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Three Years Rolling Plan 2010-2013 District Attock
THREE YEARS ROLLING PLAN2010 - 2013
DISTRICT LODHRAN
Three Years Rolling Plan (2010-2013) District Lodhran
Table of Contents
Acronyms....................................................................................................5
Executive Summary....................................................................................6
SECTION 1: DISTRICT HEALTH PROFILE.......................................................9
I. Vision of the District..............................................................................9
II. Background of the District.....................................................................9
III. Map of the District............................................................................10
IV. Demography.....................................................................................10
V. Socio Economic Indicators................................................................12
VI. Health Indicators..............................................................................13
a) Reproductive Health.........................................................................13
VII. Organizational Structure of District Health Administration...............14
VIII. Health Resources..............................................................................15
i. Health Facilities................................................................................15
a) Public.............................................................................................15
b) Private...........................................................................................17
ii. Human Resource..............................................................................17
a) Administrative................................................................................17
b) Facility Based.................................................................................18
c) Outreach........................................................................................28
d) Training Institutions....................................................................28
iii. Health Financing............................................................................30
IX. Disease Pattern................................................................................31
X. Status of Vertical Programs..............................................................34
i. National Program for FP & PHC.........................................................34
ii. EPI.....................................................................................................34
iii. MNCH Program..............................................................................35
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Three Years Rolling Plan (2010-2013) District Lodhran
iv. TB Control Program........................................................................35
v. Malaria Control Program...................................................................35
vi. Hepatitis Control Program.............................................................35
vii. School Health Services Program....................................................36
SECTION 2: PROBLEM ANALYSIS................................................................37
I. Objectives............................................................................................37
II. Plan Development Process..................................................................38
a) Problem Identification.......................................................................39
i. Health Problems.............................................................................39
b) Problem Prioritization.......................................................................40
Underlying causes of prioritized problems.............................................41
ii. Service delivery/Management problems........................................42
Underlying causes of Management Problems.........................................43
III. MDGs and MSDS...............................................................................44
a) Human Resource..............................................................................45
i. DHQ Hospital.................................................................................45
ii. THQ Hospitals................................................................................46
b) Equipment........................................................................................47
i. DHQ Hospital.................................................................................48
ii. THQ Hospital..................................................................................56
SECTION 3: INTERVENTIONS AND TARGETS..............................................66
I. Health Problems..................................................................................66
II. Management Problems........................................................................80
SECTION 4: COSTING AND FINANCING PLAN.............................................93
I. Activity based costing..........................................................................93
a) Health Problems...............................................................................93
b) Management Problems...................................................................106
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Three Years Rolling Plan (2010-2013) District Lodhran
II. Financial Outlay including 3YRP Activities.........................................115
a) Health Problems.............................................................................115
b) Management Problems...................................................................117
III. Summaries......................................................................................120
a) Problem-wise Costing.....................................................................120
i. Health Problem............................................................................120
ii. Management Problems...................................................................121
b) Activity-wise Costing......................................................................122
i. Health Problems..........................................................................122
ii. Management Problems................................................................127
SECTION 5: MONITORING & EVALUATION................................................133
I. M&E of Plan.......................................................................................133
Annex - I..................................................................................................138
Annex-II...................................................................................................141
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Three Years Rolling Plan (2010-2013) District Lodhran
Acronyms
3YRP Three Years Rolling plan
ADB Asian Development Bank
AE Assistant Entomologist
APMO Additional Principal Medical Officer
ARI Acute Respiratory Infections
ASV Assistant Superintendent Vaccination
BHU Basic Health Center
BoD Burden of Disease
CDC Communicable Disease Control
CDR Case Detection Rate
CPR Contraceptive Prevalence Rate
DC District Coordinator
DHIS District Health Information System
DHQH District Head Quarter Hospital
DoH Department of Health
DR Default Rate
DSV District Superintendent Vaccination
EDO(H) Executive District Officer Health
EPI Expended Program on Immunization
HSRP Health Sector Reforms Program
IMR Infant Mortality Rate
IPC Interpersonal Communication
IV Inspector Vaccination
M & E Monitoring and Evaluation
M & R Maintenance and Repair
MCH Maternal Child Health
MMR Maternal Mortality Ratio
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Three Years Rolling Plan (2010-2013) District Lodhran
MNCH Maternal Newborn and Child Health
MO Medical Officer
MoV Means of Verification
MSDS Minimum Service Delivery Standards
PDSSP Punjab Devolved Social Services Program
PHC Primary Health Care
PMO Principal Medial Officer
POL Petrol, Oil and Lubricant
RHC Rural Health Center
SCR Sputum Conversion Rate
SHC Secondary Health Care
SMO Senior Medical Officer
TAMA Technical Assistance Management Agency
TB Tuberculosis
THQH Tehsil Head Quarter Hospital
TNA Training Need Assessment
WHO World Health Organization
WMO Women Medical Officer
Executive Summary
Page 6
Three Years Rolling Plan (2010-2013) District Lodhran
Prior to devolution, planning process was carried out at provincial level. Districts were supposed to implement plans and programs developed/designed at provincial and federal levels. Devolution brought a paradigm shift where planning became a district responsibility. This change provided an opportunity to the district at one hand and challenge on other due to their limited capacity in planning and budgeting. Planning focus also changed from short term to medium term planning recognizing the flexibility /adaptability it provided. Government envisions that medium term plan .i.e. 3YRP will be instrumental in using health resources effectively and efficiently through adapting Minimum Service Delivery Standards (MSDS) as the strategy to achieve objectives of MDGs.
Districts have been preparing 3YRP (medium term plan) for last few years under the auspices/patronage of Department of Health (DoH) Government of Punjab through technical assistance of Punjab Devolved Social Services Programme (PDSSP). This year government of the Punjab through Health Sector Reforms Program (HSRP) with the technical assistance from a team of consultants (SP09) and wide consultations/inputs from all key stake holders has established a bench mark in standardization of the format of 3YRP. Capacity building of the districts has been done on the standardized format.
Current 3 Years Rolling Plan (3YRP) plan is first attempt by the district on that agreed format. First section of the format (District Health Profile) contains all relevant information on Geography, Demographic, Socioeconomic and Health indicators of the district. It also takes stock of health resources in terms of human resource, infrastructure and others. District diseases pattern compiled from DHIS Primary and Secondary Health Care reports and current status of vertical /national programs is part of the profile. In fact district profile is a health related fact sheet of the district and depicts the true picture of health status and health resources/services of the district. An accurate district health profile provides a sound basis for evidence-based planning.
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Three Years Rolling Plan (2010-2013) District Lodhran
3YRP plan has been developed by following the standard planning cycle approach. 3YRP details the current year activities, physical targets and fiscal targets. Projections of second and third year physical and financial targets are given. Section Two includes problems identification from various perspectives, and their prioritization by applying WHO prioritization criteria. This section also contains underlying causes of the prioritized problems. Section Three of the plan relates to developing best possible interventions/activities and setting physical targets for each year. Section Four consists of costing based on additional requirements taking account of implementation of current status of activities. Best available estimates have been used to accurately cost the activities. The detailed activity based costing of the Health and Service Delivery problems has been developed on automated Excel sheets, and annexed for details as ready reference. Last section of the 3YRP consists of Monitoring and Evaluation of plan to gauge the progress of different activities and targets of the plan using reliable district data sources. This permits timely remedial action for smooth implementation of planned activities.
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Three Years Rolling Plan (2010-2013) District Lodhran
District Lodhran
SECTION 1: DISTRICT HEALTH PROFILE
I. Vision of the District
Health Department District Government Lodhran aims to provide to every citizen (1.62 M) regardless of the socio0economic status, an effective, efficient, and most modern health care delivery system, by mean acceptable to them, base on scientific method, at a cost that community and country can afford, in the true spirit of self realize.
II. Background of the District
The foundation of Lodhran city was laid in 1830. The British rule extended to Punjab, district Multan including the area of Lodhran also came under the British rule. At that time district Multan comprised of five pargana (Tehsil) i.e. Multan, Shuja Abad, Lodhran, Malsi and Sarai Sadhu.Settalement operation in tehsil Lodhran was started in 1873 which concluded in April 1875.Kehror Pacca and Dunyapur were the part of tehsil Malsi which were annexed with Lodhran in 1924.
Lodhran District is located on the North side of the river Satluj.On its north are the districts of Multan, Khaniwal and Vehari while Bahawalpur is on its southern side. On the east lies the districts of Vehari and Bahawalpur while district Multan lies on the western side. Lodhran lies between 29° 0 21°, to 29° – 55° latitudes and 71° – 23° to 72° – 11° longitudes. Total area is 2778 square Kilometers or 111105 acres. It is almost rectangular in shape with one arm 34.54 kilometers and other 51.80 kilometers long. It comprises 438 Mauzas.
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Three Years Rolling Plan (2010-2013) District Lodhran
The climate of the district is hot and dry in summer and cold in winter season. The summer season begins in April and continues till October. The hottest months are May, June and July. The maximum and minimum temperature ranges between 42 0 28 centigrade respectively. The entire area is smooth plain, almost whole under cultivation through canals and tube wells. The soil is suitable for growing Mangos,
The District Headquarter is connected with its Tehsil Headquarters through Railway line and roads. Lodhran railway station is junction of railway lines. Total metalled raods length is about 853 killometers. The district is linked with Multan, Bahawalpur, Vehari, Khaniwal, Jalapur and Shuja abad through metalled raods. The main ethnic groups are Gujjar, Bhutta, Jam, Mughal, Rajput, Awan, kanjoo, Balouch, Arain and Sandhi.
III. Map of the District
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Three Years Rolling Plan (2010-2013) District Lodhran
IV. Demography
Total Population 16, 20, 795 persons
Annual growth rate 2.0 %
Population density 422 persons per sq. km
Area wise population
Area Population Percentage
Rural 13, 90, 795 85.80%
Urban 2, 30, 00 14.20%
Source: DCR 1998 (Projected population)
Gender wise population
Gender Population Percentage
Male 8, 42, 813 52%
Female 7, 77, 982 48%
Source: DCR 1998 (Projected population)
Population groups
Population GroupsStandard Demographic (%)
Estimated Population
Under 1 year of age 2.7 43, 761
Under 5 years 13.4 2, 17, 186
Under 15 years 44 7, 13, 149
Women in child bearing age (15-49 years)
22 3, 56, 574
Married Child Bearing age Women 16 2, 59, 327
Expected pregnancies 3.4 55, 107
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Three Years Rolling Plan (2010-2013) District Lodhran
Source: Bureau of Statistics (Projected from Census 1998)
V. Socio Economic Indicators
Education and Literacy
Age Literacy Rate
10+yrs 45%
Adult 15+yrs 41%
Adult 15024yrs 60%
Literacy rateRural Urban
Male FemaleOverall District
%age 26.8% 47.7% 26.8
16.0
29.9
Source: MICS 2070208
Per capita income 875 $/Annum
HousingOwnership of house 76%Mean household size 6.8Mean number of persons per room 3.7Total Housing Units 861437Pacca Housing Units 504369Electrified 183988Piped water supply 21510Gas for Cooking 2500
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Three Years Rolling Plan (2010-2013) District Lodhran
Mean household sizeOverall district 6.8 personsTehsil Lodhran 6.7 personsTehsil Dunya Pur 6.9 personsTehsil Kehror Pacca 7.0 persons
Water and SanitationPhysical access to drinking water (within dwelling) 93 %Use of improved drinking water sources 99 %Use of properly treated water 1.5 %Safe drinking water without bacteria 32 %Use of sanitary means of excreta disposal 58 %Use of improved water sources and improved Sanitation 58 % Proper disposal of ; Waste water 24 %Solid waste 4.3 %Hand washing adequately;Before meal 48%After using latrine 52 %
VI. Health Indicators
Infant Mortality Rate 71.9/100
Neonatal mortality Rate 45/100
Under 5 mortality Rate 94/1000 Live births
Maternal mortality Ratio 222/100,000
Life expectancy 65 years
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Three Years Rolling Plan (2010-2013) District Lodhran
Proportion of children under 1 years immunized 85%against measles
a) Reproductive Health
Contraception Use of contraceptives (any method)
23% Contraceptive drop out
3.6% Unwilling pregnancy
27%
Maternal and newborn health
Antenatal care (ANC) 46% Skilled attendant at delivery 31% Institutional deliveries 28% Postnatal care (PNC) 29%
Source: MICS 2007-2008
VII. Organizational Structure of District Health Administration
There exists a three-tier system in the health sector in the country. At federal level, Federal Secretary of Health is responsible to administer and supervise the health related activities and programs. Major function of federal tier is to provide policy guidelines and ensure quality of health care standards through federal legislation. After the 18th amendment in the constitution, and announcement of National Finance Award, most of the existing federal level programs will be transferred to the provincial level. At provincial level, provincial Secretary of Health along with Director General Health Services is responsible for managing and supervising health care services. The district is still an administrative entity in the system and EDO (Health) acts as head of the district health department,
Page 14
ORGANOGRAM
(Executive District Officer (Health)
MS THQHosp Dunyapur
DistrictOfficerHealth
PrincipalGeneral Nursing School
Deputy District Officer Health
Drug Inspector
DSI CDCO Entamologist
District Coordination Officer
MS DHQHosp. Lodhran
Three Years Rolling Plan (2010-2013) District Lodhran
under overall supervision of DCO. The organizational structure at district level is as under:
VIII. Health Resources
i. Health Facilities
a) Public
Details of physical infrastructure of public health facilities in the district is given in the table below
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Three Years Rolling Plan (2010-2013) District Lodhran
Facility Type No. of FacilityBed Strength
No. of Functional Beds
Remarks
Teaching hospitals
0 0 0 0
DHQ Hospital 1 40 40
New DHQ of 125 Beds is under construction
THQ Hospital 2 40 2812 more beds are required
RHCs 4 32 24RHC 53 M is 8 bedded
BHUs 48 96 96
Govt. Rural Dispensaries
1 0 0 0
MCH Centers 0 0 0 0
Sub Health Centers
0 0 0 0
TB Clinics 0 0 0 0
Rural Dispensaries (ZC)
0 0 0 0
City Dispensaries
0 0 0 0
Health house 1011 0 0 0
Data source: DHIS/EDOH office
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Three Years Rolling Plan (2010-2013) District Lodhran
b) Private
The district has provided a list of private service providers including hospitals, clinics, laboratories and maternity homes. These private providers are used for providing support in preventive programs like Polio and other EPI activities. With the passage of time, role of private providers will expand, and there is a need to develop an effective coordination between public and private sector. Detailed list of private sector health facilities is attached as Annex-I.
ii. Human Resource
The Human resource of district health department has been placed in following categories:
a) Administrativeb) Facility basedc) Outreachd) Training institutions
a) Administrative
Sr.No Post Sanctioned Filled
1. Executive District Officer Health
1 1
2. District Officer Health 1 1
3. Deputy DOH Lodhran 1 1
4. Drug Inspector 1 1
5. Assistant Entomologist 1 1
6. CDC Officer 1 1
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No Post Sanctioned Filled
7. Statistical Officer 1 1
8. Office Superintendent 1 1
9. District Sanitary Inspector 1 1
10. Assistant 1 0
11. Head Clerk 1 1
12. Statistical Assistant 1 1
13. Assistant Superintendent Vaccination
1 1
14. Assistant Inspectoress Health Centers
1 0
15. Tehsil Sanitary Inspector 1 0
16. Senior Clerk 4 4
17. Junior Clerk 5 3
18. Accountant 1 0
19. Drivers 3 3
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No Post Sanctioned Filled
20. Insect Collector 2 2
21. Naib Qasid 7 7
22. Chowkidar 5 5
23. Ward Cleaner 1 1
b) Facility Based
Basic Health Units
Sr.No
Post Sanctioned
Filled
1. Medical Officer 48 48
2. Nutrition Supervisors 48 48
3. Computer Operator 48 0
4. Deputy Medical Officer 4 2
5. Medical Technician 44 44
6. Lady Health Visitor 48 48
7. Sanitary Inspectors 48 48
8. Dispenser 48 48
9. Midwife 44 44
10. Naib qasid 48 48
11. Chowkidar 48 48
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No
Post Sanctioned
Filled
12. Ward Cleaner 30 30
Rural Health Centres
Sr.No
Post Sanctioned
Filled
1. Senior Medical Officer 4 4
2. Medical Officer 4 3
3. Woman Medical Officer
4 4
4. Dental Surgeon 4 4
5. Charge Nurses 24 6
6. Homeopathic Healer 2 2
7. Homeopathic Dispenser
2 2
8. Hakeem 2 2
9. Dawasaz 2 2
10. Dispenser 16 15
11. Dresser 8 7
12. Lady Health Visitor 8 8
13. Computer Operator 4 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No
Post Sanctioned
Filled
14. Dental Technician 4 0
15. Laboratory Technician
4 1
16. Radiographer 4 4
17. Senior Clerk 4 4
18. Junior Clerk 4 0
19. Laboratory Assistant 4 4
20. Midwife 16 0
21. Driver 4 4
22. Naib Qasid 8 8
23. Chowkidar 8 8
24. Mali 4 0
25. Water Carrier 4 0
26. Ward Servant (M&F) 12 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No
Post Sanctioned
Filled
27. Sweepers 16 16
28. Dawakoob 2 2
29. WMO MNCH 4 1
30. LHV MNCH 4 4
THQ Hospitals
Sr. No. Nomenclature of Post
Sanctioned Filled Vacancy Gap
1 Medical Superintendent
2 2 0
2 Additional MS 0 0 0
3 D.M.S 0 0 0
4 Physician 2 1 1
5 Surgeon 2 2 0
6 Gynecologist 2 2 0
7 Pediatrician 2 2 0
8 Anesthetist 2 1 1
9 Opthathmologist 2 2 0
10 ENT Specialist 2 0 2
11 Pathologist 0 0 0
12 Radiologist 0 0 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Nomenclature of Post
Sanctioned Filled Vacancy Gap
13 Orthopedic Surgeon
0 0 0
14 Clinical Psychologist
0 0 0
15 Emergency Specialist
0 0 0
16 Trauma Surgeon 0 0 0
17 Forensic Expert 0 0 0
18 Urologist 0 0 0
19 Cardiologist 0 0 0
20 Neurosurgeon 0 0 0
21 Psychiatrist 0 0 0
22 TB & Chest Specialist
0 0 0
23 Dermatologist 0 0 0
24 Pediatric Surgeon
0 0 0
25 Neurologist 0 0 0
26 Epidemiologist 0 0 0
27 Medical Officer 6 6 0
28 APMO 3 3 0
29 APWMO 0 0 0
30 EMO 4 4 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Nomenclature of Post
Sanctioned Filled Vacancy Gap
31 WMO Labor Room
6 6 0
32 MO Intensive care
4 4 0
33 BTO 0 0 0
34 Dental Surgeon 2 2 0
35 Charge Nurse 20 20 0
36 Head Nurse 2 2 0
37 Nursing Superintendent
0 0 0
38 Budget & Accounts Officer
0 0 0
39 Accountant 0 0 0
40 Social Welfare Officer
0 0 0
41 Bio Medical Engineer
0 0 0
42 Pharmacist 0 0 0
43 Health & Nutrition Supervisor
0 0 0
44 Speech Therapist
0 0 0
45 Statistical Specialist
0 0 0
Page 24
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Nomenclature of Post
Sanctioned Filled Vacancy Gap
46 Radiographer 4 4 0
47 Dental Technician
0 0 0
48 Lab Technician 0 0 0
49 Lab Assistant 4 4 0
50 Dispenser 8 8 0
51 Eye Refractions 0 0 0
52 Ophthalmic Technician
0 0 0
53 Bio Medical Technician
0 0 0
54 ECG Technician 0 0 0
55 OT Technician 6 0 6
56 LHV 2 2 0
57 Dresser 2 2 0
58 Midwifes 0 0 0
59 Store keeper 2 2 0
60 Computer Operator
0 0 0
61 Naib Qasid 6 6 0
62 Chowkidar 6 6 0
63 Senior Clerk 0 0 0
64 Driver 4 4 0
65 Water Carrier 0 0 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Nomenclature of Post
Sanctioned Filled Vacancy Gap
66 Cashier 0 0 0
67 Junior Clerk 2 2 0
68 Head Clerk 0 0 0
69 Baildar 0 0 0
70 Car Painter 0 0 0
71 Cook 2 2 0
72 Plumber 0 0 0
73 Almoner 0 0 0
74 Gate Keeper 0 0 0
75 Dental Assistant 2 2 0
76 Telephone Operator
0 0 0
77 Physiotherapy/ Aids Technician
0 0 0
78 Structure Bearer 0 0 0
79 Projectionist 0 0 0
80 St. Assistant 0 0 0
81 OTA 2 2 0
82 Sanitary Inspector
0 0 0
83 Lab Attendant 0 0 0
84 Gardner/ Mali 4 4 0
85 Sanitary Worker 14 14 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Nomenclature of Post
Sanctioned Filled Vacancy Gap
86 Ward Servant 14 14 0
87 Electrician 0 0 0
88 Tailor 0 0 0
89 Dhobi/ Washer Man
2 0 2
90 A.C Mechanic 0 0 0
91 Tube Well Operator
2 2 0
DHQ Hospital
Sr.No Post Sanctioned
Filled
1. Medical Superintendent 1 1
2. Physician 1 0
3. Surgeon 1 1
4. Gynecologist 1 1
5. Pediatrician 1 1
6. Anestheseist 1 0
7. Ophthalmologist 1 1
8. ENT Specialist 1 0
9. Pathologist 1 0
10. Radiologist 1 0
11. Orthopedic Surgeon 1 1
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No Post Sanctioned
Filled
12. Cardiologist 1 1
13. Psychiatrist 1 0
14. Medical Officer 3 3
15. APMO 5 2
16. APWMO 3 0
17. EMO 6 6
18. WMO Labour Room 2 2
19. MO Intensive Care 3 3
20. Blood Transfusion Officer 1 0
21. Dental Surgeon 2 1
22. Head Nurse 2 0
23. Charge Nurse 13 13
24. Accountant 1 1
25. Pharmacist 1 1
26. Radiographer 3 3
27. Dental Technician 1 1
28. Laboratory Assistant 3 2
29. Dispenser 8 8
30. Lady Health Visitor 2 2
31. Head Clerk 1 1
32. Senior Clerk 2 2
33. Junior Clerk 4 2
34. Dental Assistant 1 1
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No Post Sanctioned
Filled
35. Store Keeper 2 1
36. OTA 1 1
37. Dresser 3 3
38. Midwife 3 2
39. Naib Qasid 9 9
40. Chowkidar 5 4
41. Driver 9 9
42. Baildar 2 2
43. Cook 3 3
44. Gate Keeper 1 1
45. Gardener 2 2
46. Sanitary Worker 14 13
47. Ward Servant 12 12
48. Dhobi 1 1
49. Tube well Operator 1 1
c) Outreach
This information is about outreach program workers such as Vaccinators, CDC Supervisors and Sanitary Inspectors which are not part of above mentioned health facilities.
Post Sanctioned Filled
Vaccinator 55 54
CDC Supervisor 40 37
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Three Years Rolling Plan (2010-2013) District Lodhran
Sanitary Inspector 48 22
d) Training Institutions
A number of training institutions are working in the district, which include the following:
Type of institute Number
DHDC Nil
General Nursing school1
DHDC
DHDC in Lodhran is still to be established. All types of trainings are being arranged in the existing EDO(H) office building at District Complex 10 M chak. DOH is officiating the job of Program Director DHDC. It is requested that the appropriate measures must be taken for the DEVELOPMENT of District Health Development Center. The following posts are require to be sanctioned for DHDC Lodhran along with the standard DHDC building.
General Nursing School
Sr.No Post Sanctioned
Filled
1. Principal 1 1
2. Instructor 3 2
3. Assistant Instructor
1 1
4. Public Health Supervisor
2 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No Post Sanctioned
Filled
5. Librarian 1 1
6. House Keeper 1 1
7. Stenographer 1 0
8. Senior Clerk 1 1
9. Accountant 1 1
10. Junior Clerk 1 1
11. Naib Qasid 1 1
12. Chowkidar 4 4
13. Cook 1 1
14. Bearer 2 2
15. Mali 3 2
16. Aya Female 2 2
17. Sweeper 3 3
18. Driver 1 1
19. Computer Operator MNCH
1 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr.No Post Sanctioned
Filled
20. Instructor Midwifery MNCH
2 0
21. Clinical Supervisor MNCH
1 0
22. Driver MNCH 1 1
23. Security Guard MNCH
1 0
iii. Health Financing
The provision of financial resources at district level is prime responsibility of district government. However, keeping in view the budget constraints at the district level, federal and provincial governments also augment financial resources in form of kind and cash, through different programs. Financial resources of the district during the last three years out of different sources are given as under:
Rs. Million
Source of funding
Year
20708 20809 209010
Allocation
Exp. Allocation
Exp. Allocation
Exp.
Developmental 111.00 67.00 202.914 135.645
148.269 62.00
Non developmental
199.522 173.563
206.583 212.187
302.464 194.638
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Three Years Rolling Plan (2010-2013) District Lodhran
Sub-Total 30.522 240.563
409.497 347.832
450.733 256.638
PHRSP 23.976 0 44.576 5.232 39.344 0PMDGP 0 0 73.720 0 73.720 21.30 PDSSP 18.151 0 18.151 15.287 24.260 2.864 Provincial development budget
--- ---- ---- ---- ---- ----
Other sources (CM initiative)
0 0 1.440 0 1.440 0.920
Total
42.127 0 137.887 20.519 138.764 25.084
Grand Total 342.649 240.563
547.384 368.351
589.497 281.722
IX. Disease Pattern
The disease pattern is determined through regular and periodic reporting through surveys and studies. Punjab health department has adopted DHIS as regular reporting mechanism to collect information on diseases and other variables. Currently, DHIS is in transitional stage, and is establishing itself as a tool to be used for evidence based planning and management. The following trend of the diseases has been taken from the consolidated DHIS reports that include reports from PHC and SHC facilities.
Disease Group Percentage of Magnitude
Respiratory Disease
1 Acute upper respiratory infection
20.7411
2 Pneumonia < 5years 1.483
3 Pneumonia < 5years 1.6358
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Three Years Rolling Plan (2010-2013) District Lodhran
Disease Group Percentage of Magnitude
4 TB Suspects 0.6243
5 Chronic Obstructive Pulmonary Disease
0.4673
6 Asthma 1.3559
Gastro Intestinal Disease
7 Diarrhea / Dysentery < 5 years 3.2152
8 Diarrhea / Dysentery < 5 years 3.1476
9 Enteric / Typhoid Fever 0.1228
10 Worm infestations 0.7736
11 Peptic Ulcer 1.8906
12 Cirrhosis of Liver 0.0741
Urinary Tract Disease
13 Urinary Tract infection 0.8437
14 Nephritis / Nephrosis 0.013
15 Sexually Transmitted Infections
0.0361
16 Benign Enlargement of Prostrate
0.0187
Other Communicable Disease
17 Suspected Malaria 1.9014
18 Suspected Meningitis 0.0102
19 Fever due to other causes 2.3807
Vaccine Preventable Disease
20 Suspected Measles 0.1328
21 Suspected Viral Hepatitis 0.0701
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Three Years Rolling Plan (2010-2013) District Lodhran
Disease Group Percentage of Magnitude
22 Suspected Neo0natal Tetanus 0.0393
Cardiovascular Disease
23 Ischemic Heart disease 0.1418
24 Hypertension 1.5694
Skin Disease
25 Scabies 5.3454
26 Dermatitis 1.0812
27 Cutaneous Leishmaniasis 0.026
Endocrine Disease
28 Diabetes Mellitus 1.1266
Neuro Psychiatric Disease
29 Depression 0.3025
30 Drug Dependence 0.0157
31 Epilepsy 0.0141
Disease Group Percentage of Magnitude
Eye & ENT
32 Cataract 0.2518
33 Trachoma 0.1057
34 Glaucoma 0.0625
35 Otitis Media 0.7758
Oral Disease
36 Dental Carries 0.9861
Injuries / Poisoning
37 Road Traffic Accidents 1.8177
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Three Years Rolling Plan (2010-2013) District Lodhran
Disease Group Percentage of Magnitude
38 Fractures 0.0933
39 Burns 0.1566
40 Dog Bites 0.1638
41 Snake Bites ( with sign/symptoms of poisoning
0.045
Miscellaneous Disease
42 Acute Flaccid Paralysis 0.0226
43 Suspected HIV/AIDS 0
44 Any other unusual disease ( specify )
0
Source: DHIS Reports
X. Status of Vertical Programs
The following paragraphs depict the current status of the program being implemented in the district. The indicators and their values have been taken from the program reports.
i. National Program for FP & PHC
No. of seats allocated for LHWs 1011 No. of LHWs working 922 Percentage of Population covered by the program 65
% Important program indicators
IMR 32/1000
MMR 152/100,000
CPR 49% No. of antenatal visits 90% TT Coverage of pregnant women
87%
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Three Years Rolling Plan (2010-2013) District Lodhran
ii. EPI
EPI Coverage rate of the district 85% Fully immunized children 023 months 85% Pregnant women received TT vaccine (TT02)
69% Availability of cold chain equipment 55 Health Facilities
are fully equipped with cold chain however 3 BHUs are facing equipment shortage along with repair and
maintenance problem).
iii. MNCH Program
CMW Students Admitted 53 Passed 53 Fresh CMWs batch 40 Post Sanctione
dFilled
Public Health Specialist 1 0
Social Organizer/Community coordinator
1 1
Account Assistant 1 1
iv. TB Control Program
Quarter Wise DOTS Indicators
Indicator
Q1 2009 Q2 2009 Q3 2009 Q4 2009
CDR All Types
64% 87% 93% 68%
CDR NSS+
59% 64% 106% 66%
SCR 90% 92% 91% 92%
TSR 92% 91% 91% 90%
DR 4% 5% 5% 5%
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Three Years Rolling Plan (2010-2013) District Lodhran
v. Malaria Control Program
No. of slides examined 39072No. of positive slides 03 Slides positively ratio 0.08%Percentage of plasmodium falciparum 0 %
vi. Hepatitis Control Program
No. of hepatitis tests conducted 704No. of positive cases detected 522 (B)&(C)No. of persons vaccinated against Hepatitis B 2595No. of cases treated for Hepatitis B 103No. of cases treated for Hepatitis C 419
vii. School Health Services Program1. Total Visits to the School 2616
2. No. Students Examined 24164
3. No of students referred to BHUs
9366
4. No. Students Treated at BHU
22071
5. No. of Students referred from BHU to higher facilities
30841
6. No. of Schools in catchment Areas
2120 ( 923 Girls+1197 boys)
7. No. of Students 314578
8. No of Teachers Trained 5307 ( 6490)
9. No of SH & NS 69
Source; DHDC Lodhran
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Three Years Rolling Plan (2010-2013) District Lodhran
SECTION 2: PROBLEM ANALYSIS
The Health sector in Punjab is facing enormous health and service delivery problems. Common health problems are communicable, non communicable, MNCH related diseases and accident/ trauma. The society is passing through demographic and epidemiological transition. This is due to changing life style, urbanization, ecological and other factors. Disease pattern is changing where non communicable diseases are gradually increasing and the communicable diseases are still posing serious threat. Punjab is practically facing Double Burden of Disease (BOD). Besides, health problems service delivery/ managerial issues are also hindering the access and quality of health services to the population. The service delivery/management problems are diverse in nature, and include shortage of technical human resource, capacity issues, lack of infrastructure and equipment.
Devolution was introduced during 201 affecting the administrative and financial set up of the districts. The devolution also brought political culture in the decision making of the districts in the shape of Nazims, Naib Nazims and Councilors. This system is now in the phase of reshaping and it is not clear what will be future structure and managerial shape when
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Three Years Rolling Plan (2010-2013) District Lodhran
new local bodies system is put in place. The District Manager and functionaries are in the state of uncertainty and confusion in this scenario. However, one thing is clear that the district shall remain a hub of all primary and secondary health services delivery. Despite the source of funding in the future, either from provincial or district government, health planning at district level shall continue to play a pivotal role in provision of quality health services.
In view of the above situation the district considers following objectives for developing three year rolling plan.
I. Objectives
Improve health status of the population Meeting the requirements of national and provincial health policies Achievement of MDGs through MSDS Introducing evidence0based planning culture by addressing district
specific problems/issues Addressing emerging health needs or re0emergence of health
problems (e.g. H1N1, HIV0AIDS, Polio, T.B) Ensuring effective inter0sectoral coordination with a view to
improving health indicators
The objectives would guide in problem analysis, designing interventions, setting /phasing the targets, costing and monitoring the plan activities.
II. Plan Development Process
Plan development has been a systematic and consultative process. A core planning team consisting of EDO (H), DOH, MS DHQ and THQs, Statistical officer, and Budget and Accounts Officer, was designated by Director General Health Services Punjab. This team received three days customized training from SP09 team at divisional headquarters. The main components of the trainings were: (i) developing a three0year rolling health sector plan using the standard three year rolling plan format; (ii) costing of the plan; (iii) preparing related budget projections; (iv)
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Three Years Rolling Plan (2010-2013) District Lodhran
accounting procedures; (v) preparing adequate financial reports on the use of funds.
The district planning team adopted the following steps for the preparation of three years rolling plan:
Problem identification Prioritization of identified problems Identifying underlying causes of prioritized problems Developing interventions and activities Setting targets Determining resource requirements, costing and budgeting Preparing action plans Preparing monitoring plan
a) Problem Identification
This step involved assessment of the current situation from various perspectives to establish the actual health situation in terms of health and service delivery/management problems. Problem identification is based on the district health profile, review of previous plans, MIS (DHIS, Program reports and periodic reports etc.), District specific surveys (MICS), MSDS, and national and provincial policy guidelines.
The district planning team held meetings and started with identification of problem using the training received from SP09 team and consulting the above mentioned documents. The problems identified were broadly divided into two categories i.e.
a) Health Problemsb) Health Service Delivery or Management Problems
i. Health Problems
The district specific health problems identification process started during the three years rolling plans workshop. The planning team in the initial stage prepared a long list of the health problems. The identification of health problems was based on various information sources including DHIS,
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Three Years Rolling Plan (2010-2013) District Lodhran
and district specific reports. The enlisted health problems of the district are given in the following table.
Sr.No Health Problems1. Diarrhea (Acute & Chronic)
2. ARI (Pneumonia)
3. Hepatitis B & C
4. Anemia (Pregnant Ladies and Children under 5)
5. Complications during pregnancies
6. T.B
7. Worm Infestations
8. Scabies
9. Goiter
10. Malnutrition
b) Problem Prioritization
WHO has developed standard criteria for prioritization of health problems; which is based on the following five elements:
Magnitude Severity/danger Vulnerability to intervention (feasibility) Cost0effectiveness of the intervention Political expediency
Each element has been assigned a score from 1 to 4 depending upon grade/scale of that element i.e. Very High=4, High=3, Medium=2 and Low=1.
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Three Years Rolling Plan (2010-2013) District Lodhran
Elements of the prioritization criteria were applied to each of the enlisted health problems. The aggregate of individual scores assigned to the elements of the prioritization criteria gave the total score for a health problem. A cut-off point was decided, to establish the priority health problems of the district. This total score was then used to prioritize the health problems. These problems will be addressed in the three years rolling plan.
Problem Magnitude Severity Vulnerabilit
y to
intervention
Cost
Effectiv
eness
Political
Expedienc
y
Total
Score
Priorit
y No.
Diarrhea (Acute
& Chronic)
3 2 4 4 1 14 3
ARI (Pneumonia) 4 3 4 4 1 16 2
Hepatitis B & C 3 2 3 1 2 11 5
Complications of
pregnancies
3 3 3 3 4 16 2
Anemia
(Pregnant Ladies
and Children
under 5)
4 3 4 4 2 17 1
T.B 2 2 3 3 2 12 4
Worm
Infestations
2 2 2 2 1 9 7
Scabies 3 1 3 2 1 10 6
Goiter 2 1 2 2 1 8 8
Malnutrition 4 3 3 3 1 14 3
Underlying causes of prioritized problems
Health problems have their underlying causes. It is important to know the underlying causes of the health problems so that appropriate
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Three Years Rolling Plan (2010-2013) District Lodhran
interventions are developed. There may be a long list of these causes but only few of them are vital ones; and rectifying these causes can resolve the problem to a large extent. Following table gives common causes of the prioritized health problems pertaining to the district.
Sr. # Health Problem Causes
1. Anemia in Pregnancy
Poverty and Malnutrition Lack of awareness about balanced diet Inadequate and poor MCH Services Gender discrimination Multiple pregnancies Worm infestation
3. ARI Malnutrition Air Contamination Over Crowding/Poor housing facilities Lack of proper sanitation Seasonal Variation Lack of awareness related to winter season and
hygienic practices4. Diarrhea under
5 Children Poor hygiene and sanitation Lack of safe drinking water Unhygienic practices Lack of awareness among mothers about feeding
and weaning practices
5. Tuberculosis Low socioeconomic status Overcrowding/Poor Housing Facilities Malnutrition Seasonal Variation Lack of proper sanitation Lack of awareness and hygienic practices
6. Hepatitis (B&C) Poor sanitation Unsafe drinking water Sharing of used syringes Transfusion of unsafe/unscreened blood and blood
products Unsafe sexual practices Ear piercing and tattooing Use of unsterilized equipment by dentists and
barbers
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. # Health Problem Causes
7. Scabies Overcrowding in schools and homes Low socio-economic conditions Poor Health Education
ii. Service delivery/Management problems
This segment entails the district specific management problems. Management problems are result of deficiency/lack of resources; these problems range from administrative to financial issues, and cause hindrance in the smooth delivery of health services in the district. It was observed that solution of some of these problems lies with the provincial government; whereas remaining can be addressed at the district level. While proposing the interventions, their action at provincial or district level has been specifically mentioned. The planning team discussed these problems in detail and enlisted the main problems as under:
Sr.No
Management Problems
1. Shortage of Skilled Staff MNCH related
2. Lack of Budget for POL
3. Lack of equipment
4. Deficient Infrastructure
5. Lack of Monitoring and Supervision
Underlying causes of Management Problems
Sr. #
Service Causes
1. Shortage of skilled (MNCH) Non-availability of trained staff Non-sanctioning of staff according to
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. #
Service Causes
staff
MSDS Lack of permanent postings Lack of incentivized and differential
pay package Frequent transfer postings Job insecurity Lack of conducive environment
including insecurity and transport of children for education
Political and media interference
2. Inadequate budget for POL Generator provision for backup of electricity supply
Frequent increase in prices of POL Less allocation for POL budget
3. Inadequate Equipment Deficient equipment to cater basic and comprehensive EmONC at primary and secondary level of care
Old and un-serviceable equipment Shortage of regular budget for M&R Frequent cuts on M&R budget
4. Deficient infrastructure (Staff residencies)
Debilitated condition of existing infra-structure
Lack of budget for repair and maintenance
Inadequate infrastructure for Emergency, Operation Theatre, OPD and inpatients, residences for staff at THQ and DHQ Hospitals
5. Ineffective Supervision and Monitoring system
Absence of M&E policy Inadequate resources Lack of Skills
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Three Years Rolling Plan (2010-2013) District Lodhran
III. MDGs and MSDS
The government is committed to achieve the MDGs targets. For this purpose, the government of Punjab has decided to adopt Minimum Service Delivery Standards (MSDS) as strategy to achieve the MDGs within the province. Health Department of Punjab is especially focusing on MNCH related component of MSDS for which substantial resources are coming from Asian Development Program funded Punjab Millennium Development Goal Program (PMDGP). MSDS entails a level0specific service delivery package (for primary and secondary health care) along with their standards and system specifications including human, infrastructure, equipment, medical supplies, medicine and other consumables.
In order to achieve the MDGs, the government of Punjab has adopted MSDS as strategic framework. During the development of three years rolling plans, gaps under MSDS focusing on MNCH interventions have been identified. Most essential areas for which gaps have been identified are human resource and equipment of DHQ and THQ hospitals, as per lists notified by the government in accordance with MSDS standards.
a) Human Resource
With regard to MSDS gap analysis for human resource, the difference between the standards proposed in MSDS and filled posts has been calculated as the vacancy gap. The hospitals have been categorized based on their bed strength as follows:
Hospital Category Bed Strength
DHQ Hospital
A 40 and above Beds
B 251040 Beds
C Up to 250 Beds
THQ Hospital A Above 60 Beds
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Three Years Rolling Plan (2010-2013) District Lodhran
B 41060 Beds
C Up to 40 Beds
i. DHQ Hospital
Sr. No. Nomenclature of Post
Standard as per MSDS
C Category
Sanctioned
Filled Vacancy Gap in relation to sanctioned posts
Vacancy Gap in relation to filled posts
1. Gynaecologist
3 3 3 0 0
2. Paediatrician
3 1 1 2 2
3. Anesthetist 4 1 0 3 4
4. Medical Officer including APMO, EMO
21 17 5 4 16
5. WMO, APWMO
6 5 0 5 6
6. Nurse 36 17 15
19 21
ii. THQ Hospitals
There are five THQ hospitals in the district. The following table shows the consolidated position of all the THQ hospitals in the district.
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Nomenclature of Post
Standard as per MSDS
C Category
Sanctioned
Filled
Vacancy Gap in relation to sanctioned posts
Vacancy Gap in relation to filled posts
1. Gynecologist
4 2 2 0 2
2. Pediatrician 4 2 2 0 2
3. Anesthetist 6 2 1 5 3
4. Medical Officers including SMO,APMO & PMOs
34 17 4 17 30
5. Women Medical Officers including SWMO APWMO & PMOs
8 6 6 0 2
6. Nurses 34 22 22 0 12
7. Head Nurse 2 2 2 0 0
b) Equipment
Government of Punjab has notified a standard list as yard0stick of MNCH related equipment to provide comprehensive EmONC services in the DHQ and THQ hospitals. Provision of comprehensive EmONC services is
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Three Years Rolling Plan (2010-2013) District Lodhran
essentially required to decrease the high MMR and IMR prevailing in the province.
Gaps in relation to the MNCH related equipment have been identified taking into account the equipment purchased or under process of purchase from all funds including PMDGP funds allocated/sanctioned to the district. The cost of equipment gap has been included in the equipment portion of the Management/Service delivery problems. The detailed costing of equipment gaps for DHQ and THQ hospitals is attached as Annex-II.
i. DHQ Hospital
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
1 CTG (Cardiac Tocography)
1 1 2 0 1
2 Foetal Doppler 3 5 5 0 3
3 Diagnostic Laparoscope
1 1 2 0 1
4 Bulb Sucker 10
20
20
10 0
5 Baby Warmer 3 3 6 0 3
6 Mechanical Sucker 3 3 6 4 0
7 Fetal Stethoscope 4 4 4 4 0
8 Delivery Table 2 2 3 1 1
9 D&C Set 2 3 4 2 0
10 Outlet forceps 4 4 4 4 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
11 Myoma Screw 2 2 2 2 0
12 Kochers forceps 4 4 8 4 0
13 Volselum forceps 6 8 10
6 0
14 Lanes Tissue holding forceps
2 2 4 2 0
15 Vaginal Retractors 10
10
10
10 0
16 Polypectomy forceps 2 2 2 2 0
17 Sponge holder 10
15
20
10 0
18 Uterine elevator 1 1 1 1 0
19 CosCo Speculum
Small, Medium, Large (for each category)
6 10
10
6 0
20 Examination light 3 3 6 2 1
21 Suction Curette 1 2 2 1 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 2 0 1
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 2 1 0
24 Cardiac Monitor 1 1 2 5 0
25 Pump Breast Electronic
1 1 1 1 0
26 Vaginal Hysterectomy Set
2 2 4 2 0
26.1 Toothed Tissue Forceps (8”)
2 2 4 2 0
26.2 Non-Toothed Tissue Forceps (8”)
2 2 4 2 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
26.3 Dissection Scissors (Curved 7”)
2 2 4 2 0
26.4 Dissection Scissors (Straight 7”)
2 2 4 2 0
26.5 Hysterectomy Clamps (Straight)
8 8 16
8 0
26.6 Hysterectomy Clamps (Curved)
8 8 16
8 0
26.7 Uterine Sound 2 2 4 2 0
26.8 Needle Holder (7”) 2 2 4 2 0
26.9 Needle Holder (10”) 2 2 4 2 0
26.10
Artery Forceps (Straight 6”)
16
16
32
16 0
26.11
Artery Forceps (Curved 6”)
16
16
32
16 0
26.12
Allis Forceps 8 8 16
8 0
26.13
Towel Clamps 8 8 16
8 0
26.14
Single blade Sims speculum
4 4 8 4 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
26.15
Double blade Sims speculum
4 4 8 4 0
26.16
Sponge holding forceps
8 8 16
8 0
26.17
Volselum forceps 4 4 8 4 0
26.18
Uterine Sound 2 2 4 2 0
26.19
Bladder Sound 2 2 4 2 0
27 Delivery Sets 10
10
15
10 0
27.1 Episiotomy Scissors 10
10
15
10 0
27.2 Straight Scissors 10
10
15
10 0
27.3 Needle holder 10
10
15
10 0
27.4 Non-toothed tissue forceps 8 inches
10
10
15
10 0
27.5 Toothed tissue forceps 8 inches
10
10
15
10 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
27.6 Sims Speculum single blade
20
20
30
20 0
27.7 Sims Speculum double blade
20
20
30
20 0
27.8 Sponge holding forceps
40
40
60
40 0
27.9 Artery forceps 40
40
60
40 0
27.10
Straight clamps (cord)
20
20
30
20 0
27.11
Vacuum Extractor pump
1 1 1 0 1
27.12
Towel clip 40
40
60
40 0
28 Caesarian Section 6 8 10
6 0
28.1 Scalpel 6 8 10
6 0
28.2 Artery Forceps Straight 6 inches
24
32
40
24 0
28.3 Artery Forceps Curved 6 inches
24
32
40
24 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
28.4 Artery forceps 8 inches
24
32
40
24 0
28.5 Myoma Scissors straight 7 inches
6 8 10
6 0
28.6 Dissecting scissors (curved) 7 inches
6 8 10
6 0
28.7 Green Armtage forceps 8 inches
24
32
40
24 0
28.8 Obstetric outlet forceps (pair)
6 8 10
6 0
28.9 Doyene’s Retractor 6 8 10
6 0
28.10
Small Retractors 12
16
20
12 0
28.11
Towel Clippers 24
32
40
24 0
28.12
Suction Nozzle 6 8 10
6 0
29 MNCH Related Radiology Equipments
29.1 Ultrasound Machine 1 2 3 1 0
29.2 X0Ray Unit 50 kw 1 1 1 1 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
29.3 Color Doppler 0 1 1 0 0
29.4 Lead Screen for X0Ray Unit
1 1 1 1 0
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Go0dal Sheets
1 1 1 1 0
29.6 Safe Light 1 1 1 1 0
29.7 X0RT Film Processing Tank
1 1 1 1 0
29.8 Chest Stand 1 1 1 1 0
29.9 X-Ray film Illuminator 2 2 2 2 0
29.10
X-Ray Film Hangers All sizes
4 4 4 4 0
30 MNCH Related Paediatrics Equipments
30.1 Paediatric Ventilator 1 2 2 0 1
30.2 Incubator 1 1 2 0 1
30.3 Photo Therapy Unit 1 1 1 1 0
30.4 Over-head Radiant Warmer
1 1 1 1 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
30.5 Infant Length Measuring Scale
2 2 2 2 0
30.6 Infant Weighing Machine
2 2 2 2 0
30.7 Nebulizer 1 1 2 1 0
30.8 Billirubino0meter 1 1 2 1 0
30.9 Exchange Blood Transfusion Set
1 1 2 0 1
30.10
Nasal Probe Paed size 2 2 4 2 0
31 Anesthesia/ICU 0
31.1 Anesthesia Machine 1 1 2 1 0
31.2 Ventilators 1 1 1 1 0
31.3 Nebulizer 1 1 1 1 0
31.4 Pulse Oximetry 1 1 1 1 0
31.5 Defibrillator 1 1 1 1 0
31.6 Airway Oral and 0sal 2 3 4 2 0
31.7 Tracheostomy tube (adult and paeds)
2 2 4 2 0
31.8 Face mask of all sizes 2 2 4 2 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
31.9 Double Cuff Tourniquet (for regio0l block)
1 2 2 1 0
31.10
AMBO bag adult 2 2 4 2 0
31.11
AMBO Bag paeds 2 2 4 2 0
31.12
Red Rubber 0sal tubes all sizes without cuff
4 4 8 4 0
32 Blood Bank 0
32.1 Blood storage cabinet (10 bag capacity)
1 1 2 1 0
32.2 Packed cell machine 1 1 1 1 0
32.3 Cell Separator 1 1 1 1 0
32.4 Freezer for Fresh Frozen Plasma
1 1 1 1 0
32.5 Blood bag shaker 1 1 2 1 0
32.6 RH view box 2 2 4 2 0
32.7 Water bath 2 2 2 2 0
32.8 Micro-pipette 4 6 8 4 0
32.9 Blood grouping tiles 3 3 6 3 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
32.10
Plasma Extractor 1 1 1 1 0
32.11
Platelets agitator 1 1 1 1 0
32.12
Blood thawing bath 1 1 1 1 0
32.13
Microscopes 1 1 2 1 0
33 Gynae & Labour Room Related Laboratory Equipment
33.1 Hematology Analyzer 1 1 1 1 0
33.2 Electrolyte Analyzer 1 1 1 1 0
33.3 Analyzer Bio-chemistry Semi0automatic
1 1 1 1 0
33.4 Glucometer 2 2 2 2 0
33.5 Haemoglobino0meter 2 2 4 2 0
33.6 Centrifuge 1 1 2 1 0
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Three Years Rolling Plan (2010-2013) District Lodhran
ii. THQ Hospital
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
1 CTG (Cardiac Tocography)
1 1 1 0 1
2 Foetal Doppler 2 2 3 0 2
3 Diagnostic Laparoscope
1 1 1 1 0
4 Bulb Sucker 5 10
20
5 0
5 Baby Warmer 2 2 3 2 0
6 Mechanical Sucker 3 3 3 3 0
7 Fetal Stethoscope 2 3 4 2 0
8 Delivery Table 2 2 2 2 0
9 D&C Set 2 2 2 2 0
10 Outlet forceps 4 4 4 4 0
11 Myoma Screw 2 2 2 2 0
12 Kochers forceps 4 4 4 4 0
13 Volselum forceps 4 4 6 4 0
14 Lanes Tissue holding forceps
2 2 2 2 0
15 Vaginal Retractors 4 4 6 4 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
16 Polypectomy forceps
2 2 2 2 0
17 Sponge holder 10
10
15
10 0
18 Uterine elevator 1 1 1 1 0
19 CosCo Speculum
Small, Medium, Large (for each category)
4 6 6 4 0
20 Examination light 3 3 3 1 0
21 Suction Curette 1 1 2 0 1
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 1 0 1
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo0tracheal tube, BP Apparatus, Chargeable light)
1 1 1 1 0
24 Cardiac Monitor 1 1 1 0 1
25 Pump Breast Electronic
1 1 1 0 1
26 Vaginal Hysterectomy Set
2 2 2 2 0
26.1 Toothed Tissue Forceps (8”)
2 2 2 2 0
26.2 Non-Tooted Tissue Forceps (8”)
2 2 2 2 0
26.3 Dissection Scissors (Curved 7”)
2 2 2 2 0
26.4 Dissection Scissors (Straight 7”)
2 2 2 2 0
26.5 Hysterectomy Clamps (Straight)
8 8 8 8 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
26.6 Hysterectomy Clamps (Curved)
8 8 8 8 0
26.7 Uterine Sound 2 2 2 2 0
26.8 Needle Holder (7”) 2 2 4 2 0
26.9 Needle Holder (10”)
2 2 2 2 0
26.10 Artery Forceps (Straight 6”)
16
16
16
16 0
26.11 Artery Forceps (Curved 6”)
16
16
16
16 0
26.12 Allis Forceps 8 8 8 8 0
26.13 Towel Clamps 8 8 8 8 0
26.14 Single blade Sims speculum
4 4 4 4 0
26.15 Double blade Sims speculum
4 4 4 4 0
26.16 Sponge holding forceps
8 8 8 8 0
26.17 Volselum forceps 4 4 4 4 0
26.18 Uterine Sound 2 2 2 2 0
26.19 Bladder Sound 2 2 2 2 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
27 Delivery Sets 6 6 10
6 0
27.1 Episiotomy Scissors
6 6 10
6 0
27.2 Straight Scissors 6 6 10
6 0
27.3 Needle holder 6 6 10
6 0
27.4 Non-toothed tissue forceps 8 inches
6 6 10
6 0
27.5 Toothed tissue forceps 8 inches
6 6 10
6 0
27.6 Sims Speculum single blade
12
12
20
12 0
27.7 Sims Speculum double blade
12
12
20
12 0
27.8 Sponge holding forceps
40
40
40
40 0
27.9 Artery forceps 40
40
40
40 0
27.10 Straight clamps (cord)
20
20
30
20 0
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
27.11 Vacuum Extractor pump
1 1 1 1 0
27.12 Towel clip 40
40
40
40 0
28 Caesarian Section 4 4 6 4 0
28.1 Scalpel 4 4 6 4 0
28.2 Artery Forceps Straight 6 inches
16
16
24
16 0
28.3 Artery Forceps Curved 6 inches
16
16
24
16 0
28.4 Artery forceps 8 inches
16
16
24
16 0
28.5 Myoma Scissors straight 7 inches
4 4 6 4 0
28.6 Dissecting scissors (curved) 7 inches
4 4 6 4 0
28.7 Green Armtage forceps 8 inches
16
16
24
16 0
28.8 Obstetric outlet forceps (pair)
4 4 6 4 0
28.9 Doyene’s Retractor
4 4 6 4 0
Page 66
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
28.10 Small Retractors 8 8 12
8 0
28.11 Towel Clippers 16
16
24
16 0
28.12 Suction Nozzle 4 4 6 4 0
29 MNCH Related Radiology Equipments
29.1 Ultrasound Machine
1 1 2 1 1
29.2 X0Ray Unit 50 kw 1 1 1 0 1
29.3 Color Doppler 0 0 0 0 0
29.4 Lead Screen for X0Ray Unit
1 1 1 1 0
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Go0dal Sheets
1 1 1 1 0
29.6 Safe Light 1 1 1 1 0
29.7 X-Ray Film Processing Tank
1 1 1 1 0
29.8 Chest Stand 1 1 1 1 0
Page 67
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
29.9 X-Ray film Illumi0tor
2 2 2 2 0
29.10 X-Ray Film Hangers All sizes
4 4 4 4 0
30 MNCH Related Paediatrics Equipments
0
30.1 Paediatric Ventilator
1 1 2 1 1
30.2 Incubator 1 1 1 1 0
30.3 Photo Therapy Unit 1 1 1 1 0
30.4 Over0head Radiant Warmer
1 1 1 1 0
30.5 Infant Length Measuring Scale
2 2 2 2 0
30.6 Infant Weighing Machine
2 2 2 2 0
30.7 Nebulizer 1 1 1 1 0
30.8 Billirubino-meter 1 1 1 1 0
30.9 Exchange Blood Transfusion Set
1 1 1 1 1
Page 68
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
30.10 Nasal Probe Paed size
1 2 2 1 0
31 Anesthesia/ICU
31.1 Anesthesia Machine
1 1 1 1 1
31.2 Ventilators 1 1 1 1 0
31.3 Nebulizer 1 1 1 1 0
31.4 Pulse Oximetry 1 1 1 1 0
31.5 Defibrillator 1 1 1 1 0
31.6 Airway Oral and 0sal
1 2 2 1 0
31.7 Tracheostomy tube (adult and paeds)
1 2 2 1 0
31.8 Face mask of all sizes
1 2 2 1 0
31.9 Double Cuff Tourniquet (for regio0l block)
1 1 1 1 0
31.10 AMBO bag adult 1 2 2 0 1
31.11 AMBO Bag paeds 2 2 2 0 2
Page 69
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
31.12 Red Rubber 0sal tubes all sizes without cuff
4 4 4 4 0
32 Blood Bank 0
32.1 Blood storage cabinet (10 bag capacity)
1 1 1 1 0
32.2 Packed cell machine
1 1 1 1 0
32.3 Cell Separator 1 1 1 1 0
32.4 Freezer for Fresh Frozen Plasma
1 1 1 1 0
32.5 Blood bag shaker 1 1 1 1 0
32.6 RH view box 1 2 2 1 0
32.7 Water bath 2 2 2 2 0
32.8 Micro-pipette 4 4 6 4 0
32.9 Blood grouping tiles
3 3 3 3 0
32.10 Plasma Extractor 1 1 1 1 0
32.11 Platelets agitator 1 1 1 1 0
32.12 Blood thawing bath
1 1 1 1 0
Page 70
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No. Equipment Standard as per MSDS
(Qty.)
Available
Gap
C B A
32.13 Microscopes 1 1 1 1 0
33 Gynae & Labour Room Related Laboratory Equipment
33.1 Hematology Analyzer
1 1 1 1 0
33.2 Electrolyte Analyzer
1 1 1 1 0
33.3 Analyzer Bio-chemistry Semi-automatic
1 1 1 1 0
33.4 Glucometer 2 2 2 2 0
33.5 Haemoglobinometer
1 1 1 1 0
33.6 Centrifuge 1 1 1 1 0
Page 71
Three Years Rolling Plan (2010-2013) District Lodhran
SECTION 3: INTERVENTIONS AND TARGETS
After enlisting the vital causes of prioritized health problems, team proposed appropriate interventions to tackle the problems. Once interventions and activities had been identified, next task the planning team performed was to set the number and quality of specific activities (targets) that have to be carried out. It is pertinent to mention over here that the plan envisages additional activities along with routine activities under regular budget.
I. Health Problems
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
1.
Anemia in pregnancy
· Poverty & malntrition
· Awareness raising for behaviour change
· Messages on local cable network
Monthly Messages telecat packages
36 12 12 12 -
Lack of Improving Printing Brochur 300,000 100,000 100,000 100,000 -
Page 72
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
awareness about balanced diet
ante-natal coverage
and distribution of IPC material
e
Multiple
pregnancies Improving ante-natal coverage
Printing and distribution of IPC material
Poster 30,000 10,000 10,000 10,000 -
Inadequate and poor MCH services
Deworming campaign
Short refresher trainings of LHWs about balanced diet and provision of micro-
Batch of 50 LHWs For 1 Days
20 10 5 5 -
Page 73
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
nutrients
Gender discrimination
Provision/ Distribution of micro-nutrient supplements
Procurement of de-worming tablets
No. of courses
150,000 50,000 50,000 50,000 -
Worm infestation
Diagnosis and treatment of infections
Purchase of medicine ( Folic Acid)
Pack of 100 Tablets
150,000 50,000 50,000 50,000 -
Page 74
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
Purchase of medicine (Ferrous Sulphate)
Pack of 100 Tablets
150,000 50,000 50,000 50,000 -
2. ARI Malnutrition Health
promotion campaign
Messages on local cable networks
Monthly Telecast
36 12 12 12 Integrated Activity
Air contamination
Capacity building of health staff in Integrated Management of Childhood Illnesses
Messages through FM radio channels
Monthly Telecast
36 12 12 12 -
Page 75
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
(IMCI)
Over-crowding/Poor housing facilities
Provision of medicines for ARI
Printing and distribution of IPC material
Poster 30,000 10,000 10,000 10,000 -
Lack of proper sanitation
Timely referral of complicated cases
Training of medics and para-medics in IMCI
Batch 6 3 2 1 -
Seasonal variation
- Procurement of drugs
Oral Medicine Package
390,000 130,000 130,000 130,000 -
Lack of awareness
- - Injectable
78,000 26,000 26,000 26,000 -
Page 76
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
related to winter season and hygienic practices
Procurement of nebulizing drugs
Drug 6,000 3,000 1,500 1,500 -
3. Diarrhea
Poor Hygiene & sanitation
Coordination with TMA for improvement of water supply and sanitation
Quarterly co-ordination meetings with TMA and other agencies
Meetings
12 4 4 4 -
Page 77
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
Lack of safe drinking water
Awareness raising campaign
Messages on local cable network
Monthly Telecast
36 12 12 12 Integrated Activity
Unhygienic practices
Proper treatment of Diarrhea including ORT
Printing and distribution of IPC material
Poster 30,000 10,000 10,000 10,000 -
Lack of awareness among mothers about feeding and weaning
Health awareness in the community
Conduction of HES in Schools
Sessions 1,000 500 300 200 -
Page 78
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
practices
Capacity building of health staff in Integrated Management of Childhood Illnesses (IMCI)
Training of medics and paramedics in IMCI
Batch 6 3 2 1 In
tegrated Activity
- Procurement and distribution of ORS and Zinc
ORS packets
1,200,000 400,000 400,000 400,000 -
Page 79
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
Sulphate
Procurement and distribution of Zinc Sulphate
Syrup 600,000 200,000 200,000 200,000 -
4. TB Low socio-economic status
Health education/promotion
Messages on local cable networks
Monthly telecast
36 12 12 12 Integrated activity
Over-crowding/Poor housing facilities
Str
engthening TB DOTS program through involvement of
Messages through FM radio channels
Monthly telecast
36 12 12 12 Integrated activity
Page 80
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
private sector
Malnutrition - Printing and distribution of IPC and TB awareness material
Poster 30,000 10,000 10,000 10,000 -
Seasonal variation
- Procurement of drugs to address deficiency according to regimen
treatment day
6,000 2,000 2,000 2,000 -
Lack of proper
- Procurement of reagents
Diagnostics
- - - - Need Assessm
Page 81
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
sanitation and slides for notified diagnostic facilities under DOTS program
ent
5. Hepatitis
Poor sanitation
Health Education/Promotion
Quarterly co-
ordination meetings with TMA and other agencies
- 12 4 4 4 Integrated Activity
Unsafe drinking water
Campaign against quackery
Messages on local cable network
Monthly Package
36 12 12 12 Integrated Activity
Page 82
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
Sharing of used syringes
Strengthening blood transfusion services for safe transfusions
· Printing and distribution of IPC and hepatitis awareness material
Poster 20,000 10,000 5,000 5,000 -
Transfusion of
u
nsafe/unscreened blood and blood products
Campaign against drug addiction
Procurement and supply of screening kits
Kits 400,000 150,000 150,000 100,000 -
Unsafe sexual practices
Regulatory mechanism to ensure
Procurement of safety boxes
Syringe cutter
400 200 100 100 -
Page 83
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
use of safe instruments by dentists, barbers etc.
Ear piercing and tattooing
Procurement of drugs for treatment of Hepatitis patients
Injection 1,500 500 500 500 -
Use of unsterilized equipment by dentists and barbers
Develop and implement SOPs for sterilization of
- - - - - SOPs
Page 84
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
equipment
6. Scabies
Overcrowding in schools and homes
Awareness raising campaign
Community health education sessions
HES 100 50 25 25 No Cost
Low socio-economic conditions
Provision of medicines
Printing & Distribution of IPC Material
Brochure 15,000 5,000 5,000 5,000 -
Poor Health Education
- Supply of anti scabies drugs
drug 250,000 100,000 75,000 75,000 -
Page 85
Three Years Rolling Plan (2010-2013) District Lodhran
II. Management Problems
Human Resource Plan to bridge gap between MSDS and Existing sanctioned posts
Sr. No.
Name of Post
Basic
Scale
Basic Pay
Allowances
Requirement as per
Gap
Physical Targets
Year I Year II Year III
1 Gynaecologist 18 12,910
18,099 2 1 1 0
2 Paediatricians 18 12,910
18,099 4 2 1 1
3 Anesthetists 18 12,910
18,099 6 3 2 1
4 MO / WMO 17 9,850 15,345 67 33 17 17
Page 86
Three Years Rolling Plan (2010-2013) District Lodhran
5 Nurses 16 6,060 8,934 72 36 18 18
6 Lady Health Visitors 9 3,820 4,750 23 10 7 6
Page 87
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
1. Shortage of skilled staffs MNCH related
Non-availability of trained staff
Filling of the vacant posts
Filling of the vacant posts of medics and the paramedics through existing recruitment committees
- - - - - Recruitment
- Non-sanctioning of staff according to MSDS
Sanctioning of trained staffs according to MSDS
Temporary filling of vacant positions on contract
- - - - - Recruitment
- Lack of Incentivize Demand - - - - - Plan
Page 88
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
permanent postings
d pay package at all levels
generation and request to the Department of Health by the districts for recruitment through PSC against vacant posts
- Lack of incentivized and differential
Well defined career structure
Orientation trainings of the recruited staffs
Batch 7 3 2 2 -
Page 89
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
pay package
including opportunities for higher education
- Frequent transfer postings
High level political commitment for providing protection to staff working in health facilities
Consensus building between the districts for uniform incentivized pay package for all categories and levels
- - - - - Meeting
Page 90
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
staff
- Job insecurity
- Request to the Provincial Government for approval and implementation of agreed pay packages
- - - - - Plan
- Lack of basic amenities at
- Review and revise the career structure of
- - - - - Technical assistanc
Page 91
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
workplace medics and paramedics
e
- Lack of conducive environment including insecurity and transport of children for education
- Filling of Human Resource gaps as per MSDS
Posts 151 75 39 37 Detail HR plan is attached
- - - - Posts 23 10 7 6 Detail HR plan is attached
Page 92
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
- Political and media interference
- - HR 174 85 46 43 Detail HR plan is attached
2. Inadequate budget for POL
Generator provision for backup of electricity supply
Rational increase in POL budget
Assessment of additional requirement
- - - - - NO COST ACTIVITY
Less budget allocation
- Costing and submission of additional demand
- - - - - -
Page 93
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
· Frequent increase in prices
- Provision of POL budget for District Level supervisor
litre 86,400 28,800 28,800 28,800 -
Provision of POL budget for EPI
litre 27,000 9,000 9,000 9,000 -
Provision of POL budget for generator
litre 87,600 29,200 29,200 29,200 -
3. Deficient infra
Debilitated condition of existing
Make up the deficiencie
Identify the gaps in infrastructur
- - - - - Need Assessment
Page 94
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
structure
infra-structure
s against standards specified in MSDS
e of THQ and DHQ hospitals individually
- Lack of repair and maintenance
Devise appropriate mechanisms for repair and maintenance
Costing of the gaps
- - - - - Plan
- Inadequate infrastructure for
Provision of infrastruct
Phasing - - - - - Demand submission
Page 95
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
Emergency, Operation Theatre, OPD and Inpatients, residences for staff at THQ and DHQ hospitals
ure at THQ and DHQ according to the MSDS
- - Construction of residence of WMO at DHQ and
Construction of residences at DHQ hospital
1100 per squared yard
1,750 1,750 - - -
Page 96
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
THQ hospital
- - - Construction of residences at THQ hospitals (2*1)
1100 per square yard
3,500 1,750 1,750 - -
4. Lack of MNCH related equipments
Deficient equipment to cater basic and comprehensive EmONC at
Provision of the equipment in accordance with the notified
Procurement of equipments for THQ and DHQ hospitals based on the
- - - - - Detail attached
Page 97
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
primary and secondary level of care
equipment list
gaps between MSDS and existing available
Old and un-serviceable equipment
Provision of adequate budget for maintenance and repair
Allocation of enhanced amount for M&R of equipments
- - - - - Submission of demand
Shortage of regular budget for
Capacity building of staff
Orientation of staffs in maintenance
- - - - - Plan
Page 98
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
M&R regarding maintenance of log books of each equipment
of logos for equipments
5. Ineffective supervision / monitoring
No monitoring policy
Development of supervision/ monitoring policy
Training of district managers in supervision and monitoring
batch 6 2 2 2 -
Lack of Capacity building of
Procurement of
Vehicles 1 1 - - -
Page 99
Three Years Rolling Plan (2010-2013) District Lodhran
Problem CausesIntervention
Activity UnitPlan Activities Targets
Target for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
skills mangers transport for supervision
Inadequate resources
Arrange logistic support
- Vehicles 4 2 2 - -
Development and printing of monitoring tools
Stationery checklist visit form
300 100 100 100 -
Page 100
Three Years Rolling Plan (2010-2013) District Lodhran
SECTION 4: COSTING AND FINANCING PLAN
I. Activity based costing
The planning team has used the best available data sources, for calculation of estimates for the intervention/activities. It is pertinent to mention that the costing of the plan is based on additional needs and activities. The detailed activity based costing of the Health and Service Delivery problems has been performed on automated Excel sheets, which are annexed with the plan as Annex-III and Annex-IV. A moderate estimate of equipment cost has been taken, as there is wide variation between the minimum and maximum cost. The summary of activity and problem wise costing is given below.
Page 101
Three Years Rolling Plan (2010-2013) District Lodhran
a) Health Problems
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
1 Anemia in pregnancy
Messages on local cable network
Monthly Messages telecast packages
35,000 36 420,000
462,000
508,200 1,390,200
-
Printing and distribution of IPC material
Brochure
5 300,000 500,000
550,000
605,000 1,655,000
-
Printing and distribution
Poster 30 30,000 300,000
330,000
363,000 993,000 -
Page 102
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
of IPC material
Short refresher
trainings of LHWs about balanced diet and provision of micro-nutrients
Batch of 50 LHWs For 1 Days
79,000 20 790,000
434,500
477,950 1,702,450
-
· Procurement of de-worming tablets
No. of coursers
20 150,000 1
,000,000
1,100,000
1,210,000
3,310,000
-
Page 103
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
Purchase of medicine ( Folic Acid)
Pack of 100 Tablets
30 150,000 1,500,000
1,650,000
1,815,000
4,965,000
-
Purchase of medicine (Ferrous Sulphat)
Pack of 100 Tablets
50 150,000 2,500,000
2,750,000
3,025,000
8,275,000
-
2 ARI Messages on local cable networks
Monthly Telecast
- 36 _ _ _ - Integrated Activity
Messages
through FM radio channels
Monthly Telecast
35,000 36 420,000
462,000
508,200 1,390,200
-
Page 104
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
Printing and distribution of IPC material
Poster 30 30,000 300,000
330,000
363,000 993,000 -
Training of medics and Para-medics in IMCI
Batch 240,000 6 720,000
528,000
290,400 1,538,400
-
Procurement of drugs
Oral Medicine Package
70 390,000
9,100,000
10,010,000
11,011,000
30,121,000
-
Page 105
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
- Injectable
800 78,000 20,800,000
22,880,000
25,168,000
68,848,000
-
Procurement of nebbulizing drugs
Drug 30 6,000 90,000
49,500 54,450 193,950 -
3 Diarrheal diseases
Quarterly co-ordination meetings with TMA and other agencies
Meetings
3,000 12 12,000
13,200 14,520 39,720 -
Messages on local cable
Monthly
- 36 - - - - Integrated Activity
Page 106
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
network Telecast
Printing and distribution of IPC material
Poster 30 30,000 300,000
330,000
363,000 993,000 -
Conduction of HES in Schools
Sessions
2,000 1,000 1,000,000
660,000
484,000 2,144,000
-
Training of medics and paramedics in IMCI
Batch - 6 - - - - Integrated Activity
Procurement and
ORS packets
5 1,200,000
2,000,000
2,200,000
2,420,000
6,620,000
-
Page 107
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
distribution of ORS and Zinc Sulphate
Procurement and distribution of Zinc Sulphate
Syrup 60 600,000 12,000,000
13,200,000
14,520,000
39,720,000
-
4 TB Messages on local cable networks
Monthly telecast
- 36 - - - - Integrated activity
Messages through FM radio
Monthly telecas
- 36 - - - - Integrated activity
Page 108
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
channels t
Printing and distribution of IPC and TB awareness material
Poster 30 30,000 300,000
330,000
363,000 993,000 -
Procurement of drugs to address deficiency according to regimen
Treatment day
4,800 6,000 9,600,000
10,560,000
11,616,000
31,776,000
-
Procurement of reagents and slides for
Diagnostics
- - - - - - Need Assessment
Page 109
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
notified diagnostic facilities under DOTS program
5 Hepatitis
Quarterly co-ordination meetings with TMA and other agencies
- - 12 - - - - Integrated Activity
Messages on local cable network
Monthly Package
- 36 - - - - Integrated Activity
Page 110
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
Printing and distribution of IPC and hepatitis awareness material
Poster 30 20,000 300,000
165,000
181,500 646,500 -
Procurement and supply of screening kits
Kits 50 400,000 7,500,000
8,250,000
6,050,000
21,800,000
-
Procurement of safety boxes
Syringe cutter
500 400 100,000
55,000 60,500 215,500 -
Procurement of drugs for
Injection
15,000 1,500 7,500,000
8,250,000
9,075,000
24,825,000
-
Page 111
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
treatment of Hepatitis patients
Develop and implement SOPs for sterilization of equipment
- - - - - - - SOPs
6 Scabies Community health education sessions
HES - 100 - - - - No Cost
Printing & Distribution of IPC
Brochure
30 15,000 150,000
165,000
181,500 496,500 -
Page 112
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity
Year I Year II Year III
Material
Supply of anti scabies drugs
drug 50 250,000
5,000,000
4,125,000
4,537,500
13,662,500
-
- - - - - - - - -
- - - 84,202,000
89,839,200
95,265,720
269,306,920
-
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Three Years Rolling Plan (2010-2013) District Lodhran
b) Management Problems
Human Resource Plan to bridge between MSDS and existing Sanctioned posts
Sr. No.
Name of Post
BS
Basi
c Pa
y
Allo
wan
ces
Requirement as per Gap
Financial Targets
Year I Year II Year III
Pay of Officers
Pay of other staff
Allowances
Pay of Officers
Pay of other staff
Allowances
Pay of Officers
Pay of other staff
Allowances
Page 114
Three Years Rolling Plan (2010-2013) District Lodhran
1 Gynaecologist
18 12,910
18,099 2 154,920 - 217,188 340,824 - 477,814 374,906 - 525,595
2 Paediatricians 18 12,910
18,099 4 309,840 - 434,376 511,236 - 716,720 749,813 - 1,051,190
3 Anesthetists 18 12,910
18,099 6 464,760 - 651,564 852,060 - 1,194,534 1,124,719 - 1,576,785
4 MO / WMO 17 9,850
15,345 67 3,900,600 - 6,076,620 6,501,000 - 10,127,70
0
9,582,474 - 14,928,230
5 Nurses 16 6,060
8,934 72 2,617,920 - 3,859,488 4,319,568 - 6,368,155 6,335,366 - 9,339,961
6 Lady Health Visitors
9 3,820
4,750 23 - 458,400 570,000 -
857,208
1,065,900 -
1,275,727
1,586,310
Grand Total 7,448,040 458,400 11,809,236 12,524,688 857,208 19,950,82
3
18,167,279 1,275,727 29,008,071
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
1 Shortage of skilled staffs MNCH related
Filling of the vacant posts of medics and the paramedics through existing
- - - - - - - Recruitment
Page 115
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
recruitment committees
Temporary filling of vacant positions on contract
- - - - - - - Recruitment
Demand generation and request to the Department of Health by the districts for recruitment through PSC against vacant
- - - - - - - Plan
Page 116
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
posts
Orientation trainings of the recruited staffs
Batch 330,500 2,518,410
991,500
727,100
799,810 2,518,410
-
Consensus building between the districts for uniform incentivized pay package for all categories and levels staff
- - - - - - - Meeting
Request to the Provincial Government
- - - - - - - Plan
Page 117
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
for approval and implementation of agreed pay packages
Review and revise the career structure of medics and paramedics
- - - - - - - Technical assistance
Filling of Human Resource gaps as per MSDS
Posts - 38,140,007
7,448,040
12,524,688
18,167,279
38,140,007
Detail HR plan is attached
Page 118
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
Posts - 2,591,335
458,400
857,208
1,275,727
2,591,335
Detail HR plan is attached
HR - 60,768,130
11,809,236
19,950,823
29,008,071
60,768,130
Detail HR plan is attached
2 Inadequate budget for POL
Assessment of additional requirement
- - - - - - - NO COST ACTIVITY
Costing and submission of additional demand
- - - - - - - -
Provision of POL budget for
litre 75 7,149,600
2,160,000
2,376,000
2,613,600
7,149,600
-
Page 119
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
District Level supervisor
Provision of POL budget for EPI
litre 75 2,234,250
675,000
742,500
816,750 2,234,250
-
Provision of POL budget for generator
litre 75 7,248,900
2,190,000
2,409,000
2,649,900
7,248,900
-
3 Deficient infra structure
Identify the gaps in infrastructure of THQ and DHQ hospitals individually
- - - - - - - Need Assesment
Page 120
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
· Costing of the gaps
- - - - - - - Plan
Phasing - - - - - - - Demand submission
Construction of residences at DHQ hospital
1100 per squared yard
1,100 1,925,000
1,925,000
- - 1,925,000 -
Construction of residences at THQ hospitals (2*1)
1100 per squared yard
1,100 4,042,500
1,925,000
2,117,500
- 4,042,500 -
4 Lack of Procurement - - 16,628, 7,189, 9,438,5 - 16,628,0 Detail
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Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
MNCH related equipments
of equipments for THQ and DHQ hospitals based on the gaps between MSDS and existing available
045 500 45 45 attached
Allocation of enhanced amount for M&R of equipments
- - - - - - - Submission of demand
Orientation of staffs in maintenance of logos for equipments
- - - - - - - Plan
Page 122
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
5 Ineffective supervision / monitoring
Training of district managers in supervision and monitoring
batch 35,000 231,700 70,000 77,000 84,700 231,700 -
Procurement of transport for supervision
Vehicles
3,800,000 3,800,000
3,800,000
- - 3,800,000
-
- Vehicles
900,000 3,780,000
1,800,000
1,980,000
- 3,780,000
-
Development and printing of monitoring tools
Stationery checklist visit
10,000 3,310,000
1,000,000
1,100,000
1,210,000
3,310,000
-
Page 123
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Define Financial Targets Total Cost
Remarks
Unit Rate Quantity Year I Year II Year III
form
II. Financial Outlay including 3YRP Activities
The costing of the plan includes routine recurring budget with 15% price escalation for subsequent years and additional cost involved on the basis of health and management problems; which is essentially required to bring visible improvement in the health system. Other financial resources expected from provincial level through ADP and PMDGP are also part of this plan.. Overall financial outlay of the plan is as under:
a) Health Problems
Object Classifica
tion
2010-2011 2011-2012 2012-2013
Regular Additional
Total Regular Additional
Total Regular Additional
Total
A03907 547,637 840,000 1,387,637 629,783 924,000 1,553,783 724,250 1,016,40 1,740,65
Page 124
Three Years Rolling Plan (2010-2013) District Lodhran
Object Classifica
tion
2010-2011 2011-2012 2012-2013
Regular Additional
Total Regular Additional
Total Regular Additional
Total
0 0
A03902 1,800,250
2,150,000
3,950,250 2,070,288
2,200,000
4,270,288 2,380,831 2,420,000
4,800,831
A03820 - 12,000 12,000 - 13,200 13,200 - 14,520 14,520
A03927 73,142,000
71,090,000
144,232,000
84,113,300
76,774,500
160,887,800
96,730,295
84,451,950
181,182,245
A13101 4,546,900
- 4,546,900 5,228,935
- 5,228,935 6,013,275 - 6,013,275
A09501 - - - - - - - - -
A09601 20,578,000
- 20,578,000
23,664,700
- 23,664,700
27,214,405
- 27,214,405
A03903 - 1,000,000
1,000,000 - 660,000 660,000 - 484,000 484,000
A03801 - 1,510,00 1,510,000 - 962,500 962,500 - 768,350 768,350 Page 125
Three Years Rolling Plan (2010-2013) District Lodhran
Object Classifica
tion
2010-2011 2011-2012 2012-2013
Regular Additional
Total Regular Additional
Total Regular Additional
Total
0
A09601 20,578,000
- 20,578,000
23,664,700
- 23,664,700
27,214,405
- 27,214,405
A09404 600,000 7,600,000
8,200,000 690,000 8,305,000
8,995,000 793,500 6,110,500
6,904,000
A03807 15,448,250
- 15,448,250
17,765,488
- 17,765,488
20,430,311
- 20,430,311
A03906 313,150 - 313,150 360,123 - 360,123 414,141 - 414,141
A09802 - - - - - - - - -
A13001 6,026,000
- 6,026,000 6,929,900
- 6,929,900 7,969,385 - 7,969,385
Total 143,580,187
84,202,000
227,782,187
165,117,215
89,839,200
254,956,415
189,884,797
95,265,720
285,150,517
A03907 547,637 840,000 1,387,637 629,783 924,000 1,553,783 724,250 1,016,40 1,740,65Page 126
Three Years Rolling Plan (2010-2013) District Lodhran
Object Classifica
tion
2010-2011 2011-2012 2012-2013
Regular Additional
Total Regular Additional
Total Regular Additional
Total
0 0
b) Management Problems
Object Classificati
on
2010-2011 2011-2012 2012-2013
Regular Additional
Total Regular Additional
Total Regular Additional
Total
A03801 - 991,500 991,500 - 727,100 727,100 - 799,810 799,810
A09601 1,248,900
7,189,500
8,438,400
1,436,235
9,438,545
10,874,780
1,651,670
- 1,651,670
A01101 - 7,448,040
7,448,040
- 12,524,688
12,524,688
- 18,167,279
18,167,279
A01270 - 11,809,2 11,809,2 - 19,950, 19,950,8 - 29,008, 29,008,071
Page 127
Three Years Rolling Plan (2010-2013) District Lodhran
Object Classificati
on
2010-2011 2011-2012 2012-2013
Regular Additional
Total Regular Additional
Total Regular Additional
Total
36 36 823 23 071
A09501 1,150 5,600,000
5,601,150
1,323 1,980,000
1,981,323
1,521 - 1,521
A03820 - - - - - - - - -
A03807 9,223,000
5,095,000
14,318,000
10,606,450
5,604,500
16,210,950
12,197,418
6,164,950
18,362,368
A03902 645,150 1,000,000
1,645,150
741,923 1,100,000
1,841,923
853,211 1,210,000
2,063,211
A01102 - 458,400 458,400 - 857,208 857,208 - 1,275,727
1,275,727
A03903 - - - - - - - - -
A12402 - 3,850,000
3,850,000
- 2,117,500
2,117,500
- - -
Total 11,118,2 43,441,67 54,559,87 12,785,93 54,300,3 67,086,29 14,703,8 56,625,8 71,329,656Page 128
Three Years Rolling Plan (2010-2013) District Lodhran
Object Classificati
on
2010-2011 2011-2012 2012-2013
Regular Additional
Total Regular Additional
Total Regular Additional
Total
00 6 6 0 64 4 20 37
III. Summaries
a) Problem-wise Costing
i. Health Problem
Sr. No.
Problem FY I FY II FY IIITotal Cost Rs.
Amount Amount Amount Amount
Page 129
Three Years Rolling Plan (2010-2013) District Lodhran
(Rs.) (Rs.) (Rs.) (Rs.)
1 Aaemia in pregnancy
7,010,000 7,276,500 8,004,150 22,290,650
2 ARI 31,430,000
34,259,500
37,395,050
103,084,550
3 Diarrhoeal diseases 15,312,000
16,403,200
17,801,520
49,516,720
4 TB 9,900,000 10,890,000
11,979,000
32,769,000
5 Hebititus 15,400,000
16,720,000
15,367,000
47,487,000
6 Scabies 5,150,000 4,290,000 4,719,000 14,159,000
Total 84,202,000
89,839,200
95,265,720
269,306,920
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Three Years Rolling Plan (2010-2013) District Lodhran
ii. Management Problems
Sr. No.
ProblemFY I FY II FY III
Total Cost Rs.
Amount (Rs.)
Amount (Rs.)
Amount (Rs.)
Amount (Rs.)
1 Shortage of skilled staffs MNCH related
20,707,176 34,059,819 49,250,887
104,017,882
2 Inadequate budget for POL
5,025,000 5,527,500 6,080,250 16,632,750
3 Deficient infra structure
3,850,000 2,117,500 - 5,967,500
4 Lack of MNCH related equipments
7,189,500 9,438,545 - 16,628,045
5 Ineffective supervision / monitoring
6,670,000 3,157,000 1,294,700 11,121,700
Page 131
Three Years Rolling Plan (2010-2013) District Lodhran
Total 43,441,676 54,300,364 56,625,837
154,367,877
Page 132
Three Years Rolling Plan (2010-2013) District Lodhran
b) Activity-wise Costing
i. Health Problems
Sr. No.
Problem ActivityFY-I FY-II FY-III Total
1 Anemia in pregnancy Messages on local cable network
420,000 462,000 508,200 1,390,200
Printing and distribution of IPC material
500,000 550,000 605,000 1,655,000
Printing and distribution of IPC material
300,000 330,000 363,000 993,000
Short refresher trainings of LHWs about balanced diet and provision of micro-nutrients
790,000 434,500 477,950 1,702,450
Procurement of de-worming tablets
1,000,000
1,100,000
1,210,000
3,310,000
Purchase of medicine 1,500,00 1,650,00 1,815,00 4,965,000
Page 133
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem ActivityFY-I FY-II FY-III Total
( Folic Acid) 0 0 0
Purchase of medicine (Ferrous Sulphat)
2,500,000
2,750,000
3,025,000
8,275,000
2 ARI Messages on local cable networks
_ _ _ -
Messages through FM radio channels
420,000 462,000 508,200 1,390,200
Printing and distribution of IPC material
300,000 330,000 363,000 993,000
Training of medics and Para-medics in IMCI
720,000 528,000 290,400 1,538,400
Procurement of drugs 9,100,000
10,010,000
11,011,000
30,121,000
- 20,800,000
22,880,000
25,168,000
68,848,000
Page 134
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem ActivityFY-I FY-II FY-III Total
Procurement of nebbulizing drugs
90,000 49,500 54,450 193,950
3 Diarrheal diseases Quarterly co-ordination meetings with TMA and other agencies
12,000 13,200 14,520 39,720
Messages on local cable network
- - - -
Printing and distribution of IPC material
300,000 330,000 363,000 993,000
Conduction of HES in Schools
1,000,000
660,000 484,000 2,144,000
Training of medics and paramedics in IMCI
- - - -
Page 135
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem ActivityFY-I FY-II FY-III Total
Procurement and distribution of ORS and Zinc Sulphate
2,000,000
2,200,000
2,420,000
6,620,000
Procurement and distribution of Zinc Sulphate
12,000,000
13,200,000
14,520,000
39,720,000
4 TB Messages on local cable networks
- - - -
Messages through FM radio channels
- - - -
Printing and distribution of IPC and TB awareness material
300,000 330,000 363,000 993,000
Procurement of drugs to address deficiency according to regimen
9,600,000
10,560,000
11,616,000
31,776,000
Page 136
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem ActivityFY-I FY-II FY-III Total
Procurement of reagents and slides for notified diagnostic facilities under DOTS program
- - - -
5 Hepatitis Quarterly co-ordination meetings with TMA and other agencies
- - - -
Messages on local cable network
- - - -
Printing and distribution of IPC and hepatitis awareness material
300,000 165,000 181,500 646,500
Procurement and supply of screening kits
7,500,000
8,250,000
6,050,000
21,800,000
Procurement of safety boxes
100,000 55,000 60,500 215,500
Page 137
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem ActivityFY-I FY-II FY-III Total
Procurement of drugs for treatment of Hepatitis patients
7,500,000
8,250,000
9,075,000
24,825,000
Develop and implement SOPs for sterilization of equipment
- - - -
6 Scabies Community health education sessions
- - - -
Printing & Distribution of IPC Material
150,000 165,000 181,500 496,500
Supply of anti scabies drugs
5,000,000
4,125,000
4,537,500
13,662,500
- - - - -
- 84,202,000
89,839,200
95,265,720
269,306,920
Page 138
Three Years Rolling Plan (2010-2013) District Lodhran
ii. Management Problems
Sr. No.
Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
1 Shortage of skilled staffs MNCH related
Filling of the vacant posts of medics and the paramedics through existing recruitment committees
- - - -
- - Temporary filling of vacant positions on contract
- - - -
Demand generation and request to the Department of Health by the districts for recruitment through PSC against vacant posts
- - - -
Page 139
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
Orientation trainings of the recruited staffs
991,500 727,100 799,810 2,518,410
Consensus building between the districts for uniform incentivized pay package for all categories and levels staff
- - - -
Request to the Provincial Government for approval and implementation of agreed pay packages
- - - -
Review and revise the career structure of medics and paramedics
- - - -
Page 140
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
Filling of Human Resource gaps as per MSDS
7,448,040 12,524,688
18,167,279
38,140,007
- 458,400 857,208 1,275,727
2,591,335
- 11,809,236
19,950,823
29,008,071
60,768,130
2 Inadequate budget for POL
Assessment of additional requirement
- - - -
Costing and submission of additional demand
- - - -
Provision of POL budget for District Level supervisor
2,160,000 2,376,000
2,613,600
7,149,600
Provision of POL budget 675,000 742,500 816,750 2,234,25
Page 141
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
for EPI 0
Provision of POL budget for generator
2,190,000 2,409,000
2,649,900
7,248,900
3 Deficient infra structure
Identify the gaps in infrastructure of THQ and DHQ hospitals individually
- - - -
Costing of the gaps - - - -
Phasing - - - -
Construction of residences at DHQ hospital
1,925,000 - - 1,925,000
Construction of residences at THQ hospitals (2*1)
1,925,000 2,117,500
- 4,042,500
Page 142
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
4 Lack of MNCH related equipments
Procurement of equipments for THQ and DHQ hospitals based on the gaps between MSDS and existing available
7,189,500 9,438,545
- 16,628,045
Allocation of enhanced amount for M&R of equipments
- - - -
Orientation of staffs in maintenance of logos for equipments
- - - -
5 Ineffective supervision / monitoring
Training of district managers in supervision and monitoring
70,000 77,000 84,700 231,700
Procurement of transport for supervision
3,800,000 - - 3,800,000
Page 143
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Problem Activity Costing (Rs.)
FY-I FY-II FY-III Total
- 1,800,000 1,980,000
- 3,780,000
Development and printing of monitoring tools
1,000,000 1,100,000
1,210,000
3,310,000
- 43,441,676
54,300,364
56,625,837
154,367,877
Page 144
Three Years Rolling Plan (2010-2013) District Lodhran
SECTION 5: MONITORING & EVALUATION
The monitoring and evaluation targets and indicators mentioned below will be used to gauge the progress of implementation of the plan. Monitoring and evaluation of the three years rolling plan would be carried out through the proposed indicators, targets and means of verifications, by the district health authorities.
I. M&E of Plan
Indicators Target % Achievement
MoV Responsibility
Frequency of monitoring
Remarks
% of planned supervisory visits conducted
50 visits /year by each supervisor
Inspection Book
EDOH/DOH/ DDOH
Quarterly
Page 145
Three Years Rolling Plan (2010-2013) District Lodhran
Indicators Target % Achievement
MoV Responsibility
Frequency of monitoring
Remarks
% of RHCs with availability of specialists of essential specialties (Physician, Surgeon, Paediatrician and Gynaecologist)
10%
During 1st year
Pay Roll EDOH / DOH
6 monthly
% of health facilities with availability of essential MNCH related equipment (level specific)
10%
During 1st year
Stock Register
EDOH/ DOH/ MSs
6 monthly
Page 146
Three Years Rolling Plan (2010-2013) District Lodhran
Indicators Target % Achievement
MoV Responsibility
Frequency of monitoring
Remarks
Availability of relevant (MNCH) laboratory equipment at appropriate level of care
10%
During 1st year
Stock Register
EDOH/ DOH/MSs, Store keeper
Quarterly
% facilities with availability of essential medicines
10%
During 1st year
Stock Register
EDOH/ DOH/ MSs, Store keeper
Monthly
% of functional ambulances in the district
10%
(DHQH/ THQH/ RHCs)
Log Book EDOH/DOH/ Transport officer
Quarterly
% utilization of sanctioned budget
10% of yearly budget
Quarterly Reports
EDOH/ DOH/ MSs/ Accounts officer
Quarterly
Page 147
Three Years Rolling Plan (2010-2013) District Lodhran
Indicators Target % Achievement
MoV Responsibility
Frequency of monitoring
Remarks
% of facilities with availability of basic EmONC services
10% in 3 years
(50% during 1st year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
% of DHQ/THQ hospitals with Comprehensive EmONC services
10% in 3 years
(50% during 1st year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
% of facilities with availability of separate or partitioned room reserved exclusively for delivery
10% in 3 years
(50% during 1st year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
Page 148
Three Years Rolling Plan (2010-2013) District Lodhran
Indicators Target % Achievement
MoV Responsibility
Frequency of monitoring
Remarks
% of targeted pregnant women newly registered by LHW
500 pregnant women in 3 years
(300 during 1st year)
DHIS Report
EDOH/ Statistical Officer
Quarterly
% of targeted pregnant women received TT02 vaccine
500 pregnant women in 3 years
(300 during 1st year)
DHIS Report
EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
Delivery conducted by or under supervision of skilled persons reported
90%
(60% During 1st year)
DHIS Report
EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
Page 149
Three Years Rolling Plan (2010-2013) District Lodhran
Indicators Target % Achievement
MoV Responsibility
Frequency of monitoring
Remarks
%of target children between 18 0 23 months of age fully immunized
10%
(20,00 children)
DHIS Report
EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
% of referred cases attended
10% DHIS Report/ LHWs monthly report
EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
% of targeted eligible couples provided knowledge and information on Family Planning methods
70% LHW’s monthly/ quarterly report
EDOH/ Statistical Officer /Coordinator NP0FP&PHC
Quarterly
Page 150
Three Years Rolling Plan (2010-2013) District Lodhran
Indicators Target % Achievement
MoV Responsibility
Frequency of monitoring
Remarks
No. of meetings with participation from other sectors
12 meetings per year
Minutes of meetings
EDOH/ Focal person/s
Quarterly
Annex - I
Private Health Facilities in District Lodhran
(Data source: Information collected by the vaccinator at district level)
TEHSIL DUNYA PUR
S.No. Name of UCs Name of the Clinic Category
1 EID GAH WALI Al shifa hospital, railway road dunyapur Qualified MBBS
2DO
Lahore poly clinic, main bazaar, dunyapur.
Qualified MBBS
3DO
Al nawaz hospital, railway road, dunyapur
Qualified MBBS
4DO
Yousif children hospital, kamate more, dunyapur
Qualified MBBS
5 DO Arshed hospital, near KB bus stand, Qualified MBBS
Page 151
Three Years Rolling Plan (2010-2013) District Lodhran
dunyapur
6237/WB
Family hospital, dokota road adda zakhira, dunyapur
Qualified MBBS
7 EID GAH WALI Ghouri hospital, kahror road, dunyapur. Qualified MBBS
8342/WB
Family hospital makhdoom aali road, dunyapur
Qualified MBBS
9HOUSING SCHEME
Madni eye clinic main bahawalpur road. Dunyapur
Qualified MBBS
10 MUKHDOOM AALI Ali hospital, makhdool aali, dunyapur Qualified MBBS
Tehsil Kahror Pakka
11 Patwarian wala Kirn hospital, railway road. Kehrorpacca Qualified MBBS
12Patwarian wala
Sadaf hospital, railway road, kehrorpacca
Qualified MBBS
13Patwarian wala
Mahreen hospital, gali rehan wali , near thana sadar, kehrorpacca
Qualified MBBS
14Bakshiwala
Suhail surgical hospital near thq hospital, kehrorpacca
Qualified MBBS
15Bakshiwala
Javeed hospital, near thq hospital, kehrorpacca
Qualified MBBS
16Zaffar Abad
Bismillah complex nearMCB bank circular road, kehrorpacca
Qualified MBBS
17Bakshiwala
Haider hospital near peli kathi, kehrorpacca
Qualified MBBS
18 Dianat Pura Al wahid hospital near chandi chowk, Qualified MBBS
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Three Years Rolling Plan (2010-2013) District Lodhran
kehrorpacca
19 Bakshiwala Siraj hospital kehrorpacca Qualified MBBS
20Zaffar Abad
Bilal hospital, bilalstreet chowk bukhari, kehrorpacca
Qualified MBBS
21Patwarian wala
Masood hospital, chowk bukhari, kehrorpacca
Qualified MBBS
22Zaffar Abad
Wanjara hospital circular road, kehrorpacca
Qualified MBBS
23Dahnote
Ahsn hospital saeed chowk dhanot, kehrorpacca
Qualified MBBS
24Dahnote
Young walfare society hospital, dhanot, kehrorpacca
Qualified MBBS
25Fareed Abad
Atta hospital chowk buddan shah, kehrorpacca
Qualified MBBS
26Patwarian wala
Salamn eye clinic, circular road. Kehrorpacca
Qualified MBBS
27 Dianat Pura Zahid eye hospital, near peli othi Qualified MBBS
28Zaffar Abad
Sharif hospital old mailsi road, kehrorpacca
Qualified MBBS
29 Patwarian wala Shahhospital raiway road, kahrorpacca Qualified MBBS
Tehsil Lodhran
30 Gangay wala Kamal complex kahror road lodhran Qualified MBBS
31 Municipal Committee
Rasheed surgical hospital near children park lodhran
Qualified MBBS
32 Municipal Ali hospital near dhq hospital lodhran Qualified MBBSPage 153
Three Years Rolling Plan (2010-2013) District Lodhran
Committee
33 Municipal Committee
Hamza surgical hospital near dhq hospital, lodhran
Qualified MBBS
34 Railway Station Muhammadi surgivcal hospital, lodhran Qualified MBBS
35Gulab Pura
Wahid surgical hospital, cjhishti wali gali, lodhrn
Qualified MBBS
36Gangay wala
Waseem hospital near post office lodhran
Qualified MBBS
37 Gangay wala Nasir complex near kahror more lodhran Qualified MBBS
38 Municipal Committee
Al noor hospital galla mandi chidren park lodhran
Qualified MBBS
39 Gulab Pura Rehman hospitalnear lari adda lodhran Qualified MBBS
40Gangay wala
Masher hospital near purani chungi lodhran
Qualified MBBS
41Railway Station
Al badar hospitalnear super chowk lodhran
Qualified MBBS
Annex-II
Costing of Equipment gaps for DHQ and THQ Hospitals
DHQ HOSPITAL LODHRAN
Page 154
Three Years Rolling Plan (2010-2013) District Lodhran
Sr. No.
Equipment Standard as per MSDS
Available
Gap Cost/Unit
Total Cost
(Qty.)
C B A
1 CTG (Cardiac Tocography)
1 1 2 0 1 28500 28500
2 Foetal Doppler 3 5 5 0 3 10100 30300
3 Diagnostic Laparoscope
1 1 2 0 1 12000 12000
4 Bulb Sucker 10 20 20 10 0 45 0
5 Baby Warmer 3 3 6 0 3 8500 25500
6 Mechanical Sucker 3 3 6 4 0 2800 0
7 Fetal Stethoscope 4 4 4 4 0 150 0
8 Delivery Table 2 2 3 1 1 1750 1750
9 D&C Set 2 3 4 2 0 210 0
10 Outlet forceps 4 4 4 4 0 90 0
11 Myoma Screw 2 2 2 2 0 320 0
12 Kochers forceps 4 4 8 4 0 235 0
13 Volselum forceps 6 8 10 6 0 235 0
14 Lanes Tissue holding forceps
2 2 4 2 0 40 0
15 Vagi0l Retractors 10 10 10 10 0 350 0
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Three Years Rolling Plan (2010-2013) District Lodhran
16 Polypectomy forceps
2 2 2 2 0 750 0
17 Sponge holder 10 15 20 10 0 30 0
18 Uterine elevator 1 1 1 1 0 150 0
19 CosCo Speculum 6 10 10 6 0 550 0
20 Exami0tion light 3 3 6 2 1 1800 1800
21 Suction Curette 1 2 2 1 0 95 0
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo0tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 2 0 1 9500 9500
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo0tracheal tube, BP Apparatus, Chargeable light)
1 1 2 1 0 1100 0
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Three Years Rolling Plan (2010-2013) District Lodhran
24 Cardiac Monitor 1 1 2 5 0 5000 0
25 Pump Breast Electronic
1 1 1 1 0 2500 0
26 Vagi0l Hysterectomy Set
2 2 4 2 0 300 0
26.1 Toothed Tissue Forceps (8”)
2 2 4 2 0 55 0
26.2 Non0Tooted Tissue Forceps (8”)
2 2 4 2 0 55 0
26.3 Dissection Scissors (Curved 7”)
2 2 4 2 0 150 0
26.4 Dissection Scissors (Straight 7”)
2 2 4 2 0 150 0
26.5 Hysterectomy Clamps (Straight)
8 8 16 8 0 150 0
26.6 Hysterectomy Clamps (Curved)
8 8 16 8 0 175 0
26.7 Uterine Sound 2 2 4 2 0 90 0
26.8 Needle Holder (7”) 2 2 4 2 0 150 0
26.9 Needle Holder (10”)
2 2 4 2 0 30 0
26.1 Artery Forceps (Straight 6”)
16 16 32 16 0 110 0
26.11
Artery Forceps (Curved 6”)
16 16 32 16 0 125 0
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Three Years Rolling Plan (2010-2013) District Lodhran
26.12
Allis Forceps 8 8 16 8 0 230 0
26.13
Towel Clamps 8 8 16 8 0 125 0
26.14
Single blade Sims speculum
4 4 8 4 0 275 0
26.15
Double blade Sims speculum
4 4 8 4 0 250 0
26.16
Sponge holding forceps
8 8 16 8 0 20 0
26.17
Volselum forceps 4 4 8 4 0 250 0
26.18
Uterine Sound 2 2 4 2 0 150 0
26.19
Bladder Sound 2 2 4 2 0 150 0
27 Delivery Sets 10 10 15 10 0 0
27.1 Episiotomy Scissors
10 10 15 10 0 125 0
27.2 Straight Scissors 10 10 15 10 0 360 0
27.3 Needle holder 10 10 15 10 0 135 0
27.4 Non0toothed tissue forceps 8 inches
10 10 15 10 0 10 0
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Three Years Rolling Plan (2010-2013) District Lodhran
27.5 Toothed tissue forceps 8 inches
10 10 15 10 0 10 0
27.6 Sims Speculum single blade
20 20 30 20 0 275 0
27.7 Sims Speculum double blade
20 20 30 20 0 250 0
27.8 Sponge holding forceps
40 40 60 40 0 250 0
27.9 Artery forceps 40 40 60 40 0 275 0
27.1 Straight clamps (cord)
20 20 30 20 0 175 0
27.11
Vacuum Extractor pump
1 1 1 0 1 1900 1900
27.12
Towel clip 40 40 60 40 0 125 0
28 Caesarian Section 6 8 10 6 0 0
28.1 Scalpel 6 8 10 6 0 50 0
28.2 Artery Forceps Straight 6 inches
24 32 40 24 0 125 0
28.3 Artery Forceps Curved 6 inches
24 32 40 24 0 125 0
28.4 Artery forceps 8 inches
24 32 40 24 0 175 0
28.5 Myoma Scissors straight 7 inches
6 8 10 6 0 150 0
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Three Years Rolling Plan (2010-2013) District Lodhran
28.6 Dissecting scissors (curved) 7 inches
6 8 10 6 0 270 0
28.7 Green Armtage forceps 8 inches
24 32 40 24 0 30 0
28.8 Obstetric outlet forceps (pair)
6 8 10 6 0 90 0
28.9 Doyene’s Retractor
6 8 10 6 0 20 0
28.1 Small Retractors 12 16 20 12 0 30 0
28.11
Towel Clippers 24 32 40 24 0 125 0
28.12
Suction Nozzle 6 8 10 6 0 250 0
29 MNCH Related Radiology Equipments
0
29.1 Ultrasound Machine
1 2 3 1 0 57500 0
29.2 X0Ray Unit 50 kw 1 1 1 1 0 6000 0
29.3 Color Doppler 0 1 1 0 0 57500 0
29.4 Lead Screen for X0Ray Unit
1 1 1 1 0 300 0
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Three Years Rolling Plan (2010-2013) District Lodhran
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Go0dal Sheets
1 1 1 1 0 1000 0
29.6 Safe Light 1 1 1 1 0 500 0
29.7 X0RT Film Processing Tank
1 1 1 1 0 500 0
29.8 Chest Stand 1 1 1 1 0 450 0
29.9 X0Ray film Illumi0tor
2 2 2 2 0 400 0
29.1 X0Ray Film Hangers All sizes
4 4 4 4 0 400 0
30 MNCH Related Paediatrics Equipments
0
30.1 Paediatric Ventilator
1 2 2 0 1 12000 12000
30.2 Incubator 1 1 2 0 1 15000 15000
30.3 Photo Therapy Unit 1 1 1 1 0 2200 0
30.4 Over0head Radiant Warmer
1 1 1 1 0 9100 0
30.5 Infant Length Measuring Scale
2 2 2 2 0 500 0
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Three Years Rolling Plan (2010-2013) District Lodhran
30.6 Infant Weighing Machine
2 2 2 2 0 310 0
30.7 Nebulizer 1 1 2 1 0 2200 0
30.8 Billirubino0meter 1 1 2 1 0 3600 0
30.9 Exchange Blood Transfusion Set
1 1 2 0 1 200 200
30.1 0sal Probe Paed size
2 2 4 2 0 700 0
31 A0esthesia/ICU 0 0
31.1 A0esthesia Machine
1 1 2 1 0 32100 0
31.2 Ventilators 1 1 1 1 0 52500 0
31.3 Nebulizer 1 1 1 1 0 16500 0
31.4 Pulse Oximetry 1 1 1 1 0 2100 0
31.5 Defibrillator 1 1 1 1 0 5000 0
31.6 Airway Oral and 0sal
2 3 4 2 0 50 0
31.7 Tracheostomy tube (adult and paeds)
2 2 4 2 0 100 0
31.8 Face mask of all sizes
2 2 4 2 0 100 0
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Three Years Rolling Plan (2010-2013) District Lodhran
31.9 Double Cuff Tourniquet (for regio0l block)
1 2 2 1 0 320 0
31.1 AMBO bag adult 2 2 4 2 0 2450 0
31.11
AMBO Bag paeds 2 2 4 2 0 300 0
31.12
Red Rubber 0sal tubes all sizes without cuff
4 4 8 4 0 100 0
32 Blood Bank 0 0
32.1 Blood storage cabinet (10 bag capacity)
1 1 2 1 0 81200 0
32.2 Packed cell machine
1 1 1 1 0 6000 0
32.3 Cell Separator 1 1 1 1 0 522500 0
32.4 Freezer for Fresh Frozen Plasma
1 1 1 1 0 11500 0
32.5 Blood bag shaker 1 1 2 1 0 100 0
32.6 RH view box 2 2 4 2 0 100 0
32.7 Water bath 2 2 2 2 0 300 0
32.8 Micro0pipette 4 6 8 4 0 800 0
32.9 Blood grouping tiles
3 3 6 3 0 300 0
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Three Years Rolling Plan (2010-2013) District Lodhran
32.1 Plasma Extractor 1 1 1 1 0 1000 0
32.11
Platelets agitator 1 1 1 1 0 1000 0
32.12
Blood thawing bath
1 1 1 1 0 300 0
32.13
Microscopes 1 1 2 1 0 11500 0
33 Gy0e & Labour Room Related Laboratory Equipment
0
33.1 Hematology A0lyzer
1 1 1 1 0 42500 0
33.2 Electrolyte A0lyzer 1 1 1 1 0 62500 0
33.3 A0lyzer Bio0chemistry Semi0automatic
1 1 1 1 0 6900 0
33.4 Glucometer 2 2 2 2 0 250 0
33.5 Haemoglobino0meter
2 2 4 2 0 100 0
33.6 Centrifuge 1 1 2 1 0 13300 0
Grand Total= 718950
Page 164
Three Years Rolling Plan (2010-2013) District Lodhran
THQ HOSPITALSr. No.
Equipment Standard as per MSDS
Available
Gap Cost/Unit
Total Cost
(Qty.)
C B A
1 CTG (Cardiac Tocography)
1 1 1 0 1 28500 28500
2 Foetal Doppler
2 2 3 0 2 10100 20200
3 Diagnostic Laparoscope
1 1 1 1 0 12000 0
4 Bulb Sucker 5 10 20 5 0 45 0
5 Baby Warmer 2 2 3 2 0 8500 0
6 Mechanical Sucker
3 3 3 3 0 2800 0
7 Fetal Stethoscope
2 3 4 2 0 150 0
8 Delivery Table
2 2 2 2 0 1750 0
9 D&C Set 2 2 2 2 0 210 0
10 Outlet forceps
4 4 4 4 0 90 0
11 Myoma Screw
2 2 2 2 0 320 0
Page 165
Three Years Rolling Plan (2010-2013) District Lodhran
12 Kochers forceps
4 4 4 4 0 235 0
13 Volselum forceps
4 4 6 4 0 235 0
14 Lanes Tissue holding forceps
2 2 2 2 0 40 0
15 Vagi0l Retractors
4 4 6 4 0 350 0
16 Polypectomy forceps
2 2 2 2 0 750 0
17 Sponge holder
10 10 15 10 0 30 0
18 Uterine elevator
1 1 1 1 0 150 0
19 CosCo Speculum
4 6 6 4 0 550 0
20 Exami0tion light
3 3 3 1 0 1800 0
21 Suction Curette
1 1 2 0 1 95 95
Page 166
Three Years Rolling Plan (2010-2013) District Lodhran
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 1 0 1 9500 9500
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 1 1 0 1100 0
24 Cardiac Monitor
1 1 1 0 1 5000 5000
Page 167
Three Years Rolling Plan (2010-2013) District Lodhran
25 Pump Breast Electronic
1 1 1 0 1 2500 2500
26 Vagi0l Hysterectomy Set
2 2 2 2 0 300 0
26.1 Toothed Tissue Forceps (8”)
2 2 2 2 0 55 0
26.2 Non-Tooted Tissue Forceps (8”)
2 2 2 2 0 55 0
26.3 Dissection Scissors (Curved 7”)
2 2 2 2 0 150 0
26.4 Dissection Scissors (Straight 7”)
2 2 2 2 0 150 0
26.5 Hysterectomy Clamps (Straight)
8 8 8 8 0 150 0
26.6 Hysterectomy Clamps (Curved)
8 8 8 8 0 175 0
26.7 Uterine Sound
2 2 2 2 0 90 0
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Three Years Rolling Plan (2010-2013) District Lodhran
26.8 Needle Holder (7”)
2 2 4 2 0 150 0
26.9 Needle Holder (10”)
2 2 2 2 0 30 0
26.1 Artery Forceps (Straight 6”)
16 16 16 16 0 110 0
26.11
Artery Forceps (Curved 6”)
16 16 16 16 0 125 0
26.12
Allis Forceps 8 8 8 8 0 230 0
26.13
Towel Clamps
8 8 8 8 0 125 0
26.14
Single blade Sims speculum
4 4 4 4 0 275 0
26.15
Double blade Sims speculum
4 4 4 4 0 250 0
26.16
Sponge holding forceps
8 8 8 8 0 20 0
26.17
Volselum forceps
4 4 4 4 0 250 0
Page 169
Three Years Rolling Plan (2010-2013) District Lodhran
26.18
Uterine Sound
2 2 2 2 0 150 0
26.19
Bladder Sound
2 2 2 2 0 150 0
27 Delivery Sets 6 6 10 6 0 0
27.1 Episiotomy Scissors
6 6 10 6 0 125 0
27.2 Straight Scissors
6 6 10 6 0 360 0
27.3 Needle holder
6 6 10 6 0 135 0
27.4 Non-toothed tissue forceps 8 inches
6 6 10 6 0 10 0
27.5 Toothed tissue forceps 8 inches
6 6 10 6 0 10 0
27.6 Sims Speculum single blade
12 12 20 12 0 275 0
27.7 Sims Speculum double blade
12 12 20 12 0 250 0
Page 170
Three Years Rolling Plan (2010-2013) District Lodhran
27.8 Sponge holding forceps
40 40 40 40 0 250 0
27.9 Artery forceps
40 40 40 40 0 275 0
27.1 Straight clamps (cord)
20 20 30 20 0 175 0
27.11
Vacuum Extractor pump
1 1 1 1 0 1900 0
27.12
Towel clip 40 40 40 40 0 125 0
28 Caesarian Section
4 4 6 4 0 0
28.1 Scalpel 4 4 6 4 0 50 0
28.2 Artery Forceps Straight 6 inches
16 16 24 16 0 125 0
28.3 Artery Forceps Curved 6 inches
16 16 24 16 0 125 0
28.4 Artery forceps 8 inches
16 16 24 16 0 175 0
Page 171
Three Years Rolling Plan (2010-2013) District Lodhran
28.5 Myoma Scissors straight 7 inches
4 4 6 4 0 150 0
28.6 Dissecting scissors (curved) 7 inches
4 4 6 4 0 270 0
28.7 Green Armtage forceps 8 inches
16 16 24 16 0 30 0
28.8 Obstetric outlet forceps (pair)
4 4 6 4 0 90 0
28.9 Doyene’s Retractor
4 4 6 4 0 20 0
28.1 Small Retractors
8 8 12 8 0 30 0
28.11
Towel Clippers
16 16 24 16 0 125 0
28.12
Suction Nozzle
4 4 6 4 0 250 0
Page 172
Three Years Rolling Plan (2010-2013) District Lodhran
29 MNCH Related Radiology Equipments
0
29.1 Ultrasound Machine
1 1 2 1 1 57500 57500
29.2 X-Ray Unit 50 kw
1 1 1 0 1 6000 6000
29.3 Color Doppler 0 0 0 0 0 57500 0
29.4 Lead Screen for X-Ray Unit
1 1 1 1 0 300 0
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Go0dal Sheets
1 1 1 1 0 1000 0
29.6 Safe Light 1 1 1 1 0 500 0
29.7 X-RT Film Processing Tank
1 1 1 1 0 500 0
29.8 Chest Stand 1 1 1 1 0 450 0
29.9 X-Ray film Illumi0tor
2 2 2 2 0 400 0
Page 173
Three Years Rolling Plan (2010-2013) District Lodhran
29.1 X-Ray Film Hangers All sizes
4 4 4 4 0 400 0
30 MNCH Related Paediatrics Equipments
0 0
30.1 Paediatric Ventilator
1 1 2 1 1 12000 12000
30.2 Incubator 1 1 1 1 0 15000 0
30.3 Photo Therapy Unit
1 1 1 1 0 2200 0
30.4 Over-head Radiant Warmer
1 1 1 1 0 9100 0
30.5 Infant Length Measuring Scale
2 2 2 2 0 500 0
30.6 Infant Weighing Machine
2 2 2 2 0 310 0
30.7 Nebulizer 1 1 1 1 0 2200 0
30.8 Billiubino-meter
1 1 1 1 0 3600 0
Page 174
Three Years Rolling Plan (2010-2013) District Lodhran
30.9 Exchange Blood Transfusion Set
1 1 1 1 1 200 200
30.1 0sal Probe Paed size
1 2 2 1 0 700 0
31 A0esthesia/ICU
0
31.1 A0esthesia Machine
1 1 1 1 1 32100 32100
31.2 Ventilators 1 1 1 1 0 52500 0
31.3 Nebulizer 1 1 1 1 0 16500 0
31.4 Pulse Oximetry
1 1 1 1 0 2100 0
31.5 Defibrillator 1 1 1 1 0 5000 0
31.6 Airway Oral and 0sal
1 2 2 1 0 50 0
31.7 Tracheostomy tube (adult and paeds)
1 2 2 1 0 100 0
31.8 Face mask of all sizes
1 2 2 1 0 100 0
Page 175
Three Years Rolling Plan (2010-2013) District Lodhran
31.9 Double Cuff Tourniquet (for regio0l block)
1 1 1 1 0 320 0
31.1 AMBO bag adult
1 2 2 0 1 2450 2450
31.11
AMBO Bag paeds
2 2 2 0 2 300 600
31.12
Red Rubber 0sal tubes all sizes without cuff
4 4 4 4 0 100 0
32 Blood Bank 0 0
32.1 Blood storage cabinet (10 bag capacity)
1 1 1 1 0 81200 0
32.2 Packed cell machine
1 1 1 1 0 6000 0
32.3 Cell Separator
1 1 1 1 0 522500 0
32.4 Freezer for Fresh Frozen Plasma
1 1 1 1 0 11500 0
32.5 Blood bag shaker
1 1 1 1 0 100 0
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Three Years Rolling Plan (2010-2013) District Lodhran
32.6 RH view box 1 2 2 1 0 100 0
32.7 Water bath 2 2 2 2 0 300 0
32.8 Micro-pipette 4 4 6 4 0 800 0
32.9 Blood grouping tiles
3 3 3 3 0 300 0
32.1 Plasma Extractor
1 1 1 1 0 1000 0
32.11
Platelets agitator
1 1 1 1 0 1000 0
32.12
Blood thawing bath
1 1 1 1 0 300 0
32.13
Microscopes 1 1 1 1 0 11500 0
33 Gy0e & Labour Room Related Laboratory Equipment
0
33.1 Hematology A0lyzer
1 1 1 1 0 42500 0
33.2 Electrolyte A0lyzer
1 1 1 1 0 62500 0
Page 177
Three Years Rolling Plan (2010-2013) District Lodhran
33.3 A0lyzer Bio-chemistry Semi-automatic
1 1 1 1 0 6900 0
33.4 Glucometer 2 2 2 2 0 250 0
33.5 Haemoglobino-meter
1 1 1 1 0 100 0
33.6 Centrifuge 1 1 1 1 0 13300 0
Grand Total= 9438545
Page 178