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APPROVAL OF STATE PROGRAMME IMPLEMENTATION PLAN 2012-13: TAMIL NADU

May 2012

MINISTRY OF HEALTH & FAMILY WELFARE GOVERNMENT OF INDIA

Preface

I truly believe that the National Rural Health Mission affords us a unique opportunity to be

aspirational and to bring about transformational change.

This document evolves out of a shared vision – about where the State of Tamil Nadu must

reach and the path to be traversed. Strides in the right direction get the State more money while

there is danger too of losing funds for slippages.

As NRHM embarks on the second phase of its journey, let us be inspired by what Mahatma

Gandhi said “A small body of determined spirits fired by an unquenchable faith in their mission

can alter the course of history.’’

Let us believe in ourselves and our ability to make a difference.

Anuradha Gupta Additional Secretary & Mission Director, NRHM

No. 10 (11)/2012-NRHM-1 Government of India

Ministry of Health and Family Welfare (National Rural Health Mission)

Nirman Bhavan, New Delhi

Dated: May 31, 2012 The Mission Director, (NRHM) State Health Society, Government of Tamil Nadu 5th Floor, DMS Complex, Tenopate, 359, Anna Salai, Chennai – 600006

Subject: Approval of NRHM State Programme Implementation Plan for the year 2012-13

This refers to the Programme Implementation Plan (PIP) for the year 2011-12 submitted by the State and subsequent discussions in the NPCC meeting held on May 10, 2012 at New Delhi. 2. Against a resource envelope of Rs 1363.93 crores, the administrative approval of the PIP for your State is conveyed for an amount of Rs 1080.35 crores. Details are provided in Table A, B and C below: TABLE-A

Rs. crores Uncommitted Unspent Balance available under NRHM as on 01.04.2012

206.62

GOI Resource Envelope for 2012-13 under NRHM 867.98 25% State Share (2012-13) 289.33 Total 1363.93

TABLE-B

Break up of total resources under NRHM (Rs. crores) Sr. No.

Programme Uncommitted Unspent balance available as on

01.04.2012

GoI Resource Envelope

under NRHM

Total

1 RCH Flexible Pool 151.14 220.48 371.62 2 NRHM Flexible Pool 55.48 273.93 329.41 3 Immunization (from RCH

Flexible Pool) 0 10.78 10.78

4 NIDDCP 0 0.24 0.24 5 IDSP 0 1.10 1.10 6 NVBDCP 0 9.08 9.08 7 NLEP 0 2.28 2.28 8 NPCB 0 24.47 24.47 9 RNTCP 0 17.71 17.71

10 Direction & Administration 0 298.14 298.14 11 PPI Operation Cost 0 9.77 9.77 12 25% State Share 289.33 289.33

Total Resource Envelope 1363.93 Committed Unspent Balance up to 2011-12 to be

revalidated in 2012-13 Rs. 215.34 crores

TABLE-C

Sr. No. Scheme /Programme

Approved Amount (Rs. In

Crores) Annex ref

1 RCH Flexible Pool 362.14 1 2 NRHM Flexible Pool 342.56 2 3 Immunization and PPI operation cost 15.41 3 4 NIDDCP 0.43 4A 5 IDSP 4.47 4B 6 NVBDCP 9.4 4C 7 NLEP 2.28 4D 8 NPCB 24.47 4E 9 RNTCP 21.05 4F

10 Infrastructure maintenance(Treasury route) 298.14 Total 1080.35

Thus, there is a cushion of Rs. 283.58 crores (Rs. 1363.93 less Rs.1080.35 crores) for which, State is advised to send a supplementary PIP urgently. Targets, conditionalities and road map

3. State has been assigned mutually agreed goals and targets. The state is expected to achieve them, adhere to key conditionalities introduced this year and implement the road map provided in each of the sections of the approval document.

4. District resource envelope as indicated in the PIP should be respected by the State

5. All buildings/vehicles supported under NRHM should prominently carry NRHM logo in English/ Hindi & regional languages.

Mandatory disclosures

6. In addition, the State is directed to ensure mandatory disclosure on the state NRHM website of the following:

Facility wise deployment of all contractual staff engaged under NRHM with name and designation.

MMUs- total number of MMUs, registration numbers, operating agency, monthly schedule and service delivery data on a monthly basis.

Patient Transport ambulances and emergency response ambulances- total number of vehicles, types of vehicle, registration number of vehicles, service delivery data including clients served and kilometres logged on a monthly basis.

All procurements- including details of equipments procured (as per the directions of CIC which have been communicated to the States by this Ministry vide letter 'No.Z.28015/162/2011-H' dated 28th November 2011)

Buildings under construction/renovation –total number, name of the facility/hospital along with costs, executing agency and execution charges (if any) date of start & expected date of completion

Release of second tranche of funds 7. Action on the following issues would be looked at while considering the release of second tranche of funds:

Compliance with conditionalities.

Physical and financial progress made by the State.

It is expected that 25% of the State share, based on release of funds by Government of India is credited to the account of the State Health Society as early as possible.

Timely submission of Statutory Audit Report for the year 2011-12 is a must for release of 2nd tranche of funds.

Before the release of funds up to 100% of BE of your state for the year 2012-13, State needs to provide Utilization Certificates against the grant released to the State up to 2010-11 duly signed by Mission Director and Auditor.

Monitoring requirements 8. State shall ensure submission of quarterly report on progress against targets and expenditure including an analysis of adverse variances and corrective action proposed to be taken. 9. All approvals are subject to the observations made in this document.

10. The State shall not make any change in allocation among different budget heads without approval of GoI. 11. The accounts of State/ grantee institution/ organization shall be open to inspection by the sanctioning authority and audit by the Comptroller& Auditor General of India under the provisions of CAG (DPC) Act 1971 and internal audit by Principal Accounts Officer of the Ministry of Health & Family Welfare. 12. State shall ensure submission of details of unspent balance indicating inter alia, funds released in advance & 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.

Yours faithfully,

(Dr. Suresh K. Mohammed) Director (NRHM - I)

APPROVAL OF STATE PROGRAMME IMPLEMENTATION PLAN, 2012-13: TAMIL NADU

Table of Contents

SUMMARY ....................................................................................................................................... 11

SERVICE DELIVERY TARGETS: ......................................................................................................... 2

FINANCE: KEY ISSUES AND GUIDING PRINCIPLES ............................................................................ 4

ROAD MAP FOR PRIORITY ACTION ................................................................................................. 6

PROGRAMME WISE BUDGET ....................................................................................................... 10

SUMMARY BUDGET 12-13: TAMIL NADU ..................................................................................... 13

REPRODUCTIVE AND CHILD HEALTH ................................................................................................ 15

MATERNAL HEALTH ..................................................................................................................... 15

CHILD HEALTH & IMMUNIZATION ................................................................................................ 27

FAMILY PLANNING ....................................................................................................................... 43

ADOLESCENT HEALTH .................................................................................................................. 52

URBAN RCH ................................................................................................................................. 58

TRIBAL HEALTH ............................................................................................................................ 60

PC-PNDT ...................................................................................................................................... 63

HUMAN RESOURCES AND PROGRAM MANAGEMENT .................................................................. 66

MISSION FLEXI POOL (MFP) ............................................................................................................. 78

ASHA ........................................................................................................................................... 79

UNTIED FUNDS/ RKS/ AMG .......................................................................................................... 82

NEW CONSTRUCTIONS/ RENOVATION AND SETTING UP .............................................................. 84

PROCUREMENT ........................................................................................................................... 86

MOBILE MEDICAL UNIT (MMU) ................................................................................................... 90

REFERRAL TRANSPORT................................................................................................................. 92

AYUSH ......................................................................................................................................... 94

IEC/BCC ....................................................................................................................................... 96

MONITORING AND EVALUATION (HMIS)/ MCTS .......................................................................... 98

OTHERS ..................................................................................................................................... 102

NATIONAL DISEASE CONTROL PROGRAMMES (NDCP) ................................................................... 111

NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP) .......................... 112

INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP) ....................................................... 116

NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME .................................................... 121

NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) ........................................................... 131

NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB) ................................................. 135

REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME ..................................................... 138

ANNEXURE .................................................................................................................................... 144

DETAILED BUDGET: REPRODUCTIVE AND CHILD HEALTH (RCH FLEXIPOOL) ................................ 145

DETAILED BUDGET: MISSION FLEXIPOOL (MFP) ......................................................................... 173

DETAILED BUDGET: IMMUNIZATION AND PPI OPERATION COST ................................................ 195

DETAILED BUDGET: NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP) .................................................................................................................................................. 199

DETAILED BUDGET: INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP) ......................... 201

DETAILED BUDGET: NATIONAL VECTOR BORNE DISEASES CONTROL PROGRAMME (NVBDCP) ... 205

DETAILED BUDGET: NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) ............................ 213

DETAILED BUDGET: NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB) .................. 216

DETAILED BUDGET: REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME ...................... 218

SUMMARY

Approval of Programme Implementation Plan – Tamil Nadu 2012-13 Page 1

STATE-SPECIFIC GOALS

The following are the goals and service delivery targets specifically laid out for the state of Tamil Nadu:

INDICATOR

INDIA TAMIL NADU STATE TARGETS / ELA

Current status

RCH II/ NRHM (2012) goal

Trend (year & source) 2011-13 2013-15 2015-17

MATERNAL HEALTH

Maternal Mortality Ratio (MMR)

212

(SRS 07-09)

<100 134

(SRS 01-03)

111

(SRS 04-06)

97

(SRS 07-09)

83 71 60

CHILD HEALTH 2013 2014 2015

Under 5 Mortality 59

(SRS 2010)

36

(SRS 2008)

33

(SRS 2009)

27

(SRS 2010)

17 14 11

Infant Mortality Rate (IMR)

47

(SRS 2010)

<30 31

(SRS 2008)

28

(SRS 2009)

24

(SRS 2010)

15 12 9

Neonatal Mortality Rate (NMR)

33

(SRS 2010)

21

(SRS 2008)

18

(SRS 2009)

16

(SRS 2010)

10 8 6

Early NMR 25

(SRS 2010)

15

(SRS 2008)

13

(SRS 2009)

13

(SRS 2010)

7 6 5

FAMILY PLANNING

Total Fertility Rate (TFR)

2.5

(SRS 2010)

2.1 1.7

(SRS 2008)

1.7

(SRS 2009)

1.7

(SRS 2010)

Maintain


SERVICE DELIVERY TARGETS:

Indicators DLHS-2 (2002-04)

DLHS-3 (2007-08)

CES (2009)

State Targets/ ELA 2012-13 2013-14 2014-15

Maternal Health Mothers who had 3 or more Ante Natal Check-ups (%)

Institutional delivery (%) in public health institutions (as proportion of the total estimated live births)

77 79 82

Line listing and follow up of Severely Anaemic pregnant women (numbers)

15411 15493 15576

Child Health Full Immunisation (%) 77.3 90 95 100 Line listing and follow up of Low Birth Weight babies Nos; (%)

27535 (5%)

38550 (6%)

52317 (9%)

Family Planning Female sterilisations (lakhs) 3.25

(HMIS 10-11)

3.5 3.55 3.6

Post-Partum sterilizations (lakhs) 2.83 (HMIS, 10-

11)

2.9 2.95 3.0

Male sterilisations (lakh) 0.02 (HMIS: 10-

11

0.03 0.04 0.05

IUD insertions (lakhs) 3.5 (HMIS, 10-

11)

3.6 3.8 4.0

Disease Control ABER for malaria (%) <11% API for malaria (per 1000 population)

0.3

Annualized New Smear Positive Detection Rate of TB (%)

60%-70%

Success Rate of New Smear Positive Treatment initiated on DOTS (%)

86%-88%

Cataract operations(lakhs) 6.5 NGO - 5


KEY CONDITIONALITIES AND INCENTIVES

As agreed, the following key conditionalities would be enforced during the year 2012-13.

a) Rational and equitable deployment of HR with the highest priority accorded to high focus districts and delivery points1.

b) Facility wise performance audit and corrective action based thereon2.

Non-compliance with either of the above conditionalities may translate into a reduction in outlay upto 7 ½% and non-compliance with both translating into a reduction of upto 15%.

c) Gaps in implementation of JSSK may lead to a reduction in outlay upto 10%.

d) Continued support under NRHM for 2nd ANM would be contingent on improvement on ANC coverage and immunization as reflected in MCTS.

e) Vaccines, logistics and other operational costs would also be calculable on the basis of MCTS data.

INCENTIVES

Initiatives in the following areas would draw additional allocations by way of incentivisation of performance:

a) Responsiveness, transparency and accountability (upto 8% of the outlay).

b) Quality assurance (upto 3% of the outlay).

c) Inter-sectoral convergence (upto 3% of the outlay).

d) Recording of vital events including strengthening of civil registration of births and deaths (upto 2% of the outlay).

e) Creation of a public health cadre (by states which do not have it already) (upto 10% of the outlay)

f) Policy and systems to provide free generic medicines to all in public health facilities (upto 5% of the outlay)

Note:

The Framework for Implementation of NRHM to be strictly adhered to while implementing the approved PIP.

1 Rational and equitable deployment would include posting of staff on the basis of case load, posting of specialists in teams (eg. Gynaecologist and Anaesthetist together), posting of EmOC/ LSAS trained doctors in FRUs,optimal utilization of specialists in FRUs and above and filling up vacancies in high focus/ remote areas. 2 Performance parameters must include OPD/ IPD/ normal deliveries/ C. Sections (wherever applicable).


FINANCE: KEY ISSUES AND GUIDING PRINCIPLES

1. 15% State share Contribution status :

Year Amounts required on

basis of releases

Amount credited in SHS Bank A/C (Rs.

in Crore)

(-) Excess/ (+)Shortfall (Rs. In Crore)

2007-08 96.45 0 96.45

2008-09 88.52 58.02 30.50

2009-10 112.78 95.92 16.86

2010-11 123.90 162.00 -38.10

2011-12 135.01 117.67 17.34

Total 556.66 433.61 123.05

State is to ensure that outstanding state’s share is deposited into bank account of State Health Society

at the earliest. Further with effect from 2012-13, State’s share would be 25%.

2. Before the release of funds upto 100% of BE of your state for the year 2012-13, State needs to

provide Utilization Certificates against the grant released to the State up to 2010-11 and audit

report and U/C for 2011-12. The details for such pending U/Cs is as under :

(Rs. in Crore)

Year 2007-08 2008-09 2009-10 2010-11 Total

RCH-II 0.00 0.00 9.45 163.08 172.53

Mission Flexipool Nil Nil 0.00 98.22 98.22

3. Release of 100% of funds for the year 2012-13 would be contingent on the state providing

utilisation certificates of 2009-10 and 2010-11 and audit report and U/C for 2011-12.

4. The appointment of Concurrent Auditor for the year 2012-13 is a prerequisite for release of 2nd

tranche of funds.

5. Timely submission of Statutory Audit Report for the year 2011-12 is must for release of 2nd

tranche of funds.


6. State is required to comply with the instructions and/or guidelines issued for maintenance of bank

account vide D. O. No. G-27017/21/2010-NRHM-F dated January 23, 2012.

7. State needs to prioritise the internal control procedures for all transactions.

8. The state must ensure due diligence in expenditure and observe, in letter and spirit, all rules,

regulations, and procedures to maintain financial discipline and integrity particularly with regard

to procurement; competitive bidding must be ensured and only need-based procurement should

take place.

9. Ensure that the Mission Director and the Director (Finance) / Chief Accounts Officer, should not be

holding any additional charges / dual charges.

10. Ensure not to keep high balances of advances and ensure timely settlement of advances. State

shall carry out age-wise analysis of outstanding advances every month.

11. Ensure to provide a defined action plan to monitor the utilisation of Untied Fund, RKS Fund and

AMG fund, so that high unspent balance of these funds can be avoided.

12. State Finance officials viz. SFM/ SAM invariably shall make a plan for field visit of districts and

below that, at least nine days in a month with a view to monitoring and improving the financial

management system and gearing up the pace of funds utilization and to submit a monitoring

report to Mission Director.

13. The state shall ensure timely submission of FMR& SFP covering all NDCPs and MIS reports both

monthly and quarterly including HR position.

14. The state shall make a plan for training of the Block and District accounts personnel in operational

guidelines for financial management and share the same with FMG-NRHM.

15. Appointment of the statutory auditor for the year 2011-12 is pending and must be completed in

the first quarter of 2012-13.


ROAD MAP FOR PRIORITY ACTION

NRHM must take a ‘systems approach’ to Health. It is imperative that States take a holistic view and work towards putting in place policies and systems in several strategic areas so that there are optimal returns on investments made under NRHM. For effective outcomes, a sector wide implementation plan would be essential. Some of the key strategic areas in this regard are outlined below for urgent and accelerated action on the part of the State:

S. NO. STRATEGIC AREAS ISSUES THAT NEED TO BE ADDRESSED

PUBLIC HEALTH PLANNING & FINANCING

1. Planning and financing Mapping of facilities, differential planning for districts / blocks with poor health indicators; resources not to be spread too thin / targeted investments; at least 10% annual increase in state health budget (plan) over and above State share to NRHM resource envelope; addressing verticality in health programmes; planning for full spectrum of RCH services; emphasis on quality assurance in delivery points

2. Management strengthening Full time Mission Director for NRHM and a full-time Director/ Jt. Director/ Dy. Director Finance, not holding any additional responsibility outside the health department; fully staffed programme management support units at state, district and block levels; training of key health functionaries in planning and use of data. Strong integration with Health & FW and AYUSH directorates

3. Developing a strong Public Health focus

Separate public health cadre, induction training for all key cadres; public health training for doctors working in health administrative positions; strengthening of public health nursing cadre, enactment of Public Health Act

HUMAN RESOURCES

4. HR policies for doctors, nurses paramedical staff and programme management staff

Minimising regular vacancies; expeditious recruitment (e.g. taking recruitment of MOs out of Public Service Commission purview); merit –based and transparent selection; opportunities for career progression and professional development; rational and equitable deployment; effective skills utilization; stability of tenure; sustainability of contractual human resources under RCH / NRHM and plan for their inclusion in State budget

5. HR Accountability Facility based monitoring; incentives for both the health service provider and the facility based on functioning; performance appraisal against benchmarks; renewal of contracts/ promotions based on performance; incentives for performance above



benchmark; incentives for difficult areas

6. Medical, Nursing and Paramedical Education (new institutions and upgradation of existing ones)

Planning for enhanced supply of doctors, nurses, ANMs, and paramedical staff; mandatory rural posting after MBBS and PG education; expansion of tertiary health care; use of medical colleges as resource centres for national health programmes; strengthening/ revamping of ANM / GNM training centres and paramedical institutions; re-structuring of pre service education; developing a highly skilled and specialised nursing cadre

7. Training and capacity building

Strengthening of State Institute of Health & Family Welfare (SIHFW)/ District Training Centres (DTCs); quality assurance; availability of centralised training log; monitoring of post training outcomes; expanding training capacity through partnerships with NGOs / institutions; up scaling of multi skilling initiatives, accreditation of training

STRENGTHENING SERVICES

8. Policies on drugs, procurement system and logistics management

Articulation of policy on entitlements on free drugs for out / in patients; rational prescriptions and use of drugs; timely procurement of drugs and consumables; smooth distribution to facilities from the district hospital to the sub centre; uninterrupted availability to patients; minimisation of out of pocket expenses; quality assurance; prescription audits; essential drug lists (EDL) in public domain; computerised drugs and logistics MIS system; setting up dedicated corporation e.g.: TNMSC

9. Equipments Availability of essential functional equipments in all facilities; regular needs assessment; timely indenting and procurement; identification of unused/ faulty equipment; regular maintenance and MIS/ competitive and transparent bidding processes

10. Ambulance Services and Referral Transport

Universal availability of GPS fitted ambulances; reliable, assured free transport for pregnant women and newborn/ infants; clear policy articulation on entitlements both for mother and newborn; establishing control rooms for timely response and provision of services; drop back facility; a prudent mix of basic level ambulances and emergency response vehicles

11. New infrastructure and Maintenance of buildings; sanitation, water, electricity, laundry, kitchen,

New infrastructure, especially in backward areas; 24x7 maintenance and round the clock plumbing, electrical, carpentry services; power backup; cleanliness and sanitation; upkeep of toilets; proper disposal of bio medical waste; drinking water; water



facilities for attendants in toilets; electricity; clean linen; kitchens, facilities for attendants

12. Diagnostics Rational prescription of diagnostic tests; reliable and affordable availability to patients; partnerships with private service providers; prescription audits, free for pregnant women and sick neonates

COMMUNITY INVOLVEMENT

13. Patient’s feedback and grievance redressal

Feedback from patients; expeditious grievance redressal; analysis of feedback for corrective action

14. Community Participation Active community participation; empowered PRIs; strong VHSNCs; social audit; effective Village Health & Nutrition Days (VHNDs), strengthening of ASHAs, policies to encourage contributions from public/ community

15. IEC Comprehensive communication strategy with a strong behaviour change communication (BCC) component in the IEC strategy; dissemination in villages/ urban slums/ peri urban areas

CONVERGENCE, COORDINATION & REGULATION

16. Inter Sectoral convergence Effective coordination with key departments to address health determinants viz. water, sanitation, hygiene, nutrition, infant and young child feeding, gender, education, woman empowerment, convergence with SABLA, SSA, ICDS etc.

17. NGO/ Civil Society Mechanisms for consultation with civil society; civil society to be part of active communitisation process; involvement of NGOs in filling service delivery gaps; active community monitoring

18. Private Public Partnership (PPP)

Partnership with private service providers to supplement governmental efforts in underserved and vulnerable areas for deliveries, family planning services and diagnostics

19. Regulation of services in the private sector

Implementation of Clinical Establishment Act; quality of services, e.g. safe abortion services; adherence to protocols; checking unqualified service providers; quality of vaccines and vaccinators, enforcement of PC-PNDT Act

MONITORING & SUPERVISION

20. Strengthening data 100% registration of births and deaths under Civil Registration



capturing, validity / triangulation

System (CRS); capturing of births in private institutions; data collection on key performance indicators; rationalising HMIS indicators; reliability of health data / data triangulation mechanisms

21. Supportive Supervision Effective supervision of field activities/ performance; handholding; strengthening of Lady Health Visitors (LHVs), District Public Health Nurses (DPHNs), Multi Purpose Health Supervisors (MPHS) etc.

22. Monitoring and Review Regular meetings of State/ District Health Mission/ Society for periodic review and future road map; clear agenda and follow up action; Regular, focused reviews at different levels viz. Union Minister/ Chief Minister/ Health Minister/ Health Secretary/ Mission Director/ District Health Society headed by Collector/ Officers at Block/ PHC level; use of the HMIS/ MCTS data for reviews; concurrent evaluation

23. Quality assurance Quality assurance at all levels of service delivery; quality certification/ accreditation of facilities and services; institutionalized quality management systems

24. Surveillance Epidemiological surveillance; maternal and infant death review at facility level and verbal autopsy at community level to identify causes of death for corrective action; tracking of services to pregnant women and children under MCTS

25. Leveraging technology Use of GIS maps and databases for planning and monitoring; GPS for tracking ambulances and mobile health units; mobile phones for real time data entry; video conferencing for regular reviews; closed user group mobile phone facility for health staff; endless opportunities- sky is the limit!


PROGRAMME WISE BUDGET

RCH, 36213.58341

MFP, 34256.23987

Immunisation, 1540.92

National Disease Control

Programmes, 6210.47

Infrastructure Maintenance,

29814.00

APPROVED BUDGET (BY PROGRAM), 2012-13: Rs. 108035 LAKHS

Human Resources Training

Infrastructure

Procurements

IEC/BCC

Untied Funds

ASHARKS

JSY

Sterlization

Referral Transport

JSSK

Other RCH Activities

Vulnerable Group

Other Mission

Activities

PPP/NGO

Operational Cost

(NDCPs)

Financial Aid/Grants

to Institutions

(NDCPs)

PPI

Other NDCPs

Infrastructure Maintenance

FUNCTIONAL HEAD-WISE BUDGET Rs. 108035 LAKH


Maternal Health33%

Child Health3%

Family Planning9%ARSH

3%

Urban RCH1%

Tribal RCH1%

Infrastructure & HR39%

Training5%

Programme Management

6%

RCH FLEXIBLE POOL BUDGET Rs. 36226 lakh

ASHA1% Untied Funds

8%

Annual Maintenance Grants

5%Hospital Strengthening

18%

New Constructions and setting up

20%

Corpus Grants to HMS/RKS

5%

Mainstreaming of AYUSH

5%

IEC/BCC2%

Mobile Medical units3%

Referral Transport5%

PPP/ NGOs1%

Innovations5%

Planning, Implementation and Monitoring

5%Procurement

14%

Support services3%

MISSION FLEXIBLE POOL BUDGET Rs. 34256.24 LAKH


RI Strengthninig32%

Salary of Contractual Staffs

2%

Cold chain maintenance

1%ASHA incentive for full Immunization

2%

Pulse Polio Operational Cost

(Tentative)63%

IMMUNISATION BUDGET Rs. 1540.92 Lakhs

NLEP 4%

RNTCP35%

NPCB39%

IDSP7%

NIDDCP1%

NVBDCP15%

DISEASE CONTROL BUDGET Rs. 6310.51 lakhs


SUMMARY BUDGET 12-13: TAMIL NADU

S. No. Budget Head

FY 2012-13 Budget ( Rs lakhs )

Proposed Approved % 1. RCH

A1 Maternal Health 14046.54 8297.39 7.68 A2 Child Health 2829.62 1239.82 1.15 A3 Family Planning 560.315 206.36 0.19 A4 ARSH 0.00 1186.69 1.10 A5 Urban RCH 379.86 379.86 0.35 A6 Tribal RCH 1004.24 357.60 0.33 A7 PNDT & Sex Ratio 0.00 0.00 0.00 A8 Infrastructure & HR 15071.07 14119.27 13.07 A9 Training 2411.21 1857.73 1.72

A10 Programme Management 2562.12 1970.91 1.82 A11 Vulnerable groups 0.00 0.00 0.00

Total Base Flexi Pool 38864.98 29847.30 27.63 A12 JSY 3353.28 3572.48 3.31 A13 Sterilisation & IUD Compensation, and

NSV Camps 2391.20 3025.48 2.80 Total Demand Side 5744.48 6366.28 5.89 Total RCH Flexi Pool 44609.46 36213.58 33.52 2. MFP

B1 ASHA 607.11 278.7075 0.26 B2 Untied Funds (ongoing) 3081.65 2624.38 2.43 B3 Annual Maintenance Grants (ongoing)

2044.50 1828.38 1.69 B4 Hospital Strengthening 7083.41 6114.41 5.66 B5 New Constructions/ Renovation and

Setting up 6910.79 6910.79 6.40 B6 Corpus Grants to HMS/RKS (ongoing)

2470.00 1541.46 1.43 B7 District Action Plans (including block,

village) 20.00 20.00 0.02 B8 Panchayati Raj Initiative 0.00 B9 Mainstreaming of AYUSH 3517.09 1640.09 1.52

B10 IEC-BCC NRHM 527.36 527.36 0.49 B11 Mobile Medical Units (Including recurring

expenditures) 1859.81 1159.81 1.07 B12 Referral Transport 3859.04 1726.00 1.60 B13 PPP/ NGOs 447.50 447.50 0.41 B14 Innovations (if any) 2256.45 1627.25 1.51 B15 Planning, Implementation and

Monitoring 2047.63 1628.30 1.51 B16 Procurement 5243.89 4888.497 4.52


S. No. Budget Head

FY 2012-13 Budget ( Rs lakhs )

Proposed Approved % B17 Regional drugs warehouses 0.00 B18 New Initiatives 0.00 B19 Health Insurance Scheme 0.00 B20 Research, Studies, Analysis 20.00 20.00 0.02 B21 State level Health Resources Center 100.00 100.00 0.09 B22 Support Services 1464.30 1173.31 1.09 B23 Other Expenditures (Power Backup,

Convergence etc) 0.00 TOTAL MFP 43560.53 34256.24 31.71 3. IMMUNIZATION

C1 RI strengthening project (Review meeting, Mobility support, Outreach services etc) 1285.62 492.87 0.46

C2 Salary of Contractual Staffs 28.32 28.32 0.03 C3 Training under Immunisation 0.00 0.00 0.00 C4 Cold chain maintenance 11.26 11.26 0.01 C5 ASHA Incentive 31.80 31.80 0.03

Total Immunization 1357.00 564.25 0.52 C6 Pulse Polio Operational Cost - 976.67 0.90

Total RI & PPO costs 1357.00 1540.92 1.43 4. NATIONAL DISEASE CONTROL PROGRAMMES

4A. National Iodine Deficiency Disorders Control Programme (NIDDCP)

47.50 43.17 0.04 4B. Integrated Disease Surveillance

Programme(IDSP) 511.95 446.87 0.41 4C. National Vector Borne Disease Control

Programme (NVBDCP) 918.00 940.00 0.87 4D. National Leprosy Eradication Programme

(NLEP) 493.83 228.26 0.21 4E. National Programme for control of

Blindness (NPCB) 5484.00 2447.00 2.27 4F. Revised National Tuberculosis Control

Programme (RNTCP) 2653.08 2105.17 1.95 Total NDCP 10108.36 6210.47 5.75 5. INFRASTRUCTURE MAINTENANCE

Total Infrastructure Maintenance 29814.00 29814.00 27.60

GRAND TOTAL 129449.35 108035.21 100.00


REPRODUCTIVE AND CHILD HEALTH

MATERNAL HEALTH


GOALS AND SERVICE DELIVERY TARGETS: MATERNAL HEALTH

Maternal Health: Goals and Targets for 2012-13

Indicator Target

Maternal Mortality Ratio 83 per 100000 live births (2010-12)

71 per 100000 live births (2013-15)

4 ANCs 1042917 in 2012-13

Institutional Deliveries (out of the total estimated

deliveries) to be conducted in Public health institutions

from 72% in 2010-11 to 77% in 2012-13

908404 in 2012-13

Caesarean Section rate * in public health facilities from

17% in 2010-11 to 17% in 2012-13

154338 in 2012-13

Severely Anemic Pregnant Women** out of total anemic

pregnant women (@2% )

15411 in 2012-13

**As per WHO standards less than 10% CS rate is indicative of gaps in EmOC. **At the rate of 2% of pregnant anemic women; this is critical for timely identification and management of severely anemic pregnant woman.

Trainings:

Training Target LSAS 96 EmOC 48 BEmOC 372 SBA 182 MTP 177 MOs, 279 SNs RTI/STI 65MOs ,65 Nurses ,65 LTs

Delivery Points:

Level of Facility Target DHs and other similar district level facilities like District women and children hospitals

38

FRUs-(CHCs and other health facilities at sub district level) 130 PHCs and Non FRU-CHCs 785 SCs All identified SC Level delivery

points


ROAD MAP FOR PRIORITY ACTION

Commitment No. 1- Operationalizing Delivery Points

Gaps in the identified delivery points to be assessed and filled through prioritized allocation of the

necessary resources in order to ensure quality of services and provision of comprehensive RMNCH

services at these facilities.

The targets for different categories of facilities are:

A) All District Hospitals and other similar district level facilities(e.g. District women and children

hospital) to provide the following services:

24*7 service delivery for CS and other Emergency Obstetric Care.

1st and 2nd trimester abortion services.

Conduct Facility based MDR.

Essential newborn care and facility based care for sick newborns.

Family planning and adolescent friendly health services

RTI/STI services.

Have functional BSU/BB.

B) 130 CHCs and other health facilities at sub district level (above block and below district level)

functioning as FRUs to provide the same comprehensive RMNCH Services.

C) 785 PHCs and Non FRU-CHCs to provide the following services:

24*7 BEmOC services including conducting normal delivery and handling common obstetric

complications.

1st trimester safe abortion services. ( MVA upto 8 weeks and MMA upto 7 weeks)

RTI/STI services.

Essential newborn care.

Family planning

D) All identified SC Level delivery point facilities will provide the following services :

Delivery by SBAs.

IUD insertion

Essential new born care.

ANC, PNC and Immunization.

Nutritional and Family planning counselling.

VHND and other outreach services on designated days.


Commitment No. 2- Implementing free entitlements under JSSK

A) JSSK entitlements to be ensured to all PW and sick newborns accessing Public health facilities.

B) At least 70% drop back to be ensured to PW delivering in the PHFs.

Commitment No. 3- Centralized Call Centre and Assured Referral

Every State needs to ensure availability of a centralized call centre for referral transport at State

or district level as per requirements along with GPS fitted ambulances.

Response time for the ambulance to reach the beneficiary not to exceed 30 minutes.

Commitment No. 4- Essential Drug List

A) Every State to have an Essential Drug List (EDL) for SC, PHCs, CHCs, DHs, and Medical colleges

and ensure timely procurement and supply to Sub centres, PHCs, CHCs, DHs and MCs.

B) The EDL should include drugs for maternal and child health including drugs for safe abortion

services, RTI/STI.

C) Differential distribution of types and quantities of drugs to performing and non performing

facilities.

Commitment No. 5- Capacity Building

A) Delivery points to be first saturated with trained HR. High focus/ remote areas to be covered first.

B) Shortfall in trained human resource at delivery points particularly sub centres and those in HFDs/

tribal/ remote areas to be addressed on priority.

C) Shortfall in trained human resource at delivery points particularly sub centres in HFDs to be

addressed on priority.

D) Training load for skill based trainings to be estimated after gap analysis.

E) Certification /accreditation of the training sites is mandatory.

F) Training plan to factor in reorientation training of HR particularly for those posted at non

functional facilities and being redeployed at delivery points. Orientation training of field

functionaries on newer interventions e.g. MDR/ HBNC etc.

G) Performance Monitoring during training/post-deployment needs to be ensured

H) Specific steps to strengthen SIHFW/ any other nodal institution involved in planning,

implementation, monitoring and post training follow up of all skill based trainings under NRHM.

Commitment No. 6– Tracking severe anemia


A) All severely anemic pregnant women (2% of the anemic pregnant women) to be tracked and line

listed for providing treatment of anemia.

Commitment No. 7– For High Focus Districts

A) The State to make use of the MCH sub plans made for these districts in the recent past and

develop and operationalise the identified facilities as delivery points.

B) At least 25% of all sub centres under each PHC to be made functional as delivery points in the

HFDs.

Commitment No. 8-– Job clarity of both ANMs working at the Sub-centre to ensure availability of one

ANM at the SC and the other for outreach activities for the geographically demarcated population.

Commitment No. 9: Pre service Nursing Training (For 12 High Focus States)

At least one state Master Nodal centre shall be created and made functional.

State nursing cell will be created and made functional.

Commitment No. 10: State, district and regional quality assurance committees to be made functional.

Commitment No. 11: Strengthening Mother & Child Tracking System

A) State level MCTS call centre to be set up to monitor service delivery to pregnant women and children.

B) MCTS to be made fully operational for regular and effective monitoring of service delivery including tracking and monitoring of severely anaemic women, low birth weight babies and sick neonates.


DETAILED BUDGET: MATERNAL HEALTH

FMR Code Budget Head Unit cost Physical

Target

BUDGET (Rs. Lakhs) Remarks

Proposed Approved A.1 MATERNAL HEALTH

A.1.1 Operationalise facilities

A.1.1.1 Operationalise FRUs (Operationlisation of Blood storage centres)

A.1.1.1.1

Fuel charges Rs.15000/ generator

268 generato

rs

40.20 40.20 Approved

A.1.1.1.2

Camp arrangement Rs.1000/ camp

2 camps/3

85 blocks

7.70 7.70 Approved

A.1.1.2 Operationalise 24x7 PHCs

A.1.1.2.1

Hiring of specialists Rs.1000/ case

20000 cases

200.00 0.00 Not approved. Super-specialist services cannot be made available at the Primary level Health facility. Such high risk cases are few in number and should be timely detected and referred. Similarly routine lab facilities should be available in house and for specialized services. The cases can be timely referred.

A.1.1.2.2

Hiring of diagnostic services Rs.500/ case

20000 cases

100.00 0.00

A.1.1.3 MTP services at health facilities

A.1.1.4 RTI/STI services at health facilities

A.1.1.5 Operationalise Sub-centres

A.1.2 Referral Transport

A.1.3 Integrated outreach RCH services

A.1.4 Janani Suraksha Yojana / JSY

A.1.4.1 Home Deliveries Rs.500/ delivery

500 deliveries

2.50 2.50 Approved

A.1.4.2 Institutional Deliveries A.1.4.2 Rural Rs.700/ 335189 2346.32 2346.32 Approved



Target


Proposed Approved .a delivery deliveries A.1.4.2.b

Urban Rs.600/ delivery

140796 deliveries

844.78 844.78 Approved

A.1.4.2.c

C-sections

A.1.4.3 Administrative expenses 159.68 159.68 Approved A.1.4.4 Incentive to ASHAs A.1.4.4.1

Rural & Urban Rs.200/ woman

67200 women

134.40 Approved. Shifted from MFP

A.1.4.4.2

Tribal Areas Rs.200/ woman

42400 women


A.1.5 Maternal Death Review A.1.5.1 Regional workshop Rs.150000/

workshop 8

workshops


A.1.5.2 Monthly bulletin Rs.10/bulletin/m

20000 bulletin/

m

24.00 8.00 Approved for quarterly printing of bulletin and not monthly.

A.1.5.3 MD audit expenditure Rs.10000/death

900 deaths

90.00 0.00 Not Approved. Honorarium to experts, POL, and incidental expenses do not conform with GOI Guidelines on MDR. Budget for TA /DA can be utilized out of comprehensive monitoring fund. Honorarium for RCH activities should not exceed its norm.

A.1.6 Other strategies/ activities A.1.6.3 Printing of safe motherhood

booklet Rs.10/ booklet

1500000 booklets

150.00 150.00 Approved



Target


Proposed Approved A.1.6.4 Establishment of JSSK

Centre 1)Telephone 2)Recharge charges 3) Salary for call centre staff 4)Awareness workshop for JSSK 5)Display board

1) Rs.7.25 L 2)Rs.17.4

0 L 3)Rs.6 L

4) Rs.42 L 5)Rs.67.5

0 L

140.15 29.04 1) & 2) Approved for JSSK Grievance redressal at district level @ Rs 6000/m for 12 months x 32 districts = Rs 23.04 lakhs 3) Rs 6.00 lakhs approved at State level Call centre for Salary for Call centre staff of 4 in no. @ Rs 12,500/m x 4 staff for 12 months = Rs.6.00 lakhs 4) IEC should be district specific Can be approved for Rs 1 lakh per district x 32 districts = 32 lakhs. This needs to be shifted to MFP. 5) Not approved. The cost is on higher side. State to plan for comprehensive IEC /BCC for all MH /RCH activities and budget accordingly under IEC.

A.1.6.5 Funds for Diet and refreshments for High Risk Mothers

Rs.160 mother

57000 mothers

912.00 0.00 Not approved

A.1.6.6 Incidental expenditure to Staff Nurses

Rs.100/ mother

57000 mothers


A.1.7.1 Janani Shishu Suraksha Karyakram

A.1.7.1 Drugs and Consumables

A.1.7.1.1.1

Drugs and Consumables for Normal Deliveries

Rs.350/ ND 478000 NDs

1673.00 2677.50 Approved for 7.65 lakh NDs. Separate approval will not be given for drugs and kits for different levels of facilities. However utilization will be as per differential EDL.



Target


Proposed Approved A.1.7.1.1.2

Drugs and Consumables for Caesarean Deliveries

Rs.1600/ C-Sec

91553 C-Secs

1464.85 2160.00 Approved for1.35 lakh C-Secs. Separate approval will not be given for drugs and kit However utilization will be as per differential EDLs.

A.1.7.2 Diagnostic

A.1.7.3 Blood Transfusion

A.1.7.4 Diet

A.1.7.4.1

Dietary charges for normal deliveries

Rs.80/ND/day

288000 NDs for 3

days

691.20 691.20 Approved

A.1.7.4.2

Dietary charges for LSCS deliveries

Rs.80/C-Sec/day

5000 C-Secs for 7

days


A.1.7.4.3

Dietary charges for AN women

Rs.25/PW 975000 PW

243.75 243.75 Approved

A.1.7.5 Referral Transport

A.1.7.5.1

Pick up of AN mothers Rs.954/ PW 334000 PW

3133.89 2250.00 Approved for 9 lakh PW @ Rs 250 /PW A.1.7.5

.2 Drop back of PN mothers Rs.900/ PW 668000

PW 4860.00

A.1.7.6 Janani Shishu Suraksha Karyrakram (JSSK) - incidental charges

Rs.200/ PW 109400 PW


Sub-total Maternal Health (excluding JSY) 14046.54 8297.39 Sub-total JSY 3353.28 3572.48 A.9.3 Maternal Health Training A.9.3.1 Skilled Birth Attendance /

SBA training Rs.1.03 L/batch

182 batches

187.65 187.65 Approved

A.9.3.2 Comprehensive EmOC training (including c-section)

A.9.3.2.1

EmOC Training-MO Rs.5.14 L/batch

6 batches 30.82 30.82 Approved

A.9.3.2.2

Exam cost Rs.2.5 L 2.50 2.50 Approved

A.9.3.2.3

Existing FOGSI 32.00 32.00 Approved



Target


Proposed Approved A.9.3.2.4

Establishment 3 tertiary training centres

Rs.53.91 L/centre

3 centres 161.73 161.73 Approved. Additional tertiary centres can be approved subject to a separate training proposal on this for considering by GoI. State to send a detailed proposal separately. However the lump sum budget can be approved, subject to submission of the proposal on the above suggested line.

A.9.3.2.5

Refresher training for EmOC Rs.27310 /batch

17 batches

4.64 4.64 Approved

A.9.3.3 Life saving Anaesthesia skills training

Rs.3.34 /batch

12 batches


A.9.3.3.1

Exam cost Rs.2.8 L 2.80 2.80 Approved

A.9.3.3.2

Comprehensive Monitoring Cost

Rs.11.70 L 11.70 11.70 Approved. May budget for comprehensive monitoring of all activities at one place. Rs 11.70 lakhs can be approved for monitoring of all MH /RCH Trainings

A.9.3.4 Safe abortion services training (including MVA/ EVA and Medical abortion)

A.9.3.5 RTI / STI training A.9.3.5.1

RTI/STI Training MOs Rs.45350 /MO

65 MOs 29.48 29.48 Approved

A.9.3.5.2

RTI/STI Training SNs Rs.24132/SN

65 SNs 15.69 15.69 Approved

A.9.3.5.3

RTI/STI Training LTs Rs.21070/LT

65 LTs 13.70 13.70 Approved

A.9.3.6 BEmOC training A.9.3.6.1

AMTSL ( 2 ND SPELL BEmONC - MO) and SN

Rs.25850 /batch

175 45.24 0.00 Not approved



Target


Proposed Approved A.9.3.6.2

BEmONC (3rd spell)-MO Rs.43395 /batch

372 batch

161.43 74.00 The BeMOC Training for Medical Officers is of 10 days duration as per GoI guidelines and State is requested not to carry out part by part trainings. Hence Rs 74.00 lakhs approved for training of 370 MOs in a batch size of 5 per batch. Training and expenditure may be done as per GoI norms.

A.9.3.7 Other MH training (Blood storage Training)

Rs.99638 /batch

18 batches


Sub-total training (Maternal Health) 624.71 B15.3.1.3

MCTS

State MCTS Cell {1-Joint Director @ Rs. 50,000 per month

50000 p.m 1 14.40 14.40 Approved

1-Assistant Director@ Rs. 35,000 per month and 1-IT Coordinator@ 16,500 per month}

35000 p.m. (- AD, 16500 p.m. - IT Coordinator)

1+1 6.18 6.18 Approved

‘Own a Laptop’ sharing 20% of the cost to strengthen MCTS


sub total 226.06 26.06 B16 Procurement B16.1 Procurement of Equipment B16.1.1 Procurement of Equipment

for MH

B16.1.1.1

Equipment for FRUs 1471.85 1471.85 Approved. The State is to provide a list of all the facilities along with the equipments to be procured and no additional funds for procurement of equipments will be



Target


Proposed Approved asked for these facilities.

B16.2 Procurement of Drugs and supplies

B16.2.1 Procurement of supplies for MH

B16.2.1.1

Iron sucrose – Maternal Anaemia

1428932 doses

429.00 429.00 Approved

B16.2.1.2

Albendazole for Antenatal mothers

1190777 8.34 8.34 Approved

B16.2.1.3

Gestational Diabetes 1612 161.20 161.20 Approved

Sub-total Procurement for Maternal Health 2070.39 Grand total – Maternal Health 14591.03


CHILD HEALTH & IMMUNIZATION


TARGETS: CHILD HEALTH AND IMMUNIZATION

A OUTCOME INDICATORS Current Status

(SRS 2010) SRS 2013 SRS 2014 SRS 2015

1 Early Neonatal Mortality

13 7 6 5

Early neonatal deaths estimated

14,222

7,658

6,564

5,470

2 NMR 16 10 8 6 Neonatal deaths Estimated

17,504 10,940 8,752 6,564

3 IMR 24 15 12 9 Infant deaths Estimated

26,256 16,410 13,128 9,846

4 U5MR 27 17 14 11 Under 5 deaths Estimated in an year

29,538 18,598 15,316 12,034

Current Status Target for 2012-13

2013-14 2014-15

B KEY PERFORMANCE INDICATORS (CUMULATIVE) 1 Establishment &

operationalisation of SNCUs

44 61

*subject to approval in NPCC

^ built from assistance of World Bank

2 Establishment & operationalisation of NBSU

164^ 164

3 NBCC at delivery points

1488 1727*

4 Establishment of NRCs

0 2

5 Personnel trained in IMNCI (ANM+LHV)

No. 10712 17001 % 60% 94%

6 Personnel trained in F-IMNCI (MO+SN)

No. 0 3125 % 0% 59%

7 Personnel trained in NSSK (MO+ANM+SN)

No. 8092 10242 % 61% 77%

8 ASHA trained in Module 6&7

No. 0 6850 % 0% 100%

C KEY PERFORMANCE INDICATORS (NON CUMULATIVE) 1 New borns visited

by ASHA (as per HBNC guidelines)

No. 0 656400 929900 1094000 % 0 60% 85% 100%

2 New borns breastfed with one hour of birth (CES 2009)

No. 427754 711100 929900 1094000 % 39.10% 65% 85% 100%

3 LBW children (state No. 101742 43760 21880 0


HMIS) % 9% 4% 2% 0% D KEY PERFORMANCE INDICATORS- IMMUNIZATION (NON CUMULATIVE) 1 Fully immunized

children by age of 12-23 months (CES 2009)

No. 845662 984600 1039300 1094000 % 77.30% 90% 95% 100%

2 DPT-3 coverage for 12-23 months (CES 2009)

No. 859884 984600 1039300 1094000 % 78.60% 90% 95% 100%

3 DPT 1st booster in children aged 18-23months (CES 2009)

No. 863166 984600 1039300 1039300 % 78.90% 90% 95% 95%

4 Sessions held (HMIS)

No. 110357 452712 500000 500000 % 98% 100% 100% 100%

*Operationalisation under process from 2011-12 onwards. PIP 12-13 enlists them as being under process.

Note: The targets are calculated for achieving MDG by 2015 and have been aligned with funds recommended for approval in FY 2012-13


ROAD MAP FOR PRIORITY ACTION: CHILD HEALTH AND IMMUNIZATION

A. Priority Actions to be carried out by state for Child Health Interventions

1. All the delivery points should have a functional Newborn Care Corner consisting of essential equipment and staff trained in NSSK. The staff must be trained in a 2 days NSSK training package for skills development in providing Essential Newborn Care.

2. Special Newborn care Units (SNCU) for care of the sick newborn should be established in all Medical Colleges and District Hospitals. All resources meant for establishment of SNCUs should be aligned in terms of equipment, manpower, drugs etc. to make SNCUs fully operational.

3. SNCUs are referral centres with provision of care to sick new born the entire district and relevant information must be given to all peripheral health facilities including ANM and ASHA for optimum utilisation of the facility. Referral and admission of out born sick neonates should be encouraged and monitored along with inborn admissions.

4. NBSUs being set up at FRUs should be utilised for stabilization of sick newborns referred from peripheral units. Dedicated staff posted to NBSU must be adequately trained and should have the skills to provide care to sick newborns.

5. All ASHA workers are to be trained in Module 6 & 7 (IMNCI Plus) for implementing Home Based Newborn Care Scheme. The ASHA kit and incentives for home visits should be made available on a regular basis to ASHAs who have completed the Round 1 of training in Module 6

6. All ANMs are to be trained in IMNCI.

7. All Medical Officers and Staff Nurses, positioned in FRUs/DH and 24x7 PHCs should be prioritised for F-IMNCI training so that they can provide care to sick children with diarrhoea, pneumonia and malnutrition.

8. Infant and Under fives Death Review must be initiated for deaths occurring both at community and facility level.

9. In order to promote early and exclusive breastfeeding, the counselling of all pregnant and expectant mothers should be ensured at all delivery points and breastfeeding initiated soon after birth. At least two health care providers should be trained in ‘Lactation Management’ at District Hospitals and FRUs; other MCH staff should be provided 2 days training in IYCF and growth monitoring.

10. Nutrition Rehabilitation Centres are to be established in District Hospitals (and/or FRUs), prioritising tribal and high focus districts with high prevalence of child malnutrition. The optimum utilisation of NRCs must be ensured through identification and referral of Severe Acute Malnutrition cases in the community through convergence with Anganwadi workers under ICDS scheme.

11. Line listing of newly detected cases of SAM and Low birth weight babies must be maintained by the ANM and their follow-up must be ensured through ASHA.

12. In order to reduce the prevalence of anaemia among children, all children between the ages of 6 months to 5 years must receive Iron and Folic Acid tablets/ syrup (as appropriate) as a preventive measure for 100 days in a year. Accordingly appropriate formulation and logistics


must be ensured and proper implementation and monitoring should be emphasised through tracking of stocks using HMIS.

13. Use of Zinc should be actively promoted along with use of ORS in cases of diarrhoea in children. Availability of ORS and Zinc should be ensured at all sub-centres and with ASHAs.

14. Data from SNCU, NBSU and NRC utilisation and child health trainings (progress against committed training load) must be transmitted on a regular basis to the Child Health Division.

B. Priority Actions to be carried out by state for Immunisation

1. The year 2012 has been declared as the ‘Year of Intensification’ of Routine Immunisation. Therefore, state must prepare a detailed district plan for Intensification of Routine Immunization with special focus on districts with low coverage.

2. The birth dose of immunisation should be ensured for all newborns delivered in the institutions, before discharge.

3. A dedicated State Immunisation Officer should be in place. District Immunisation Officer should be in place in all the districts. The placement of ANMs at all session sites must be ensured.

4. Due list of beneficiaries must be available with ANM and ASHA and village wise list of beneficiaries should be available with ASHA after each session.

5. The immunisation session must be carried out on a daily basis in District Hospitals and FRUs/ 24x7 PHCs with considerable case load in the OPD.

6. Cold chain mechanics must be placed in every district with a definite travel plan so as to ensure that at least 3 facilities are visited every month as a preventive maintenance of cold chain equipment.

7. The paramedic person instead of a clerical staff should be identified as the Cold Chain Handler in all cold chain points and their training must be ensured along with one more person as a backup.

8. It has been observed that the coverage of DPT 1st booster and Measles 2nd dose to be given at the age of 18 months is less than 50% across the country. Therefore coverage of DPT 1st booster and measles 2nd dose must be emphasised and monitored.

9. District AEFI Committees must be in place and investigation report of every serious AEFI case must be submitted within 15 days of occurrence.

10. Rapid response team should be in place in priority districts of the states to identify pockets of low immunization coverage and to respond to any threat of polio.

11. Special micro plans are to be developed for inaccessible, remote areas and urban slums. The micro plans developed under polio programme must be utilised and special focus should be given to the migrant population


DETAILED BUDGET: CHILD HEALTH & IMMUNIZATION

FMR Code Budget Head Unit cost Physical Target

BUDGET (Rs. In lakh) Remarks Proposed Approved

A.2 CHILD HEALTH A.2.1 IMNCI A.2.1.1 Prepare detailed

operational plan for IMNCI across districts (Supplies, Logistics, Supportive supervision at the District level )

Rs.1000/visit

4 visit /month x

30 district x 12

months


A.2.1.2 Implementation of IMNCI activities in districts

A.2.1.3 Monitor progress against plan; follow up with training, procurement, etc (State Level – IMNCI cell)

Rs.25000/m

1 meeting/

m

3.00 3.00 Approved

A.2.1.4 Pre-service IMNCI activities in medical colleges, nursing colleges, and ANMTCs

A.2.2 Facility Based Newborn Care/FBNC (SNCU, NBSU, NBCC)

A.2.2.1 Essential Newborn care (Operational cost (existing + new ) NBCCs)

Rs.20000/NBCC

1606 NBCCs

321.20 0.00 Not approved.

A.2.2.2 Sick Newborn Care Operational cost for NBSUs (existing + new) NBSU

Rs.1.75 L/NBSU

156 NBSUs

273.00 202.80 Approved for 9 months only. 42 units under process & 114 units to be established with support from World Bank.

A.2.2.3 Up gradation of Existing NBSU at Sec Health Care System

Rs.2 L/NBSU

114 NBSUs


A.2.2.4 Operational cost for SNCUs (existing + upgradation proposed )

Rs.10 L/SNCU

61 SNCUs 610.00 525.00 Approved for 44 units for 1 year and 17 units for 6 months

A.2.2.5 Up gradation of Existing SNCUs in 20 Centers(17 Dist Hospitals and 3 Med College - Hospitals

Rs.15 L/SNCU

20 SNCUs 300.00 255.00 Approved at 7 DHQ +10 SDH only. SNCU at 3 medical colleges in Chennai not approved.

A.2.3 Home Based Newborn Care/HBNC




A.2.4 Infant and Young Child Feeding/IYCF

A.2.5 Care of Sick Children and Severe Malnutrition at facilities (e.g. NRCs, CDNCs etc.)

A.2.5.1. Establishing new NRC Rs.2L/NRC 2 NRCs 4.00 4.00 Approved A.2.5.2 Operational cost for new

NRCs Rs.7.8 L 2 NRCs 15.60 7.80 Approved for 6 months

only A.2.6 Management of

Diarrhoea, ARI and Micronutrient Malnutrition

A.2.7 Other Activities A.2.7.1 Rapid Assessment of

SNCUs by Core group committee

Rs.15000/visit

12 visits 1.80 1.80 Approved

A.2.7.2 State Level Quarterly reviews of SNCU activities in the Districts

Rs.5000/visit

43 visits to 43

SNCUs every

quarter

8.60 8.60 Approved

A.2.7.3 Establishment of Early Intervention center for Children with developmental disorder in PPP mode

Rs.3.93 L/centre

8 centres 31.42 31.42 Approved

A.2.7.4 Prenatal Screening to detect fetal anomaly in PPP mode – cost for online auditing and software

Rs.95000/facility

232 facilities


A.2.7.5 Conduction of well baby clinic in PHCs by Peadiatrician in NICU in 10 high IMR blocks

Rs.6000/clinic/m

10 clinics 7.20 0.00 Not approved. As per the comments received from the state, clinics are to be held at PHCs and not at NICU. It is proposed that doctors from these PHCs be trained in F-IMNCI so that specialised care is available to the children throughout the year rather than on a monthly basis.




A.2.7.6 Workshop on Customization of teleradiology enabled modules for training in Ultrasonagram to detect foetal anomaly

Rs.1 L/worksho

p

2 workshop

s

2.00 0.00 To be mobilised from IEC budget

A.2.8 Infant Death Audit A.2.8.1 Infant Death Audit of

case sheets and preconference workshop

Rs.1.50 L/worksho

p

4 workshop

s

6.00 6.00 Approved

A.2.8.2 Infant Death Audit at Facility level

Rs.1000/death

15000 deaths

150.00 0.00 Not approved as cost proposed is too high. Facility based audit should not be linked to incentives as these are to be carried out by the hospital staff /administration.

A.2.9 Incentive to ASHA under Child Health

A.2.10 JSSK- Janani Shishu Surakhsha Karyakram (for Sick neonates upto 30 days)

A.2.10.1 Drugs & Consumables Rs.5939/neonate

10658 neonates

633.00 180.00 Approved for 90,000 sick neonates @ Rs.200/sick neonate.

A.2.10.2 Diagnostic A.2.10.3 Referral Subtotal Child Health 2829.62 1239.82

A.9.5 Child Health Training

A.9.5.1 IMNCI Training

A.9.5.1.1 General IMNCI - TOT Rs.70535/ batch


A.9.5.1.2 Monitoring cost Rs.20000/ batch

1 batch 0.20 0.20 Approved

A.9.5.1.3 Refresher General IMNCI-VHN/SHN/CHN

Rs.32580/ batch

202 batches

65.81 65.81 Approved.

A.9.5.1.4 Refresher General IMNCI-AWW

Rs.27405/ batch

300 batches

82.22 0.00 Not approved. Training should be planned with DWCD and funds mobilised from DWCD.

A.9.5.2 F-IMNCI training




A.9.5.2.1 FIMNCI-Pvt Students Rs.1500/ student

350 students

5.25 5.25 Approved

A.9.5.2.2 SNCU - Refresher Training

Rs.2.22 L/batch

9 batches 20.00 0.00 Not approved. It is proposed that for the existing staff nurses who have already been trained skills assessment for each one of them be done by the SNCU doctors and on the job skill enhancement be provided.

A.9.5.2.3 SNCU - Newer Training Rs.2.22 L/batch

9 batches 20.00 13.33 Approved condition to Observership plan being provided by the state. 17 SNCUs x 10 SN in each=170, 6 batches approved. The remaining nurses (1 for each SNCU =44+17=61) who are supposed to provide counseling should be trained accordingly (e.g.; in IYCF, management of LBW babies, advise on follow up and so on).

A.9.5.2.4 NBSU - MO Rs.2.9 L/batch

15 batches

43.50 0.00 To be included in F-IMNCI training load

A.9.5.2.5 NBSU - SN Rs.2.24 L/batch

12 batches

26.86 0.00

A.9.5.3 Home Based Newborn Care training

A.9.5.4 Care of Sick Children and severe malnutrition training

A.9.5.4.1 SAM TOT Rs.89400/ batch




A.9.5.4.3 SAM - MO/SN Rs.35325/ batch

21 batches

7.42 7.42 Approved

A.9.5.4.4 SAM - CHN/SHN/VHN Rs.18500/ batch

95 batches





A.9.5.5 Other CH training (pls specify)

A.9.5.5.1 NSSK (ANM-Urban) Rs.35690/ batch


A.9.5.5.2 NSSK (ANM/VHN) Rs.32240/ batch

66 batches


A.9.5.5.3 Orientation IYCF - TOT Rs.74675/ batch




A.9.5.5.5 Orientation IYCF - MO Rs.24050/ batch

341 batches


A.9.5.5.6 Orientation IYCF - CHN/SHN/VHN

Rs.10000/ batch

448 batches


A.9.5.5.7 USG - MO 78 CEmONC Rs.31200/ batch

20 batches

6.24 0.00 Not approved. GoI is still in the process of finalising curriculum for ultrasonography training.

A.9.5.5.8 USG - MO 154 CHC Rs.31200/ batch

39 batches

12.17 0.00

A.9.5.5.9 Refresher training to detect foetal anomaly

Rs.7600/ batch

64 batches

4.86 0.00

Sub-total CH training 475.63 273.11

B1 ASHA

B1.1.3.1.i Home Based Newborn Care (new)

250 2650*16 106.00 106.00 Approved. The State may give incentives to ASHAs only after training of ASHAs as per GoI guidelines.

B1.1.3.1.ii Reporting of Infant Deaths and children in 5 years (new)

25 2650*5 3.31 3.31 Approved

B1.1.3.1.iii Village Health and Nutrition Days (ongoing)

100 2650*12 31.80 31.80 Approved

B1.1.3.1.vi Immunization activity (new)

100 p m 2650 31.80 0.00 Approved

B1.1.3.1.vii Incentives for Vitamin A and Deworming campaign (ongoing)

200 each 2 sessions each


Sub-total ASHA (Child Health)

194.11 162.31

B7 District Plans




Save the Girl child scheme (new) 20.00 20.00

Sub-total 20.00 20.00

B10 BCC / IEC

B10.2.2 IEC - IEC/BCC Activities for CH

B10.2.2.1 a. EMRI boards for Neonatal transport, b.SNCU boards, c.LBW protocols etc

75000/ district, 25000/ center,

1500/ center,

500/ center

29 47

1612 8706

101.21 101.21 Approved

B14 INNOVATIONS

B14.4 Congenital and Developmental Defects (new)

B14.4.1 Congenital and Developmental Defects and Follow Up - Phase I

126.32 126.32 Approved

B14.4.2 Congenital and Developmental Defects and Follow Up - Phase II

300.00 300.00 Approved

B14.4.3 Congenital and Developmental Defects and Follow Up - Phase III


Sub-total IEC/BCC 583.95 583.95

B16 Procurement

B16.1 Procurement of Equipment

B16.1.2 Procurement of Equipment: CH

B16.1.2.1 Equipment for SNCU @ 10 lakhs

10 lakh 20 200.00 170.00 Approved for 17 units

B16.1.2.2 Equipment for Sick newborn transport system @ 4.5 lakhs

4.5 lakh 29 130.50 0.00 Not approved

B16.1.2.3 Equipment for new born corner for 73 new PHCs, 31 level 1 MCH centre

85000 239 203.15 203.15 Approved




and 135 UPHCs @ Rs.85000/-

B16.1.2.4 Equipment, medication and consumable for ASHA home based new born care in 2650 tribal and 4200 program specific VHVs @ Rs. 2000 per VHV

1500 6850 137.00 0.00 Not approved

B16.1.2.5 Equipment for training for prenatal screening to detect fetal anomalies in 78 CEmONC centers and 154 PHCs

B16.1.2.5.i Desktop and Accessories @ Rs.11000/-

Rs. 35000 for

desktops and 11000

for accessories

232 106.72 106.72 Approved

Sub-total procurement 777.37 479.87

B13 PPP /NGOs

B13.2.1 Pilot Project on Management of Children affected with Muscular Dystrophy Disorder

125.50 125.50 Approved

B13.2.4 Home Based Newborn Care Project in PPP mode - for identification, referral, follow-up and ensuring survival in low birth babies - based on Gadchiroli model

3200 per VHV

1500 72.00 72.00 Approved

Sub-total PP/ NGOs 197.5 197.5

Grand total Child Health 5585.18 2956.56


Part C –Immunization

FMR Code

Activities( As proposed by the State)

Unit Cost (wherever applicable)

Physical Target

Amount Proposed

Amount Approved

Remarks

C.1 RI Strengthening Project (Review meeting, Mobility Support, Outreach services etc c.1.a Mobility Support for

supervision for district level officers.

Rs.50000/ Year /district level officers.

16.00 16.00 All activities

related to mobility

support and monitoring projected

under state specific

activities are recommended but are to be met from the

amount recommended

under c.1.a and c.1.b

c.1.b Mobility support for supervision at state level

Rs. 100000 per year.

3.00 1.00

c.1.c Printing and dissemination of Immunization cards, tally sheets, monitoring forms etc.

Rs. 5 beneficiaries

211.61 119.80

c.1.d Support for Quarterly State level review meetings of district officer

10.00 4.80

c.1.e Quarterly review meetings exclusive for RI at district level with one Block MOs, CDPO, and other stake holders

- -

c.1.f Quarterly review meetings exclusive for RI at block level

- -

c.1.g Focus on slum & underserved areas in urban areas/alternative vaccinator for slums

24.36 24.36


FMR Code



Physical Target

Amount Proposed

Amount Approved

Remarks

c.1.h Mobilization of children through ASHA or other mobilizers

Rs. 150 per session

- -

c.1.i Alternative vaccine delivery in hard to reach areas

Rs. 100 per session

- -

c.1.j Alternative Vaccine Delivery in other areas

Rs. 50 per session

452.71 226.36

c.1.k To develop microplan at sub-centre level

@ Rs 100/- per subcentre

- -

c.1.l For consolidation of microplans at block level

Rs. 1000 per block/ PHC and Rs. 2000 per district

- -

c.1.m POL for vaccine delivery from State to district and from district to PHC/CHCs

Rs100,000/ district/year

14.00 14.00

c.1.n Consumables for computer including provision for internet access for RIMS

@ 400/ - month/ district

- -

c.1.o Red/Black plastic bags etc.

Rs. 2/bags/session

263.17 46.51

c.1.p Hub Cutter/Bleach/Hypochlorite solution/ Twin bucket

Rs. 900 per PHC/CHC per year

c.1.q Safety Pits - c.1.r State specific

requirement 290.77 40.04

C.1-Sub Total 1,285.62 492.87 C.2 Salary of Contractual Staffs -Sub Total

c.2.a Computer Assistants support for State level

Rs.12000-15000 per person per month

1.44 1.44


FMR Code



Physical Target

Amount Proposed

Amount Approved

Remarks

c.2.b Computer Assistants support for District level

8000-10000 per person per month

26.88 26.88

C.2-Sub Total

28.32

28.32

C.3 Training under Immunization c.3.a District level Orientation

training including Hep B, Measles & JE(wherever required) for 2 days ANM, Multi Purpose Health Worker (Male), LHV, Health Assistant (Male/Female), Nurse Mid Wives, BEEs & other staff ( as per RCH norms)

- -

c.3.b Three day training including Hep B, Measles & JE(wherever required) of Medical Officers of RI using revised MO training module)

- -

c.3.c One day refresher training of distinct Computer assistants on RIMS/HIMS and immunization formats

- -

c.3.d One day cold chain handlers training for block level cold chain handlers by State and district cold chain officers

- -

c.3.e One day training of block level data handlers by DIOs and District cold chain officer

- -

C.3-Sub Total - -


FMR Code



Physical Target

Amount Proposed

Amount Approved

Remarks

C.4 Cold chain maintenance Rs.500/PHC/CHCs per year District Rs.10000/year

11.26 11.26

C.5 ASHA incentive for full Immunization

31.80 31.80

To be factored into part C from part B. Rs 31.8 lakhs recommended. However the incentive is to be given as per Rs 100 for every child fully immunized under 1 year.

Total 1,357.00 564.25 C.6 Pulse Polio Operational

Cost (Tentative) - 976.67

Total 1,357.00 1,540.92

The projected amount is lower than the recommended amount because of provisioning of Pulse Polio Operational Cost

Activities under state specific requirement include Hiring of alternate vaccinators in rural areas


FAMILY PLANNING


ROAD MAP FOR PRIORITY ACTION: FAMILY PLANNING

MISSION: “The mission of the national Family Planning Program is that all women and men (in reproductive age group) in India will have knowledge of and access to comprehensive range of family planning services, therefore enabling families to plan and space their children to improve the health of women and children”. GUIDING PRINCIPLES: Target-free approach based on unmet needs for contraception; equal emphasis on spacing and limiting methods; promoting ‘children by choice’ in the context of reproductive health. STRATEGIES: 1. Strengthening spacing methods:

a. Increasing number of providers trained in IUCD 380A b. Strengthening Fixed Day IUCD services at facilities. Increased focus on IUCD services

at subcentres for at least 2 fixed days a week c. Introduction of Cu IUCD 375 d. Delivering contraceptives at homes of beneficiaries (in pilot states/ districts)

2. Emphasis on post-partum family planning services: a. Strengthening Post-Partum IUCD (PPIUCD) services at least at DH level b. Promoting Post-partum sterilisation (PPS) c. Establishing Post-Partum Centers at women & child hospitals at district levels d. Appointing counsellors at high case load facilities

3. Strengthening sterilization service delivery a. Increasing pool of trained service providers (minilap, lap & NSV) b. Operationalising FDS centers for sterilisation c. Holding camps to clear back log

4. Strengthening quality of service delivery: a. Strengthening QACs for monitoring b. Disseminating/ following existing protocols/ guidelines/ manuals c. Monitoring of FP Insurance

5. Development of BCC/ IEC tools highlighting benefits of Family Planning specially on spacing methods

6. Focus on using private sector capacity for service delivery (exploring PPP availability): 7. Strengthening programme management structures:

a. Establishing new structures for monitoring and supporting the programme b. Strengthening programme management support to state and district levels

KEY PERFORMANCE INDICATORS:

a. % IUD inserted against ELA b. % PPIUCD inserted against total IUCD c. % PPIUCD inserted against institutional deliveries d. % of sterilisations conducted against ELA


e. % post-partum sterilisation against total female sterilisations f. % of male sterilisation out of total sterilisations conducted g. % facilities delivering FDS services against planned h. % of personnel trained against planned i. % point decline in unmet need j. point decline in TFR k. % utilisation of funds against approved

CONDITIONALITIES FOR FP PIP: 2012-13

SN. Indicator Target / ELA-

2012-13

Minimum Level of Achievement

Remarks By Sep. 2012

By March 2013

1 Goal (target):

1.1 Reduction in TFR – 2013 Maintain TFR

level NA NA

Current TFR - 1.7 (SRS 2010)

2 Service delivery (ELA):

2.1 IUCD:

2.1.1 Post-partum IUCD 30000 12000 27000

2.1.2 Interval IUCD 320000 128000 288000

2.2 Sterilisation:

2.2.1 Tubectomy 350000 105000 280000

2.2.2 Post-partum sterilisation (subset of tubectomy)

290000 87000 232000

2.2.3 Vasectomy 4000 1200 3200

3 Training of personnel (target):

3.1 Post-partum IUCD

3.1.1 MO 1464 366 1098

3.1.2 SN/ ANM 0 0 Not proposed

3.2 interval IUCD

3.2.1 MO 54 14 41


SN. Indicator Target / ELA-

2012-13

Minimum Level of Achievement

Remarks By Sep. 2012

By March 2013

3.2.2 SN 1240 310 930

3.2.3 ANM/ LHV 1860 465 1395

3.3 Minilap 664 166 498

3.4 NSV 192 48 144 107 trained

3.5 Laparoscopic 44 11 33 117 trained

4 Others (target):

4.1 Appointment of FP Counsellors 100% DH 100% DH NA 172 FP Counsellors

4.2 Regular reporting of the scheme of “home delivery of contraceptives by ASHAs”

Regular reporting

Monthly reporting till

Sep 12

Quarterly reporting after

Sep 12

Scheme is not under

implementation in the state

4.3 Fixed Day Services for IUCD Wkly once - HSC, PHC, UFWC, HPC.

Daily - PPCs NA 100%

State has mentioned that

services would be provided as mandated;

however, number of facilities have

not been provided

4.4 Fixed Day Services for Sterilisation F.S: 639 facilities M.S: 97 facilities

NA 100%

5 YEARS PROJECTION OF KEY INDICATORS

SN. Indicator Current Status Target/ ELA

2012-13 2013-14 2014-15 2015-16 2016-17 1 Goal Indicators:

1.1 Total Fertility Rate (TFR) 1.7

(SRS 2010) Maintain

1.2 Contraceptive Prevalence Rate (CPR)

57.8 (DLHS-3)

65.0 70.0 72.5 75.0 80.0

1.3 Unmet Need 19.4

(DLHS-3) 14.0 12.0 11.0 9.0 8.0

2 Service delivery:


SN. Indicator Current Status Target/ ELA

2012-13 2013-14 2014-15 2015-16 2016-17

2.1 IUCD - Total 349654

(HMIS: 2010-11) 350000 375000 400000 435000 460000

2.2 Post-partum IUCD (subset of IUCD-total)

30000 40000 55000 70000 90000

2.3 Female Sterilisation 325090

(HMIS: 2010-11) 350000 355000 360000 365000 370000

2.4 Post-partum sterilisation (subset of tubectomy)

283058 (HMIS: 20101-11)

290000 295000 300000 305000 310000

2.5 Male sterilisation 2172

(HMIS0: 2010-11) 4000 5000 6500 9000 10000

3 Input/ facility operationalization: 3.1 Fixed Day service delivery:

3.1.1 IUCD (daily at DH, SDH, CHC) Wkly once - HSC, PHC, UFWC, HPC.

Daily - PPCs

Weekly @ PHC +

CHC

Weekly @ PHC +

CHC

Weekly @ PHC +

CHC

Weekly @ PHC +

CHC All SHC

3.1.2 Sterilisation F.S: 639 facilities M.S: 97 facilities

All DH

DH + 1 SDH/

FRU per dist

DH + all FRU per

dist

DH + all FRU +

25% PHC per dist

DH + all FRU + 50%

PHC per dist

3.2 Appointment of FP counsellors 172 counsellors All DH

DH + 1 SDH/

FRU per dist

DH + all FRU per

dist

DH + all FRU per

dist

DH + all FRU per

dist


DETAILED BUDGET: FAMILY PLANNING


Target

BUDGET (Rs. Lakhs) Remarks Proposed Approved

A.3 FAMILY PLANNING

A.3.1 Terminal/Limiting Methods

A.3.1.1

Orientation workshop and dissemination of manuals on FP standards & quality assurance of sterilisation services

Rs. 25000/ district

32 districts

8.00 8.00 Approved

A.3.1.1.1

Prepare operational plan for provision of sterilisation services at facilities (fixed day) as well as camps , review meetings

Rs. 5000-9000/

meeting

24 meetings

1.60 1.60 Approved

A.3.1.2

Organise female sterilisation camps Rs.15000/camp

252 (12 camps / yr

x 21 Blocks)

37.80 37.80 Approved As per the GoI norm at least 100 sterilisations to be conducted at each camp.

A.3.1.3

Organise NSV camps Rs.35000/camp

192 camps


A.3.1.4 Compensation for female sterilisation

Rs.1000/sterilisation

219000 sterilisatio

ns

2190.00 2190.00 Approved

A.3.1.5

Compensation for NSV Acceptance Rs.2000/sterilisation

3200 sterilisatio

ns

64.00 48.00 1. State has proposed Rs. 2000/ NSV which is against the GoI approved norm of Rs. 1500/ male sterilisation. 2.Budget has been accordingly



Target


revised and approved

A.3.1.6 Accreditation of private providers to provide sterilisation services

Rs.1500/sterilisation

40000 Sterilisatio

ns


A.3.2 Spacing Methods

A.3.2.1 IUD camps Rs.2000/camp

624 camps


A.3.2.2 Implementation of IUD services by districts (including fixed day services at SHC and PHC)

A.3.2.2.1 Provide IUD services at health facilities / compensation

Rs.20/IUD insertion

350000 IUDs


A.3.2.2.2 PPIUCD services

A.3.2.3 Accreditation of private providers to provide IUD insertion services

A.3.2.4

Social Marketing of contraceptives (including delivery of contraceptive by ASHA at door step) Propagate information on IUCD insertion through VHAs as well as incentivise them for brining IUCD cases @ Rs. 100.

Rs.100/VHV 1639 VHV x 5 IUCD = 8195 IUCD insertions

8.20 0.00 (1) Not approved. State may do so with its own funds. (2)State has proposed to propagate information on IUCD insertion through VHAs as well as incentivise them for bringing IUCD cases @ Rs. 100. (3) GoI only provides Rs. 20/ IUCD and no separate budgetary provision may be approved.



Target


A.3.2.5 Contraceptive Update seminars

A.3.3 POL for Family Planning/ Others (including additional mobility support to surgeon's team if req)

A.3.4

Repairs of Laparoscopes Single puncture - Rs. 35000

Double Puncture- Rs.

65000

Single puncture-

77 Double

Puncture- 25

43.20 43.20

Approved

A.3.5 Other strategies/activities (please specify):

A.3.5.1

Monitor progress, quality and utilisation of services (both terminal and spacing methods) including complications / deaths / failure cases. Note: cost of insurance / failure and death compensation NOT to be booked here

Rs. 8000/ dist 32 districts

2.56 2.56

Approved

A.3.5.2

Performance reward if any 2.00 2.00 (1) Best 3 districts, 3 PHCs, 3 Govt. Hospital, 3 Voluntary organizations in sterilization Performance & 3 districts in NSV performances. Ist prize (Rs.15000), IInd prize (Rs.10,000) & IIIrd Prize (Rs. 8000). Conducting the ward function @ Rs.35000. (2) State needs to develop minimum benchmark



Target


over and above which awards would be given. (3) Approved

A.3.5.3

World Population Day’ celebration (such as mobility, IEC activities etc.): funds earmarked for district and block level activities


A.3.5.4

Printing of Forms and Registers Rs. 1 L/distt 32 districts

32.00 32.00 Approved. State has planned to print Sterilisation Consent Forms along with Checklist, Sterilisation Registers, IUD Registers, MTP Registers, Consolidation Registers & Monthly Reporting format from HSC to PHC and from Institution to DFWB.

A.3.5.5

Dietary charges for beneficiaries who underwent sterilisation

Rs.400/case 100000 cases

400.00 100.00 Approved @ Rs. 100/ per case. Shifted from MH.

A.3.5.6 IUCD Camps in tribal areas Rs.2000/cam

p 624

camps 12.48 0.00 Not approved

Sub-total Family Planning (excluding compensation) 560.32 206.36 Sub-total Sterilisation and IUD compensation & NSV camps 2391.20 3025.48


ADOLESCENT HEALTH


ROAD MAP FOR PRIORITY ACTION: ADOLESCENT HEALTH

Priority Actions to be carried out by the State: SETTING UP OF AH CELL A unit for adolescent health at state level with a nodal officer supported by four consultants one each for ARSH, SHP, Menstrual hygiene and WIFS; one nodal officer (rank of ACMHO) for all the components of Adolescent Health at district level to take care of Adolescent health programme including the SHP. PROGRAMME SPECIFIC ESSENTIAL STEPS FOR IMPLEMENTATION: I. Adolescent Reproductive Sexual Health (ARSH) Programme

Clinics Number of functional clinics at the DH, CHC, PHC and Medical Colleges (dedicated

days, fixed time, trained manpower). Number of clinics integrated with ICTCs Quarterly Reporting from the ARSH clinics to be initiated to GoI. Establish a Supportive supervision and Monitoring mechanism

Outreach Utilisation of the VHND platform for improving the clinic attendance. Demand generation in convergence with SABLA and also through Teen Clubs of

MOYAS Capacity Building/Training:

Calculation of the training load and development of training plans/ refresher trainings.

Deployment of trained manpower at the functional clinics. II. School Health Programme:

GoI Guidelines including terms of reference of stakeholders adapted by States and operational plan in place.

School health committee with diverse stakeholders beyond the health department; this committee with representation of academia will be responsible for implementation and monitoring of the programme.

Involvement of nodal teachers from schools in the programme (Screening and communication - preventive and promotive) is to be ensured.

Height / weight measurement and BMI calculation should be part of School Health Card.

All children in government and government aided schools should be covered. The programme should focus on three Ds- Deficiency, Disease and Disability. Referral of children must be tied up and complete treatment at higher facilities to be

ensured. An effort should be made to have dedicated teams for school health. The teams should

also conduct health check- ups for children below 6 years at AWCs.

III. Menstrual Hygiene Scheme (MHS):


Formation of State and district level steering committees. Training / re-orientation of service providers(MOs, ANMs, ASHAs) Monthly meeting with BMO. Regular feedback on quality of sanitary napkins to be sent to GoI Identification of appropriate storage place for sanitary napkins. Mechanism of distribution of SN right upto the user level. Reporting and accounting system in place at various levels. Utilizing MCTS for service delivery by checking with ASHAs and ANMs about supply

chain management of IFA tabs and Sanitary napkins. Distribution of Sanitary Napkins to school going adolescent girls to be encouraged in

schools and preferably combined with Weekly Iron Folic Acid Supplementation (WIFS).

IV. Weekly Iron and Folic Acid Supplementation programme (WIFS): Procurement policy in place for procurement of EDL including IFA and deworming

tablets. Establish “Monday” as a fixed day for WIFS. Plan for training and capacity building of field level functionaries of concerned

Departments (i.e. Department of Women and Child Development and Department of Education) and plan for sensitization of Programme Planners on WIFS.

Programme Planners on WIFS. Ensure that monitoring mechanism as outlined in the operational framework (Shared

with the States during the National Adolescent Health Workshop) are put in place across levels and departments.


DETAILED BUDGET: ADOLESCENT HEALTH

FMR Code Budget Head Unit

cost Physical Target


A.4 ADOLESCENT REPRODUCTIVE SEXUAL HEALTH (ARSH)

A.4.1 Adolescent services at health facilities

A.4.2 School Health Programme

A.4.2.1 Implementation of School Health Programme by districts.

0.00 911.47 Shifted from E 2.3. Approved

A.4.2.2 Developing and printing of HEAL modules for Middle/High/Hr.sec Schools with TANSAC training material included


A.4.2.3 Monitor progress and quality of services.

0.00 111.57 Shifted from E 2.3.Approved

A.4.3 Other strategies/activities (please specify) Details of the Menstrual Hygiene project to be provided and budgeted under this head

Sub-total ARSH 0.00 1186.69


DETAILED BUDGET: SCHOOL HEALTH

FMR Code

Activity Unit Rate (Rs.)

Physical Target/ Expected Output

BUDGET 12-13 (Rs. Lakhs)

Remarks

Proposed Approval

Under RCH flexipool A 4.2.1 Prepare and

disseminate guidelines for School Health Programme.

Developing and printing of HEAL modules for Middle/High/Hr.sec Schools with TANSAC training material included

Rs.1500/- per unit

10910 Heal module and DVD sets (9918 schools+992 buffer=10,910)

163.65 163.65 Recommended for approval under FMR A 4.2.1, In the state budget this is projected under E 2.1

A 4.2.2 Prepare detailed operational plan for School Health Programme across districts (cost of plan meeting should be kept)

A 4.2.3 Implementation of School Health Programme by districts.

911.47 911.47

1 Replenishment of fund to Health Promotion committee in each school

1000 42769 Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.2. Please add details of expenditure under this head for FY 2011-12

2 Appraisal register to each school

100 47046 (42,769+4,277 buffer = 47046)

Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.3.

3 Referral register to each school

100 47046 (42,769+4,277 buffer = 47046)


4 Transport charges for referred student- onetime payment

100 34000 Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.4.


FMR Code

Activity Unit Rate (Rs.)

Physical Target/ Expected Output

BUDGET 12-13 (Rs. Lakhs)

Remarks

Proposed Approval

5 Health Kiosk (One Kiosk / PHC) @ Rs.8000/- kiosk

8000 1773 (1612+161)


6 Question Box / School 500 42769 Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.7.

A 4.2.4 Monitor progress and quality of services.

111.57 111.57

1 Printing of SH cards for 1st & 6th std students

6 1792811 (16,29,828 + 1,62,983 Buffer)


2 Online data entry package

400000 1 Recommended for approval under FMR A 4.2.4, In the state budget this is projected under E 2.8.

Subtotal Adolescent Health

1186.69 1186.69

A 8 Infrastructure & HR (Contractual)

Hiring of Doctors One Doctor / PHC for 10 months @ Rs.1000/- visit

10000 1612 161.20 161.20 Recommended for approval under FMR A 8, In the state budget this is projected under E 2.5.

A 9 Training Training for Teachers

& Health Personnel 15.21 15.21 Recommended for approval

under FMR A 9, In the state budget this is projected under E 2.1. State to give number of participants, batch size and unit cost of batch

Grand total for Adolescent Health

1363.1 1363.1


URBAN RCH


ROAD MAP FOR PRIORITY ACTION: URBAN RCH

Priority Actions to be carried out by the State:

Carry out a comprehensive third party evaluation of UHCs/ NGO performance including an assessment of reasons for low expenditure (9.6 % in the first 9 months of 2011-12). State to apprise MoHFW of action taken on the basis of the findings of the evaluation by September 2012.

Monitor performance of UHCs/NGOs against targets.

Staffing at UHCs to be linked to case load.

BUDGET: URBAN RCH


Target


A.5.1 URBAN RCH A.5.1.1 Establishment of

75 Urban Health Center

A.5.1.2 Staff salary 550.80 A.5.1.3 Rent for UPHC Rs.4000/

m 62 UPHCs 29.76

A.5.1.4 Furniture ,Stores & equipments, Computer Accessories

Rs.1.46 L/UHC

75 new UPHCs

109.50

Total 690.06 Amount already sanctioned under supplementary budget (RoP 11-12) 310.20 Amount proposed (2012-13) 379.86 379.86 The total proposed

budget for Urban RCH is Rs.690.06 lakhs, but State has Rs.310.20 lakhs as sanctioned amount for this activity hence has proposed Rs. 379.86 lakhs only, which has been approved accordingly.


TRIBAL HEALTH


ROAD MAP FOR PRIORITY ACTION: TRIBAL HEALTH


State to closely monitor progress (physical, expenditure) on all health activities in notified tribal areas.

On a quarterly basis, a progress report, including constraints faced and action proposed to be sent to MoHFW.

The State shall focus on health entitlements of vulnerable social groups like SCs, STs, OBCs, minorities, women, disabled, migrants etc.

BUDGET


Target


A.6 TRIBAL RCH A.6.1 Birth Waiting Room in 17

Tribal PHCs

A.6.1.1 Contingency Rs.2500/ unit/m

17 units for 8 months

3.40 3.40 Approved

A.6.1.2 Electricity Charges Rs.2500/ unit/m


3.40 3.40 Approved

A.6.1.3 POL charges Rs.8000/ unit/m



A.6.1.4 Honorarium to CHN Rs.500/ unit/m


0.68 0.68 Approved

A.6.1.5 Honorarium to Sanitary Worker

Rs.500/ worker/m

51 workers for 8 months

2.04 2.04 Approved

A.6.2 Tribal MMU A.6.2.1 Salary for Doctors Rs.40000/

m 21 doctors 85.68 0.00 Approved

under HR A.6.2.2 POL charges Rs.18000/

m/MMU 21 MMU 45.36 43.20 Approved only

for existing 20 MMUs.

A.6.3 Referral Services A.6.3.1 Operational cost for the

proposed 24 new four wheel drive for referral services

Rs.1 L/vehicle/m

24 vehicles for 6 months

144.00 0.00 New Procurement of MMU vehicles for tribal areas not approved, since already



Target


every block has MMU. MMUs from some of the better performing non-tribal blocks, can be diverted, if required.

A.6.3.2 Operational cost for the existing 24 four wheel drive for referral services

Rs.1 L/vehicle/m

24 vehicles for 12 months

288.00 288.00 Approved

A.6.3.3 Procurement / fabrication of 24 new four wheel drive

Rs.11.5 L/vehicle

24 vehicles 276.00 0.00 Not approved.

A.6.3.4 Procurement of 13 new four wheel drive vehicles @ 7.6 lakhs (MMU outreach services by NGO)

Rs.7.6 L 13 98.80 0.00 Not approved.

A.6.4 Other Activities A.6.4.1 Grant In Aid(Bed Grant)

for 4 Hospitals in 3 district through PPP mode (Through NGO)

Rs.10 L/hospital

4 hospitals 40.00 0.00 Not approved

A.6.4.2 Tribal counselors in Govt. Institutions

Rs.5000/ counselor/m

10 counselors

6.00 6.00 Approved subject to State providing list of facilities where the counselors would be placed and those facilities should not have any other counselor viz. FP and/or ARSH counselor.

Sub total Tribal Health 1004.24 357.60


PC-PNDT


ROAD MAP FOR PRIORITY ACTION: PNDT


Strengthening programme management structures: Appointment of Nodal officer Strengthening of Human resource Formation of PNDT Cell at state and district level

Establishment of statutory bodies under the PC&PNDT Act

Constitution of 20 member State Supervisory Board Reconstitution every three years (other than ex-officio

members) Four meetings in a year

Notification of three members Sate Appropriate Authority, Constitution of 8 member State Advisory Committee

Reconstitution in every 3 years At least 6 meetings in a year

Notification of District Appropriate Authorities Constitution of 8 member district Advisory Committees

Reconstitution in every 3 years At least 6 meetings in a year

Strengthening of monitoring mechanisms Monitoring of sex ratio at birth through civil registration of birth data Formulation of Inspection and Monitoring committees Increasing the monitoring visits Review and evaluation of registration records Online availability of PNDT registration records Online filling and medical audit of form Fs Ensure regular reporting of sales of ultrasound machines from manufactures Enumeration of all Ultrasound machines and identification of un-registered

ultrasound machine Ensure compliance for maintenance of records mandatory under the Act Ensure regular quarterly progress reports at state and district level

Capacity building and sensitisation of program managers

Appropriate Authorities Advisory committee members Nodal officers both State and District

Sensitisation and Alliance building with Judiciary


Medical Council / associations Civil society

Development of BCC/ IEC/ IPC Campaigns highlighting provisions of PC& PNDT Act and

promotion of Girl Child

Convergence for Monitoring of Child sex Ratio at birth KEY PERFORMANCE INDICATORS:

Improvement in child sex ratio at birth % of civil registration of births Statutory bodies in place % registrations renewed Increase in inspections and action taken No. of unregistered machines identified % of court cases filed % of convictions secured No. of medical licences of the convicted doctor cancelled or suspended

NO BUDGET HAS BEEN PROPOSED BY THE STATE


HUMAN RESOURCES AND PROGRAM MANAGEMENT


ROAD MAP FOR PRIORITY ACTION: HUMAN RESOURCES


A comprehensive HR policy to be formulated and implemented; to be uploaded on the website too.

Underserved facilities particularly in high focus districts/ areas, to be first strengthened through contractual staff engaged under NRHM. Similarly high case load facilities to be supplemented as per need

All appointments under NRHM to be contractual; contracts to be renewed not routinely but based on structured performance appraisal

Decentralized recruitment of all HR engaged under NRHM by delegating recruitment process to the District Health Society under the chairpersonship of the District Collector/ Rogi Kalyan Samitis.

Preference to be given to local candidates to ensure presence of service providers in the community. Residence at place of posting to be ensured.

Quality of HR ensured through appropriate qualifications and a merit- based transparent recruitment process.

Vacant regular posts to be filled on a priority basis: at least 75% by March 2013. It has been observed that contractual HR engaged under NRHM i.e. Specialists,

Doctors (both MBBS and AYUSH), Staff Nurses and ANM are not posted to the desired extent in inaccessible/hard to reach areas thereby defeating the very purpose of the Mission to take services to the remotest parts of the country, particularly the un-served and under-served areas. It must therefore be ensured that the remotest Sub-Centres and PHCs are staffed first. Contractual HR must not be deployed in better served areas until the remotest areas are adequately staffed. No Sub-Centre in remote/difficult to reach areas should remain without any ANM. No PHC in these areas should be without a doctor. Further, CHCs in remote areas must get contractual HR ahead of District Hospitals. Compliance with these conditionalities will be closely monitored and salaries for contractual HR dis-allowed in case of a violation.

Details of facility wise deployment of all HR engaged under NRHM to be displayed on the state NRHM web site.

For SHCs with 2 ANMs, population to be covered to be divided between them. Further, one ANM to be available at the sub-centre throughout the day while the other ANM undertakes field visits; timings for ANM’s availability in the SHC to be notified.

AYUSH doctors to be more effectively utilised e.g. for supportive supervision, school health and WIFS.

All contractual staff to have job descriptions with reporting relationships and quantifiable indicators of performance.

Performance appraisal and hence increments of contractual staff to be linked to progress against indicators.


Staff productivity to be monitored. Continuation of additional staff recruited under NRHM for 24/7 PHCs/FRUs/SDH, etc, who do not meet performance benchmarks, to be reviewed by State on a priority basis.

All performance based payments/ difficult area incentives should be under the supervision of RKS/ Community Organizations (PRI).

DETAILED BUDGET: HUMAN RESOURCES


Target


A.8 INFRASTRUCTURE & HUMAN RESOURCES

A.8.1.1

ANMs, supervisory nurses, LHVs

SNs: Ph1

@Rs.6000/m

Ph2 @ Rs.5000/m

PPC @ Rs.4000/m Ambulance

@ Rs.6000/m

SNCU/NICU@

Rs.6000/m Tribal

MMU@ Rs.10000/

m MCH L1@ Rs.11000/

m MCH L2@

Rs.4500/m

Ph1-4263 Ph2-354 PPC-172

Ambulance-24

SNCU/NICU -781 Tribal

MMU-20 MCH L1-93

MCH L2-378

4881.64 3966.3

State has not provided details of staff required in the FMR format; further, the same items seem to have been proposed under both RCH and MFP. For 2012-13, the state's HR has been approved at the same level (reflected in Unit rate and Physical targets) as in ROP 2011-12.

A.8.1.2

Laboratory Technicians, MPHWs

Rs.6000/m 20 0 11.52

A.8.1.3

Specialists (Anaesthetists, Paediatricians, Ob/Gyn, Surgeons, Physicians, Dental Surgeons,



Target


Radiologist, Sonologist, Pathologist, Specialist for CHC )

A.8.1.4

PHNs at CHC/ PHC level

A.8.1.5

Medical Officers at PHCs and CHCs

Rs.38000/m

783 existing

1189.94 2997.18

A.8.1.6

Additional Allowances/ Incentives to M.O.s of PHCs and CHCs (Mobility support for emergency call (5 calls per month))

Rs.500/call 931 calls/m/30

dists

139.65 139.65

A.8.1.7

Others - Computer Assistants/ BCC Co-ordinator etc

Systems manager

@Rs.25000/m

Security services @ Rs.4000/m

staff at ICTC @

Rs.29114/m

Housekeeping services

@ Rs.2500/m

Driver for outreach MMU @

Rs.4000/m Driver for

tribal MMU @

Rs.8000/m Driver for

Ambulance services for emergency

transport of mothers

and children @

Systems manager -

24 Security

services -129

staff at ICTC -399

Housekeeping staff-

183 Driver for outreach

MMU-385 Driver for

tribal MMU-20 Driver for Ambulance services

for emergency


and children-

24 Cleaner for MMU-385

SW for MCH L1-93

1835.95



Target


Rs.4500/m Cleaner for

MMU @ Rs.3000/m

SW for MCH L1@

Rs.2500/m Pharmacist for MCH L2

@ Rs.21000/

m Junior

Asstt. MCH L2@

Rs.11000/m

Hospital Workers

for MCH L2 @

Rs.7500/m SW for

MCH L2 @ Rs.7500/m

Pharmacist for MCH

L2-42 Junior

Asstt. MCH L2-42

Hospital Workers for MCH

L2-42 SW for

MCH L2-42

A.8.1.7.1

Staff for NRC

A.8.1.7.2

Staff Nurse for NRC Rs.7500/m 48 SNs 3.06 5.92 Approved

A.8.1.7.3

Nutrition Counselor Rs.15000/m

12 Counselors

1.53 Approved

A.8.1.7.4

Cook cum Care taker Rs.5000/m 12 cooks 0.51 Approved

A.8.1.7.5

Attendant Rs.5000/m 24 attendants

1.02 Approved

A.8.1.8

Incentive/ Awards etc. to SN, ANMs etc.

A.8.1.8.1

Honorarium to hired Obstetrician for emergency LSCS

3500 32800 520.00 100.00 1) Approved only for the Incentives to LSAS & EmOC trained doctors @ Rs 2000 fixed and Rs 400 per case upto max of 5000 to 7000 cases. Total

A.8.1.8.4

Mobility support (for more than 8 km travel)

500 16400 82.00

A.8.1.8.5

Honorarium to hired Anesthetist for

2250 32800 342.00



Target


emergency LSCS budget approved lumpsum is Rs 50.00 lakhs. 2) Mobility support @ Rs 500 can be approved as lump sum for Rs 50.00 lakhs. 3) Not approved for calling experts from Private sector since State has enough number of regular and trained doctors.

A.8.1.8.8


500 16400 82.00

A.8.1.8.9

Incentive to EmOC trained doctor for emergency LSCS

750 2750 8.25

A.8.1.8.12


500 1375 6.88

A.8.1.8.13

Incentive to LSAS trained doctor for emergency LSCS

750 2750 8.25

A.8.1.8.16


500 1375 6.88

A.8.1.8.17

Additional services by Govt specialists (Obstetrician )for Emergency LSCS

500 10000 50.00

A.8.1.8.19


500 5000 25.00

A.8.1.8.20

Additional services by Govt specialists (Anaesthetist )for Emergency LSCS

500 10000 50.00

A.8.1.8.22


500 5000 25.00

A.8.1.8.23

Honorarium to hired pediatricians

750 9000 27.50

A.8.1.8.26

Mobility support (for more than 8 km)

500 4500 22.50

A.8.1.8.27

Additional services by Govt paediatricians for emergency MCH care

500 5000 25.00

A.8.1.8.29


500 2500 12.50

A.8.1.8.30

Delivery incentive to VHN

Rs.25/mother

288000 mothers

72.00 72.00 Approved subject to registration within 12 weeks, provision of full ANC, maintaining partographs of each case, giving birth dose of OPV, BCG, Hep B and Vit K injection.



Target


A.8.1.8.31

Delivery incentive to ANM/SN

Rs.25/mother

288000 mothers

72.00 72.00 Approved condition to registration within 12 weeks, provision of full ANC, maintaining partographs of each case, giving birth dose of OPV, BCG, Hep B and Vit K injection.

A.8.1.9

Human Resources Development (Other than above)

A.8.1.9.1

HR as per facility. 1)Staff salary

Establishment of 20

new PHCs @

Rs.270.2 L 2) Staff

salary for Operation

alisation of 3 new

sanctioned PHCs @

Rs.40.53 L 3)Staff

salary of 20 new PHCs @

Rs.131.8 L 4) Staff

salary for Up-

gradation of existing

PHCs @Rs.390.4

8 L 5)Staff

salary for Up-

gradation of

5889.65 4049.32 Proposed under MFP. Approved as per RoP 11-12



Target


proposed PHCs @

Rs.325.4 L 6)Human resources

for new PHCs @

Rs.2242.08 L

7) Human resources

for new UG PHCs

@ Rs.2489.16

L

A.8.1.9.2

Hiring of Doctors One Doctor / PHC for 10 months @Rs.1000/- visit for SHP

RS.1000/ visit

1612 visits/mon

th for 10 months

161.20 161.20 Approved.

A.8.1.9.3

Salary of FP Counselors in PPCs Rs.7500/m 172

counselors

131.58 131.58 Approved. Only 85 % of salary requirement is budgeted.

A.8.1.9.4

Salary for the Staff Nurses of the training team

Rs.22000/m

770 SNs 863.94 506.88 Approved for 6 Staff Nurses per district (32 Distts) to cover 12 block in each district.

A.8.1.9.5

Provision of EmOC trained doctors to MCH for observation of High Risk Mothers

Rs.38000/m

36 doctors for 6

months (salary

proposed at 85%)

69.77 69.77 Medical Colleges is not generally a part of the NRHM. However, the Medical Colleges are high delivery points. 2 M.O per Institution x 6 months x Rs 38,000 P.M. x 18 Institutions x 85 %=69.77 lakhs approved. Name-wise list along with delivery load and C section to be shared.

A.8.1.9.6

MPA on Contract basis at 44 existing SCNU

Rs.5000/m 132 MPA for 6

39.60 0.00 Not approved as No provision under



Target


months operational guidelines ; Should be provided from state budget.

A.8.1.9.7

MPA -Male on contract basis at 20 SNCU taken up for upgradation

Rs.5000/m 60 MPA for 6

months

18.00 0.00

A.8.1.9.8

MPA- Female at 44 Existing NICU

RS.3500/m 183 MPA for 12

months

76.86 0.00

A.8.1.9.9

MPA -Male on contract basis at 20 SNCU taken up for upgradation

RS.3500/m 69 MPA for 6

months

14.49 0.00

A.8.1.9.10

Multipurpose Assistant for MCH L2

Rs.5000/m 42 MPA for 9

months

18.90 0.00

A.8.1.9.11

Sanitary Worker Salary RS.2500/m 31 SW for 9 months

6.97 0.00 Already approved under A.8.1.7

Sub total Infrastructure and HR

15071.07 14119.27

B9 Mainstreaming of AYUSH

B9.1 Human Resources (ongoing)

475 units (300 set up in 2009-10

and 175 set-up in 2010-11) 1519.09 1519.09 Approved

Sub-total HR including AYUSH

16590.09 15638.36


ROAD MAP FOR PRIORITY ACTION: PROGRAMME MANAGEMENT

A full time Mission Director is a prerequisite. Stable tenure of the Mission Director should also be ensured.

A regular full time Director/ Joint Director/ Deputy Director (Finance) (depending on resource envelope of State), from the State Finance Services not holding any additional charge outside the Health Department must be put in place, if not already done, considering the quantum of funds under NRHM and the need for financial discipline and diligence.

Regular meetings of state and district health missions/ societies must take place.

Key technical areas of RCH to have a dedicated / nodal person at state/ district levels; staff performance to be monitored against targets and staff sensitised across all areas of NRHM such that during field visits they do not limit themselves only to their area of functional expertise.

Performance of staff to be monitored against benchmarks; qualifications, recruitment process and training requirements to be reviewed.

Delegation of financial powers to district/ sub-district levels in line with guidelines should be implemented.

Funds for implementation of programmes both at the State level and the district level must be released expeditiously and no delays should take place.

Evidence based district plans prepared, appraised against pre determined criteria; district plans to be a “live” document. Variance analysis (physical and financial) reports prepared and discussed/action taken to correct variances.

Supportive supervision system to be established with identification of nodal persons for districts; frequency of visits; checklists and action taken reports.

Remote/ hard to reach/ high focus areas to be intensively monitored and supervised. An integrated plan and budget for providing mobility support to be prepared and submitted for review/approval; this should include allocation to State/ District and Block Levels.


DETAILED BUDGET: PROGRAMME MANAGEMENT


Target


A10 PROGRAMME MANAGEMENT

A.10.1 SPMU 791.75 594.97 No unit wise breakup provided only lumpsum amounts proposed. Approval restricted to last years level of Rs.645 lakhs less 50.03 lakhs - 25 % of mobility support approved on interim basis. State to provide integrated mobility support plan and budget

A.10.2 DPMU 803.94 508.94 Proposed amount is 17.7% higher than approved amount in 11-12. Reasons for increase not clear. Approved at last yr’s level of Rs.682.82 lakhs less Rs.173.88 lakhs which is 25% of mobility support approved on interim basis. State to provide integrated mobility support plan and budget.

A.10.3 BPMU 942.13 845.40 Amount as per RoP 11-12 levels. Proposed amount is 11 % higher than approved amount in 11-12. Reasons for increase not clear.

A.10.4 Other : Hiring of contractual staff for Maternal Health Wing

A.10.4.1 Expert Advisor Rs.85000/m

1 for 9 months

7.65 7.65 Approved

A.10.4.2 Health Officer / Medical Officer

Rs. 38000/m

2 for 9 months

6.84 6.84 Approved

A.10.4.3 Assistant Director(Statistics)

Rs.35000/m

1 for 9 months

3.15 3.15 Approved

A.10.4.4 Maternal and Child Health Officer

Rs.24000/m

1 for 9 months

2.16 2.16 Approved

A.10.4.5 Honorarium for involving experts in MCH activities

Rs.20000/m

1 for 9 months

1.80 1.80 Approved



Target


A.10.4.6 Office contingency including Outsourcing of DEO

Rs.30000/m

1 for 9 months

2.70 0.00 Not approved. Outsourcing not allowed. State has sufficient resources.

Sub total Programme Management 2562.12 1970.91


MISSION FLEXI POOL (MFP)


ASHA

TARGETS: S. No. Activity Targets 1. ASHAs with Drug kits 4611 2. ASHAs trained in 6th and 7th modules 6250

ROAD MAP FOR PRIORITY ACTION: ASHA

Clear criteria for selection of ASHA

Well functioning ASHA support system including ASHA days, ASHA coordinators

Performance Monitoring system for ASHAs designed and implemented (including analysis of pattern of monthly payments; identification of non/under-performing ASHAs and their replacement; and reward for well performing ASHAs). State to report on a quarterly basis on ASHA’s average earnings/ range per month.

Timely replenishment of ASHA kits.

Timely payments to ASHAs and move towards electronic payment.

Detailed data base of ASHAs created and continuously updated; village wise name list of ASHA to be uploaded on website with address and cell phone number

DETAILED BUDGET:

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B1 ASHA B1.1. ASHA Cost

B1.1.1 Selection and Training of ASHA

B1.1.2

Procurement of ASHA Drug Kit (ongoing)

Drug Kit for 2650 ASHAs 600 2650 15.90 9.28

Approved for replenishment @ Rs. 350 per ASHA

Training and drug kit for dropout ASHA 6750+600 320 35.20 23.52 Approved.

Training and drug kit for 4200 ASHAs 6750+600 4200 208.20 14.70

Only replenishment of drug kits is


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks approved

B1.1.3

Performance Incentives/ Other Incentives to ASHAs

B1.1.3.1

ASHAs in Tribal, Hilly, Difficult and Hard to reach areas(2650)

B1.1.3.1.i

Home Based Newborn Care (new) 250 2650*16 106.00 106.00

Approved. The State may give incentives to ASHAs only after training of ASHAs as per GoI guidelines.

B1.1.3.1.ii

Reporting of Infant Deaths and children in 5 years (new) 25 2650*5 3.31 3.31 Approved

B1.1.3.1.iii

Village Health and Nutrition Days (ongoing) 100 2650*12 31.80 31.80 Approved

B1.1.3.1.iv

Attending PHC monthly review meeting (ongoing) 100 2650*12 63.60 31.80 Approved

B1.1.3.1.v

Adolescent Anemia Control Programme (ongoing)

100 twice a year 2650 5.30 5.30 Approved

B1.1.3.1.vi Immunization activity (new) 100 p m 2650 31.80 0.00 Approved

B1.1.3.1.vii

Incentives for Vitamin A and Deworming campaign (ongoing) 200 each

2 sessions each 21.20 21.20 Approved

B1.1.3.1.viii

Surveillance and reporting of fever, ARI, AGE, Jaundice, etc (ongoing) 100 pm 2650 31.80 31.80 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B1.1.3.1.ix

Family Welfare Services(Motivation of Eligible couples for female and male sterilisation)

Rs. 100 per case of female

sterilisation and Rs. 250 per case of

male sterilisation 2650*(10+4) 53.00 0.00

Not approved as this is already a part of the compensation package budgeted under Family Planning

B1.1.3.2

ASHA (Programme specific) incentive for 4200 non tribal and plains for MCH activities) 16325 4200 0.00 0.00

Sub-total ASHA Incentives 347.81 231.21

B1.1.4 Awards to ASHAs/ link Workers 0.00 0.00

B1.1.5

ASHA Resource Centre/ ASHA Mentoring Group - Supportive Supervision (new activity)

B1.1.5.1 VHV Coordinator at State Level 1103000 1 0.00 0.00

B1.1.5.2 VHV Coordinator at District Level 276000 33 0.00 0.00

B1.1.5.3 Block Level 386400 112 0.00 0.00 B1.1.5.4 At PHC Level 21000 336 0.00 0.00

Sub-total supportive supervision of ASHA 0 0

Sub-total 607.11 278.71


UNTIED FUNDS/ RKS/ AMG

ROAD MAP FOR PRIORITY ACTION FOR UNTIED FUNDS/ RKS/ AMG:

Timely release of untied funds to all facilities; differential allocation based on case load. Funds to be utilized by respective RKS only and not by higher levels.

Well functioning system for monitoring utilization of funds as well as purposes for which funds are spent.

Plan for capacity building of RKS members developed and implemented. RKS meetings to take place regularly. Audit of all untied, annual maintenance grants and RKS funds. The State must take up capacity building of Village Health & Sanitation Committees Rogi

Kalyan Samitis and other community/ PRI institutions at all levels The State shall ensure regular meetings of all community Organizations/ District / State

Mission with public display of financial resources received by all health facilities The State shall also make contributions to Rogi Kalyan Samitis

BUDGET:

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B2 Untied Fund

B2.1

Untied funds to CHCs(385) and PHCs(65) offering with CHC services 50000 450 225.00 154.09 Approved

B2.2 Untied funds to PHCs 25000 1162 290.50 290.50 Approved B2.3 Untied funds to HSCs 10000 8706 870.60 788.84 Approved

B2.4

Village Health, Water, Sanitation and Nutrition Committee 10000 15158 1515.80 1275.95

Approved. Funds for training of VHSNC members available in the State.

B2.5 Others B2.5.1 Untied funds to DHs 100000 31 31.00 0.00 Not approved B2.5.2 Untied funds to SDHs 50000 230 115.00 115.00 Approved B2.5.3 Untied funds to UPHCs 25000 135 33.75 0.00 Not approved Total 3081.65 2624.38

B3 Annual Maintenance Grants(AMG)

B3.1

AMG to CHCs(385) and PHCs(65) offering with CHC services 100000 450 450.00 233.39 Approved

B3.2 AMG to PHCs 50000 1162 581.00 838.32 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B3.3 AMG to HSCs 10000 6510 651.00 526.67 Approved B3.4 Others B3.4.1 AMG to DHs 100000 31 31.00 0.00 Not approved B3.4.2 AMG to SDHs 100000 230 230.00 230.00 Approved B3.4.3 AMG to UPHCs 50000 135 67.50 0.00 Not approved

B3.4.4

AMG to Medical Colleges and attached institutions 100000 34 34.00 0.00 Not approved

Total 2044.50 1828.38

B6 Patients Welfare Society (PWS)

B6.1 Funds to DHs 500000 31 155.00 155.00 Approved

B6.2

Funds to CHCs(385) and PHCs(65) offering with CHC services 100000 450 450.00 214.61 Approved

B6.3 Funds to PHCs 100000 1162 1162.00 1162.00

Approved for 1139 functional PHCs and 3 new PHCs which are proposed for operationalization = 1142 PHCs.

B6.4 Others

B6.4.1 Funds to SDHs 100000 230 230.00 9.85 Approved

B6.4.2 Funds to CEmONC (as add on fund) 100000 103 103.00 0.00 Not Approved.

B6.4.3 Funds to UPHCs 100000 135 135.00 0.00 Not Approved.

B6.4.4 Funds to Medical College Hospitals 1000000 17 170.00 0.00 Not Approved.

B6.4.5 Funds to attached Hospitals under DME 500000 12 60.00 0.00 Not Approved.

B6.4.6 Funds to attached Institutions under DME 100000 5 5.00 0.00 Not Approved.

Total 2470.00 1541.46


NEW CONSTRUCTIONS/ RENOVATION AND SETTING UP

All newly constructed SCs to be strengthened with 2 ANMs and service delivery closely monitored.

ROAD MAP FOR PRIORITY ACTION:

Works must be completed within a definite time frame. For new constructions upto CHC level, a maximum of two years and for a District Hospital, a maximum period of 3 years is envisaged. Renovation/ repair should be completed within a year. Requirement of funds should be projected accordingly. Funds would not be permissible for constructions/ works that spill over beyond the stipulated timeframe. Progress of works being executed to be closely monitored

Standardized drawing/ detailed specifications and standard costs must be evolved keeping in view IPHS.

Third party monitoring of works through reputed institutions to be introduced to ensure quality.

Information on all ongoing works to be displayed on the NRHM website

Approved locations for constructions/ renovations will not be altered

All government health institutions in rural areas should carry a logo of NRHM as recognition of support provided by the Mission in English/ Hindi & Regional languages.

BUDGET:

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B5

New Constructions/ Renovation and Setting - up

B5.7 Strengthening of FRUs

B5.7.1

Infrastructure Up-gradation In FRUs (new) Civil Works 40 1920.00 1920.00

Approved. 40% of the total cost is proposed and approved for this year.

B5.7.2

Equipment for Medical Colleges (new) 965.61 965.61 Approved

B5.7.3

Center of Excellence in Reproductive and Child Health in 512200000 2 3000.00 3000.00 Approved.


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks Madurai and Salem Medical colleges (new)

B5.7.4

Comprehensive Emergency Management Centre (new activity) 5437000 14 761.18 761.18 Approved.

B5.10.1

Establishment of skill laboratories in all the GNM schools I (new) 1100000 24 264.00 264.00 Approved

Sub-total Health Infrastructure 6910.79 6910.79


PROCUREMENT

ROAD MAP FOR PRIORITY ACTION - PROCUREMENT:

Strict compliance of procurement procedures for purchase of medicines, equipments etc as per state guidelines.

Competitive bidding through open tenders and transparency in all procurements to be ensured.

Only need based procurement to be done strictly on indent/requisition by the concerned facility.

Procurement to be made well in time & not to be pushed to the end of the year.

Audit of equipment procured in the past to be carried out to ensure rational deployment.

Annual Maintenance Contract (AMC) to be built into equipment procurement contracts.

A system for preventive maintenance of equipment to be put in place.

BUDGET:

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B16 Procurement


B16.1.1 Procurement of Equipment for MH

B16.1.1.1 Equipment for FRUs 1471.85 1471.85

Approved. The State is to provide a list of all the facilities along with the equipments to be procured and no additional funds for procurement of equipments will be asked for these facilities.


B16.1.2.1 Equipment for SNCU @ 10 lakhs 10 lakh 20 200.00 170.00

Approved for 17 units


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B16.1.2.2

Equipment for Sick newborn transport system @ 4.5 lakhs 4.5 lakh 29 130.50 0.00 Not approved

B16.1.2.3

Equipment for new born corner for 73 new PHCs, 31 level 1 MCH centre and 135 UPHCs @ Rs.85000/- 85000 239 203.15 203.15 Approved

B16.1.2.4

Equipment, medication and consumable for ASHA home based new born care in 2650 tribal and 4200 program specific VHVs @ Rs. 2000 per VHV 1500 6850 137.00 0.00 Not approved

B16.1.2.5

Equipment for training for prenatal screening to detect fetal anomalies in 78 CEmONC centers and 154 PHCs

B16.1.2.5.i

Desktop and Accessories @ Rs.11000/-

Rs. 35000 for desktops and

11000 for accessories 232 106.72 106.72 Approved

B16.1.3 Procurement of equipment: FP

B16.1.3.1 NSV Kit 1000 1000 10.00 10.00 Approved B16.1.3.3 Minilap sets 3500 15.00 15.00 Approved B16.1.3.5 Kelly's Forceps 2700 400 10.08 10.08 Approved

B16.1.5

Annual Maintenance contract / Maintenance and repair for Equipment

10% of the total

procurement cost 800.00 800.00 Approved

Sub-total (equipment) 3084.30 2786.80



FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks


B16.2.1.1 Iron sucrose – Maternal Anaemia

1428932 doses 429.00 429.00 Approved

B16.2.1.2 Albendazole for Antenatal mothers 1190777 8.34 8.34 Approved

B16.2.1.3 Gestational Diabetes 1612 161.20 161.20 Approved

B16.2.3 FW Drugs and equipments 0.00 0.00

B16.2.5

General drugs and supplies for health facilities

B16.2.5.1

Procurement of drugs under ARSH for WIFS

B16.2.5.1.1

Procurement of IFA

0.13 5864754 396.46 396.46

Approved. State needs to ensure that although not budgeted in this activity, all the school boys are also provided with weekly iron/ folic acid supplementation.

B16.2.5.1.2

Procurement of Albendazole 0.70 5864754 82.11

Approved

B16.2.5.2 Modified School Health Programme 20000000 140.00 0.00

B16.2.5.3

Drugs for Urban Health post for medical college hospitals @ 2.5 Lakh per centre 16 centers 40.00 40.00 Approved

B16.2.5.4

Drugs and consumables for 75 municipalities @ Rs. 2.35 Lakhs 75 centers 176.25 176.25 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B16.2.5.5 First aid kits for schools 100 per kit 42769 42.77 42.77 Approved

B16.2.5.6 Disposable syringes 3 Cr 300.00 300.00 Approved

B16.2.5.7

Provision of gloves and syringes for NCD screening program (Phase I and Phase II) 465.57 465.57 Approved

Sub total (drugs) 2159.59 2101.70 Sub-total 5243.89 4888.50


MOBILE MEDICAL UNIT (MMU)


Route chart to be widely publicised

GPS to be installed for tracking movement of vehicles

Performance of MMUs to be monitored on a monthly basis (including analysis of number of patients served and services rendered).

MMUs to be well integrated with Primary Health Care facilities and VHND.

Engagement with village panchayats / communities for monitoring of services

AWCs to be visited for services to children below 6 years of age

AWCs to maintain record of services rendered

Service delivery data to be regularly put in public domain on NRHM website.

A universal name ‘Rashtriya Mobile Medical Unit’ to be used for all MMUs funded under NRHM. Also uniform colour with emblem of NRHM (in English/ Hindi & Regional languages), Government of India and State Government to be used on all the MMUs.

BUDGET:

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B11 MOBILE MEDICAL UNITS

B11.1 Medical Officer 456000 385 44.26 44.26 Approved B11.2 Staff nurse 96000 385 169.59 169.59 Approved B11.3 Driver 48000 385 56.90 56.90 Approved B11.4 Cleaner 36000 385 24.71 24.71 Approved B11.5 Lab technician 30000 385 98.18 98.18 Approved B11.6 AVLT system 35000 385 134.75 134.75 Approved

B11.7

Vehicle maintenance per annum 5000 385 19.25 19.25 Approved

B11.8 POL 10000 4620 92.42 92.42 Approved

B11.9 Contingency per annum 10000 385 38.50 38.50 Approved

B11.10

Mobile Medical Unit Drugs to PHCs 100000 385 385.00 385.00 Approved

B11.11 Lab reagents for MMU 25000 385 96.25 96.25 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B11.12

New Vehicles for replacement of old vehicles 700000 100 700.00 0.00 Not approved

Total 1859.81 1159.81


REFERRAL TRANSPORT

ROAD MAP FOR PRIORITY ACTION: Free referral transport to be ensured for all pregnant women and sick neonates

accessing public health facilities. Universal access to referral transport throughout the State, including to difficult and

hard to reach areas, to be ensured. A universal toll free number to be operationalized and 24x7 call centre based approach

adopted. Vehicles to be GPS fitted for effective network and utilization. Rigorous and regular monitoring of usage of vehicles to be done Service delivery data to be regularly put in public domain on NRHM website.

FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B12

EMERGENCY REFERRAL TRANSPORT

B12.1 EMRI

B12.1.1 Reach Ambulance modification

2 @ Rs. 2.7 lakh (neonatal), 28 @ Rs. 0.25 lakh for minor modification, 76 @ Rs. 3.75 lakh for modification 106 0.00 0.00 Not approved

B12.1.2 Non-recurring cost - infrastructure 0.00 0.00 Not approved

B12.1.3 Vehicle replacement 12.5 lakh 100 1250.00 0.00 Not approved

B12.1.4

Procurement for 29 new vehicles of sick newborn transport system @ Rs. 12 lakhs per vehicle 12 lakh 29 348.00 0.00 Not approved

B12.2 Operating cost

B12.2.1 Operational Cost 1726.00 1726.00 20% of total OP cost approved.

B12.2.2

a. Operational Cost for UNICEF vehicle for transport of sick new born.

Rs 1 lakh / Vehicle / month x 12 months

6 Ambulances 72.00 0.00 Not Approved


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B12.2.3

b.Operational cost for Existing 29 vehicle with Neonatal Support System.

Rs 1 lakh / Vehicle / month x 12 months

29 Vehicle with sick

new born transport 348.00 0.00 Not Approved

B12.2.4

d.Operational cost for the 29 new vehicle proposed for transport of sick new born

Rs 1 lakh / Vehicle / month x 3 months 29 87.00 0.00 Not Approved

B12.2.5

Training on Emergency transport of Maternal and Infants - EMRI Staff Rs.25860/batch 4 batches 1.03 0.00 Not approved

B12.2.6

Training on Emergency transport of Maternal and Infants - District level staff Rs.73360/batch 2 batches 1.47 0.00 Not approved

B12.2.7

Training on Emergency transport of Maternal and Infants - EMRI Technician Rs.63860/batch 40 batches 25.54 0.00 Not approved

Total 3859.04 1726.00


AYUSH


State to co-locate AYUSH in district hospitals and provide post graduate doctors for at least two streams: Ayurveda and homoeopathy (or Unani, siddha, Yoga as per the local demand). Panchakarma Unit should also be considered.

OPD in AYUSH clinics will be monitored along with IPD/OPD for the facility as a whole.

The AYUSH pharmacist/compounder to be engaged only in facilities with a minimum case load.

Adequate availability of AYUSH medicines at facilities where AYUSH doctors are posted to enable them to practice their own system of Medicine without difficulty.

At CHCs and PHCs any one system viz., Homeopathy/Ayurveda/ Unani/Sidha to be considered depending on local preference.

At CHC/PHC level, Post-Graduate Degree may not be insisted upon.

District Ayurveda Officer should be a member of District Health Society in order to participate in decision making with regard to indent, procurement and issue of AYUSH drugs.

Infrastructure at facilities proposed to be collocated would be provided by Department of AYUSH.

Those PHC/CHC/Sub-Divisional hospitals which have been identified as delivery points under NRHM should be given priority for collocation of AYUSH as these are functional facilities with substantial footfalls.

AYUSH medical officers should increasingly be involved in the implementation of national health programmes and for the purpose of supportive supervision and monitoring in the field. They should be encouraged to oversee VHND and outreach activities and in addition programmes such as school health, weekly supplementation of iron and folic acid for adolescents, distribution of contraceptives through ASHA, menstrual hygiene scheme for rural adolescent girls etc.

AYUSH medical officer should also be member of the RKS of the facility and actively participate in decision making.

AYUSH doctors need to be provided under NRHM first in the remotest locations and only thereafter in better served areas.


BUDGET:

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks



475 units (300 set up in 2009-10

and 175 set-up in 2010-11) 1519.09 1519.09 Approved

B9.3 Other activities B9.3.1 IEC (new) 34.00 34.00 Approved

B9.3.2

Training of all VHNs in Yoga and Naturopathy (new) 87.00 87.00 Approved

B9.3.3

Provision of kit of medicines to pregnant mothers during antenatal and postnatal period. (new)

450 per patient 429.00 0.00 Not Approved.

B9.3.4

Provision of medicines to ISM wings (new)

3 lakh per annum 475 1423.00 0.00

Not approved. Financial assistance may be sought from the Department of AYUSH. State Government is requested to liquidate the pending UCs and forward the proposals with AYUSH PIP as per the scheme guidelines.

B9.3.5

Networking the Commissionerate with DSMOs and the Colleges. (new) 25.00 0.00 Not approved

Sub total Mainstreaming of AYUSH 3517.09 1640.09


IEC/BCC


Comprehensive IEC/ BCC strategy prepared. IPC given necessary emphasis and improved inter-sectoral convergence particularly with WCD.

Details of activities carried out to be displayed on the website

BUDGET:

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B10 BCC / IEC

B10.2 Implementation of BCC and IEC strategy


B10.2.2.1

a. EMRI boards for Neonatal transport, b.SNCU boards, c.LBW protocols etc


1500/ center,

500/ center

29 47

1612 8706 101.21 101.21 Approved

B.10.2.3 BCC/IEC activities for FP 34.60 34.60 Approved

B.10.2.4 BCC/IEC activities for ARSH Approved

B.10.2.4.1 Printing of posters to each VHN 100 9576 9.58 9.58 Approved

B.10.2.4.2

Printing of IEC materials to ICTC counselors and NCD staff nurses 100 1049 1.05 1.05 Approved

B.10.2.4.3 IEC material to ICDS centers 250 59672 149.18 149.18 Approved

B10.2.5 Other activities

B10.2.5.1 BCC / IEC Activities in RCH / NRHM Activities 100.00 100.00 Approved

B10.2.5.2 IEC/BCC- School Health Programme


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B10.2.5.3

Printing of IEC Materials - Middle /High/ Hr.sec Schools

720 per schools

10910 sets with DVDs (

9918 schools+992

buffer=10,910) 78.55 78.55 Approved

B10.2.5.4 IEC kit for PHC 3000 per

kit

1773 (1612 PHC+ 161

buffer= 1773) 53.19 53.19 Approved Sub-total 527.36 527.36


MONITORING AND EVALUATION (HMIS)/ MCTS


Data is uploaded, validated and committed; data for the month available by the 15th of the following month.

Uploading of facility wise data by the first quarter of 2012-13.

Facility based HMIS to be implemented. HMIS data to be analysed, discussed with concerned staff at state and district levels and necessary corrective action taken.

Program managers at all levels use HMIS for monthly reviews.

MCTS to be made fully operational for regular and effective monitoring of service delivery including tracking and monitoring of severely anemic women, low birth weight babies and sick neonates.

Pace of registration under MCTS to be speeded up to capture 100% pregnant women and children

Service delivery data to be uploaded regularly.

Progress to be monitored rigorously at all levels

MCTS call centre to be set up at the State level to check the veracity of data and service delivery.

BUDGET:

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B15


B15.1 Community Monitoring

B15.1.1

Statewide project for community monitoring and village plan development (new) 5 lakh 36 180.00 180.00 Approved

B15.1.2

Continuation of support for Community Action for Health (CAH) in 6 HUDs. (new) 50 6 300.80 300.80 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B15.2

Quality Assurance (Additional Manpower (Regional NRHM consultants)) Rs.35000/m

6 for 9 months 18.90 0.00

Not approved

B15.3 Monitoring and Evaluation

B15.3.1

Monitoring and Evaluation/ HMIS/ MCTS

B15.3.1.1

State level and regional level workshop / review meeting 5.48 5.48 Approved

B15.3.1.2

Strengthening of HMS in District / Sub District Hospitals

B15.3.1.3 MCTS

State MCTS Cell {1-Joint Director @ Rs. 50,000 per month 50000 p.m 1 14.40 14.40 Approved


35000 p.m. (- AD, 16500

p.m. - IT Coordinator) 1+1 6.18 6.18 Approved

‘Own a Laptop’ sharing 20% of the cost to strengthen MCTS 200.00 0.00

Not approved

sub total 226.06 26.06

B15.3.2

Computerization/ HMIS and e-governance, e-health

B15.3.2.1

Computers and networking for District Hospitals (31 x 20 x 44200) 274.04 274.04 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B15.3.2.2

Computers and networking for Sub District Hospitals (230 x 7 x 44200)` 711.62 711.62 Approved

B15.3.2.3 IT coordinator 16500 pm 42 62.37 62.37 Approved

B15.3.2.4 IT coordinator Rs.16500/ month x 2 2.97 2.97 Approved

B15.3.2.5

Comprehensive Networking of all sections of DPH, DMS and DFW

B15.3.2.6

Computers (DGS&D Rate for 358 numbers) (i3 processor with OS, antivirus and other necessary software) 35000 358 127.09 0.00

Not approved.

B15.3.2.7 UPS (10 x 110000) 11.00 0.00 Not approved.

B15.3.2.8

Provision of LAN connectivity (including OFC cable linking) 42.22 0.00

Not approved.

B15.3.2.9

Server (DGS&D Rate for 4 server) (Dell-R710 – 64GB RAM – 1 TB HDD) 20.00 0.00

Not approved.

B15.3.2.10

Computers (DGS&D Rate for 23 numbers) (i3 processor with OS, antivirus and other necessary software) Rs. 35,500/- 23 8.17 8.05 Approved

B15.3.2.11

Up-gradation of existing LAN network setup at Directorate of Medical Education 52.90 52.90 Approved

sub-total 1312.38 1111.95 B15.3.3 Other M&E activities

B15.3.3.1

4 Review cum workshop and review meeting for DTT MOs 129250 4 5.17 5.17 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B15.3.3.2 Quarterly Review meeting of DDHSs 1.08 4 4.32 4.32 Approved

sub-total 9.49 9.49

Sub total Monitoring and Evaluation 1547.93 1147.50

Sub total Planning, Implementation and Monitoring 2047.63 1628.30


OTHERS

BUDGET: HOSPITAL STRENGTHENING

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B4 Hospital Strengthening

B4.1

Upgradation of CHCs, PHCs, District Hospitals

B4.1.1 District Hospitals B4.1.2 CHCs B4.1.3 PHCs

B4.1.3.1

Up-gradation of PHCs Existing (new)

B4.1.3.1.i Civil Works (new) 7000000 24 1680.00 1680.00

Approved. A comprehensive plan for upgradation of each of the PHCs is to be prepared by the State. New OT constructions are to be done only for the PHCs where there are no OTs. The activity is to be completed in 2012-13 itself.

B4.1.3.1.ii

Other infrastructure (new) 1500000 24 360.00 0.00

Approval is pended till details of 'other infrastructure' is provided by the state for each of these PHCs.

B4.1.3.2

Up-gradation of PHCs Proposed (new)

B4.1.3.2.i Civil Works 7500000 20 0.00 0.00


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B4.1.3.2.ii Other infrastructure 1500000 20 300.00 0.00 Not Approved.

B4.1.4

Infrastructure up gradation in HSCs to facilitate the stayal of VHN in villages (new) 5000000 42 2100.00 2100.00

Approved. The activity is to be completed in this year itself.

B4.2 Strengthening of PHCs (new)

B4.2.1

Establishment of 20 new PHCs sanctioned by GoTN (new activity)

B4.2.1.1 Civil Works (new) 2500000 20 500.00 500.00 Approved.

B4.2.1.2

Other infrastructure (new) 295000 20 59.00 59.00 Approved

B4.2.2

Establishment of 20 other new PHCs (new)

B4.2.2.1 Civil Works (new) 2500000 20 200.00 0.00 Not Approved.

B4.2.2.2

Other infrastructure (new) 295000 20 59.00 0.00 Not Approved.

B4.2.3

Operationalisation of 3 new PHCs sanctioned - other infrastructure (new activity) 215000 3 6.45 6.45 Approved

B4.2.4

Additional fund for increased cost for construction work (ongoing activity)

B4.2.4.1 PHCs 39 214.50 214.50

Approved. All the pending works are to be completed by the State in 2012-13 and no further funds shall be provided in the


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks next years.

B4.2.4.2 UG PHCs 12 204.00 204.00

B4.2.5

Construction of New buildings for 9 old PHCs (new) 2500000 9 225.00 175.00

Approved for the 7 facilities which are delivery points.

B4.2.5.1

Adoption of Kasthuriba Gram Hospital in Erode District (new) 1946000 1 19.46 19.46 Approved

B4.2.6

Maintenance and repairs of HSCs (new) 5000000 42 500.00 500.00

The State has a balance of Rs. 16 Crores which is permitted to be used for plugging the infrastructure gaps in HSCs. Additional requirement of Rs. 5 Crores is approved. Number of HSCs with locations are to be provided by the State before incurring expenditure against this approval.

Upgradation of existing Blood storage centre to Blood Bank lumpsum 25.00 25.00

Approved (shifted from RCH)


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

Establishment of Blood storage centres in MCH wings of Medical College Hospitals

Rs.4 L/facility 18 facilities 72.00 72.00

Approved (shifted from RCH)

B4.3

Sub-Centre Rent and Contingencies (ongoing) 1000 p.m 2173 0.00 0.00

Fund is available with the State. The norm is Rs. 3000 p/a for rent and Rs. 3200 p/a for contingencies per SHC.

B4.4.1

Outsourcing of House keeping and cleaning Services in Hospitals (new)

5 Lakh p.m. 40 100.00 100.00 Approved.

B4.4.2

Outsourcing of hospital services to be continued in Cuddalore, Pudukottai, Tiruppur, Tambaram Hospitals for 2012-13 @ 10% increase over previous year's cost (ongoing) 55 Lakh 4 250.00 250.00 Approved

B4.4.3

Outsourcing of cleaning, sanitation and certain other hospital services in CEmONC hospitals (new)

1 lakh p.m.

17 CEMONC centers +

advertisement (Rs. 5 lakh) 209.00 209.00 Approved

Sub total - Hospital Strengthening 7083.41 6114.41

BUDGET: DISTRICT HEALTH PLANS


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B7 District Plans

Save the Girl child scheme (new) 20.00 20.00 Approved

Sub-total 20.00 20.00 BUDGET: PPP/ NGOS

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B13 PPP /NGOs B13.2

B13.2.1

Pilot Project on Management of Children affected with Muscular Dystrophy Disorder 125.50 125.50 Approved

B13.2.2

Palliative care (new) - includes setting-up of Palliative care centers for 25.6 lakh in each district including drugs and support services, training, IEC activity and incentives to VHVs. 30 5 districts 150.00 150.00 Approved

B13.2.3

Anaemia Control Programme by PPP mode - (new) - to be run with DHAN Foundation in 50 blocks of the State 100.00 100.00 Approved

B13.2.4

Home Based Newborn Care Project in PPP mode - for identification, referral, follow-up and ensuring survival in low birth babies - based on Gadchiroli model

3200 per VHV 1500 72.00 72.00 Approved

Sub-total 447.50 447.50


BUDGET: INNOVATIONS

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B14 INNOVATIONS

B14.1

Quality Management System in Public Health Care (new)

B14.1.1 State level 0.00 0.00 B14.1.2 District level 0.00 0.00 B14.1.3 Grading of PHCs 0.00 0.00

sub-total Quality Management System 0.00 0.00

B14.2

Strengthening of Dental Services (ongoing)

B14.2.1

Establishment and operation of 65 new dental units 65 271.70 271.70 Approved

B14.2.2 Operation cost for 230 existing dental units 230 396.05 396.05 Approved

sub-total 921.95 667.75

B14.3

Accreditation of Government Hospitals (new)

B14.3.1 Non recurring 226.75 226.75 Approved B14.3.2 Recurring 350000 78 52.50 52.50 Approved sub-total 279.25 279.25

B14.4

Congenital and Developmental Defects (new)

B14.4.1

Congenital and Developmental Defects and Follow Up - Phase I 126.32 126.32 Approved

B14.4.2

Congenital and Developmental Defects and Follow Up 300.00 300.00 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks - Phase II

B14.4.3

Congenital and Developmental Defects and Follow Up - Phase III 56.42 56.42 Approved

Sub-total 731.42 356.42

B14.5

Screening for oral Cancer in Tamil Nadu (new) 300.00 300.00 Approved

B14.6

Prevention and Control of Silicosis (new) 23.83 23.83 Approved

Sub - Total innovations 2256.45 1627.25

BUDGET: IMPACT ASSESSMENT OF NRHM

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B20

Impact Assessment of NRHM Component

Impact assessment of NRHM and various components (new) 20.00 20.00 Approved

Sub-total 20.00 20.00

BUDGET: STATE HEALTH SYSTEMS RESOURCE CENTRE

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B21

State Health Systems Resource Centre

Capacity building for State Health Systems Resource 100.00 100.00 Approved


FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks Centre

Sub-total 100.00 100.00 BUDGET: SUPPORT SERVICES

FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B22 Support Services

B22.3 Support for NVBDCP 770.88 577.00 Approved

B22.4 Support for RNTCP 99.91 99.91

Activities: a) State level logistics for STDC / IRL / SDS, Furnishing of STDC for training. RNTCP. Approved amount: 6,08,000 Comment: May be approved as there is no provision in RNTCP b) NGO Payment (Pending payment) Approved Amount: 93,83,400 Comment: May be approved. Pendency of payment is seriously affecting NGO involvement in Tamil Nadu

B22.6

Other NDCP support programmes

IDSP

Establishment of 24 District Public Health Laboratories 1788000 24 429.12 429.12

Approved by IDSP Division

Operational cost existing 6 DPHL 816000 6 65.28 65.28



FMR Code Activity

Unit Cost (wherever

applicable)

Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

Provision New Computers for existing DSUs & Medical Colleges 64.17 0.00 Not approved

Inclusion of Urban Surveillance in Major Corporations 845000 1 8.45 0.00 Not approved

Training programme on epidemic prevention, control, investigation and management under NRHM 111312 22 24.49 0.00 Not approved

NLEP - NRHM - Internet facilities at districts 25 2.00 2.00

Approved as recommended by the division

Total 1464.30 1173.31


NATIONAL DISEASE CONTROL PROGRAMMES (NDCP)


NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP)

TARGETS:

Bring the prevalence of IDD to below 5% by 2017

To ensure 100% consumption of adequately iodated salt (15ppm) at the household level.

ROAD MAP FOR PRIORITY ACTION (NIDDCP)

Establishment of State IDD Cell for implementation programme activities.

Establishment of State IDD monitoring laboratory for conducting quantitative analysis of iodated salt and urine for iodine content and urinary iodine excretion.

All the sanctioned posts i.e. Technical Officer, Statistical Assistant, LDC/DEO, Lab Technician and Lab Assistant of State IDD Cell and State IDD Monitoring Laboratory filled on regular/contractual basis.

Supply, availability and consumption of adequately iodated salt in the state monitored.

District IDD survey/re-surveys undertaken as per NIDDCP guidelines to assess the magnitude of IDD in the respective districts as approved in the PIP and reports accordingly submitted.

Use of Salt testing kits by ASHA/Health Personnel in the endemic districts for creating awareness & monitoring of iodated salt consumption at household level monitored and monthly reports submitted as per the prescribed proforma.

ASHA incentives Rs. 25/- per month for testing 50 salt samples per month in endemic districts made available on regular basis to ASHA.

Health education and publicity conducted with more focus in the endemic districts with emphasis on IDD and promotion of consumption of adequately iodated salt. Global IDD Celebrations on 21st October conducted and report submitted.

State Govt to complete IDD Survey of four districts and send the reports.


DETAILED BUDGET:

(Rs. In lakhs) FMR Code

Activity Unit cost (wherever applicable)

Physical target Amount Proposed

Amount Approved

Remarks

D

IDD

The sanctioned vacant posts i.e. Statistical Assistant & LDC should be filled up on regular/contract basis on priority.

State Govt. may conduct and co-ordinate approved programme activities and furnish quarterly financial & physical achievements as per prescribed format.

D.1 Establishment of IDD Control Cell-

Implementation & monitoring of the programme

10.00 10.00

D.1.a Technical Officer 1

D.1.b Statistical Assistant

1

D.1.c LDC Typist 1

D.2 Establishment of IDD Monitoring Lab-

Monitoring of district level iodine content of salt and urinary iodine excretion as per Policy Guidelines.

5.00 The sanctioned posts of Lab Technician & Lab Asst. should be filled up on regular/ contract basis on priority.

State Govt. may conduct quantitative analysis of salt & urine as per NIDDCP Guidelines and furnish

D.2.a Lab Technician 1

D.2.b Lab. Assistant 1


FMR Code



Amount Approved

Remarks

monthly/quarterly statements.

D.3 Health Education & Publicity

Increased awareness about IDD and iodated salt.

21.00 7.00 IDD publicity activities including Global IDD Day celebrations at various level.

D.4 IDD Survey/Resurveys

Rs. 50,000 per district

4 districts 10.50 2.00 State. Govt. may under take 4 districts IDD survey as per guidelines and furnish report.

D.5 Salt Testing Kits supplies by GOI inform of kind grant for 21 endemic districts

12 STK per annum per ASHA

Creating iodated salt demand and monitoring of the same at the community level.

State Govt. to monitor the qualitative analysis of iodated salt by STK through ASHA in 21 endemic districts i.e. Trichrapalli

Dindigul, Madurai, Coimbatore, Ramananthapuram, The Nilgiris, Thiruvarur, Salem,

Virudhnagar, Villupuram, Kanyakumari, Dharmapuri, Pudukottai, Namakkal, Nagapattanum, Erode, Perambalur, Tuticoran,

D.6 ASHA Incentive Rs. 25/- per month for testing 50 salt samples/ month

50 salt samples per month per ASHA in 21 endemic districts

19.17


FMR Code



Amount Approved

Remarks

Thanjavur, Chennai, Cuddlore

TOTAL 47.50* 43.17

Including Rs. 5.00 lakh for mobility and Rs. 1.00 lakh for procurement of equipment which are not allowed under the programme.

(*) The total fund proposed includes printing, supply of Health workers manual on NIDDCP, formats & reports,g lab consumable, organisation of workshops/seminars/meetings which are not allowed under the Programme.


INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP)


There are 32 vacant posts of technical contractual staff (31 Epidemiologists, 1

Entomologist) under IDSP in the State as on March 2012. The State needs to expedite the

recruitment of these staff by September 2012.

The training of Master trainers (ToT) and 2-week FETP for District Surveillance Officers

under IDSP has been completed for the State/Districts. However, the State may give the

additional list of participants to be trained for ToT and 2-week FETP.

Presently only 81% of all the Reporting Units are reporting weekly surveillance data in P-

form through IDSP Portal. The State needs to ensure regular weekly reporting of all

surveillance data (S, P, L) by all the Reporting Units of all Districts through IDSP Portal.

The State has to ascertain regular reporting from all districts in 2012-13.

The State has to ensure consistent reporting of L form in portal by the district priority labs

at Cuddalore and Ramanthapuram.

The Referral Lab Network needs to be utilized for etiological confirmation of epidemic

prone diseases. Appropriate clinical samples need to be sent for the required lab

investigations for more number of disease outbreaks. In 2011, clinical samples were sent

for laboratory investigation for only 72% of the disease outbreaks in which 31% were lab

confirmed.

The State needs to send full investigation report for each disease outbreak. Presently,

such investigation reports are available for only a few outbreaks.

Reply of state on Observations made by auditors for 2010-11 is pending. In few districts

the separate Fixed Assets Register of IDSP is not maintained.

State has to ensure timely submission of quarterly Financial monitoring Report and annual

audit report.


DETAILED BUDGET:

FMR Code

Activity Unit Cost (where-ever applicable)

Amount Proposed (Rs. in lakhs)

Amount Approved (Rs in lakhs)

Comments

E.1 Operational Cost E.1.4 Field Visits

Rs 2,40,000 per District Surveillance Unit per annum

Rs 5,00,000 State Surveillance Unit per annum

78.144 (4.22 [SSU] + 59.276 [DSU] + 4.088 [Newly Formed Districts] + 10.56 [Medical Colleges])

78.15 The operational cost for Medical Colleges will be borne by the district where they are located.

Office Expenses Broad Band

expenses Outbreak

investigations including Collection and Transport of samples

E.1.3 Review Meetings

Sub Total

78.15 78.15

# Laboratory Support District Priority Lab Rs.

4,00,000 per district priority lab per annum

8.00 (4.00 × 2) 8.00 (4.00 × 2)

Referral Network Lab

Rs. 5,00,000 per referral lab per annum

40.00 (5.00 × 8) 40.00 (5.00 × 8)

District Public Health Labs*

Rs. 2,00,000 per annum for consumables

29.52 (for 6 District PH Labs)

0.00 Funds will be approved once the labs are functional.

Sub Total

77.52 48.00

E.2 Human Resources

E.2.1 Remuneration of Epidemiologists

Rs.25,000 - Rs. 40,000/ per month

153.60 ([40,000 × 2 × 12] + [40,000 × 30 ×

153.60 ([40,000 × 2 × 12] +


FMR Code




Comments

12]) [40,000 × 30 × 12])

E.2.2 Remuneration of Microbiologists

Rs. 25,000 - Rs. 40,000 (Medical Graduates) Rs. 15,000 - Rs. 25,000 (Others)

27.00 ([25,000 × 3 × 12] + [25,000 × 6 × 12])

27.00 ([25,000 × 3 × 12] + [25,000 × 6 × 12])

E.2.3 Remuneration of Entomologists

Rs. 15,000 - Rs. 25,000

3.00 (25,000 × 1 × 12)

3.00 (25,000 × 1 × 12)

Veterinary Consultant

Rs. 25,000 -Rs.40,000

4.80 (40,000 × 1 × 12)

0.00

E.3 Consultant-Finance/ Procurement

Rs. 14,000 1.68 (14,000 × 1 × 12)

1.68 (14,000 × 1 × 12)

E.3.1 Consultant-Training/ Technical

Rs. 28,000 3.36 (28,000 × 1 × 12)

3.36 (28,000 × 1 × 12)

E.3.2 Data Manager Rs. 14,000 (State) Rs. 13,500 (District)

51.90 ([14,000 × 1 × 12] + [13,500 × 31 × 12])

51.90 ([14,000 × 1 × 12] + [13,500 × 31 × 12])

E.3.3 Data Entry Operator Rs. 8,500 49.98 (8,500 × 49 × 12)

49.98 (8,500 × 49 × 12)

Sub Total

295.32 290.52

E.8 Training As per NRHM Guidelines

Training of RRT is undertaken by Central Surveillance Unit. Additional List of trainees may be sent to CSU.

One day training of Hospital Doctors

Rs. 5.617 lakhs (for 32 batches [640 persons] @ Rs. 17555/- per batch)

Rs. 1.10 lakhs (for 100 persons @ Rs. 1100/- per person)

One day training of Hospital Pharmacist / Nurses



One day training of Medical College

Rs. 2.38 lakhs (for 16 batches

Rs. 1.60 lakhs (for 80


FMR Code




Comments

Doctors [336 persons] @ Rs. 14875/- per batch)

persons @ Rs. 2000/- per person)

One day training for Data Entry and analysis for Block Health Team

Rs. 15.20 lakhs approx (for 96 batches @ Rs. 15830/- per batch)


Rapid Response Team


0.00

One day training of DM & DEO



Sub Total

36.39925 10.20

E7 ID Hospital Network Rs. 3,00,000/- per annum for IDH

3.00 (1 × 3.00) 3.00 (1 × 3.00)

# Surveillance in Metro Cities

Rs. 10,000,00 /- per annum per metro city

14.56 10.00

# New formed Districts

Rs. 3,50, 000/- per newly formed district

7.00 (3.50 × 2) 7.00 (3.50 × 2)

The amount to be utilized for procurement of ICT equipments under IDSP as per program guidelines.

Total 511.95 446.87


Proposal under Additionalities

FMR Code


Amount Proposed

Amount Approved

Comment

Establishment of 24 District Public Health Laboratories

17.88 429.12 429.12 May be approved; Procurement of equipment and civil works may be done as per NRHM guidelines.

Operational cost existing 6 DPHL

8.16 65.28

65.28

May be approved; Procurement of equipment and civil works may be done as per NRHM guidelines.

Provision of New Computers for Existing DSUs & Medical Colleges AND provision of 1 Data Entry Operator & Computer with Accessories for 12 Addl. HUDs

64.17

0 Not Approved

Budget under NRHM support for provision of Data Entry Operator & New Computer with Accessories for 5 Major Corporations

8.45 8.45 0 Not Approved

Training programme on epidemic prevention, control, investigation and management under NRHM

24.49 0 Not Approved .

TOTAL 591.51 494.40

# FMR Code not allotted.

Comments:

1. The following heads will be approved / modified once approval from EFC is obtained.

Remuneration of Veterinary Consultant @ Rs. 25,000 - Rs.40, 000.

2. Based on past trend, Rs 110.00 lakhs has been approved for Tamil Nadu State under IDSP for 2012-13. However, if there is increase in expenditure by State as per IDSP approved norm, the budget for State could be increased at RE stage


NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME


State Specific Goal

Sr. No.

Physical Targets

Indicator 2010 2011 2012 Remarks 1 Annual Blood

Examinate Rate (ABER) i.e. % of population screened annually for Malaria

11.44% 11.42% <11%

2 Annual Parasite Incidence (API) i.e. Malaria cases per 1000 population annually

0.25 0.32 0.3

3 Sentinel Surveillance Hospital made functional for Dengue & Chikungunya

13 27 30

4 Sentinel Surveillance Hospital made functional for JE

5 5 7 2 additional sentinel sites proposed are already functioning for dengue & chikungunya. Their functionality needs to be ensured for JE also

6 No. of districts with less than 1% Mf rate

20 20 20

Priority Area for Focussed Attention

1 Malaria in Rameshwaram Island and Chennai need to be contained.

2 JE affected areas like Trichy, Thiruvallur,Thiruvarur and Madurai need attention.

3 Mf rate has been continuously below 1% hence validation process to be started.

Essential Conditionality

1 Two review meetings in a year under the Chairmanship of Principal Secretary (Health)/Mission Director may be conducted - one before transmission period and second during transmission period.


DesirableConditionality

1 The proposal for recruitment of regular human resource like regular MPW and Lab Technician required for NVBDCP should be initiated by end of 1st quarter.

Post Sanctioned In position

Vacant Target for 2012-13

1 Multipurpose Health Supervisor (Male) - MPWs

5700 3101 2605 Priority to be accorded for filling of these posts

Sr. No.

District wise goals (To be done by State)

ABER API Deaths Mf Rate

Name of Districts 2011 2012

2011 2012

2011 2012

2011 2012

1 2 3

Road Map: Surveillance & monitoring under NVBDCP is done throughout the year. Following salient points are to monitor the implementation of programme activities in different quarters. • April to June - 1st round spraying and observance of anti-malaria month to be ensured and accordingly funds availability at districts to be ensured • July to Sept. - 2nd round of spray and observance of anti-dengue month. Preparatory activities for stoppage of Mass Drug Administration towards filaria elimination to be started. • Oct. to Dec.-Review and Monitor physical and financial performance and preparation of next annual plan. • Jan. to March - Consolidation of previous year's physical and financial achievement and plan for next year.


BUDGET:

Sr.No. Component Unit Cost (wherever applicable)

Physical target/

Deliverables

Amount Proposed

Amount Approved

Remarks

F.1 DBS (Domestic Budgetary Support)

F.1.1 Malaria F.1.1.a Contractual Payments F.1.1.a.i MPW contractual F.1.1.a.ii Lab Technicians ( against

vacancy )

F.1.1.a.iii VBD Technical Supervisor (one for each block)

F.1.1.a.iv District VBD Consultant (one per district) (Non- Project States) State Consultant (Non – Project States), - VBD Consultant (preferably entomologist)

F.1.1.b ASHA Incentive 9.99 15.00 F.1.1.c. Operational Cost F.1.1.c.i Spray Wages F.1.1.c.ii Operational cost for IRS F.1.1.c.iii Impregnation of Bed

nets- for NE states

F.1.1.d Monitoring , Evaluation & Supervision & Epidemic Preparedness including mobility

97.82 75.00

F.1.1.e IEC/BCC 29.69 35.00 may be used for other VBDs activites

F.1.1.f PPP / NGO and Intersectoral Convergence

F.1.1.g Training / Capacity Building

22.31 35.00 may be used in an integrative manner for other VBDs also

F.1.1.h Zonal Entomological units

F.1.1.i Biological and Environmental



Physical target/

Deliverables

Amount Proposed

Amount Approved

Remarks

Management through VHSC

F.1.1.j Larvivorous Fish support Total : Malaria 159.81 160.00 F.1.2 Dengue and

Chikungunya

F.1.2.a Strengthening surveillance (As per GOI approval)

F.1.2.a(i) Apex Referral Labs recurrent

21.37 29.00

F.1.2.a(ii) Sentinel surveillance Hospital recurrent

F.1.2.a(iii) ELISA facility to sentinel surveillance labs

F.1.2.b Test kits (Nos.) to be supplied by GoI (kindly indicate numbers of ELISA based NS1 kit and Mac ELISA Kits required separately)

0.00

F.1.2.c Monitoring and evaluation

178.82 171.00 Funds allocated as per Mid Term Plan strategy. State to implement as per guidelines of Mid Term Strategy.

F.1.2.d Epidemic containment F.1.2.e Case management F.1.2.f Vector control &

environmental management

F.1.2.g IEC BCC for Social Mobilization

F.1.2.h Inter-sectoral convergence

F.1.2.i Training including operational research

Total : Dengue/Chikungunya

200.19 200.00

F.1.3 AES/JE F.1.3.a Diagnostics and Case

Management 66.04 120.00

F.1.3.b IEC/BCC specific to J.E. in endemic areas

48.87 10.00

F.1.3.c Capacity Building 3.94 10.00



Physical target/

Deliverables

Amount Proposed

Amount Approved

Remarks

F.1.3.d Monitoring and supervision

4.39 10.00

F.1.3.e Technical Malathion 36.76 10.00 F.1.3.f Fogging Machine 0.00 0.00 F.1.3.g Operational costs for

malathion fogging 0.00 0.00

F.1.3.h Operational Research 0.00 0.00 F.1.3.i Rehabilitation Setup for

selected endemic districts

0.00 0.00

F.1.3.j ICU Establishment in endemic districts

0.00 0.00

F.1.3.k ASHA Insentivization for sensitizing community

0.00 0.00

F.1.3.l Other Charges for Training /Workshop Meeting & payment to NIV towards JE kits at Head Quarter

0.00 0.00

Total : JE 160.00 160.00 F.1.4 Elimination of Lymphatic

Filariasis

F.1.4.a State Task Force, State Technical Advisory Committee meeting, printing of forms/registers, mobility support, district coordination meeting, sensitization of media etc., morbidity management, monitoring & supervision and mobility support for Rapid Response Team and contingency support

53.00 53.00

F.1.4.b Microfilaria Survey (Night Survey)

10.00 10.00

F.1.4.c Monitoring & Evaluation (Assessment)/by Medical College/ Regional Institutions

3.00 3.00



Physical target/

Deliverables

Amount Proposed

Amount Approved

Remarks

F.1.4.d Training of District Officers, PHC MOs, Paramedical staff, drug distributors etc.

21.00 21.00

F.1.4.e Specific Advocacy/IEC/BCC including centre, state, district/PHC, sub centre

84.00 74.00

F.1.4.f Honorarium for Drug Distribution including ASHAs and supervisors

F.1.4.g Verification and validation for stoppage of MDA in LF endemic districts

F.1.4.g.i a) Additional MF Survey (Night Survey)

14.00 14.00

F.1.4.g.ii b) ICT Survey 30.00 30.00 F.1.4.g.iii c) ICT Cost F.1.4.h Verification of LF

endemicity in non-endemic districts

15.00 15.00

F.1.4.i Post-MDA surveillance 0.00 0.00 Total : ELF 230.00 220.00 F.1.5 Kala-azar F.1.5 Case search/ Camp

Approach Not

Applicable Not

Applicable

F.1.5.a Spray Pumps & accessories

F.1.5.b Operational cost for spray including spray wages

F.1.5.c Mobility/POL/supervision F.1.5.d Monitoring & Evaluation F.1.5.e Training for spraying F.1.5.f IEC/ BCC/ Advocacy Total Kala-azar 0.00 0.00 Total (DBS) 750.00 740.00 F.2 Externally aided

component

F.2.a World Bank support for



Physical target/

Deliverables

Amount Proposed

Amount Approved

Remarks

Malaria F.2.b Human Resource Not

Applicable Not

Applicable

F.2.c Training /Capacity building

F.2.d Mobility support for Monitoring Supervision & Evaluation including printing of format & review meetings, Reporting format (for printing formats)

Kala-azar World Bank assisted project

F.2.e Human resource Not Applicable

Not Applicable

F.2.f Capacity building F.2.g Mobility F.3 GFATM support for

Malaria

F.3.a Project Management Unit including human resource of N.E. states

Not Applicable

Not Applicable

F.3.b Training/Capacity Building

F.3.c Planning and Administration( Office expenses recurring expenses, Office automation , printing and stationary for running of project)

F.3.d Monitoring Supervision (supervisory visits including travel expenses, etc) including printing of format and review meetings,

F.3.e IEC / BCC activities as per the project



Physical target/

Deliverables

Amount Proposed

Amount Approved

Remarks

F.3.f Operational cost for treatment of bednet and Infrastructure and Other Equipment (Computer Laptops, printers, Motor cycles for MTS )

Total : EAC component 0.00 0.00 F.4 Any Other Items ( Please

Specify) 0.00 0.00

F.5 Operational costs ( mobility, Review Meeting, communication, formats & reports)

0.00 0.00

Grand Total for cash assistance under NVBDCP

750.00 740.00

F.6 Assistance required for decentralized commodities

F.6.a Chloroquine tablets 1.16

200.00

F.6.b Primaquine 7.5 mg

tablets 2.50

F.6.c Primaquine 2.5 mg tablets

0.00

F.6.d Quinine sulphate tablets F.6.e Quinine Injections F.6.f DEC 100 mg tablets F.6.g Albendazole 400 mg

tablets

F.6.h NS1 Dengue Ag Kit (ELISA based) under Dengue/Chikungunya

F.6.i Temephos, Bti (AS) / Bti (wp) (for polluted & non polluted water)

30.53

F.6.j Pyrethrum Extract 2% 132.70 F.6.k ACT ( For Non Project

states) 1.11

F.6.l RDT Malaria – bi-valent (For Non Project states)

F.6.m Any Other Items ( Please



Physical target/

Deliverables

Amount Proposed

Amount Approved

Remarks

Specify) Total for Decentralized

Commodities 168.00 200.00

Grand Total for grant-in-aid under NVBDCP

918.00 940.00

Commodity Grants 0.00 Total NVBDCP Cash +

Commodity 918.00 940.00

Cash Assistance required under NRHM Flexi Fund

Proposal for Anti Malaria activity in Rameswaram Island, Ramanathapuram District

28.20 28.00

Contractual Mazdoors for IRS & Anti larval operation in Malaria in Endemic District

19.12 19.00

Tent-type mosquito Net for Rameswaram Island

60.00 0.00 May be met from state resources as an innovative trial considering the feasibility of use of nets being a seashore area with heavy sea breeze during evening.

Wages for Temporary mazdoors in Rameswaram Island

8.24 8.00

Scrub Typhus

122.24 0.00 Not under NVBDCP

Vector control activity with less than 1 lakh population

222.03 222.00

Purchase of Bti. for vector control activities under NFCP

311.05 300.00 Should be shown under decentralized commodity, however, may be



Physical target/

Deliverables

Amount Proposed

Amount Approved

Remarks

approved from NRHM additionality as this year's proposal

Total under NRHM Flexi Fund

770.88 577.00


NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP)

TARGETS FOR 2012-13:

S.No Goals & Target September'12 March 2013

1 Elimination at Sate level NA NA

2 Elimination at District level NA NA

3 Case detection through ASHA 500 1000

4 Special activity plan in 6 blocks 6 Blocks Complete 6 Blocks

5 MCR footwear procurement & supply 7500 15700

6 RCS 55 110

7 Development of leprosy expertise 50% of Plan 100% of Plan

8 Treatment Completion Rate assessment for 2011-12 Completed -

9 Audited Report for the year 2011-12 Completed -

10 Expenditure incurred against approved plan budget 50% 100%


DETAILED BUDGET:

(Rs. In Lakh)

FMR code

Activity proposed Unit Cost (In Rupees)

Physical Targets

Amount proposed

Amount approved

Remarks

G 1. Improved early case detection

G 1.1 Incentive to ASHA MB 500 400 7.50 2.00 PB 300 600 6.00 1.80 G1.1 a Sensitization of ASHA 50 - - -

G 1.2 Specific -plan for High Endemic Distrcts

1 D 1.92/block 6 blocks 140.16 11.52

G 2 Improved case management

G 2.1

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

MCR - 250/- Aids/Applian

ce -12500 Welfare/RCS

- 10,000

15700 30

110

47.10 7.20

11.00

39.25 3.75

11.00

G 2.2

Urban L:eprosy Control, (Mega city - 1 , Medium

city (1) -4 , Med. City (2)-1 Township -22)

Meg -280000 Med (1)- 120000

Med. (2) - 236000 Town - 57000

1 4 1

22

5.60 9.60 4.72

25.08

2.80 4.80 2.36

12.54

G 2.3 Material & Supplies

G 2.3 a

Supportive drugs, lab. reagents & equipments and printing works

52,000 30 24.00 15.60

G 2.4 NGO - SET Scheme 500000 - - -

G 3 Stigma Reduced

G 3.1

Mass media, Outdoor media, Rural media, Advocacy media

50,000 30 30.00 15.00

G 4.

Development of Leprosy Expertise sustained

As NLEP rates are very low, higher rates

agreed in keeping with

other programmes

G 4.1 Training of new MO 60000 - - -

G 4.2 Refresher training of MO 40000 900 29.80 12.00

G 4.3 Training to New H.S/H.W. 30000 1200 20.16 12.00

G 4.4 Other training - 30000 150 2.52 1.50


FMR code


Physical Targets

Amount proposed

Amount approved

Remarks

Physiotherapist

G 4.5 Training to Lab. Tech. 30000 300 5.04 3.00

G 4.6 Management training for District Nucleus Team

30000 150 5.40 1.50

G 5.

Monitoring, Supervision and Evaluation System improved

G 5.1 Travel Cost and Review Meeting

G 5.1 i

travel expenses - Contractual Staff at State level

70000 1 1.00 0.70

G 5.1 ii

travel expenses - Contractual Staff at District level

15000 30 7.50 4.50

G 5.1 iii Review meetings 25000 4 2.00 1.00

G 5.2 Office Operation & Maintenance

G 5.2 i Office operation - State Cell

38000 1 0.75 0.38

G 5.2 ii Office operation - District Cell

18000 30 10.50 5.40

G 5.2 iii Office equipment maint. State

30000 1 0.50 0.30

G 5.3 Consumables G 5.3 i State Cell 28000 1 0.50 0.28

G 5.3 ii District Cell 14000 30 9.00 4.20

G 5.4 Vehicle Hiring and POL

G 5.4 i State Cell 85000 2 vehicle 2.00 1.70


G 6. Programme Management ensured

G 6.1 Contractual Staff at State level

G 6.1 i SMO 1 40000 x12 4.80 4.80

G 6.1 ii BFO cum Admn. Officer 1 30000 x12 3.60 3.60 G 6.1 iii Admn. Asstt. 1 16000 x12 1.92 1.92 G 6.1 iv DEO 1 12000 x12 1.44 1.44 G 6.1 v Driver 1 11000 x12 1.32 1.32

G 6.2 Contractual Staff at Disrrict level


FMR code


Physical Targets

Amount proposed

Amount approved

Remarks

G 6.2 i Driver 15 11000 x12 21.12 19.80

G 6.2 ii Contractual Staff in selected States, NSM 20000 - -

G 7. Others

G 7.1

Travel expenses for regular staff for specific programme / training need, awards etc

2.00 Added as essential

requirement

TOTAL 493.83 228.26

Additionality in Annual Plan

NRHM - Internet facilities at dsitricts

25 2.00 2.00

WHO/ILEP/ICMR/Others


NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB)


1. The emphasis will be on primary health care all vision centers will be established immediately after receipt of grant with PMOA is in position to facilitate eye care delivery at the primary health centre.

2. Eye Bank to be established only in Government Hospital and Government Medical College. The names and address may be furnished in the reports submitted to GOI. The amount will not be split up to more than 1 eye bank.

3. Management of Health Society be restricted within Rs.14 lakh only. 4. Payment of Rs.750/- will be made to NGO per operated case if the NGO has used all

facilities of their own like Drugs & Consumables, Sutures, Spectacles, Transports/POL, organization and publicity and IOL, Viscoelastics & addl. Consumables including their own Eye Hospital and Doctors.

5. For organizing and motivating identified persons & transporting them to Govt. / NGO fixed facilities, the NGO would be eligible for support not exceeding Rs.175/- per operated case. (Transport/POL and organization & publicity.)

6. No payment will be released towards reimbursement to be made to NGOs w.e.f. 01.04.2012 if data entry on Management Information System (MIS) is not completed by them.

7. Full details of the NGO funded be provided including the facilities created and the free operations being done by them in lieu thereof. The amount will be released for only one NGO and amount will not be split up into more than one NGO.


Budget:

NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS GRANT-IN-AID TO STATES/UTS FOR VARIOUS

Physical Target

Funds Requested

Funds Approved

As Per Guidelines

Remarks

Sl.No. H 1 Recurring Grant-in-aid

H 1.1 For Free Cataract Operation @ Rs.750/- per case 650000 NGO-500000

3750.00 2114.00 Approved on reimburseme

nt basis H 1.2 Other Eye Diseases@ Rs.1000/- 1000 10.00 10.00 Approved H 1.3 School Eye Screening Programme@ Rs.200/- per

case 50000 100.00 100.00 Approved

H 1.4 Blindness Survey 385 577.50 0 Not Approved

H 1.4 Private Practitioners @as per NGO norms 5.00 5.00 Approved H 1.5 Management of State Health Society and Distt.

Health Society Remuneration (salary , review meeting, hiring of vehicle and Other Activities & Contingency) @ Rs.14 lakh/ Rs.7 lakh depending on the size of state

SBCS-1

DBCS-32 (2 new distt. formed)

14.00

128.00

14.00

0.00

Approved

Not approved

H 1.6 Recurring GIA to Eye Donation Centers @ Rs.1000/- per pair

200 eye 1.00 1.00 Approved

H 1.7 Eye Ball Collection by Eye Bank @ Rs.1500/- per pair

6000eyes 45.00 45.00 Approved

H 1.9 Training PMOA and MIS training 404 50.00 15.00 Approved for PMOA and

MIS training for 1 time

H 1.10 IEC, Eye Donation Fortnight, World Sight Day & awareness programme in state & districts etc

32 lump sum for the state

10.00 31.00 Approved for 1 lac per

distt. and 2 lac for state

H 1.11 Procurement of Ophthalmic Equipment (foldable IOL @ Rs.500 per IOL)

15 Medical College@1000

per annum

75.00 0 Through NRHM flexipool

H 1.12 Maintenance of Ophthalmic Equipments 6.00 6.00 Approved H.2 Non Recurring Grant-in-aid H.2.1 For RIO (new services Lasik)

Starting new zonal [email protected] lakh 1 5

200.00 200.00

0

Through NRHM

flexipool H.2.2 For Medical College@ Rs.40 lakh 2 80.00 40.00 Approved for

1 MC H.2.3 For vision Centre @ Rs.50000/- 10 5.00 5.00 Approved for

10 Vision Centre



Physical Target

Funds Requested

Funds Approved

As Per Guidelines

Remarks

H.2.4 For Eye Bank @ Rs.15 lakh 2 30.00 15.00 Approved for 1 Eye Bank in Govt. Hospital

H.2.5 For Eye Donation Centre @ Rs.1 lakh 2 2.00 1.00 Approved for 1 EDC

H.2.6 For NGOs @ Rs.30 lakh 0.00 0.00 H.2.7 For Eye Wards and Eye OTS @ Rs.75 lakh 2 150.00 0.00 Through

NRHM flexipool

H.2.8 For Mobile Ophthalmic Units with tele-network @ Rs.60 lakh

0.00

Grant-in-aid for strengthening of Distt. Hospitals @ Rs.20 lakh

2 40.00 40.00 Approved

Grant-in-aid for strengthening of Sub Divisional. Hospitals@ Rs.5 lakh

1 5.00 5.00 Approved

H.3 Contractual Man Power H.3.1 Ophthalmic Surgeon@ Rs.25000/- p.m 15 0.00 0.00 H.3.2 Ophthalmic Assistant @ Rs.8000/- p.m 20 0.00 0.00 H.3.3 Eye Donation Counsellors @ Rs.10000/- p.m. 20 0.00 0.00 5484.00 2447.00

* The unutilized funds in any of the above said recurring components may be used in any other recurring component.


REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME TARGETS

Target for Annualized New Smear Positive Case Detection rate per lakh population (April 2012 to September 2012 )

Target for Annualized New Smear Positive Case Detection rate per lakh population (October 2012 to March 2013 )

Target for Treatment Success rate (April 2012 to September 2012 )

Target for Treatment Success rate (October 2012 to

March 2013 )

60% 70% 86% 88%


S.No Indicators 2011 2012

1 Annual Suspects Examined Per Lakh Population

234 234

2 Annual Smear Positive Case Notification Rate (%)

60% 70%

3 Treatment Success Rate among new smear positive cases

86% 88%

4 Default Rate among New Smear Positive TB cases

6% 4%

5 Treatment Success rate among Smear Positive Re-treatment cases

60% 85&

Conditionality:

All the Key RNTCP contractual staff positions at State/Districts should be filled and ensuring timely payment of salaries

The State level RNTCP review meetings to be chaired by Health Secretary/Mission Director (NRHM) at least once in a quarter

To conduct State TB control society meeting, State Coordination committee meeting (TBHIV) atleast once in a quarter

Scaling up of DOTS Plus services as per the State DOTS Plus action plan Conduct ACSM/Training activities at State/Districts as per the State annual action plan To involve Private Practitioners and NGOs in the RNTCP Timely payment of DOT Providers honorarium at Districts Strengthening Supervision and Monitoring at all levels The state could be approved more funds based on expenditure pattern in the first six

months


BUDGET: RNTCP

FMR Code Activity

Unit cost (wherever applicable)

Physical target/ expected output Estimated

Budget Approved

Budget Remarks

I.1 Civil works

As per Revised

Norms and Basis of

Costing for RNTCP

1) Civil work Up gradation and maintenance completed as

planned 56.11 56.11

Approved 100%. Approved 3 DOTS Plus sites, new constriction of DTC

I.2 Laboratory materials

As per Revised Norms and Basis of Costing for RNTCP

1) Sputum of TB Suspects Examined per lac population per quarter;

2) All districts subjected to IRL On Site Evaluation and Panel Testing in the year;

3) IRLs accredited and functioning optimally 136.40 90.00

Approved 65% of the amount.

I.3.a Honorarium


1) All eligible Community DOT Providers are paid honorarium in all districts in the FY

77.87 31.15

Approved amount based on the utilization.

I.4 IEC/ Publicity


1) All IEC/ACSM activities proposed in PIP completed;

2) Increase in case detection and improved case holding 68.41 40.61

Approved amount based on the utilization. The remuneration for the 6 communication facilitators should be met from this head.


FMR Code Activity



Budget Approved

Budget Remarks

I.5 Equipment maintenance


1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as planned;

2) All BMs are in functional condition 35.66 25.00

Approved amount permissible as per the norm. Not approved the proposal for TV and A/C maintenance .

I.6 Training


1) Induction training, Update and Re-training of all cadre of staff completed as planned 56.17 45.00

Approved amount permissible as per the norm.

I.7 Vehicle maintenance


1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained

88.50 60.00

Approved amount based on the utilization..

I.8 Vehicle hiring


1) Increase in supervisory visit of DTOs and MOTCs;

2) Increase in case detection and improved case holding 115.13 36.00


I.9 NGO/PPP support

As per Revised Norms and Basis of Costing for

1) Increase in number of NGOs/PPs involved in signed schemes 241.70 100.00

Approved amount based on the utilization. *If the state is anticipating deficit in laboratory capacity to


FMR Code Activity



Budget Approved

Budget Remarks

RNTCP of RNTCP;

2) Contribution of NGOs/PPS in case detection and provision of DOT

conduct C&DST test, then state may budget for funds under C&DST scheme in the NGO /PP head as the RNTCP guidelines for NGO and PPs, as a priority.

I.10 Miscellaneous


1) All activities proposed under miscellaneous head in PIP completed

144.95 108.79

Approved amount permissible as per norm.

I.11 Contractual services


1) All contractual staff appointed and paid regularly as planned

1260.71 1182.26


The remuneration for communication facilitators, should be met form the amount approved for IEC activities.

The salary budgeted for the new TBHVs is approved only for 10 months, considering the delay in approval and appointment.

I.12 Printing

As per Revised Norms and Basis of

1) All printing activities at state and district level completed as

50.85 30.00



FMR Code Activity



Budget Approved

Budget Remarks

Costing for RNTCP

planned

I.13 Research and studies


1) Proposed Research has been initiated or completed in the FY as planned;

2) Funds in the head utilized against approved amount 20.00 10.00

Approved the proposal for studying the prevalence of TB as this is a CTD priority.

I.14 Medical Colleges


1) All activities proposed under Medical Colleges head in PIP completed; 2) Funds in the head utilized against approved amount 256.25 255.95


I.15

Procurement –vehicles


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

Approved 100% of the budgeted amount

Four wheeler

Two Wheeler 23.50 23.50

I.16 Procurement – equipment

As per Revised Norms and Basis of Costing for

1) Procurement of equipments completed as planned 20.88 10.80



FMR Code Activity



Budget Approved

Budget Remarks

RNTCP

17 Tribal Action Plan

Total (A) 2653.08 2105.17

18 Additionality funds from NRHM (B)

99.91 99.91

TOTAL (A+B) Rs. 2205.08

Budget approved under NRHM additionalities 2012-13

Activity

Proposed amount Approved amount

Remarks

State level logistics for STDC / IRL / SDS Furnishing of STDC for training.

6.08 6.08

Approved

NGO Payment (Pending payment)


Grand Total 99.91 99.91


ANNEXURE


Annex 1

DETAILED BUDGET: REPRODUCTIVE AND CHILD HEALTH (RCH FLEXIPOOL)


Target

BUDGET (Rs.Lakhs) Remarks Proposed Approved

A.1 MATERNAL HEALTH

A.1.1 Operationalise facilities

A.1.1.1 Operationalise FRUs (Operationlisation of Blood storage centres)

A.1.1.1.1 Fuel charges Rs.15000/generator

268 generators


A.1.1.1.2 Camp arrangement Rs.1000/camp

2 camps/385

blocks

7.70 7.70 Approved

A.1.1.2 Operationalise 24x7 PHCs

A.1.1.2.1 Hiring of specialists Rs.1000/case

20000 cases

200.00 0.00 Not approved. Super-specialist services cannot be made available at the Primary level Health facility. Such high risk cases are few in number and should be timely detected and referred. Similarly routine lab facilities should be available in house and for specialized services. The cases can be timely referred.

A.1.1.2.2 Hiring of diagnostic services

Rs.500/case

20000 cases

100.00 0.00

A.1.1.3 MTP services at health facilities

A.1.1.4 RTI/STI services at health facilities

A.1.1.5 Operationalise Sub-centres

A.1.2 Referral Transport

A.1.3 Integrated outreach RCH services



Target


A.1.4 Janani Suraksha Yojana / JSY

A.1.4.1 Home Deliveries Rs.500/delivery

500 deliveries

2.50 2.50 Approved

A.1.4.2 Institutional Deliveries A.1.4.2.a Rural Rs.700/de

livery 335189

deliveries 2346.32 2346.32 Approved

A.1.4.2.b Urban Rs.600/delivery

140796 deliveries

844.78 844.78 Approved

A.1.4.2.c C-sections A.1.4.3 Administrative expenses 159.68 159.68 Approved A.1.4.4 Incentive to ASHAs A.1.4.4.1 Rural & Urban Rs.200/w

oman 67200

women 134.40 Approved. Shifted

from MFP A.1.4.4.2 Tribal Areas Rs.200/w

oman 42400

women 84.80 Approved. Shifted

from MFP A.1.5 Maternal Death Review A.1.5.1 Regional workshop Rs.150000

/workshop

8 workshops


A.1.5.2 Monthly bulletin Rs.10/bulletin/m

20000 bulletin/m

24.00 8.00 Approved for quartely printing of bulletin and not monthly.

A.1.5.3 MD audit expenditure Rs.10000/death

900 deaths 90.00 0.00 Not Approved. Honorarium to experts, POL, and incidental expenses do not conform with GOI Guidelines on MDR. Budget for TA /DA can be utilized out of comprehensive monitoring fund. Honorarium for RCH activities should not exceed its norm.

A.1.6 Other strategies/ activities

A.1.6.3 Printing of safe Rs.10/boo 1500000 150.00 150.00 Approved



Target


motherhood booklet klet booklets A.1.6.4 Establishment of JSSK

Centre 1)Telepho

ne 2)Recharge charges 3) Salary

for call centre

staff 4)Awarne

ss workshop

for JSSK 5)Display

board

1) Rs.7.25 L 2)Rs.17.40

L 3)Rs.6 L

4) Rs.42 L 5)Rs.67.50

L

140.15 29.04 1) & 2) Approved for JSSK Grievance redressal at district level @ Rs 6000/m for 12 months x 32 districts = Rs 23.04 lakhs 3) Rs 6.00 lakhs approved at State level Call centre for Salary for Call centre staff of 4 in no. @ Rs 12,500/m x 4 staff for 12 months = Rs.6.00 lakhs 4) IEC should be district specific Can be approved for Rs 1 lakh per district x 32 districts = 32 lakhs. This needs to be shifted to MFP. 5) Not approved. The cost is on higher side. State to plan for comprehensive IEC /BCC for all MH /RCH activities and budget accordingly under IEC.

A.1.6.5 Funds for Diet and refreshments for High Risk Mothers

Rs.160/mother

57000 mothers


A.1.6.6 Incidental expenditure to Staff Nurses

Rs.100/mother

57000 mothers


A.1.7.1 Janani Shisu Suraksha Karyakram

A.1.7.1 Drugs and Consumables



Target


A.1.7.1.1.1

Drugs and Consumables for Normal Deliveries

Rs.350/ND

478000 NDs

1673.00 2677.50 Approved for 7.65 lakh NDs . Separate approval will not be given for drugs and kits for different levels of facilities. However utilization will be as per differential EDL.

A.1.7.1.1.2

Drugs and Consumables for Caesarean Deliveries

Rs.1600/C-Sec

91553 C-Secs

1464.85 2160.00 Approved for1.35 lakh C-Secs.Separate approval will not be given for drugs and kit However utilization will be as per differential EDLs.

A.1.7.2 Diagnostic

A.1.7.3 Blood Transfusion

A.1.7.4 Diet

A.1.7.4.1 Dietry charges for normal delivereis

Rs.80/ND/day

288000 NDs for 3

days

691.20 691.20 Approved

A.1.7.4.2 Dietry charges for LSCS delivereis

Rs.80/C-Sec/day

5000 C-Secs for 7

days


A.1.7.4.3 Dietry charges for AN women

Rs.25/PW 975000 PW 243.75 243.75 Approved

A.1.7.5 Referral Transport

A.1.7.5.1 Pick up of AN mothers Rs.954/PW

334000 PW 3133.89 2250.00 Approved for 9 lakh PW @ Rs 250 /PW A.1.7.5.2 Drop back of PN mothers Rs.900/P

W 668000 PW 4860.00

A.1.7.6 Janani Shishu Suraksha Karyrakram (JSSK) - incidental charges

Rs.200/PW

109400 PW 218.80 0.00 Not approved

Sub-total Maternal Health (excluding JSY) 14046.54 8297.39 Sub-total JSY 3353.28 3572.48 A.2 CHILD HEALTH A.2.1 IMNCI



Target


A.2.1.1 Prepare detailed operational plan for IMNCI across districts (Supplies, Logistics, Supportive supervision at the District level )

Rs.1000/visit

4 visit /month x

30 district x 12 months


A.2.1.2 Implementation of IMNCI activities in districts

A.2.1.3 Monitor progress against plan; follow up with training, procurement, etc (State Level – IMNCI cell)

Rs.25000/m

1 meeting/m

3.00 3.00 Approved

A.2.1.4 Pre-service IMNCI activities in medical colleges, nursing colleges, and ANMTCs

A.2.2 Facility Based Newborn Care/FBNC (SNCU, NBSU, NBCC)

A.2.2.1 Essential Newborn care (Operational cost (existing + new ) NBCCs)

Rs.20000/NBCC

1606 NBCCs


A.2.2.2 Sick Newborn Care Operational cost for NBSUs (existing + new) NBSU

Rs.1.75 L/NBSU

156 NBSUs 273.00 202.80 Approved for 9 months only. 42 units under process & 114 units to be established with support from World Bank.

A.2.2.3 Up gradation of Existing NBSU at Sec Health Care System

Rs.2 L/NBSU

114 NBSUs 228.00 0.00 Not approved.

A.2.2.4 Operational cost for SNCUs (existing + upgradation proposed )

Rs.10 L/SNCU

61 SNCUs 610.00 525.00 Approved for 44 units for 1 year and 17 units for 6 months

A.2.2.5 Up gradation of Existing SNCUs in 20 Centers(17 Dist Hopsitals and 3 Med Coll Hospitals

Rs.15 L/SNCU

20 SNCUs 300.00 255.00 Approved at 7 DHQ +10 SDH only. SNCU at 3 medical colleges in Chennai not approved.

A.2.3 Home Based Newborn Care/HBNC

A.2.4 Infant and Young Child Feeding/IYCF



Target


A.2.5 Care of Sick Children and Severe Malnutrition at facilities (e.g. NRCs, CDNCs etc.)

A.2.5.1. Establishing new NRC Rs.2L/NRC 2 NRCs 4.00 4.00 Approved A.2.5.2 Operational cost for new

NRCs Rs.7.8 L 2 NRCs 15.60 7.80 Approved for 6

months only A.2.6 Management of

Diarrhoea, ARI and Micronutrient Malnutrition

A.2.7 Other Activities A.2.7.1 Rapid Assessment of

SNCUs by Core group committee

Rs.15000/visit

12 visits 1.80 1.80 Approved

A.2.7.2 State Level Quarterly reviews of SNCU activities in the Districts

Rs.5000/visit

43 visits to 43 SNCUs

every quarter

8.60 8.60 Approved

A.2.7.3 Establishment of Early Intervention center for Children with developmental disorder in PPP mode

Rs.3.93 L/centre

8 centres 31.42 31.42 Approved

A.2.7.4 Prenatal Screening to detect fetal anomaly in PPP mode – cost for online auditing and software

Rs.95000/facility

232 facilities


A.2.7.5 Conduction of well baby clinic in PHCs by Peadiatrician in NICU in 10 high IMR blocks

Rs.6000/clinic/m

10 clinics 7.20 0.00 Not approved. As per the comments received from the state, clinics are to be held at PHCs and not at NICU. It is proposed that doctors from these PHCs be trained in F-IMNCI so that specialised care is available to the children throughout the year rather than on a monthly basis.



Target


A.2.7.6 Workshop on Customization of teleradiology enabled modules for training in Ultrasonagram to detect foetal anamoly

Rs.1 L/worksho

p

2 workshops

2.00 0.00 To be mobilised from IEC budget

A.2.8 Infant Death Audit A.2.8.1 Infant Death Audit of

case sheets and preconference workshop

Rs.1.50 L/worksho

p

4 workshops

6.00 6.00 Approved

A.2.8.2 Infant Death Audit at Facility level

Rs.1000/death

15000 deaths

150.00 0.00 Not approved as cost proposed is too high. Facility based audit should not be linked to incentives as these are to be carried out by the hospital staff /administration.

A.2.9 Incentive to ASHA under Child Health

A.2.10 JSSK- Janani Shishu Surakhsha Karyakram (for Sick neonates upto 30 days)

A.2.10.1 Drugs & Consumables Rs.5939/neonate

10658 neonates

633.00 180.00 Approved for 90,000 sick neonates @ Rs.200/sick neonate.

A.2.10.2 Diagnostic A.2.10.3 Referral Sub total Child Health 2829.62 1239.82

A.3 FAMILY PLANNING

A.3.1 Terminal/Limiting Methods

A.3.1.1

Orientation workshop and dissemination of manuals on FP standards & quality assurance of sterilisation services

Rs. 25000/ district

32 districts 8.00 8.00 Approved

A.3.1.1.1

Prepare operational plan for provision of sterilisation services at facilities (fixed day) as well as camps , review meetings

Rs. 5000-9000/

meeting

24 meetings

1.60 1.60 Approved



Target


A.3.1.2

Organise female sterilisation camps

Rs.15000/camp

252 (12 camps / yr

x 21 Blocks)


A.3.1.3

Organise NSV camps Rs.35000/camp

192 camps 67.20 67.20 Approved As per the GoI norm at least 50 sterilisations to be conducted at each camp.

A.3.1.4 Compensation for female sterilisation

Rs.1000/sterilisatio

n

219000 sterilisatio

ns

2190.00 2190.00 Approved

A.3.1.5

Compensation for NSV Acceptance


n

3200 sterilisatio

ns

64.00 48.00 1. State has proposed Rs. 2000/ NSV which is against the GoI approved norm of Rs. 1500/ male sterilisation. 2.Budget has been accordingly revised and approved

A.3.1.6 Accreditation of private providers to provide sterilisation services


n

40000 Sterilisatio

ns


A.3.2 Spacing Methods

A.3.2.1 IUD camps Rs.2000/camp

624 camps 12.48 12.48 Approved

A.3.2.2

Implementation of IUD services by districts (including fixed day services at SHC and PHC)

A.3.2.2.1 Provide IUD services at health facilities / compensation

Rs.20/IUD insertion

350000 IUDs


A.3.2.2.2 PPIUCD services

A.3.2.3 Accreditation of private providers to provide IUD insertion services



Target


A.3.2.4

Social Marketing of contraceptives (includng delivery of contraceptive by ASHA at door step) Propagate information on IUCD insertion through VHAs as well as incentivise them for brining IUCD cases @ Rs. 100.

Rs.100/VHV

1639 VHV x 5 IUCD =

8195 IUCD insertions

8.20 0.00 (1) Not approved. State may do so with its own funds. (2)State has proposed to propagate information on IUCD insertion through VHAs as well as incentivise them for bringing IUCD cases @ Rs. 100. (3) GoI only provides Rs. 20/ IUCD and no separate budgetary provision may be approved.

A.3.2.5 Contraceptive Update seminars

A.3.3

POL for Family Planning/ Others (including additional mobilty support to surgeon's team if req)

A.3.4

Repairs of Laparoscopes Single punctur - Rs. 35000

Double Puncture- Rs. 65000

Single puncture-

77 Double

Puncture- 25

43.20 43.20

Approved

A.3.5 Other strategies/activities (please specify):

A.3.5.1

Monitor progress, quality and utilisation of services (both terminal and spacing methods) including complications / deaths / failure cases.Note: cost of insurance / failure and death compensation NOT to be booked here

Rs. 8000/ dist

32 districts 2.56 2.56

Approved



Target


A.3.5.2

Performance reward if any

2.00 2.00 (1) Best 3 districts, 3 P.H.Cs, 3 Govt. Hospital, 3 Voluntary organizations in sterilization Performance & 3 districts in NSV performances. Ist prize (Rs.15000), IInd prize (Rs.10,000) & IIIrd Prize (Rs. 8000). Conducting the ward function @ Rs.35000. (2) State needs to develop minimum benchmark over and above which awards would be given. (3) Approved

A.3.5.3

World Population Day’ celebration (such as mobility, IEC activities etc.): funds earmarked for district and block level activities

17.00

Approved. Shifted from MFP

A.3.5.4

Printing of Forms and Registers

Rs. 1 L/distt

32 districts 32.00 32.00 Approved. State has planned to print Sterilisation Consent Forms along with Checklist, Sterilisation Registers, IUD Registers, MTP Registers, Consolidation Registers & Monthly Reporting format from HSC to PHC and from Institution to DFWB.

A.3.5.5 Dietary charges for beneficiaries who underwent sterilisation

Rs.400/case

100000 cases

400.00 100.00 Approved @ Rs. 100/ per case. Shifted from MH.



Target


A.3.5.6 IUCD Camps in tribal areas

Rs.2000/camp

624 camps 12.48 0.00 NOT APPROVED. Already approved under A.3.2.1.

Sub-total Family Planning (excluding compensation)

560.32 206.36

Sub-total Sterilisation and IUD compensation & NSV camps

2391.20 3025.48

A.4 ADOLESCENT REPRODUCTIVE SEXUAL HEALTH (ARSH)

A.4.1 Adolescent services at health facilities

A.4.2 School Health Programme

A.4.2.1 Implementation of School Health Programme by districts.


A.4.2.2 Developing and printing of HEAL modules for Middle/High/Hr.sec Schools with TANSAC training material included


A.4.2.3 Monitor progress and quality of services.

0.00 111.57 Shifted from E 2.3.Approved

A.4.3 Other strategies/activities (please specify) Details of the Menstrual Hygiene project to be provided and budgeted under this head

Sub-total ARSH 0.00 1186.69 Details of School Health Programme available in Annexure 1.

A.5.1 URBAN RCH A.5.1.1 Establishment of 75

Urban Health Center

A.5.1.2 Staff salary 550.80 A.5.1.3 Rent for UPHC Rs.4000/

m 62 UPHCs 29.76

A.5.1.4 Furniture ,Stores & Rs.1.46 75 new 109.50



Target


equipments, Computer Accessories

L/UHC UPHCs

Total 690.06 Amount already sanctioned under supplementary budget (RoP 11-12) 310.20 Amount proposed (2012-13) 379.86 379.86 The total proposed

budget for Urban RCH is Rs.690.06 lakhs, but State has Rs.310.20 lakhs as sanctioned amount for this activity hence has proposed Rs. 379.86 lakhs only, which has been approved accordingly.

A.6 TRIBAL RCH A.6.1 Birth Waiting Room in 17

Tribal PHCs

A.6.1.1 Contingency Rs.2500/unit/m


3.40 3.40 Approved

A.6.1.2 Electricity Charges Rs.2500/unit/m


3.40 3.40 Approved

A.6.1.3 POL charges Rs.8000/unit/m



A.6.1.4 Honorarium to CHN Rs.500/unit/m


0.68 0.68 Approved

A.6.1.5 Honorarium to Sanitary Worker

Rs.500/worker/m

51 workers for 8

months

2.04 2.04 Approved

A.6.2 Tribal MMU A.6.2.1 Salary for Doctors Rs.40000/

m 21 doctors 85.68 0.00 Approved under HR

A.6.2.2 POL charges Rs.18000/m/MMU

21 MMU 45.36 43.20 Approved only for existing 20 MMUs.

A.6.3 Referral Services A.6.3.1 Operational cost for the

proposed 24 new four wheel drive for referral services

Rs.1 L/vehicle/

m

24 vehicles for 6

months

144.00 0.00 New Procurement of MMU vehicles for tribal areas not approved, since already every block has MMU. MMUs from some of the



Target


better performing non-tribal blocks, can be diverted , if required.

A.6.3.2 Operational cost for the existing 24 four wheel drive for referral services

Rs.1 L/vehicle/

m

24 vehicles for 12

months

288.00 288.00 Approved

A.6.3.3 Procurement / fabrication of 24 new four wheel drive

Rs.11.5 L/vehicle

24 vehicles 276.00 0.00 Not approved.

A.6.3.4 Procurement of 13 new four wheel drive vehicles @ 7.6 lakhs (MMU outreach services by NGO)

Rs.7.6 L 13 98.80 0.00 Not approved.

A.6.4 Other Activities A.6.4.1 Grant In Aid(Bed Grant)

for 4 Hospitals in 3 district through PPP mode (Through NGO)

Rs.10 L/hospital

4 hospitals 40.00 0.00 Not approved

A.6.4.2 Tribal counsellors in Govt. Institutions

Rs.5000/counsellor/

m

10 counsellors

6.00 6.00 Approved subject to State providing list of facilities where the counsellors would be placed and those facilities should not have any other counsellor viz. FP and/or ARSH counsellor.

Sub total Tribal Health 1004.24 357.60 A7 PNDT & Sex Ratio Not proposed A.8 INFRASTRUCTURE &

HUMAN RESOURCES



Target


A.8.1.1 ANMs,supervisory nurses, LHVs

SNs: Ph1

@Rs.6000/m

Ph2 @ Rs.5000/

m PPC @

Rs.4000/m

Ambulance @

Rs.6000/m

SNCU/NICU@

Rs.6000/m

Tribal MMU@

Rs.10000/m

MCH L1@ Rs.11000/

m MCH L2@ Rs.4500/

m

Ph1-4263 Ph2-354 PPC-172

Ambulance-24

SNCU/NICU -781

Tribal MMU-20

MCH L1-93 MCH L2-

378

4881.64 3966.3

State has not provided details of

staff required in the FMR format; further

, the same items seem to have been

proposed under both RCH and MFP. For

2012-13, the state's HR has been

approved at the same level (reflected

in Unit rate and Physical targets) as

in ROP 2011-12. A.8.1.2 Laboratory Technicians, MPHWs

Rs.6000/m

20 0 11.52

A.8.1.3 Specialists (Anaesthetists, Paediatricians, Ob/Gyn, Surgeons, Physicians, Dental Surgeons, Radiologist, Sonologist, Pathologist, Specialist for CHC )

A.8.1.4 PHNs at CHC/ PHC level A.8.1.5 Medical Officers at PHCs

and CHCs Rs.38000/

m 783

existing 1189.94 2997.18



Target


A.8.1.6 Additional Allowances/ Incentives to M.O.s of PHCs and CHCs (Mobility support for emergency call (5 calls per month))

Rs.500/call

931 calls/m/30

dists

139.65 139.65

A.8.1.7 Others - Computer Assistants/ BCC Co-ordinator etc

Systems manager

@Rs.25000/m

Security services

@ Rs.4000/

m staff at ICTC @

Rs.29114/m

Housekeeping

services @

Rs.2500/m

Driver for outreach MMU @ Rs.4000/

m Driver for

tribal MMU @ Rs.8000/

m Driver for Ambulance services

for emergenc

y transport

of mothers

and

Systems manager -

24 Security

services -129

staff at ICTC -399

Housekeeping staff-

183 Driver for outreach

MMU-385 Driver for

tribal MMU-20 Driver for

Ambulance services for emergency


and children-24 Cleaner for MMU-385

SW for MCH L1-93 Pharmacist

for MCH L2-42

Junior Asstt. MCH

L2-42 Hospital Workers for MCH

L2-42

1835.95



Target


children @

Rs.4500/m

Cleaner for MMU

@ Rs.3000/

m SW for

MCH L1@ Rs.2500/

m Pharmacist for MCH

L2 @ Rs.21000/

m Junior Asstt.

MCH L2@ Rs.11000/

m Hospital Workers for MCh

L2 @ Rs.7500/

m SW for

MCH L2 @ Rs.7500/

m

SW for MCH L2-42

A.8.1.7.1 Staff for NRC A.8.1.7.2 Staff Nurse for NRC Rs.7500/

m 48 SNs 3.06 5.92 Approved

A.8.1.7.3 Nutrition Councellor Rs.15000/m

12 Councellor

s

1.53 Approved

A.8.1.7.4 Cook cum Care taker Rs.5000/m

12 cooks 0.51 Approved

A.8.1.7.5 Attender Rs.5000/m

24 attenders

1.02 Approved

A.8.1.8 Incentive/ Awards etc. to



Target


SN, ANMs etc. A.8.1.8.1 Honarorium to hired

Obstetrician for emergency LSCS

3500 32800 520.00 100.00

1) Approved only for the Incentives to LSAS & EmOC trained doctors @ Rs 2000 fixed and Rs 400 per case upto max of 5000 to 7000 cases. Total budget approved lumpsum is Rs 50.00 lakhs. 2) Mobility support @ Rs 500 can be approved as lump sum for Rs 50.00 lakhs. 3) Not approved for calling experts from Private sector since State has enough number of regular and trained doctors.

A.8.1.8.4 Mobility support (for more than 8 km travel)

500 16400 82.00

A.8.1.8.5 Honarorium to hired Anaesthetist for emergency LSCS

2250 32800 342.00

A.8.1.8.8 Mobility support (for more than 8 km travel)

500 16400 82.00

A.8.1.8.9 Incentive to EmOC trained doctor for emergency LSCS

750 2750 8.25

A.8.1.8.12


500 1375 6.88

A.8.1.8.13

Incentive to LSAS trained doctor for emergency LSCS

750 2750 8.25

A.8.1.8.16


500 1375 6.88

A.8.1.8.17

Additional services by Govt specialists (Obstetrician )for Emergency LSCS

500 10000 50.00

A.8.1.8.19


500 5000 25.00

A.8.1.8.20

Additional services by Govt specialists (Anaesthetist )for Emergency LSCS

500 10000 50.00

A.8.1.8.22


500 5000 25.00

A.8.1.8.23

Honarorium to hired pediatricians

750 9000 27.50

A.8.1.8.26


500 4500 22.50

A.8.1.8.27

Additional services by Govt paediatricians for emergency MCH care

500 5000 25.00

A.8.1.8.29


500 2500 12.50



Target


A.8.1.8.30

Delivery incentive to VHN Rs.25/mother

288000 mothers

72.00 72.00 Approved subject to registration within 12 weeks, provision of full ANC, maintaining partographs of each case, giving birth dose of OPV, BCG, Hep B and Vit K injection.

A.8.1.8.31

Delivery incentive to ANM/SN

Rs.25/mother

288000 mothers

72.00 72.00 Approved condition to registration within 12 weeks, provision of full ANC, maintaining partographs of each case, giving birth dose of OPV, BCG, Hep B and Vit K injection.

A.8.1.9 Human Resources Development (Other than above)

A.8.1.9.1 HR as per facility. 1)Staff salary

Establishment of 20

new PHCs @ Rs.270.2

L 2) Staff

salary for Operationalisation of 3

new sanctioned

PHCs @ Rs.40.53 L

3)Staff salary of 20

new PHCs @ Rs.131.8

L 4) Staff

salary for

5889.65 4049.32 Proposed under MFP. Approved as per RoP 11-12



Target


Up-gradation

of existing PHCs

@Rs.390.48 L

5)Staff salary for

Up-gradation

of proposed

PHCs @ Rs.325.4 L 6)Human resources

for new PHCs @

Rs.2242.08 L

7) Human resources

for new UG PHCs @

Rs.2489.16 L

A.8.1.9.2 Hiring of Doctors One Doctor / PHC for 10 months @Rs.1000/- visit for SHP

RS.1000/visit

1612 visits/mont

h for 10 months

161.20 161.20 Approved.

A.8.1.9.3 Salary of FP Counsellors in PPCs Rs.7500/

m 172

councellors

131.58 131.58 Approved. Only 85 % of salary requirement is budgeted.

A.8.1.9.4 Salary for the Staff Nurses of the training team

Rs.22000/m

770 SNs 863.94 506.88 Approved for 6 Staff Nurses per district (32 Distts) to cover 12 block in each district.



Target


A.8.1.9.5 Provision of EmOC trained doctors to MCH for observation of High Risk Mothers

Rs.38000/m

36 doctors for 6

months (salary

proposed at 85%)

69.77 69.77 Medical Colleges is not generally a part of the NRHM. However, the Medical Colleges are high delivery points. 2 M.O per Institution x 6 months x Rs 38,000 P.M. x 18 Institutions x 85 %=69.77 lakhs approved. Name-wise list along with delivery load and C section to be shared.

A.8.1.9.6 MPA on Contract basis at 44 existing SCNU

Rs.5000/m

132 MPA for 6

months

39.60 0.00

Not approved as No provision under operational guidelines ; Should be provided from state budget.

A.8.1.9.7 MPA -Male on contract basis at 20 SNCU taken up for upgradation

Rs.5000/m

60 MPA for 6 months

18.00 0.00

A.8.1.9.8 MPA- Female at 44 Existing NICU

RS.3500/m

183 MPA for 12

months

76.86 0.00

A.8.1.9.9 MPA -Male on contract basis at 20 SNCU taken up for upgradation

RS.3500/m

69 MPA for 6 months

14.49 0.00

A.8.1.9.10

Multipurpose Assistant for MCH L2

Rs.5000/m

42 MPA for 9 months

18.90 0.00

A.8.1.9.11

Sanitary Worker Salary RS.2500/m

31 SW for 9 months

6.97 0.00 Already approved under A.8.1.7

Sub total Infrastructure and HR 15071.07 14119.27 A9 TRAINING A.9.1 Strengthening of

Training Institutions (SIHFW, ANMTCs, etc.)

A.9.1.1 Infrastructure strengthening of Training Centres

Rs.3.5 L/centre

8 centres 28.00 28.00 Approved condition to State specifying location of these RTCs since State already has 3 HFWTCs, 9 ANMTCs and 3 MPW.

A.9.1.2 Centre for Advanced Rs.24.50 2 centres 49.00 49.00 Aprroved



Target


Midwifery Training L/centre A.9.2 Development of training

packages

A.9.3 Maternal Health Training A.9.3.1 Skilled Birth Attendance

/ SBA training Rs.1.03 L/batch

182 batches

187.65 187.65 Approved

A.9.3.2 Comprehensive EmOC training (including c-section)

A.9.3.2.1 EmOC Training-MO Rs.5.14 L/batch


A.9.3.2.2 Exam cost Rs.2.5 L 2.50 2.50 Approved A.9.3.2.3 Existing FOGSI 32.00 32.00 Approved A.9.3.2.4 Establishment 3 teritiary

training centres Rs.53.91L/

centre 3 centres 161.73 161.73 Approved. Additional

tertiary centres can be approved subject to a separate training proposal on this for considering by GoI. State to send a detailed proposal separately. However the lump sum budget can be approved, subject to submission of the proposal on the above suggested line.

A.9.3.2.5 Refresher training for EmOC

Rs.27310/batch


A.9.3.3 Life saving Anaesthesia skills training

Rs.3.34/batch


A.9.3.3.1 Exam cost Rs.2.8 L 2.80 2.80 Approved A.9.3.3.2 Comprehensive

Monitoring Cost Rs.11.70 L 11.70 11.70 Approved. May

budget for comprehensive monitoring of all activities at one place. Rs 11.70 lakhs can be approved for monitoring of all MH /RCH Trainings



Target


A.9.3.4 Safe abortion services training (including MVA/ EVA and Medical abortion)

A.9.3.5 RTI / STI training A.9.3.5.1 RTI/STI Training MOs Rs.45350/

MO 65 MOs 29.48 29.48 Approved

A.9.3.5.2 RTI/STI Training SNs Rs.24132/SN

65 SNs 15.69 15.69 Approved

A.9.3.5.3 RTI/STI Training LTs Rs.21070/LT

65 LTs 13.70 13.70 Approved

A.9.3.6 BEmOC training A.9.3.6.1 AMTSL ( 2 ND SPELL

BEmONC - MO) and SN Rs.25850/

batch 175 45.24 0.00 Not approved

A.9.3.6.2 BEmONC (3rd spell)-MO Rs.43395/batch

372 batch 161.43 74.00 The BeMOC Training for Medical Officers is of 10 days duration as per GoI guidelines and State is requested not to carry out part by part trainings. Hence Rs 74.00 lakhs approved for training of 370 MOs in a batch size of 5 per batch. Training and expenditure may be done as per GoI norms.

A.9.3.7 Other MH training (Blood storage Training)

Rs.99638/batch


A.9.4 IMEP Training A.9.5 Child Health Training A.9.5.1 IMNCI Training A.9.5.1.1 General IMNCI - TOT Rs.70535/

batch 8 batches 5.64 5.64 Approved

A.9.5.1.2 Monitoring cost Rs.20000/batch


A.9.5.1.3 Refersher General IMNCI-VHN/SHN/CHN

Rs.32580/batch

202 batches

65.81 65.81 Approved.



Target


A.9.5.1.4 Refersher General IMNCI-AWW

Rs.27405/batch

300 batches

82.22 0.00 Not approved. Training should be planned with DWCD and funds mobilised from DWCD.

A.9.5.2 F-IMNCI training A.9.5.2.1 FIMNCI-Pvt Students Rs.1500/s

tudent 350

students 5.25 5.25 Approved

A.9.5.2.2 SNCU - Refersher Training

Rs.2.22 L/batch

9 batches 20.00 0.00 Not approved. It is proposed that for the existing staff nurses who have already been trained skills assessment for each one of them be done by the SNCU doctors and on the job skill enhancement be provided.

A.9.5.2.3 SNCU - Newer Training Rs.2.22 L/batch

9 batches 20.00 13.33 Appoved condition to Observership plan being provided by the state. 17 SNCUs x 10 SN in each=170, 6 batches approved. The remaining nurses ( 1 for each SNCU =44+17=61) who are supposed to provide counselling should be trained accordingly (eg; in IYCF, management of LBW babies, advise on follow up and so on).

A.9.5.2.4 NBSU - MO Rs.2.9 L/batch

15 batches 43.50 0.00 To be included in F-IMNCI training load A.9.5.2.5 NBSU - SN Rs.2.24

L/batch 12 batches 26.86 0.00

A.9.5.3 Home Based Newborn Care training

A.9.5.4 Care of Sick Children and severe malnutrition training



Target


A.9.5.4.1 SAM TOT Rs.89400/batch




A.9.5.4.3 SAM - MO/SN Rs.35325/batch


A.9.5.4.4 SAM - CHN/SHN/VHN Rs.18500/batch


A.9.5.5 Other CH training (pls specify)

A.9.5.5.1 NSSK (ANM-Urban) Rs.35690/batch


A.9.5.5.2 NSSK (ANM/VHN) Rs.32240/batch


A.9.5.5.3 Orientation IYCF - TOT Rs.74675/batch




A.9.5.5.5 Orientation IYCF - MO Rs.24050/batch

341 batches


A.9.5.5.6 Orientation IYCF - CHN/SHN/VHN

Rs.10000/batch

448 batches


A.9.5.5.7 USG - MO 78 CEmONC Rs.31200/batch

20 batches 6.24 0.00 Not approved. GoI is still in the process of finalising curriculum for ultrasonography training.

A.9.5.5.8 USG - MO 154 CHC Rs.31200/batch

39 batches 12.17 0.00

A.9.5.5.9 Refresher training to detect foetal anomoly

Rs.7600/batch

64 batches 4.86 0.00

A.9.6 Family Planning Training A.9.6.1 Laparoscopic Sterilisation

training

A.9.6.2 Minilap training A.9.6.3 NSV training A.9.6.3.1 TOT on NSV

Rs. 14000/bat

ch

21 (7 Batches)

1.00 0.98 State has proposed ToT for NSV @ Rs. 14000/ batch; however, total amount has wrongly been put as Rs. 1.00 lakhs. As per the rate actual amount is Rs. 0.98 lakhs, accordingly revised



Target


and approved

A.9.6.3.2 NSV training for Medical Officers

Rs. 12250/bat

ch

192 (64 batches), 5

Days

7.84 7.84 Approved

A.9.6.4 IUD Insertion training A.9.6.4.1 TOT for IUD insertion A.9.6.4.2 Training of Medical

officers in IUD insertion Rs.

32000/MO

Monitoring - Rs.

2.00 lakhs

54 MOs


A.9.6.4.3 Training of staff nurses in IUD insertion

Rs. 46000/bat

ch

1240 SNs (62

batches)


A.9.6.4.4 Training of ANMs / LHVs in IUD insertion Rs.

46000/batch

1860 ANM/LHV

(93 batches)


A.9.6.5 Contraceptive Update training Rs.

20000/batch

124 batches-

12400 service

providers


A.9.6.6 Other FP training (pls specify)

A.9.6.6.1 Training on CuT-375 IUD TOT-60 Doctors &

60 SNs 2000

Doctors 3000 SNs

&6000 ANMs


A.9.6.6.2 TOT on PPIUCD Rs.40500/batch

33 doctors (3 batches)

1.21 1.21 Approved

A.9.6.6.3 Training on MOs in PPIUCD insertion

Rs.22700/batch

1464 (122 Batches)


A.9.7 Adolescent Reproducti-



Target


veand Sexual Health/ARSH Training

A.9.7.1 ARSH training for medical officers

Rs.50925 /batch


A.9.7.2 ARSH training for VHN/SHN/CHN

Rs.64438/batch


A.9.7.3 ARSH training for ICTC Counselor and SN

Rs.85375/batch


A.9.7.4 Training for Teachers & Health Personnel under SHP


A.9.8 Programme Management Training

A.9.8.1 SPMU Training A.9.8.2 DPMU Training A.9.9 Other training (pls

specify)

A.9.9.1 Training on Comprehensive package to acclerate the reduction of IMR & MMR - State level

Rs.3. 04 L/batch

1batch 3.04 3.04

Approved condition to linkage with performace indicators.

A.9.9.2 Training on Comprehensive package to acclerate the reduction of IMR & MMR-District level

Rs.33750/batch

32 batches 10.80 10.80

A.9.9.6 MCH Skill lab training - MO

Rs.91392/batch


A.9.9.7 MCH Skill lab training - SN/ANM

Rs.74062/batch


A.9.9.8 Gender Training A.9.9.8.1 Sensitisation by State

Task Force Rs.15 L 1 meeting 1.50 0.00 Not approved

A.9.9.8.2 Gender Trg- TOT Rs.1.18 L/batch


A.9.9.8.3 Gender Trg - MOs Rs.1.29 L/batch


A.9.9.8.4 Gender Trg - VHN/SHN/SNs

Rs.94500/batch


A.9.9.9 Risk identification and management among AN mothers

Rs.17700/batch

316 batches




Target


A.9.9.10 CENTRE OF ADVANCE MIDWIEFERY TRAINING

A.9.9.10.1

CAMT-Master Trainer Training - Tot From Medical Colleges

Rs.1.93 L/batch


A.9.9.10.2

CAMT-Master Trainer Training - For Faculty Of Nurshing Colleges And Gnm Schools

Rs.4.95 L /batch


A.9.9.10.3

Training on leadership and motivation - MOs

Rs.1.19 /batch

140 batches

166.32 166.32 Approved

A.9.9.10.4

Training on leadership and motivation - ANM/VHN

Rs.62500/batch

350 batches

218.75 218.75 Approved

A.9.9.10.5

Training of block training team

Rs.1.03 /batch

156 batches


Sub total Training 2411.21 1857.73

A10 PROGRAMME MANAGEMENT

A.10.1 SPMU 791.75 594.97 No unit wise breakup provided only lumpsum amounts proposed. Approval restricted to last years level of Rs.645 lakhs less 50.03 lakhs - 25 % of mobility support approved on interim basis.State to provide integrated mobility support plan and budget

A.10.2 DPMU 803.94 508.94 Proposed amount is 17.7% higher than approved amount in 11-12. Reasons for increase not clear. Approved at last yr's level of Rs.682.82 lakhs less Rs.173.88 lakhs which is 25% of mobility support approved on interim



Target


basis. State to provide integrated mobility support plan and budget.

A.10.3 BPMU 942.13 845.40 Amount as per RoP 11-12 levels. Proposed amount is 11 % higher than approved amount in 11-12. Reasons for increase not clear.

A.10.4 Other : Hiring of contractual staff for Maternal Health Wing

A.10.4.1 Expert Advisor Rs.85000/m

1 for 9 months

7.65 7.65 Approved

A.10.4.2 Health Officer / Medical Officer

Rs. 38000/m

2 for 9 months

6.84 6.84 Approved

A.10.4.3 Assistant Directotr(Statistics)

Rs.35000/m

1 for 9 months

3.15 3.15 Approved

A.10.4.4 Maternal and Child Health Officer

Rs.24000/m

1 for 9 months

2.16 2.16 Approved

A.10.4.5 Honorarium for involving experts in MCH activities

Rs.20000/m

1 for 9 months

1.80 1.80 Approved

A.10.4.6 Office contingency including Outsourcing of DEO

Rs.30000/m

1 for 9 months

2.70 0.00 Not approved. Outsourcing not allowed. State has sufficient resources.

Sub total Programme Management 2562.12 1970.91 A.11 VULNERABLE GROUPS Not proposed A.11.1 Implementation of RCH

activities

Total RCH II Base Flexi Pool

38864.98 29847.30

Total RCH II Demand Side

5744.48 6366.28

GRAND TOTAL RCH II 44609.46 36213.58


Annex-2

DETAILED BUDGET: MISSION FLEXIPOOL (MFP)

FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B1 ASHA B1.1. ASHA Cost

B1.1.1 Selection and Training of ASHA

B1.1.2

Procurement of ASHA Drug Kit (ongoing)

Drug Kit for 2650 ASHAs 600 2650 15.90 9.28

Approved for replenishment @ Rs. 350 per ASHA

Training and drug kit for dropout ASHA 6750+600 320 35.20 23.52 Approved.

Training and drug kit for 4200 ASHAs 6750+600 4200 208.20 14.70

Only replenishment of drug kits is approved

B1.1.3

Performance Incentives/ Other Incentives to ASHAs

B1.1.3.1

ASHAs in Tribal, Hilly, Difficult and Hard to reach areas(2650)

B1.1.3.1.i

Home Based Newborn Care (new) 250 2650*16 106.00 106.00

Approved. The State may give incentives to ASHAs only after training of ASHAs as per GoI guidelines.

B1.1.3.1.ii

Reporting of Infant Deaths and children in 5 years (new) 25 2650*5 3.31 3.31 Approved

B1.1.3.1.iii

Village Health and Nutrition Days (ongoing) 100 2650*12 31.80 31.80 Approved

B1.1.3.1.iv

Attending PHC monthly review meeting (ongoing) 100 2650*12 63.60 31.80 Approved


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B1.1.3.1.v

Adolescent Anemia Control Programme (ongoing)

100 twice a year 2650 5.30 5.30 Approved

B1.1.3.1.vi

Immunization activity (new) 100 p m 2650 31.80 0.00 Approved

B1.1.3.1.vii

Incentives for Vitamin A and Deworming campaign (ongoing) 200 each

2 sessions each 21.20 21.20 Approved

B1.1.3.1.viii

Surveillance and reporting of fever, ARI, AGE, Jaundice, etc (ongoing) 100 pm 2650 31.80 31.80 Approved

B1.1.3.1.ix

Family Welfare Services(Motivation of Eligible couples for female and male sterilisation)

Rs. 100 per case of female

sterilisation and Rs. 250 per

case of male sterilisation 2650*(10+4) 53.00 0.00

Not approved as this is already a part of the compensation package budgeted under Family Planning

B1.1.3.2

ASHA (Programme specific) incentive for 4200 non tribal and plains for MCH activities) 16325 4200 0.00 0.00

Sub-total ASHA Incentives 347.81 231.21

B1.1.4 Awards to ASHAs/ link Workers 0.00 0.00

B1.1.5

ASHA Resource Centre/ ASHA Mentoring Group - Supportive Supervision (new activity)

B1.1.5.1 VHV Coordinator at State Level 1103000 1 0.00 0.00

B1.1.5.2 VHV Coordinator at District Level 276000 33 0.00 0.00

B1.1.5.3 Block Level 386400 112 0.00 0.00


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B1.1.5.4 At PHC Level 21000 336 0.00 0.00

Sub-total supportive supervision of ASHA 0 0

Sub-total 607.11 278.71 B2 Untied Fund

B2.1

Untied funds to CHCs(385) and PHCs(65) offering with CHC services 50000 450 225.00 154.09 Approved

B2.2 Untied funds to PHCs 25000 1162 290.50 290.50 Approved

B2.3 Untied funds to HSCs 10000 8706 870.60 788.84 Approved

B2.4

Village Health, Water, Sanitation and Nutrition Committee 10000 15158 1515.80 1275.95

Approved. Funds for training of VHSNC members available in the State.

B2.5 Others B2.5.1 Untied funds to DHs 100000 31 31.00 0.00 Not approved

B2.5.2 Untied funds to SDHs 50000 230 115.00 115.00 Approved

B2.5.3 Untied funds to UPHCs 25000 135 33.75 0.00 Not approved

Total 3081.65 2624.38

B3

Annual Maintenance Grants(AMG)

B3.1

AMG to CHCs(385) and PHCs(65) offering with CHC services 100000 450 450.00 233.39 Approved

B3.2 AMG to PHCs 50000 1162 581.00 838.32 Approved B3.3 AMG to HSCs 10000 6510 651.00 526.67 Approved B3.4 Others B3.4.1 AMG to DHs 100000 31 31.00 0.00 Not approved B3.4.2 AMG to SDHs 100000 230 230.00 230.00 Approved B3.4.3 AMG to UPHCs 50000 135 67.50 0.00 Not approved


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B3.4.4

AMG to Medical Colleges and attached institutions 100000 34 34.00 0.00 Not approved

Total 2044.50 1828.38

B4 Hospital Strengthening

B4.1

Upgradation of CHCs, PHCs, District Hospitals

B4.1.1 District Hospitals B4.1.2 CHCs B4.1.3 PHCs

B4.1.3.1 Up-gradation of PHCs Existing (new)

B4.1.3.1.i Civil Works (new) 7000000 24 1680.00 1680.00

Approved. A comprehensive plan for upgradation of each of the PHCs is to be prepared by the State. New OT constructions are to be done only for the PHCs where there are no OTs. The activity is to be completed in 2012-13 itself.

B4.1.3.1.ii

Other infrastructure (new) 1500000 24 360.00 0.00

Approval is pended till details of 'other infrastructure' is provided by the state for each of these PHCs.

B4.1.3.2

Up-gradation of PHCs Proposed (new)

B4.1.3.2.i Civil Works 7500000 20 0.00 0.00 B4.1.3.2.ii Other infrastructure 1500000 20 300.00 0.00 Not Approved.


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B4.1.4

Infrastructure up gradation in HSCs to facilitate the stayal of VHN in villages (new) 5000000 42 2100.00 2100.00

Approved. The activity is to be completed in this year itself.

B4.2 Strengthening of PHCs (new)

B4.2.1

Establishment of 20 new PHCs sanctioned by GoTN (new activity)

B4.2.1.1 Civil Works (new) 2500000 20 500.00 500.00 Approved.

B4.2.1.2 Other infrastructure (new) 295000 20 59.00 59.00 Approved

B4.2.2

Establishment of 20 other new PHCs (new)

B4.2.2.1 Civil Works (new) 2500000 20 200.00 0.00 Not Approved.

B4.2.2.2 Other infrastructure (new) 295000 20 59.00 0.00 Not Approved.

B4.2.3

Operationalisation of 3 new PHCs sanctioned - other infrastructure (new activity) 215000 3 6.45 6.45 Approved

B4.2.4

Additional fund for increased cost for construction work (ongoing activity)

B4.2.4.1 PHCs 39 214.50 214.50

Approved. All the pending works are to be completed by the State in 2012-13 and no further funds shall be provided in the next years.

B4.2.4.2 UG PHCs 12 204.00 204.00

B4.2.5

Construction of New buildings for 9 old PHCs (new) 2500000 9 225.00 175.00

Approved for the 7 facilities which are delivery points.


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B4.2.5.1

Adoption of Kasthuriba Gram Hospital in Erode District (new) 1946000 1 19.46 19.46 Approved

B4.2.6

Maintenance and repairs of HSCs (new) 5000000 42 500.00 500.00

The State has a balance of Rs. 16 Crores which is permitted to be used for plugging the infrastructure gaps in HSCs. Additional requirement of Rs. 5 Crores is approved. Number of HSCs with locations are to be provided by the State before incurring expenditure against this approval.

B4.2.7

Upgradation of existing Blood storage centre to Blood Bank lumpsum 25.00 25.00 Approved

B4.2.8

Establishment of Blood storage centres in MCH wings of Medical College Hospitals Rs.4 L/facility 18 facilities 72.00 72.00 Approved

B4.3

Sub-Centre Rent and Contingencies (ongoing) 1000 p.m 2173 0.00 0.00

Fund is available with the State. The norm is Rs. 3000 p/a for rent and Rs. 3200 p/a for contingencies per SHC.


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B4.4.1

Outsourcing of House keeping and cleaning Services in Hospitals (new) 5 Lakh p.m. 40 100.00 100.00 Approved.

B4.4.2

Outsourcing of hospital services to be continued in Cuddalore, Pudukottai, Tiruppur, Tambaram Hospitals for 2012-13 @ 10% increase over previous year's cost (ongoing) 55 Lakh 4 250.00 250.00 Approved

B4.4.3

Outsourcing of cleaning, sanitation and certain other hospital services in CEmONC hospitals (new) 1 lakh p.m.

17 CEMONC centers +

advertisement (Rs. 5 lakh) 209.00 209.00 Approved

Sub total - Hospital Strengthening 7083.41 6114.41

B5

New Constructions/ Renovation and Setting - up

B5.7 Strengthening of FRUs

B5.7.1

Infrastructure Up-gradation In FRUs (new) Civil Works 40 1920.00 1920.00

Approved. 40% of the total cost is proposed and approved for this year.

B5.7.2

Equipment for Medical Colleges (new) 965.61 965.61 Approved

B5.7.3

Center of Excellence in Reproductive and Child Health in Madurai and Salem Medical colleges (new) 512200000 2 3000.00 3000.00 Approved.


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B5.7.4

Comprehensive Emergency Management Centre (new activity) 5437000 14 761.18 761.18 Approved.

B5.10.1

Establishment of skill laboratories in all the GNM schools I (new) 1100000 24 264.00 264.00 Approved

Sub-total Health Infrastructure 6910.79 6910.79

B6 Patients Welfare Society (PWS)

B6.1 Funds to DHs 500000 31 155.00 155.00 Approved

B6.2

Funds to CHCs(385) and PHCs(65) offering with CHC services 100000 450 450.00 214.61 Approved

B6.3 Funds to PHCs 100000 1162 1162.00 1162.00

Approved for 1139 functional PHCs and 3 new PHCs which are proposed for operationalization = 1142 PHCs.

B6.4 Others

B6.4.1 Funds to SDHs 100000 230 230.00 9.85 Approved

B6.4.2 Funds to CEmONC (as add on fund) 100000 103 103.00 0.00 Not Approved.

B6.4.3 Funds to UPHCs 100000 135 135.00 0.00 Not Approved.

B6.4.4 Funds to Medical College Hospitals 1000000 17 170.00 0.00 Not Approved.

B6.4.5

Funds to attached Hospitals under DME 500000 12 60.00 0.00 Not Approved.

B6.4.6

Funds to attached Institutions under DME 100000 5 5.00 0.00 Not Approved.

Total 2470.00 1541.46 B7 District Plans


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

Save the Girl child scheme (new) 20.00 20.00 Approved

Sub-total 20.00 20.00



475 units (300 set up in 2009-

10 and 175 set-up in 2010-11) 1519.09 1519.09 Approved

B9.3 Other activities B9.3.1 IEC (new) 34.00 34.00 Approved

B9.3.2

Training of all VHNs in Yoga and Naturopathy (new) 87.00 87.00 Approved

B9.3.3

Provision of kit of medicines to pregnant mothers during antenatal and postnatal period. (new) 450 per patient 429.00 0.00 Not Approved.

B9.3.4

Provision of medicines to ISM wings (new)

3 lakh per annum 475 1423.00 0.00

Not approved. Financial assistance may be sought from the Department of AYUSH. State Government is requested to liquidate the pending UCs and forward the proposals with AYUSH PIP as per the scheme guidelines.

B9.3.5

Networking the Commissionerate with DSMOs and the Colleges. (new) 25.00 0.00 Not approved


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

Sub total Mainstreaming of AYUSH 3517.09 1640.09

B10 BCC / IEC

B10.2 Implementation of BCC and IEC strategy


B10.2.2.1

a. EMRI boards for Neonatal transport, b.SNCU boards, c.LBW protocols etc


1500/ center, 500/ center

29 47

1612 8706 101.21 101.21 Approved

B.10.2.3 BCC/IEC activities for FP 34.60 34.60 Approved

B.10.2.4 BCC/IEC activities for ARSH Approved

B.10.2.4.1

Printing of posters to each VHN 100 9576 9.58 9.58 Approved

B.10.2.4.2

Printing of IEC materials to ICTC counselors and NCD staff nurses 100 1049 1.05 1.05 Approved

B.10.2.4.3

IEC material to ICDS centers 250 59672 149.18 149.18 Approved

B10.2.5 Other activities

B10.2.5.1

BCC / IEC Activities in RCH / NRHM Activities 100.00 100.00 Approved

B10.2.5.2

IEC/BCC- School Health Programme

B10.2.5.3

Printing of IEC Materials - Middle /High/ Hr.sec Schools 720 per schools

10910 sets with DVDs (

9918 schools+992

buffer=10,910) 78.55 78.55 Approved


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B10.2.5.4 IEC kit for PHC 3000 per kit

1773 (1612 PHC+ 161

buffer= 1773) 53.19 53.19 Approved Sub-total 527.36 527.36

B11 MOBILE MEDICAL UNITS

B11.1 Medical Officer 456000 385 44.26 44.26 Approved B11.2 Staff nurse 96000 385 169.59 169.59 Approved B11.3 Driver 48000 385 56.90 56.90 Approved B11.4 Cleaner 36000 385 24.71 24.71 Approved B11.5 Lab technician 30000 385 98.18 98.18 Approved B11.6 AVLT system 35000 385 134.75 134.75 Approved

B11.7

Vehicle maintenance per annum 5000 385 19.25 19.25 Approved

B11.8 POL 10000 4620 92.42 92.42 Approved

B11.9 Contingency per annum 10000 385 38.50 38.50 Approved

B11.10 Mobile Medical Unit Drugs to PHCs 100000 385 385.00 385.00 Approved

B11.11 Lab reagents for MMU 25000 385 96.25 96.25 Approved

B11.12

New Vehicles for replacement of old vehicles 700000 100 700.00 0.00 Not approved

Total 1859.81 1159.81

B12

EMERGENCY REFERRAL TRANSPORT

B12.1 EMRI

B12.1.1 Reach Ambulance modification

2 @ Rs. 2.7 lakh (neonatal),

28 @ Rs. 0.25 lakh for minor modification, 76 @ Rs. 3.75

lakh for modification 106 0.00 0.00 Not approved


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B12.1.2 Non-recurring cost - infrastructure 0.00 0.00 Not approved

B12.1.3 Vehicle replacement 12.5 lakh 100 1250.00 0.00 Not approved

B12.1.4

Procurement for 29 new vehicles of sick newborn transport system @ Rs. 12 lakhs per vehicle 12 lakh 29 348.00 0.00 Not approved

B12.2 Operating cost

B12.2.1 Operational Cost 1726.00 1726.00 20% of total OP cost approved.

B12.2.2

a. Operational Cost for UNICEF vehicle for transport of sick new born.

Rs 1 lakh / Vehicle /

month x 12 months 6 Ambulances 72.00 0.00 Not Approved

B12.2.3

b.Operational cost for Existing 29 vehicle with Neonatal Support System.


month x 12 months

29 Vehicle with sick new

born transport 348.00 0.00 Not Approved

B12.2.4

d.Operational cost for the 29 new vehicle proposed for transport of sick new born


month x 3 months 29 87.00 0.00 Not Approved

B12.2.5

Training on Emergency transport of Maternal and Infants - EMRI Staff

Rs.25860/batch 4 batches 1.03 0.00 Not approved

B12.2.6

Training on Emergency transport of Maternal and Infants - District level staff


B12.2.7

Training on Emergency transport of Maternal and Infants - EMRI Technician


Total 3859.04 1726.00


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B13 PPP /NGOs B13.2

B13.2.1

Pilot Project on Management of Children affected with Muscular Dystrophy Disorder 125.50 125.50 Approved

B13.2.2

Palliative care (new) - includes setting-up of Palliative care centers for 25.6 lakh in each district including drugs and support services, training, IEC activity and incentives to VHVs. 30 5 districts 150.00 150.00 Approved

B13.2.3

Anaemia Control Programme by PPP mode - (new) - to be run with DHAN Foundation in 50 blocks of the State 100.00 100.00 Approved

B13.2.4

Home Based Newborn Care Project in PPP mode - for identification, referral, follow-up and ensuring survival in low birth babies - based on Gadchiroli model 3200 per VHV 1500 72.00 72.00 Approved

Sub-total 447.50 447.50 B14 INNOVATIONS

B14.1

Quality Management System in Public Health Care (new)

B14.1.1 State level 0.00 0.00


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B14.1.2 District level 0.00 0.00 B14.1.3 Grading of PHCs 0.00 0.00

sub-total Quality Management System 0.00 0.00

B14.2

Strengthening of Dental Services (ongoing)

B14.2.1

Establishment and operation of 65 new dental units 65 271.70 271.70 Approved

B14.2.2

Operation cost for 230 existing dental units 230 396.05 396.05 Approved

sub-total 921.95 667.75

B14.3

Accreditation of Government Hospitals (new)

B14.3.1 Non recurring 226.75 226.75 Approved B14.3.2 Recurring 350000 78 52.50 52.50 Approved sub-total 279.25 279.25

B14.4

Congenital and Developmental Defects (new)

B14.4.1

Congenital and Developmental Defects and Follow Up - Phase I 126.32 126.32 Approved

B14.4.2

Congenital and Developmental Defects and Follow Up - Phase II 300.00 300.00 Approved

B14.4.3

Congenital and Developmental Defects and Follow Up - Phase III 56.42 56.42 Approved

Sub-total 731.42 356.42

B14.5

Screening for oral Cancer in Tamil Nadu (new) 300.00 300.00 Approved


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B14.6

Prevention and Control of Silicosis (new) 23.83 23.83 Approved

Sub - Total innovations 2256.45 1627.25

B15


B15.1 Community Monitoring

B15.1.1

Statewide project for community monitoring and village plan development (new) 5 lakh 36 180.00 180.00 Approved

B15.1.2

Continuation of support for Community Action for Health (CAH) in 6 HUDs. (new) 50 6 300.80 300.80 Approved

B15.2

Quality Assurance (Additional Manpower (Regional NRHM consultants)) Rs.35000/m

6 for 9 months 18.90 0.00 Not approved

B15.3 Monitoring and Evaluation

B15.3.1

Monitoring and Evaluation/ HMIS/ MCTS

B15.3.1.1

State level and regional level workshop / review meeting 5.48 5.48 Approved

B15.3.1.2

Strengthening of HMS in District / Sub District Hospitals

B15.3.1. MCTS


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks 3

State MCTS Cell {1-Joint Director @ Rs. 50,000 per month 50000 p.m 1 14.40 14.40 Approved


35000 p.m. (- AD, 16500 p.m.

- IT Coordinator) 1+1 6.18 6.18 Approved

‘Own a Laptop’ sharing 20% of the cost to strengthen MCTS 200.00 0.00 Not approved

sub total 226.06 26.06

B15.3.2

Computerization/ HMIS and e-governance, e-health

B15.3.2.1

Computers and networking for District Hospitals (31 x 20 x 44200) 274.04 274.04 Approved

B15.3.2.2

Computers and networking for Sub District Hospitals (230 x 7 x 44200)` 711.62 711.62 Approved

B15.3.2.3 IT coordinator 16500 pm 42 62.37 62.37 Approved B15.3.2.4 IT coordinator

Rs.16500/ month x 2 2.97 2.97 Approved

B15.3.2.5

Comprehensive Networking of all sections of DPH, DMS and DFW

B15.3.2.6

Computers (DGS&D Rate for 358 numbers) (i3 processor with OS, antivirus and other necessary software) 35000 358 127.09 0.00 Not approved.


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks B15.3.2.7 UPS (10 x 110000) 11.00 0.00 Not approved.

B15.3.2.8

Provision of LAN connectivity (including OFC cable linking) 42.22 0.00 Not approved.

B15.3.2.9

Server (DGS&D Rate for 4 server) (Dell-R710 – 64GB RAM – 1 TB HDD) 20.00 0.00 Not approved.

B15.3.2.10

Computers (DGS&D Rate for 23 numbers) (i3 processor with OS, antivirus and other necessary software) Rs. 35,500/- 23 8.17 8.05 Approved

B15.3.2.11

Up-gradation of existing LAN network setup at Directorate of Medical Education 52.90 52.90 Approved

sub-total 1312.38 1111.95

B15.3.3 Other M&E activities

B15.3.3.1

4 Review cum workshop and review meeting for DTT MOs 129250 4 5.17 5.17 Approved

B15.3.3.2

Quarterly Review meeting of DDHSs 1.08 4 4.32 4.32 Approved

sub-total 9.49 9.49

Sub total Monitoring and Evaluation 1547.93 1147.50

Sub total Planning, Implementation and Monitoring 2047.63 1628.30

B16 Procurement


B16.1.1 Procurement of Equipment for MH


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B16.1.1.1 Equipment for FRUs 1471.85 1471.85

Approved. The State is to provide a list of all the facilities along with the equipments to be procured and no additional funds for procurement of equipments will be asked for these facilities.


B16.1.2.1

Equipment for SNCU @ 10 lakhs 10 lakh 20 200.00 170.00

Approved for 17 units

B16.1.2.2

Equipment for Sick newborn transport system @ 4.5 lakhs 4.5 lakh 29 130.50 0.00 Not approved

B16.1.2.3

Equipment for new born corner for 73 new PHCs, 31 level 1 MCH centre and 135 UPHCs @ Rs.85000/- 85000 239 203.15 203.15 Approved

B16.1.2.4

Equipment, medication and consumable for ASHA home based new born care in 2650 tribal and 4200 program specific VHVs @ Rs. 2000 per VHV 1500 6850 137.00 0.00 Not approved

B16.1.2.5

Equipment for training for prenatal screening to detect fetal anomalies in 78 CEmONC centers and 154 PHCs


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B16.1.2.5.i

Desktop and Accessories @ Rs.11000/-

Rs. 35000 for desktops and

11000 for accessories 232 106.72 106.72 Approved

B16.1.3 Procurement of equipment: FP

B16.1.3.1 NSV Kit 1000 1000 10.00 10.00 Approved B16.1.3.3 Minilap sets 3500 15.00 15.00 Approved B16.1.3.5 Kelly's Forceps 2700 400 10.08 10.08 Approved

B16.1.5

Annual Maintenance contract / Maintenance and repair for Equipment

10% of the total

procurement cost 800.00 800.00 Approved

Sub-total (equipment) 3084.30 2786.80



B16.2.1.1

Iron sucrose – Maternal Anaemia

1428932 doses 429.00 429.00 Approved

B16.2.1.2

Albendazole for Antenatal mothers 1190777 8.34 8.34 Approved

B16.2.1.3

Gestational Diabetes 1612 161.20 161.20 Approved

B16.2.3 FW Drugs and equipments 0.00 0.00

B16.2.5

General drugs and supplies for health facilities

B16.2.5.1

Procurement of drugs under ARSH for WIFS


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B16.2.5.1.1

Procurement of IFA

0.13 5864754 396.46 396.46

Approved. State needs to ensure that although not budgeted in this activity, all the school boys are also provided with weekly iron/ folic acid supplementation.

B16.2.5.1.2

Procurement of Albendazole 0.70 5864754 82.11

Approved

B16.2.5.2 MSHP 20000000 140.00 0.00

B16.2.5.3

Drugs for Urban Health post for medical college hospitals @ 2.5 Lakh per centre 16 centers 40.00 40.00 Approved

B16.2.5.4

Drugs and consumables for 75 municipalities @ Rs. 2.35 Lakhs 75 centers 176.25 176.25 Approved

B16.2.5.5

First aid kits for schools 100 per kit 42769 42.77 42.77 Approved

B16.2.5.6 Disposable syringes 3 Cr 300.00 300.00 Approved

B16.2.5.7

Provision of gloves and syringes for NCD screening program (Phase I and Phase II) 465.57 465.57 Approved

Sub total (drugs) 2159.59 2101.70 Sub-total 5243.89 4888.50

B20

Impact Assessment of NRHM Component

Impact assessment of NRHM and various components (new) 20.00 20.00 Approved

Sub-total 20.00 20.00


FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

B21

State Health Systems Resource Centre

Capacity building for State Health Systems Resource Centre 100.00 100.00 Approved

Sub-total 100.00 100.00 B22 Support Services B22.3 Support for NVBDCP 770.88 577.00 Approved

B22.4 Support for RNTCP 99.91 99.91

Activities: a) State level logistics for STDC / IRL / SDS, Furnishing of STDC for training.RNTCP. Approved amount : 6,08,000 Comment: May be approved as there is no provision in RNTCP b) NGO Payment (Pending payment) Approved Amount: 93,83,400 Comment: May be approved. Pendency of payment is seriously affecting NGO involvement in Tamil Nadu

B22.6 Other NDCP support programmes

IDSP

Establishment of 24 District Public Health Laboratories 1788000 24 429.12 429.12


Operational cost existing 6 DPHL 816000 6 65.28 65.28



FMR Code Activity


Physical target/

Deliverables Amount

Proposed Amount

Approved Remarks

Provision New Computers for existing DSUs & Medical Colleges 64.17 0.00 Not approved

Inclusion of Urban Surveillance in Major Corporations 845000 1 8.45 0.00 Not approved

Training programme on epidemic prevention, control, investigation and management under NRHM 111312 22 24.49 0.00 Not approved

NLEP - NRHM - Internet facilities at districts 25 2.00 2.00

Approved as recommended by the division

Total 1464.30 1173.31

NRHM GRAND TOTAL 43560.53 34256.24


Annex 3

DETAILED BUDGET: IMMUNIZATION AND PPI OPERATION COST

FMR Code


Unit Cost (whereever applicable)

Physical Target

Amount Proposed

Amount Approved

Remarks

C.1 RI Strengthninig Project (Review meeting, Mobility Support, Outreach services etc c.1.a Mobility Support for

supervision for distict level officers.

Rs.50000/ Year /district level officers.

16.00 16.00 All activities

related to mobility

support and monitoring projected

under state specific

activities are recommended but are to be met from the

amount recommended

under c.1.a and c.1.b

c.1.b Mobility support for supervision at state level

Rs. 100000 per year.

3.00 1.00

c.1.c Printing and dissemination of Immunization cards, tally sheets, monitoring forms etc.

Rs. 5 beneficiaries

211.61 119.80

c.1.d Support for Quarterly State level review meetings of district officer

10.00 4.80

c.1.e Quarterly review meetings exclusive for RI at district level with one Block Mos, CDPO, and other stake holders

- -

c.1.f Quarterly review meetings exclusive for RI at block level

- -

c.1.g Focus on slum & underserved areas in urban areas/alternative vaccinator for slums

24.36 24.36


FMR Code



Physical Target

Amount Proposed

Amount Approved

Remarks

c.1.h Mobilization of children through ASHA or other mobilizers

Rs. 150 per session

- -

c.1.i Alternative vaccine delivery in hard to reach areas

Rs. 100 per session

- -

c.1.j Alternative Vaccine Deliery in other areas

Rs. 50 per session

452.71 226.36

c.1.k To develop microplan at sub-centre level

@ Rs 100/- per subcentre

- -

c.1.l For consolidation of microplans at block level

Rs. 1000 per block/ PHC and Rs. 2000 per district

- -

c.1.m

POL for vaccine delivery from State to district and from district to PHC/CHCs

Rs100,000/ district/year

14.00 14.00

c.1.n Consumables for computer including provision for internet access for RIMs

@ 400/ - month/ district

- -

c.1.o Red/Black plastic bags etc. Rs. 2/bags/session

263.17 46.51

c.1.p Hub Cutter/Bleach/Hypochlorite

solution/ Twin bucket

Rs. 900 per PHC/CHCper year

c.1.q Safety Pits - c.1.r State specific requirement 290.77 40.04

C.1-Sub Total 1,285.62 492.87 C.2 Salary of Contractual Staffs -Sub Total

c.2.a Computer Assistants support for State level

Rs.12000-15000 per person per month

1.44 1.44

c.2.b Computer Assistants support for District level

8000-10000 per person per month

26.88 26.88


FMR Code



Physical Target

Amount Proposed

Amount Approved

Remarks

C.2-Sub Total 28.32 28.32 C.3 Traininng under Immunization

c.3.a District level Orientation training including Hep B, Measles & JE(wherever required) for 2 days ANM, Multi Purpose Health Worker (Male), LHV, Health Assistant (Male/Female), Nurse Mid Wives, BEEs & other staff ( as per RCH norms)

- -

c.3.b Three day training including Hep B, Measles & JE(wherever required) of Medical Officers of RI using revised MO training module)

- -

c.3.c One day refresher traning of distict Computer assistants on RIMS/HIMS and immunization formats

- -

c.3.d One day cold chain handlers traning for block level cold chain hadlers by State and district cold chain officers

- -

c.3.e One day traning of block level data handlers by DIOs and District cold chain officer

- -

C.3-Sub Total - - C.4 Cold chain maintenance

Rs.500/PHC/CHCs per year District Rs.10000/year

11.26 11.26


FMR Code



Physical Target

Amount Proposed

Amount Approved

Remarks

C.5 ASHA incentive for full Immunization

31.80 31.80

To be factored into part C from part B. Rs 31.8 lakhs recommended. However the incentive is to be given as per Rs 100 for every child fully immunized under 1 year.

Total 1,357.00 564.25 C.6 Pulse Polio Operational

Cost (Tentative) - 976.67

Total 1,357.00 1,540.92

The projected amount is lower than the recommended amount because of provisioning of Pulse Polio Operational Cost

Activities under state specific requirement include Hiring of alternate vaccinators in rural areas


Annex 4A

DETAILED BUDGET: NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP)

( Rs. In lakhs) FMR Code



Amount Approved

Remarks

D

IDD

The sanctioned vacant posts i.e. Statistical Assistant & LDC should be filled up on regular/contract basis on priority. State Govt. may conduct and co-ordinate approved programme activities and furnish quarterly financial & physical achievements as per prescribed format.

D.1 Establishment of IDD Control Cell-

Implementation & monitoring of the programme

10.00 10.00

D.1.a Technical Officer 1 D.1.b Statistical

Assistant 1

D.1.c LDC Typist 1

D.2 Establishment of IDD Monitoring Lab-

Monitoring of district level iodine content of salt and urinary iodine excretion as per Policy Guidelines.

5.00 The sanctioned posts of Lab Technician & Lab Asst. should be filled up on regular/ contract basis on priority. State Govt. may conduct quantitative analysis of salt & urine as per NIDDCP Guidelines and furnish monthly/quarterly statements.

D.2.a Lab Technician 1 D.2.b Lab. Assistant 1

D.3 Health Education & Publicity

Increased awareness about IDD and iodated salt.

21.00 7.00 IDD publicity activities including Global IDD Day celebrations at various level.

D.4 IDD Survey/Resurveys

Rs. 50,000 per district

4 districts 10.50 2.00 State. Govt. may under take 4 districts


FMR Code



Amount Approved

Remarks

IDD survey as per guidelines and furnish report.

D.5 Salt Testing Kits supplies by GOI inform of kind grant for 21 endemic districts

12 STK per annum per ASHA

Creating iodated salt demand and monitoring of the same at the community level.

State Govt. to monitor the qualitative analysis of iodated salt by STK through ASHA in 21 endemic districts i.e. Trichrapalli Dindigul, Madurai, Coimbatore, Ramananthapuram, The Nilgiris, Thiruvarur, Salem, Virudhnagar, Villupuram, Kanyakumari, Dharmapuri, Pudukottai, Namakkal, Nagapattanum, Erode, Perambalur, Tuticoran, Thanjavur, Chennai, Cuddlore

D.6 ASHA Incentive Rs. 25/- per month for testing 50 salt samples/ month

50 salt samples per month per ASHA in 21 endemic districts

19.17

TOTAL 47.50* 43.17

Including Rs. 5.00 lakh for mobility and Rs. 1.00 lakh for procurement of equipment

which are not allowed under the programme.

(*) The total fund proposed includes printing, supply of Health workers manual on NIDDCP, formats & reports,G lab consumable, organisation of workshops/seminars/meetings which are not allowed under the Programme.


Annex 4B

DETAILED BUDGET: INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP)

FMR Code




Comments

E.1 Operational Cost E.1.4 Field Visits

Rs 2,40,000 per District Surveillance Unit per annum

Rs 5,00,000 State Surveillance Unit per annum

78.144 (4.22 [SSU] + 59.276 [DSU] + 4.088 [Newly Formed Districts] + 10.56 [Medical Colleges])

78.15 The operational cost for Medical Colleges will be borne by the district where they are located.

Office Expenses Broad Band

expenses Outbreak

investigations including Collection and Transport of samples

E.1.3 Review Meetings

Sub Total

78.15 78.15

# Laboratory Support District Priority Lab Rs.

4,00,000 per district priority lab per annum

8.00 (4.00 × 2) 8.00 (4.00 × 2)

Referral Network Lab

Rs. 5,00,000 per referral lab per annum

40.00 (5.00 × 8) 40.00 (5.00 × 8)

District Public Health Labs*

Rs. 2,00,000 per annum for consumables

29.52 (for 6 District PH Labs)

0.00 Funds will be approved once the labs are functional.

Sub Total

77.52 48.00

E.2 Human Resources


FMR Code




Comments

E.2.1 Remuneration of Epidemiologists

Rs.25,000 - Rs. 40,000/ per month

153.60 ([40,000 × 2 × 12] + [40,000 × 30 × 12])

153.60 ([40,000 × 2 × 12] + [40,000 × 30 × 12])

E.2.2 Remuneration of Microbiologists

Rs. 25,000 - Rs. 40,000 (Medical Graduates) Rs. 15,000 - Rs. 25,000 (Others)

27.00 ([25,000 × 3 × 12] + [25,000 × 6 × 12])

27.00 ([25,000 × 3 × 12] + [25,000 × 6 × 12])

E.2.3 Remuneration of Entomologists

Rs. 15,000 - Rs. 25,000

3.00 (25,000 × 1 × 12)

3.00 (25,000 × 1 × 12)

Veterinary Consultant

Rs. 25,000 -Rs.40,000

4.80 (40,000 × 1 × 12)

0.00

E.3 Consultant-Finance/ Procurement

Rs. 14,000 1.68 (14,000 × 1 × 12)

1.68 (14,000 × 1 × 12)

E.3.1 Consultant-Training/ Technical

Rs. 28,000 3.36 (28,000 × 1 × 12)

3.36 (28,000 × 1 × 12)

E.3.2 Data Manager Rs. 14,000 (State) Rs. 13,500 (District)

51.90 ([14,000 × 1 × 12] + [13,500 × 31 × 12])

51.90 ([14,000 × 1 × 12] + [13,500 × 31 × 12])

E.3.3 Data Entry Operator Rs. 8,500 49.98 (8,500 × 49 × 12)

49.98 (8,500 × 49 × 12)

Sub Total

295.32 290.52

E.8 Training As per NRHM Guidelines

Training of RRT is undertaken by Central Surveillance Unit. Additional List of trainees may be sent to CSU.

One day training of Hospital Doctors



One day training of Hospital Pharmacist / Nurses




FMR Code




Comments

One day training of Medical College Doctors



One day training for Data Entry and analysis for Block Health Team



Rapid Response Team


0.00

One day training of DM & DEO



Sub Total

36.39925 10.20

E7 ID Hospital Network Rs. 3,00,000/- per annum for IDH

3.00 (1 × 3.00) 3.00 (1 × 3.00)

# Surveillance in Metro Cities

Rs. 10,000,00 /- per annum per metro city

14.56 10.00

# New formed Districts

Rs. 3,50, 000/- per newly formed district

7.00 (3.50 × 2) 7.00 (3.50 × 2)

The amount to be utilized for procurement of ICT equipments under IDSP as per program guidelines.

Total 511.95 446.87


Proposal under Additionalities

FMR Code


Amount Proposed

Amount Approved

Comment

Establishment of 24 District Public Health Laboratories

17.88 429.12 429.12 May be approved; Procurement of equipment and civil works may be done as per NRHM guidelines.

Operational cost existing 6 DPHL 8.16 65.28

65.28

May be approved; Procurement of equipment and civil works may be done as per NRHM guidelines.

Provision of New Computers for Existing DSUs & Medical Colleges AND provision of 1 Data Entry Operator & Computer with Accessories for 12 Addl. HUDs

64.17

0 Not Approved

Budget under NRHM support for provision of Data Entry Operator & New Computer with Accessories for 5 Major Corporations

8.45 8.45 0 Not Approved

Training programme on epidemic prevention, control, investigation and management under NRHM

24.49 0 Not Approved .

TOTAL 591.51 494.40

# FMR Code not allotted.

Comments:

3. The following heads will be approved / modified once approval from EFC is obtained.

Remuneration of Veterinary Consultant @ Rs. 25,000 - Rs.40, 000.

4. Based on past trend, Rs 110.00 lakhs has been approved for Tamil Nadu State under IDSP for 2012-13. However, if there is increase in expenditure by State as per IDSP approved norm, the budget for State could be increased at RE stage


Annex 4C

DETAILED BUDGET: NATIONAL VECTOR BORNE DISEASES CONTROL PROGRAMME (NVBDCP)

Rs. In Lakh

FMR Code

Component Unit Cost (wherever applicable)

Physical target/

Deliverables

Ammount Proposed

Ammount Approved

Remarks

F.1 DBS (Domestic Budgetary Support)

F.1.1 Malaria F.1.1.a Contractual Payments F.1.1.a.i MPW contractual F.1.1.a.ii Lab Technicians ( against

vacancy )

F.1.1.a.iii VBD Technical Supervisor (one for each block)

F.1.1.a.iv District VBD Consultant (one per district) (Non- Project States) State Consultant (Non – Project States), - VBD Consultant (preferably entomologist)

F.1.1.b ASHA Incentive 9.99 15.00 F.1.1.c. Operational Cost F.1.1.c.i Spray Wages F.1.1.c.ii Operational cost for IRS F.1.1.c.iii Impregnation of Bed

nets- for NE states

F.1.1.d Monitoring , Evaluation & Supervision & Epidemic Preparedness including mobility

97.82 75.00

F.1.1.e IEC/BCC 29.69 35.00 may be used for other VBDs activites

F.1.1.f PPP / NGO and Intersectoral Convergence

F.1.1.g Training / Capacity Building

22.31 35.00 may be used in an


FMR Code


Physical target/

Deliverables

Ammount Proposed

Ammount Approved

Remarks

integrative manner for other VBDs also

F.1.1.h Zonal Entomological units

F.1.1.i Biological and Environmental Management through VHSC

F.1.1.j Larvivorous Fish support Total : Malaria 159.81 160.00 F.1.2 Dengue and

Chikungunya

F.1.2.a Strengthening surveillance (As per GOI approval)

F.1.2.a(i) Apex Referral Labs recurrent

21.37 29.00

F.1.2.a(ii) Sentinel surveillance Hospital recurrent

F.1.2.a(iii) ELISA facility to sentinel surveillance labs

F.1.2.b Test kits (Nos.) to be supplied by GoI (kindly indicate numbers of ELISA based NS1 kit and Mac ELISA Kits required separately)

0.00

F.1.2.c Monitoring and evaluation

178.82 171.00 Funds allocated as per Mid Term Plan strategy. State to implement as per guidelines of Mid Term Strategy.

F.1.2.d Epidemic containment F.1.2.e Case management F.1.2.f Vector control &

environmental management

F.1.2.g IEC BCC for Social Mobilization

F.1.2.h Inter-sectoral convergence

F.1.2.i Training including operational research


FMR Code


Physical target/

Deliverables

Ammount Proposed

Ammount Approved

Remarks

Total : Dengue/Chikungunya

200.19 200.00

F.1.3 AES/JE F.1.3.a Diagnostics and Case

Management 66.04 120.00

F.1.3.b IEC/BCC specific to J.E. in endemic areas

48.87 10.00

F.1.3.c Capacity Building 3.94 10.00 F.1.3.d Monitoring and

supervision 4.39 10.00

F.1.3.e Technical Malathion 36.76 10.00 F.1.3.f Fogging Machine 0.00 0.00 F.1.3.g Operational costs for

malathion fogging 0.00 0.00

F.1.3.h Operational Research 0.00 0.00 F.1.3.i Rehabilitation Setup for

selected endemic districts

0.00 0.00

F.1.3.j ICU Establishment in endemic districts

0.00 0.00

F.1.3.k ASHA Insentivization for sensitizing community

0.00 0.00

F.1.3.l Other Charges for Training /Workshop Meeting & payment to NIV towards JE kits at Head Quarter

0.00 0.00

Total : JE 160.00 160.00 F.1.4 Elimination of Lymphatic

Filariasis

F.1.4.a State Task Force, State Technical Advisory Committee meeting, printing of forms/registers, mobility support, district coordination meeting, sensitization of media etc., morbidity management, monitoring & supervision and mobility support for

53.00 53.00


FMR Code


Physical target/

Deliverables

Ammount Proposed

Ammount Approved

Remarks

Rapid Response Team and contingency support

F.1.4.b Microfilaria Survey (Night Survey)

10.00 10.00

F.1.4.c Monitoring & Evaluation (Assessment)/by Medical College/ Regional Institutions

3.00 3.00

F.1.4.d Training of District Officers, PHC MOs, Paramedical staff, drug distributors etc.

21.00 21.00

F.1.4.e Specific Advocacy/IEC/BCC including centre, state, district/PHC, sub centre

84.00 74.00

F.1.4.f Honorarium for Drug Distribution including ASHAs and supervisors

F.1.4.g Verification and validation for stoppage of MDA in LF endemic districts

F.1.4.g.i a) Additional MF Survey (Night Survey)

14.00 14.00

F.1.4.g.ii b) ICT Survey 30.00 30.00 F.1.4.g.iii c) ICT Cost F.1.4.h Verification of LF

endemicity in non-endemic districts

15.00 15.00

F.1.4.i Post-MDA surveillance 0.00 0.00 Total : ELF 230.00 220.00 F.1.5 Kala-azar F.1.5 Case search/ Camp

Approach Not

Applicable Not

Applicable

F.1.5.a Spray Pumps &


FMR Code


Physical target/

Deliverables

Ammount Proposed

Ammount Approved

Remarks

accessories F.1.5.b Operational cost for

spray including spray wages

F.1.5.c Mobility/POL/supervision F.1.5.d Monitoring & Evaluation F.1.5.e Training for spraying F.1.5.f IEC/ BCC/ Advocacy Total Kala-azar 0.00 0.00 Total (DBS) 750.00 740.00 F.2 Externally aided

component

F.2.a World Bank support for Malaria

F.2.b Human Resource Not Applicable

Not Applicable

F.2.c Training /Capacity

building

F.2.d Mobility support for Monitoring Supervision & Evaluation including printing of format & review meetings, Reporting format (for printing formats)

Kala-azar World Bank assisted project

F.2.e Human resource Not Applicable

Not Applicable

F.2.f Capacity building F.2.g Mobility F.3 GFATM support for

Malaria

F.3.a Project Management Unit including human resource of N.E. states

Not Applicable

Not Applicable

F.3.b Training/Capacity Building

F.3.c Planning and Administration( Office expenses recurring expenses, Office automation , printing


FMR Code


Physical target/

Deliverables

Ammount Proposed

Ammount Approved

Remarks

and stationary for running of project)

F.3.d Monitoring Supervision (supervisory visits including travel expenses, etc) including printing of format and review meetings,

F.3.e IEC / BCC activities as per the project

F.3.f Operational cost for treatment of bednet and Infrastructure and Other Equipment (Computer Laptops, printers, Motor cycles for MTS )

Total : EAC component 0.00 0.00 F.4 Any Other Items ( Please

Specify) 0.00 0.00

F.5 Operational costs ( mobility, Review Meeting, communication, formats & reports)

0.00 0.00

Grand Total for cash assistance under NVBDCP

750.00 740.00

F.6 Assistance required for decentralized commodities

F.6.a Chloroquine tablets 1.16

200.00

F.6.b Primaquine 7.5 mg

tablets 2.50

F.6.c Primaquine 2.5 mg tablets

0.00

F.6.d Quinine sulphate tablets F.6.e Quinine Injections F.6.f DEC 100 mg tablets F.6.g Albendazole 400 mg

tablets


FMR Code


Physical target/

Deliverables

Ammount Proposed

Ammount Approved

Remarks

F.6.h NS1 Dengue Ag Kit (ELISA based) under Dengue/Chikungunya

F.6.i Temephos, Bti (AS) / Bti (wp) (for polluted & non polluted water)

30.53

F.6.j Pyrethrum Extract 2% 132.70 F.6.k ACT ( For Non Project

states) 1.11

F.6.l RDT Malaria – bi-valent (For Non Project states)

F.6.m Any Other Items ( Please Specify)

Total for Decentralized Commodities

168.00 200.00

Grand Total for grant-in-aid under NVBDCP

918.00 940.00

Commodity Grants 0.00 Total NVBDCP Cash +

Commodity 918.00 940.00

Cash Assistance required under NRHM Flexi Fund

Proposal for Anti Malaria activity in Rameswaram Island, Ramanathapuram District

28.20 28.00

Contractual Mazdoors for IRS & Anti larval operation in Malaria in Endemic District

19.12 19.00

Tent-type mosquito Net for Rameswaram Island

60.00 0.00 May be met from state resources as an innovative trial considering the feasibility of use of nets being a seashore area with


FMR Code


Physical target/

Deliverables

Ammount Proposed

Ammount Approved

Remarks

heavy sea breeze during evening.

Wages for Temporary mazdoors in Rameswaram Island

8.24 8.00

Scrub Typhus

122.24 0.00 Not under NVBDCP

Vector control activity with less than 1 lakh population

222.03 222.00

Purchase of Bti. for vector control activities under NFCP

311.05 300.00 Should be shown under decentralized commodity, however, may be approved from NRHM additionality as this year's proposal

Total under NRHM Flexi Fund

770.88 577.00


Annex 4D

DETAILED BUDGET: NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) (Rs. In lakh)

FMR code


Physical Targets

Amount proposed

Amount approved

Remarks

G 1. Improved early case detection

G 1.1 Incentive to ASHA MB 500 400 7.50 2.00 PB 300 600 6.00 1.80 G1.1 a Sensitization of ASHA 50 - - -

G 1.2 Specific -plan for High Endemic Distrcts

1 D 1.92/block 6 blocks 140.16 11.52

G 2 Improved case management

G 2.1

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

MCR - 250/- Aids/Applian

ce -12500 Welfare/RCS

- 10,000

15700 30

110

47.10 7.20

11.00

39.25 3.75

11.00

G 2.2

Urban L:eprosy Control, (Mega city - 1 , Medium

city (1) -4 , Med. City (2)-1 Township -22)

Meg -280000 Med (1)- 120000

Med. (2) - 236000 Town - 57000

1 4 1

22

5.60 9.60 4.72

25.08

2.80 4.80 2.36

12.54

G 2.3 Material & Supplies

G 2.3 a

Supportive drugs, lab. reagents & equipments and printing works

52,000 30 24.00 15.60

G 2.4 NGO - SET Scheme 500000 - - -

G 3 Stigma Reduced

G 3.1

Mass media, Outdoor media, Rural media, Advocacy media

50,000 30 30.00 15.00

G 4.

Development of Leprosy Expertise sustained

As NLEP rates are very low, higher rates

agreed in keeping with

other

G 4.1 Training of new MO 60000 - - -

G 4.2 Refresher training of MO 40000 900 29.80 12.00

G 4.3 Training to New H.S/H.W. 30000 1200 20.16 12.00


FMR code


Physical Targets

Amount proposed

Amount approved

Remarks

G 4.4 Other training -Physiotherapist

30000 150 2.52 1.50 programmes

G 4.5 Training to Lab. Tech. 30000 300 5.04 3.00

G 4.6 Management training for District Nucleus Team

30000 150 5.40 1.50

G 5.

Monitoring, Supervision and Evaluation System improved

G 5.1 Travel Cost and Review Meeting

G 5.1 i

travel expenses - Contractual Staff at State level

70000 1 1.00 0.70

G 5.1 ii

travel expenses - Contractual Staff at District level

15000 30 7.50 4.50

G 5.1 iii Review meetings 25000 4 2.00 1.00

G 5.2 Office Operation & Maintenance

G 5.2 i Office operation - State Cell

38000 1 0.75 0.38

G 5.2 ii Office operation - District Cell

18000 30 10.50 5.40

G 5.2 iii Office equipment maint. State

30000 1 0.50 0.30

G 5.3 Consumables G 5.3 i State Cell 28000 1 0.50 0.28


G 5.4 Vehicle Hiring and POL

G 5.4 i State Cell 85000 2 vehicle 2.00 1.70


G 6. Programme Management ensured

G 6.1 Contractual Staff at State level

G 6.1 i SMO 1 40000 x12 4.80 4.80

G 6.1 ii BFO cum Admn. Officer 1 30000 x12 3.60 3.60 G 6.1 iii Admn. Asstt. 1 16000 x12 1.92 1.92 G 6.1 iv DEO 1 12000 x12 1.44 1.44 G 6.1 v Driver 1 11000 x12 1.32 1.32

G 6.2 Contractual Staff at Disrrict level


FMR code


Physical Targets

Amount proposed

Amount approved

Remarks

G 6.2 i Driver 15 11000 x12 21.12 19.80

G 6.2 ii Contractual Staff in selected States, NSM 20000 - -

G 7. Others

G 7.1

Travel expenses for regular staff for specific programme / training need, awards etc

2.00 Added as essential

requirement

TOTAL 493.83 228.26

Additionality in Annual Plan

NRHM - Internet facilities at dsitricts

25 2.00 2.00

WHO/ILEP/ICMR/Others


Annex 4E

DETAILED BUDGET: NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB)

NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS

GRANT-IN-AID TO STATES/UTS FOR VARIOUS Physical Target

Funds Requested

Funds Approved

As Per Guidelines

Remarks

Sl.No. H 1 Recurring Grant-in-aid

H 1.1 For Free Cataract Operation @ Rs.750/- per case 650000 NGO-500000

3750.00 2114.00 Approved on reimburseme

nt basis H 1.2 Other Eye Diseases@ Rs.1000/- 1000 10.00 10.00 Approved H 1.3 School Eye Screening Programme@ Rs.200/- per

case 50000 100.00 100.00 Approved

H 1.4 Blindness Survey 385 577.50 0 Not Approved

H 1.4 Private Practitioners @as per NGO norms 5.00 5.00 Approved H 1.5 Management of State Health Society and Distt.

Health Society Remuneration (salary , review meeting, hiring of vehicle and Other Activities & Contingency) @ Rs.14 lakh/ Rs.7 lakh depending on the size of state

SBCS-1

DBCS-32 (2 new distt. formed)

14.00

128.00

14.00

0.00

Approved

Not approved

H 1.6 Recurring GIA to Eye Donation Centers @ Rs.1000/- per pair

200 eye 1.00 1.00 Approved

H 1.7 Eye Ball Collection by Eye Bank @ Rs.1500/- per pair

6000eyes 45.00 45.00 Approved

H 1.9 Training PMOA and MIS training 404 50.00 15.00 Approved for PMOA and

MIS training for 1 time

H 1.10 IEC, Eye Donation Fortnight, World Sight Day & awareness programme in state & districts etc

32 lump sum for the state

10.00 31.00 Approved for 1 lac per

distt. and 2 lac for state

H 1.11 Procurement of Ophthalmic Equipment (foldable IOL @ Rs.500 per IOL)

15 Medical College@1000

per annum

75.00 0 Through NRHM flexipool

H 1.12 Maintenance of Ophthalmic Equipments 6.00 6.00 Approved H.2 Non Recurring Grant-in-aid H.2.1 For RIO (new services Lasik)

Starting new zonal [email protected] lakh 1 5

200.00 200.00

0

Through NRHM

flexipool H.2.2 For Medical College@ Rs.40 lakh 2 80.00 40.00 Approved for



Physical Target

Funds Requested

Funds Approved

As Per Guidelines

Remarks

1 MC H.2.3 For vision Centre @ Rs.50000/- 10 5.00 5.00 Approved for

10 Vision Centre

H.2.4 For Eye Bank @ Rs.15 lakh 2 30.00 15.00 Approved for 1 Eye Bank in Govt. Hospital

H.2.5 For Eye Donation Centre @ Rs.1 lakh 2 2.00 1.00 Approved for 1 EDC

H.2.6 For NGOs @ Rs.30 lakh 0.00 0.00 H.2.7 For Eye Wards and Eye OTS @ Rs.75 lakh 2 150.00 0.00 Through

NRHM flexipool

H.2.8 For Mobile Ophthalmic Units with tele-network @ Rs.60 lakh

0.00

Grant-in-aid for strengthening of Distt. Hospitals @ Rs.20 lakh

2 40.00 40.00 Approved

Grant-in-aid for strengthening of Sub Divisional. Hospitals@ Rs.5 lakh

1 5.00 5.00 Approved

H.3 Contractual Man Power H.3.1 Ophthalmic Surgeon@ Rs.25000/- p.m 15 0.00 0.00 H.3.2 Ophthalmic Assistant @ Rs.8000/- p.m 20 0.00 0.00 H.3.3 Eye Donation Counsellors @ Rs.10000/- p.m. 20 0.00 0.00 5484.00 2447.00

* The unutilized funds in any of the above said recurring components may be used in any other recurring component.


Annex 4F

DETAILED BUDGET: REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME

FMR Code Activity


Physical target/expected

output Estimated

Budget Approved

Budget Remarks

I.1 Civil works

As per Revised

Norms and Basis of

Costing for RNTCP

1) Civil work Up gradation and maintenance completed as

planned

56.11 56.11

Approved 100%. Approved 3 DOTS Plus sites, new constriction of DTC

I.2 Laboratory materials


1) Sputum of TB Suspects Examined per lac population per quarter;

2) All districts subjected to IRL On Site Evaluation and Panel Testing in the year;

3) IRLs accredited and functioning optimally 136.40 90.00

Approved 65% of the amount.

I.3.a Honorarium


1) All eligible Community DOT Providers are paid honorarium in all districts in the FY

77.87 31.15


I.4 IEC/ Publicity


1) All IEC/ACSM activities proposed in PIP completed;

2) Increase in case detection and improved case

68.41 40.61

Approved amount based on the utilization. The remuneration for the 6 communication facilitators should be met from this head.


FMR Code Activity



output Estimated

Budget Approved

Budget Remarks

holding

I.5 Equipment maintenance


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 35.66 25.00

Approved amount permissible as per the norm. Not approved the proposal for TV and A/C maintenance .

I.6 Training


1) Induction training, Update and Re-training of all cadre of staff completed as planned 56.17 45.00


I.7 Vehicle maintenance


1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained

88.50 60.00

Approved amount based on the utilization..

I.8 Vehicle hiring


1) Increase in supervisory visit of DTOs and MOTCs;

2) Increase in case detection and improved case

115.13 36.00



FMR Code Activity



output Estimated

Budget Approved

Budget Remarks

holding

I.9 NGO/PPP support


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 241.70 100.00

Approved amount based on the utilization. *If the state is anticipating deficit in laboratory capacity to conduct C&DST test, then state may budget for funds under C&DST scheme in the NGO /PP head as the RNTCP guidelines for NGO and PPs, as a priority.

I.10 Miscellaneous


1) All activities proposed under miscellaneous head in PIP completed

144.95 108.79


I.11 Contractual services


1) All contractual staff appointed and paid regularly as planned

1260.71 1182.26


The remuneration for communication facilitators, should be met form the amount approved for IEC activities.

The salary budgeted for the new TBHVs is approved only for 10 months, considering the


FMR Code Activity



output Estimated

Budget Approved

Budget Remarks

delay in approval and appointment.

I.12 Printing


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

50.85 30.00


I.13 Research and studies


1) Proposed Research has been initiated or completed in the FY as planned

20.00 10.00

Approved the proposal for studying the prevalence of TB as this is a CTD priority.

I.14 Medical Colleges


1) All activities proposed under Medical Colleges head in PIP completed

256.25 255.95


I.15

Procurement –vehicles


1) Procurement of vehicles completed as planned

Approved 100% of the budgeted amount

Four wheeler

Two Wheeler 23.50 23.50

I.16 Procurement – equipment

As per Revised Norms and

1) Procurement of equipments completed as

20.88 10.80



FMR Code Activity



output Estimated

Budget Approved

Budget Remarks

Basis of Costing for RNTCP

planned

17 Tribal Action Plan

Total (A) 2653.08 2105.17

18 Additionality funds from NRHM (B)

99.91 99.91

TOTAL (A+B) Rs. 2205.08

Budget approved under NRHM additionalities 2012-13

Activity

Proposed amount

Approved amount Remarks

State level logistics for STDC / IRL / SDS Furnishing of STDC for training.

6.08 6.08

Approved

NGO Payment (Pending payment) 93.83 93.83 Approved

Grand Total 99.91 99.91

Documents

npcc