Training at the State Level for District Trainer completed in July 2008.
Training at the District Level for Block Level Trainers completed in August 2008.
Training at the Block Level for ASHAs to be taken up now. ASHA books have been translated and are under print.
Training of ASHA for 6 districts being given to NGO. Matter under process
Tenders for ASHA kit have been received and would be made available by 31/12/2008.

30. WORK DONE – RECRUITMENT
No recruitment done in ,
Fresh recruitment at the State Level made in November 2007 and State Programme Management Unit set up.
Fresh recruitment of doctors and nurses started in March 2008.
Great emphasis given on recruitment of Staff in the Hospitals and Sub-Centres.
3 recruitment drives launched – July 2008, October 2008 and December Recruitment has been made a monthly features.
All vacant posts of ANMs for last 5-6 years at Sub-Centres (514) filled up under 2211 scheme. 2nd ANM provided at 954 bigger Sub-Centers.
For Gynaecologist and MO(F), advertisement given for increased pay packages. Basic pay increased from 15,000/- and 20,000/- to 20,000/- and 25,000/-.

31. WORK DONE – RECRUITMENT
Letter written to Civil Surgeons on 8/12/2008 for identifying remote/extremely remote areas. We will give the regular and contractual lady doctor special incentive during
Recruitment at 4 levels –
State Programme Management Unit
District Programme Management Unit
Block Programme Management Unit
Doctors, Nurses, ANMs etc. in the Health Institutions
1 Medical Officer appointed in PHCs in the Malwa Districts of the State where there was no doctors. Against 95 posts, 59 posts filled up. Remaining posts advertised. We should try to provide at least one doctor in each PHC in the PIP 31

32. Consolidated Salary PM
RECRUITMENT -
STATE PROGRAMME MANAGEMENT UNIT SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 1
Director Finance
On Deputation 2
State Programme Manager
From State Govt. 3
Maternal Health Specialist
40,000
Rs 30,000/- from Dec
Services have been terminated 4
Family Welfare Specialist 5
Procurement Manager
25,000
Advertisement for recruitment issued on 1/12/2008 6
Manager (HRD)
20,000
Officer Resigned Advertisement for recruitment issued on 1/12/2008 7
Manager (F&A) 8
Manager (M&E) 9
State NGO Coordinator
30,000 10
Programme Coordinator (ARSH & Gender)

33. Consolidated Salary PM
…contd… SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 11
Programme Coordinator (BCC) 1
20,000 12
Consultant (Admn)
Candidate resigned 13
Consultant (M&E) 14
System Analyst
15,000
Officer Resigned Advertisement for recruitment issued on 1/12/2008 15
Accounts Officer 2 16
Statistical Assistant 4
10,000 17
Hardware Supervisor 19
Accountant-cum-Cashier

34. Consolidated Salary PM
…contd… SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 20
Computer Assistant 4
8,000
Selection has been done for the vacant position candidate is yet to join 21
Office Assistant 9
7,000 23
Graphic Designer 1
10,000 24
Procurement Assistant 2
Candidates have been adjusted at State HQ from the districts 25
Drivers
5,000
Action is being initiated 26
Class-IV 3
3,000
Total 44 35

35. Consolidated Salary PM
RECRUITMENT -
DISTRICT PROGRAMME MANAGEMENT UNITS SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 1
District Programme Manager 20 18 2
20,000
Selection has been Done.
District Accounts Officer 17 3
15,000
Advertisement for recruitment issued on 1/12/2008
District Monitoring & Evaluation Officer 4
Procurement Officer 16 5
Maintenance Engineer
12,000 6
Statistical Assistant
8,000 7
Procurement Assistant
No further recruitment to be made. Procurement Assistant have been adjusted as Statistical Assistant or accountant as per their qualification 8
Accountant-cum-Cashier 9
BCC Facilitator
Total
180

36. Consolidated Salary PM
RECRUITMENT -
BLOCK PROGRAMME MANAGEMENT UNITS SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 1
Block Statistical Assistant
118 98 20
8,000
Advertisement for recruitment issued on 1/12/2008 2
Block Accountant cum Cashier 93 25 3.
Computer Operator
173
155 18
5,000
Total
409
346 63

37. Consolidated Salary PM
RECRUITMENT - FRUs SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 1
Obstetricians 60
21+21 39
Rs /- +
Rs. 3000/- HRA+ Rs. 1000/ EmOC + Rs. 500/- per delivery conducted + Rs. 200/ MTP
28 Recruited, 7 resigned. Advertisement issued for 39 posts on 1/12/2008 2
Paediatricians
22+3 35
Rs. 200/- per Emergency Case during off duty hours + Rs. 3000/- HRA
31 Recruited, 9 resigned. Advertisement issued for 35 posts on 1/12/2008 3
Anaesthesia
Rs. 1500/- on call per case + TA Rs. 6/KM upto 50 KM
Empanelment for CHCs at District level 4
Staff Nurses
300
287 13
Rs. 8500/- + Rs. 1500/- (if accommodation is not provided)
Advertisement for recruitment issued on 1/12/2008 5
OT Assistant 10 50
Rs. 4000/ /- evey Major OT Case + Rs. 1500/- HRA
Not required to recruit

38. Consolidated Salary PM
RECRUITMENT -
PHCs 24x7 SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 1
Female Medical Officer
101 50
51*
Rs PM + Rs. 500 per Delivery+ Rs. 200/ MTP + Rs. 3000/- HRA
*Advertisement for recruitment issued on 1/12/2008 2
Staff Nurses
303
269
34*
Rs. 5000/- + Rs. 500/- per delivery conducted + Rs. 100/- per delivery assisted and Rs. 1500/- HRA (if accommodation is not provided)

39. Consolidated Salary PM
RECRUITMENT -
Mobile Medical Unit (MMU) SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 1
Medical Officer (Male) 20 10
22,000
20 recruited 10 resigned/ not joined Advertisement issued for 10 posts on 1/12/2008 2
Medical Officer (Female) 8 12
20 recruited 12 resigned/ not joined Advertisement issued for 12 posts on 1/12/2008 3
Nurses 17
8,000
Advertisement for recruitment issued on 1/12/2008 4
Radiographer 5
Lab Technician 6
Driver
7,000
*Placement agency hired 7
Helper
4,000

40. Consolidated Salary PM
RECRUITMENT – MO (Mini PHC) & ANM for Urban Slum Area & Sub-Centres SN
Name of the Post
Sanctioned Post
Filled
Vacant
Consolidated Salary PM
Remarks 1
Medical Officer for Mini PHC 95 61 34
20,000
Advertisement issued for the recruitment on 1/12/2008
MPHW (Female) for urban slums
230 *0
6,000 2
ANM for vacant sub-centres (2211)
514
1265
203
Mainly reserved posts
Advertisement for recruitment issued on 1/12/2008 3
2nd ANM for 954 sub-centres
954

41. WORK DONE - SCHOOL HEALTH
32,64,926 of students are in Primary and Secondary level
Special Campaigns under School Health Programme held
13th August (held in slum areas of key districts) person examined
14th August (held in CHCs and SDHs) school children examined
2nd October (held in CHCs, SDHs, & DHs) Eye checkup camps under which free spectacles distributed to school children
Requirement of Drugs :-
IFA Tablets-
Pediatric with2 0 mg elementary iron 7 Crore Tabs
Adult with60 mg elementary iron 60mg 3 Crore Tabs
Deworming Tablets lakh Tabs
Procured and distributed
School
No. of Students
Primary
7,09,747
6,29,510
13,39,257
Middle-Secondary
10,39,509
8,86,160
19,25,679
Total
17,49,256
15,15,670
32,64,926

42. WORK DONE - SCHOOL HEALTH
Free Treatment of School Students for CHD & RHD
Decision taken on 4/11/2008 for free treatment of students (upto +2 level) studying in Govt. & Govt. aided schools suffering from Congenital Heart Disease (CHD) and Rheumatic Heart Disease (RHD) in PGI Chandigarh. So far 16 students referred to PGI and Rs lacks deposited.
Directions given to heads of PHCs, CHCs and dispensaries to diagnose school students suffering from RHD and CHD and refer to PGI.
Work of examination of School Children – not so systematic. Students cards are under print and would be supplied to the Schools.
Civil Surgeons have been directed to fix the target and show achievement alongwith certificates from the School Headmaster that the health team has visited the school and examined the children.

43. WORK DONE - COMMUNITY MONITORING & PLANNING COMMITTEES
To involve the community in the decision making and monitoring of initiatives and ongoing health programmes, Health Monitoring & Planning Committees are being constituted at Village, PHC, Block, District and State level with the following objectives
provide systematic info about community needs
provide feedback according to
locally developed yardsticks
key indicators.
increase involvement and participation of community
Validate sector wide data from other sources
Triangulation

44. WORK DONE – SEX RATIO
Survey for sex ratio commissioned in September Report likely to be received by 28/2/2009.

45. PROGRAMME IMPLEMENTATION PLAN
STATE
PROGRAMME IMPLEMENTATION PLAN

46. PIP 2008-2009 COMPONENTS DESCRIPTION OUTLAY (Rs. In crores) PART A RCH
56.95
PART B
NRHM ADDITIONALITIES
80.80
PART C
IMMUNIZATION & PPI
12.34
PART D
NATIONAL DISEASE ONTROL PROGRAMME
14.73
PART E
INTERSECTORAL CONVERGENCE
5.33
TOTAL
NRHM
170.15
CENTRALLY SPONSORED SCHEMES (Already under Implementation but now merged with NRHM)
59.34
GRAND TOTAL
229.49

47. GoI contribution Rs. 180 Cr., GoP contribution Rs. 30 Cr.
PIP
GoI contribution Rs. 180 Cr., GoP contribution Rs. 30 Cr.
Previous funds available – GoI- Rs Cr.; GoP – Rs Cr. = TOTAL – Rs Cr.
TOTAL FUNDS AVAILABLE FOR Rs. 210 Cr. + Rs. 38 Cr.= Rs. 248 Cr.

48. Releases/ Expenditure
PART A- RCH FLEXI POOL
Rs. In lakhs
Allocation
Releases/ Expenditure SN
Sub Components 1
Maternal Health
235.00
52.50
Janani Suraksha Yojna
186.00
171.50 2
ASHA
334.50
440.00 3
Child Health & IMNCI
86.15
.67 4
Family Planning
920.60
937.71 5
ARSH
27.07
10.02 6
Urban RCH
135.60
32.90 7
PNDT Sex Ratio
64.84
21.57
Innovations / PPP/NGO
442.50 8
Infrastructure & Human Development
221.87
Logistic Management
323.34
95.35
Quality Assurance and Infection Control Programme
HMIS Monitoring and Evaluation 9
Training
461.88
276.70 10
Behaviour Change Communications
291.76
40.75 11
Procurement
122.50
125.91 13
Programme management Units SPMU and DPMUs
347.26
264.35 12
Flexi pool
157.50
11.70
Total A (RCH II)

49. ..contd.. PART A
Digitization of Civil Registration Systems (CRS). RFP under preparation. Under e-Governance Project of the State on pilot basis CRS is being implemented in district Kapurthala & Nawanshahar. Work has been allotted to WIPRO. Work allotment for digitization of CRS for whole Punjab is under process.
Sex Ratio Survey. The work has been allotted to AMS, Luckhnow. First inception report of the survey submitted.
City Specific GIS mapping for Urban Health Mission for three cities i.e. Amritsar, Jalandhar and Ludhiana which was assigned to Punjab Engineering College, Chandigarh has been completed
To ensure dissemination of information relating to NRHM to field level functionaries and to ensure immediate reporting, steps have been taken to finalize website of the NRHM. The work will be completed by the end of this month.

50. Releases/ Expenditure
PART B- NRHM ADDITIONALITIES
Rs. In lakhs
Allocation
Releases/ Expenditure SN
Sub Components B
NRHM Additionalties a
Village Health & Sanitation Committees
0.00 b
ASHA - proposed under RCH II c
SC Untied Fund & Maintenance
286.20
285.80 d
PHC Untied Fund & Maintenance
121.00 e
CHC Untied Fund & Maintenance
64.00 f
Annual Maintenance Grant
162.00
655.80 g
Mobile Medical/ Health Units
397.40
111.20 h
Upgradation of CHC I
Upgradation of PHC
821.43 j
Upgradation of SC
725.38 k
Upgradation of SHC
600.00 l
Upgradation on SDH/ FRUs
100.00 m
Upgradation of DH
370.00 n
School Health
500.00
12.45 o
Strengthening of Programme Management
476.56 p
Strenthning of Logistics Management
50.00 q
Rogi Kalyan Samitiis
12.33 r
Emergency Response Services
937.50 s
Mobile Phones for ANMs
134.00
Total B

51. ..contd.. PART B Extension of New Institutions
40 New Sub Centre's is to be constructed at a cost of Rs. 2.5 crore.
One new CHC to be constructed at Zirakpur at a cost of Rs. 2.5 crore
Up-gradation of Institutions
77 Sub Centres to be renovated at a cost of Rs Lakh each
10 PHCs to be repaired / renovated at cost of rs Lakh.
PHC at Adampur and Rural Hospital Morinda to be completely renovated.
Following Sub Divisional Hospitals to be upgraded with an outlay of Rs.6.00 Crore
Batala (50 to 80 beds) ... Rs. 1.5 crore
Patti (50 to 80 beds) ... Rs. 1.5 crore
Nabha (100 to 130 beds) ……… Rs. 1.5 crore
Pathankot (100 to 130 beds) …… Rs. 1.5 crore

52. ..contd.. PART B Following District Hospitals to be upgraded
Mohali (70 to 120 beds) … Rs Crore
Mata Kaushalya Hospital Patiala … Rs.2.00 Crore
(154 to 250 beds)
Gurdaspur (100 to 150 beds) … Rs.2.50 Crore
Ludhiana (addition of 30 beds burnh Unit)… Rs Crore
Bathinda (Renovation) Rs.0.50 Crore
Equipment and furniture worth Rs.6.50 Crore to be provided in CHCs as per IPHS Norms
Equipment and furniture worth Rs.1.83 Crore to be provided in the PHCs as per IPHS norms
Drugs and consumables as per following details to be given:
- CHCs … Rs Crore
- PHCs … Rs.4.84 Crore
- SHCs … Rs.6.00 Crore

53. Releases/ Expenditure
PART C- IMMUNIZATION
Rs. In lakhs
Allocation
Releases/ Expenditure SN
Sub Components a
Alternative vaccine Delivery
103.34 b
Mobilization of Children by AWW/TBA/ASHA
68.59 c
Strengthening of Monitoring and Supervision
9.18 d
Computer Assistant to DIO, Provision for Additional Support, Slums and underserved area
79.58
Total C
260.69
91.63

54. Releases/ Expenditure
PART D-
NATIONAL DISEASE CONTROL PROGRAMME
Rs. In lakhs
Allocation
Releases/ Expenditure SN
Sub Components a
RNTCP
522.16
201.52 b
Leprosy
0.76
26.35 c
IDSP
79.91
43.86 d
National Iodine Deficiency Disorder Control Programme. - NIDDCP 20
0.00 e
Malaria & Vector Borne
212.36
19.88 f
Blindness Control
637.5
75.00
Total D
366.61 54

55. Releases/ Expenditure
PART E-
INTERSECTORAL CONVERGENCE
Rs. In lakhs
Allocation
Releases/ Expenditure SN
Sub Components a
Convergence with AYUSH
424.80
0.00 b
Co ordination & Orientation with PRIs
75.15 c
Special innovation for Minorities
33.45
Total E
533.40
Part II
CSS Family Welfare Head 2211
Appointment of one Ayurveda MO & one Homeopathy MO in 121 PHCs & 112 CHCs respectively.
99 Ayurveda MOs already recruited. 22 MOs of reserved categories (9 SC, 1 FF, 2 Sports, 3 Handicapped, 6 Exn, 1 General)
Written test & Counseling for appointment of 112 Homeopathy MOs done. Appointment letters being issued

56. DRINKING WATER SUPPLY
There are numerous schemes for providing clean drinking water in rural and urban areas :
Under JNNURM, UIDSSMT and BSUP high priority has been given to providing drinking water supply. The total allocation for current year is Rs. 350 crore.
Under Municipal Development Fund a sum of Rs. 1 crore is to be spent in various towns.
For Rural Areas, there are various schemes – Accelerated Rural Water Supply Scheme (Rs. 110 crore), NABARD (Rs. 70 crore), World Bank (Rs. 132 crore), Rajiv Gandhi National Drinking Water Mission (Rs. 10 crore), RO Process (Rs. 25 crore) for clean drinking water.
Under SSA, funds can be provided for drinking water in elementary schools in the State.

57. SANITATION
Sewerage works will be executed in urban areas under JNNURM and JBIC Projects.
For Rural Areas there is a State Government schemes for providing individual toilets (Rs. 5 crore).
Under Total Sanitation Programme of GoI we have Rs. 77 crore project for providing toilets in schools, Aanganwadi Centers, Community toilets and individual toilets.
Under World Bank Project, there is a provision for laying underground sewer in 1000 villages and cleaning of village ponds.
For cleaning of village ponds we have a State Scheme (Rs. 5 crore). NREGA funds can also be used for this purpose in all the districts without any limit.

58. SCHOOLS – WATER & TOILETS
Schools not having Water & Toilet facilities have been identified by a survey.
480 Schools are without drinking water facilities Water & Sanitation Department would provide these facilities from their regular schemes like ARWSP.
4447 schools are without Toilet facilities Water & Sanitation Department has been asked to prepare estimates.
Funds to the extent Rs per school will be provided from Total Sanitation Campaign (TSC) & above Rs from 12th Finance Commission of Rural Development Department.

59. NUTRITION
Under ICDS Programme (50:50) the State Government will be spending Rs. 55 crore in
Under Kishori Shakti Yojana (Nutrition for adolescent girls) will spent Rs crore through Woman and Child Development.
Under these 2 programmes a total of lakh children and mothers were provided nutrition.

60. VILLAGE HEALTH COMMITTES
The Village Health & Sanitation Committees has been constituted in all the villages. These committees are headed by Sarpanch/ Panches.
The new Panches and Sarpanches have been inducted in the already constituted VHSCs and the Health Department would thereafter coordinate these 3 programmes – Water Supply, Sanitation and Nutrition at block level.
The Agriculture Department would also be involved.

61. COORDINATION WITH OTHER DEPARTMENTS
We are holding regular meetings with WSS, Rural Development, Woman and Child Development Departments.
We are going to constitute Coordination Committees with these departments for greater synergy.

62. OTHER INITIATIVES

63. NATIONAL URBAN HEALTH MISSION
GoI proposes to launch NUHM from to (4 years). Current year allocation is likely to be Rs crore and Punjab would get about Rs. 25 crore.
The target population would be urban poor living in slum areas, homeless poor and construction workers.
3 towns - Amritsar, Jalandhar and Ludhiana will be taken up from and the remaining 10 towns – Patiala, Abohar, Batala, Bathinda, Moga, Malerkotla, Khanna, Pathankot, Hoshiarpur and Mohali from
The programmes aims at upgradation of Primary Urban Health Centers in terms of infrastructure and man power. Urban Social Health Activist (USHA) will be provided for every 1000 population.
Private hospitals would be empanelled in case there are no government institutions in the slum areas.
There would be a separate Health Insurance Scheme for Urban Slum Poor's and they would be free to seek treatment from Government and Private referral hospitals.
State has already initiated the process for GIS mapping of the urban slums (notified & non notified) and health facilities (Private & public) in three cities, work has been allotted to Punjab Engineering College Chandigarh. The work will be completed in the first week of September 08.

64. EMERGENCY RESPONSE SERVICE IN THE STATE
240 Ambulances equipped with medical facilities and medical technicians to be deployed.
60 ambulances will have advance life saving equipment (cardiac care, highway trauma care, EmOC)
180 ambulances will have basic life saving equipment (EmOC, highway trauma etc.).
Patient to be shifted to nearest centre through the ambulance positioned with trained medical technician and expert driver.
Capital cost of the ambulances will be Rs.29 crore and for establishing IT infrastructure and Emergency Response Centre the capital cost will be Rs. 12 crore. Total initial cost will be Rs. 41 crore. Recurring cost will be Rs. 25 cr. per annum
Emergency Call Centre with a common three digit toll free number.
Tenders have been received and work is being allotted.

65. OTHER INITIATIVES
Web Site of Punjab NRHM – prepared and hosted
Service particulars of MOs – Service particulars with complete details including postings computerized and placed on the website for final checkup by Civil Surgeons. It would be easy to determine the status of postings, transfers and vacancies in the health institutions. Would be ready by 25/12/2008.
Administrative Maps – Maps being developed with the help of Punjab Remote Sensing Agency at Ludhiana. All details received except from District Gurdaspur, Jalandhar and Mohali. These maps are necessary for depiction of information on GIS, Tracking of MMUs and EMRI Ambulances.
Pregnancy Tracking – Pilot project being developed for Mohali and Ropar district for online registration of pregnancies. Tender for allotment of work being invited.
Mobiles phones for ANMs – Continuous contacts and information.
Special incentives for Remote and Extremely Remote Areas to MO(F) and Gynecologist.

66. MONITORING AND STATUS (31/10/2008)
Institutional Deliveries
Annual pregnancies – 4,80,000
Deliveries in health department institutions in – 25269
Total institutional deliveries – About 52%
Performance upto October 2008 (Health Department Institutions) –
Increase of 24.10%
4 Excel Sheets

67. INSTITUTIONAL DELIVERIES
INSTITUTIONAL DELIVERIES
Year & (Up to October 08)

68. Trend of Institutional Deliveries – Month wise
(Health Department Institutions)
24%

69. District wise Institutional Deliveries-
& (till Oct 08)

70. Institutional Deliveries- District Hospitals
& (till Oct 08)

71. Institutional Deliveries- Sub Divisional Hospitals
& (till Oct 08)

72. Institutional Deliveries- FRUs
& (till Oct 08)

73. Institutional Deliveries- 24x7 PHCs
& (till Oct 08)

74. Institutional Deliveries- CHCs other than FRUs
& (till Oct 08)

75. JANANI SURAKSHA YOJNA
Cash assistance scheme for BPL and SCs/STs mothers (age 19 and above upto 2 living children) on birth in Public or Private accredited health units.
Rural area Rs.700/-
Urban area Rs. 600/-
Non Institutional delivery Rs.500/-
Rs.1500/- to be provided for hiring the services of specialists to carry out the caesarean in a Govt. Institution
– beneficiaries covered against the target of 90,000 per annum.
– Till October 19,949 beneficiaries covered constituting 22.17% of the annual target. It should have been 60% at the end of October

76. District wise Beneficiaries covered (till Oct 08)
JSY Performance
District wise Beneficiaries covered (till Oct 08)

77. UTILIZATION OF FUNDS
As per GOI condition funds upto to be utilized and UC sent for further release of GOI funds during
Similarly funds upto to be utilized for release of funds during
UCs to be sent for
Utilization during Rs cr. was given to districts and various agencies.

78. District wise utilization of funds (till Oct 08)

79. Ranking of the districts
To achieve more and to strengthen the NRHM programme the districts have been ranked on performance basis on different health parameters
Ranking of the districts-

80. THANK YOU