F. No. M-11011/2/10-NRHM-III Government of India Ministry ...rrcnes.gov.in/ROP/Arunachal Pradesh 2010-11.pdf · Department of Health & Family Welfare Nirman Bhawan, New Delhi Dated:

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F. No. M-11011/2/10-NRHM-III

Government of India Ministry of Health & Family Welfare

Department of Health & Family Welfare Nirman Bhawan, New Delhi

Dated: 04th May, 2010

To, The Mission Director, (NRHM) Government of Arunachal Pradesh

Subject: Approval of State Programme Implementation Plan of NRHM for the year 2010-11

Madam/Sir,

Please refer to your letter submitting draft Programme Implementation Plan (PIP) for

the year 2010-11 and the discussions of the same in the meeting of NPCC held on 04.03.2010 at

New Delhi and subsequent deliberations1.

2. The administrative approval of the PIP for your State is conveyed for an amount of Rs.

74.9 Cr. (Detail at Table C below) against the resource envelope available comprising of the

following:-

Table A

Likely Uncommitted Unspent Balance Available under

NRHM as on 1.4.2010 4.08

GOI Resource Envelope for 2010-11 under NRHM (15%

higher than current year’s Budget Estimate for over

planning purpose) 53.89

15% State share 8.27 Total 66.24

1.Budgets may be realigned within 3 months of the issue of the Order, to achieve Monitorable Targets indicated in Attachment F, in case there has been inadequate provision in the PIP, to meet national goals. 2. The actual resource allocation shall be in accordance with the budgetary allocation of 2010-11 and may be lower than the resource envelope being approved

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The Resource Pool wise break up of total NRHM resources is as follows:

(Rs. in Crores)

Table B

Sl

No. Programmes Likely Uncommitted

Unspent balance

available as on

1.4.2010

GoI Resource

Envelope under

NRHM

Total

1 RCH Flexible Pool 0.61 12.70 13.31

2 NRHM Flexible Pool 3.47 13.48 16.95

3 Immunization ( from RCH Flexible Pool)

4 NVBDCP 0.00 4.90 4.90

5 RNTCP 0.00 2.38 2.38

6 NPCB 0.00 2.44 2.44

7 NLEP 0.00 0.75 0.75

8 IDSP 0.00 0.58 0.58

9 NIDDCP 0.00 0.38 0.38

10 Director & Admn.

(Treasury route)

0.00 8.44 8.44

11 PPI Oper. Cost 0.00 0.81 0.81

12. 15% State share 0.00 8.27 8.27

13. 15% over and above GoI

resource envelope for

purpose of NPCC

approval

0.00 7.03 7.03

Total (**) 4.08 62.16 66.24

Committed Unspent

Balance up to 2009-10 to

be Revalidated in 2010-

11

Rs.8.16Crore

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SUMMARY OF APPROVAL

(Details provided in respective Annexes)

Table C

S.No Scheme/Programme Approved Amount ( In Crores)

1 RCH Flexible Pool (Details at Attachment A)

19.47

2 NRHM Mission Flexible Pool (Details at Attachment B)

30.23

3 Immunization ( from the RCH Flexible Pool) (Details at Attachment C)

1.78

4 RNTCP (Details at Attachment D) 3.13

5 NVBDCP (Details at Attachment D) 6.3

6 IDSP (Details at Attachment D) 1.27

7 NPCB (Details at Attachment D) 2.44

8 NIDDCP (Details at Attachment D) 0.38

9 NLEP (Details at Attachment D) 0.65

10 Infrastructure Maintenance 8.44

11 Pulse Polio Operating Cost 0.81

TOTAL 74.9

In addition to above following activities under NPPCD for provisioning of funding from

National Programme for Prevention and Control of Deafness.

Scheme/Programme Approved Amount ( In Rs. Crores)

12 NPPCD/Mental Health/ Tobacco/etc

(Details at Attachment E)

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3. The above approval is subject to the following mandatory requirements. Non

compliance to any of the following requirement may entail in suspension of grant to the

State.

A. Monitoring Requirements

1. State/UT shall ensure submission of quarterly report on the Measurable

Target/indicators at the end of every quarter as per Attachment F and expected outputs

stated in the Record of Proceeding in Annexures of Attachment G. Budgets may be

realigned within 3 months of the issue of the Order to achieve Monitorable Targets

indicated in Attachment F in case there has been inadequate provision in the PIP, to

meet national goals,

2. All approvals are subject to the observations made in the RoP of NPCC for NRHM

(Attachment G) which is inclusive of commodity grants under Disease Control

Programme in the respective Annexures.

B. Human Resource

3. All Posts under NRHM shall be on contract and for the Plan period. All such

appointments would be for a particular facility and non transferable in nature. Priority

in contractual recruitments and placements would be for backward districts, difficult,

most difficult and inaccessible health facilities.

4. All States would ensure that appropriate skill mix of human resource is made available

to ensure provision of minimum service guarantee to health facilities. All professionals

multi skilled under NRHM shall be placed in facilities where the skills can be utilized.

5. State shall submit action plan for recruitment, deployment and training of human

resources within six months from the issue of the Order.

C. Infrastructure

6. All civil works undertaken to achieve IPHS standards, would be based on expected

patient load and priority would be accorded to inaccessible and remote areas as per

prescribed criteria.

7. In all new constructions, care should be taken to ensure that the location of these

facilities are such that beneficiary households can access them easily. They should

preferably be located in the midst of habitation and definitely not in agriculture fields,

and outskirts of villages, under any circumstances. Any deviation from the above would

be treated as ineligible expenditure under NRHM.

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8. All new constructions would require prior approval of GoI if names of facilities have not

been mentioned in the NRHM-PIP, and also if any shift is proposed. No shift from

backward and inaccessible areas would be allowed.

9. The State shall set up implementation arrangement to monitor all civil works being

undertaken, on a monthly basis, to ensure quality of works and completion as per

schedule.

D. Communitization

10. The State shall ensure that all operational guidelines relating to VH&NDs are complied

with.

11. The State shall ensure timely performance based payments to ASHAs/Community Link

Workers. State to ensure that supportive supervision mechanism is put in place within

six months.

12. The State shall ensure that RKS meets as frequently as possible and mandatorily at least

once in every quarter to review proper utilisation of allocated funds for achievement of

goals. The proceedings of such meetings should be maintained for scrutiny.

E. Financial

13. The State shall not make any change in allocation among different components/

activities without approval of GoI. Any proposal for re-appropriation between activities

within activities should be informed to GoI in advance. However, such re-appropriation

should reflect realignment of activities in accordance with priority to high focus

districts/involvement of NGOs etc.

14. The State shall ensure that 15% of the State share, based on release of funds by

Government of India, is credited on the account of the State Health Society, within one

month of issue of the release order. The over-all expenditure on health by the State

Government should also go up by a minimum of 10 percent each year.

15. The State shall ensure the completion of delegation of administrative and financial

powers during the current financial year. Funding of NRHM to the State in 2010-2011

will be based on clear delegation as per earlier directions.

16. The State shall follow all the financial management systems under operation under

NRHM and shall submit Audit Reports, Quarterly Summary Concurrent Audit Report,

FMRs, Statement of Fund Position, as and when they are due. State also agrees to

undertake Monthly District Audit and periodic assessment of the financial system.

17. The accounts of the State/ grantee institution/ organization shall be open to inspection

by the sanctioning authority and audit by the Comptroller and Auditor General of India

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under the provisions of CAG (DPC) Act 1971 and internal audit by Principal Accounts

Office of the Ministry of Health & Family Welfare.

18. State shall ensure submission of details of unspent balance indicating, inter alia, funds

released in advance and funds available under State Health Societies. The State shall

also intimate the interest amount earned on unspent balance. This amount can be spent

against activities already approved and will also count towards the central share.

F. Miscellaneous

19. The State shall ensure establishment of supportive supervisory structures for RCH and

other national programmes in lagging districts and for ensuring quality services, within

six months of the issue of the Order.

20. The State shall maintain essential drug list /develop Standard Protocols , and enforce its

implementation through State machinery.

21. Component for the salary of staff and mobility support which is being approved in IDSP

Annexure would be subject to approval of EPC/MSG under NRHM. The support for

expenditure to be incurred by Central Surveillance Unit (CSU) and the State is subject to

approval of World Bank for restructuring and Extension.

22. State shall ensure taking appropriate action to monitor the performance of the cold chain

/ILR Points and implementation details of ProMIS.

Yours faithfully

(G.R Khetarpal)

Under Secretary to the Govt. of India

011-2306 1203

Copy to:

1. All JSs in the Ministry of Health and Family Welfare 1. All Programme Division Heads of NRHM/ RCH/ Disease Control Programmes 2. DS/Director Finance (NRHM) 3. All Under Secretaries concerned 4. IFD 5. PPS to Secretary(H&FW)/PS to AS&MD, NRHM 6. Sanction Folder

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ATTACHMENT A

Approval of RCH II PIP 2010-11

S. No. Activity Proposed Approved(Rs. Lakhs)

Major expected outcome in PIP

1

Maternal health( excluding JSY)

50.87 320 outreach camps and 96 RCH camps. Mother and baby kit to ensure 48 hrs. stay of mother at HF.

2 JSY 163.97 1000 home deliveries, 12963 institutional deliveries

3 Child Health 61.40 13 IMNCI districts .Awareness programme in 16 districts,10 schools per district.

4 Family Planning( excluding compensation )

8.36 32 female sterilization camps. 32 NSV camps.

5 Sterilisation & IUD compensation & NSV camps

26.05 1600 female sterilizations, 7500 IUDs

6 ARSH 57.8 Adolescent clinics in 14 DH/GH 7 URBAN RCH 46.16 2 UHC 8 INNOVATIONS/ PPP/

NGO 520.17 16 PHCs under PPP and 2 existing MNGOs and 5 new

MNGOs 9 INFRASTRUCTURE & HR 270.74 112 ANMs, 60 LTs (30 existing and 30 new), 60 SNs

and 2 Statistical Investigators. One FRU, Eight 24x7 PHC, Four FRUs.

10 INSTITUTIONAL STRENGTHENING

100.19 1 HR consultant, 1 logistics consultant and One HMIS and 21 data assistants, annual maintenance of state HMIS/M&E cell.

11 TRAINING 192.14 Equipment for SIHFW; training consultant, 25 MOs and 120 ANM/GNM for SBA training, 1 master trainer and I MO for EmoC, 4 MO for Life saving Anaesthesia skills training, 50 MOs - MTP training, 40 MO, 20 ANM, 25 GNM- RTI / STI Training, 52 MO and 52 ANM- IMNCI, 30 MO and 30 ANM/GNM- Facility Based Newborn Care, F-IMNCI - 10 ToT, 60 MO, 60 ANM/ GNM; NSSK – 16; Capacity building for New born and child stabilization unit at FRU - 6 MO and 6 SN; Multi-skilled training on paediatrics – 6 MOs-Other CH training . 3 gynaecologists- Laparoscopic Sterilisation. 25 MOs- Minilap Training, 51 MOs and 230 ANMs- IUD Insertion Training, 80 MO/officials- Contraceptive Update Training, 32 MO and 160 ANM/GNM-ARSH training and Refresher training of 364 ANMs, QAC state level 9 members,144 district members.

12 BCC / IEC 73.91 13 PROCUREMENT 182.70 Anaesthesia equipment for 1 DH; Delivery Kits for 31

CHCs and 85 PHCs; One Genset for DH Changlang; 16 Gensets for PHCs / CHCs; 550 MVA sets; 30 MTP sets; 50 Binocular Microscopes and SNCU equipment for one FRU; 3 NBSU for 3 FRUs; 71 NBCC equipment.

14 PROGRAM MANAGEMENT

192.55

GRAND TOTAL RCH II 1947.01

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ATTACHMENT-B

APPROVAL OF MISSION FLEXI POOL

S. No.

Activity Proposed Approved(Rs. Lakhs)


1 ASHA 386.2 3862 Functional ASHAs in place with Drug Kits and trained up to the 6th Module

2 Untied funds 365.25 3 Hospital

Strengthening(Upgradation of CHCs, PHCs, Dist. Hospitals to IPHS)

25 BMW Management in DH efficiently executed

Annual Maintenance Grants

100.8 Minor maintenance activities done in all CHCs, Minor maintenance activities done in all PHCs, Minor modifications for service delivery, well maintained SC.

New Constructions/ Renovation and Settingup

829.4 Availability of 24 hours services by ensuring stay of health workers, Availability of 24 hours by ensuring stay of health workers, Functional Labour Room with all accessories, Functional OT with surgeries including CS being carried out by posting of specialists, Round the clock ensured services at 24X7 PHCs. Pregnant Women from faraway places are staying in the facility before delivery, SCs are functioning in their own building.

Corpus Grants to HMS/RKS

195 Functional RKS with Community Ownership, Functional RKS at all CHCs and more Community Involvement, Functional RKS with Community Ownership, Timely formulation and submission of need based SPIP and 16 DHAPs.

IEC- NRHM 252.8 Coverage of unreached areas and remote areas along with documentation of performance, Regular Camps organised by MMU.

Referral Transport 54 Referral services functional at PHCs

Additional Contractual Staff (Selection, Training, Remuneration)

446.28 Round the clock services at 24X7 PHCs ensuring availability of qualified manpower. Regular service delivery at SCs, Regular service delivery at PHCs and 24X7 functional PHCs Specialist services made available, Dental Care at PHC/CHC made available, Diagnostic services ensured at CHC level Breakdown time minimised for cold chain.

Training 97.23 State Level Training facilities functional. Improved Financial Management at Health Institutions, Localised Action taken on deficiencies. Timely submission of FMRs.

Planning, Implementation and Monitoring

5.23 Training completed and Community Monitoring Process operational

Support Services 66.58 Continuous supply of water and electricity. Proper waste management. Culture & DST Lab in the state fully functional as planned; 2) Funds in the head utilized against approved amount. Uninterrupted supply of electricity.

NRHM Management Costs/ Contingencies

80.64 Management of health institutions strengthened.

Differential Planning for Difficult/ Most Difficult & Inaccessible Areas

119.28 Retaining staff at difficult areas to ensure service delivery, Retaining staff to ensure service delivery.

Grand Total 3023.68

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ATTACHMENT-C

APPROVAL OF IMMUNIZATION STRENGTHENING PROGRAMME

S. No.



1 Mobility support for Supervision and Monitoring at districts and state level.

9 Improved supervision for programme

2 Cold Chain Maintenance 2.4 Strengthening of cold chain 3 Alternate Vaccine Delivery to Session

sites 9.33 Timely supply of vaccine to 9336

session sites 4 Focus on urban slum & underserved

areas 5.37 Conduction of 384 session to

urban area/urban slums 5 Social Mobilization by ASHA /Link

workers 14 Ensure universal access

6 Computer Assistants support at State / District Level

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7 Printing and dissemination of immunization cards, tally sheets, charts, registers, receipt book, monitoring formats etc. 3

Strengthen Monitoring

8 Quarterly review meeting at state level 4.75 Regular meeting for Programme Review 9 Quarterly review meeting at District

level 5.01 10 Quarterly review meeting at block level 10.5 11 District level Orientation for 2 days

ANMs, MPHW,LHV 44.36 Capacity building of Medical Officers, Health Workers and other Immunization related staffs 12 Three days training of Mos on RI 16.25

13 One day refresher training of District Computer Assistant 0.79

14 One day Cold Chain Handlers Training 3.63 15 To develop micro plan at sub-centre

level 0.27 Conduction of 273 session regularly

16 For consolidation of micro plan at block level 1.62

17 POL for vaccine delivery from state to District and PHC/CHCs

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18 Consumables for computer including provision for internet access

0.82

19 Red/Black/Zipper bags 0.4 Injection waste disposal as per CPCB guidelines 20 Bleach/Hypochlorite solution 0.65

21 Twin Bucket 0.52 22 Bio Medical Waste Pit 6.4 23 POL and maintenance for WIC generator

at State Headquarter 0.5

Total 178.57

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ATTACHMENT-D APPROVAL OF RNTCP

S. No.



1 Civil works 16.50 1)Civil work Upgradation and maintenance completed as planned; 2) Funds in the head utilized against the approved amount

2 Laboratory materials

12.00 1) Sputum of TB Suspects Examined per lac population per quarter; 2) All districts subjected to IRL OSE and Panel Testing in the year; 3) IRLs accredited and functioning optimally; 4) Funds in the head utilized against the approved amount

3 Honorarium 10.00 1) All eligible Community DOT Providers are paid honorarium in all districts in the FY; 2) Funds in the head utilized against the approved amount

4 IEC/ Publicity 15.00 1) All IEC/ACSM activities proposed in PIP completed; 2) Increase in case detection and improved case holding; 3) Funds in the head utilized against approved amount

5 Equipment maintenance

4.92 1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as planned; 2) All BMs are in functional condition; 3) Funds in the head utilized against approved amount

6 Training 11.00 1) Induction training, Update and Re-training of all cadre of staff completed as planned; 2) Funds in the head utilized against approved amount

7 Vehicle maintenance

22.15 1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained; 2) Funds in the head utilized against approved amount

8 Vehicle hiring 10.28 1) Increase in supervisory visit of DTOs and MOTCs; 2) Increase in case detection and improved case holding; 3) Funds in the head utilized against approved amount

9 NGO/PP support 20.00 1) Increase in number of NGOs/PPs involved in signed schemes of RNTCP; 2) Contribution of NGOs/PPS in case detection and provision of DOT 3) Funds in the head utilized against approved amount

10 Miscellaneous 42.00 1) All activities proposed under miscellaneous head in PIP completed; 2) Funds in the head utilized against approved amount

11 Contractual services

132.33 1) All contractual staff appointed and paid regularly as planned; 2) Funds in the head utilized against approved amount

12 Printing 10.00 1) All printing activities at state and district level completed as planned

15 Procurement –vehicles

5.00 1) Procurement of vehicles completed as planned; 2) Funds in the head utilized against approved amount

16 Procurement – equipment

1.80 1) Procurement of equipments completed as planned; 2) Funds in the head utilized against approved amount

Total 312.98

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APPROVAL OF NVBDCP

S. No.



1 Malaria 613 Efforts should be made to train all ASHAs and community volunteers to enable early diagnosis and complete treatment in these areas. The referal mechanism should be strengtherned in these disricts for timely referal and provision of critical care services should be ensured at the rereral centers to prevent the deaths.

2 JE 5.00 3 Decentralized drugs 12.17 Total Cash assistance

under NVBDCP 630.17

4 Commodity support under NVBDCP

5 Commodity support for Malaria by GoI

190.15

6 Commodity support under GFATM

66.60 for LLINS, SP ACT, Artemesiinine inj and RDKs

Total 886.92

APPROVAL OF IDSP

S. No.



1 Surveillance Preparedness

118.34 Training of Hospital Doctors, Training of Hospital Pharmasist / Nurses, Training of Data Managers & DEO.

2 Outbreak investigation and response

4.88 Estimated to get 10 informations per month from volunteers a total of 120 such information in a year per district. Consumables for District Labs

3 Analysis and use of data

3.94

Total 127.16

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APPROVAL OF NPCB

S. No.



Recurring Grant-in-aid-

100.00 free Cataract operations, and other Approved schemes

Non recurring Grant-in-aid-

110.50 For Vision Centres, For Eye Bank, For NGOs, For Eye Wards & Eye OTs

Contractual Manpower-

34.08 Ophthalmic Surgeon

Total 244.58

APPROVAL OF NIDDCP

S. No.



1 Establishment of IDD Control Cell

7.00 Better implementation and monitoring of programme activities.

2 Establishment of IDD Monitoring Lab

4.00 Monitoring of iodine content of salt and urine samples in districts.

3 a)Health Education and Publicity b) Salt Testing Kits supplies by GOI (20,000 No)

24.00

Increased awareness about IDD and iodated salt. Creating iodated salt demand and monitoring of the same at community level.

4 IDD surveys 3.00 Prevalence of IDD in 6 districts of state Total 38.00

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APPROVAL OF NLEP

S. No. Activity Proposed Approved(Rs. Lakhs)


1 Contractual Services

10 Functional leprosy cell at state/district level

2 Services through ASHA/USHA

0.5 Functional leprosy cell at state/district level

3 Office expenses & Consumables

6 Functional leprosy cell at state/district level

4 Capacity building 11 Improvement in skills in diagnosis & treatment of leprosy

5 Behavioral Change Communication

10 Better self reporting as a result of increased awareness

6 POL/Vehicle operation & hiring

13.5 Improvement in mobility of SLOs & DLOs

7 DPMR 3.5 Decrease in recurrence of foot ulcers and reduction in grade II disability through RCS

8 Material & Supplies 2.5 Management of reaction cases 9 Supervision,

Monitoring & Review

4 Better, supervision & monitoring of programme

10 Cash assistance 4 Better, supervision & monitoring of programme

Total 65

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ATTACHMENT-F

The State agrees to the following targets to be achieved during/up to 2010-2011.

SL ACTIVITY /

MEASURABLE

INDICATOR

ACHIEVEMENT

IN/UP TO 2009-10 TARGET

(CUMULATIVE)

IN/UP TO 2010-2011

ADDITION

DURING THE

YEAR

I Monitoring Progress

Against Standards

A Maternal Health

1 Institutional Deliveries 47% 60% 13%

2 24X7 Primary Health

Centres

20 (17%) 30 (26%) 10

3 Functional First Referral

Units

3 (21%) 7(50%) 4

4 Functional Sub Centres 273 (48%) 303(54%) 30

B. Child Health

5 Sick New Born Care Units 0 1(7%) 1

Newborn Corners in PHCs 3 (3%) 71(61%) 68

6 Stabilization Units in CHCs 0 3(10%) 3

7 Full Immunization 40% > 70% 30%

C. Population Stabilization

8 Male Sterilization 1 upto Jan '2010

(0%)

5(0.0023%) 5

9 Female Sterilization 1021 upto Jan

'2010 (0.49%)

3200(2%) 3200

10 No. of IUD insertions 863 upto Jan 2010

(7.45%)

30,000 (14%) 30000

D. Disease Control

11 Case Detection Rate of TB

among new sputum

positive patients

91% (2009) > 93%

12 Treatment Success Rate

among new sputum

88% (2009) >88%

15

positive patients initiated

on DOTS

13 ABER for malaria 17.5% (2009) >10%

14 API for malaria 18.05 (2009) 15

15 No. of Reconstructive

surgeries performed under

NLEP

Nil 5

16 Annual New Case

Detection Rate for Leprosy

(per lakh population)

2.8 2.7

17 Cataract Surgeries

performed

579 600

II. Human Resource

including training

18 Appointment of ANMs 100% 100% 0 ( to continue with

the already

appointed 252

ANMs)

19 Appointment of Staff

Nurses

194 194 Continue with the

existing

20 Percent of ANMs trained as

Skilled Birth Attendant

53 till Jan 2010

(35%)

120(79%) 67

21 Doctors trained on EmOC 5 (36%) 5+2(50%) 2

22 Doctors trained on LSAS 5 (36%) 5+4 4

23 Doctors trained in NSV/

Conventional vasectomy

35 doctors 3

24 Doctors trained in Minilap

Tubectomy

42 Doctors 25

25 Doctors trained in

laproscopic Tubectomy

9 Doctors -

26 Personnel trained in IMNCI 79 MO (60%) + 60

Nurses (54%)

131 MO, 112 Nurses 52 MO (40%), 52

Nurse (46%)

III. Communitisation Process

27

Functional VHSCs 2177 (56%) 3012(78%) 835

16

28 ASHAs completed four

modules of training

(minimum 15 days

training)

2229 (58%) 3862(100%) 1633

29 ASHAs with Drug kits 2622 (68%) 3862(100%) 3862 (to all ASHAs)

30 Percent expenditure of

NRHM funds through Non

Governmental

organizations.

100% 100% 100%

31 Percentage Districts having

community monitoring

system in place

0 2(13%) 2(13%)

IV Flexible Financing

32 Percent utilization of untied

grants

Very less 70% 70%

V Improved Management

33 Percent districts uploading

timely HMIS Data and

confirming

60% districts 90% districts 30%

34 Tracking of pregnant

mothers and children

0 Proposed for all

districts i.e 16 districts

16

35 Computerization of HMIS

(level of data entry and unit

of data entry)

District level District level District level to be

strenghtend

36 Cold Chain Management (

No. of functional ILR

points)

80 96 16

37 Procurement System (

implementation of Pro

MIS/ TMNSC like

structure)

nil Proposed during 10-

11

Proposed during

10-11

VI Backward Districts

38 Functional Mobile Medical

Units

16 (100%) 16(100%) 0 (continue with

the exiting MMUs)

39 Backward district thrust – 0 East Kameng, Kurung 4 districts

17

special interventions and its

monitoring in place in

percent districts

Kumey, Upper

Subansiri

40 Difficult, Most Difficult,

inaccessible area thrust in

provision of infrastructure

and human resources.

0 Proposed for 3

categories

131 difficult area, 72

most difficult and 87

inaccessible areas

identified and

proposed for HR &

Infrastructure

Proposed for 3

categories

131 difficult area,

72 most difficult

and 87 inaccessible

areas identified and

proposed for HR &

Infrastructure

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Attachment G

NATIONAL RURAL HEALTH MISSION

RECORD OF PROCEEDINGS 2010-11

Record of Proceedings of the National Programme Coordination Committee (NPCC) for

Arunachal Pradesh held under the Chairmanship of Shri P.K. Pradhan, Additional Secretary

and Mission Director, NRHM for approval of NRHM Programme Implementation Plan (PIP)

of State and UTs for the year 2010-11.

I. A meeting of the NPCC of NRHM was held under the Chairmanship of AS & MD,

NRHM, to approve the PIP of .Arunachal Pradesh on 04.03.2010. The list of members who

attended the meeting is placed at Annex. VI. The NPCC meeting was convened after the pre-

appraisal meeting for the State, with written and oral comments provided to the State to modify

the proposal before the NPCC.

II. State Government apprised about the likely uncommitted unspent balance available

under NRHM as on 1.4.2010, and were apprised of the GOI Resource Envelope for 2010-11

under NRHM which is 15% higher than current year’s Budget Estimate for over planning

purpose and 15% State share. It was also clarified that the actual resource allocation shall be in

accordance with the budgetary allocation of 2010-11 and may be lower than the resource

envelope indicated. The Monitorable Targets for the State was also indicated. It was stated that

the budgets may be realigned to achieve Monitorable Targets in case there has been inadequate

provision in the PIP, to meet national goals. After detailed discussions and subsequent

deliberations, the PIP was finalised for amounts indicated under different components as

detailed in the Annexure I to V.

III. The attention of the State was drawn to the following areas for further action :

A. Planning

1. The State Government shall, within 45 days of the issue of Record of Proceedings by the

Ministry of Health and Family Welfare, issue detailed Record of Proceedings for each district.

B. Human Resource

2. All posts under NRHM on contract and based on local criteria shall be done by the Rogi

Kalyan Samiti /District Health Society. Residence at place of posting must be ensured.

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3. Blended payments comprising of a base salary and a performance based component, should

be encouraged.

4. Transparent transfer and career progression systems should be implemented in the State.

5. The State shall put in place a transparent and effective human resource policy so that

difficult, most difficult and inaccessible areas attract and retain human resources for health.

C. Infrastructure

6. The State shall furnish list of facilities to be upgraded with identification of inaccessible

and remote facilities and finalization of district action plans for the identified backward districts

within three months.

7. The State shall furnish information relating to physical and financial status of

infrastructure and building works already taken up every quarter to Infrastructure Division.

8. The State shall under take all construction activities in meeting health infrastructure

gaps with particular focus in backward districts and inaccessible facilities.

D. Communitisation

9. The State shall take up capacity building exercise of Village Health and Sanitation

Committees, Rogi Kalyan Samitis and other community /PRI institutions at all levels, involving

Non Governmental organizations after a selection process.

10. The State shall ensure regular meetings of all community Organizations /District /State

Mission with public display of financial resources received by all health facilities.

11. The State shall also make contributions to Rogi Kalyan Samitis besides introducing user

charges wherever feasible protecting the interest of the poor.

12. All performance based payments/incentives should be under the supervision of

Community Organizations (PRI)/RKS.

13. The State shall focus on the health entitlements of vulnerable social groups like SCs, STs,

OBCs, minorities, women, disabled friendly, migrants etc.

E. HMIS

14. State shall set up a transparent and credible procurement and logistics system. State agrees

to periodic procurement audit by third party to ascertain progress in this regard.

15. The State shall undertake institution specific monitoring of performance of Sub Centre,

PHCs, CHCs, DHs, etc. in the prescribed format which is to be regularly uploaded as Monthly,

Quarterly and Annual Data on the HMIS.

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F. Specific Programme Related

16. The State shall operationalise fixed day services in family planning in addition to periodic

camps.

17. The states shall henceforth provide only F-IMNCI training to doctors and staff nurses

whilst IMNCI is to be provided only to ANMs/AWW and other field functionaries.

18. The State Govt. would co-locate AYUSH in PHCs/CHCs, wherever feasible.

19. The State shall undertake the following on priority basis

• Adhere to the norms of manpower and service delivery for opening any health

institutions in the state.

• Proper sanction before opening any health institution by the State Govt.

• Facility based approval and Completion of civil works approved under NRHM on

priority.

• Rational posting of ANMs and ensuring availability of ANM at vacant sub-centres.

• Ensuring quality service delivery as per 24X7 guidelines at CHCs and PHCs.

• Creating DPMU units in remaining districts and making them fully operational.

• Ensuring implementation of Financial and administrative delegation of power up to

facility level (PHCs).

• Concurrent audit at districts and periodic review of financial status.

• Adherence of rules for Procurement of drugs and consumables.

• Utilization of MMU for patient services.

IV. Based on the State’s PIP and deliberations thereon the Plan for the State is finalised as

per the detail of Annexure I (RCH Flexible Pool), Annexure II (NRHM Flexible Pool), Annexure-

III (Immunization) & Annexure –IV (National Disease Control Programmes) with summary of

Infrastructure , Human Resource and Training at Annexure V.

21

ANNEX-I APPROVAL OF RCH II PIP 2010-11: ARUNACHAL PRADESH

(Rs. Lakhs) S.

No. BUDGET HEAD PROPOSED APPROVED

1 Maternal Health 89.23 50.87 2 Child Health 92.61 61.40 3 Family Planning 38.56 8.36 4 ARSH 57.80 57.80 5 Urban RCH 46.16 46.16 6 Tribal RCH 0.00 0.00 7 Vulnerable Groups 0.00 0.00 8 Innovations/ PPP/ NGO 612.57 520.17 9 Infrastructure & HR 529.40 270.74 10

Institutional Strengthening 100.19 100.19

11

Training 364.22 192.14

12

BCC / IEC 246.37 73.91

13

Procurement 182.70 182.70

14

Programme Management 212.10 192.55

Total RCH II Base Flexi Pool 2571.91 1756.99 15

JSY 216.96 163.97

16

Sterilisation & IUD Compensation, and NSV Camps 57.80 26.05

Total RCH II Demand Side 274.76 190.02 GRAND TOTAL RCH II 2846.67 1947.01 NOTE: 1. Activities have been re-classified as per FMR/ Operating Manual heads; details are

provided in attachment “A”. 2. Details of activities approved/ not approved, and specific comments, are provided in

attachment “A”. 3. Expenses are to be booked as approved in attachment “A”. 4. The above includes Rs. 78.96 lakhs for programme management proposed by the State

under Mission flexible pool; shifted to RCH II (see details in attachment “A”, A.14 – Programme Management).

22

ATTACHMENT “A” Summary of RCH-II PIP 2010-11

(Rs. Lakhs) FMR Code ACTIVITY PROPOSED

(Rs. Lakhs) APPROVED (Rs. Lakhs)

EXPECTED OUTPUT

REMARKS

A.1 MATERNAL HEALTH A.1.3 Integrated outreach RCH

services

A.1.3.1 RCH Outreach Camps 25.28 25.28 320 outreach camps and 96 RCH camps

A.1.4 Janani Suraksha Yojana / JSY A.1.4.1 Home Deliveries 5.00 5.00 1000 deliveries A.1.4.2 Institutional Deliveries 211.96 158.97 12963

deliveries State needs to provide bifurcation of urban and rural beneficiaries and adhere to JSY guidelines for payment to ASHA and beneficiaries. (approved 75% of the budget, target lowered)

A.1.4.2.1 Rural A.1.4.2.2 Urban

A.1.5 Other strategies/activities 63.95 25.59 12797 mothers Mother and baby kit to ensure 48 hrs. stay of mother at HF approved @ 200 per kit instead of Rs 500 proposed

Sub-total Maternal Health (excluding JSY)

89.23 50.87

Sub-total JSY 216.96 163.97 A.2 CHILD HEALTH A.2.1 Integrated Management of

Neonatal & Childhood Illness/IMNCI

30.20 30.20 13 IMNCI districts

State needs to provide details of the activities

A.2.4 School Health Programme 62.41 31.20 Awareness programme in 16 districts,10 schools per district

Activities approved, 50% of budget approved as State has utilized only 15% of the budget approved in 2009-10

Sub-total Child Health 92.61 61.40

23

FMR Code ACTIVITY PROPOSED


EXPECTED OUTPUT

REMARKS

A.3 FAMILY PLANNING A.3.1 Terminal/Limiting Methods A.3.1.2 Female Sterilisation camps 2.56 2.56 32 camps A.3.1.3 NSV camps 4.80 4.80 32 camps A.3.1.4 Compensation for female

sterilisation 32.00 16.00 1600 sterilizations

50% approved based on last year’s performance

A.3.2 Spacing Methods A.3.2.2 IUD services at health

facilities / compensation 21.00 5.25 7500 IUDs 25% approved based

on last year’s performance

A.3.5. Other strategies/activities 36.00 5.80

QACs at state and 16 districts

QAC details given in PIP is of Rs. 5.80 lakhs only

Sub-total Family Planning (excluding compensation)

38.56 8.36

Sub-total Sterilisation & IUD compensation & NSV camps

57.80 26.05

A.4 ARSH A.4.1 Adolescent services at health

facilities. 57.80 57.80 Adolescent clinics in 14 DH/GH

Sub-total ARSH 57.80 57.80 A.5 URBAN RCH A.5.1 Urban RCH Services

46.16 46.16

2 UHC The amount proposed in the original PIP was Rs 105.36 lakhs which was reduced to Rs 54.68 lakhs in revised PIP dated 22nd Feb 2010. Revised Annex 3e sent on March 24, 2010 shows Rs 46.16 lakhs, but there is no revised write up attached. The amount is approved subject to that the changes in the salary component have been made as decided in the NPCC.

Sub-total Urban RCH 46.16 46.16

24



EXPECTED OUTPUT

REMARKS

A.6 TRIBAL RCH Sub-total Tribal RCH 0.00 0.00 A.7 VULNERABLE GROUPS Sub-total Vulnerable Groups 0.00 0.00 A.8 INNOVATIONS/ PPP/ NGO A.8.2 Public Private Partnerships 537.36 482.57 16 PHCs under

PPP As mentioned in last year's RoP the State has to share the budget. Management of PHCs was approved for a period of 3 years (ending 2008-09). State was asked to provide the evaluation report, and as mentioned in the PIP last year, the state was to meet the expenditure towards salary of MOs and administrative staff from State Budget. State needs to ensure the above. State was also asked to provide a sustainability plan for this intervention from 2010-11 onwards. PPP for 16 PHCs and 1 CHC approved subject to above mentioned points. Approved as per last year's rate. In case of scale up, the State has to share the cost.

A.8.3 NGO Programme

75.21 37.60

2 existing MNGOs and 5 new MNGOs

50% of the proposed budget approved as the State has not reported any expenditure in 2009-10

Sub-total 612.57 520.17

25



EXPECTED OUTPUT

REMARKS

Innovations/PPP/NGO A.9 INFRASTRUCTURE & HR A.9.1 Contractual Staff & Services A.9.1.1 ANMs

188.16 96.76 112 ANMs State has proposed

Rs. 14000/ month, whereas ANMs and LTs were approved @ Rs. 6000 last year. Considering 20% hike salary would be Rs. 7200 - approved accordingly.

A.9.1.2 Laboratory Technicians

100.80 51.84

60 LTs (30 existing and 30 new)

A.9.1.3 Staff Nurses

129.60 64.80

60 SNs State has proposed Rs. 18000/ month, whereas SNs were approved @ Rs. 7500 last year. Considering 20% hike salary would be Rs. 9200 - approved accordingly.

A.9.1.5 Other contractual staff 3.84 3.84 2 Statistical

Investigators .

A.9.2 Major civil works (new construction/extension/ addition)

A.9.2.1 Major civil works for operationalisation of FRUS

10.00 5.00 One FRU 50% amount

approved. A.9.2.2 Major civil works for

operationalisation of 24 hour services at PHCs

72.00 36.00 Eight 24x7 PHC

50% amount approved.

A.9.3 Minor civil works A.9.3.1 Minor civil works for

operationalisation of FRUs 25.00 12.50

Four FRUs 50% amount approved.

Sub-total Infrastructure & HR

529.40 270.74

A.10 INSTITUTIONAL STRENGTHENING

A.10.1 Human Resources Development

3.00 3.00 1 HR consultant

A.10.2 Logistics management/ improvement

3.00 3.00 1 logistics consultant

A.10.3 Monitoring & Evaluation / HMIS

94.19 94.19 One HMIS and 21 data assistants,

Approved, subject to time bound action plan for uploading

26



EXPECTED OUTPUT

REMARKS

annual maintenance of state HMIS/M&E cell

data on the HMIS Portal and improvement in data quality

Sub-total Institutional Strengthening

100.19 100.19

A.11 TRAINING A.11.1 Strengthening of Training

Institutions 32.40 16.20 Equipment for

SIHFW; training consultant

50% approved.

A.11.3 Maternal Health Training A.11.3.1 Skilled Birth Attendance /

SBA

48.32 24.16 12 MOs and 60 ANM/GNM

As per revised GoI guidelines, SBA Training is of 21 days duration for all cadre of health workers. State may revise accordingly. 50% approved.

A.11.3.2 EmOC Training 6.46 6.46

1 master trainer and I MO

A.11.3.3 Life saving Anaesthesia skills training 9.78 9.78 4 MO

A.11.3.4 MTP training 16.36 8.18 25 MOs 50% approved. A.11.3.5 RTI / STI Training

2.95 1.48 20 MO, 10 ANM, 12 GNM

50% approved.

A.11.3.7 Other MH Training 1.83 1.83 10 MO and 10

LT

A.11.5 Child Health Training A.11.5.1 IMNCI

14.19 7.10 26 MO and 26 ANM

IMNCI is being recommended only for ANM/AWW/health workers only, not for MOs and SNs. 50% approved.

A.11.5.2 Facility Based Newborn Care

12.89 6.45 15 MO and 15 ANM/GNM

F-IMNCI is being recommended for MOs and SNs only. 50% approved.

A.11.5.5 Other CH Training 40.96 20.48 F-IMNCI - 5

ToT, 30 MO, 30 MOs/SNs should be trained in NSSK. F-

27



EXPECTED OUTPUT

REMARKS

ANM/ GNM; NSSK – 8; Capacity building for New born and child stabilization unit at FRU - 3 MO and 3 SN; Multi-skilled training on paediatrics – 3 MOs

IMNCI is being recommended as a multi skilling training package for MOs for meeting the acute shortage of specialists. 50% approved.

A.11.6 Family Planning Training A.11.6.1 Laparoscopic Sterilisation

Training 2.00 2.00 3 gynaecologists

A.11.6.2 Minilap Training 6.80 3.40 12 MOs 50% approved. A.11.6.4 IUD Insertion Training

26.26 13.13 25 MOs and 115 ANMs

50% approved.

A.11.6.5 Contraceptive Update Training

5.67 5.67 40 MO/officials

50% approved.

A.11.7 ARSH Training 15.86 15.86 16 MO and 80

ANM/GNM 50% approved.

A.11.9 Other training

91.99 45.99

Refresher training of 182 ANMs, QAC state level 9 members,144 district members

50% approved.

A.11.9.1. Continuing Medical & Nursing Education 29.50 29.50 200 MOs and

150 GNMs 50% approved.

Sub-total Training 364.22 192.14 A.12 BCC / IEC A.12.1 Strengthening of BCC/IEC

Bureaus 33.14 9.94 Activities approved. Budget approved for 30% of the proposed budget as the reported expenditure of the State in IEC/BCC is only 50 % of Rs.90.46 lakhs approved for 2009-10

A.12.2 Development of State BCC/IEC strategy

9.60 2.88

A.12.3 Implementation of BCC/IEC strategy

0.00

A.12.3.1 BCC/IEC activities for MH 36.28 10.88 A.12.3.2 BCC/IEC activities for CH 40.00 12.00 A.12.3.3 BCC/IEC activities for FP 20.20 6.06 A.12.3.4 BCC/IEC activities for ARSH 25.60 7.68 A.12.4 Other activities 81.55 24.47

28



EXPECTED OUTPUT

REMARKS

Sub-total BCC/ IEC 246.37 73.91 A.13 PROCUREMENT A.13.1 Procurement of Equipment A.13.1.1 Procurement of MH

equipment 78.45 78.45 Anaesthesia

equipment for 1 DH; Delivery Kits for 31 CHCs and 85 PHCs; One Genset for DH Changlang; 16 Gensets for PHCs / CHCs; 550 MVA sets; 30 MTP sets; 50 Binocular Microscopes

A.13.1.2 Procurement of CH equipment

104.25 104.25 SNCU equipment for one FRU; 3 NBSU for 3 FRUs; 71 NBCC equipment

Sub-total Procurement 182.70 182.70 A.14 PROGRAM

MANAGEMENT

A.14.1 Strengthening of State society/ SPMU

11.76 11.76 SPMU and DPMU cost shifted from Mission Flexipool A.14.2 Strengthening of District

society/ DPMU 67.20 67.20

A.14.3 Strengthening of Financial Management systems 48.48 39.28 Details in PIP are for

Rs. 39.28 lakhs only A.14.4 Other activities (Program

mgmt. expenses, mobility support)

84.66 74.31

Rs. 10.35 lakhs for maintenance of vehicles not approved. State may provide its own funds.

Sub-total Program Management

212.10 192.55

Total RCH II Base Flexi Pool 2571.91 1756.99 Total RCH II Demand Side 274.76 190.02

29



EXPECTED OUTPUT

REMARKS

GRAND TOTAL RCH II 2846.67 1947.01

RECLASSIFICATION OF ACTIVITIES Activities from the revised PIP sent by the state (post NPCC) have been reclassified as per the FMR/ operating manual heads. State needs to comply with this while booking the expenses and reporting in FMR:

1. A.1.3.1 RCH outreach camps include RCH camps and RCH outreach camps both.

2. Other Strategies under MH A.1.5 includes Mother and Baby kits for ensuring 48 hours stay.

3. Other Innovations(QAC) proposed by state has been included under A.3.5 ‘ Other activities under family planning

4. Strengthening of training institutes include Rs.3 lakhs for Contractual staff recruited and in position

5. A.9.1.5 Others under contractual staff and services include Rs.3.84 lakhs for statistical investigators

6. A.11.5.5. Other CH trainings include F-IMNCI, Navjaat Sishu Suraksha Karyakaram,

and Capacity building for NCSU.

7. A.11.9.1. Other training includes • Refresher training of ANM • Quality Assurance training • HMIS • PC & PNDT • IEC/BCC training • Workshop for PRI • Ultrasound for MO

8. Strengthening of SPMU and DPMU has been shifted from Mission flexi-pool. The

amounts mentioned in strengthening of SPMU –DPMU which were other programme management cost have been clubbed under other activities (programme management expenses etc.)

30

Annex-II

SUMMARY OF MISSION FLEXIBLE POOL (MFP) PIP 2010-11

Activity Proposed Amount ( in Lakhs)

Approved

Amount ( In

Lakhs)

Expected Output at the end of

2010-11

Remarks

B1 ASHA B1.1 Selection & Training of ASHA Training for 6th Sector (HBNC)

for 160 District Trainers 4.387 386.2 3862

Functional ASHAs in place with Drug Kits and trained up to the 6th Module

The expenditure of ASHA component during 2009-10 is low. The training and support system should be prioritised in 2010-11. Total budget proposed of 404.14 lakhs is higher than the allocated 10,000 per ASHA per year. The State has to prioritise activities related to ASHA within the approved budget of 386.20 lakhs

Training for 6th Sector (HBNC) for 4249 Trainees (3862 ASHAs + 387 ASHA Facilitators)

119.453

Training of newly recruited ASHA Facilitators & Community Mobilizers

6.348

Reorientation Training for 3862 ASHAs (12 days in a year)

48.275

B1.2 Procurement of ASHA Drug Kit Procurement of ASHA Drug Kit

@ 1300 X 3862 ASHAs once a year

50.206

B1.3 Performance related incentives to ASHAs

Performance Incentives for ASHA Facilitators

73.53

B1.4 Other ASHA Monthly Meeting with ASHA

facilitators and Block ASHA Coordinator at Block Level

7.026

Bi-Monthly Meeting with ASHAs and Block ASHA Coordinator at Block Level

46.344

Monthly Meeting of ASHA facilitators at District Level

18.576

Bi-Monthly Meeting of District Community Mobilizers at State Level

0.6

31

Honorarium for 16 District Mobilizers

23.04

Honorarium for 1 State Community Mobilizer

1.68

TA & DA for Field visits by AMG members and State Level Quarterly Meeting

4.68

B2 Untied Funds B2.1 CHC: 31 @ 50,000 15.5 15.5 Clean and

functional facilities

B2.2 PHC: 85 @ 25,000 21.25 21.25 B2.3 SC: 273 @ 10,000 27.3 27.3 B2.4 VHSC: 3012 @ 10,000 301.2 301.2 Organizatio

n of monthly VHND in all villages

During 2009-10 holding of VHNDs was poor .

B3 Hospital Strengthening B3.1 Upgradation of CHCs, PHCs,

Dist. Hospitals to IPHS

Incinerator installation in DH: 06 @ 25 Lakhs

150 25 BMW Management in DH efficiently executed

Arunachal Pradesh Pollution Control Board guidelines may be consulted. On pilot basis, operationalise in one facility.

B4 Annual Maintenance Grants B4.1 CHC: 31 @ 1 lakh 31 31 Minor

maintenance activities done in all CHCs

B4.2 PHC: 85 @ 50,000 42.5 42.5 Minor maintenance activities done in all PHCs

B4.3 SC: 273 @ 10,000 27.3 27.3 Minor modifications for service delivery, well maintained SC

B5 New Constructions/ Renovation and Settingup

32

Construction of Residential Quarter (Type III) for FRU “Ruksin CHC”: 05 @ 12 lakhs

60 36 Availability of 24 hours services by ensuring stay of health workers

Approved for 3 Quarters. Priority for emergency service providers

Upgradation of Koloriang CHC to DH: Approved activity of 18.11 Crores. 8.15 Crores released during 09-10

996 0 Functional District Hospital

Funding may be under Forward & Backward Linkages for NE States

Construction of 5 Type 3 residential quarters each in 8 CHCs: 40 Nos. (Jang, Dumporijo, Nari, Jengging, Mahadevpur, Palin, Mechuka, Maryang)

480 115.2 Availability of 24 hours by ensuring stay of health workers

Approved 3 doctors’ quarters in each CHC for 8 CHCs. As availability of doctors are not more than 2-3 in each CHC. 40% of approved fund of Rs. 288 Lakh to be provided in FY 2010-11.

Labour Room in 4 CHCs & 10 PHCs:1 4 Nos.

84 84 Functional Labour Room with all accessories

Construction of OT in Deomali CHC: 1 No.

12 12 Functional OT with surgeries including CS being carried out by posting of specialists

Construction of residential barracks At PHCs: 85 barracks at 23PHCs (Bameng, Mengio, Sangram, Nacho, Sille, Jeying, Anpum, Etalin, Wakro, Wallong, Khimiyong, Nampong, Wakka, Bana, Pakke Kessang, Jote, Tellam, Raga, Yachuli, Yangte, Maro, Lathao, Namtok)

1020 331.2 Round the clock ensured services at 24X7 PHCs.

Approved for 2 doctors quarter and one nurse quarter in all 23 PHCs to be operational as 24X7. As availability of doctors are only two and nurses also two, utilisation of quarters is to be

33

ensured. Earlier years releases for quarters for 15 PHCs for staff nurses may be verified to avoid duplication. 40% of Approved 828 to be released this year.

Provision of waiting rooms and furniture at 30 PHCs: 30 @ 3.25 lakhs

97.5 65 Pregnant Women from faraway places are staying in the facility before delivery

Approved for 20 PHCs functional as 24X7 and where round the clock doctors and nurses are staying as per situation analysis. .

Construction of SCs: 62 @ 12 lakhs

744 186 SCs are functioning in their own building

Estimates of quarters for all SCs are @12 lakhs. May be justified with drawing and APWD rates. Already approval of 85 new SC buildings and 122 quarter extensions has been granted till 2009-10. List of new construction to be submitted along with earlier sites of extension and new constructions. 25% of Approved 744 lakhs to be released this year.

B6 Corpus Grants to HMS/RKS B6.1 DH/GHs : 14 @ 5 lakhs 70 70 Functional

RKS with Community

Utilisation of Corpus grants with

34

Ownership community involvement may be documented and submitted.

B6.2 CHCs: 31 @ 1 lakh 31 31 Functional RKS at all CHCs and more Community Involvement

Utilisation of Corpus grants with community involvement may be documented and submitted.

B6.3 PHCs: 85 @ 5 lakhs 85 85 Functional RKS with Community Ownership

Utilisation of Corpus grants with community involvement may be documented and submitted.

Preparation of District Health Action Plan: 16 @ 50,000

8 8 Timely formulation and submission of need based SPIP and 16 DHAPs

Preparation of SPIP and State level reports on NRHM: 1 @ 2 lakhs

2 1

B10 IEC- NRHM B10.1 Health Mela: 16 @ 7.1 lakhs 113.6 80 Coverage of

unreached areas and remote areas along with documentation of performance

Approved @ 5 lakh / Mela

Support for MMU: 16 @ 9 lakhs 144 144 Regular Camps organised by MMU

Utilisation of MMU vehicles for patient services was very poor during 2009-10. Review of monthly activities of MMU to be monitored.

Salary of MMU Drivers: 48 @ 5000 / month

28.8 28.8

B12 Referral Transport

35

Ambulances for 24X7 PHC: 9 @ 6 lakhs

54 54 Referral services functional at PHCs

Already 20 PHCs were provided ambulances, only approved for 24X7 PHCs

Critical Care Ambulances for FRUs: 4 @ 19 lakhs

76 0 Not approved as FRUs are not functional.

Salary of ambulance drivers: 20 @ 5000 / month

12

B12.2 Operating Cost (POL) B13 School Health Programme Budgetted

under RCH B14 Additional Contractual Staff

(Selection, Training, Remuneration)

Contractual GNM: 134 @ 18,000 / month

289.44 144.72 Round the clock services at 24X7 PHCs ensuring availability of qualified manpower.

During 2009-10, salary was @ 7500/ pm. 20% increase of that agreed at @ 9000/pm.

Contractual ANM: 40 @ 14,000 / month

67.2 34.56 Regular service delivery at SCs

20% increase of 2009-10 salary @ 6000/ pm and fixed at @ 7200/ pm

Health Assistant: 20 @ 12,000 / month

28.8 0 Health Assistant is a Supervisory Staff of ANM. Salary proposed lower than of ANM. Whether these are assistants at sub-centres or other staff.

Contractual Doctors: 82 @ 30,000 / month

295.2 196.8 Regular service delivery at PHCs and 24X7 functional PHCs

Approved @ 20,000/ pm considering the existing salary of @ 15,000 /pm during 2009-10

Contractual Specialists: 3 @ 35,000 / month

12.6 12.6 Specialist services made available

Specialist may be agreed @ 35,000 as they are difficult to retain

36

BDS: 15 @ 30,000 / month 54 36 Dental Care at PHC/CHC made available

Approved @ 20,000/pm

Contractual Radiographer: 16 @ 14,000 / month

26.88 17.28 Diagnostic services ensured at CHC level

Approved @ 9000/ pm with 20% increase of 2009-10 salary

Refrigerator Mechanic: 4 @ 16,000 / month

7.68 4.32 Breakdown time minimised for cold chain.

Approved @ 9000 /pm

B16 Training B16.2 New Training Institutions/School State Training Centre: 1 @ 2

Crores 150 70 State Level

Training facilities functional

Approved amount was 2 Crores. In 2009-10 60 Lakh was sanctioned. Remaining amount would be 1.4 Crores. 50% of remaining cost to be provided this year.

District Level Clinical Training Center: 8 @ 8 lakhs: East Kameng, Lower Subansiri, West Siang, Lohit, Tirap, Tawang, Upper Subansiri, Dibang Valley

64 0 Not approved. Let State Govt. first operationalise State Level Training Centre.

Nursing School 1734.3 0 Separate DPR may be submitted to the Nursing Division or NE Division for funding under Forward & Backward Linkages.

B16.3 Training and Capacity Building Under NRHM

Orientation training on Financial Management & Accounting: 1 Batch of 105 Trainees

4.105 4.1 Improved Financial Managemen

37

Skill Upgradation Training on Finance, Accounts & Audit: 1 Batch of 105 Trainees

9.868 9.86 t at Health Institutions

Induction Training of Block Accountant: 1 Batch of 84 Trainees

4.176 4.176

Skill Upgradation Training on Customized Tally: 1 Batch of 105 Trainees

5.096 5.09 Timely submission of FMRs

Review Meeting: 4 @ 2.5 lakhs 10 4 Localised Action taken on deficiencies

Approved @ 1 lakh per meeting.

B16.3.4 Other Training B18 Planning, Implementation and

Monitoring

B18.1.2 District level Programme Management : 2

districts @ 75,000 1.5 1.5 Training

completed and Community Monitoring Process operational

2 Districts

Training: 2 batches @ 1.869 3.7375 3.73

B27 Support Services B27.3 Support Strengthening RNTCP B27.3.1 Procurement of vehicle for STDC

cum IRL 16 0 Not

Justified Provision already available under the RNTCP

4 wheeler and a Mini Bus

B27.3.2 Miscellaneous 11 11 Continuous supply of water and electricity.

May be approved, no provision under RNTCP

Digging of Bore Well ( Rs. 3 lakhs),

Transformer for 3 phases electric connection (Rs. 8 Lakhs)

B27.3.3 Procurement of equipment 10 10 Proper waste management


Mini Incinerator

B27.3.4 IEC Activity 5 0 Not Justified

Provision already available under the RNTCP

Publication of Booklet on TB.

38

B27.3.5 Procurement of equipment Culture & DST Lab in the state fully functional as planned; 2) Funds in the head utilized against approved amount


One Cold Room for IRL 15.51

B27.3.7 Silent Generator Set 15KVA 10.395 Uninterrupted supply of electricity


B27.6 Other Support Programmes IDSP Salary 187.38 0 Detail may be

from IDSP budget line.

Mobility Support: 17 @ 4,000 / month

8.16

Training: 17 @ 1 lakh 17 Immunization Cold Chain Room at the State

level 19.67 19.67

B28 NRHM Management Costs/ Contingencies

B28.1 Block Level PMU Block Accountant-cum-Data

Assistant: 84 @ 16,000 / month 161.28 80.64 Managemen

t of health institutions strengthened.

Approved @8,000/ pm increasing from @6,500/ pm during 2009-10.

B28.2 District level District Programme Manager: 16

@ 25,000 / month 48 0 Approved

under RCH District Accounts Manager: 16 @

20,000 / month 38.4 0 Approved

under RCH B28.3 State level State Finance Manager: 1 @

30,000 / month 3.6 0 Approved

under RCH State Accounts Manager: 1 @

25,000 / month 3 0 Approved

under RCH State Data Manager: 1 @ 25,000 /

month 3 0 Approved

under RCH State Accountant: 1 @ 18,000 /

month 2.16 0 Approved

under RCH

39

B31 Differential Planning for Difficult/ Most Difficult & Inaccessible Areas

B31.1 Incentive Scheme Difficult Area: 323 Staff @ 2000 /

month: ANM 83, MO 41, Specialist 2, Pharmacist 57, Radiographer 1, Lab.Tech 24, Staff Nurse 115

77.52 38.76 Retaining staff at difficult areas to ensure service delivery

50% of fund to be provided subject to approval of GoI separately

Most Difficult Area: 139 Staff @ 4000 / month: ANM 57, MO 16, Pharmacist 21, Lab. Tech 4, Staff Nurse 41

66.72 33.36 Retaining staff at difficult areas to ensure service delivery


Inaccessible Area: 131 Staff @ 6000 / month: ANM 74, MO 13, Pharmacist 13, Lab. Tech 5, Staff Nurse 26

94.32 47.16 Retaining staff to ensure service delivery


Type I: 23 @ 4 lakhs 92 0 BADP funds may be used Type II: 21 @ 6 lakhs 126 0

Type III: 24 @ 9 lakhs 216 0 SC Building: 13 @ 12 lakhs 156 0 TOTAL 9268.89 3023.68

40

Annexure - III

Immunization Strengthening Programme Arunachal Pradesh (2010-11)

S. No.

Activities

Amount Proposed

(Rs. In Lakhs)

Amount Approved

(Rs. in Lakhs)

Outcome

1 Mobility support for Supervision and Monitoring at districts and state level.

10.00 9.00 Improved supervision for programme

2 Cold Chain Maintenance 9.60 2.40 Strengthening of cold chain

3 Alternate Vaccine Delivery to Session sites

18.67 9.33 Timely supply of vaccine to 9336 session sites

4 Focus on urban slum & underserved areas

5.37 5.37 Conduction of 384 session to urban area/urban slums

5 Social Mobilization by ASHA /Link workers

18.67 14.00 Ensure universal access

6 Computer Assistants support at State / District Level

32.64 21.00

7 Printing and dissemination of immunization cards, tally sheets, charts, registers, receipt book, monitoring formats etc. 3.00 3.00

Strengthen Monitoring

8 Quarterly review meeting at state level 4.75 4.75 Regular meeting for Programme Review 9 Quarterly review meeting at District

level 5.01 5.01 10 Quarterly review meeting at block level 10.50 10.50 11 District level Orientation for 2 days

ANMs, MPHW,LHV 58.88 44.36 Capacity building of Medical Officers, Health Workers and other Immunization related staffs

12 Three days training of Mos on RI 29.37 16.25 13 One day refresher training of District

Computer Assistant 0.79 0.79 14 One day Cold Chain Handlers Training 3.63 3.63 15 To develop micro plan at sub-centre

level 0.27 0.27 Conduction of 273 session regularly

16 For consolidation of micro plan at block level 1.62 1.62

17 POL for vaccine delivery from state to District and PHC/CHCs

18.00 18.00

18 Consumables for computer including provision for internet access

3.24 0.82

19 Red/Black/Zipper bags 0.60 0.40 Injection waste disposal as per CPCB guidelines 20 Bleach/Hypochlorite solution 0.65 0.65

21 Twin Bucket 0.52 0.52 22 Bio Medical Waste Pit 6.40 6.40 23 Mobility for cold chain personnel for

cold chain maintenance for State HQ 0.50 0.00

24 Mobility for cold chain personnel for cold chain maintenance for district

3.00 0.00

41

S. No.

Activities

Amount Proposed

(Rs. In Lakhs)

Amount Approved

(Rs. in Lakhs)

Outcome

25 POL and maintenance for WIC generator at State Headquarter

0.50 0.50

26 Procurement of solar plates 16.25 0.00 27 Procurement of batteries for solar

refrigeration system 18.00 0.00

28 Maintenance of Vaccine Vans by GOI 32.00 0.00 29 Mobility support for outreach sessions 14.00 0.00

Total 326.43 178.57

Strengths

Ø The State is showing an improving trend in immunization coverage.

State needs to

Ø The State needs to address the issues of accessibility to immunization services as well as dropout from BCG- DPT3. The proportion of children with “No Immunization” has hardly improved from 27.9 as per DLHS-2(2002-04) to 24.8% only in DLHS-3(2007-08), while full immunization is only 40.3%.

Ø As per the RHS Bulletin (as on March 2008) there is shortage of manpower especially the Health workers (ANMs and MPW-M) as well as ASHAs. The state need to address this crucial issue on priority to strengthen service delivery mechanism.

Ø The state needs to clearly enunciate the strategic plans to improve accessibility to immunization services along with number of beneficiaries to be covered.

Ø Health workers training needs to be completed. The state needs to plan and implement the TOT for Medical officers within the state. Any support required in the form of trainers may be intimated to Government of India.

Ø There is need to strengthen VPD and AEFI surveillance systems in the state. Items restricted or not permissible in Immunization PIP

1. Mobility for cold chain personnel for cold chain maintenance for State HQ - Rs. 0.50 lakh

2. Mobility for cold chain personnel for cold chain maintenance for district – Rs. 3.00 lakh 3. Procurement of solar plates – Rs.16.25 lakh 4. Procurement of batteries for solar refrigeration system – Rs.18.00 lakh 5. Maintenance of Vaccine Vans by GOI - Rs. 32.00 lakh 6. Mobility support for out reach sessions - Rs. 14.00 lakh

42

ANNEX-IV

Approval under the National Disease Control Programmes

RNTCP

Sr. No.

Activity Proposed

Approved (Rs. in lacs)

Expected Output (by 31st March 2011)

Remarks

1 Civil works 16.50 1) Civil work Upgradation and maintenance completed as planned; 2) Funds in the head utilized against the approved amount

IRL civil works is a one time payment which has already been provided;It is too early to plan for DP site with no functioning IRL

2 Laboratory materials

12.00 1) Sputum of TB Suspects Examined per lac population per quarter; 2) All districts subjected to IRL OSE and Panel Testing in the year; 3) IRLs accredited and functioning optimally; 4) Funds in the head utilized against the approved amount

Civil works for IRL cannot be budgeted here.

3 Honorarium 10.00 1) All eligible Community DOT Providers are paid honorarium in all districts in the FY; 2) Funds in the head utilized against the approved amount

4 IEC/ Publicity 15.00 1) All IEC/ACSM activities proposed in PIP completed; 2) Increase in case detection and improved case holding; 3) Funds in the head utilized against approved amount

As per norms and previous expenditure

5 Equipment maintenance

4.92 1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as planned; 2) All BMs are in functional condition; 3)

43

Funds in the head utilized against approved amount

6 Training 11.00 1) Induction training, Update and Re-training of all cadre of staff completed as planned; 2) Funds in the head utilized against approved amount

TB/HIV trainings are funded by SACS; A realistic assessment of retraining need required;Calculation not as per norms

7 Vehicle maintenance

22.15 1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained; 2) Funds in the head utilized against approved amount

8 Vehicle hiring 10.28 1) Increase in supervisory visit of DTOs and MOTCs; 2) Increase in case detection and improved case holding; 3) Funds in the head utilized against approved amount

9 NGO/PP support 20.00 1) Increase in number of NGOs/PPs involved in signed schemes of RNTCP; 2) Contribution of NGOs/PPS in case detection and provision of DOT 3) Funds in the head utilized against approved amount

Previous expenditure too low; More amount can be allocated based on expenditure in the first 2 quarters

10 Miscellaneous 42.00 1) All activities proposed under miscellaneous head in PIP completed; 2) Funds in the head utilized against approved amount

Based on previous expenditure; there is no justifiction for excess amont budgeted

11 Contractual services

132.33 1) All contractual staff appointed and paid regularly as planned; 2) Funds in the head utilized against approved amount

Dots plus related staff not approved; justification for additional contractual LTs not provided-hence not approved

44

12 Printing 10.00 1) All printing activities at state and district level completed as planned; 2) Funds in the head utilized against approved amount

Based on previous expenditure

13 Research and studies

0

14 Medical Colleges 0 1) All activities proposed under Medical Colleges head in PIP completed; 2) Funds in the head utilized against approved amount

15 Procurement –vehicles

5.00 1) Procurement of vehicles completed as planned; 2) Funds in the head utilized against approved amount

2 wheelers to be condemned as per state rules; 4 wheelers only after written approval from CTD

16 Procurement – equipment

1.80 1) Procurement of equipments completed as planned; 2) Funds in the head utilized against approved amount

No provision for photocopier;

Total 312.982

In addition to this, a commodity grant of 11.88 lacs has been approved for central level procurement of Anti TB Drugs and Laboratory Equipments for sputum culture & drug sensitivity. Annexure III – Summary of Mission Flexible Pool (MFP) PIP 2010-11

SL.

No. Activity

Amount

Approved

(Rs. in

lakhs)

Expected Output Remarks

1

Procurement of vehicle for STDC cum IRL 4 wheeler and a Mini Bus

0

Not Justified Provision already

available under the

RNTCP

2 Miscellaneous Digging of Bore Well, Transformer for 3 phases electric connection

11.0

Continuous supply of

water and electricity.

May be approved, no

provision under RNTCP

45

3 Procurement of equipment Mini Incinerator

10.0 Proper waste

management

May be approved, no


4 IEC Activity Publication of Booklet on TB.

0 Not Justified Provision already

available under the

RNTCP

5 Procurement of equipment One Cold Room for IRL

15.51

Culture & DST Lab in the

state fully functional as

planned; 2) Funds in the

head utilized against

approved amount

May be approved, no


Cooling Incubators- 2Nos For IRL

0 Not Justified Provision already

available under the

RNTCP

Silent Generator Set 15KVA

10.395 Uninterrupted supply of

electricity

May be approved, no


46.290 46.290 approved

(i) Targets to be achieved during 2010-11:

• Detection rate of at least 93% and maintain treatment success rate above 88%. • All RNTCP districts have supervisory structure for disease control programme.

(ii) Information under 27-B:

PERFORMANCE: State Anuualised NSP case detection rate Success rate of NSP Arunachal Pradesh 91% 88%

The State need to strengthen the services in the following districts: District ANSPCDR Success Rate Lower Subansiri 39.3% 80.0% West Siang 55.5% 73.3%

HUMAN RESOURCE:

46

Vacancy position of various categories of staff and the training status of existing staff is placed below:

DTO MOTC STS STLS DMC LT/Microscopist

Sanctioned

Vacancy

Total in

place &

trained

Sanctioned

Vacanc

y

Total in place & trained

Sanctioned

Vacancy

Total in place & trained

Sanctioned

Vacanc

y

Total in

place &

trained

Sanctioned

Vacanc

y

Total in

place &

trained

13 0 13 6 0 6 13 0 13 13 0 12 43 0 31

Medical Officer (at BPHC /PHC /CHC /district

hospital /other) Paramedical staff including

health workers

Vacancy In place and

yet to be trained

Vacancy In place and

yet to be trained

0 28 0 412 New Contractual Position: The following new contractual positions have been sanctioned under the revised financial norm of RNTCP for building capacity of districts and states to implement new initiatives like TB HIV Collaborative services and programmatic management of MDR TB: State Level Positions: • Asst. Programme Officer/Epidemiologist – 1 per state • DOTS Plus Site Sr. Medical Officer – 1 per DOTS Plus site • DOTS Plus Site Statistical Assistant – 1 per DOTS Plus site • Sr. LT at IRL – 1 per IRL • Store Assistant (SDS) – 1 per SDS • DEO (IRL) – I per IRL District Level Positions: • Sr. DOTS Plus and TB HIV Supervisor - 1 per district (as per phased expansion of DOTS Plus and intensified TB-HIV activities) State is requested to fill up all existing vacancies as well as new contractual postions and arrange for the training of the staff.

47

NVBDCP

Sl.No. Activity Proposed Proposed Budget Rs. (in lakhs)

NVBDCP Approved Allocation Rs. (in lakhs)

Remarks

1 Domestic Budget Support (DBS)

1.1 Malaria (DBS)

a MPW 400.32 200.00 The state has been allocated 356 have MPWs so far they have engaged 200 salary for 12 months for200 and 6 months salary for 156 which will be recruited during the year 2010-11 has been budgeted. Based on the expenditure of fund additional allocation will be made at RE stage

b Incentive to ASHA 33.14 10.00 incentives to ASHASs have been proposed for high endemic district only Based on the expenditure of fund additional allocation

48

will be made at RE stage

c Monitoring and evaluation including HMIS

10.00 6.00 The fund has been allocated for data reporting and Monitoring and Evaluation

Total 443.46 216.00

d Training MPW 3.20 9.00 Some of the

training expenditure may be met through integrated training fund of NRHM

Spray workers 3.20 Health Supervisor 3.20 Health Worker 2.40 Spray team 2.40 ASHA 9.60 Total 24.00 9.00 e IEC News Paper Advert. 4.20 18.00 Print Media 59.00 Activities are

justified. Some of the activities can be covered under integrated IEC budget of State / NRHM additionality

Poster, Hoardings, Pamphlets, Sticker, Leaflet,

guidelines, TV campaign, Radio etc at State as well as District level.

Total 63.20 18.00 f Operational Expenses Salary of spray staff 48.60 150.00 under cetral

assistance the spray wages and other operational cost is to be included

12 month contingency 24.30 TA/DA for spray team 18.00

POL 10.00 Motor Vehicle (Repairing) Office expenses 10.00 TA/DA for state & Dist

Regular/contractual staff 17.00

49

Procurement of vehicle 25.00 Rental Charges of Store room 11.40 g Equipments & Materials Pricking needles 6.00 Microslide 7.00 Microscopes 36.00 Stain – i & ii 6.00 H. C. Pump 14.00 Spare parts for HC pump 8.00 Oil Immersion lenses (100x) 3.50 Eye piece ( 5x, 10x) 3.75 Microscope maintenance 5.00 Total 253.55 150.00 Sub Total (DBS) 760.21 393.00 Total cash assitance under

GFATM 625.77 220.00 The amount

has been allocated for Round - 9 project implementation wef 1st July 2010 and the additional funds shall be given at the RE stage on the basis of progress of expenditure

Human Resource Training Planing and Administration Monitoring and Evaluation BCC/IEC total cash assitance under

GFATM 625.77 220.00

Total cash assitacne under for

malaria 1385.98 613.00

1.2 JE Fogging Machine 6.00 5.00 JE is endemic

in only 1 to 2 districts Elisa Kits 10.00

IEC Materials 5.00 Training 10.00

50

Technical Malathion 5.00 For vaccination of Lohit

District 9.80

For vaccination of Changlang District

9.80

Total 55.60 5.00 Decentrelized drugs 37.00 12.17 Total Cash asisstacne under

NVBDCP 1478.58 630.17

Commodity support under NVBDCP

Commodity support for Malaria by GoI

190.15

Commodity support under GFATM

66.60 for LLINS, SP ACT, Artemesiinine inj and RDKs

Total 256.75

NVBDCP Total 1556.58 886.92

NRHM Additionality LTs 78.00 78.00 The proposed

additional 65 nos. of LTs is required to fill up the gap in prioritized PHC

AMO 14.40 14.40 Out of 15 dist only 9 dist are having AMO in position. 6 nos. of contractual AMO is required to fill up on contractual basis @ Rs. 20000/- Pm

Procurement of bednets 180.58 90.00 For procurement of LLIN in the coming year.

Sub Total of NRHM Additionalities

272.98 182.40

Grand Total of Malaria + GFATM (IMCP) + JE+ NRHM Additionalities

1829.56 1069.32

51

PHYSICAL TARGETS

1. ABER

2008 2009* (P) Target for 2010 20.68 17.5 >10

2. API 2008 2009* (P) Target for 2010

24.03 18.05 There is a chance of Increase in API due to improvement in

surveillance (ABER)

3. LLIN Total LLINs required for 80%

coverage of Households in Sub Centers with API >2

LLIN Supplied till

2009-10

LLIN to be supplied in

2010-11

Targeted coverage for

2010

606026 0 20000 8%

4. IRS Population

Targeted 80% coverage of the target

1066807 853445

5. HUMAN RESOURCES

A. Key Staff in Position

Particulars

Targeted to be in position

by end of 2010

VBD Consultants 15

MTS 45

Contractual LTs 11

Contractual MPW 156

52

B. Training

Sl. No. Category of Man Power No. of Batch

1 M.O. 4

2 Lab Technician 3

3 MTS 1

4

Health Supervisior (M)

16 5

Health Supervisior (F)

6 MPW (M)

16 7 MPW (Contractual)

8 Spray worker 16

9 Health Worker 16

10 Spray team 16

11 ASHA 64

1. Surveillance is poor (<10%) in 5 districts namely Anjaw, Upper Dibang Velly, Upper Subansiri, Lower Subansiri and West Kemang. Since these are the high endemic districts, the MPWs allocated under NVBDCP should be deployed in these areas. 2. East Siang, Lower Dibang Valley, East Kameng, West Siang, Lohit, K/Kumey, Papum Pare, Changlang, Tirap, Upper Siang, Upper Subansiri, Upper Dibang Valley, Lower Subansiri,Anjaw are the districts having API >2. Efforts should be made to train all ASHAs and community volunteers to enable early diagnosis and complete treatment in these areas. 3.Lower Dibang valley, Papum Pare, East Kameng districts reported deaths. The referal mechanism should be strengtherned in these disricts for timely referal and provision of critical care services should be ensured at the rereral centers to prevent the deaths.

53

IDSP

Budget-sheet - Arunachal Pradesh ( Districts - 16 ) Activity Sub-activity Tasks Remarks

Surveillance Preparedness

1. Training 1.1 Training of Hospital Doctors

2.46 20 per district, 10 per batch, 2 batch per district Per head training cost = 1100/-. Unit cost per participant: training material 100; travel: 300; Food: 250 (10

1.2 Training of Hospital Pharmasist / Nurses

3.36 40 per district, 20 per batch, 2 batch per district per head training cost = 750/-. Unit cost per participant: training material 50; travel: 100; Food: 150 (20 x 300) + Other exp

1.3 Training of Data Managers & DEO

0.38 Per head training cost= 1600 /-, 2 days training Unit cost per participant: {[training material 50 + Food 150 x 2] + travel: 500} x 20 + Other expenses (computer hiring) 10000; Trainer charges: 4000 = Total 31,000/- per batch

Sub total 6.20 2. Staff Salary

2.1 Epidemiologists (17)

42.84 Rs 30000 per month

2.2 Microbiologists (2)


2.3 Entomologists (1) 2.40 Rs 20000 per month

2.4 Consultants (Finance) (1)


2.5 Consultants (Training) (1)


54

2.6 Data Managers (17)


2.7 Data Entry Operators (17)


Sub Total 100.02 3.

Operational Cost

3.1 Mobility Support 7.68 (Rs 1000 per visit x 4 visits)/ per month per district

3.2 Office Expenses @ 2000 P.M.

4.44 Rs 2000 at districts and Rs 5000 at SSU per month

Sub total 12.12 Sub Total (Surv.

Preparedness) 118.34

Outbreak investigation and response

4 4.1 ASHA incentives for Outbreak reporting

1.92 Estimated to get 10 informations per month from volunteers a total of 120 such information in a year per district. Each informant to be given an incentive of 100/-

4.2 Consumables for District Labs

2.00 Rs 200 000 per lab

4.3 Collection & transportation of samples

0.96 Rs 6000 per district per year

Sub Total (OB Investiga & Resp)

4.88

Analysis and use of data

5 5.1 IDSP reports including alerts

0.30 Rs 30 000 per SSU per year

5.2 Printing of Reporting Forms

1.60 Rs 10000 per district and Medical College per year

5.3 Broadband Expenses

2.04 Rs 1000 per district+SSU+Medical Colleges

Sub Total 3.94 TOTAL 127.16

55

NPCB

Physical Target

Funds required

Approved (Rs.

In Lakhs)

Remarks

Recurring Grant-in-aid (*)

For free Cataract operations @ Rs 750/- per case and other Approved schemes as per financial norms(*)

1,84,83,000 100.00

(*) Approved under

scheme GIA for Catops and other approved activities

Non recurring Grant-in-aid

For RIO (new) @ 60 Lakhs

For Medical Colleges @ 40 lakhs/-

For Vision Centres @ 50000/-

6 Nos 3,00,000 3.00

Approved For Eye Bank @ 15 Lakhs

1 No 15,00,000 15.00 Approved For Eye Donation Centre @ 1 Lakhs

For NGOs @ 30 Lakhs

1 (continue 2nd Instal)

17,50,000

17.50

Approved For Eye Wards & Eye OTs @ 75 Lakhs

2 Nos 1,50,00,000 75.00

Approved For Mobile Ophthalmic Units with tele-network @ 60 Lakhs

1 No 60,00,000

Contractual

Manpower

Ophthalmic Surgeon (Salary of 25000/- p. m.)

4 No 12,00,000 12.00

Approved Ophthalmic Assistant (Salary of 8000/- p.m.)

18 No 17,28,000 17.28

Approved Eye Donation Counsellor (Salary of 10000/- p.m.)

4 Nos 4,80,000

4.80

Approved Total Grant-in-aid 4,64,41,000 244.58

56

(*) = Recurring Grant-in-Aid for Free Cataract Operations and various other schemes which include: Other Eye Diseases @ Rs 1000/-, School Eye Screening Programme @ Rs 200/- per pair of spectacles, Private Practitioners @ as per NGO norms , Management of State Health Society and District Health Society @ Rs 14 lakhs/ 7 lakhs, Recurring GIA to Eye Donation Centres @ Rs 1000/- pair of Eye Ball collection and Eye Banks @ Rs 1500/- per pair of Eye Ball collection Rs 1500 Training, IEC, Procurement of Ophthalmic Equipment, Maintenance of Ophthalmic Equipments, Remuneration, Other Activities & Contingency.

All the expenditures from the NPCB budget allocations and from the funds obtained from NRHM flexi-pool should be done strictly according to the Physical norms and Financial Norms approved in the 11th Plan five year plan of NPCB as communicated earlier.

The above said allocations are as per the requirements proposed by the state and in case the funds in a specific allocation are exhausted the funds from other unspent allocations for NPCB activities can be utilized ; with due intimation to GOI. Grant-in-aid for cataract operations and various other schemes includes free cataract operation, other eye diseases, School Eye Screening Programme, training, IEC, Private Practitioners, management of State Health Society and District Health Society, recurring GIA to Eye Donation Centres and Eye Banks, maintenance of Ophthalmic Equipments, SBCS, Remuneration, other activities & Contingency etc.

How many of the targets projected in the PIP 2009-10 have been achieved.

57

NIDDCP

Activity Proposed

Approval in lakhs

Expected output Remarks

1 Establishment of IDD Control Cell

7.00 Better implementation and monitoring of programme activities.

Filling up of all sanctioned vacant posts of IDD Cell and IDD Lab by the state government on regular or contractual basis.

Survey should be conducted as per GOI guidelines of NIDDCP @ 50,000/- per district.

2 Establishment of IDD Monitoring Lab

4.00 Monitoring of iodine content of salt and urine samples in districts.

3 a)Health Education and Publicity b) Salt Testing Kits supplies by GOI (20,000 No)

24.00

Increased awareness about IDD and iodated salt. Creating iodated salt demand and monitoring of the same at community level.

4 IDD surveys 3.00 Prevalence of IDD in 6 districts of state

Total 38.00

58

NLEP

RECORD OF PROCEEDINGS OF NATIONAL LEPROSY ERADICATION PROGRAMME

FOR 2010-11 ARUNACHAL PRADESH

The approved amount for Arunachal Pradesh State under National Leprosy Eradication

Programme for 2010-11 is 0.65 crores. Targets to be achieved during 2010-11 are as follows –

1. Annual New Case Detection Rate – 2.70 per 1,00,000 population

NATIONAL LEPROSY ERADICATION PROGRAMME APPROVED ARUNACHAL PRADESH STATE ACTION PLAN 2010-

11

( in lakhs)

S. No.

Activity proposed Amount proposed

Amount approved

Expected Output

Remarks

1) Contractual Services

5.82 10.00

Functional leprosy cell at state/district level

Contractual staff to be kept in

place

State - SMO, BFO cum AO, DEO,Administrative Assistant, Driver

District - Drivers

2) Services through ASHA/USHA

0.27 0.50

Increase in percentage of cases reported by ASHA

Honararium to ASHA, sensitization of ASHA

3) Office expenses & Consumables 6.00 6.00

Functional leprosy cell at state/district level

4) Capacity building

11.00 11.00

Improvement in skills in diagnosis & treatment of leprosy

4 days training of newly appointed MO (rural & urban)

3 days training of newly appointed health worker & health supervisor

2 days refresher training of MO

5 days training of newly appointed Lab. Technician

59

5) Behavioral Change Communication

10.00 10.00

Better self reporting as a result of increased awareness

Quiz,folk show,IPC workshop,Meeting of opinion leaders,Health melas

Wall painting,Rallies,Hoardings etc

6) POL/Vehicle operation & hiring

13.70 13.50 Improvement in mobility of SLOs & DLOs

2 vehicles at state level & 1 vehicle at district level

7) DPMR

3.50 3.50

Decrease in recurrence of foot ulcers and reduction in grade II disability through RCS

MCR footwear, Aids and appliances, Welfare allowance to BPL patients for RCS, Support to govt. institutions for RCS

8) Material & Supplies

2.40 2.50 Management of reaction cases

Supportive drugs, lab. reagents & equipments and printing forms

9)

Urban Leprosy Control - renovation of 4 leprosy wards 11.66 - Budget not provided under

this component

10)

Supervision, Monitoring & Review 8.98 4.00

Better, supervision & monitoring of programme

Review meetings and travel expenses

11) Cash assistance - 4.00

Better, supervision & monitoring of programme

12) Others 1.70 -

TOTAL 75.03 65.00

60

Annex-V

SUMMARY of MAIN APPROVED ACTIVITIES

(INFRASTRUCTURE, HUMAN RESOURCES, TRAINING)

FMR Code

ACTIVITY PROPOSED (Rs. Lakhs)

APPROVED (Rs. Lakhs)

EXPECTED OUTPUT

BUDGETED IN

Infrastructure A.9.2 Major civil works

(new construction/extension

/ addition)

RCH-II

A.9.2.1 Major civil works for operationalisation of

FRUS

10 5 One FRU RCH-II

A.9.2.2 Major civil works for operationalisation of 24 hour services at

PHCs

72 36 Eight 24x7 PHC

RCH-II

A.9.3 Minor civil works RCH-II A.9.3.1 Minor civil works for

operationalisation of FRUs

25 12.5 Four FRUs RCH-II

B3 Hospital Strengthening

MFP

B3.1 Upgradation of CHCs, PHCs, Dist. Hosp. To IPHS.

MFP

B3.1.1 District Hospitals MFP Incinerator installation

in DH: 06 @ 25 Lakhs 150 25 BMW

Management in DH efficiently executed

MFP

B5 New Constructions/ Renovation and

Settingup

MFP

B5.1 CHCs MFP Construction of

Residential Quarter (Type III) for FRU

“Ruksin CHC”: 05 @ 12 lakhs

60 36 Availability of 24 hours services by

ensuring stay of health workers

MFP

61

Construction of 5 Type 3 residential quarters each in 8 CHCs: 40 @

12 lakhs (Jang, Dumporijo, Nari,

Jengging, Mahadevpur, Palin, Mechuka, Maryang)

480 115.2 Availability of 24 hours by ensuring stay

of health workers

MFP

Labour Room in 4 CHCs: 4 @ 6 lakhs (Balijan, Mechuka,

Maryang, Kanubari)

24 24 Functional Labour Room

with all accessories

MFP

Construction of OT in Deomali CHC: 1 @ 12

lakhs

12 12 Functional OT with surgeries

including CS being carried

out by posting of specialists

MFP

B5.2 PHCs MFP Construction of

residential barracks At PHCs: 85 barracks

1020 331.2 Round the clock ensured

services at 24X7 PHCs.

MFP

Construction of Labour Rooms at PHCs: 10 @

6 lakhs (Mengio, Sangram, Jeying,

Pakke Kessang, Jote, Raga, Yachuli, Yangte,

Maro, Namtok)

60 60 Operational Labour Room

MFP

Provision of waiting rooms and furniture at

30 PHCs: 30 @ 3.25 lakhs

97.5 65 Pregnant Women from

faraway places are

staying in the facility before

delivery

MFP

B5.3 SHCs/Sub Centers MFP Construction of SCs: 62

@ 12 lakhs 744 186 SCs are

functioning in their own building

MFP

B16.1 Strengthening of Existing Training

Institutions/Nursing School

MFP

B16.2 New Training Institutions/School

MFP

62

State Training Centre: 1 @ 2 Crores

150 70 State Level Training facilities

functional

MFP

Cold Chain Room at the State level

19.67 19.67 MFP

SUB-TOTAL( INFRASTRUCTURE)

2924.17 997.57

Human Resources A.9.1 Contractual Staff &

Services RCH-II

A.9.1.1 ANMs 188.16 96.76 112 ANMs RCH-II

A.9.1.2 Laboratory Technicians

100.8 51.84 60 LTs (30 existing and

30 new)

RCH-II

A.9.1.3 Staff Nurses 129.6 64.8 60 SNs RCH-II A.9.1.5 Other contractual staff 3.84 3.84 2 Statistical

Investigators RCH-II

Block Accountant-cum-Data Assistant: 84

@ 16,000 / month

161.28 80.64 Management of health

institutions strengthened.

RCH-II

Salary of MMU Drivers: 48 @ 5000 /

month

28.8 28.8 RCH-II

B14 Additional Contractual Staff


MFP

B14.1 Additional Staff/ Supervisory Nurses

PHC,CHC (Including Ayush Stream)

MFP

Contractual GNM: 134 @ 18,000 / month

289.44 144.72 Round the clock services at 24X7 PHCs

ensuring availability of

qualified manpower.

MFP

B14.2 Additional ANM, LHV, MPW for Sub-

Center

MFP

Contractual ANM: 40 @ 14,000 / month

67.2 34.56 Regular service

delivery at SCs

MFP

B14.3 PHNs at PHC level MFP B14.4 Medical Officers at

PHCs (Including AYUSH stream)

MFP

63

Contractual Doctors: 82 @ 30,000 / month

295.2 196.8 Regular service

delivery at PHCs and

24X7 functional

PHCs

MFP

B14.5 Additional Allowances to MOs PHC

MFP

B14.6 Lab technicians, Gynecologists, Anesthetists,

Pedisterian, Specialist CHC, Radiologist,

Sonologist, Pathologist, Dental

Surgeons.

MFP

Contractual Specialists: 3 @ 35,000 / month

12.6 12.6 Specialist services made

available

MFP

BDS: 15 @ 30,000 / month

54 36 Dental Care at PHC/CHC

made available

MFP

Contractual Radiographer: 16 @

14,000 / month

26.88 17.28 Diagnostic services

ensured at CHC level

MFP

B14.7 Others Additional Contractual Staff


MFP

Refrigerator Mechanic: 4 @ 16,000 / month

7.68 4.32 Breakdown time

minimised for cold chain.

MFP

B31.1 Incentive Scheme MFP Difficult Area: 323 Staff

@ 2000 / month: ANM 83, MO 41, Specialist 2,

Pharmacist 57, Radiographer 1,

Lab.Tech 24, Staff Nurse 115

77.52 38.76 Retaining staff at

difficult areas to ensure service

delivery

MFP

Most Difficult Area: 139 Staff @ 4000 /

month: ANM 57, MO 16, Pharmacist 21, Lab. Tech 4, Staff Nurse 41

66.72 33.36 Retaining staff at

difficult areas to ensure service

delivery

MFP

64

Inaccessible Area: 131 Staff @ 6000 / month:

ANM 74, MO 13, Pharmacist 13, Lab.

Tech 5, Staff Nurse 26

94.32 47.16 Retaining staff to

ensure service delivery

MFP

B28.1 Block Level PMU MFP Block Accountant-

cum-Data Assistant: 84 @ 16,000 / month

161.28 80.64 Management of health

institutions strengthened.

MFP

Sub Total 1765.32 972.88 TRAINING A.11.1 Strengthening of

Training Institutions 32.4 16.2 Equipment

for SIHFW; training

consultant

RCH-II

A.11.3 Maternal Health Training

RCH-II

A.11.3.1 Skilled Birth Attendance / SBA

48.32 24.16 25 MOs and 120

ANM/GNM

RCH-II

A.11.3.2 EmOC Training 6.46 6.46 1 master trainer and I

MO

RCH-II

A.11.3.3 Life saving Anaesthesia skills

training

9.78 9.78 4 MO RCH-II

A.11.3.4 MTP training 16.36 8.18 50 MOs RCH-II

A.11.3.5 RTI / STI Training 2.95 1.48 40 MO, 20 ANM, 25

GNM

RCH-II

A.11.3.7 Other MH Training 1.83 1.83 10 MO and 10 LT

RCH-II

A.11.5 Child Health Training RCH-II

A.11.5.1 IMNCI 14.19 7.1 52 MO and 52 ANM

RCH-II

A.11.5.2 Facility Based Newborn Care

12.89 6.45 30 MO and 30 ANM/GNM

RCH-II

65

A.11.5.5 Other CH Training 40.96 20.48 F-IMNCI - 5 ToT, 30 MO,

30 ANM/ GNM; NSSK – 8; Capacity building for New born and child

stabilization unit at FRU - 3 MO and 3 SN; Multi-

skilled training on

paediatrics – 3 MOs

RCH-II

A.11.6 Family Planning Training

RCH-II

A.11.6.1 Laparoscopic Sterilisation Training

2 2 3 gynaecologist

s

RCH-II

A.11.6.2 Minilap Training 6.8 3.4 12 MOs

RCH-II

A.11.6.4 IUD Insertion Training 26.26 13.13 25 MOs and 115 ANMs

RCH-II

A.11.6.5 Contraceptive Update Training

5.67 5.67

40 MO/officials

RCH-II

A.11.7 ARSH Training 15.86 15.86

16 MO and 80 ANM/GNM

RCH-II

A.11.9 Other training 91.99 45.99 Refresher training of 182 ANMs, QAC state level 9 members,144 district members

RCH-II

A.11.9.1.

Continuing Medical & Nursing Education

29.5 29.5 200 MOs and 150 GNMs

RCH-II

B16 Training MFP

B16.3

Training and Capacity Building Under

NRHM

MFP

B16.3.3

Other training and capacity building

programmes

MFP

66

Orientation training on Financial Management & Accounting: 1 Batch

of 105 Trainees 4.11 4.1

Improved Financial

Management at Health

Institutions

MFP

Skill Upgradation Training on Finance, Accounts & Audit: 1 Batch of 105 Trainees 9.87 9.86

MFP

Induction Training of Block Accountant: 1 Batch of 84 Trainees 4.18 4.18

MFP

Skill Upgradation Training on

Customized Tally: 1 Batch of 105 Trainees 5.1 5.09

Timely submission of

FMRs

MFP

Review Meeting: 4 @

2.5 lakhs 10 4

Localised Action taken

on deficiencies

MFP

Sub Total 397.47 244.9

GRAND TOTAL 5,086.96 2,215.35

67

Annex - VI

List of participants for the meeting of the NPCC held on to consider the PIPs of State of

Arunachal Pradesh

Sl.NO Name of Designation E-mail address/ Contact no.

1. Shri. P. K. Pradhan, AS & MD (NRHM), MOHFW

[email protected]

2. Shri Amarjeet Sinha, JS(P), MOHFW [email protected]

3. Shri Amit Mohan Prasad, JS(RCH) [email protected]

4. Ms.Vandana Gurnani, Director (RCH-DC)

[email protected]

5. Ms. Archana Varma, Director (NRHM)

[email protected]

6. Sh. Puneet Kansal [email protected]

7. Dr. Mr. A. Raghu. Asst. Adv(Ayush) [email protected]

8. Dr. Shalini Singh, Consultant( NIHFW)

9899838746

9. Dr.L.Lam Khan Piang, Lecturer (NIHFW

9711135357

10. Dr.K. Nishing, Addl-DHS (NVBDCP 9436041756

11. Dr. Anoop Kumar Puri, Central Leprosy Division (NLEP)

23061869

12. Dr. Prema Sundararajan, Consultant, SPH (Child Health)

[email protected]

13. Dr. S.K.Sikdar, Assistant Commissioner (Family Planning)

[email protected]

14. Dr. P.K. Prabhakar, Assistant Commissioner(ID)

[email protected]

15. Dr. B.K.Tiwari, Advisor (Nutrition) [email protected]

16. Dr. Prabha Arora, Joint Director( NVBDCP)

17. Dr. V.Rajshekhar, DADG (Opthalmology)

[email protected]

mailto:[email protected]










68

18. Ms. Neetu Singh, IT Expert( M & E Division)

19. Dr. Malik Parmar (Central TB Division)

9654727772

20. Dr. Niraj Kulshresth(Central TB Division)

[email protected]

21. Dr. Premila , Maternal Health Division

[email protected]

22. Mr. Rahul Pandey, Consultant-TMSA/MSG

41327343

23. Mr. G.R. Khetarpal , US (NE) 23061203

24. Mr. N.S. Chauhan, SO(NE) [email protected]

25. Mr. S.K. Bose, Investigator- NRHM III

[email protected]

26. Mr. Suresh Kumar Singh, Investigator- NRHM III

[email protected]

27. Mr. Aman Kumar Ram, FMG 98188 07120

28. Dr. Abhishek Gupta, Consultant (NE), NRHM III.

[email protected]

29. Ms. Geetanjli Agrawal Consultant, ARSH

[email protected]

List of participants from RRC-NE

1. Dr. A.C. Baishya, Director, (RRC- NE)

[email protected]

2. Dr. Ashoke Roy,Advisor-Public Health(RRC-NE)

[email protected]

3. Dr. Dilip Singh, Advisor-Public Health (RRC-NE)

[email protected]

List of participants from Govt. of Arunachal Pradesh

1.Shri A.B. Shukla, Secretary (Health) 9436040022

2.Shri. Talem Tapok, Mission Director 9436227291

3.Dr.D. Padung, Nodal Officer NRHM 9436227290

4.Dr.L.Jawpa,SSO-IDSP 94360557430


69

Documents

F. No. M-11011/2/10-NRHM-III Government of India Ministry ...rrcnes.gov.in/ROP/Arunachal Pradesh 2010-11.pdf · Department of Health & Family Welfare Nirman Bhawan, New Delhi Dated: