- The hospital presented its annual report for 2010-2011, highlighting key accomplishments such as expanding school health programs, holding envisioning workshops, and obtaining internet access. - Major strategic focuses included team and spiritual building, staff development, leadership development, and addressing diseases like kala-azar, malaria, and tuberculosis. - Initiatives to help the poor and marginalized included reduced costs for deliveries, implementing the RSBY public health insurance program, and partnering with other organizations.

1. Hospital Name Presentation of Annual Report for the year 2010-2011 Prem Jyoti Community Hospital

2. Major service areas Hospital – Barhait and Pathna block ( ~ 2 lakh population) Community work – Maltos in 4 blocks ( ~ 20,000 population)

3. Key accomplishments / Major achievements during the year School health program me -11 centers CHE Envisioning workshop Liaising with Govt: RNTCP, JSY, RSBY TBGFR9 for ACSM in Sahibganj Internet facility > 2 years’ gap 2000 sq.ft. training hall and 1 km long PCC road by Govt

4. Highlights of Progress on Strategic Plans

5. Recapturing the core

6. A.1.1 – Team and Spiritual Building Visible Outcome Spiritual nourishment and refreshing time with God’s word Children growing in God’s word Fun and closeness within team. Dependence on God. Children given firm foundations Builds team spirit and time of fun Major Activities in 2010-11 Spiritual retreat VBS for 272 Malto children Staff Picnic Weekly bible studies and fasting & Chain prayer Weekly Sunday school for staff children Quarterly Get together and Talent-night Gardening

7. A.1.1 – Team and Spiritual Building Expected Outcome Discipling –Malto & Santhal churches Ownership & Oneness Personal Spiritual growth Sharing the vision Breaks hierarchy and brings a openness to do all work Major activities for 2011-12 CHE Women’s Fellowship Prayer & Bible study Care group leaders (II line) Quarterly Get together

8. A.2.1 – Staff Development (PDP) Benefits for Staff and Unit Building HR for ANM school Improving quality and recognition as DMC Improving the implementation on CH program Deputed as RSBY coordinator Opens possibility of being recognized as State Training Site Staff Developed –Major highlights Ms. Teresa sent for M.Sc Nsg Mr. Ajose - Govt malaria Lab training & RNTCP training Mr. Christopher - CDO refresher training & Project management training. Mr. Francis - trained in Tally software Dr. Vijila – Master TOT for Sahiyya training

9. A.2.1 – Staff Development (PDP) Expected Benefits for Staff and Unit Training missionaries in health care in grass root level Equipping to become project officer To match increase in obstetric services. Developing expertise & leadership of Malto community Long term II line leadership Plans for 2011-12 Ms.Sumathy - CLHTC – CMC Vellore Mr. Christopher - orientation in project management Mrs. Sangeetha Malto in RCH Mrs. Mariam Malto in mid-wifery Mary Malto – GNM Lydia Malto – ANM Dr. Benedict- MS

10. A.3.1 – Leadership Development Visible Outcome Junior members involved in planning, decision making  learn management skills  share vision & mission Encourage other Malto staff and deal with conflict resolution 5 Nurses trained so far – 2 still in training – potential nurse leaders of the future Shared Responsibility & Ownership Major Steps taken to Identify and Develop leaders II line leadership included in Management committee 4-member Malto support forum Capacity building of Malto community members Nurses Core Group

11. A.4.1 – Culture of Learning – Systems for recognition & rewards Effect / Impact Improved motivation Career planning- training in house/formal courses Joy of serving motivates the peers and better utilization of services Team encouraged to persevere in faith Plans for 2011-12 Verbal appreciation for good & Innovative practices PDAP CHVs-Appreciation in kind for patient services, Annually Sharing of testimonies-Patient related (resource poor setting)

13. B.1.1 – Quality Management Systems - Quality & Holistic care Visible Changes Quality in clinical service improved. Protocols made for common diseases. Analyzing the charts and finding whether anything was missed. Empowering nurses to identify complication early and also manage obstetrics qualitatively. List three key areas of improvement Clinical services meeting bimonthly. Death audit. In-service training of nurses

14. B.1.1 – Quality Management Systems - Quality & Holistic care Expected Changes /Outcome Better care for patients Improved staff safety & infection control Address the spiritual need of the patients and means of sharing Gospel Plans for 2011-12 Establishing protocols for common diseases ( QMI ) Establishing waste management system(BMW) To have Saline solution workshop

15. B.1.2 – Addressing new & emerging health problems Steps taken to address Signed MoU with CRS-Ranchi Planning search campaign in pockets with high prevalence DDT spraying Impregnation of mosquito nets with Pyrethoid Hospital recognized as DMC & DOTS centre for RNTCP ACSM to increase awareness about TB through GFTB. Major Problems Identified Kala-azar is still prevalent Malaria(P. F ) incidence is on the increase Tuberculosis incidence is high

16. B.1.2 – Addressing new & emerging health problems Expected Outcome Improved health status Reduction in mortality rates Improvement in awareness about HIV prevention Better utilization of services & Cost effective care District wide impact in reducing the burden of TB Plans for Integrated Health Care Programs Community & Hospital work together to reduce the disease burden Adolescent health – CH working along with the church network Partnership with Govt programmes: RNTCP, JSY Networking with other NGOs: GFTB ( EFICOR & Catholic Dioc )

17. B.2.1 – Reduce Disease Burden Outcome Incentive for institutional deliveries is attracting more hospital deliveries. BPL patient need not worry about medical expenses and encourages to bring pt. in early stage. Financial burden for ATT removed. List three initiatives taken Signed MoU for JSY Implemented RSBY program RNTCP implemented

18. B.2.1 – Reduce Disease Burden Expected Outcome Better reach of this facility to the real needy. Decrease malarial incidence. Elimination of kala-azar disease. Plans for next year T o increase awareness about RSBY and help in logistic support (if need be) in enrollment. DDT spraying in target villages and FMPB run hostels. Search campaign to identify kala-azar cases and treating them

19. B.2.3 – Focus on Poor & Marginalized Visible Changes More Malto women come to hospital for delivery  reduction in maternal deaths Poor patients get treatment at affordable price Sensitive to economic status of the patients. Major innovations Booked Malto patient needs to pay only Rs.1000 for vaginal delivery and Rs.2000 for LSCS. Patients categorized to A, B, C according to economic status Poor patients are helped financially by GSF which is a fund by staff’s contribution.

20. B.2.3 – Focus on Poor & Marginalized Expected Impact Rehabilitation of severely malnourished children Those who really deserve RSBY subsidy will be helped to get reimbursements Free availability of CDMU drugs to NGOs in Jharkhand Plans for future Malnutrition treatment centre through NRHM Enrollment drive for RSBY in partnership with missionaries Partnership with CDMU – low-cost drug provider from Kolkata

21. B.3.1 – Become and Making Disciples of Christ (Pastoral care for staff & Staff involvement in sharing the gospel) Outcome Spiritual and commitment renewal. Engaging in conversation with pt., praying for them and sharing Gospel. Dependance on God for everything. Helps in getting rooted with word of God and grow spiritually. Major Initiatives taken Staff retreat- one for married staffs and another for single staff held. Ward prayer every day morning. Fasting prayer every Saturday Bible study every saturday

22. B.3.1 – Become and Making Disciples of Christ-Pastoral care for staff & Staff involvement in sharing the gospel Expected Outcome Spiritual refreshment and a strength to hold on to God’s calling. Whole team understanding the concept of holistic ministry . Support system within the team and carrying one another. Spiritual revival in near-by villages which have back slidden. Plans for future To have LRS/retreat every 6 months . Saline solution training Making care group functional. Visiting near-by villages and conducting Sunday service.

23. B.4.1 – Financially sustainable and Alternate revenue generating models Visible & Expected Outcome Better rapport with Govt functionaries  inroads with the system  more partnerships  more benefits to the poor Periodical visits, involvement, financial support; help in staff recruitment Major Innovations Tapping Government resources Partnering with churches to promote prayer and financial support- Locally (JJCH,HCH,BCH,HBM,EMMS)

25. C.1 – Partnerships and Networking with like minded organizations in developing health initiatives Visible & Expected impact Building a younger Malto generation that is spiritual and morally good. Disseminating health awareness and preventive medicine. Training missionaries who will be doing ministry in remote villages. Present and future networks FMPB- Adolescent program, Career counseling & Youth mela EFICOR- Dr. Vijila is a member of TAG committee (CSP) ESAF- Health training for their animators. CMC vellore- with DEDU for CLHTC program. CHE program

26. C.2 – Training programs based on our strength Visible & Expected impact Decrease in mortality & morbidity. Quality health care can be availed by pt. who live near to the clinic. Decreases MDR TB incidence. Present and future training programs CHV training program Lab assistant training and nurse practioner trg. for FMPB run clinic. CLHTC training for missionaries of Bihar & Jharkhand. RMP’s training as a part of GFTB.

27. C.3 – Partnerships and Networking with other organizations for Integral mission programs Visible & Expected impact Decision to commit themselves for medical need in remote areas. Understanding relevance of primary care in rural setting and motivated to replicate it elsewhere. Openness for God’s leading. Present and future programs CMC vellore- 1 batch of Medical students - peripheral posting (SHP-2). CFH,ODC- 3 month community posting for DNB-family medicine to PJ. TN medical students coming for medical exposure visits.

28. C.4 – Providing consultancies – Enabling others to respond to emerging health & development needs in India Visible & Expected impact Helping eradicate kala-azar from jharkhand and improving quality in health centres. Engaging with government and helping in giving quality training. Present and future consultancies Dr. Isac CRS,Jharkhand for kala-azar elimination program and in creating STG/SOP for all catholic health centres in Jharkhandto CDMU-facilitation in JH Dr.Vijila is a part of TAG and certified ASHA trainer for module-6,7

29. Best practices 2010-11 ( List Five best practices initiated in clinical areas by which quality of care has improved and also Patient Satisfaction) Survey on waiting time of patients in OPD taken and now it has been decreased considerably. Decision to shifting time of delivery patients to OT is decreased to 15-20 mins. Clinical service meeting & death audits helped identify areas for improvement. Avoiding poly pharmacy Package for Obstetric services & Surgical camp

30. Best practices 2010-11 ( List Five best practices initiated in Admin and Technical areas by which quality of care has improved and also Patient and employee Satisfaction has improved) Pharmacy made centralized - ↓ pilferage New salary scale implemented Package costing done for deliveries - ↓ billing time

31. Best practices 2010-11 ( List Five best practices initiated in Nursing and Other Education by which quality of care has improved and also Patient and employee Satisfaction has improved) Weekly classes and ward side teaching has improved competance of nurses. Core nurses meeting comprising of senior nurses has helped share nursing responsibility. Regular assesments, PDAPs and feed-back of their performance has helped nurses to set goals and move forward in the culture of learning.

32. Best practices 2010-11 ( List Five best practices initiated in CH&D areas by which quality of care has improved and also Patient and employee Satisfaction has improved) Drop-out CHVS replaced by new, illiterate women CHVs  improved RCH services Improved supervision  ↓ drop-outs, ↑ reporting CHV incentive made performance-based  improvement in motivation Evaluation conducted to identify way forward

33. Hospital Performance Hospital Performance

34. Summary of Hospital Statistics More details in Annexure-II (Hospital Performance – Service Statistics) #Particulars 08-09 (Projected 08-09 (Actuals) 09-10 (Projected 09-10 (Actuals) 10-11 (Projected 10-11 (Actuals) 11-12 (Projected) Total OPD Pts. NA 7078 9000 6565 8400 10395 12720 Total Admissions NA 904 1200 1048 1400 1379 1620 Bed Occupancy Rate NA 53 83 54 77 68 78 Deliveries NA 181 350 314 425 495 600 Major Gen Surgeries NA 1 20 6 30 19 10 Major OBGY Surgeries NA 40 87 62 90 107 120 Lab Tests NA 10221 13550 8657 9500 12673 15300 Ultrasounds NA 73 150 138 200 100 150 X-Ray NA 295 500 463 500 333 400

35. Mention the areas ( Increase in statistics for the last 3 years & specify reasons) More details in Annexure-II (Hospital Performance – Service Statistics) #Particulars 08-09 09-10 10-11 11-12 (Projected) Specific Reasons Total OPD patients 7078 6565 10395 12720 RNTCP Daily OPD Surgical camps Total Admissions 904 1048 1379 1620 Diarrhoeal epidemic Obstetrics Bed Occupancy Rate 53 54 68 78 -do- Deliveries 181 314 495 600 -do- Continued availability of doctors Major OBGY Surgeries 40 62 107 120 Lab Tests 10221 8657 12673 15300 TB, Kala azar programmes

36. Highlights of Hospital Income and Comments More details in Annexure-III (Summary of Revenue Budget) # Particulars Comments Increase in OPD Lab fee compared to IP Lab fee Optimum utilization of Lab services and staff Introduction of new tests Increase in Pharmacy Income Better purchase and monitoring systems are introduced. Purchase margin is much better Change in suppliers Decrease in Ultrasound Income Non availability of personnel Increase in OBGY Income No of ANC cases and Deliveries gone up Delivery charges are revised

37. Highlights of Hospital Expenses and Comments More details in Annexure-III (Summary of Revenue Budget) # Particulars Comments Establishment Expenses gone up from 37% to 41% New Salary scale implemented New staff joined Administrative Expenses Increase New Staff joined travel expenses and joining expenses increased. V-Sat Installed during the year. Medical Surgical Supply cost gone up IV supply booked under Med.Surg. Purchases of Surgical supply for Surgical Camps Linen & Bedding supply gone up 1. Purchased supply for OT and Wards House Keeping Expenditure gone up 1. Steps taken for quality management Pharmacy Supply purchase cost come down 1. Centralized Pharmacy system started. Vehicle Maintenance Exps decrease 1. New Vehicle needs less Maintenance ` Utility Expenditure increased No IP / OP attendance increase. Needs frequent use of Generator.

38. Summary of Hospital Income & Expenses #Particulars#Particulars 08-09 (Projected 08-09 (Actuals) 09-10 (Projected 09-10 (Actuals) 10-11 (Projected 10-11 (Actuals) 11-12 (Projected) OP Income 1600000 1000230 1500000 999870 1302000 1180346 1526400 IP Income 148906 1169050 2000000 1979312 2400000 3436548 4455000 Total Income 3089060 2169280 3500000 2979182 3702000 4616894 5981400 Establishment Expenses 1122000 2082151 2797561 2567471 5246586 3670805 5104054 Pharmacy Supplies 0 531443 690000 692400 725000 580929 750000 Maintenance 0 0 200000 149939 200000 156929 318000 Charity 600000 598672 600000 631025 800000 1014950 1172650 HRD Expenses 427500 1637824 225500 117923 160000 64504 290352 Total Expenses 2149500 4850090 4513061 4158758 7131586 5488117 7635056 Average Daily Income 8463 5943 9589 8162 10142 12649 16387 Average Daily Expenses 5889 13288 12365 11394 19539 15036 20918

39. Summary of Hospital Finances Annexure-VI (CL & CA) # Particulars As on March’11 As on 15 th June’11 Payable to Central Office (PF,HDF,MHF etc) Nil Nil Payable to Suppliers 18707 53030 Payable to Staff Nil Nil Payable to Banks Nil Nil Bank Balances (Local Account) 705330 419168.75 Bank Balances (FC) 89978.82 64978.82 Cash Balance (Local) 94271 33721 Investments (FD,RD etc) Nil Nil Closing stock 202914 Recoverable from Staff (Loans and advances) 13150 82800 Recoverable from Central Office & Other units 57755 57755 Total Income (General) 6679965 Total Expenses (General) 5743935 Income Over Expenditure /Excess of Expenditure 936030 Total Income (FC) 2935618 Total Expenses (FC) 2704356 Income Over Expenditure / Excess of Expenditure 231262 Fixed Assets Purchased from General account 444800 Fixed Assets Purchased from FC account 411632

40. HR Summary More details in Annexure-V (HR Summary & Staff Development) Category of Staff As on Mar’09 As on Mar’10 As on Mar’11 Projection 2011-12 Clinical Staff Medical 0 3 3 5 Nursing 0 16 12 15 Para Medical 0 5 3 3 Total Clinical Staff 0 24 18 23 Non Clinical Non Clinical Administration 0 7 5 5 Technical 0 2 2 2 Support Staff 0 7 7 11 Total Non-Clinical Staff 0 16 14 18 Project Staff 0 4 3 10 Daily Wages 0 0 0 0 Total Staff (Clinical + Non-clinical) 0 40 32 41 0 Hospital Staff 0 40 32 41 Project Staff 0 4 3 10

41. Revised Budget for 11-12

42. Highlights of the Revised Revenue Budget 11-12 Revenue Budget Revised from 1.18lakhs to 1.27lakhs. Tear Fund Grant Budgeted for this year Rs.12,00000/- Initiatives taken for Missionary Training Budget.Rs.2.92000/- Expecting More local Donations Budget.Rs.10,50000/- More Govt. Grants for Govt. Schemes running through our hospital for the benefit of Poor and Marginalized. Implementation of New Salary Scale – Projected New 21 staff to join –Establishment Budget Rs.51,04054/- Special Provision for the Development of Malto Staff.Budget.Rs.86400/- Planned for Renovation of Staff Quarters and other Major repairs.Budget.Rs.2,00,000/- More details in Annexure-III (Revised Budget)

43. Highlights of the Revised Capital Budget 11-12 Proposed Capital Budget Revised to Rs.11,53,500/- Renovation of Training Block Rs.1.65 lakhs Major Renovation of Staff Quarters Rs. 3.Lakhs. Planning for Missionary Training- Furniture and Appliances Budget.Rs1,57,000/- More details in Annexure-V (Capital Budget)

44. Statutory & Legal matters

45. Update on Administrative/Management meetings # Particulars Status (How many times meetings were held in 2010-11) Unit Management Committee (UMC) 9 Staff Meetings 12 Purchase Committee 9 Therapeutics Committee _ Citizens Advisory Committee _ Infection Control Committee _ Spiritual Life Committee 11 Clinical Services Committee 8 Medical and Death Audits 6 In Service Education for Doctors 2 In Service Education for Nurses 2/month

46. Update on Important aspects # Particulars Status Annual Staff Health Checkup _ Patient Satisfaction Survey (Feedback) Patient Waiting Time in OPD Hospital Inventory / Fixed Asset Register IN Progress (completed for 7 yrs '04-’11) Housing Agreements Nil Compliance on Daily wage workers Nil TDS deductions of contractors Nil Attendance Registers Up to date

47. Update on Statutory Requirements # Statutory Requirement Status Hospital Registration In Process Income Tax Up to date FCRA In Process Society matters - Ultrasound registration Valid upto2014 Bio-medical waste To Be implemented Drug license In Process Building & Land – Taxes Up to date Leased Land – Renewal status Nil (Mutation to be done) Vehicle Insurance Up to date Any other Nil

48. Update on Legal Matters # Legal Issue Status Income Tax Case Nil Labour Court Dormant Consumer case Nil Any other Nil

49. Challenges, Learning

50. Major Challenges and Learning’s during the year Learning’s Perseverance Prevailing Prayer fpr God’s provision Promotional work among family & friends in raising local support Senior CHVs recruited as Part time supervisors Replaced by Lady CHVs(RCH) Janani Suraksha Yojana Major Challenges Internet Connectivity- Hughes Financial Deficiet Lack of adequate Supervisors in CH CHV Drop Outs High Maternal Mortality Annexure-VII (Praise and Prayer points)

51. Spiritual Ministries

52. Visible Transformational impact Dependence on God. Discipling –Malto & Santhal churches Ownership & Oneness Personal Spiritual growth Sharing the vision

53. Spiritual Transformational Story (10-11) Village: Simbi 8 Christians families and rest non-Christians Sukra Malto: boils in his thigh. Sukra’s elder brother_Davud CHV Baby Malto, Kadagdoni washed his boils applied MSG and gave Septran (antibiotic) Davud a Christian, hated his non-Christian younger brother CHV came to know about this, helped them reconcile with each other & told Davud to help Sukra Now... both live happily – in good relationship with each other. After a week Sukra met the CHV and thanked her His skin infection had healed completely More than that, he was also reconciled with his estranged brother.

54. Thank You