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Orissa Npcc 08 09.Txt


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Orissa Npcc 08 09.Txt

  1. 1. Project Implementation Plan National Rural Health Mission (NRHM) Orissa 2008-09
  2. 2. ORISSA <ul><li>Demographic Profile </li></ul><ul><li>Total Population : 3.68 Crore </li></ul><ul><ul><li>Scheduled Tribe : 22.13% </li></ul></ul><ul><ul><li>Scheduled Caste : 16.53% </li></ul></ul><ul><ul><li>Urban Population : 15% </li></ul></ul><ul><li>No of Districts : 30 </li></ul><ul><li>Sex ratio : 972 </li></ul><ul><li>B.P.L : 47.15% </li></ul><ul><li>Life expectancy : 61.64 </li></ul>
  3. 3. Health Infrastructure <ul><li>Dist. HQ Hosp. : 32 </li></ul><ul><li>SD Hospitals : 22 </li></ul><ul><li>Other Hospitals : 120 </li></ul><ul><li>CHC : 231 </li></ul><ul><li>PHC : 117 </li></ul><ul><li>PHC (New) : 1162 </li></ul><ul><li>Sub-centers : 6688 </li></ul><ul><li>PPC : 79 </li></ul><ul><li>MHU : 90 </li></ul>
  4. 4. Human Resource 162 Radiographer 801 Laboratory Technician 1551 Health Supervisor (Female) 7121 Health Worker (Female) 4911 Health Worker (Male) 1551 Health Supervisor (Male) 2039 Pharmacist 2244 Staff Nurse 2629 Assistant Surgeon 824 Specialist 762 Medical Officers Number Category of post
  5. 5. * Sources NFHS - 3 State Goals 80 75 39%* Institutional deliveries 80 65 61* Full ANC 2010 2008-09 2005-06 2.1 2.2 2.4 SRS TFR 50 60 73- SRS /65* IMR 250 275 358 SRS MMR 85 70 44 ( 52%)* Full immunization 65 58 47 CPR 90 85 46.4 Deliveries with SBA
  6. 6. Important State Initiatives
  7. 7. Important State Initiatives <ul><li>Increase in MBBS seats in VSS, Burla and Berhampur Medical colleges (43 each). </li></ul><ul><li>Doubling of seats in DMLT (Lab. Tech.) & DMRT(X-ray Tech.) courses in 3 medical colleges. </li></ul><ul><li>33% increase in seats in all the 16 ANM training centres. </li></ul><ul><li>Enhancement of remuneration for contractual doctors in KBK and 3 difficult districts </li></ul><ul><li>Doubling of rate of daily diet for indoor patients </li></ul><ul><li>Doubling of State drug budget </li></ul>
  8. 8. Important State Initiatives <ul><li>Running of new courses </li></ul><ul><li>M.Sc Nursing course in Nursing College, Berhampur. </li></ul><ul><li>B.Sc Nursing course in SCB medical college from 2008-09. </li></ul>
  9. 9. Additional incentive for regular doctors ( Boudh, Phulbani & Gajapati) FOR KBK & 3 backward districts Rs. 8000 Rs. 5000 PHC/CHC/Area Hospitals/ PHC (New) Rs. 4000 Rs. 2000 DHH/SDH Revised Existing Level
  10. 10. Important State Initiatives <ul><li>Up gradation of post at entry level for doctors from class II to class I </li></ul><ul><li>Restructuring of cadre for better promotional avenues </li></ul><ul><li>Increase in specialist allowances from Rs. 150/- to Rs. 3000/-per month </li></ul><ul><li>Enhancement of remuneration for Junior doctors </li></ul><ul><li>Enhancement of service condition of paramedicals </li></ul>
  11. 11. State Budget Rs. in lakhs 100400.03 80191.81 69607.46 Total 50.00 50.00 50.00 Central Sponsored Plan 17046.05 14982.05 13231.75 Central Plan 25.3 64719.48 15119.50 2008-09 15.21 55658.20 9501.56 2007-08 51388.67 4937.04 2006-07 % increase Non-Plan State Plan Financial Year
  12. 12. NRHM State PIP 2008-09
  13. 13. RCH-II Maternal Health <ul><li>Improve facilities in health institutions </li></ul><ul><li>Strengthening Referral transport </li></ul><ul><li>Improve access to services </li></ul><ul><li>Enhance institutional deliveries (JSY) </li></ul><ul><li>Capacity Building of MOs and Paramedics </li></ul><ul><li>Training of TBAs </li></ul><ul><li>Improving out reach services </li></ul><ul><li>Strengthening the fixed health day </li></ul><ul><li>Clinical and Social Audit of Maternal deaths </li></ul><ul><li>Advocacy & IEC </li></ul><ul><li>New schemes </li></ul>
  14. 14. Operationalisation of FRUs <ul><li>Basic 3 criteria of GOI guideline to operationalise FRU </li></ul><ul><li>Micro Planning for FRUs & 24X7 - Workshops, Field visits, Review & modification </li></ul>More than three criteria 16 5 Three criteria absent 24 4 Two criteria absent 48 3 One criteria absent 39 2 Fulfills all criteria* 22 1 Features Numbers Category
  15. 15. Operationalisation of Facilities
  16. 16. RCH II- Janani Surakhya Yojana <ul><ul><ul><li>Total JSY beneficiaries : 6.60lakhs </li></ul></ul></ul>Institutional Home 513544 340,966 151452 21126 8598.96 146592 Total 2443.80 75752 2006-07 5901.33 65,559 2007-08(till Jan) 253.83 5281 2005-06 Financial Assistance (Rs. In lakhs) Mothers benefited Year
  17. 17. Impact of Janani Surakhya Yojana (JSY)
  18. 18. Impact of Janani Surakhya Yojana (JSY)
  19. 19. Janani Surakhya Yojana (JSY)
  20. 20. JSY Proposal for 2008-09 <ul><li>Total no of deliveries - 9.54 lakhs </li></ul><ul><li>Targetted Coverage under JSY - 85% </li></ul><ul><li>Institutional Coverage - 75% </li></ul><ul><li>Rural beneficiaries - 80% </li></ul><ul><li>Total amount proposed - Rs.11051.25lakhs </li></ul><ul><li>Strengthening District cell </li></ul><ul><li>Cheque payment for ASHA </li></ul><ul><li>Free of cost Referral transport Facility </li></ul>
  21. 21. Operationalisation of FRUs Strategy - Anaesthesia (Short Term Course) -18x2 batches - 36 - Already trained - 18 - In service PG & others - 4 - Private Medical College - 6 - Total - 64
  22. 22. Operationalisation of Facilities <ul><li>Multi Skilling of MBBS Doctors </li></ul><ul><li> - Anesthesia - 23 </li></ul><ul><li> - Emoc - 12 </li></ul><ul><li>Blood Storage Training- 104 </li></ul><ul><li>Emoc Training </li></ul><ul><li>- No. to be trained 8x2 batches(16 Doctors) </li></ul><ul><li>( To be placed to FRUs having higher delivery load) </li></ul><ul><li>RTI/STI Training - 488 </li></ul><ul><li>Blood Storage training for MO/LT- 20 </li></ul><ul><li>PNDT Training - 540 </li></ul>
  23. 23. Operationalisation of Facilities <ul><li>SBA Training </li></ul><ul><li>District Level TOT - 30 Districts </li></ul><ul><li>15 days Training - 367/748 </li></ul><ul><li>21 days Training - 78/487 </li></ul><ul><li>Trg of MOs, O&G, Paediatrician- 422 </li></ul><ul><li>Training of Paramedical - 264 </li></ul><ul><li>No of Venues operational - 57 </li></ul><ul><li>No of Districts Trg initiated - 21 </li></ul>
  24. 24. New Schemes <ul><li>Janani Sahayata Yojana </li></ul><ul><ul><li>- Accreditation of Private Hospitals for Institutional Delivery for BPL women </li></ul></ul><ul><ul><li>- Rs. 2000/- to be reimbursed to the institutions </li></ul></ul><ul><ul><li>- Rs. 500/- to the Beneficiary </li></ul></ul><ul><li>Incentive for Institutional Delivery </li></ul><ul><li>- To Health Providers at Block and Sub Block level </li></ul><ul><li>- Gradation of institutions as per specialist availability and delivery load </li></ul><ul><li>- An amount of Rs.200 per delivery after the prescribed limit </li></ul><ul><li>- Incentive amount to be provided </li></ul><ul><li>- 50% to Medical officer </li></ul><ul><li>- 25% to RKS </li></ul><ul><li>- 25% to Staff </li></ul>
  25. 25. Comments and Compliance <ul><li>RCH- Goal for 2008-09 Already included </li></ul><ul><li>Maternal health Strategy Already included </li></ul><ul><li>JSY break up for institutional </li></ul><ul><li>and Home delivery Already provided </li></ul><ul><li>Facility augmentation </li></ul><ul><li>and planning Already provided </li></ul><ul><li>Emphasis on PNC Planned through </li></ul><ul><li>Motivation by ASHA </li></ul><ul><li>Strengthening of VHND </li></ul><ul><li>Training Other mismatch corrected </li></ul>
  26. 26. BUDGET SUMMARY OF MATERNAL HEALTH FOR THE YEAR 2008- 09 Rs. in Lakhs   13,818.82 953.65 14,772.47 Total of Maternal Health 11,051.25 800.00 11,851.25 JSY 2,767.57 153.65 2,921.22 Sub-Total     0.54 Other     245.16 Incentive for Institutional delivery     9.60 Matru Smriti Yojana     30.00 Orientation of SHG to support VHND     1,147.26 Janani Suraksha Yojana (Other strategies)     434.89 Integrated outreach RCH services     37.20 Operationalise RTI/STI services at health facilities     15.78 Operationalise MTP services at health facilities     231.04 Referral Transport (Janani Express)     578.70 Operationalise PHCs to provide 24-hour services     191.05 Operationalise Block PHCs/CHCs/ SDHs/DHs as FRUs Balance proposed in 2008-09 PIP Unspent balance of previous year Total Budget Programme
  27. 27. Child Health Progress so far <ul><li>IMNCI training in 12 high IMR districts Basic Health Worker–1908 </li></ul><ul><li>Special New Born Care Unit (II) established in Mayurbhanj. </li></ul><ul><li>Prustikar Diwas for treating Malnourished children. </li></ul><ul><li>Treatment Protocol developed for Prustikar Diwas </li></ul><ul><li>53% full immunization achieved </li></ul>
  28. 28. <ul><li>IMNCI training in 10 Districts -2976 </li></ul><ul><li>FBNC training - 384 </li></ul><ul><li>Establishment of SNCU - I in FRUs </li></ul><ul><li>Establishment of SNCU - II in 5 Districts </li></ul><ul><li>Establishment of SNCU - III in 3 Medical colleges </li></ul><ul><li>School Health programme 6 to 11 year </li></ul><ul><ul><li>30% of the total child population of 232000 </li></ul></ul><ul><li>Support to Prustikar Diwas </li></ul><ul><ul><li>Investigation costs </li></ul></ul><ul><ul><li>Equipments </li></ul></ul><ul><ul><li>Referral transport cost </li></ul></ul>RCH Child Health Proposal
  29. 29. <ul><li>Nutrition Rehabilitation Centre (NRC) </li></ul><ul><li>Establishment of NRC in Kalahandi & Mayurbhanj </li></ul><ul><li>Incentive Scheme for Full immunisation </li></ul><ul><li>Rs 500/- incentive on completion of full immunisation to mother from supported OHSP funds </li></ul><ul><li>NIPI Supported activities </li></ul><ul><li>Home Based New born care Training for ASHAs in one District </li></ul><ul><li>Strengthening of the Block and District Child Health Resource units </li></ul>Child Health Proposal
  30. 30. Compliances <ul><li>FBNC target for Medical Officers and staff nurse enhanced from 125 to 384 </li></ul><ul><li>IMNCI logistic like drugs and monitoring has been included under procurement and institutional strengthening in RCH-II </li></ul><ul><li>Details of SNCU-I implies new born care corner, which has been provided under detailed compliance write up </li></ul><ul><li>IYCF dissemination activities included under BCC/ IEC activities. </li></ul><ul><li>Detailed section on child health provided in the revised PIP </li></ul>
  31. 31. BUDGET SUMMARY OF CHILD HEALTH FOR THE YEAR 2008- 09 869.84 95.86 965.70 Total     53.50 Addl Support for Immunization     115.64 Support for Prustikar Divas     34.10 Care of Sick Children and Severe Malnutrition at FRUs     352.40 School Health Programme     410.06 Facility Based Newborn Care/FBNC Balance proposed in 2008-09 PIP Unspent balance of previous year Total Budget Programme Rs. in Lakhs  
  32. 32. Immunisation Compliance <ul><li>Status Report on training Provided. </li></ul><ul><li>Training of health worker presently ongoing. </li></ul><ul><li>RIMS upload status completed in 15 districts. </li></ul><ul><li>Unicef support for monitoring of training sessions. </li></ul>
  33. 33. RCH-II Family Planning <ul><li>Total No of sterilization (Dec’ 07) – 52106 </li></ul><ul><li>IUD insertion (Dec’07) – 15033 </li></ul><ul><li>New compensation package from Dec’07 </li></ul><ul><li>Contraceptive update training – 20 </li></ul><ul><li>SSD Training for 166 (MOs & Paramedics) </li></ul><ul><li>Regular District & State Quality Assurance Committee meetings. </li></ul><ul><li>73 Accredited Family Planning institutions in the private sector </li></ul>
  34. 34. <ul><li>Female sterilization target – 1,60,000 </li></ul><ul><li>NSV -- 10,000 </li></ul><ul><li>IUD -- 2,00,000 </li></ul><ul><li>Sterilization and NSV on fixed days </li></ul><ul><li>Training </li></ul><ul><li>Contraceptive update (MOs) - 500 </li></ul><ul><li>Mini Lap - 180 </li></ul><ul><li>Laparoscopy - 180 </li></ul><ul><li>NSV - 50 </li></ul><ul><li>Establishing Condom vending machine </li></ul><ul><li>Piloting female condoms </li></ul><ul><li>NSV campaign </li></ul><ul><li>Accreditation of Private institutions </li></ul>RCH - II Family Planning(Proposal)
  35. 35. Compliance <ul><li>BCC/ IEC plan on Family Planning included under BCC/ IEC Component </li></ul><ul><li>Fixed day sterilization and NSV concept specified in the PIP. </li></ul><ul><li>Progress Monitoring, quality and audits by QA committee proposed in PIP </li></ul><ul><li>Trainers for minilap, laparoscopic, NSV, IUD already available </li></ul><ul><li>NSV, minilap, IUD kits have been included under procurement </li></ul><ul><li>Repair, maintenance and procurement of laparoscopes are being undertaken from 2007-08 funds </li></ul><ul><li>Incentive to the MOs to be provided for achieving highest sterilization after a fixed benchmark </li></ul>
  36. 36. BUDGET SUMMARY OF FAMILY PLANNING FOR THE YEAR 2008- 09 Balance proposed in 2008-09 PIP Unspent balance of previous year Total Budget Programme Rs. in Lakhs   213.53 4.70 218.23 Total     13.60 Other     15.00 Quality Assurance committee meeting expenditure     10.20 Advisory committee meetings expenses for district     1.00 Incentive to MO achieving Highest Sterilization     20.00 Compensation for IUD Acceptance     2.78 Mobility at the State & District Level     19.70 Condom Vending machine & Recurring cost     62.91 Spacing Methods     73.04 Terminal/Limiting Methods
  37. 37. RCH-II Adolescent Health (Progress) <ul><li>TOT for five districts completed. </li></ul><ul><li>Training Manual for ANMs & LHVs developed in Oriya language </li></ul><ul><li>Sensitisation training of district level personnel undertaken. </li></ul><ul><li>Planning for operationalisation of adolescent Health clinics. </li></ul><ul><li>Convergence with MNGOs and establishment of adolescent ‘Saathi’ Centres. </li></ul><ul><li>The budget for the component proposed – Rs.42.30 lakhs </li></ul>
  38. 38. Compliance on ADOLESCENT HEALTH <ul><li>Monitoring & evaluation Matrix - Shared with Prog </li></ul><ul><li>Managers </li></ul><ul><li>Use of Matrix for - Shall be used </li></ul><ul><li>monitoring </li></ul><ul><li>& evaluation </li></ul><ul><li>Standards of services - Included in the revised </li></ul><ul><li>PIP </li></ul><ul><li>State Adolescent Health - monitor the accessibility & </li></ul><ul><li>Centre quality of services in the AFHC. </li></ul><ul><li>Indicators for monitoring - Being Developed </li></ul><ul><li>ARSH services </li></ul>
  39. 39. <ul><li>Monitoring quality of ARSH services - During monitoring of </li></ul><ul><li>other </li></ul><ul><li>NRHM activities. </li></ul><ul><li>The budget for repair - Amount has been </li></ul><ul><li>excluded. </li></ul><ul><li>Implementation Guidelines would be followed to expand quality, access and profile of services. </li></ul><ul><li>Operational plan included in the PIP and also the training budget for ARSH has been included under the training component. </li></ul><ul><li>Proposed to designate SCB Medical College, Cuttack as the State Adolescent Health Centre. The terms of reference have been included in the PIP. </li></ul>
  40. 40. RCH-II Urban Health(Progress) <ul><li>Guidelines developed for PPP in Urban Slum Health for Tier-I and Tier – II Programme </li></ul><ul><li>11 NGOs selected and supported to manage Tier-I Urban Health Centres. </li></ul><ul><li>Urban Health Advisory Committee under the Chairmanship of Municipality Chairman formed. </li></ul>
  41. 41. Proposal for Urban Health <ul><li>6 Additional Tier-I and 4 Tier-II Urban Health Centres to be established </li></ul><ul><li>Laboratory services and other services under National Health Programmes like DOTS, NVBDCP and Family Planning services including IUD, NSV, RTI, STI and referral to the 2nd Tier. </li></ul><ul><li>Two Tier Referral Centre of Municipal areas will be strengthened and upgraded. </li></ul><ul><li>Appointment of Urban ASHAs. </li></ul><ul><li>Mega Slum Health Mela. </li></ul><ul><li>A total budget Rs. 324 lakhs is proposed </li></ul>
  42. 42. Compliances <ul><li>Designated Nodal officer at State & District for Urban Slum Health Programme </li></ul><ul><li>Advisory committee for USHP constituted for policy & technical support </li></ul><ul><li>Programme has already been started during 07-08, Rs-28.01 lakhs disbursed </li></ul><ul><li>During 2007-08 substantial time taken in developing process and NGO selection. In 08-09 activities shall be accelerated </li></ul>
  43. 43. <ul><li>Regional Workshop on tribal health needs and issues. </li></ul><ul><li>Prototype message design on IEC/BCC </li></ul><ul><li>Tribal study. </li></ul><ul><li>Swasthya Mela in 118 Tribal sub plan blocks. </li></ul><ul><li>Maternity waiting hall at 10 blocks on pilot basis. </li></ul><ul><li>RCH camps in approximately 2330 Tribal dominated sub centres. </li></ul>RCH-II Tribal Health Proposal
  44. 44. Compliances <ul><li>Designated state consultant to look after Tribal Health programme. </li></ul><ul><li>Local specific strategies developed to address Tribal health issues. </li></ul><ul><li>Innovative strategies- Delivery Huts in tribal dominated Blocks. </li></ul><ul><li>Expenditure made – Rs - 23.73 lakhs against released amount- Rs.68.43 </li></ul><ul><li>Total budget proposed Rs 284.29 lakhs </li></ul>
  45. 45. <ul><li>Workshops/Consultative meeting on health needs </li></ul><ul><li>Mapping of facilities, needs of vulnerable group </li></ul><ul><li>Referral transport for pregnant women to the institution </li></ul><ul><li>Establishment of maternity waiting hall </li></ul><ul><li>Undertaking need based health intervention for Vulnerable groups. </li></ul><ul><li>A total of Rs. 67.10 lakhs proposed </li></ul>RCH-II Vulnerable Groups Proposal
  46. 46. Behaviour Change Communication <ul><li>Provision in PIP for Skill Enhancement Training for District & Block level Health Officials </li></ul><ul><li>Innovative BCC Programmes are in line with Activities Outlined in PIP </li></ul><ul><li>Strategies & Activities have been designed to suit District & Local requirements </li></ul><ul><li>Many BCC Activities in current PIP were not before implementation of NRHM </li></ul>
  47. 47. Behavior change communication <ul><li>Strategies & Activities as per the Provisions of ‘Intra-Communication Flow Chart’. </li></ul><ul><li>BCC Consultants & Officials of different Programmes made to Operate from SIHFW-Nodal BCC Directorate. </li></ul><ul><li>‘ Supervision & Monitoring’ streamlined by appointing District-wise Nodal Officers. </li></ul><ul><li>Innovations/Advocacy Tools to be Publicized through a ‘News Letter’ for use by Stakeholders. </li></ul>
  48. 48. Behaviour change communication <ul><li>Steps have been taken for Integrating BCC at Implementation level </li></ul><ul><li>Details of Activities have been enumerated in both District & Sub-District level Action Plan </li></ul><ul><li>Discrete BCC Activities have been planned under each Component with emphasis on ‘Theme-based Campaign’ </li></ul>
  49. 49. New BCC Initiatives by State <ul><li>SIHFW - officially made to function as the Nodal Centre for all IEC/BCC Activities </li></ul><ul><li>‘ Communication Facilitators’ placed in Strategic locations for facilitating Integrated BCC Implementation </li></ul><ul><li>Exhaustive Guidelines (both Operational & Financial) supplied to Districts better ‘Programmatic Intervention’ </li></ul><ul><li>‘ Monitoring & Supervision’ strengthened by appointing District wise Nodal Officers </li></ul>
  50. 50. New BCC Initiatives by State <ul><li>Initiatives taken to set up an ‘Integrated BCC Cell’ that will work as Technical Hub </li></ul><ul><li>NRHM is making the best use of GRAMSAT platform for sensitizing & educating Stakeholders </li></ul><ul><li>A total of Rs. 210.35 lakhs is proposed </li></ul>
  51. 51. Monitoring & Evaluation <ul><li>Integrated approach for redesigning the MIES field level format </li></ul><ul><li>Capacity Building training undertaken </li></ul><ul><li>Regular Reporting to GOI on integrated MIES since April 2007 </li></ul><ul><li>New MIS registers printed and distributed to Districts and Sub district </li></ul><ul><li>Data centre being established at district level </li></ul><ul><li>GIS mapping for different programme on major indicators </li></ul><ul><li>NIC involved in developing web enabled HMIS </li></ul><ul><li>IT infrastructure with internet connectivity provided to district and sub-district </li></ul><ul><li>AMC process being initiated for IT infrastructure </li></ul>
  52. 52. Compliances <ul><li>Regular reporting on new MIES format since April 2007 </li></ul><ul><li>District Data centre being established for integration of all programmes information </li></ul><ul><li>SRS 2006 data used as vital information </li></ul><ul><li>The M & E strategy and budget designed for different programmes as per PIP frame work. </li></ul><ul><li>GIS being used to map health care resources and also as a tool & for planning and monitoring for different. </li></ul>
  53. 53. <ul><li>Computerisation, manpower and MIS training has been kept under institutional strengthening under Monitoring & Evaluation. </li></ul><ul><li>Evaluation survey and study reports like SRS, DLHS-II, NFHS-III, CES-2006, Regional Evaluation Team report observation has been taken up for situational analysis and planning. </li></ul><ul><li>Record keeping register designing being initiated. </li></ul>Compliances
  54. 54. PPP in PHC management <ul><li>Contracting out 20 nos. of PHC (N) and 5 CHCs to private agencies including corporate bodies. </li></ul><ul><li>Develop and establish accreditation process to facilitate partnership with credible NGOs & finalization of the PPP policy for the State. </li></ul><ul><li>Recruitment of AYUSH doctors in PPP PHC[N] </li></ul>
  55. 55. RCH NGO Programme <ul><li>Continuation of MNGO programme in 22 districts and selection of MNGOs in 8 vacant districts with training support by RRC. </li></ul><ul><li>Mid Term Evaluation of selected MNGOs on completion of one / two years performance. </li></ul><ul><li>MNGOs / FNGOs convention at State level with the support of RRC. </li></ul><ul><li>ASHA Training through MNGOs & FNGOs. </li></ul>
  56. 56. PPP in PHC Management <ul><li>Undertake social marketing of contraceptive and RCH Goods by PPP NGOs. </li></ul><ul><li>Facilitating formation of Village Health and Sanitation Committee in revenue villages through PPP NGOs. </li></ul><ul><li>A total of Rs 730.59 lakhs proposed </li></ul>
  57. 57. <ul><li>Mapping of Human Resource </li></ul><ul><li>Development of HR system for contractual staff </li></ul><ul><li>Performance appraisal and reward system </li></ul><ul><li>Management Development Programmes for Medical officers </li></ul><ul><li>Special allowance for Emoc and anaesthesia trained Medical officers </li></ul><ul><li>Training of staff in logistics management </li></ul><ul><li>Strengthening of M&E cell and state level data centre </li></ul>INSTITUTIONAL STRENGTHENING
  58. 58. <ul><li>Establishment of District level data centre </li></ul><ul><li>Strengthening of existing HMIS </li></ul><ul><li>Development web based programme and financial reporting system </li></ul><ul><li>Monitoring and supervision of programmes </li></ul><ul><li>Mobility expenses of Districts and Blocks </li></ul>INSTITUTIONAL STRENGTHENING
  59. 59. <ul><li>Additional ANM- 620 </li></ul><ul><li>Additional staff Nurse- 764 </li></ul><ul><li>Equipment maintenance at the district and Blocks </li></ul><ul><li>Rent of of 3921 Sub-centres </li></ul><ul><li>Repair of 400 Sub-centres </li></ul><ul><li>Provision of Drinking Water for 100 Sub centres </li></ul>Infrastructure and Human Resource
  60. 60. Programme Management <ul><li>SPMU and DPMU established and functional </li></ul><ul><li>BPMU established </li></ul><ul><li>Block Programme organiser - 203 </li></ul><ul><li>Block Accountant - 132 </li></ul><ul><li>Training of all BPOs undertaken </li></ul><ul><li>Performance Based appraisal for contract renewal </li></ul><ul><li>Basic office infrastructure and mobility support provided </li></ul><ul><li>to Programme Management units </li></ul><ul><li>Revised TOR for DPMU and BPMU developed and circulated </li></ul>
  61. 61. <ul><li>Strengthening of State Programme Management Unit </li></ul><ul><li>- Joint Director (Technical) </li></ul><ul><li>- Joint Director (Adminstration) </li></ul><ul><li>- Programme Associate - 1 </li></ul><ul><li>- Junior Engineer - 1 </li></ul><ul><li>- Adminstrative Assistant -1 </li></ul><ul><li>Additional support staff </li></ul>Programme Management
  62. 62. <ul><li>Strengthening of District Programme Management </li></ul><ul><li>- Associate Programme Manager </li></ul><ul><li>- Office Assistant in all DPMUs </li></ul><ul><li>- An accountant in all DPMUs </li></ul><ul><li>Strengthening Sub-block level institution </li></ul><ul><li>- Accounts assistant to 1162 PHC(N) </li></ul>Programme Management
  63. 63. <ul><li>Development of Accounting Softwares </li></ul><ul><li>Training of District and block level officials in Finance and software application </li></ul><ul><li>Operationalise E-Banking to the Block level </li></ul><ul><li>Training of Programme Management Staff </li></ul><ul><li>Annual and Concurrent Audit </li></ul>Programme Management
  64. 64. RCH –II Budget Summary 08-09 Rs in lakhs 11051.25 1760.00 22617.44 JSY Compensation for Sterilization NSV Acceptance TOTAL 46.59 GIS & Public Health 14 567.13 Programme Management 13 189.26 Procurement 12 210.35 BCC/IEC 11 632.96 Training 10 943.94 Institutional Strengthening 9 1679.86 Infrastructure and Human Resource 8 730.59 Innovation/PPP/NGO 7 284.29 Tribal Health 6 324.00 Urban RCH 5 42.30 Adolescent Health 4 213.53 Family Planning 3 869.84 Child Health 2 2767.57 Maternal Health 1
  65. 65. NRHM Initiative -ASHA 99% 100% 21521 12730 Achieved 21594 12730 Target 2006-07 2005-06 ASHA
  66. 66. Compensation to ASHA <ul><li>Institutional delivery @ Rs. 600 </li></ul><ul><li>Motivation for Sterilisation @ Rs. 150 (Per case) </li></ul><ul><li>Immunization @ Rs. 150 (per session) </li></ul><ul><li>DOTs Provider @ Rs. 250 </li></ul><ul><li>(on completion of treatment in six months) </li></ul>19.76Lakhs 11910   Immunization, DOTs, Sterilisation etc. 669.06Lakhs 103178 70814 Nos. of mother accompanied by ASHA (JSY)   Amount paid 2007-08    2006-07 Assisted by ASHA
  67. 67. ASHA <ul><li>ASHA Resource Centre </li></ul><ul><li>- At State District and Block level initiated </li></ul><ul><li>Drug kit Provision </li></ul><ul><li>- 12676 ASHAs provided with Drug Kits </li></ul><ul><li>ASHA thematic training being undertaken through </li></ul><ul><li>NGOs </li></ul>
  68. 68. NRHM <ul><li>ASHA </li></ul><ul><li>- New ASHA to be recruited for new AWC </li></ul><ul><li>- ASHA Resource Centre at the State , District and block level to be functional </li></ul><ul><li>- Training of ASHA </li></ul><ul><li>- Provision of Drug Kit to ASHA </li></ul><ul><li>- Reward mechanism to ASHA </li></ul><ul><li>Untied Fund </li></ul><ul><li>- Sub-centre </li></ul><ul><li>- PHC(N) </li></ul>
  69. 69. Rogi Kalyan Samiti 531 1162 PHC(N) 4 391 403 PHC/CHC 3 22 22 SDH 2 32 32 DHH /Capital Hospital & RGH-Rourkela 1 Achieved Target Institution S.N.
  70. 70. Rogi Kalyan Samiti Rs. 288.28lakhs Expenditure Purchase and repair of equipment, minor repair / modification, maintenance, wage for sweeper & others, water purifier, generators, emergency lights, security services etc. Major activities taken up Rs.1036.65 lakhs Funds released 913nos. (G.B. –403 and E.B.- 510) No. of Meetings
  71. 71. NRHM <ul><li>Rogi Kalyan Samitis </li></ul><ul><li>- Formation of New RKS in select institutions </li></ul><ul><li>- Continuation of grant for existing institutions </li></ul><ul><li>- Exposure visits and sensitization for members </li></ul><ul><li>- Reward System for RKS </li></ul><ul><li>Village Health and Sanitation committees </li></ul><ul><li>- 20% VHSC in approx 14000 villages. </li></ul>
  72. 72. NRHM <ul><li>Mainstreaming AYUSH </li></ul><ul><li>- Appointment of AYUSH Doctors in 1162 PHC(N) </li></ul><ul><li>- Appointment and training of 314 AYUSH paramedics </li></ul><ul><li>- Training of existing doctors in SBA </li></ul><ul><li>- AYUSH health camps in the Districts </li></ul><ul><li>Drug procurement and Logistics </li></ul><ul><li>- Provision of kits to health institutions </li></ul><ul><li>- Strengthening the Drug procurement </li></ul><ul><li>system </li></ul>
  73. 73. New Advocacy Initiatives by State <ul><li>Process-oriented Approach followed in ‘Developing & Publishing’ Advocacy Resource Materials for different Stake Holders </li></ul><ul><li>Sensitization of PRI members for effective implementation of NRHM </li></ul><ul><li>Designated Health Days observed across the State for widening ‘Support Base’ </li></ul><ul><li>Customized Government Diaries-2008 with NRHM Logo & Information distributed among Officials & Stakeholders </li></ul>
  74. 74. NRHM <ul><li>Infrastructure </li></ul><ul><ul><li>Special Renovation for 1 DHH Sundergarh </li></ul></ul><ul><ul><li>Renovation 0f 28 DHH </li></ul></ul><ul><ul><li>Construction of 10 Drug warehouse in the Districts and 22 in SDH </li></ul></ul><ul><ul><li>Attendant Rest Shed in 20 DHH </li></ul></ul><ul><ul><li>Establishment of DPMU and construction for 27 district data centres </li></ul></ul><ul><ul><li>Renovation of SDH </li></ul></ul><ul><ul><li>CHC Upgradation </li></ul></ul>
  75. 75. New Schemes-Swasthya Sebika Yojana <ul><li>Objective </li></ul><ul><li>To sponsor SC/ST Nursing students to meet the shortage of trained persons with Bsc Nursing/Msc nursing in the tribal pockets </li></ul><ul><li>Sponsor the GNM SC/ST Nursing Students to serve compulsorily in rural areas for 5 years after course completion </li></ul><ul><li>A bond of Rs 2.00lakhs to be signed with State Govt to serve for minimum of 5 years </li></ul><ul><li>Will make institutions viable and also provide technical manpower in remote Districts </li></ul>
  76. 76. Financial Management <ul><li>E-Transfer of funds from state to district through SBI </li></ul><ul><li>Viewing rights for accounts at District level to keep track on funds movement from District to Block. </li></ul><ul><li>Financial Management reporting format prescribed by GOI adopted and physical progress closely monitored. </li></ul><ul><li>Financial Management Group formed at state and district level. </li></ul><ul><li>Financial and administrative powers delegated through FMG. </li></ul><ul><li>DPMU at district level also delegated financial power as joint signatory for operation of Bank Account along with Nodal officer </li></ul>
  77. 77. Financial Management <ul><li>Monthly internal audit system implemented in all 30 Districts and State for all the programmes under NRHM . </li></ul><ul><li>Books of Account maintained through Tally package at the State and District level. </li></ul><ul><li>All Procurement of stores / equipment / furniture etc. undertaken as per procurement guidelines of GOI or as per OGFR – 2A, with approval of purchase committee. </li></ul><ul><li>ANMs at sub-centre level given one day simple Training on maintenance of cash book for JSY and Untied fund. </li></ul>
  78. 78. FINANCIAL MANAGEMENT <ul><li>Monthly internal audit system implemented in all 30 Districts and State for all the programmes under NRHM . </li></ul><ul><li>Books of Account maintained through Tally package at the State and District level. </li></ul><ul><li>All Procurement of stores / equipment / furniture etc. undertaken as per procurement guidelines of GOI or as per OGFR – 2A, with approval of purchase committee. </li></ul><ul><li>ANMs at sub-centre level given one day simple Training on maintenance of cash book for JSY and Untied fund. </li></ul>
  79. 79. FINANCE MANAGEMENT <ul><li>. </li></ul><ul><li>E-Transfer of funds from state to district through SBI. </li></ul><ul><li>Viewing rights for accounts at District level to keep track on funds moment from District to Block. </li></ul><ul><li>Financial Management reporting format prescribed by GOI adopted and physical progress closely monitored. </li></ul><ul><li>Financial Management Group formed at state and district level. </li></ul><ul><li>Financial and administrative powers delegated through FMG. </li></ul><ul><li>DPMU at district level also delegated financial power as joint signatory for operation of Bank Account along with Nodal officer. </li></ul>
  80. 80. Proposed Budget for Disease Control 08-09 20.00 IDD 6 6529.05 TOTAL 2840.39 NVBDCP 5 1694.75 NPCB 4 190.99 IDSP 3 522.06 NLEP 2 1260.87 RNTCP 1 Amount in lakhs PROGRAMME Sl NO
  81. 81. SUMMARY BUDGET FOR 2008-09 Rs. in lakhs 6923.95 39235.67 46159.61 7496.21 53655.83 Total 979.36 5549.69 6529.05 55.82 6584.87 NDCPs 5 2320.79 13151.14 15471.193 5798.87 21270.80 NRHM Initiative 4 63.85 361.81 425.66 92.34 518.00 IPPI 3 161.33 948.21 1115.54 1115.54 Immunization 2 3392.62 19224.82 22617.44 1549.18 24166.62 RCH-II 1 15% State matching Share 85% GOI share Balance proposed in o8-09 Unspent Balance of Previous years Total Budget Programme Sl No
  82. 82. RCH-II Budget The original budget proposed for RCH-II including JSY, Compensation for Sterilization and NSV was Rs.26577.00 lakhs which was reduced to Rs.22617.44 lakhs subsequently. The allocation suggested by GOI and the budget proposed for RCH-II is as follows: Rs. in lakhs 5.39 1213.98 23732.98 22519.00 Total 59.36 415.54 1115.54 700.00 Immunization 4 (1.68) (30.00) 1760.00 1790.00 Compensation for Sterilization & NSV 3 (4.23) (488.75) 11051.25 11540.00 JSY 2 15.52 1317.18 9806.18 8489.00 RCH Flexible pool 1 % Amount Increase Amount proposed in the PIP Amount allocated by GOI Particular Sl No.
  83. 83. Mission Flexible Pool Budget Rs. in lakhs 28.68 4740.93 21270.80 16529.87 Total 79.64 985.93 2223.93 1238.00 15 % extra for Innovation and New activities 4 87.39 1082.00 2320.00 1238.00 15 % state Share 3 32.38 2673.00 10928.00 8255.00 Mission Flexible pool 2 - - 5798.87 5798.87 Likely unspent balance as on 01.04.08 1 % Amount Increase Amount proposed in the PIP Amount allocated by GOI Particular Sl No.
  84. 84. (Rs. in Crores) Financial Progress under NRHM 144.65 256.35 2007-08 (Till Feb’08) 94.17 154.95 2006-07 35.34 114.64 2005-06 Expenditure Receipt Year
  85. 85. Statement Showing Programme wise Fund Position under NRHM for the year 2007-08 (upto 29.02.08) Rs. in lakhs 25,661.29 14,465.36 28064.39 40,126.65 25,635.21 14,491.45 Total 1,081.71 1,688.37 2383.07 2,770.08 2,117.95 652.14 NDCPs 5 15,972.57 3,441.41 11253.37 19,413.98 10,382.20 9,031.78 NRHM Initiative 4 135.60 557.79 601.05 693.39 659.85 33.54 IPPI 3 492.54 391.41 773.06 883.95 546.26 337.69 Immunization 2 7,978.88 8,386.37 13053.84 16,365.25 11,928.95 4,436.30 RCH-II 1 Balance Expenditure incurred from 01.04.07 to 29.02.08 Fund released to executing agencies till 29.02.08 Total fund available Funds received including GOO share Opening Balance as on 01.04.07 Components Sl No
  86. 86. Thank You