1ABBREVIATIONS AYUSH Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy AD Allopathic Dispensary/ New Type PHC ASHA Accredited Social Health Activist ANC Antenatal Checkup ANM Auxiliary Nurse Midwife AFHC Adolescent Friendly Health Centre AWC Anganwadi Centre AWW Anganwadi Worker ADMO Assistant District Medical officer (AYUSH) BMO Block Medical Officer BPL Below Poverty Line BAM Block Accounts Manager BB Blood Bank BM&EO Block Monitoring & Evaluation Officer BSU Blood Storage Unit CHC Community Health Centre CMO Chief Medical Officer DHS District Health Society DIO District Immunization Officer DMEIO District Mass Education and Information Officer DPMU District Programme Management Unit DPM District Programme Manager DAM District Accounts Manager D M& EO District Monitoring & Evaluation Officer FBNC Facility Based Newborn Care. FRU First Referral Unit FMPHW Female Multi Purpose Health Worker HBNC Home Based Newborn Care HMIS Health Management Information System ICDS Integrated Child Development Services IMR Infant Mortality Rate IUCD Intra Uterine Contraceptive Device JSY Janani Suraksha Yojana JSSK Janani Shishu Suraksha Karyakaram MCTS Mother and Child Tracking System MMA Medical Methods of Abortion MMR Maternal Mortality Rate MAC Medical AID Centre/ Sub Centre MVA Manual Vacuum Aspiration 2 NBCC Newborn Care Corner NBSU Newborn Stabilization Unit NMR Neonatal Mortality Rate NRC Nutrition Rehabilitation Centre NRHM National Rural Health Mission NPCC National Programme Co-ordination Committee NUHM National Urban Health Mission PHC Primary Health Centre PRIs Panchayati Raj Institutions PIP Programme Implementation Plan PNC Postnatal Checkups RCH Reproductive & Child Health Programme RKS Rogi Kalyan Samiti ROP Record of Proceedings RBSK Rashtriya Bal Swasthya Karyakaram SHS State Health Society SDH Sub District Hospital SC Sub Centre SNCU Sick Newborn Care unit TFR Total Fertility Rate VHND Village Health & Nutrition Day VHSNC Village Health Sanitation & Nutrition Committee WIFS Weekly Iron Folic Acid Supplementation 3 NATIONAL RURAL HEALTH MISSION National Rural Health Mission (NRHM) was launched at the National Level in April 2005. However, in J&K State it was started in December 2005. The Goal of the Mission is to improve the availability of and access to quality health care by people especially for those living in rural areas. NRHM aims to undertake architectural corrections in the health system enabling it to promote policies that strengthen public health management and service delivery throughout the country with special focus on those States which have weak public health indicators and/ or weak infrastructure. Jammu and Kashmir State is one of the focused States. NRHM is a platform to provide affordable, equitable and accessible health services, especially people residing in rural areas. In the first phase of NRHM (2005-12), the focus was on bridging infrastructure gaps and augmentation of manpower to improve the delivery of health care services. In the second phase of NRHM (2012-17) the focus should be more on health system reforms for sustainable turnaround of health system in the State. The State would focus on strategies/ interventions which are aligned with key goals of NRHM viz reduction of MMR, IMR and stabilization of TFR. OBJECTIVES OF NATIONAL RURAL HEALTH MISSION i. To reduce Maternal Mortality Rate (MMR) ii. To reduce Infant Mortality Rate (IMR) iii. To reduce Total Fertility Rate (TFR) STRATEGIES i) Strengthening of the Health Institutions providing Primary Health Care (CHCs, PHCs and Sub Centres) so as to provide all the basic and emergency obstetric care. ii) Strengthening of the Routine Immunization for the vaccine preventable diseases. iii) Improving the health services and the services determining the health of the society viz sanitation and potable drinking water. iv) Decentralizing the health planning and management of the health institutions by way of: Constitution of District Health Missions and District Health Societies for planning and implementing the health related initiatives in the respective districts. Formation of Rogi Kalyan Samitis (RKS) and Village Health Sanitation and Nutrition Committees (VHSNC). v) Bringing all the centrally sponsored Health schemes under the umbrella of NRHM. Programme Action Plan (PIP) for 2013-14 The Ministry of Health and Family Welfare, Govt. of India conveyed administrative approval to the implementation of State PIP for the year 2013-14 for an amount of Rs. 207.65 crores The State PIP has been approved for the components and activities detailed in forthcoming paragraphs subject to compliance of following key conditionalities. 4 Key Conditionalities A) Rational and equitable deployment of HR with the highest priority accorded to high priority districts and delivery points. B) Facility wise performance audit and corrective action based thereon. C) Performance Measurement system set up and implemented to monitor performance of regular and contractual staff. D) Baseline assessment of competencies of all SNs, ANMs Lab Technicians to be done and corrective action taken thereon. - Approval is being granted for HR of all cadres under NRHM for six months only and continuation for the next six months would be contingent on compliance of the above four conditionalities. Further, it is expected that the State will henceforth fill up their vacant regular HR positions and will not use NRHM funds to substitute State spending. Therefore, from 1 st October 2013, under NRHM, funds for salary to contractual HR would be granted only to make payments to contractual staff over and above the sanctioned regular positions in the State. E) Gaps in implementation of JSSK may lead to a reduction in outlay up to 10% of RCH base flexi pool. The major heads of operation are: 1. RCH Flexible Pool 2. NRHM Flexible Pool 3. Immunization The detailed district wise/ activity wise budget for the year 2013-14 has already been circulated to the District Health Societies for implementation of the approved activities during the current year. The approval, however, is subject to the compliance of Key conditionalities given above. The District Health Societies shall furnish the monthly progress report in the format given in Annexure “A”. STATE-SPECIFIC GOALS Jammu & Kashmir’s IMR at 41 (SRS 2011) has decreased from 49 (SRS 2008). TFR has also decreased from 2.2 (SRS 2008) to 1.9 (SRS 2011).The following are the agreed goals and service delivery targets for the State of Jammu & Kashmir: Indicator CURRENT CAD (%) Jammu & Kashmir State Targets India Jammu & Kashmir India Jammu & Kashmir 2013-14 2014-15 Target for 12th Plan CAD (%) Maternal Health MMR (SRS 07-09) 212 - -5.8 - NA NA NA NA 5 Child Health U5MR (SRS 2011) 55 45 -7.3 -6.5 36 32 -- -10.2 IMR (SRS 2011) 44 41 -6 -5.8 33 30 24 -10.2 NMR (SRS 2011) 31 32 -4 -6.4 26 23 -- -10.2 Family Planning TFR (SRS 2011) 2.4 1.9 -2.6 -4.8 Maintain TFR Note CAD: Compounded Annual Decline; MMR from 04-06 to 07-09; U5MR; IMR; NMR and TFR from 2008 to 2011; targets from latest current status to 2015. KEY CONDITIONALITIES AND INCENTIVES FROM GOVERNMENT OF INDIA 2013-14 Jammu & Kashmir has made significant progress in responding to conditionalities. Following conditionalities shall be adhered to by the States and are to be treated as non-negotiables: Mandatory disclosures 1. The State must ensure mandatory disclosure on the State NRHM website of the following and act on the information: Facility wise deployment of all HR including contractual staff engaged under NRHM with name and designation. Facility wise service delivery data particularly on OPD, IPD, Institutional Delivery, C- section, Major and Minor surgeries etc. MMUs- total number of MMUs, registration numbers, operating agency, monthly schedule and service delivery data on a monthly basis. Patient Transport ambulances and emergency response ambulances- total number of vehicles, types of vehicle, registration number of vehicles, service delivery data including clients served and kilometres logged on a monthly basis. All procurements- including details of equipments procured (as per directions of CIC which have been communicated to the States by this Ministry vide letter No 'No.Z.28015/162/2011-H' dated 28th November 2011.). Buildings under construction/renovation –total number, name of the facility/hospital along with costs, executing agency and execution charges (if any), date of start & expected date of completion. Supportive supervision plan and reports shall be part of mandatory disclosures. Block- wise supervisory plan and reports should be uploaded on the website. NGOs/PPP funded under NRHM would be treated as ‘public authority' and will fall under the ambit of the RTI Act2005 under Section 2(h). Further, details of funds allotted /released to NGOs/PPP to be uploaded on website 6 2. State/UT to ensure that JSY payments are made through Direct Benefit Transfer (DBT) mechanism through AADHAAR enabled payment system/Core Banking Solution where DBT mechanism has been rolled out. Further, cash payment or bearer cheque payment is henceforth disallowed across the States. 3. Timely updation of MCTS and HMIS data including facility wise reporting 4. Line listing of high risk pregnant women, including extremely anaemic and Low Birth Weight (LBW) babies 5. As agreed, the following key conditionalities would be enforced during the year 2013-14. a) Rational and equitable deployment of HR 1 with the highest priority accorded to high priority districts and delivery points. b) Facility wise performance audit 2 and corrective action based thereon. c) Performance Measurement system set up and implemented to monitor performance of regular and contractual staff. d) Baseline assessment of competencies of all SNs, ANMs, Lab Technicians to be done and corrective action taken thereon. Approval is being granted for HR of all cadres under NRHM for six months only and its continuation for the next six months would be contingent on compliance of the above four conditionalities. Further, it is expected that the State will henceforth fill up their vacant regular HR positions and will not use NRHM funds to substitute State spending. Therefore, from 1 st October 2013, under NRHM, funds for salary to contractual HR would be granted only to make payments to contractual staff over and above the sanctioned regular positions in the State. e) Gaps in implementation of JSSK may lead to a reduction in outlay upto 10% of RCH base flexipool. 6. Initiatives in the following areas would draw additional allocations by way of incentivisation of performance: a) Responsiveness, transparency and accountability (upto 8% of the outlay). b) Quality assurance (upto 3% of the outlay). c) Inter-sectoral convergence (upto 3% of the outlay). d) Recording of vital events including strengthening of civil registration of births and deaths (upto 2% of the outlay). e) Creation of a public health cadre (by States which do not have it already) (upto 5% of the outlay) f) Policy and systems to provide free generic medicines to all in public health facilities (upto 5% of the outlay) . g) Timely roll out of RBSK (upto 5% of the outlay) 7 h) Enacting/adopting a bill like the Clinical Establishment Act, 2010 as per their requirement, to regulate the quality and cost of health care in different public and private health facilities in the State (upto 5% of outlay). i) States providing more than 10% increase in its annual health budget as compared to the previous year will attract additional incentive. j) States to implement the nurse practitioner model to strengthen the nursing services. Note: The Framework for Implementation of NRHM to be strictly adhered to while implementing the approved PIP. State should adhere to the clauses mentioned in the MOU signed and achieve the agreed performance benchmarks. FINANCE: KEY ISSUES AND GUIDING PRINCIPLES 1. Quarterly FMR must be submitted on time with both physical and financial progress duly reflected. 2. State must also furnish a monthly statement of fund position and expenditure in format prescribed in the operational guidelines, as Annexure V. 3. Status of Contribution of State share: Year Amounts required on basis of releases (Rs. in Crore) Amount Credited Commulative Balance 2007-08 27.64 0 27.64 2008-09 12.85 12.46 28.03 2009-10 22.02 0 50.05 2010-11 29.82 61.16 18.71 2011-12 42.89 27.16 34.44 2012-13 22.09 59.15 +(2.62) Total 157.31 159.93 State is to ensure that outstanding state share needs to be deposited in to the Account of State Health Society. It is to be noted that from 2012-13, funding from the Centre and from the States will be in the ratio of 90:10. 1. Release of full funds as per the entitlements for the year 2013-14, would be contingent on the State providing Utilization Certificate against the grant released to the state up to 2011-12 for all the programmes under NRHM. 2. The appointment of Concurrent Auditor for the year 2013-14 is a prerequisite for release of 2nd tranche of funds. 3. Timely submission of Statutory Audit Report for the year 2012-13 is a must for release of 2nd tranche of funds. 8 4. State is required to comply with the instructions and/or guidelines issued for maintenance of bank account vide D. O. No. G-27017/21/2010-NRHM-F dated January 23, 2012. 5. State should ensure submission of Action Taken Report/ Compliance Report on the FMR Analysis (2013-14) and Audit Report Analysis for FY 2012-13. 6. State needs to strengthen the internal control procedures/mechanism for all transactions. 7. State should ensure proper maintenance of books of accounts at district and block level as per the operational guidelines for NRHM issued by the Ministry. 8. Appointment of Auditor for the year 2012-13 must be completed in the first quarter of 2013-14 as per the RFP issued by this Ministry. 9. The state must ensure due diligence in expenditure and observe, in letter and spirit, all rules, regulations, and procedures to maintain financial discipline and integrity particularly with regard to procurement; competitive bidding must be ensured and only need-based procurement should take place. 10. State should ensure expenditure of at least of 15% by June 2013 and 45% by September 2013 of their approved resource envelop under each pool under financial year 2013-14. 11. Unit Costs in relation to various procurements of equipments and printing etc. are only indicative for the purpose of estimations. However, actual expenditure must be incurred after following rules and due processes”. MATERNAL HEALTH ROAD MAP FOR PRIORITY ACTION FROM GOI: Road Map for essential commitments Commitment No. 1- Operationalizing Delivery Points Gaps in the identified delivery points to be assessed and filled through prioritized allocation of the necessary resources in order to ensure quality of services and provision of comprehensive RMNCH+A services at these facilities as per the levels. MNH toolkit is to be used for planning and operationalizing services at different levels of delivery points. Level 3 should be planned for comprehensive CEmOC and RMNCH+A services and similarly level 2 for BEmOC and RMNCH+A services. The targets for different categories of facilities are: 9 Level 3 delivery points functioning as CEmOC facilities a) District Hospitals and other similar district level facilities (e.g District women and children hospital) b) CHCs and other health facilities at sub district level (above block and below district level) functioning as FRUs To provide the following services: 24*7 service delivery for CS and other Emergency Obstetric Care. 1 st and 2 nd trimester abortion services. Conduct Facility based MDR. Essential newborn care and facility based care for sick newborns. Family planning and adolescent friendly health services RTI/STI services. Have functional BSU/BB. Level 2 delivery points functioning as BEmOC facilities: Non FRU-CHCs, 24*7 PHC and other PHCs To provide the following services 24*7 BeMOC services including conducting normal delivery and handling common obstetric complications. 1st trimester safe abortion services. (MVA upto 8 weeks and MMA upto 7 weeks) RTI/STI services. Essential newborn care. Family planning All identified SC Level delivery point facilities will provide the following services: 10 Delivery by SBAs. IUD insertion Essential new born care. ANC, PNC and Immunization. Nutritional and Family planning and Adolescent counselling. VHND and other outreach services on designated days. All identified delivery points should be comprehensively planned for saturating them in terms of HR, Equipment, Capacity building, infrastructural requirements etc. before spreading the resources to other health facilities. Monthly performance monitoring of each delivery point needs to be undertaken and reviewed at District level and quarterly level at State level. Commitment No. 2- Implementing free entitlements under JSSK JSSK entitlements to be ensured to all PW and sick newborns accessing Public health facilities. At least 70% drop back to be ensured to PW delivering in the PHFs. Drop back should be given only after 48 hrs stay in the health facility. Commitment No. 3- Centralized Call Centre and Assured Referral Transport All NRHM Supported Ambulances should be designated as “National Ambulance Service” with GOI prescribed color coding and other details. Every State needs to ensure availability of a centralized call centre with 102 or 108 as Toll Free no. for referral transport at State or district level along with GPS fitted ambulances. Response time for the ambulance to reach the beneficiary not to exceed 30 minutes and should reach the referred facility within next 30 mins. Monthly data on utilization of each ambulance (eg. Trips per day) to be maintained, analyzed and take corrective action if anything to be taken 11 Commitment No. 4- Essential Drug List Every State to have an Essential Drug List (EDL) for SC, PHCs, CHCs, DHs, and Medical colleges and ensure timely procurement and supply to Sub centres, PHCs, CHCs, DHs and MCs. The EDL should include drugs for maternal and child health including drugs for safe abortion services, RTI/STI. Differential distribution of types and quantities of drugs to performing and non performing facilities and also as per level of facility. Procurement should be done through competitive bidding and indent to be taken from each facility based on consumption pattern through computerized inventory management system. All Procurement process including periodic testing of drugs through govt. certified labs be carried out by the process of randomized sampling. All the drugs should have atleast 5/6 th of the shelf life at the time of receiving the durgs at indenting facility. All other govt. procedure for procurement needs to be followed. Commitment No. 5- Capacity Building Shortfall in trained human resource at delivery points particularly sub centres in High focus/ High Priority districts to be addressed on priority. Training load for skill based trainings to be estimated after gap analysis. Certification /accreditation of the training sites is mandatory. Training plan to factor in reorientation training of HR particularly for those posted at non functional facilities and being redeployed at delivery points. Orientation training of field functionaries on newer interventions e.g. MDR/ HBNC etc. Performance Monitoring during training/post-deployment needs to be ensured Specific steps to strengthen SIHFW/ any other nodal institution involved in planning, implementation, monitoring and post training follow up of all skill based trainings under NRHM. 12 Commitment No. 6– Tracking severe anemia All severely anemic pregnant women (2% of the anemic pregnant women) to be tracked and line listed for providing treatment of anemia. The line listing should be maintained and followed up at SCs and PHCs. Commitment No. 7– For High Priority Districts The State to make use of the MNH toolkit to operationalize the identified facilities as delivery points. At least 10% of all sub centres under each PHC to be made functional as delivery points in the HPDs. At least one CEmOC CENTRES to be made functional. Planning for operationalizing 10-15 BEmOC Centres in phases. Commitment No. 8— Job clarity of both ANMs working at the Sub-centre to ensure availability of one ANM at the SC and the other for outreach activities for the geographically demarcated population. Commitment No. 9: Pre service Nursing Training (For 12 High Focus States) At least one State Master Nodal centre shall be created and made functional. State nursing cell under the directorate of health should be created and made functional. A road map for strengthening of ANM and GNM schools be prepared as per GoI guidelines. Commitment No. 10: State, district and regional quality assurance committees to be made functional. Commitment No. 11: Establishment of Skill Labs: At least one skill lab to be established and made functional for a group of 4-5 districts as per skill lab operational guidelines. Commitment No. 12: MCH wings All 100 bedded MCH wings should be planned comprehensively as per GoI road map and must include equipments, obstetric ICU, SNCU, OT, labor room, Skill lab, academic wing and other details as per MNH toolkit. 13 The plan for MCH wing should be shared with the MH nodal officer and he should be involved in its monitoring. All the MCH wing must be located within the campus of the existing health facility and completed in 2-3 years. State needs to ensure strict compliance of the following non-negotiable under JSY: 1. State will ensure that JSY guidelines are strictly followed and payments are made as per the eligibility criteria. 2. State will ensure that AADHAAR numbers/EID and bank account details of the JSY beneficiaries are captured in the integrated RCH registers and seeded in the MCTS database. 3. State will ensure that there would be no delays in JSY payments to the beneficiaries and full amount of financial assistance is given to the beneficiary before being discharged from the health facility after delivery. 4. State/UT to ensure that JSY payments are made through Direct Benefit Transfer (DBT) mechanism through AADHAAR enabled payment system/Core Banking Solution where DBT mechanism has been rolled out. In case, Direct Benefit Transfer mechanism is not implemented in the State/UT, JSY payments to be made only through account payee cheques. Compliance of the above is a pre-requisite for JSY releases to the State/UT. 5. State will ensure that strict monitoring and verification of beneficiaries is done by State and district level health authorities to check malpractices. 6. State will ensure that grievance redressal mechanisms as stipulated under JSY guidelines are activated at the district and State levels. State will ensure the accuracy of JSY data reported at the HMIS portal of MOHFW and also furnish the Quarterly progress reports to the Ministry within the prescribed timeframe COMPONENTS Janani Suraksha Yojana (JSY) In order to promote safe Institutional deliveries, the GOI has implemented JSY throughout the country including J&K. Under this scheme, the incentives are being paid to mother beneficiaries at the following norms: S.No Area Incentive for mother beneficiary 1 Rural areas Rs. 1400.00 2 Urban areas Rs. 1000.00 3 BPL mothers delivering at home. Rs. 500.00 14 ASHAs will facilitate Antenatal checkups and accompany the mothers to the health institutions for delivery and will get the following incentives: S.No Districts Incentive for ASHA 1 All High focus and Non High Focus Districts Rs.600.00(Rs 300 for full ANC and Rs 300 for escorting the pregnant women) JSY cards, MCP cards and broader guidelines of JSY have already been made available to the District Health Societies. NOTE: JSY guidelines to be strictly followed and payments made as per the eligibility criteria. JSY benefit to the mother should be paid at the Health facility immediately after the delivery and before discharge. All payments to be made through crossed cheques / e-banking. The DDO should ensure that the JSY, MCP Card and Discharge slip have been prepared before making payment to the beneficiary as well as ASHA. JSY card and MCP card to be filled at the time of registration of pregnant women and not at the time of disbursement of cheque to the beneficiary and should be followed till the completion of pregnancy. Regular monitoring by Deputy Chief Medical Officers (District Nodal officers) for JSY. Physical verification of JSY beneficiaries to be done by the State and district level health authorities as per the following norms: ii) State level officers 2%. iii) Chief Medical Officer 5%. iv) District Nodal Officer (Deputy CMO) 5% v) Block Medical Officer 10% Accuracy of JSY data reported at the HMIS portal of MOH&FW to be ensured besides furnishing quarterly progress reports to the State Health Society as per the prescribed format for onward transmission to Ministry within the given timeframe. The list of JSY beneficiaries to be displayed at prominent places in the Health facility. Grievance redressal mechanisms as stipulated under JSY guidelines to be activated at the district and State levels. Quarterly reports of complaints received and action taken thereon by the Grievance Redressal Cell to be submitted to the State Health Society. Mother and Child Health Card (MCP) The State has already initiated Joint MCP card developed by the Ministry of Health & Family Welfare and Social Welfare for monitoring the services of MCH and Nutrition interventions. 15 This card will be filled at the time of first ANC. ASHA incentives and JSY benefits to the mother will be given upon verification and checking the entries in the Joint MCP card prepared by the ANM. Janani Shishu Suraksha Karyakram (JSSK) The Janani Shishu Suraksha Karyakram (JSSK) has been implemented in the State with a view to encourage all pregnant women to deliver in Public Health Facilities and full fill the commitment of achieving cent percent institutional deliveries. All Pregnant women and sick neonates till 30 days after birth who access government Health Institutions including SMGS Hospital, Jammu, Lal Ded Srinagar, G.B. Pant Hospital Srinagar and SKIMS Srinagar shall be entitled for availing following benefits:- S. No Entitlements for Pregnant Women: Entitlements for Sick Newborn till 30 days after birth 1 Free delivery Free and zero expense treatment. 2 Free caesarian section 3 Free drugs and consumables Free drugs &consumables. 4 Free diagnostics (Blood, Urine tests and Ultrasonography etc.) Free diagnostics. 5 Free diet during stay (up to 3days for normal delivery and 7days for caesarian section) Diet for mother during the stay of sick children in hospital for 5 days. 6 Free provision of blood (Relatives and attendants should be encouraged to donate blood for replacement) Free provision of blood. (Relatives and attendants should be encouraged to donate blood for replacement) 7 Free transport from home to health institution, between health institutions in case of referrals and drop back home Free transport from home to health institution, between health institutions in case of referrals and drop back home. 8 Exemption from all kinds of user charges Exemption from all kinds of user charges. NOTE: JSSK entitlements to be ensured to all pregnant women and sick newborns accessing Govt. health institutions. Drop back to be ensured to at least 70% of pregnant women delivering in the public health facilities. Effective IEC to be ensured. Grievance Redressal Cells constituted for JSY shall also look into the Grievances for JSSK. Submission of Quarterly Reports to be ensured. 16 Accredited Social Health Activist (ASHA) ASHA is the first port of call for any health related demands of deprived sections of the population, especially women and children, who find it difficult to access health services. She is a trained female health activist in the community who creates awareness on health and its social determinants and mobilizes the community towards local health planning and increased utilization and accountability of the existing health services. She is a good promoter of health practices. Criteria for selection of ASHA One ASHA has to be in place for a population of 1000. ASHA must be a woman resident of the village--- ‘Married/Widow/Divorced’ and preferably in the age group of 25 to 45 yrs. She should be a literate woman with formal education up to Eighth Std. In case the special circumstances require relaxation of the educational qualification of ASHA, the District Health Society needs to send the proposal to the State Health Society with full justification for seeking approval from Ministry of Health and Family Welfare, Government of India. She should have effective communication skills, leadership qualities and be able to reach out to every section of the community. Adequate representation from disadvantaged population groups should be ensured to serve such groups better. 12000 ASHAs have been engaged in the State so far. However during the year 2012-13, engagement of 2000 additional ASHAs has been approved in the Programme Implementation Plan (PIP). ASHAs are in place in majority of the villages and have been trained in module I to V. In the year 2013-14, the ASHAs will be trained in Module VI-VII. Uniforms to ASHA in High Focus Districts @ Rs. 1000.00 and in other districts @ Rs. 750.00. The amount has to be e-transferred to the account of ASHA. All payments to ASHAs be made through payees account Cheque/ electronic transfer on 10th of every month. ASHAs are not paid any fixed monthly remuneration. However, they are paid performance based incentives. Incentives for ASHAs: S.No Activity Incentive 1 Incentive under JSY Rs.600/- per delivery (Rs 300/ for full ANC + Rs 300/ for escorting pregnant women) 2 Incentive to ASHA for registration within 12 weeks. Rs 50/- 3 Incentive for full immunization per child(upto 1 year age) Rs 100 per child for full immunization in 1 st year of age 17 S.No Activity Incentive 4 Incentive for full immunization per child upto 2 years age(all vaccination received between 1 st and 2 nd year age after completing full immunization at 1 year age) Rs 50 per child for ensuring complete immunization upto 2 nd year of age of Child. 5 Incentive for Home Based Newborn Care Rs 250/- 6 Mobilizing Drop out Children for Immunization Sessions on VHND Rs 150 /- session 7 Incentive for birth registration, death registration Rs 50/- 8 Maternal Death Reporting Rs 200/- 9 Infant Death Reporting Rs 100/- 10 Incentive to ASHA for Roster duty at ASHA help desk in selected Delivery points. Rs. 150/- for 8 hours duty on rotation basis. 11 Reimbursement for Mobile user charges for ASHA Rs. 100 per month 12 Monthly meetings of ASHAs (Travel Expenses/Refreshment) Rs 75/- Meeting 13 ASHA incentive for sale of 50 sanitary napkins packs (In Pilot Districts only) Rs. 50/- 14 ASHA incentives for testing 50 salt samples per month in endemic districts Rs. 25/- per month 15 Leprosy Detection MB(Complete treatment) PB (Complete treatment) Rs 250/- 600/- 400/- 16 Motivation of any beneficiary for tubectomy/laproligations Rs 150 /- per operation 17 Motivation of any beneficiary for vasectomy Rs 200 /- per operation 18 Providing DOTS to the TB. Patients Rs 250 /- on completion of treatment 19 Pulse Polio Day Rs 75 /- x 3 days = Rs 225 20 For facilitating the monthly meeting of VHNCS followed by meeting of women and adolescent girls. Rs 150/- per month Job functions of ASHA Activities as mentioned in the table above and mobilizing the Pregnant Ladies for Antenatal checkups/dropouts for immunization. Accompanying the pregnant ladies to the institution for delivery. Tracking of Pregnant women from early registration in the first trimester up to post natal care after delivery in her respective areas. Tracking of Children up to full immunization stage Maintenance of ASHA Diary 18 Record of house hold visits, under one year children, pregnant ladies and the eligible couple register. Assisting the FMPHWs and AWWs in organizing Village Health & Nutrition Days. Facilitating the monthly meeting of VHSNC followed by the meeting of women and adolescent girls. Maintenance of register in which all the services provided viz registration of pregnant women, ANC, immunization, Oral pills, IUCD, sterilization- Male female, referral of sick newborns/children/ infants, spacing methods etc. are recorded with signature of the concerned health person. Monthly reports generated by ASHA as per her diary is to be consolidated at SC level. ASHA is a main service provider for Home Based Neonatal Care. She has to provide newborn care through a series of home visits which include the skills for weighing the newborn, measuring newborn temperature, ensuring warmth, promoting hand washing, providing skin, cord & eye care, supporting exclusive breast feeding, accessing low birth weight babies through the use of protocols and managing such babies through various means like monitoring weight supporting / counseling etc., detect signs and symptoms of sepsis, recognize post partum complications in the mother and refer appropriately etc. ASHA Diary ASHA has to record and track the pregnant women upto 42 days postnatal period and has also to follow the children till they are fully immunized. Besides, she has to attend Village Health and Nutrition Days for mobilizing women and children to avail health services being provided on VHN Day. She has also to facilitate holding of meeting of the Village Health Sanitation and Nutrition Committees (VHSNCs) and maintain records of untied funds of VHSNCs. All these activities need to be recorded for tracking them later on. The State Health Society is providing the diary to the District Health Society for distribution among ASHA for this purpose. Drug kit for ASHA ASHA have been provided drug kit in the previous year which will be replenished by the Block Medical Officer out of the available stock of medicines. Home Based Newborn Care (HBNC) Kit will be provided to ASHAs for Home Based Newborn Care. The contents of the kits will be as under: S.No. Equipment No. 1 Baby weighing scale with sling 1 2 Digital thermometer 1 3 Digital watch/Timer device 1 Consumables 4 Cotton 5 Gauze 6 Soap & Soap Case 19 S.No. Equipment No. 7 Baby Blankets, Locally made and Locally Procured 2 8 Spoon-stainless steel 1 ASHA Help Desk/ASHA Greh (New Activity) Escorting pregnant women to the hospital for institutional delivery is one of the important activities that an ASHA performs. The ASHA has to escort the pregnant women even during the odd hours which necessitates for keeping a provision of Help desk-cum-rest room at the hospitals which would provide space to the ASHAs for freshening up and taking rest for some time. Besides, it will also act as a help desk to provide required information to ASHAs. In the year 2012-13 30 ASHA Grehs were sanctioned and were also operationalized. In this year 2013-14 20 more ASHA Grehs have to be established at the health facilities Annexure “B”. ASHA GREH will be having one room with attached toilet and bathroom facility, having proper electrical fittings like light, fan or heater etc. The room should have a provision of at least two beds with all other accessories like bed sheets, bed covers, pillows, drinking water facility etc. Relevant informative documents on health issues shall remain available in ASHA GREH for reference. The room should be exclusively used by ASHAs and accessible for use on 24x7 basis. The management of ASHA GREH shall be assigned to ASHAs selected on the basis of performance and belonging to the nearby locality. Each selected ASHA shall be assigned the task of managing ASHA GREH on daily rotation basis. A roster duty register shall be maintained to record the use of the facility and performance of the duty by ASHAs. ASHAs will receive incentives for performing duty on roster basis. The overall management of ASHA GREH will be under the control of Rogi Kalyan Samiti (RKS) of the concerned health institution. ASHA shall be given incentive of Rs. 150 / day for performing roster duty for 8 hours. ASHAs from the adjoining areas will be called for roaster duty to be prepared by the concerned Block Medical Officer and submitted to the Medical Superintendent of the concerned Hospital. The incentives to ASHA for performing roaster duty shall be paid by the concerned Block Medical Officer after getting attendance from the I/C ASHA GREH/Medical Suptd of the Hospitals. Cost of Operationalization of ASHA HELP DESK/ASHA GREH will be Rs. 10, 000/facility as per the breakup given below: S.No. Items Upto a maximum of 1 Two wooden Beds @ Rs. 1500/- Rs. 3000/- 2 Bedding and Linen @ Rs. 1500/ Rs 3000/- 3 Fan and Heater Rs 2000/- 4 Table and Chair Rs. 2000/- Total Rs.10,000/- 20 Delivery points At present there are 133 functional delivery points (Annexure C) in the State as per the benchmark set by GoI i.e. i. SCs conducting > 3 deliveries/ month. ii. PHCs/Non-FRUs conducting > 10 deliveries/month. iii. FRUs conducting >20 deliveries/ month. iv. District Hospitals conducting >50 deliveries/ month. Services to be provided in these Delivery Points: A) All District Hospitals and other similar district level facilities to provide the following services: 24x7 service delivery for CS and other Emergency Obstetric Care. 1st and 2nd trimester abortion services. Facility based MDR. Essential newborn care and facility based care for sick newborns. Family planning and adolescent friendly health services RTI/STI services. Functional Blood Storage Unit / Blood Bank. B) CHCs and other health facilities at sub district level (above block and below district level) functioning as FRUs to provide the same comprehensive RMNCH Services as the district hospitals. C) 24x7 PHCs and Non FRUs to provide the following services: 24x7 BeMOC services including conducting normal delivery and handling common obstetric complications. 1st trimester safe abortion services. (MVA upto 8 weeks and MMA upto 7 weeks) RTI/STI services. Essential newborn care and facility based care for sick newborns. Family planning D) All identified SCs/ facilities will: Conduct Delivery by SBAs. Provide IUD Services Provide Essential New born care services. Provide ANC, PNC and Immunization services. Provide Nutritional and Family planning counseling. Conduct designated VHND and other outreach services. Maternal Death Review (MDR) Under NRHM, various attempts are being made to reduce Maternal Mortality by improving quality of maternal health care delivery and stepping up monitoring. Government of India has 21 decided to take up Community based maternal death review (CBMDR) and the Facility based maternal death review (FBMDR) which would help in identifying the gaps in the existing health care delivery systems, prioritizing and planning for intervention strategies and to reconfigure health services. The Maternal Death Review will be taken up both at Facility level and Community level in all Districts of the State. Community-Based MDR Community based MDR using a verbal autopsy format is a method of finding out the medical causes of death and ascertaining the personal, family or community factors that may have contributed to the death. The verbal autopsy consists of interviewing people who are knowledgeable about the events leading to the death such as family members, neighbors and traditional birth attendants. Community based reviews must be taken up for all deaths that occurred in the specified geographical area, irrespective of the place of death, be it at home, facility or in transit. Procedure for Community-Based Verbal Autopsy i) The ASHA/AWW/ANM will inform/intimate all women deaths in the age group of 15 to 49 years from her area by telephone to the BMO within 24 hour. The local panchayats and other relevant persons/ groups may also be encouraged to inform the BMO about women’s death in their area. ii) The ASHA/AWW/ANM will fill up the format for primary informant (Annexure “D”) for all women deaths (age 15-49) and send the format to the BMO within 24 hours. Format for primary informer gives information whether the death is a suspected maternal death or a non maternal death. iii) Line listing of maternal deaths should be submitted to the BMO by the ASHA by 5th of every month. In case no death has occurred during the month, the ASHA has to submit a ‘Nil’ report. iv) The ASHA/AWW/ANM should also ensure the presence of the respondents during the visit of the investigation team Facility-Based MDR Facility Based Maternal Death Review will be taken up for all Government hospitals viz. Medical College/DHs/SDHs/CHCs where more than 500 deliveries are conducted in a year. Procedure for Facility-Based Autopsy i) All Maternal deaths occurring in the hospital, including abortions and ectopic gestation related deaths, in pregnant women or within 42 days after termination of pregnancy irrespective of duration or site of pregnancy should be informed immediately by the Medical officer who has treated the mother and was on duty at the time of occurrence of death to the Facility Nodal officer (FNO) 22 ii) The FNO of the hospital should inform the maternal death to the District Nodal Officer (DNO) and State Nodal Officer on telephone within 24 hours of the occurrence of death. iii) The Nodal Officer of the hospital should complete the format for Primary informant Annexure “D” and send it to the District Nodal Officers within 24hrs of the occurrence of maternal death At the District level the Maternal Death Review is envisaged at two levels. Maternal Death Review under chairmanship of CMO. Maternal Death Review by District Level Committee under chairmanship of District Magistrate. Composition of District Level Committee District Magistrate Chairperson Chief Medical Officer Member Secy/ Convener Dy. Chief Medical Officer Member District Nodal Officer (MDR) Member Facility Based Nodal Officer (MDR) Member Representative of Federation of Obstetric and Gynecological Society of India (FOGSI) Member Committee should meet at least once in a month to review the maternal death cases and should submit the minutes of the meeting and corrective actions taken to reduce the maternal deaths to the State Health Society. The meeting of the District Committee shall be held irrespective of the fact whether any maternal death has occurred in that particular month or not. Maternal Death Reporting:- A provision of Rs. 200.00 has been kept for reporting maternal death by a community volunteer/ ASHA. The report of such deaths will be submitted to the District Health Society who will take appropriate action. Maternal Death Investigation (Verbal Autopsy):- An amount of Rs. 250 per investigation shall be provided to Deputy CMO/BMO/MO for Maternal Death Investigation (Verbal Autopsy). Investigation reports are to be furnished to GOI through State Health Society on monthly basis/Quarterly basis. Incentive to SBAs for conducting home deliveries. To reduce the MMR and to ensure safe deliveries in inaccessible/snow bound areas of the State, GoI has approved an incentive of Rs1000/ delivery for SBA trained health functionaries (ANMs/LHVs/SNs) for conducting home deliveries. 23 This incentive will be provided with the condition that there should be at least 50% Institutional Deliveries at the end of the year in the nearest PHC. This scheme is launchead as a pilot project in the following Districts Bandipora, Baramulla, Shopian, Kupwara, Kargil, Leh, Kishtwar, Reasi, Doda and Udhampur. Incentives will be given in only those areas where the pregnant women cannot reach the facility and this will be certified by the ASHA/Panches/Sarpanches of the concerned areas. This will ensure safe delivery to the beneficiary and also she will be entitled for JSY and JSSK benefits as per guidelines. CHILD HEALTH ROAD MAP FOR PRIORITY ACTION: CHILD HEALTH Priority Actions to be carried out by state for Child Health Interventions during 2013-14. 1. All the delivery points should have a functional Newborn Care Corner consisting of essential equipment and staff trained in NSSK. The staff must be trained in a 2 days NSSK training package for skills development in providing Essential Newborn Care. 2. Special Newborn care Units (SNCU) for care of the sick newborn should be established in all Medical Colleges and District Hospitals. All resources meant for establishment of SNCUs should be aligned in terms of equipment, manpower, drugs etc. to make SNCUs fully operational. 3. SNCUs are referral centres with provision of care to sick new born in the entire district and relevant information must be given to all peripheral health facilities including ANM and ASHA for optimum utilisation of the facility. Referral and admission of out born sick neonates should be encouraged and monitored along with inborn admissions. 4. NBSUs being set up at FRUs should be utilised for stabilization of sick newborns referred from peripheral units. Dedicated staff posted to NBSU must be adequately trained and should have the skills to provide care to sick newborns. 5. All ASHA workers are to be trained in Module 6 & 7 (IMNCI Plus) for implementing Home Based Newborn Care Scheme. The ASHA kit and incentives for home visits should be made available on a regular basis to ASHAs who have completed the Round 1 of training in Module 6 6. All ANMs are to be trained in IMNCI. 7. All Medical Officers and Staff Nurses, positioned in FRUs/DH and 24x7 PHCs should be prioritised for F-IMNCI training so that they can provide care to sick children with diarrhoea, 24 pneumonia and malnutrition. 8. Infant and Under fives Death Review must be initiated for deaths occurring both at community and facility level. 9. In order to promote early and exclusive breastfeeding, the counselling of all pregnant and expectant mothers should be ensured at all delivery points and breastfeeding initiated soon after birth. At least two health care providers should be trained in ‘Lactation Management’ at District Hospitals and FRUs; other MCH staff should be provided 2 days training in IYCF and growth monitoring. 10. Nutrition Rehabilitation Centres are to be established in District Hospitals (and/or FRUs), prioritising tribal and high focus districts with high prevalence of child malnutrition. The optimum utilisation of NRCs must be ensured through identification and referral of Severe Acute Malnutrition cases in the community through convergence with Anganwadi workers under ICDS scheme. 11. Line listing of newly detected cases of SAM and Low birth weight babies must be maintained by the ANM and their follow-up must be ensured through ASHA. 12. In order to reduce the prevalence of anaemia among children, all children between the ages of 6 months to 5 years must receive Iron and Folic Acid tablets/ syrup (as appropriate) as a preventive measure for 100 days in a year. Accordingly appropriate formulation and logistics must be ensured and proper implementation and monitoring should be emphasised through tracking of stocks using HMIS. As per National Iron Plus Initiative, IFA syrup is to be administered in biweekly fashion under supervision from ASHA. 13. Use of Zinc should be actively promoted along with use of ORS in cases of diarrhoea in children. Availability of ORS and Zinc should be ensured at all sub-centres and with ASHAs. 14. Data from SNCU, NBSU and NRC utilisation and child health trainings (progress against committed training load) must be transmitted on a monthly basis to the Child Health Division. 15. Infant Young Child Feeding Practices Guidelines launched by GoI to be implemented in current financial year. Growth monitoring equipments to made available at each Health Facility i.e Sub Centre, PHC, District Hospital. At District Hospitals and high case load facilities, RMNCHA counsellor to be hired to undertake IYCF counselling after growth monitoring by Staff Nurse/ANM. IYCF trainings for ASHA/ANM/Staff Nurses to be undertaken. B. Priority Actions to be carried out by state for Immunization 25 1. Immunization weeks should be continued as a part of routine strategy during non – immunization days to improve coverage especially in community where no immunization services are provided or services are deficient or all high risk pockets or migrant population as identified in pulse polio program etc. The available human resources to be redeployed during these weeks for effective implementation 2. The micro plans for routine immunization must be updated on 6 monthly intervals both for Routine Immunization and Immunization weeks, taking into account the information available and information on migrant population/ missed areas covering inaccessible, remote areas and urban slums. The missed areas or migrant population as identified during polio programme or any other source of information must be incorporated in the micro plans and activities carried out as per micro-plan. 3. Full time State Immunisation Officer should be in place. 4. District Immunisation Officer should be in place in all the districts. The placement of ANMs at all session sites must be ensured. 5. Due list of beneficiaries must be available with ANM and ASHA and village wise list of beneficiaries should be available with ASHA after each session and tickler bags should be used for monitoring in addition to the timely and regular updating of information in MCTS portal. 6. The immunisation session must be carried out on a daily basis in District Hospitals and FRUs/ 24x7 PHCs with considerable case load in the OPD. 7. Cold chain mechanics must be placed in every district with a definite travel plan so as to ensure that at least 3 facilities are visited every month as a preventive measure (check-up of equipment). 8. The paramedical staff should be identified as the Cold Chain Handler in all cold chain points and their training must be ensured. In case of non-availability, the responsibility should be given to next para medical staff in position that should be equally trained. 9. The coverage of immunization to children at 18 months of age is very low. The opportunity for Full immunization of the children at 1year and ensuring that these children are also vaccinated at 2nd year of age must be emphasized and monitored. The ASHAs/link workers are especially encouraged by providing financial incentive of Rs 100 and Rs 50 per child to achieve this. 11. District AEFI Committees must be in place and investigation report of every serious AEFI 26 case must be submitted within 15 days of occurrenceRapid response team should be in place in priority districts identified by the states. 12. There should be a regular evening meeting on Immunization days to review the implementation of open vial policy and also reviewing implementation of programmatic gaps. 13. Quarterly review at all levels should be conducted on the issues as identified during evening meetings, for which funds are provided under ROP Introduction Before launch of NRHM in the State, the Infant Mortality Rate was 52 as per Sample Registration System (SRS) 2006. Different strategies have been adopted under NRHM which are directed towards reduction of NMR & IMR in the State. State has to achieve the following targets as fixed by MoH&FW, GoI by end of March 2014. Indicator Current Status (SRS 2011) Target 2013-14 Neonatal Mortality Rate (NMR) 32 27 Infant Mortality Rate (IMR) 41 34 Under 5 Mortality 45 37 With these targets in consideration, the following specific interventions are being taken up during the current year: A) Facility Based New born Care:- During the current year, emphasis will be continued upon strengthening of existing Facility Based Newborn Care Units viz. SNCUs/NBSUs/NBCCs at different levels for their optimum utilization. Special Newborn Care Units: - Special Newborn Care unit (SNCU) is a neonatal unit in the vicinity of labour room at District hospital which would provide level-II care for Sick New Borns. Twelve SNCUs have been operationalized till date & three more are to be established during this year. Please refer Annexure “E” for list of Hospitals where SNCUs are established and are going to be set up. List of Equipments for SNCU Equipment for Individual Care S No. Item Description Essential /Desirable. Quantity 1 Open care system: radiant warmer, fixed height, with trolley, drawers, O2-bottles E 12 27 2 Phototherapy Unit, Single Head, High Intensity E 6 3 Resuscitator hand-operated for neonate, neonate,250ml E 2 4 Resuscitator hand-operated for neonate, neonate,500ml E 4 5 Laryngoscope set, neonate E 6 6 Suction Pump,portable,220V E 2 7 Suction Pump, foot operated E 2 8 Surgical Instrument, suture/SET E 2 9 Syringepump,10,20,50 ml, single phase E 3 10 Oxygen hood, S and M, set of 3 each, including connecting tubes E 6 11 Oxygen supply system E 1 12 Oxygen concentrator D 4 13 Thermometer, clinical, digital, 32-43 C. E 12 14 Electonic baby- weighing scale, 10 kg <5g> E 4 15 Pulse oxymeter,bedside,neonatal E 6 16 Stethoscope, binaural,neonate E 12 17 Sphygmomanometer, neonate,electronic E 6 18 Examination Light, Mobile, 220-12V E 6 19 Syringe Hub Cutter E 2 20 Measuring tape, vinyl-coated, 1.5 m E 2 21 Kidney basin, stainless steel, 825 ml E 4 22 Dressing tray, stainless steel, 300x200x30 mm E 4 23 Infusion stand, double hook,on castors E 1 24 Indicator, TST control spot/ PAC-300 D 1 25 Irradiance meter for phototherapy units D 2 26 Monitor, vital sign, NIBP, HR, SpO2, ECG, RR, Temperature D 1 27 ECG Unit, 3 channel, poratable D 2 28 Infantometer, plexi E 1 29 X-Ray Mobile D 1 30 Transport incubator, basic, with battery and oxygen D 1 31 Autoclave, steam, bench top D 1 General Equipments 1 AC (1.5 tonne) E 1 2 Generator Set, 25-50 KVA E 1 3 Refrigerator, Hot Zone, 1101 E 1 4 Voltage servo-stabilizer(three phase): 25-50 KVA E 1 5 Room Heater(Oil) D 4 28 6 Computer with printer D 1 7 Spot lamps E 2 8 Wall clock with second hand E 2 Equipment for Disinfection 1 Sterilising Drum, 165 diameter D 1 2 Electric sterilizer D 1 3 Washing machine with dryer E 1 4 Gowns for staff and mothers E 1 5 Washable slippers E 4 Laboratory Equipment 1 Centrifuge, hematocrit, Benchtop, upto 12000 rpm, including rotor E 1 2 Microscope, Binocular with illuminator D 1 3 Bilirubinometer, Capillary based D 1 4 Glucometer with Dextrostix E 3 Operational cost has been approved for 10 SNCUs @ Rs 10 lakhs and @ Rs. 5 lakhs for the SNCUs which have been established during last quarter of 2012-13 or are going to be operationalised soon. Please refer Annexure “F” for list of Hospitals in this regard. The component wise detail of Operational Cost is given below: Consumables for SNCU includes meconium aspirator adaptors, infusion pumps, Cuvettes, Vacuum tubes, lancets, capillary tubes, sealing compound, masks & caps, surgical gloves, suction tubes, feeding tubes, syringes & needles, cotton wool, compress gauze, connectors, disinfectants & antiseptics, adhesive tapes, scalpels, umbilical venous catheters, blood transfusion sets, endotracheal tubes, electrodes for ECG recorder, microscopic slides, paper sheets crepe for sterilization pack, etc. Human Resources approved for this financial year for each SNCU at District Hospitals:- 1. One Child Specialist. 2. Four Medical Officers (MBBS) to be engaged on contract basis. 3. Five Staff Nurses. 4. One Lab Technician. Recurring or running cost per year Operational cost of Rs. 10.00 Lakhs (for One Year) Operational cost of Rs. 5.00 lakhs (for six months) Consumables Rs. 3,50,000 1,75,000 Maintenance cost Rs. 6,50,000 3,25,000 Sub Total Rs. 10,00,000 5,00,000 29 Newborn Stabilization Units:- Stabilization unit is facility within or in close proximity of the Maternity ward where sick and low birth weight new born can be cared for short period. 75 NBSUs have been established till date. List of Equipments for NBSU S No. Item Description Essential/ Desirable. Quantity 1 Open care system: radiant warmer, fixed height, with trolley, drawers, O2-bottles E 3 2 Phototherapy Unit, Single Head, High Intensity E 1 3 Resuscitator hand-operated for neonate, neonate,500ml E 1 4 Laryngoscope set, neonate E 2 3 Electronic baby weighing scale 10 kg <5g> E 1 4 Suction Pump, foot operated E 1 5 Thermometer, Clinical, Digital. E 4 6 Light examination, mobile, 220-12 V E 4 9 Syringe Hub Cutter E 1 Strengthening of existing NBSUs will be carried out this financial year for which an amount @ Rs 87,500 /unit has been approved as operational cost for 72 NBSUs. List annexed as Annexure ‘G’. Recurring or running cost per year Amount in Rupees Consumables Rs.12,500 Maintenance cost Rs. 75,000 Sub Total Rs. 87,500 Consumables for NBSU includes I/V cannula 24/26 G, mucous extractors, feeding tubes, oxygen cylinder 8 F, suction tubes, Sterile gloves, Cotton wool, Disinfectants etc. Newborn Care Corners: All the delivery points should have a functional Newborn Care Corner consisting of essential equipment and staff trained in NSSK. 273 Newborn Care Corners have been established in the State till date for providing essential newborn care. List of Equipments for NBCC S No. Item Description Essential /Desirable. Quantity 1 Open care system: radiant warmer, fixed height, with trolley, drawers, O2-bottles E 1 30 2 Resuscitator hand-operated for neonate, neonate,500ml E 1 3 Weighing Scale, spring E 1 4 Pump suction, foot operated D 1 5 Room Thermometer E 1 6 Light examination, mobile, 220-12 V D 1 Consumables required for NBCC 7 I/V Cannula 24 G, 26 G E 8 Extractor, mucus, 20ml E 9 Towels for drying and wrapping the baby E 10 Sterile equipment for cutting and tying the cord E 11 Tube, feeding, CH07, L40cm, E 12 Oxygen cylinder 8 F D 13 Sterile Gloves E For strengthening of existing NBCCs Operational cost for 273 units @ Rs 10,000/unit has been approved this financial year with the condition that the districts will saturate the functional delivery points with NSSK trained personnel and radiant warmer and utilize the resources optimally. List of NBCCS annexed as Annexure ‘H’. Recurring or running cost per year Amount in Rupees Consumables Rs. 2,500 Maintenance cost Rs. 7,500 Sub Total Rs. 10,000 Note: Detailed FBNC Guidelines & Toolkit for setting up of SNCUs/ NBSUs/ NBCCs has already been circulated to the districts. These guidelines are also available on website of National Rural Health Mission, J&K www.jknrhm.com. B. Home Based Newborn Care:- Reducing infant and child mortality is one of the foremost goals of NRHM. The country as a whole and J&K in particular has made significant progress in reducing infant mortality rates. However it is now clear that a high proportion of the infant death burden is related to newborn deaths, and further gains in reducing IMR are likely only through a focuses effort at implementing evidence based cost effective interventions that affect neonatal health outcomes. There is sufficient evidence to demonstrate that despite the increasing numbers of institutional deliveries a substantial proportion of neonatal deaths occur in the home. Thus the provision of Home Based New Born Care is an effective approach for achieving the desired reduction in infant mortality in rural and poor population. 31 Under this programme ASHA is supposed to visit the newborns in their homes and provide visits on (Day 3, 7, 14, 21, 28, 42) in case of institutional deliveries and seven visits (Day 1, 3, 7, 14, 21, 28, 42) in case of Home deliveries. HBNC visits are to be monitored by the ASHA facilitators and ascertained by concerned ANM. The ASHA is to be paid Rs 250/- for conducting home visits for the care of newborn and post partum mother as per HBNC guidelines. Payments to be made subject to following:- Ensure that birth weight is recorded in MCP card. Ensure that the newborn is immunized with BCG, first doses of OPV & DPT/ Pentavalent vaccine. Ensuring birth registration. Both mother and newborn are safe until 42 nd day of delivery. During home visits ASHA will provide following services which include, Weighing the newborn, Measuring newborn temperature, Ensuring warmth, Supporting exclusive breastfeeding, Diagnosing and counseling in case of problems with breastfeeding, Promoting hand washing , Providing skin, cord and eye care, Health promotion and counseling mothers and families on key messages on newborn care, Ensuring prompt identification of sepsis or other illnesses. C. Janani Shishu Suraksha Karyakram (JSSK) JSSK has been implemented in the State vide Govt. Order No. 516-HME of 2011. Since the inception of scheme benefits under this prograame were proved to neonates only (0-30 days), however during the current financial year entitlements for sick child has been extended upto infants (0 to 1 year age group). Details given under Maternal Health Programme. D. Nutrition Rehabilitation Centre –NRC NRC is a unit in a health facility where children with Severe Acute Malnutrition (SAM) are admitted and managed. Children are admitted as per the defined admission criteria and provided with medical and nutritional therapeutic care. Once discharged from the NRC, the child continues to be in the nutrition rehabilitation program till he/she attains the defined discharge criteria as per the guidelines. Location and size of NRC NRC is a special unit, located in a health facility and dedicated to the initial management nd nutrition rehabilitation of children with severe acute malnutrition. The unit should be a distinct area within the health facility and should be in proximity to the pediatric ward/inpatient facility. The NRC should have the following Facilities: Patient area to house 10 beds; in NRC adult beds are kept so that the mother can be with the child. 32 Play and counseling area with toys; audiovisual equipment like TV, DVD player and IEC material. Nursing station Kitchen and food storage area attached to ward, or partitioned in the ward, with enough space for cooking, feeding and demonstration. Attached toilet and bathroom for mothers and children, along with two separate hand washing areas. The approximate covered area of the NRC should be about 150 square feet per bed, plus 30% for ancillary area. A 10 bedded NRC should have a covered area of about 1950 square feet; this will include the patient area, play and counseling area, nursing station, kitchen, storage space, two bathrooms and two toilets. NRC should have a cheerful, stimulating environment; it should be child friendly. Walls can be brightly painted and decorated. Ward should have sufficient space for all mothers/caregivers staying with the children to sit together and be given cooking and feeding demonstration. One Nutrition Rehabilitation Centre has been established at G.B Pant Hospital, Srinagar and another one is under construction in SMGS Hospital, Jammu. Budget for 10 bedded NRC as per Guidelines of MoH & FW, GoI S. no. Items Unit cost Total cost A. One-time expenditure A1 Civil Work (renovation) 1.1 Ward 25,000 25,000 1.2 Kitchen 20,000 20,000 1.3 Bathroom and toilets 15,000 15,000 A2 Cots and Mattresses (10 Cots & mattresses @ Rs 2500 each) 2,500 25,000 A3 Essential Ward equipments 50,000 50,000 A4 Other Ward equipments 35,000 35,000 A5 Kitchen equipments 30,000 30,000 One-time expenditure 2,00,000 B. Recurrent expenditure B1 Kitchen Supplies 15,000 (per month) 1,80,000 B2 Pharmacy Supplies and Consumables 15,000(per month) 1,80,000 B3 Other Costs Wage Compensation and food for mother/care giver* (Rs 100 X 10 beds X 30days X 12 months) Rs.100/day 3,60,000 Maintenance of equipments, linen, Cleaning supplies 3,500(per month) 42,000 Contingency 1,500(per month) 18,000 33 Subtotal 64,500 7,80,000 TOTAL COST (A+B) 9,80,000 Details of equipments and supplies for NRC i. Essential Ward equipments Glucometer (1) Thermometers (preferably low-reading) (2) Weighing scales (Digital) (3: one each to be kept in Ward, OPD and Emergency area) Infantometer (1 each for OPD & NRC) Stadiometer (to measure standing height) (1) Resuscitation equipments Suction equipment (low pressure) ii. Other Ward equipments IV stands Almiras, Shoe racks, Dust bins, Room Heaters IEC – Audio/visual materials (TV; DVD player) Toys for structural play Calculator & Clock Reference height and weight charts iii. Kitchen equipments Cooking Gas Dietary scales (to weigh to 5 gm.) Measuring jars Electric Blender (or manual whisks) Water Filter Refrigerator Utensils (large containers, cooking utensils, feeding cups, saucers, spoons and jugs, etc.) iv. Drugs and Consumables Antibiotics: (Ampicillin/Amoxicillin/Benzyl penicillin Chloamphenicol Cotrimoxazole Gentamycin Metronidazole Tetracycline or Chloramphenicol eye drops Atropine eye drops ORS Electrolyte and minerals Potassium chloride Magnesium chloride/ Sulphate iron syrup Multivitamin Folic acid vitamin A syrup Zinc Sulfate or dispersible Zinc tablets Glucose (or sucrose) 34 IV fluids (ringer’s lactate solution with 5% glucose; 0.45% (half normal) saline with 5% glucose; 0.9% saline (for soaking eye pads) Cannulas, IV sets, Pediatric Nasogastric tubes v. Kitchen Supplies Supply for making Starter and Catch up Diet Dried Skimmed Milk Whole dried milk Fresh whole milk Puffed rice vegetable oil Foods similar to those used in home E. Infant and Young Child Feeding : Infant and Young Child Feeding is a set of well-known and common recommendations for appropriate feeding of new-born and children under two years and includes the following care practices: a. Initiation of breastfeeding immediately after birth, preferably within one hour. b. Exclusive breastfeeding during the first six months of life i. e 180 days (no other foods or fluids, not even water; but allows infant to receive ORS, drops, syrups of vitamins, minerals, medicines, when required) c. Timely introduction of complementary foods (solid, semisolid or soft foods) after the age of six months i. e 180 days. d. Age appropriate complementary feeding for children 6-23 months, while continuing breastfeeding. e. Active feeding for Children during and after illness. f. Continued breastfeeding for 2 years or beyond The adoption of appropriate IYCF practices by the families: Reduce the risk of child mortality Reduces the risk of infant and child hood illnesses Increases productivity by enhancing cognitive functions Helps spacing pregnancies as Breast Feeding is the most effective contraceptive (98.2%) in the first six months of lactation. Reduces burden on health system and costs for societies by protecting against chronic diseases Reduces cost of managing malnutrition (both undernutrition and obesity) Interventions are being implemented by other Departments, however the reach of counselling for improvement in the status of Infant and Young Child Feeding remain poor. National Rural Health Mission provides a valuable opportunity to bring greater attention and commitment to 35 promote IYCF interventions through the health system, both at the health facility and community outreach level. IYCF Counselling Centre State proposes to establish 24 IYCF Counselling Centre in 22 District Hospitals and 02 Medical Colleges this financial year .The one time establishment cost for each centre is Rs 12,500/- has been approved by MoH&FW, GoI for 24 Centres. The breakup of the budget is as under: Activity Unit Cost Remarks Infrastructure Rs. 10,000 per centre Infrastructure cost includes minor renovations, paint, curtains and furniture. Equipment(for both inpatient & OPD) Rs. 2500 per site Infantometer, weighing scales, WHO growth standards (Charts), doll & breast model, syringe pump, 250 ml capacity steel bowl, spoon, specific stationary, counseling flip chart. The counseling centre would provide following package of services: 1. Communication and counselling on IYCF. 2. Growth monitoring. 3. Information about services available through community outreach (e.g.; immunization) 4. Provision for Vitamin A and IFA s supplements (if not received in the outreach) for children older than 6 months. 5. In case child is born prematurely or with low birth weight, one to one counselling session should be conducted with the mother/caregiver and follow up visits to the centre requested. A Nutrition counsellor/ IYCF counsellor needs to be appointed to manage these centres to counsel and solve referral problems. Nutrition counsellor can provide counselling and support not only to mothers/ caregivers of children discharged from SCNU but also other babies including LBW and preterm babies born at these facilities or referred from peripheral health facilities. They shall also regularly visit children admitted as inpatients and counsel caregivers of children identified as underweight or stunted. The State proposes to hire 24 RMNCH/IYCF counsellors for 22 District Hospitals and 2 Govt. Medical Colleges. Breast Feeding Awareness Week: For creating awareness among the people on benefits of breast feeding, IEC & BCC activities shall be carried out during Breast Feeeding week (1–7 August 2013) at all block/ district headquarters and medical colleges for promoting breast feeding. An amount of Rs. 3600/- has 36 been approved to be kept at the disposal of the heads of the institutions for carrying out activities like IEC and organizing camps with focus of initiation of breastfeeding within one hour of delivery. E. Child Death Review (CDR) Reducing infant mortality is one of the key goals under NRHM. Multipronged, evidence based strategies have been adopted in the national programmes to prevent neonatal, infant and child deaths. The decline in neonatal mortality is slow and has not kept pace with the overall decline in child mortality. It is well understood that for any further progress to be made now, the focus must shift to age groups most vulnerable to morbidity and mortality and to geographical areas and populations areas where mortality is higher. Children in the age group 0-59 months will be included in the review. All deaths in this age group will be reported irrespective of the place it takes place: at home, in health facility or in transit. The review processes will remain the same for all children; however the details to be investigated will vary in neonates (0-28 days) and children (29 days-59 months). Child Death Review will be undertaken at two levels: 1. Community level (Community Based Child Death Review) 2. Facility Level (Facility Based Child Death Review ) A. Guidelines for Community Based Child Death Review Community based reviews are undertaken for deaths that occur in the specified geographical area, irrespective of the place it takes place: at home, in health facility or in transit. Steps for community based Child Death Review are as follows: Step 1: Notification of child death Step 2: Investigation of death Step 3: Data transmission and analysis Step 4: Feedback for improved planning and institution of corrective measures. 37 B. Guidelines for Facility-Based CDR Facility Based Child Death Review will be taken up in all government teaching and referral hospitals and First Referral Units (District, Sub district, Area Hospitals/Taluq Hospitals) that have been designated as ‘delivery points’. Steps for Facility- Based CDR Step 1: Notification of Child Deaths. Step 2: Investigation Step 3: Data Flow & Ananlysis Step 4: Feedback for improved planning and instituting corrective measures. Annual Child Death report should be prepared and disseminated to all stakeholders. It should also be used for the purpose of formulating Annual State and District programme Implementation plans. The reports are to be formally presented at District and State level at the following platforms: District Child Death Review Committee State Level Taskforce District Child Death Review Committee: The Maternal CDR Committee should be assigned the responsibility of reviewing Child Death Reports as there are inter-linkages between maternal and neonatal deaths and the indirect causes are likely to be same in many cases. Additional members may be brought on the same committee for review of child deaths and the following composition is suggested: Members of District Child Review Committee: 1. District Magistrate/District Collector ( Chairperson) 2. Chief Medical Officer/Civil Surgeon (Member Secretary) 3. District Nodal Officer (for Child Death Review ) 4. District Project Officer for ICDS 5. Representative/s from recognised professional bodies (Indian Academy of Paediatrics, National Neonatology Forum, IAPSM) 6. Expert from medical college/development agency (if present/located in the district) 7. Any other official or person deemed important for providing a specific technical input (at the discretion of the Chairperson) 38 Incentives: Infant Death Reporting (0-1 year): - A provision of Rs.100 has been kept for reporting infant death by a community volunteer/ ASHA. The report of such deaths is to be submitted to the District Health Society who will take appropriate action. Infant Death Investigation (Verbal Autopsy):- An amount of Rs. 250 per investigation shall be provided to Medical Superintendent/ Deputy CMO/BMO/ Paediatrician for Infant Death Investigation (Verbal Autopsy). Investigation reports are to be furnished to GOI through State Health Society on monthly and quarterly basis. F. Rashtriya Bal Swastha Karyakram (School Health Programme): Rashtriya Bal Swasthya Karyakram (RBSK), is new initiative of MoH&FW, GoI, under National Rural Health Mission, aimed at screening children from 0 to 18 years of age for 4 Ds- Defects at birth, Diseases, Deficiencies and Developmental Delays including Disabilities. Children diagnosed with illnesses shall receive treatment including surgical interventions and follow up at tertiary level, free of cost under this programme. The objective of this initiative is to improve the overall quality of life of children, decrease child mortality, morbidity and out of pocket expenditure of the poor families. Child Health Screening and Early Intervention Services envisage to cover 30 identified health conditions for early detection, free treatment and management through dedicated mobile health teams at block level in the country. The teams will carry out screening of all children in the pre- school age (0-5) enrolled at Anganwadi centres at least twice a year besides screening of all children (6-18) studying in Government and Government aided schools, whereas the newborns will be screened for birth defects in health facilities by service providers and during the home visits by ASHAs. District Early Intervention Centres are planned to be set up as first referral point for further investigation, treatment and management. Tertiary care centres would be roped in for management of complicated cases requiring high-end medical care and treatment. This herculean effort is ultimately targeted to benefit more than 27 crore children annually in a phased manner in the country. The scheme has been pended in the RoP 2013-14, due to limited resource cap. However the scheme shall be again submitted in supplementary PIP for approval. Implementation Mechanisms The Operational Guidelines outline the following mechanism to reach all the target groups of children for health screening- For new born: • Facility based newborn screening at public health facilities, by existing health manpower. • Community based newborn screening at home through ASHAs for newborn till 6 weeks of age during home visitation on (Day 3, 7, 14, 21, 28, 42) in case of institutional deliveries and seven visits (Day 1, 3, 7, 14, 21, 28, 42) in case of Home deliveries. For children 6 weeks to 6 years: • Anganwadi Center based screening by the dedicated Mobile Health Teams twice a year. 39 For children 6 years to 18 years: • Government and Government aided school based screening by dedicated Mobile Health Teams twice a year. District Early Intervention Center (DEIC). Under this component an Early Intervention Center will be established at the District Hospitals. The Early Intervention Center will function as first referral point for further investigation, management and for providing referral support to children detected with health conditions during screening check-ups. The proposed composition of team as per the guidelines of MoHFW, GOI at the District Early Intervention Center (DEIC) is as under: 1. Paediatrician -1 2. Medical Officer (MBBS) 1 3. Dental Doctor -1 4. Physiotherapist 1 5. Audiologist & Speech Therapist 1 6. Psychologist 1 7. Optometrist 1 8. Early Interventionist cum Special Educator cum Social Worker 1 9. Lab Technician 2 10. Dental Technician 1 11. Manager 1 12. Data Entry Operator 1 Role of District Early Intervention Centre: 1. Providing referral services to referred children for confirmation of diagnosis and treatment. 2. Screening children at the “District Early Intervention Center” 3. Visit all newborns delivered at the District Hospital, including those admitted in SNCU, postnatal and children wards for screening all newborns irrespective of their sickness for hearing, vision, congenital heart disease before discharge 4. Ensure that every child born sick or preterm or with low birth weight or any birth defect is followed up at the District Early Intervention Center 5. All the referrals for developmental delay are followed and records maintained 6. The Lab Technician of the DEIC would screen the children for inborn error of metabolism and other disorders, at the District level depending upon the logistics and local epidemiological situations 7. Ensure linkage with tertiary care facilities through agreed MOU. Mobile Health Teams: Block will be the hub of activity for the programme; at least two to three dedicated Mobile Health Teams in each Block will be engaged to conduct screening of children. Villages within the jurisdiction of the Block would be distributed amongst the mobile health teams. The number of teams may vary depending on the number of Anganwadi Centers, difficult to reach areas and 40 children enrolled in the schools. The screening of children in the Anganwadi Centers would be conducted at least twice a year and at least once a year for school children to begin with. The proposed composition of Mobile Health Teams at block level as per the guidelines of MoHFW, GOI, is as under: 1. Two Medical officers (AYUSH) - 1 Male and 1 Female. 2. One ANM/Staff Nurse. 3. One Pharmacist* with proficiency in computer for data management. *In case a Pharmacist is not available, other paramedics – Lab Technician or Ophthalmic Assistant with proficiency in computer for data management may be considered. Teams will screen all the children upto 6 years of age registered with the Anganwadi Centers and all children enrolled in Government and Government aided schools. In order to facilitate implementation of the health screening process, vehicles will be hired for movement of the teams to Anganwadi Centers, Government and Government aided schools. A tool kit with essential equipment for screening of children will also be provided to the Mobile Health Team members. Composition of Tool Kit for Mobile Health Teams Equipments for Screening including Developmental Delays • Bell, rattle, torch, one inch cubes, small bottle with raisins, squeaky toys, coloured wool • Vision charts, reference charts • BP apparatus with age appropriate calf size • Manual and a card specific to each age with age appropriate developmental check list to record milestones to identify developmental delays (6 weeks -9 years) Equipments for Anthropometry • Weighing scale (mechanical newborn weighing scale, standing weighing scale) • Height measuring – Stadiometers/Infantometers • Mid arm circumference tape/ bangle • Non stretchable measuring tape for head circumference The Block teams will work under the overall guidance and supervision of the Block Medical Officer. The Block Programme Manager will chalk out a detailed screening plan for all the three teams in consultation with schools, Anganwadi Centers and Block Medical Officer. IMMUNIZATION The immunization coverage needs to be strengthened all over the State with a special focus on poor performing Districts. The level of fully immunized children by age of one year (CES 2009) is 66.60 %. Full immunization gives a child one of the best chances for healthy and disease free life. In this connection we need to address the following issues on priority basis:-. The birth dose of immunization should be ensured for all newborns delivered in the institutions, before discharge. Daily Immunization services should be available in PHCs, CHCs/ DHs. 41 To reach the inaccessible areas by holding special immunization camps, and tracing the dropouts and bringing them to the immunization session by utilizing services of ASHAs. Generating demand through IEC Activities. Holding of VHNDs regularly & supervisory monitoring by BMO/CMO. Focusing upon Name based tracking of Children for immunization. Launch of Pentavalent Vaccine Pentavalent vaccine against five killer diseases, Diphtheria, Pertussis, tetanus, Hepatitis B and Hemophilics influenza type B (Hib) has been launched in the State on 21-02-2013 by Hon’ble Minister of Health and Family Welfare. The Pentavalent vaccine comes in a liquid (LPV) vail of 10 doses, 0.5 ml of each dose and it is to be kept at 2 to 8 degrees Celsius. The route of administration is same as of DPT i.e. intramuscular injection in the antrolateral aspect of the mid thigh in infants. The introduction of Hib vaccine would prevent the morbidity and mortality associated with this disease which is a public health problem as it causes:- a) Inflammation of membranes that cover and protect spinal cord and brain. b) Pneumonia( inflammation of Lungs) c) Septicemia (presence of pathogenic i.e. bacteria in the blood) Hib mostly affect the children and is a infectious disease which spread from infected child to other children through coughing and sneezing. The schedule of the pentavalent vaccine will remain the same as that of DPT and Hepatitis B. First Dose At six week 2 nd and 3 rd Dose After an interval of four weeks each. There is no booster dose of Pentavalent vaccine Following activities have been approved in the current year for immunization strengthening. i. Mobility Support for Supervision and Monitoring at district and State level:- An amount of Rs. 2,50,000/- has been allotted to each district. The said amount should be allotted for incurring expenditure on POL for the Supervision and Monitoring of immunization programme by the Dy. CMO and DIO. Districts need to provide a minimum of Rs 20,000 to each block for supervision of Immunization activity from Block and PHC. Detailed monthly tour diary should be sent. ii. Focus on Slums & underserved areas in urban areas:- The funds under this sub head are meant for hiring of an ANM for providing immunization in the identified slum areas of Jammu (city), Anantnag, Srinagar (city), Baramulla, Leh & Budgam Districts. The ANM has to conduct four sessions of immunization every month for twelve months. The hired ANM is to be paid Rs. 450.00 per session for four sessions per 42 month per slum of ten thousand population and Rs 300.00 per month has been kept as contingency for hiring of room and furniture etc for the sessions. iii. ASHA Incentives under Immunization:- ASHA incentive for full immunization per child upto 1 year age= Rs 100. ASHA incentive for full immunization per child upto 2 yrs age = Rs 50. (Provided all vaccines received between 1 st & 2 nd year of age after completing full immunization at 1 year of age). iv. Support for Computer Assistant. Services of the Computer Assistant engaged under immunization strengthening programme at the State/district level shall be continued based on performance of previous year. v. Quarterly Review meetings:- A review meeting has to be held at the district HQs on quarterly basis where in steps to improve the immunization Programme can be discussed. The BMOs, the Dy CMO, DIOs and DMEIOs should attend such meetings. The CDPOs and one medical officer of the PHC on rotation basis have also to be called to attend these meetings. The amount has to be utilized for meeting expenses like light refreshment to the participants and other organizational expenses. It is advised to call 3-4 ANMs from each block by rotation to attend such meetings. Participation of ANMs of Sub Centre should also be made mandatory. The Refrigerator Mechanic should also be invited for attending such meetings. The dates for review meetings be intimated to the State Health Society well in advance so that some officer from this office shall be in a position to attend the meetings. Moreover minutes of the meetings should reach office of State Health Society, J&K on regular basis. vi. Preparation of Microplan:- Microplan for immunization has to be prepared right form Sub Centre level. The microplan, besides institutional immunization services should include the outreach and underserved areas where immunization services have to be provided. It should be ensured that neither any outreach area nor any underserved area is left in the microplan. The expenditure to be incurred in preparing Block/PHC levels microplan is Rs.1000.00 each and for sub-center Rs. 100 each. All ANMs, ASHAs and AWWs are to be involved in this activity. vii. POL for vaccine delivery from State to District and from District to PHC/CHC level:- This amount is to be utilized for POL charges required for carriage of vaccine under proper cold chain system from State to District and from District to Block Head Quarters. viii. Alternate vaccine Delivery to Session Site:- This amount is to be incurred at the rate of Rs. 150.00 per session for delivery of vaccine at session site falling in most difficult and hilly terrains and Rs 75.00 per session for other than difficult areas. Preparation of microplan is mandatory for this activity as stated above. 43 District Health Societies shall identify the sub centres on this basis in their respective district. ix. Consumables for computer including provision for internet access for RIMs Rs. 400 per month per district has been approved for this activity. x. Procurement of Plastic bags for Biomedical Waste Disposal:- Two bags per session of immunization for every sub-centre functioning in each district have to be procured and issued to the Sub Centres at the earliest. xi. Procurement of Bleach / Hypochlorite Solution for safe disposal of waste (syringes & needles)/Twin buckets:- Bleach/hydrochloride solutions are to be procured for every PHC and CHC functioning in each district. Two buckets preferably are to be procured for use of immunization waste for each PHC and CHC (excluding CHCs functioning as District hospitals in newly created districts). The procurement/purchases should be made after fulfilling all codal formalities and as per the rates approved by the Rate Contract Committee. FAMILY PLANNING ROAD MAP FOR PRIORITY ACTION: MISSION: “The mission of the National Family Planning Program is that all women and men (in reproductive age group) in India will have knowledge of and access to comprehensive range of family planning services, therefore enabling families to plan and space their children to improve the health of women and children”. GUIDING PRINCIPLES: Target-free approach based on unmet needs for contraception; equal emphasis on spacing and limiting methods; promoting ‘children by choice’ in the context of reproductive health. STRATEGIES: 1. Strengthening spacing methods: a. Increasing number of providers trained in IUCD 380A b. Strengthening Fixed Day IUCD services at facilities c. Introduction of Cu IUCD 375 44 d. Delivering contraceptives at homes of beneficiaries. e. Delaying first pregnancy for at least two years after marriage, spacing of at least three years between first and second child and adoption of permanent method after one or two children ( couples to be motivated by ASHA). 2. Emphasis on post-partum family planning services: a. Strengthening Post-Partum IUCD (PPIUCD) services at least at DH, SDH, FRU, CHC/BPHC level at high case load facilities. b. Promoting Post-partum sterilisation (PPS) c. Establishing Post-Partum Centers at women & child hospitals at district levels d. Appointing counsellors at high case load facilities 3. Strengthening sterilization service delivery a. Increasing pool of trained service providers (minilap, lap & NSV) b. Operationalising FDS centers for sterilisation c. Holding camps to increase accessibility and availability of services. 4. Strengthening quality of service delivery: a. Strengthening QACs for monitoring/review b. Disseminating/ following existing protocols/ guidelines/ manuals c. Monitoring of FP Indemnity scheme 5. Development of BCC/ IEC tools highlighting benefits of Family Planning specially on spacing methods 6. Focus on using private sector capacity for service delivery (exploring PPP availability): 7. Strengthening programme management structures: a. Establishing new structures for monitoring and supporting the programme 45 b. Strengthening programme management support to state and district levels. 8. World Population Day Celebrations. KEY PERFORMANCE INDICATORS: a. % IUD inserted against ELA b. % PPIUCD inserted against institutional deliveries c. % PPIUCD inserted against total IUCD d. % of sterilisations conducted against ELA e. % post-partum sterilisations against total female sterilisations f. % of male sterilisations out of total sterilisations conducted g. % facilities delivering FDS services against planned h. % of personnel trained against planned i. % point decline in unmet need j. Point decline in TFR k. % utilization of funds against approved Introduction The State has achieved the target of reduction of Total Fertility Rate (TFR) to 2.0 (SRS 2010) against the target of TFR to 2.1 by 2012. The State has achieved the target of 1.8 by the end of 12 th Five year Plan. The TFR target for 2013 is 1.9. Family Planning Programme is being strengthened by distribution of Condoms/ contraceptives through ASHAs at Village level at the door steps of needy clients. It will not only help in avoiding unwanted pregnancies but also protection against HIV/ AIDS and other Sexually transmitted diseases. The scheme is being implemented as pilot project in 4 districts of Jammu Division viz. Rajouri, Poonch, Udhampur & Doda. From this year (2013-14) the scheme is being implemented in the entire State of J&K The approved activities and the permissible amount are mentioned in the table:- S No. Activity Target Permissible Amount 46 However, while organizing such camps all efforts should be made to conduct around 100 cases in each of the camp. The guidelines issued by Govt. of India for this component have already been provided to all the Districts. Quality Assurance Committees (QAC) QACs for monitoring family planning activities have been constituted at the District Level. The quarterly meetings of these committees need to be organized for which Rs 5000.00 per quarter are being provided to each of the district. The Districts are required to submit the Minutes of these Meetings to the State Health Society on regular basis. Block Level NRHM Sammelans During the current financial year, the block level NRHM Sammelans shall be organized in each of the block. These Sammelans aim at creating awareness among the PRIs, prominent citizens, NGOs, health functionaries viz CMOs, BMOs/MOs (Block PHCs) and mainly for the field functionaries like Field NGOs, FMPHWs, ASHAs and AWWs who are directly associated with the implementation of various schemes/ programmes under NRHM at the ground level. Rs. 20000/- has been approved for each Sammelan at Block Level. Guidelines for organizing BLOCK Level NRHM Sammelans have been circulated to the districts. ADOLESCENT HEALTH ROAD MAP FOR PRIORITY ACTION: SETTING UP OF AH CELL 1 World Population Day Celebration: (Such as mobility, IEC activities etc.): funds earmarked for District and block level activities One per District Rs 1.5000 lakh/ district 2 Sterilization Camps a) Male One Per District Rs. 10,000 per camp b) Female One Per District Rs.7500 per camp 3 Package for Sterilization a) Male Targets being given separately in District PIP Rs.1500 per case b) Female Rs. 1000 per case 4 Compensation for IUCD service Targets being given separately in District PIP Rs. 20 per case 47 A unit for adolescent health at state level with a nodal officer supported by four consultants one each for ARSH, SHP, Menstrual hygiene and WIFS; one nodal officer (rank of ACMHO) for all the components of Adolescent Health at district level to take care of Adolescent health programme including the SHP. PROGRAMME SPECIFIC ESSENTIAL STEPS FOR IMPLEMENTATION: I. Adolescent Reproductive Sexual Health (ARSH) Programme Clinics Number of functional clinics at the DH, CHC, PHC and Medical Colleges (dedicated days, fixed time, trained manpower). Number of clinics integrated with ICTCs Quarterly Reporting from the ARSH clinics to be initiated to GoI. Establish a Supportive supervision and Monitoring mechanism Outreach Utilisation of the VHND platform for improving the clinic attendance. Demand generation in convergence with SABLA and also through Teen Clubs of MOYAS Capacity Building/Training: Calculation of the training load and development of training plans! refresher trainings. - Deployment of trained manpower at the functional clinics. II Menstrual Hygiene Scheme (MHS) Formation of State and district level steering committees. Training / re-orientation of service providers(MOs, ANMs, ASHAs) Monthly meeting with BMO. Regular feedback on quality of sanitary napkins to be sent to GoI Identification of appropriate storage place for sanitary napkins. 48 Mechanism of distribution of SN right upto the user level. Reporting and accounting system in place at various levels. Utilizing MCTS for service delivery by checking with ASHAs and ANMs about supply chain management of IFA tabs and Sanitary napkins. Distribution of Sanitary Napkins to school going adolescent girls to be encouraged in schools and preferably combined with Weekly Iron Folic Acid Supplementation (WIFS). II Weekly Iron and Folic Acid Supplementation programme (WIFS) Procurement policy in place for procurement of EDL including IFA and deworming tablets. Establish “Monday” as a fixed day for WIFS. Plan for training and capacity building of field level functionaries of concerned Departments (i.e. Department of Women and Child Development and and Department of Education) and plan for sensitization of Programme Planners on WIFS. Ensure that monitoring mechanism as outlined in the operational framework (Shared with the States during the National Adolescent Health Workshop) are put in place across levels and departments. Adolescent Reproductive and Sexual Health (ARSH): - Ministry of Health and Family Welfare, Government of India has included Adolescent Reproductive and Sexual Health (ARSH) as a key technical strategy under the National RCH II programme. Mainly strategy focuses on reorganizing adolescent population that will yield dividends in terms of delaying age at marriage, reducing incidence of teenage pregnancy, prevention and management of obstetric complications including access to early and safe abortion services. A core package of services that includes preventive, promotive, curative and counselling services will be delivered during routine clinics at District level and further shall extend to sub-centre, PHCs and CHCs, and dedicated adolescent clinics on fixed days and time as well as through outreach activities. Adolescent Clinics: Adolescent Friendly Health Clinics (AFHCs) have been established across all the 22 districts of the state in addition to one clinic each in Govt. Medical College Jammu/ Kashmir at divisional level. In addition, 3 new Adolescent Clinics have been established one each in Govt. Hospital Sarwal, CHC Akhnoor and CHC Kupwara. 49 Manpower: In order to consolidate the role of AFHCs in providing youth friendly services to this high focused group, trained Lady Counselors and Data Entry Operators have been appointed in each Adolescent Clinic except 3 new clinics set up in the FY 2012-13. Operating expenses: The existing 24 clinics and the 3 new CHCs established during 2012- 13 will get a recurring amount for each Adolescent Clinic as operating expenses for printing of the stationery/IEC material/Formats for the clinic and mobility support on account of holding outreach camps/meeting by the counselor in a year. Menstrual Hygiene Programme: A new scheme for promotion of menstrual hygiene among adolescent girls (10-19) in rural areas has been launched under which the subsidized sanitary napkins are being distributed among the school going and out of school adolescent girls. Target districts:- The scheme is running successfully on pilot basis in 10 Districts of J&K State where in total 7 districts, namely Rajouri, Poonch, Doda, Kishtwar, Ramban, Udhampur and Kathua are selected in Jammu Division and three districts namely – Baramulla, Bandipora & Kupwara in Kashmir Division. Under the scheme, sanitary napkins are being procured by the Ministry of Health & Family Welfare, Govt. of India and supplied under the NRHM brand name “Free days”. Operationalization:- In the State, the scheme is being operationalized at two tier level through the wide network of the health care providers at Block/sub health centre level and ASHA as link worker between the service provider and the community at village level. The sanitary napkins shall be supplied directly to the block headquarters from the central supply and further be purchased by the ANM/LHV at Sub- Centre Level from the Block office and shall further be sold to the ASHA for future sale at village level to the adolescent girls falling under both APL/BPL categories. The cost of the sanitary napkins has been fixed at Rs.5/- per pack containing six napkins (each pack) and is being made available to the adolescent girls at the price of Rs. 6/- per pack. Initially, the ASHA will be given Imprest money of Rs. 300/- from the sub centre (untied fund) for purchase of sanitary napkin packs from the ANM at Rs. 5/- per pack and the ASHA will sell the pack to adolescent girl at Rs. 6/- regardless of APL/BPL status. The ASHA will be entitled to retain Re. 1/- as an incentive for sale of each pack of sanitary napkins and rest of Rs. 5/- will be used to purchase sanitary napkin packs for future sale. ASHA will receive one additional sanitary napkin free of cost from ANM each month for her personal usage apart from Re. 1/- as incentive. Further, the storage of the sanitary napkins shall be made at PHC/SC level and in case if additional room for storage is required, it can be taken on rent out of untied funds. Also the revenue generated out of sale of the sanitary napkins shall be deposited by the ANM with the Block Medical Officer who shall further deposit the same into the District Health Society. The 50 District Health Societies shall deposit these to the State Health Society for procurement of the napkins for further supply. SABLA Programme: - SABLA is a new centrally sponsored, comprehensive scheme, called Rajiv Gandhi Scheme for Empowerment of Adolescent Girls or SABLA, merging the erstwhile Kishori Shakti Yojna (KSY) and Nutrition Programme for Adolescent Girls (NPAG) schemes to address the multi‐dimensional problems of Adolescent Girls (AGs). Implementation: - In Jammu & Kashmir, Sabla is being implemented in 5 districts namely - Anantnag, Kupwara, Kathua, Jammu, Leh using the platform of ICDS. Under the scheme, the following services are being provided in convergence with the Departments of Health and Family welfare, Social Welfare Department and State AIDS Control Society: IFA supplementation, including supply of IFA tablets. General health check-up, including recording of height, weight, BMI for all adolescent girls, by the Medical Officer/ANM. Referral to specialized healthcare facilities, as required for conditions like malnutrition, menstrual problems, frequent headaches, prolonged acne, worm infestation, etc. Nutrition and Health Education. Family welfare and ARSH services. School Health Programme: - The School Health Programme shall focus on the health needs of the school going children so as to promote the preventive and rehabilitative health in the state of J&K. The School Health Programme shall be carried out by the Directorate of Health services Jammu/Kashmir and the Chief Medical officers of the respective Districts shall send a copy of the monthly compiled report to the Programme Manager in charge School Health Programme. Operationalization: - Under the programme, the School Health Committees shall be formed which shall be responsible for implementation and monitoring of the programme in all the Govt. and Govt.-Aided schools in the selected districts. The teams shall also conduct check- ups for children below 6 years at AWCs. The programme shall focus on three Ds- Deficiency, Disease and Disability. The referral of children shall be tied up and complete treatment at higher facilities shall be ensured. The nodal teachers from all the Govt. and Govt. aided schools shall be involved. In addition, under the school health programme apart from health needs of the school going children, the school health talks on prevention of diseases and promotion of health shall be given by the existing dedicated teams. Weekly Iron and Folic Acid Supplementation for adolescents (WIFS) As adolescent anemia is a critical public health problem in the country, the Ministry of Health and Family Welfare, Government of India, based on the empirical evidence generated by these scientific studies, has developed programmatic guidelines for Weekly Iron and Folic Acid 51 Supplementation (WIFS) of adolescent. This scheme is to reduce the prevalence and severity of anemia in adolescent population (10-19 years) and programme to be implemented for the following two target groups in both rural and urban areas: A. Adolescent girls/boys who are school going and are in government/government aided schools from 6 th -12 th classes. B. Adolescent Girls who are not in school or out of school. The WIFS programme will also cover married non-pregnant adolescent girls in order to increase their pre-pregnancy iron stores and decrease prevalence of anemia among pregnant adolescent girls. Target Districts: - The WIFS programme shall be started in the five Districts on pilot basis which are already selected under SABLA scheme namely Jammu, Kathua in Jammu Division and Anantnag, Kupwara and Leh in Kashmir Division. Operationalization: - The implementation strategy of WIFS programme involves a “fixed day’’ approach i.e. Monday for WIFS distribution to ensure high compliance. The programme shall be implemented in both urban and rural areas. Under the programme, the school adolescent population, enrolled in 6 th to 12 th standard, in rural and urban regions will be reached. The programme shall encourage consumption of weekly IFA tablets and six monthly de-worming tablets through school and ICDS platform. At district level, a monitoring committee comprising Health and Education departments will be formed to monitor the progress of the project and resolve programmatic issues. The meeting could be organized every six months with the participation of health and education block officials. Yearly meeting with nodal teachers could be organized to further streamline the project. URBAN RCH ROAD MAP FOR PRIORITY ACTION UNDER URBAN RCH Carry out a comprehensive third party evaluation of UHCs/ NGO performance including an assessment of reasons for low expenditure (9.6 % in the first 9 months of 2012-13). State to apprise MoH&FW of action taken on the basis of the findings of the evaluation by September 2012. Monitor performance of UHCs/NGOs against targets. Staffing at UHCs to be linked to case load. The Government of India has launched the National Urban Health Mission (NUHM) as a sub-mission under an overarching National Health Mission (NHM) for providing quality primary healthcare services to the urban population, especially the urban poor and other vulnerable sections of the society. The Mission is to be launched in all cities/ towns with a population of more than 50,000.All other district headquarters and State capitals Towns 52 with a population below 50,000 will be covered under the National Rural Health Mission (NRHM) the other sub-mission of the National Health Mission. National Urban Health Mission (NUHM) aims to improve the health status of the urban population, particularly the slum dwellers and other vulnerable sections by facilitating equitable access to quality health care with the active involvement of the Urban Local Bodies (ULBs). It proposes to achieve its objectives by developing appropriate public health delivery system across cities/towns with provisions for creating new systems, entering into partnerships with for-profit and not-for-profit private sector, improving access and building community capacity through community level institutions like MahilaArogyaSamiti (MAS) and link workers called Accredited Social Health Activists (ASHA). Capacity building of key stake holders like ULBs, and by making special provision for inclusion of the most vulnerable amongst the poor. The National Urban Health Mission would use the institutional structures already created under NRHM at the national, State and District levels for operationalization of the NHM and sub-mission of the NUHM. However, in order to provide dedicated focus to issues relating to urban health, the institutional mechanism under the NRHM at various levels would be strengthened for NUHM implementation. The existing governance structures and financial mechanisms existing under the NRHM would also serve NUHM as well. At the central level, the Mission Steering Group (MSG) under the Union Health Minister, the Empowered Programme Committee (EPC) under the Secretary Health & Family Welfare (H&FW) and the National Programme Coordination Committee (NPCC) under the Additional Secretary and Mission Director will be responsible for providing overall guidance and taking important decisions. The Ministers of Housing and Urban Poverty Alleviation (HUPA) and Urban Development will be included in the already existing MSC. The existing EPC will be expanded by co-opting Secretary HUPA and Secretary Urban Development as members and also a National Programme Management Unit (NPMU) would be created to facilitate and monitor implementation of NUHM. To enhance the program management capacity at State level, the State PMU of the NRHM would be strengthened by provision of Programme Manager (NUHM) on deputation from Health Department. In addition to the above, at the City level, the States may either decide to constitute a separate City Urban Health Mission/City Urban Health Society or use the existing structure of the District Health Society/Mission under NRHM with additional stakeholder members in light of State/city/town specific need suitable contextualization and flexibility would be allowed to State Governments.In our State at city level the 53 programme shall be implemented through the existing District Health Societies/Mission. The management of NUHM activities may be coordinated by a city level Urban Health Committee headed by the Municipal Commissioner/District Magistrate/Deputy Commissioner/ District collector/ Sub Divisional Magistrate/ Assistant Deputy commissioner based on whether the city is a district headquarters or a sub-divisional headquarter. This would help ensure better coordination with other related departments like Women & Child Development, Water supply and Sanitation especially in times of response to disease outbreaks/epidemics in the city. As NRHM & NUHM would be two components of the National Health Mission (NHM), Additional Secretary & Mission Director, Ministry of Health & Family Welfare would be Additional Secretary & Mission Director (NHM), comprising both the sub- missions of NRHM and NUHM. Similarly at the State level, State Mission Director, NRHM would also look after the sub-mission of NUHM in addition to the existing NRHM. State Mission Director would be Mission Director, National Health Mission encompassing both the sub- mission of NRHM and NUHM. The Mission Directorate at Central level has been vested with adequate administrative and financial powers to enable it to achieve the agreed outcomes under the overall guidance of EPC and MSG. Additional Secretary and Mission Director, NHM is vested with administrative and financial powers as approved by the Mission Steering Group, Additionally, the Mission will also have the power to frame its own rules and procedures as approved by the Mission Steering Group. Some directions were passed to take immediate actions for launch of National Urban Health Mission (NUHM) in the State: I. Planning and Baseline Survey: i. The list of cities and towns in your States /UT may be prepared which have a population more than 50,000 (as per census 2011). The State Capital will be covered under NUHM, irrespective of the population size. Since the fund available for 2013-14 is modest the State/UTs may prioritise cities/ towns that are more vulnerable in terms of larger proportion of slums, lack of provisions for Primary Health Care. ii. A baseline must be conducted in the identified cities/towns to determine the gaps which would require investment under NUHM. Slum areas in the cities (both listed and unlisted slums), other low income neighbourhoods and existing public and 54 private (not-for-profit and profit) health facilities are to be mapped and gaps in availability of primary health care are to be identified. iii. Availability of infrastructure and equipment in the existing dispensaries/ maternity homes managed by the State government/UT/ULBs, Urban Health Centres (UHC), Urban Family Welfare Centres (UFWC), etc have to be assessed in order to prepare estimates for upgradation/ strengthening the same as per norms and standards. iv. One Urban Primary Health Centre (UPHC) for every 50-60 thousand population may be planned where none exists. The new UPHCs will be located as close to low income neighbourhoods/slums as possible. Land for establishment of new UPHCs has to be identified. NUHM would provide both capital and recurrent cost for the UPHC, as per the norms in the Framework for implementation. The land for the UPHC and other such infrastructure would be given free of cost by the State Government. The cost of land shall not be included in the total project cost for the purpose of calculating the State share. Building for new UPHCs and other additional infrastructure shall be provided by the State Government as per specified parameters. The cost of such infrastructure can be counted as part of State share. v. During 2014-15 and subsequent years, the State/UT plan for Urban Community Health Centre (UCHC) at the rate of one UCHC for 5-6 UPHC in big towns, with 30 to 100 beds, if clear need for establishment of such institutions arises. NUHM will provide the capital cost of the new UCHCs as mentioned above. NUHM will not provide the recurrent cost of UCHC. vi. Creation of sub centres has not been proposed under NUHM. Outreach services will be provided through Female Health Workers (FHWs)/ Auxillary Nursing Midwives (ANMs) headquartered at the U-PHCs. Additional ANMs would be engaged as per the norm of one ANM for about 10,000 urban populations. II. Institutional Strengthening: i. The existing institutional mechanism and management structures created and functioning under NRHM would be strengthened to meet the needs of NUHM. Minister(s) in charge of Urban Development and Housing will be members(s) of the State Health Mission. The State health Society would co-opt Secretaries of the Urban Development and Housing departments as members. MD NRHM will also function as MD NUHM also. District Health Societies will be responsible for implementation of NUHM in the cities and towns. ii. State Programme Management Unit is to be strengthened for NUHM. “Urban Health Cell” need to be created within the SPMUs and DPMUs with appropriate 55 and adequate HR, exclusively for NUHM. In small State like J&K one of the Officerat SHS could be designated as the Nodal Officer/ Programme Manager of NUHM till one officer is placed on deputation from Health Department. iii. The TOR for engagement of personnel for city PMU, SPMU and DPMU will be communicated to the States/UTs in due course of time. III. Community Mobilization: Process could be initiated for formation of MahlilaArogyaSamitis (MAS) as per the norm of one MAS for 50-100 household in the slums and low income neighbourhoods. MahlilaArogyaSamitis will act as community based groups in slums, involved in community mobilization, monitoring and referral. Existing community based institutions could be utilized for the purpose. NUHM would provide untied grants and capacity building support to MAS/CBO. IV. Engaging Human Resources (HR): i. ASHAs may be engaged as per the norm of one ASHA for 200-500 households in slums. ASHA would serve as an effective and demand-generating link between the health facility and the urban slum population. However, the State/ UT have the flexibility to either engage ASHA or entrust the responsibilities to MAS/any other community based organisation (CBO). ii. ANMs may be engaged for 10,000-12,000 urban population. As there is no provision for sub centres under NUHM, they may be co-located within existing health facilities (Like urban health posts, UFWCs, etc.) till the urban PHCs become functional. They would have a clearly defined area of operation where they will be conducting outreach sessions, as per the norms under NRHM. V. Convergence: State has to work out the detailed modalities for convergence with wider determinants of health, especially housing and water supply and sanitation programmes. The management of NUHM activities may be coordinated by a city level urban Health Committee headed by the Municipal Commissioner/ District Magistrate/ Deputy Commissioner based on whether the city is a district headquarters of a sub-division headquarter. This would help ensure better coordination with related departments like Women and Child Development, Water Supply & Sanitation, especially in times of response to disease outbreaks / epidemics in the city. 56 Urban RCH is being implemented in Capital cities of Srinagar & Jammu under NRHM; Urban Health Posts and Urban Health Centres have been established in cities of Srinagar & Jammu. Urban Health Centres Manpower One Medical Officer, Three ANMs and One Helper Urban Health Posts Two ANMs and One Part Time Cleaner Conditionality for Funds: Funds under Urban RCH have been approved for six months only. However, the approval shall be given subject to the sharing of work done performance of ANMs and Medical Officers of UHCs / UHPs with the Ministry of Health and Family Welfare, GoI. The Chief Medical Officers Jammu / Srinagar shall furnish the progress report of Urban Health Centres / Posts to the State Health Society by 1 st week of July 2013 for its onward transmission and taking up the matter with GoI for sanction of funds/ salaries for next six months. TRIBAL RCH ROAD MAP FOR PRIORITY ACTION: State to closely monitor progress (physical, expenditure) on all health activities in notified tribal areas. On a quarterly basis, a progress report, including constraints faced and action proposed to be sent to MoHFW. The State shall focus on health entitlements of vulnerable social groups like SCs, STs, OBCs, minorities, women, disabled, migrants etc. J&K State has a vast geographical belt inhabited by tribal population spread over Leh and Kargil districts. Difficult hilly terrain, extreme weather conditions, poor living standards and inadequate availability of health services makes this population highly vulnerable to ill health and disease. Stagnating population size of some of their communities stands witness to the fact that their Reproductive and Child Health Status is below the desired level. Under Tribal Health AMCHI Units have been set up in District Hospitals, Community Health Centres and Primary Health Centres of Leh and Kargil districts. AMCHI Healers have been engaged in these AMCHI Units on contractual basis up to March, 2014. Manpower for AMCHI Units Two AMCHI Healers per District Hospital One AMCHI Healers per Community Health Centre; and One AMCHI Healer per Primary Health Centre 34025 patients have been treated by AMCHI Healers in Leh and Kargil districts in the year 2012 – 13. Road map for priority action under Tribal Health during the year 2013 – 14 57 Monitoring progress in terms of number of patients treated. A progress report on quarterly basis, including constraints faced and remedial action proposed, to be sent to State Health Society for onward transmission to Ministry of Health and Family Welfare, Government of India. The State shall focus on development of indigenous systems of medicine, including AMCHI system, popular in particular geographical belts of the state. Establishing Control Room for Ambulances (Toll Free No. 102) The control rooms are being established in each of the District Hospital to regulate and use all ambulances optimally. A toll free number 102 will be obtained for these control rooms. These control rooms shall be manned round the clock by operators who shall control and direct the flow of ambulances as per requirement. These are being established to ensure optimal delivery care to the patients/clients calling for help, i.e. stabilization before transport, emergency admission, preparation of the institution to receive a critical patient, etc. Detailed guidelines for operationalizing these control room have been circulated to the Chief Medical Officers. Blood Storage Centre (BSC) 26 Blood Storage Centres, the details of which mentioned in Annexure “J”, have been approved for the financial year 2012-2013 in the State. Some of these are already in the process of getting licensed and these BSCs need to be strengthened. List of equipments to be procured for such Blood Storage Centres is as follows: S.No Name of Equipment Quantity required 1 Blood Bank Refrigerator having capacity of 50 blood units 01 2 Air Conditioner 01 3 Autoclave 01 4 Binocular Microscope 01 5 Deep Freezer for freezing ice packs 01 6 Dry Incubator 01 7 Insulated Blood Bags Containers 01 8 Table Top Centrifuge 01 9 Micropippets of different capacities One each 10 Consumables, reagents, disinfectants As per workload Special incentives to doctors With a view to ensure the availability of Doctors in remote areas of the State, the Government has approved special incentive of Rs.20,000.00, Rs 15,000 and Rs. 10,000.00 for Allopathic / ISM doctors hired under NRHM and serving in Category “A”, (inaccessible areas), Category 58 “B” (very difficult areas) and Category “C” (difficult areas) respectively. List of health institutions falling in such areas is enclosed as Annexure “K”. The incentive is an additional lumpsum allowance payable over and above the existing pay/salary structure to the Allopathic / ISM doctors working on contractual basis under NRHM. In addition to this, the incentives shall also continued to be paid @ Rs.8000.00 and Rs. 4000.00 per month for MBBS / AYUSH Doctors serving in the areas notified under SRO 201 of 2006 in respect of Category “A” (Very difficult) and Category “B” (Difficult) respectively. The incentive is an additional lump sum allowance payable over and above the existing pay/salary structure to all categories of doctors irrespective of the fact whether they are appointed on regular basis or on adhoc basis or under SRO 255 on contractual basis or under NRHM on contractual basis. The incentive is payable after production of a certificate from CMO/ADMO concerned that his/her performance during the period of report has remained good and has done adequate work in terms of OPD, IPD, immunization antenatal, postnatal checkups and conduct of deliveries (wherever applicable). The incentives should be linked to the place of work and no transfer/shifting should be allowed from the place where the person is getting incentive. Permissible Manpower Sub-Centres During 2011-12, districts were allowed to hire one additional ANM on contractual basis in all the Sub-Centres which shall be continued in the year 2012-13 as well. The local residency of the ANM needs to be given priority while making recruitment. MACs renamed as Sub Centres During 2011-12, districts were allowed to hire one Male Multipurpose Health Worker on contractual basis in all the MACs (renamed as Sub-Centres) which shall be continued in the year 2012-13 as well. The local residency of the MPHW needs to be given priority while making recruitment. 24X7 PHCs In addition to the required Manpower positioned in PHCs as per sanctioned strength, the additional manpower under NRHM is also being provided on contractual basis with the purpose to provide basic obstetric care round the clock in the PHCs designated as 24x7. The category wise maximum permissible limit under NRHM (including already engaged) is as follows: One Medical Officer (MBBS) Two Staff Nurses. One Laboratory Technician. At PHC level under NRHM 59 Each PHC has been provided with 1 AYUSH Doctor and 1 AYUSH Pharmacist (Dawasaaz) during the year 2011-12 which shall be continued in the year 2012-13 as well. One Additional MBBS doctor and one additional AYUSH doctor has been provided in PHCs notified as falling in remote areas as per SRO 201 of 2006 from the year 2009-10 which shall be continued in the year 2012-13 as well. FRUs under NRHM In addition to the required Manpower positioned in FRUs as per sanctioned strength, the additional manpower under NRHM is being engaged in CHCs designated as FRUs with the objective to provide Basic and Emergency Obstetric Care round the clock. The Category wise maximum permissible limit under NRHM (including already engaged) is as follows: i. Two Medical Officers (MBBS) ii. Two Staff Nurses iii. Two O.T. Technicians iv. Two X-ray Technicians v. Two Laboratory Technicians vi. Additional 8 Staff Nurses for CHC Kupwara, Magam, Bijbhera, Akhnoor, R S Pura and Ramgarh Newly created District Hospitals The objective of providing manpower in newly created District Hospitals remains to provide the basic and emergency obstetric care round the clock. The Category wise maximum permissible limit in each of the District Hospital of newly created districts under NRHM (including already engaged) is as follows: i. Two MBBS doctors ii. Ten Staff Nurses. iii. Two O.T. Technicians iv. Two X-ray Technicians v. Two Lab. Technicians. Old District Hospitals The objective of providing additional manpower in old District Hospitals remains to provide basic and emergency obstetric care round the clock. i. Ten Staff Nurses in Old District Hospitals on contractual basis. ii. However, Govt Hospital, Sarwal, Jammu and G.B.Pant Hospital, Srinagar have also been provided Ten Staff Nurses each on contractual basis on the pattern of District Hospitals. Strengthening of Institutional Mechanism District Health Societies: 22 District Health Societies have been constituted for planning and implementing the health related initiatives in the respective districts. 60 Rogi Kalyan Samitis. 571 RKS have been constituted and registered at the level of District hospital/ CHC/PHC for community management of public hospitals. RKS at the level of new type PHCs are to be constituted on the pattern of PHCs. The District Health Societies shall initiate immediate action on constitution of the RKS for new type PHCs. Sufficient budget is provided to the District Hospitals, CHCs, PHCs and Sub Centres as Corpus fund, Untied fund & Annual Maintenance Grant for improvement and maintenance of physical infrastructure and meeting the day-to-day needs of these institutions. This budget should be utilized after identifying the needs and approval of the RKS/VHSC. The institution wise details of the budget are as under:- S.No. Name of the Institution Corpus Fund ( Rs. in Lacs) Untied fund (Rs. in Lacs) Annual * Maintenance Grant ( Rs. in Lacs) 1 District Hospital 5.00 Nil Nil 2 Community Health Centres (CHCs) 1.00 0.50 1.00 3 Primary Health Centre (PHC) 1.00 0.25 0.50 4 New Type PHCs 1.00 0.25 0.50 5 Sub Centres (SC) including MACs which have been renamed as Sub Centres Nil 0.10 0.10 *Annual Maintenance Grant is provided to the institutions located in Govt. building(s) only. NOTE The funds for New Type PHCs shall be utilized only after constitution of RKS. Meetings of RKS should be held as per schedule envisaged in the guidelines. However, incase due to some exigency, the Hon’ble MLA is not in a position to attend the meetings (s), the same may be held under the Chairmanship of any of the members present (preferably CMO/BMO as the case may be) on the schedule date. It has further to be ensured that the requisite quorum for the meeting is present and that the minutes of the meeting are properly recorded and circulated among all members including concerned Hon’ble MLA. VILLAGE HEALTH SANITATION AND NUTRITION COMMITTEES (VHSNCS) The Ministry of Health and Family Welfare, GoI vide their No. Z.18015/15/2011-NRHM-II dated 25-07-2011 has conveyed instructions to rename Village Health and Sanitation Committees as Village Health Sanitation and Nutrition Committees (VHSNCs). With a view to sensitize the PRIs about various schemes of NRHM, the State Health Society is providing diaries to Sarpanches. The diary also contains guidelines regarding constitution of Village Health Sanitation and Nutrition Committees and the norms for utilization of untied grants eligible for the committees. 61 1. During the current financial year, ASHAs shall be involved for facilitating meeting of Village Health Sanitation and Nutrition Committee in terms of GoI guidelines, as per the following conditions: i) Making payment of an incentive @ Rs 150/- to each ASHA for facilitating the monthly meeting of VHSNC followed by the meeting of women and adolescent girls. ii) Payment of the incentive should be made out of the ‘untied grants’ given to each VHSNC under NRHM. iii) ASHAs should coordinate for both VHSNC and monthly meeting of women and adolescent girls. iv) The concerned ANM at Sub-Centre / PHC will certify the conduction of the meeting. 2. Further, the under mentioned guidelines should be followed for convening the meetings of VHSNC:- i) The meeting of VHSNC should be followed by the meeting of Women and Adolescent girls where the issues pertaining to Nutrition, Reproduction & Child Health, Sanitation & Hygiene, Breast Feeding, Menstrual Hygiene, Age at Marriage, Contraception, Pre-School Education and Female Literacy etc. should be discussed. ii) The meeting of VHSNCs should be convened every month in consultation with the members of VHSNC and President of Gram Panchayat. iii) ASHAs should make all possible efforts for the sufficient publicity of the meeting so as to ensure wider participation of women and adolescent girls of the village. iv) The meeting should be fixed on the date other than that of Village Health & Nutrition Day (VHND). A Booklet containing guidelines for devolution of functions to Panchyati Raj Institutions (PRIs) in respect of Health Department containing details of VHSNCs has been published & distribution as per the Government order No: 1126-GAD of 2011 dated 22-9-2011. PC & PNDT AND GENDER MAINSTREAMING ROAD MAP: PNDT MISSION: The mission of PNDT program is to improve the sex ratio at birth by regulating the pre - conception and prenatal diagnostic techniques misused for sex selection. Guiding Principle: Deterrence for unethical practice sex selection to ensure improvement in the child sex ratio STRATEGIES: 62 Strengthening programme management structures: Appointment of Nodal officer Strengthening of Human resource Formation of PNDT Cell at state and district level Establishment of statutory bodies under the PC&PNDT Act Constitution of 20 member State Supervisory Board Reconstitution every three years (other than ex-officio members) Four meetings in a year Notification of three members State Appropriate Authority, Constitution of 8 member State Advisory Committee Reconstitution in every 3 years At least 6 meetings in a year Notification of District Appropriate Authorities Constitution of 8 member district Advisory Committees Reconstitution in every 3 years At least 6 meetings in a year Strengthening of monitoring mechanisms Monitoring of sex ratio at birth through civil registration of birth data Formulation of Inspection and Monitoring committees Increasing the monitoring visits Review and evaluation of registration records 63 Online availability of PNDT registration records Online filling and medical audit of form Fs Ensure regular reporting of sales of ultrasound machines from manufactures Enumeration of all Ultrasound machines and identification of un-registered ultrasound machine Ensure compliance for maintenance of records mandatory under the Act Ensure regular quarterly progress reports at state and district level. Capacity building and sensitisation of program managers Appropriate Authorities Advisory committee members Nodal officers both State and District Sensitisation and Alliance building with > Judiciary> Medical Council / associations > Civil society. Development of BCC/ IEC/ IPC Campaigns highlighting provisions of PC& PNDT Act and promotion of Girl Child. Convergence for Monitoring of Child sex Ratio at birth KEY PERFORMANCE INDICATORS: Improvement in child sex ratio at birth % of civil registration of births Statutory bodies in place % registrations renewed Increase in inspections and action taken 64 No. of unregistered machines identified % of court cases filed % of convictions secured No. of medical licences of the convicted doctor cancelled or suspended MISSION: The mission of PNDT programme is to improve the sex ratio at birth by regulating the pre- conception and prenatal diagnostic techniques misused for sex selection. Regulatory Mechanism under PC&PNDT Act STATE LEVEL Task Force under the Chairmanship of Chief Secretary, J&K on declining sex ratio and in particular child ratio in the State has been constituted vide Govt. order No: 401-HME of 2013 dated 12-07-2013 State Supervisory Board under the Chairmanship of the Hon’ble Health Minister, J&K and Co-Chairmanship of Hon’ble Minister of State for Health Mission Director NRHM appointed as State Nodal Officer PC&PNDT for coordination with the Ministry of Health and Family Welfare, GoI. DIVISIONAL LEVEL Divisional Advisory Committee under the Chairmanship of respective Divisional Commissioner. Divisional Appropriate Authority ----- Director Health Services, Jammu/ Kashmir. DISTRICT LEVEL District Advisory Committee under the Chairmanship of concerned Deputy Commissioner. District Appropriate Authority ---- Concerned Chief Medical Officer. DISTRICT ADVISORY COMMITTEE Reconstituted vide Government order No. 502-HME of 2011 dated: 20.09.2011 DISTRICT APPROPRIATE AUTHORITY CMOs have been designated as District Appropriate Authority vide Govt. Order No 609-HME of 2011 Dated: 22-11-2011 Composition of District Advisory Committee District Development Commissioner / Dy. Commissioner Chairman 65 Chief Medical Officer Member Secretary Medical Supdtt. District Hospital Member District Information Officer Member District Social Officer Member Senior Most Gynecologist of the District Hospital Member Senior Most Pediatrician of the District Hospital Member Leading advocate of the District to be nominated by Deputy Commissioner Member NGO to be nominated by Deputy Commissioner Member Deputy Commissioners concerned will co opt at least one people’s representative as a special invitee in the District Advisory Committee FUNCTIONS OF THE DIVISIONAL/DISTRICT ADVISORY COMMITTEES To pay surprise visits or periodic visits to centres, Laboratories and clinics with a view to check compliance of the provision of Act and Rules. To recommend to the appropriate authority cancellation or otherwise of registration of or prosecution against a centre laboratory or clinic. To check and prevent contravention of provision of the Act or Rules in the area of its purview. To advise appropriate authority about implementation of the Act and creation of public awareness on the issue of the sex selection; To seize machine as may be found appropriate. FUNCTIONS OF DIVISIONAL/DISTRICT APPROPRIATE AUTHORITY To grant, suspend or cancel registration of a Genetic counseling Centre, Genetic Laboratory or Genetic Clinics. To enforce standards prescribed for the Genetic Counseling Centre, Genetic Laboratory or Genetic Clinics. To investigate complaints of breach of the provisions of this Act or the rules made there under and take immediate action. To seek and consider the advice of the Advisory Committee, constituted under sub section (5) on application for registration and on complaints for suspension or cancellation of registration To take appropriate legal action against the use of preconception sex selection techniques by any person at any place, brought to its attention or suo motto and also to initiate independent investigation in such matters. To create public awareness against the practice of preconception sex selection or prenatal determination of sex. To supervise the implementation of the provision of the Act and Rules; and To recommend to the State Supervisory Board modifications required in the Act or Rules in accordance with changes in technology or social conditions 66 To recommended to the State Supervisory Board modifications required in the Act or Rules in accordance with changes in technology or social conditions. Composition and functions of State/Divisional level committees are available on website of pcpndt www.pcpndtjk.in STRENGTHENING OF MONITORING MECHANISMS Monitoring of sex ratio at birth through civil registration of birth data Formulation of Inspection and Monitoring committees Increasing the monitoring visits Review and evaluation of registration records Online availability of PNDT registration records Online filling and medical audit of form Fs Ensure regular reporting of sales of ultrasound machines from manufacturers Enumeration of all Ultrasound machines and identification of un-registered ultrasound machine Ensure compliance for maintenance of records mandatory under the Act Ensure regular quarterly progress reports at state and district level Note: The year 2013-14 has been declared as SAVE THE GIRL CHILD, every district is required to frame a concrete Action Plan on SAVE THE GIRL CHILD and is bound to follow that Action Plan and perform all the activities proposed in that Action Plan in a time bound manner. TRAININGS The term training refers to the acquisition of knowledge, skills and competence as a result of the teaching of vocational or practical skills and knowledge that relate to specific useful competencies. The State of Jammu and Kashmir has resolved to go into the PIP for trainings in 2013-14 adhering to the dictum of the right person for the right training at the right place, so that trainings are effective and result-oriented. Trainings /Workshops are an essential activity for updating the knowledge and skills of the workers of any organization. Upgradation of the skills of the health personnel has been taken up on priority basis under NRHM. Aim of Trainings: i) Development of human resource potential in health care for optimum output. ii) Operationalization of health care institutions developed and strengthened as per the requirements of the State, with particular emphasis on maternal and child care units. iii) Up-gradation of current medical knowledge with evidence based inputs in alignment with current health care policies and requirements. 67 iv) Creation of awareness among different stake-holders regarding issues of health and social well-being. The Mission has planned training/workshops during 2013-14 at the National/State/Divisional & District level in:- Maternal Health. Child Health. Family Planning. Immunization. Adolescent Health. Intersectoral Convergence. Accounts Trainings under the Maternal Health Skilled Birth Attendance (SBA) Training: Any pregnancy can develop complications at any stage, so timely provision of obstetric care services is extremely important for management of such cases and as such, every pregnancy needs to be cared for by a Skilled Birth Attendant (SBA) during pregnancy, childbirth and the post-partum period. GoI considers an SBA to be a person who can handle common obstetric and neonatal emergencies and is able to timely detect and recognize when a situation reaches a point beyond his/her capability, and refers the woman/newborn to an appropriate facility without delay. In order to strengthen the delivery points the Government of India has approved the budget for SBA trainings for ISM Doctors, Staff Nurses, ANMs//LHVs. With the condition that State must ensure SBA training at delivery points first and then other facilities. Trainings under Child Health NSSK Training: (Navjat Shishu Suraksha Karayakaram) This training course on basic newborn care and resuscitation program has been developed to address the high early neonatal mortality in the country. The course aims to impart the basic skills essential to manage common neonatal problems like asphyxia, infections, hypothermia and breast feeding. The course has been developed for Medical officers, Nurses and ANMs, who are based at health centres (CHCs/FRUs/24x7 PHCs) and small hospitals (not referral hospitals) and are responsible for conducting deliveries and managing newborn babies. The following categories of staff will be trained in each district during the current financial year from the designated delivery points and their retention at the facility must be ensured:- Medical Officers/SN/ANMs - 24 per batch (22 districts). Trainings under Adolescent Health 1. Orientation Training of State and District Program Managers under ARSH 2. State Level/District Level/Block Level Trainers under WIFS. 68 Other Trainings Trainings under Immunization 1. Training of vaccine handlers in cold chain system. 2. Cold chain handlers training for block level cold chain handlers by state and district cold chain officers. Trainings under Family Planning 1. NSV Training. 2. IUD Insertion Training. 3. Post-partum IUCD (PPIUCD) Training. 4. Interval IUCD Training. General Guidelines: All trainings are aimed at making health care facilities operational. Certain guidelines must be followed while nominating candidates, conducting trainings and following up on their performance: 1. For all technical trainings such as EmOC, LSAS, Blood transfusion, nomination of medical officers should be sought from centres where facilities are available i.e. FRUs/CHCs but specialists are not present. 2. Medical officers from all 24x7 PHCs must be trained in BEmOC, MTP, Safe abortion and IUCD insertion and facilities for the same be provided to them. Paramedical staff at PHCs and SCs must be trained in IUCD insertion. 3. A participant should be nominated for one technical training only. 4. For non – interventional trainings like ARSH, IMNCI, Gender equity, infection control, all categories of health care staff- Medical Officers at the divisional level, and paramedical staff (LHVs, ANMs/MPWs) at the district level should be trained. 5. All trainings must begin with a questionnaire for pre-evaluation survey of the existing knowledge of the participants followed by a post-evaluation survey to assess the efficiency of the training. 6. Only trained staff may be used as resource persons for the training. 7. For all trainings, the utilization of funds must be strictly in accordance with the budget guidelines approved by GoI. 8. All DDOs must ask for the attendance of the candidates for the period of training after the candidate rejoins his place of posting. 9. TA/ DA to all nominees is to be paid by the organizers of the training and should not be drawn from the place of posting unless specifically mentioned. 10. Feedback of each training should be sent to the headquarters within a fortnight of the completion of the training. 11. The trained manpower must be posted at suitable institutions in consonance with their expertise, and the necessary facilities be provided to them for the utilization of their services. 69 12. The performance of all medical and paramedical staff who have undergone technical trainings (SBA, EmOC, BEmOC, LSAS, MTP, MVA, IUD insertion, training in Blood transfusion) must be monitored on monthly basis. PROGRAMME MANAGEMENT UNITS ROAD MAP: HUMAN RESOURCES A comprehensive HR policy to be formulated and implemented; to be uploaded on the website. Underserved facilities particularly in high priority districts, to be first strengthened through contractual staff engaged under NRHM. Similarly high case load facilities to be supplemented as per need All appointments under NRHM to be contractual; contracts to be renewed not routinely but based on structured performance appraisal Decentralized recruitment of all HR engaged under NRHM by delegating recruitment process to the District Health Society under the chairpersonship of the District Collector or Rogi Kalyan Samitis at facility level as applicable. Preference to be given to local candidates to ensure presence of service providers in the community. Residence at place of posting to be ensured. Quality of HR ensured through appropriate qualifications and a merit- based, transparent recruitment process is mandatory. It has been observed that contractual HR engaged under NRHM i.e. Specialists, Doctors (both MBBS and AYUSH), Staff Nurses and ANM are not posted to the desired extent in inaccessible/hard to reach areas thereby defeating the very purpose of the Mission to take services to the remotest parts of the country, particularly the un-served and under-served areas. It must therefore be ensured that the remotest Sub-Centres and PHCs are staffed first. Contractual HR must not be deployed in better served areas until the remotest areas are adequately staffed. No Sub-Centre in remote/difficult to reach areas should remain without any ANM. No PHC in these areas should be without a doctor. Further, CHCs in remote areas must get contractual HR ahead of District Hospitals. Compliance with these conditionalities will be closely monitored and salaries for contractual HR dis-allowed in case of a violation. Details of facility wise deployment of all HR engaged under NRHM to be displayed on the state NRHM web site. 70 For SHCs with 2 ANMs, population to be covered to be divided between them. Further, one ANM to be available at the sub-centre throughout the day while the other ANM undertakes field visits; timings for ANM’s availability in the SHC to be notified. AYUSH doctors to be more effectively utilized eg for supportive supervision, school health and WIFS. All contractual staff to have job descriptions with reporting relationships and quantifiable indicators of performance. Performance appraisal and hence increments of contractual staff to be linked to progress against indicators. Staff productivity to be monitored. Continuation of additional staff recruited under NRHM for 24x7 PHCs, FRUs, SDH, etc, who do not meet performance benchmarks, to be reviewed by State on a priority basis. All performance based payments/difficult area incentives should be under the supervision of RKS/Community Organizations (PRI). ROAD MAP FOR PRIORITY ACTION: PROGRAMME MANAGEMENT A full time Mission Director is a prerequisite. Stable tenure of the Mission Director (minimum 3 years) should also be ensured. A regular full time Director/ Joint Director/ Deputy Director (Finance) (depending on resource envelope of State), from the State Finance Services not holding any additional charge outside the Health Department must be put in place, if not already done, considering the quantum of funds under NRHM and the need for financial discipline and diligence. Regular meetings of state and district health missions/ societies. Key technical areas of RCH to have a dedicated / nodal person at state/ district levels; staff performance to be monitored against targets and staff sensitized across all areas of NRHM such that during field visits they do not limit themselves only to their area of functional expertise. Performance of staff to be monitored against benchmarks; qualifications, recruitment process and training requirements to be reviewed. 71 Delegation of financial powers to district/ sub-district levels in line with guidelines should be implemented. Funds for implementation of programmes both at the State level and the district level must be released expeditiously and no delays should take place. Evidence based district plans prepared, appraised against pre determined criteria; district plans to be a “live” document. Variance analysis (physical and financial) reports prepared and discussed/action taken to correct variances. Supportive supervision system to be established with identification of nodal persons for districts; frequency of visits; checklists and action taken reports. Remote/ hard to reach/ high focus areas to be intensively monitored and supervised. An integrated plan and budget for providing mobility support to be prepared and submitted for review/approval; this should include allocation to State/ District and Block Levels. All facilities to maintain visitors registers. All supervisors should write their main observations and agreed action/recommendation. Supervisors should sign with their name and post (written legibly) with date of visit. All LHV positions to be filled on a priority basis. The block PHN and DPHN to be part of block and district programme management unit respectively. Similarly a Nursing nodal person to be a part of SPMU. Nursing to be made an integral part of all planning, implementation and monitoring activities. The management structure in the form of Programme Management Support Units at State, Division, District and Block Levels have been established as shown below: At the State level, State Programme Management Support Unit has been established headed by the Mission Director and comprising of officers from Finance, Planning, State Programme Manager, Programme Officers of various programmes etc. The State Programme Unit provides technical support to the State Health Society/State Health Mission in formulation and implementation of the planned activities. At the Divisional Level, the Divisional Programme Management Unit is headed by Divisional Nodal Officer and supported by Divisional Accounts Manager, Divisional Monitoring and Evaluation Officer and one Junior Assistant. One Law Officer has also been engaged on contractual basis in the Divisional Nodal office to assist the State Health Society on legal issues. 72 The Divisional Programme Management Unit has to perform all activities in their respective Division pertaining to planning, monitoring and coordinating with Divisional level Directorates / Offices in achievement of the financial and Physical targets set up under NRHM. At the District Level all the 22 Districts are manned with one District Programme Manager, One District Accounts Manager and One District Monitoring and Evaluation Officer. One Data Entry Operator has been placed in all the 22 District Hospitals and one Data Entry Operator for every Deputy CMO office of the district. At the Block Level all the 116 Blocks are manned with one Block Monitoring & Evaluation Officer and one Block Accounts Manager at every Block. Reporting system of Programme Management Units The following monitoring system needs to be ensured:- Block Programme Management unit shall report to the BMO as well as to the District Programme Management Unit. District Programme Management Unit shall report to the CMO as well as to the Divisional Programme Management Unit. Divisional Programme Management Unit shall report to the Divisional Nodal Officer as well as to the State Programme Management Unit. The State Programme Management Unit headed by the Mission Director NRHM shall provide feedback to the higher authorities both in the State / GoI. Road Map for Programme Management during the year 2013-14. A full time Mission Director is a prerequisite. Stable tenure of the Mission Director should also be ensured. A regular full time Director/ Joint Director/ Deputy Director (Finance) (depending on resource envelope of State), from the State Finance Services not holding any additional charge outside the Health Department must be put in place, if not already done, considering the quantum of funds under NRHM and the need for financial discipline and diligence. Regular meetings of state and district health missions/ societies must take place. Key technical areas of RCH to have a dedicated / nodal person at state/ district levels; staff performance to be monitored against targets and staff sensitised across all areas of NRHM such that during field visits they do not limit themselves only to their area of functional expertise. Performance of staff to be monitored against benchmarks; qualifications, recruitment process and training requirements to be reviewed. Delegation of financial powers to district/ sub-district levels in line with guidelines should be implemented. 73 Funds for implementation of programmes both at the State level and the district level must be released expeditiously and no delays should take place. Evidence based district plans prepared, appraised against pre determined criteria; district plans to be a “live” document. Variance analysis (physical and financial) reports prepared and discussed/action taken to correct variances. Supportive supervision system to be established with identification of nodal persons for districts; frequency of visits; checklists and action taken reports. Remote/ hard to reach/ high focus areas to be intensively monitored and supervised. An integrated plan and budget for providing mobility support to be prepared and submitted for review/approval; this should include allocation to State/ District and Block Levels. HMIS / MCTS ROAD MAP FOR PRIORITY ACTION MONITORING AND EVALUATION HR and Infrastructure For optimum utilisation of resources, State should integrate manpower, infrastructure, trainings, reviews, field visit etc for HMIS & MCTS since in most cases the persons to be trained, called for reviews and making field visits are same HMIS data reporting, improving data quality and its use State to ensure that 100 % HMIS facility wise data is uploaded, validated and committed; data for the month should be available by the 15 th of the following month Mission Director and Program Managers at all level to use HMIS data for monthly reviews. SAS software may be extensively used for State level analysis and feedback to be shared with GOI Regular field visits for trouble shooting, Data quality checks, clarification of conceptual issues regarding HMIS. Capacity building (Online/offline training, Refreshers training, Workshop etc) to be conducted as proposed in PIP Involvement of Regular Statistical Officials along with contractual staff for monitoring and data quality checks. Regular feedback on HMIS and MCTS to district/Blocks/facilities to be ensured. HMIS formats are under rationalization, so Printing of formats, registers may only be done after consulting MOHFW. Registration of Births and deaths: 74 Strengthen birth and deaths registration and issue birth certificates before discharge from facility and ensure information flow from lower levels to chief registrar of births and deaths Improve reporting of births and deaths (especially deaths) in HMIS portal. MCTS: ROAD MAP FOR PRIORITY ACTION States/ UTs are requested to ensure the implementation of village wise integrated RCH Register from 2013 in the State. The newly designed Register has already been shared with States/UTs. Aadhaar number and bank details of all the pregnant women and health workers (ANM, ASHA) should be captured in MCTS portal for providing the JSY benefits to the beneficiaries. State may establish a dedicated Call Centre for validating the records of the beneficiaries, informing them about Government Schemes and promoting for availing the due services on time. State may ensure that all the health facilities are timely receiving the Work-plan for necessary follow-up and providing the services to the beneficiaries accordingly. State may ensure for universal coverage from all the health facilities and private institutions including urban areas on MCTS Portal. Also ensure for 100 % qualitative, timely reporting and updating of services delivery records from all the health institutions including private facilities on MCTS Portal. State may advise DMHO and BMHO for continuous monitoring, field visit and taking of corrective action based on MCTS information and ensure for using of MCTS data for policy formulation, micro planning at different levels and redressal of bottlenecks pertaining to various programs and schemes. HMIS and MCTS are two important online monitoring tools of NRHM. HMIS portal provides all the information uploaded at the facility level thus providing information about the workload of different institutions and the delivery of services provided there. A decision was taken in the review meeting held on 15-05-2013 held under the Chairmanship of Hon’ble Minister for Health & Family Welfare, where it was decided to stop reporting in form 9 of Director Family Welfare and as per the Direction from MoH&FW, GOI, only one reporting platform should be used and it was decided to use HMIS platform for all type of reporting. In this regard a letter was circulated to CMO and Dy.CMO from State Immunization Officer to stop reporting in old Family Welfare formats and use of HMIS data only for reporting. In this regard data entry operator under Immunization would be used for reporting purpose. 75 To authenticate the data at all the levels, the MO of the Concerned PHC / New Type PHC will authenticate the data of his / her area i.e covering all the SCs and New Type SCs before it is submitted in the monthly meeting at Block level. Once the data of all the Institution is submitted to Block in the monthly meeting, the data has to verified by Block Medical Officer, before it is forwarded to the District. At the district level, the District has to add stock of that month and Compile the data of the district. At district level data has to be verified by Chief medical Officers. Once the data is verified by CMO, it has to be forwarded to the State. The latest information regarding formats and manuals is available under downloads section. Lot of new reports are available under Standard reports and reports live are now available 24 hours. User can generate any type of report depending upon his usability. MCTS is useful in tracking the Mother and Child for their due services. The basic aim of this system is to track and monitor delivery of services given to the Mother and Child, thus giving a clear picture of the gaps in the service delivery of Health system. In order to provide guidance and monitor implementation of the MCTS at the District level District-e-Mission Team has been constituted vide Govt. order no. 640-HME of 2011 dated 12- 12-2011. The Composition and role of District Project e-Mission team is given as under : Composition of District Project e Mission Team District Magistrate/Deputy Commissioner Chairman Chief Medical Officer Member Secretary District Informatics Officer-NIC Member District Programme Manager (NRHM) Member District Monitoring and Evaluation Officer (NRHM) Member Role of District Project e Mission Team a. Overall Responsibility of Project Implementation in the District. b. Close Monitoring of the project. c. Coordination with the concerned agencies. d. Communication and training. Under MCTS, mobile charges are given to ANMs and ASHAs for data recording and updation of records of Mothers and Children. As per the conditionality’s laid down in the ROP 2013-14, payment should be done on the basis of the updation of the records. In future, mobile charges should be provided to only those ANMs and ASHAs who are updating the records of Mothers and Children. (Evaluation should be based on the beneficiaries coverage on MCTS Portal. Monitoring and Evaluation for HMIS and MCTS 76 State has envisaged following monitoring protocols for Programme Management Units at different levels to ensure proper implementation of HMIS and MCTS data from different level: Block Monitoring and Evaluation Officer shall visit every PHC / CHC and 1/3 rd of the Sub Centres once a month. He will submit his tour report to the Block Medical Officer and District Health Society. District Monitoring and Evaluation Officer shall visit every Block Head Quarter, 50% of the PHCs and 25% of the Sub Centres once a month. He will submit his tour report to the Chief Medical Officer and respective Divisional Nodal Officers. Plan for Use and Feedback of HMIS/MCTS Data by the Districts and Blocks CMOs and BMOs shall hold regular monthly meetings to review the progress with regard to uploading of data, registration, updation and authentication of data on HMIS/MCTS portals. The BMOs should share the findings of the observations with the ASHAs / ANMs and take corrective steps for rectifying the errors in the filling of formats by the ANMs. The BMOs shall also ensure that the work plans are generated on regular basis and provided to ANMs for tracking the pregnant women / children for their due services. The progress with regard to follow up by the ANMs as per the work plans shall be reviewed by the BMOs in every meeting. ANMs should be called in the office of BMO, on regular roaster basis for updation of records of Mother and Children. At the District level, the Chief Medical Officers shall also review the progress of the uploading and updation of the MCTS data block wise. In details analysis of data should be done in the monthly meeting. Data on key indicators like month wise tracking of services, No. of ASHAs registered with Phone number, No. of institutions not reporting during the month an so reports should be shared with BMOs and all he concerned. This will help in improving the quality of HMIS / MCTS data. ROAD MAP FOR PRIORITY ACTION: Uploading of facility wise data is open from 25th of previous month for uploading of data. Data should be uploaded, validated and committed by the 15th of the following month. Facility based HMIS to be implemented. HMIS data to be analysed, discussed with concerned staff at state and district levels and necessary corrective action taken. Programme managers at all levels use HMIS for monthly reviews. MCTS to be made fully operational for regular and effective monitoring of service delivery including tracking and monitoring of severely anemic women, low birth weight babies and sick neonates. Pace of registration under MCTS to be speeded up to capture 100% pregnant women and children 77 Service delivery data to be uploaded regularly work plans for service delivery be generated on regular basis and should be distributed to ANMs. Progress to be monitored rigorously at all levels MCTS call centre to be set up at the State level to check the veracity of data and service delivery. Supportive Supervision & Monitoring Mechanisms The State has put in place a proper mechanism to monitor and evaluate physical and financial progress of NRHM periodically. At the State level, the Programme is being reviewed on quarterly basis through meetings under the Chairpersonship of the Hon’ble Chief Minister of J&K. Monthly review meetings are conducted in both the Divisions under the Chairpersonship of the Hon’ble Health Minister. Regular meetings of Governing Body are being held to assess and review the performance of NRHM programmes. Regular meetings of Executive Committee are conducted by Commissioner Secretary Health and Medical Education. The progress is also being reviewed on monthly basis by the Mission Director NRHM. Similarly at the District level Deputy Commissioner (Chairman District Health Society) also reviews the functioning of NRHM. MONITORING PROTOCOLS Supportive Supervision Plan Level Person Responsible Frequency Facilities to be covered Tool State State Directorate/SPMU Plan in a way that each district in state is visited atleast once a quarter (Two day visit). Three State level supportive supervision review meetings, every four months under chairpersonship of MD, NRHM At least 1 SC, 1 PHC,1 CHC (FRU and Non FRU) and 1 DH per visit. · Visit to district office Checklists for SC, PHC, CHC Divisional RPMU/CPMU/Divisional Management unit (where ever applicable) Fortnightly monitoring of facilities · Participation in one district level monthly meeting Participation in State Review meetings · At least 1 SC, 1 PHC/1 CHC per visit Checklists for SC, PHC, CHC District PHN/DPMU along with regular officers (RCHO/ADHO/ACMO/Q MO/ EMO etc) and CMO One Visit/week · One monthly meeting with a participation of DPMU and regular staff of the district · At least 2 SC, 1 PHC/visit ( per week) · At least 2VHNDs/ visit( per week) . At least 2 CHCs/FRU/month Checklists for SC, PHC, CHC 78 Level Person Responsible Frequency Facilities to be covered Tool CHC BPM along with BMO At least one field visit/week · · At least 2 SC and 1 PHC/visit· At least 2 VHNDs/visit Checklists for SC, PHC, CHC PHC LHV · At least monthly visit to each SC in her catchment area · All SC/month · 1 VHND/week Checklists for SC, PHC, CHC Medical Officer · Daily and Monthly monitoring of facility· Monthly monitoring of SC (MO- PHC).· At least 1 monthly supportive supervision meeting with the facility staff · Key Issues Daily· Whole Facility monthly· At least 2 SC and 2VHNDs/month (MO-PHC) Checklists for SC, PHC, CHC Checklists for SCs/ PHCs/ CHCs/ DHs has already been shared with the district Health Societies Monitoring by District Monitors engaged under NRHM State has hired 8 Monitors (4 for each division) who monitor and evaluate the progress of NRHM programmes in the districts assigned to them. Each monitor has to visit the districts allotted to him on regular basis and has to monitor all the activities and evaluate the performance of each District and has to submit a report of their findings on prescribed format to the Mission Director NRHM, J&K. The findings of reports of Monitors are being shared with CMOs, Director Health Services and Administrative Department. FINANCIAL MANAGEMENT 1. Cash and Bank Books:- All entries must be completed in the Cash Book and Bank Book on daily basis duly signed by the concerned DDO’s. 2. Ledger:- According to the entries of cash & bank books, all entries must be posted in the Ledger. 79 3. Journal:- Journal Ledger should be complete in all respect. All opening entries must be made in the journal along with adjustment entries as per audit report and Accounts for all the advance adjustment vouchers submitted by the concerned parties. 4. Vouchers:- All vouchers should be serially numbered and filed and kept under safe custody. 5. Bank Reconciliation Statement:- Bank Reconciliation Statement must be prepared to reconcile the Bank Book figures with the Bank statement and all un-reconciled bank entries must be identified and proper entries passed in the books of accounts. Stale cheques should also be identified and reverse entries made in the books of accounts. 6. Preparation of Trial Balance:- It is very important that trial balance to reconcile the ledger balances prepared at State/ District / Block levels. All the opening balances as per Audit Report may also be accounted for in the current financial year’s Trial Balance. It must be ensured that Trial Balance of the current year is prepared at these levels. 7. Preparation of Receipts and Payment Account, Income and Expenditure Account at each level:- On the basis of final Trial Balance, it is necessary to prepare the final accounts at each level (State/Districts/Blocks) at the close of financial year. 8. Preparation of Action Taken Report (ATR):- Action taken points of Audit Report for the previous years should be discussed in the SHS/DHS meetings and the concerned State/District/ Blocks should prepare the Action Taken Report as per Auditor's and MoH&FW observations. A copy of the Compliance Report must be sent to State Health Society for onwards transmission to Ministry at the earliest. 9. Records Keeping:- All accounts records of NRHM must be kept under lock and key with specific responsibility assigned to concerned official/officers for their proper maintenance at all the levels. All vouchers relating to accounts transactions must be kept year wise in box files or duly bound files after audit. Records, mainly cash book, petty cash book, ledgers and paid vouchers, deposit receipts etc at district/Block level may be kept properly and safely under the custody of the District Chief Medical Officer/Block Medical Officer or by an authorized officer. 10. Reminders for Advance Adjustment:- Age wise analysis of advance must be conducted at all levels and reminders for settlement of advance and refund of unspent balance must be sent to all concerned on a quarterly basis and pursued vigorously. 11. Audit Reports: Audit reports of all previous years must be kept at State and District levels, preferably with soft copies as per retention schedule of the State Govt. The previous audit reports must be scanned and also kept in computers. Action taken points of audit of previous 80 years should be finalized. District Health Societies shall also ensure to undertake monthly District Audit and periodic assessment of the financial system in the subordinate offices. 12. Upkeep of Cheque Books and Cheque Registers:- All cheque books issued by the bank must be entered in a register and kept under safe custody of the concerned officer alongwith unused / cancelled cheques. 13. Cash verification certificate:- Cash verification certificate must be obtained from the concurrent auditor at the end of each month and verified in the presence of Programme officer of the concerned program. 14. Physical verification of Fixed Assets:- All the fixed assets must be physically verified by the designated committee and a physical verification certificate must be kept safely for verification. 15. Stock Registers:- Store keeper of concerned program should maintain/complete the stock registers upto date. 16. Important Agreements/MOUs:- All the important agreements such as EMRI agreement, Rent Agreement, Contractor Agreement, Security Agreement and MOUs duly registered must be kept in safe custody. 17. Income Tax Return:- All the TDS deducted by the District Health Societies must be deposited in time in the bank and quarterly Income tax Return must be filed through NSDL agencies. 18. Concurrent Audit:- The District Health Societies should complete and finalize their concurrent Audit with reports on monthly basis and action taken thereon. 19. Transfer of Funds/ Monitoring of Bank Balance: Regular monitoring of Bank Balances may be ensured for timely and adequate transfer of funds through e-transfer/ Demand Drafts from State to District and District to Block levels in time to ensure the achievement of stipulated targets. Closing bank balance certificate/ bank statement at the end of financial year must be obtained from the Branch Manager of concerned banks. 20. FMR/Statement of Funds Position:- FMR must include all the expenditure of the SHS/DHS and statement of funds position should also show same expenditure as mentioned in the FMR. These statements should be sent in a complete form to the State Health Society by the 5th of every month. 21. Uploading of FMR on HMIS web portal: Every District must ensure that quarterly FMRs are uploaded on HMIS web portal on a regular basis. 81 22. Committed and Uncommitted Unspent Balance:- District should also calculate the Committed and Uncommitted Unspent Balance at the end of every financial year under each component. 23. The Drawing and Disbursing Officer must ensure due diligence in expenditure and observe, in letter and spirit, all rules, regulations, codal formalities and procedures to maintain financial discipline and integrity particularly with regard to procurement; competitive bidding must be ensured and only need-based procurement should take place 24. The District Health Societies shall not make any change in allocation among different components/ activities without approval of State Health Society. 25. The accounts of the State Health Societies/District Health Societies/ Implementing agencies grantee institution/ organization shall be open to inspection by the sanctioning authority and Audit by the Comptroller and Auditor General of India under the provisions of CAG(DPC) Act 1971, Internal Audit by Financial Management Group of State Health Society/Principal Accounts Office of the Ministry of Health & Family Welfare. Road Map for Priority Action on Financial Management is enclosed as Annexure “L” NRHM HELPLINE In the year 2013, A Toll free No. 18001800102 has been inaugurated by the Hon’ble Minister of State for Health (Independent charge) on 31 st May, 2013 for J&K State. Objective of NRHM Helpline In view of the peculiar geographical situation of the State having two capitals, one for summer and one for winter, two Central Universities, two Directorates of Health Services, the projection of PIP of the State separately for the two divisions regarding various centrally sponsored schemes including NPCB, NLEP, RNTCP, IDSP etc. and subsequent release of funds for two divisions separately, the decision was taken to initiate NRHM Helpline (Grievance Redressal Cell) in the Divisional Nodal Offices of NRHM, one each at Jammu and Kashmir for grievance redressal of employees and public-at-large. The process of establishment of the two landline phone lines at both the headquarters has been also accomplished. 82 ANNEXURES Annexure ‘A’ MONTHLY PROGRESS REPORT FOR THE Month _______ OF THE FINANCIAL YEAR 2012-13 District _________ S.No. (A) Cummulative Achievements on Key Startegies As on Date 83 1 No. of District Health Societies Constituted 2 No. of Rogi Kalyan Samities (RKS) Registered for I District Hospital ii CHCs iii PHCs iv ADs v Any other Hospital(Mention name) 3 No. of Village Health Sanitation & Nutrition Committees Constituted 4 No. of VHSNCs for which accounts opened 5 No. of CHCs upgraded as FRUs (Give names on separate sheet) 6 No. of PHCs made Operationalized as 24x7 PHCs(Give names on separate sheet) 7 No. of ASHAs engaged 8 No. of ASHAs trained in Module I 9 No. of ASHAs trained in Module II-IV 10 No. of ASHAs trained in Module V 11 SNCUs established 12 No. of Stablization Units established (Give names on separate sheet) 13 No. of Baby Care Corners Established(Give names on separate sheet) 14 No. of Specialists/Doctors/Paramedics engaged 15 No. of Ambulances provided from i Regular side ii NRHM 84 16 No. of ARSH Clinics Setup (B)Activity-wise Achievements during the year 2012-13 S.NO NAME OF THE ACTIVITY Ach. During 2011-12 Target 2012- 13 Cummulative Ach. Ending previous month Ach. During the reporting month Total JSY 1 Total Deliveries (Home+ Institutional) with in District 2 (i) Institutional deliveries with in District 2 (ii) Institutional deliveries outside District 3 (i) Institutional deliveries escorted by ASHAs 3(ii) No. of ASHAs given incentive under JSY 4 Mother beneficiaries given incentive under JSY a Home Deleveries i Rural ii Urban Total (a) b Institutional Deleveries i Rural ii Urban Total (b) Total (a+b) Maternal Health 1 No. of Maternal Deaths reported in the District 2 No. of Maternal Deaths occurred in i Govt. Health Institution ii At community level 3 No .of Maternal Death Autopsy conducted by Dy.CMO/ BMO 4 No. of Maternal Death Reviewed by District MDR committee 5 No. of Community based Voluntary Workers/ASHAs given incentive for reporting Maternal Death 6 No. of pregnant women given Iron Sucrose intervention Dose 85 7 No. of deliveries conducted at home by SBA trained persons 8 No. of SBA trained persons given Incentive for conducting home deliveries in inaccessiable/ Snow bound area of high focus districts VHSNCs 1 No. of VHSNCs meetings held 2 No. of meetings facilitated by ASHA 3 No. of ASHAs given incentives for facilitating meeting of VHSNCs 4 No. of meetings of Women and Adolescent girls held VHNDs 1 VHNDs conducted (Nos.) 2 No. of VHNDs supervised by i CMOs ii BMOs iii Any other Officer (DHO, DMEIO etc.) 3 No. of ASHAs who have attended the monthly meeting at Block level (PHC) JSSK 1 No. of Preganent Women given Drugs and consumables for i Normal Deliveries ii C-Section 2 No. of Preganent Women provided free i Diagnostics ii Blood transfusion 3 No.of Preganent Women provided diet for during i Normal Deliveries ii C-Section iii During stay of sick childen 4 No. of Preganent Women given free referral transport from i Home to facility ii Drop back facility iii Referral to higher facility 5 No. of Sick Neonates provided Drugs and consumable 86 7 No. of Sick Neonates given free referral transport from i Home to facility ii Drop back facility iii Referral to higher facility Child Health 1 No. of Infant deaths reported i From Govt. Health Institution ii At community level 2 Infant Death verbal autopsy conducted by Dy . CMO / BMO 3 No. of Infants deaths reviewd at District Level 4 No. of Community based Voluntary Workers / ASHAs given incentive for reporting Infant Death 5 No. of ASHA given incentive under Child Health (HBNC) 6 Total number of Sick Neonates admitted in SNCUs 7 Total number of Admissions in Stabilization Units 8 Total No. of Babies revived in NBCCs FAMILY PLANNING 1 No. of meeting held on Quality Assurance (QA) of sterilisation/Family Planning services 2 Compensation for Female sterilization (No. of cases) 3 Compensation for Male sterilization (No. of cases) 4 Male Sterlization Camp (Nos.) 5 Female Sterlization Camp (Nos.) 6 IUD insertion at Health facilities (No. of cases) 7 No. of monitoring visits conducted by Dy. CMO/BMO/Any other officer/official 87 Menstrual Hygiene Programme 1 No. of adolescent girls reached by ASHA 2 No. of Free days sanitary napkins received by ASHA 3 No of Free days sanitary napkins sold/ distributed by ASHA 4 No. of free Sanitary Napkins given to ASHA as incentive for sale of Free days sanitary napkins 5 No. of group meeting conducted by ASHA/ANM with Adolescent girls School Health Programme 1 No. of Govt./Govt. aided schools visited 2 No. of school children examined a Boys b Girls 3 No. of screening camps held at PHC level falling under Sabla district 4 No. of tablets distributed at school level a IFA b Deworming 5 No. of Peer educator identified during VHNDs in SABLA Districts PNDT 1 No. of Orientations held for programme Manager and series provider on PC and PNDT act 2 No. of Informer given reward for informing about Unregistered Ultrasound machines/Ultrasound Clinics/illegal practice of sex/Female foeticide ASHAs Incentives 1 No. of Pregnant women facilitated full ANC by ASHA 2 No. of Birth got registered by ASHA 3 No. of Deaths got registered by ASHA 4 No .of ASHAs given incentives for 88 i Full ANC ii Registration of births iii Registration of deaths 5 No .of ASHAs given incentives for event reporting 6 No. of events reported by ASHAs 7 No. of ASHAs given Incentives for performing roaster duty at ASHA help desk IEC/BCC 1 No. of symposium held for female adolescents in high/higher secondary schools and colleges 2 No. of Rallies / Debates /Seminar held in school /colleges 3 No. of Block Sammelans organised Immunization 1 No. of drop out children Mobilised through ASHA on VHNDs/Immunization sessions 2 No. of ASHA given incentive for mobilizing drop out children 3 No. of quality review meeting held exclusively for RI at district level with Block MO, CDPO and other stake holders 3 No. of Quarterly Review meeting held exclusive for R.I. at Block level. 4 No. of ASHAs given incentive for full immunization. i No. of children fully immunized (upto 1st year) through ASHA ii No. of children fully immunized through ASHA (2nd year) 5 No. of children administered BCG 6 No. of children administered DPT III/POLIO III 7 No. of children administered Measles I 89 8 No. of children administered Measles II Trainings 1 Nos. trained in SBA i MO(ISM) ii SNs iii LHVs/ANMs 2 No. of ANMs/MPWs/LHVs trained in NSSK & IMNCI 3 No. of LHVs/ANMs/SNs/MPWs trained in RTI/STI 4 No. of Mos/LHVs/ANMs trained in IUD Insertion 5 No. of Medical Officers trained in NSV 6 No. of ANMs/ trained in ARSH programme 7 Training of vaccine handlers in cold chain system (No. of persons trained) 8 Orientation training of ANMs/LHVs/Health worker in Immunization(No. of persons trained) 9 Orientation of Medical Officers in Immunization (No. of MOs trained) No. of Meetings held 1 District Health Mission (No. of meetings) 2 District Health Society (No. of Meetings) 3 District Level Vigilance & Monitoring committees (DLVMC)(Nos.) 4 Rogi Kalyan Samities (No. of meetings) ANNEXURE ‘B’ 90 Annexure C S.No Indicator Number S.No. Name of District Name of Delivery Points SC Conducting >3 26 1 Kishtwar SC Sigdi Line listing of 20 new ASHA Greh proposed for 2013-14 S.No Name of District Name of Institution 1 Doda CHC Bhaedrwah 2 Jammu CHC RS Pura 3 Kathua CHC Billawar 4 Kishtwar PHC Atholi 5 Poonch CHC Surankote 6 Rajouri CHC Nowshera 7 Reasi CHC Katra 8 Samba CHC Ramgarh 9 Udhampur CHC Ramnagar 10 Ramban CHC Banihal 11 Anantnag CHC Kokernag 12 Bandipora CHC Sumbal 13 Baramulla CHC Uri 14 Budgam CHC Magam 15 Ganderbal CHC Kangan 16 Kulgam CHC D H Pora 17 Kupwara CHC Tangdar 18 Pulwama SDH Pampore 19 Shopian CHC Keller 20 Srinagar CHC Gousia 91 S.No Indicator Number S.No. Name of District Name of Delivery Points A deliveries/month 2 Rajouri SC Tatapani 3 Udhampur SC Loudra 4 Udhampur SC Kudwah 5 Ramban SC Jatgali 6 Anantnag S/C Dehwatoo 7 Bandipora S/C Aragam 8 Bandipora S/C Ahamsharief 9 Bandipora S/C Watapora 10 Bandipora S/C Malangam 11 Bandipora S/C Aloosa 12 Bandipora S/C Pazalpora 13 Bandipora S/C Mukdamyari 14 Bandipora S/C Panzinara 15 Baramulla SC's Watergam 16 Kupwara S/C Khurhama 17 Kupwara S/C Moori 18 Kupwara S/C Thayan 19 Kupwara S/C Pathroo 20 Kupwara S/C Keran bala 21 Kupwara S/C Zonereshi 22 Kupwara S/C Farkin 23 Kupwara S/C Budnambal 24 Kupwara MAC Putushai 25 Kupwara MAC Nagsari 26 Kupwara MAC Machil No. of 24X7 PHCs conducting > 10 deliveries /month 28 1 Jammu PHC Pallanwala B 2 Kishtwar PHC Chatroo 3 Kishtwar PHC Atholi 4 Rajouri PHC Manjakote 5 Udhampur PHC Majalta 6 Ramban PHC Ukerhal 7 Ramban PHC Khari 8 Ramban PHC Ramsoo 9 Anantnag PHC Achabal 10 Anantnag PHC Larnoo 11 Anantnag PHC Aishmuqam 12 Anantnag PHC Saller 13 Anantnag PHC Verinag 14 Bandipora PHC Hajin 15 Baramulla PHC BONIYAR 16 Baramulla PHC DANGIWACHA 92 S.No Indicator Number S.No. Name of District Name of Delivery Points 17 Budgam PHC Khag 18 Budgam PHC Soibug 19 Ganderbal PHC Gund 20 Ganderbal PHC Lar 21 Kulgam PHC Qazigund 22 Kupwara PHC Kalaroose 23 Kupwara PHC Chowgal 24 Kupwara PHC Tarthpora 25 Kupwara PHC Vilgam 26 Kupwara PHC Trehgam 27 Kupwara PHC Drugmulla 28 Kupwara PHC Panzgam C No. of any other PHCs conducting > 10 deliveries/ month 2 1 Bandipora PHC Chantimulla 2 Kupwara PHC Awoora D No. of CHCs ( Non- FRU) conducting > 10 deliveries /month 2 1 Budgam CHC Chattergam 2 Budgam CHC Nagam E No. of CHCs (FRU) conducting > 20 deliveries /month 47 1 Doda CHC Bhaderwah 2 Doda CHC Gandoh 3 Jammu CHC Akhnoor 4 Jammu CHC Bishnah 5 Jammu CHC RS Pura 6 Kathua CHC Hiranagar 7 Kathua CHC Billawar 8 Poonch CHC Surankote 9 Poonch CHC Mandi 10 Poonch CHC Mendhar 11 Rajouri CHC Sunderbani 12 Rajouri CHC Kalakote 13 Rajouri CHC Nowshera 14 Rajouri CHC Kandi 15 Rajouri CHC Darhal 16 Reasi CHC Katra 17 Reasi CHC Mahore 18 Samba CHC Ramgarh 19 Samba A/H Vijaypur 20 Udhampur CHC CHENANI 93 S.No Indicator Number S.No. Name of District Name of Delivery Points 21 Udhampur CHC RAMNAGAR 22 Ramban CHC Banihal 23 Ramban CHC Batote 24 Anantnag CHC Bijbehara 25 Anantnag CHC Kokernag 26 Anantnag CHC Seer 27 Anantnag CHC Shangus 28 Bandipora CHC Sumbal 29 Baramulla CHC URI 30 Baramulla MCH SOPORE 31 Baramulla CHC KREERI 32 Baramulla CHC PATTAN 33 Baramulla CHC TANGMARG 34 Budgam CHC Beerwah 35 Budgam CHC Chadora 36 Budgam CHC Ch.Sharif 37 Budgam CHC Magam 38 Ganderbal CHC Kangan 39 Kulgam CHC D H Pora 40 Kupwara CHC Kupwara 41 Kupwara CHC Kralpora 42 Kupwara CHC Sogam 43 Kupwara CHC Tangdar 44 Pulwama SDH Pampore 45 Pulwama SDH Tral 46 Shopian CHC Keller 47 Srinagar CHC-Gousia Hosital Khanyar F No. of DH conducting > 50 deliveries /month 23 1 Doda DH Doda 2 Jammu Gandhi Nagar Hospital 3 Jammu Sarwal Hospital 4 Kathua DH Kathua 5 Kishtwar DH Kishtwar 6 Poonch DH Poonch 7 Rajouri DH Rajouri 8 Reasi DH Reasi 9 Samba DH Samba 10 Udhampur DH Udhampur 11 Ramnan DH Ramban 12 Anantnag MCCH Ang 13 Bandipora DH Bandipora 94 S.No Indicator Number S.No. Name of District Name of Delivery Points 14 Baramulla D.H. BARAMULLA 15 Budgam DH Budgam 16 Ganderbal SDH Ganderbal 17 Kargil DH Kargil 18 Kulgam DH Kugam 19 Kupwara DH Handwara 20 Leh SNM Hospital Leh 21 Pulwama District Hospital PuL 22 Shopian District Hospital Shopian 23 Srinagar JLNM G Total No. of District Women And Children hospital 2 H No. of Medical colleges conducting > 50 deliveries per month 3 Annexure D 95 FORMAT FOR PRIMARY INFORMANT Annexure E 96 SNCUs in District Hospitals S No. District Name of Institution Status 1 Jammu Gandhi Nagar Hospital Established 2 Udhampur District Hospital Udhampur Established 3 Kathua District Hospital Kathua Established 4 Leh District Hospital Leh Established 5 Anantnag MCH Anantnag Established 6 Kargil District Hospital Kargil Established 7 Poonch District Hospital Poonch Established 8 Kupwara District Hospital Kupwara Established 9 Baramulla District Hospital Baramulla Established 10 Srinagar JLNM Hospital Srinagar Established 11 Rajouri District Hospital Rajouri Established 12 Pulwama District Hospital Pulwama Established 13 Doda District Hospital Doda Under Progress 14 Budgam District Hospital Budgam Under Progress 15 Kishtwar District Hospital Kishtwar Under Progress Annexure F List of SNCUs where Operational Cost has to provided 97 S No. District Name of Institution Amount Approved 1 Jammu Gandhi Nagar Hospital Rs 10 Lakhs 2 Udhampur District Hospital Udhampur Rs 10 Lakhs 3 Kathua District Hospital Kathua Rs 10 Lakhs 4 Leh District Hospital Leh Rs 10 Lakhs 5 Anantnag MCH Anantnag Rs 10 Lakhs 6 Kargil District Hospital Kargil Rs 10 Lakhs 7 Poonch District Hospital Poonch Rs 10 Lakhs 8 Kupwara District Hospital Kupwara Rs 10 Lakhs 9 Baramulla District Hospital Baramulla Rs 10 Lakhs 10 Srinagar JLNM Hospital Srinagar Rs 10 Lakhs 11 Rajouri District Hospital Rajouri Rs 10 Lakhs 12 Pulwama District Hospital Pulwama Rs 10 Lakhs 13 Doda District Hospital Doda Rs 5 Lakhs 14 Budgam District Hospital Budgam Rs 5 Lakhs 15 Kishtwar District Hospital Kishtwar Rs 5 Lakhs Annexure G 98 Line of Health Institutions having Stabilization Units for whom Operational Cost @ Rs 87,500/- per unit has been approved List of Health Institutions having Stabilization Unit S No. District Name of Health Institution 1 Kishtwar DH Kishtwar 2 Poonch FRU Mendhar 3 FRU Mandi 4 FRU Surankote 5 Reasi FRU Katra 6 Udhampur CHC Chenani 7 CHC Ramnagar 8 Ramban CHC Banihal 9 CH Batote 10 CHC Gool 11 Kathua CHC Billawar 12 CHC Bani 13 CHC Hiranagar 14 CHC Basohli 15 CHC Parole 16 Doda CHC Bhaderwah 17 CHC Gandoh 18 CHC Thatri 19 Jammu CHC Akhnoor 20 CHC Jourian 21 CHC RS Pura 22 CHC Sohanjana 23 CHC Bishnah 24 CHC Marh 25 Rajouri FRU Sunderbani 26 FRU Nowshera 27 FRU Darhal 28 FRU Thanamandi 29 FRU kandi 30 FRU Kalakote 31 Samba CHC Ramgarh 32 EH Vijaypur 33 DH Samba 34 Anantnag FRU Bijbehra 35 FRU Dooru 99 S No. District Name of Health Institution 36 FRU Shangus 37 FRU Seer 38 FRU Kokernag 39 Bandipora DH Bandipora 40 CHC Sumbal 41 FRU Dawar 42 Baramulla FRU Tangmarg 43 CHC Pattan 44 CHC Kreeri 45 CHC Sopore 46 CHC Uri 47 CHC Chandoosa 48 Budgam FRU Beerwah 49 FRU Chadoora 50 CHC Nagam 51 FRU Khan Sahib 52 FRU Ch. Sharief 53 CHC Kremshore 54 CHC Chattergam 55 FRU Magam 56 Ganderbal FRU Kangan 57 Kargil CHC Drass 58 Kulgam CHC DH Pora 59 FRU Yaripora 60 FRU Qazigund 61 Kupwara FRU Kupwara 62 FRU Sogam 63 FRU Langate 64 FRU Tangdar 65 FRU Kralpora 66 FRU Zachaldara 67 FRU Kralgund 68 Leh SDH Disket 69 Pulwama FRU Pampore 70 FRU Tral 71 Shopian DH Shopian 72 Srinagar FRU Khanyar/ Gousia Annexure H 100 Line of Health Institutions having Newborn Care Corners for whom Operational Cost @ Rs 10,000/- per unit approved S No. District Name of Health Institution 1 Kishtwar PHC Chatroo 2 PHC Dachan 3 PHC Atholi 4 PHC Nali 5 PHC Keeru 6 PHC Afti 7 DH Kishtwar 8 Poonch PHC Chandak 9 PHC Fazalabad 10 PHC Dhargloon 11 PHC Lassana 12 PHC Loran 13 PHC Mankote 14 PHC Sawajian 15 PHC Bandichachian 16 PHC Harimarote 17 PHC Harni 18 PHC Batadhurian 19 CHC Surankote 20 CHC Mandi 21 CHC Mendhar 22 Reasi PHC Laiter 23 PHC Dharmari 24 PHC Arnas 25 PHC Pouni 26 CHC Reasi 27 CHC Katra 28 Udhampur PHC Sudhmahadev 29 PHC Bharnara 30 PHC Ghordi 31 PHC Bhugtrain 32 PHC Majalta 33 PHC Tikri 34 PHC Basantgarh 35 PHC Hartryan 36 PHC Pancheri 37 PHC Latti 101 S No. District Name of Health Institution 38 CHC Chenani 39 CHC Ramnagar 40 Ramban PHC Ukheral 41 PHC Ramsoo 42 PHC Kheeri 43 PHC Mangit 44 CHC Banihal 45 Kathua PHC Parole 46 PHC Budhi 47 PHC Dingaamb 48 PHC Hutt 49 PHC Ramkote 50 PHC Sandhar 51 PHC Koti Chadyar 52 PHC Macheedi 53 PHC Bhoond 54 PHC Lakhanpur 55 PHC Kough 56 PHC Marheen 57 PHC Sanonghat 58 PHC Lohai 59 PHC Dhani 60 CHC Billawar 61 CHC Hirangar 62 Doda PHC Assar 63 PHC Bhagwah 64 PHC Chinta 65 CHC Gandoh 66 Jammu PHC Sungal 67 PHC Mera Mandrian 68 PHC Kanachak 69 PHC Sai 70 PHC Chowki Choura 71 PHC Arnia 72 PHC Dhanger 73 PHC Rehal 74 PHC Pargwal 75 PHC Dansal 76 PHC Kotbhalwal 102 S No. District Name of Health Institution 77 PHC Pallanwala 78 PHC Ambgarota 79 Gol Gujral 80 CHC Akhnoor 81 CHC Bishnah 82 CHC RS Pura 83 CHC Sohanjana 84 CHC Jourian 85 CHC Marh 86 Rajouri PHC Manjakote 87 PHC Budhal 88 PHC Moughla 89 PHC Gambhir Mughlan 90 PHC Tralla 91 PHC Garan 92 PHC Upper Hathal 93 PHC Balshama 94 PHC Shadra Sharief 95 PHC Seeri 96 PHC Dalhori 97 PHC Peeri 98 PHC Lamberi 99 PHC Bagla Nadyal 100 PHC Kallar Chattyar 101 PHC Laroka 102 CHC Darhal 103 CHC Nowshera 104 CHC Sunderbani 105 CHC Thannamandi 106 Samba EH Vijaypur 107 PHC Ghagwal 108 PHC Purmandal 109 PHC Sanoora 110 PHC Mansar 111 PHC Gursalathia 112 PHC Nandpur 113 PHC Sumb 114 PHC Rattanpur 115 CHC Samba 103 S No. District Name of Health Institution 116 CHC Ramgarh 117 Anantnag PHC Sallar 118 PHC D.K.Pora 119 PHC Mattan 120 PHC Srigufwara 121 PHC Larnoo 122 PHC Achabal 123 PHC Verinag 124 PHC Sirhama 125 PHC Nowgam 126 PHC Ashmugam 127 PHC Wamdega 128 PHC Hakroo 129 PHC Brakpora 130 PHC Sirhama 131 PHC Akingam 132 PHC B. Kalan 133 PHC Sagam 134 PHC Khiram 135 PHC Haptnar 136 CHC Bijbehara 137 CHC Dooru 138 CHC Kokernag 139 MCH Anantnag 140 CHC Seer 141 Bandipora PHC Astangoo 142 PHC Badugam 143 PHC Naidkhah 144 CHC Hajin 145 CHC Dawar 146 CHC Sumbal 147 Baramulla PHC Mora 148 PHC Bijhama 149 PHC Shrakwara 150 PHC GK Kasim 151 PHC Hardbora 152 PHC Kahitangan 153 PHC Fategarh 154 PHC Tujar Shrief 104 S No. District Name of Health Institution 155 PHC Seriwarpora 156 PHC Dangiwacha 157 PHC Boniyar 158 PHC Sheeri 159 PHC Kalantra 160 CHC Uri 161 CHC Chandoosa 162 CHC Tangmarg 163 MCH Sopore 164 DH Baramulla 165 Budgam PHC Kralnewa 166 PHC Khag 167 PHC Soibugh 168 PHC Hardapanzoo 169 PHC OM Pora 170 PHC Poshker 171 PHC Surasyar 172 PHC Narbal 173 PHC Hafroo 174 PHC Wadwan 175 CHC Nagam 176 CHC Magam 177 CHC Beerwah 178 CHC Charie- Sharief 179 CHC Chattergam 180 CHC Pakherpora 181 CHC Khan Sahib 182 Ganderbal PHC Kullan 183 PHC Gund 184 PHC Lar 185 PHC Wussan 186 PHC Babanagri 187 PHC Kachen 188 PHC Wakura 189 PHC Sonamarg 190 CHC Kangan 191 Kargil PHC Panikhar 192 PHC Sargole 193 CHC Shankoo 105 S No. District Name of Health Institution 194 CHC Chiktan 195 CHC ZANSKAR 196 CHC DRASS 197 Kulgam PHC Qaimoh 198 PHC Katrasoo 199 PHC Bugam 200 PHC Manzgam 201 PHC Kilam 202 PHC Frisal 203 PHC Behibagh 204 PHC Tarigam 205 PHC M.Pora 206 PHC Qazigund 207 PHC Mahnpora 208 PHC Nehma 209 PHC Razloo 210 PHC Devsar 211 PHC Pahloo 212 Kupwara PHC Drugmulla 213 PHC Trathpora 214 PHC Maidanpora 215 PHC Awoora 216 PHC Keran 217 PHC Cherakote 218 PHC Harie 219 PHC Magam 220 PHC Machil 221 PHC Kalamchakla 222 PHC Ashpora 223 PHC Kalaroose 224 PHC Chogal 225 PHC Wadipora 226 PHC Villagam 227 PHC Trehgam 228 PHC Panzgam 229 CHC Sogam 230 CHC Kralgund 231 CHC Kralpora 232 CHC Tangdar 106 S No. District Name of Health Institution 233 SDH Kupwara 234 CHC Zachaldra 235 Leh PHC Nyoma 236 PHC Tangtse 237 PHC Turtuk 238 PHC Bogdang 239 PHC Digar 240 PHC Panamik 241 PHC Timisgum 242 PHC Chushul 243 CHC Khaltsi 244 CHC Skurbuchan 245 CHC Disket(Nobra) 246 Pulwama PHC Wuyan 247 PHC Khrew 248 PHC Parigam 249 PHC Kakapora 250 PHC Awantipora 251 PHC Dadsara 252 PHC Aripal 253 PHC Newa 254 PHC Tahab 255 PHC Ladhoo 256 PHC Rahmoo 257 PHC Singerwani 258 CHC Pampore 259 CHC Tral 260 Shopian PHC Sedow 261 PHC D. K. Pora 262 CHC Keller 263 CHC Zanipora 264 DH Shopian 265 Srinagar PHC Khanmoh 266 PHC Brane 267 PHC Zadibal 268 PHC Narwara 269 PHC SR Gunj 270 PHC Harwan 271 PHC Hazratbal 107 S No. District Name of Health Institution 272 PHC Lasjan 273 CHC Khanyar 108 Annexure J Line listing of Blood Storage Centres S.No Division Name Of FRU 1 Jammu FRU Bishnah 2 FRU R.S Pura 3 FRU Chennani 4 FRU Ramgarh 5 FRU Hiranagar 6 FRU Basohli 7 FRU Billawar 8 FRU Gandoh 9 FRU Thathri 10 FRU Kalakot 11 FRU Thannamandi 12 FRU Banihal 13 FRU Katra 14 Kashmir FRU Bijbehra 15 FRU Kokernag 16 FRU Magam 17 FRU Ch. Sharief 18 FRU Sogam 19 FRU Tangdhar 20 FRU Kralpora 21 FRU Pampore 22 FRU Khalsti 23 FRU Uri 24 FRU Sopore 25 FRU Kreeri 26 FRU Tangmarg 109 Annexure-K Jammu Division Revised list of CHCs/PHCs falling in Category A, B and C Areas of Jammu Division S.No District Name of Health Institution (CHC/PHC) Category 1 Doda CHC Gandoh B 2 PHC Tipri A 3 PHC Bharath A 4 PHC Malanoo B 5 PHC Changa B 6 PHC Bhagwa B 7 PHC Goha A 8 PHC Gundana A 9 PHC Chinta B 10 PHC Bhalla C 11 PHC Bhella C 12 PHC Prem Nagar C 13 PHC Assar C 14 PHC Ghat C 15 Jammu PHC Aghar Majoor A 16 PHC Dori Dager B 17 PHC Kathar B 18 PHC Gangal B 19 Kathua CHC Bani C 20 PHC Dhaggar A 21 PHC Koti Chandiar A 22 PHC Sandroon A 23 PHC Malhar A 24 PHC Lohai A 25 PHC Gudu Phalal B 26 PHC Machedi C 27 PHC Sananghat C 28 PHC Hut C 29 PHC Bhoond C 30 PHC Sandar C 31 PHC Ucha Pind C 110 32 PHC Kough C 33 Kishtwar CHC Marwah A 34 PHC Wardwan (Afti) A 35 PHC Dachhan A 36 PHC Nali A 37 PHC Keeru A 38 PHC Chingaon A 39 PHC Chattroo B 40 PHC Massu A 41 PHC Padder A 42 Ramban CHC Gool C 43 PHC Rajgarh B 44 PHC Battani B 45 PHC Trigam B 46 PHC Ukhral C 47 PHC Khari C 48 PHC Sangaldaam C 49 PHC Ramsoo C 50 PHC Mangit A 51 PHC Deeda B 52 PHC Alibass C 53 PHC Nowgam C 54 Poonch PHC Swajian C 55 PHC Loran C 56 PHC Bruti A 57 PHC Hari Marote B 58 PHC Chandimarh C 59 PHC Fazalabad B 60 PHC Lasana C 61 PHC Buflizad C 62 PHC Harni C 63 PHC Bandichichian C 64 Rajouri PHC Jamola A 65 PHC Peeri A 66 PHC Androoth A 67 PHC Gambir Mogla A 68 PHC Budhal A 69 PHC Shahdra Sharief A 70 PHC Dalouri A 71 PHC Upper Hathal A 72 PHC Bagla Nadiala A 111 73 PHC Gharan A 74 PHC Khawas A 75 PHC Lam Laroka A 76 PHC Trala B 77 PHC Moghala B 78 PHC Langar B 79 PHC Seeri B 80 PHC Kallar Chitar B 81 PHC Lah B 82 PhC Thana Mandi B 83 Reasi CHC Mahore C 84 PHC Lar A 85 PHC Bhagodas A 86 PHC Tote A 87 PHC Dharmari C 88 PHC Arnas C 89 PHC Panasa B 90 PHC Bana A 91 PHC Ghota C 92 Samba PHC Sumbh C 93 PHC Rattanpur C 94 Udhampur PHC Landhar C 95 PHC Rang B 96 PHC Basantgarh A 97 PHC Latti A 98 PHC Mongari B 99 PHC Panchari B 100 PHC Joffer A 101 PHC Sudhmadev C 102 PHC Ghordi C 103 PHC Gharian C Sd/- Director Health Services, Jammu 112 Annexure-K KASHMIR DIVISION District wise list of CHCs/PHCs falling in Category A, B and C Areas of Kashmir Division S.No District Name of Health Institution (CHC/PHC) Category Existing 1 Bandipora CHC Gureez A 2 PHC Chantimulla A 3 PHC Sheikhpora A 4 PHC Budgam A 5 Kulgam PHC K.B.Pora B 6 PHC Waltangoo B 7 Baramulla PHC Sultan Daki A 8 PHC Danisyedan A 9 PHC Warikha B 10 PHC Bijhama B 11 PHC Panzala B 12 Shopian PHC Sangarwani A 13 Ganderbal PHC Sonamarg B 14 Kupwara CHC Tangdar A 15 CHC Zachaldara B 16 CHC Kralpora B 17 PHC Monbal B 18 PHC Ashpora B 19 PHC Nowgam B 20 PHC Gabra A 21 PHC Teetwal A 22 PHC Chiterkote A 23 PHC Tikkipora B 24 PHC Kalaroose B 25 PHC Dudi Machil A 26 PHC Awoora B 27 PHC Behnipora B 28 PHC Villgam B 29 PHC Trathpora B 30 PHC Kukroosa B 113 S.No District Name of Health Institution (CHC/PHC) Category Existing 31 PHC Gonipora B 32 PHC Drugmulla B 33 PHC Nagri B 34 PHC Gushi B 35 PHC Kandi B 36 PHC Panzgam B 37 PHC Hari B 38 PHC Keran A 39 PHC Batpora B 40 PHC Magam B 41 Budgam PHC Churmunjroo B 42 PHC Kichwarai B 43 PHC Poshkar B 44 Kargil CHC Drass A 45 CHC Chiktan A 46 CHC Sankoo A 47 CHC Padoom A 48 PHC Shargoole A 49 PHC Panikhar A 50 Leh CHC Disket A 51 CHC Sukerbachan A 52 CHC Khalsti A 53 PHC Turtuook A 54 PHC Bogdang A 55 PHC Panimak A 56 PHC Diggar A 57 PHC Tamisgam A 58 PHC Saspool A 59 PHC Noyama A 60 PHC Basgo A 61 PHC Shakti A 62 PHC Cheushal A 63 PHC Thiksay A 64 PHC Tangtse A 114 S.No District Name of Health Institution (CHC/PHC) Category Existing 65 PHC Chahool A Sd/- Director Health Services Kashmir 115 Annexure “L” Priority Actions to be carried out by state for Financial Management 1. Quality FMRs must be submitted on time with both physical and financial progress fully reflected. 2. State is to ensure that state’s outstanding share is deposited. Further, with effect from 2012-13, State’s share would be 10%. 3. Release of 100% of funds for the year 2013-14 would be contingent on the state providing Utilisation certificates upto 2011-12. 4. The appointment of Concurrent Auditor for the year 2013-14 is a prerequisite for release of 2 nd tranche of funds. 5. Timely submission of Statutory Audit Report for the year 2012-13 is a must for release of 2 nd tranche of funds. 6. State is required to comply with the instructions and/or guidelines issued for maintenance of bank account vide D. O. No. G-27017/21/2010-NRHM-F dated January 23, 2012. 7. State should provide a confirmation of submission of Action Taken Report/ Compliance Report on the FMR Analysis (2012-13) and Audit Report Analysis for FY 2011-12. 8. State needs to prioritise the internal control procedures for all transactions. 9. State should ensure proper maintenance of books of accounts at all districts and blocks within the State. 10. Appointment of Auditor for the year 2012-13 is pending and must be completed in the first quarter of 2013-14. 11. The state must ensure due diligence in expenditure and observe, in letter and spirit, all rules, regulations, and procedures to maintain financial discipline and integrity particularly with regard to procurement; competitive bidding must be ensured and only need-based procurement should take place. 116 Annexure V Format of Financial Management Report to be submitted by the District/ Implementing Agency to the State Health Society_________ ("Name of the District") District Health/RCH Society// Implementing Agency: FINANCIAL REPORT FOR THE QUARTER/MONTH/____________________________of the Financial Year 2013-14 FMR Code seitititcA Physical Progress Financial Progress T a r g e t ( f o r t h e y e a r ) * * P r e v i o u s C u m u l a t i v e Achievements P e r m i s i b l e a s p e r B u d g e t S h e e t s ( 2 0 1 3 - 1 4 ) { c o l ( 1 > = 2 + 3 ) } B a l a n c e a s o n 0 1 - 0 4 - 2 0 1 3 Funds Received 2013-14 Expenditure T o t a l E x p e n d i t u r e ( C o l . 5 + 6 + 7 + 8 ) R e f u n d ( i f a n y ) C l o s i n g B a l a n c e { C o l . ( 2 + 3 + 4 ) - ( 9 + 1 0 ) } Reporting Qtr. * * P r e v i o u s C u m u l a t i v e E x p e n d i t u r e Reporting Qtr. M1 M2 M3 From SHS From other Sourc es M1 M2 M3 1 2 3 4 5 1 2 3 4 5 6 7 8 9 10 11 A. BaseFlexipool A. 1 Maternal Health A.1.3. Out Reach Camps A.1.4 Janani Suraksha Yojana / JSY Incentives to Mothers (Home Delivery) Rs.500/- per delivery Incentives to Mothers (Institutional Delivery) Rural (Rs. 1400/- per delivery) Incentives to Mothers (Institutional Delivery) Urban (Rs. 1000/- per delivery) 117 Adminstrative Expanses Performance Related incentive to ASHAs under JSY (Rs 600.00 per Case) Sub Total JSY - - - - - - - - - - - - - - - - A.1.5 Maternal Death Audit Maternal Death Autopsy by Dy.CMO / BMO @ 250/- for autopsy Incentive to community Based Volunteers for reporting maternal Death @ 200/- per report Sub Total Maternal Death Audit - - - - - - - - - - - - - - - - A.1.6 Other Activities Incentive to SBAs for conducting home deliveries in inaccessible/snow bound areas of high focus districts as a pilot project @300.00 per Deliveries Printing of MCP cards Printing of Safe motherhood booklet Other if any (Specify) Total Other Activities - - - - - - - - - - - - - - - - A1.7 Janani Shishu Suraksha Karyakram(JSSK) Drugs and Consumables for Normal Deliveries @ Rs 350.00 per case 118 Drugs and Consumables for Caesarean Deliveries @ Rs 1600.00 per case Diagnostic @ Rs 200.00 per case Blood Transfusion @ RS 300.00 per case Diet (3 days for Normal Delivery) @ Rs 100 per day for 3 days Diet (7 days for Caesarean)@ Rs 100 per day for 7 days Referral Transport For pregnant women Home to facility Drop Back faciliity Facility to Higher Facility Ironsucrose Intervention(3 doses Approved) Other if any (Specify) Sub Total JSSK - - - - - - - - - - - - - - - - G.Total Maternal Health (Including JSY) - - - - - - - - - - - - - - - - A.2 CHILD HEALTH Facility Based Newborn Care/FBNC (SNCU, NBSU, NBCC - any cost not budgeted under HR,Infrastructure, procurement, training,IEC etc.) e.g.operating cost rent,electricity etc. imprest money 119 A.2.1 Operatiional cost of SNCU A.2.2 Operational cost of NBSU @ Rs 84000.00 per unit A.2.3 Operational cost of NBCC @ RS 10,000.00 per Unit A.2.4 Home Based Newborn Care/HBNC - Printing of HBNC Guidelines @ RS 50/- Infant and Young Child Feeding/IYCF - Breat feeding Week @ Rs 3600.00 Management of Diarrhoea & ARI & Micronutrient Malnutrition Care of Sick Children and Severe Malnutrition (e.g. NRCs, CDNCs etc.) GMC- NRC Other strategies/activities (please specify)- Workshop on IYCF & Micro Nutrint A.2.8 Infant Death Audit ( @ Rs 250.00 per case and Incentive of ASHA / Informer @ Rs 100 .00 A.2.10 JSSK (for Sick neonates & infants upto 1 yr ) Drugs & Consumables for Infants @ RS 200.00 Diagnostics @ Rs 100.00 Free Referral Transport for Pick up and Drop Back Home @ Rs 500.00 120 Free Referral Transport for Referal to Higher Institution @ Rs 250.00 A.2.11 Any other interventions (eg; rapid assessments, protocol development) Incentive to ASHA/community based volunteer for reporting infant death IYCF- Settingup of IYCF Counselling Centres in 22 DHs and 2 Medical Colleges- subject to approval of councellors Printing of IYCF Guidelines Other if any (Specify) Sub Total (Child Health) - - - - - - - - - - - - - - - - A.3 FAMILY PLANNING Orientation workshop and dissemination of manuals on FP standards & quality assurance of sterilisation services @ Rs. 2000/meeting Compensation A.3.1.2 Compensation for female sterilization @ Rs. 1000/- per case A.3.1.3 Compensation for NSV Acceptance @ Rs. 1500/- per case 121 A.3.1.4 Organising Sterilization (Male) NSV camps @ Rs. 10000.00 per camp A.3.1.5 Organising Sterilization (Female) camps @ Rs. 7500.00 per camp. Provide IUD services at health facilities / compensation A.3.5 World Population fortnight celebration (such as mobility, IEC activities etc.): funds earmarked for district and block level activities @ Rs 1,15000.00 Other if any (Specify) Sub Total (FP) - - - - - - - - - - - - - - - - A.4 ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH (ARSH) Operating expenses for existing clinics @14074/-pa School health programme Other if any (Specify) Sub Total (ARSH) - - - - - - - - - - - - - - - - A.5 URBAN RCH i) Urban RCH Services 122 ii) Rent for urban health post iii) Hiring part time cleaner iv) Rent for urban health center. v) ANM Urban Health Centre ( 3 per UHC) and Urban Health Posts ( 2 per UHP) vi) Helper Urban Health Centre. vii) Link Worker Urban Health Centre Hon. viii) Medical Officers Urban Health Centre ( 1 per Urban Center) Other if any (Specify) Sub Total (Urban RCH) - - - - - - - - - - - - - - - - A.6 TRIBAL RCH Tribal RCH services Engagement of AMCHI Healers @10800/= PM for 5 months (26 AMCHI Healers) District Hospital 2, CHC -7, PHCs- 15 Other if any (Specify) Sub Total of Tribal Health - - - - - - - - - - - - - - - - A.7 PNDT & Sex Ratio Other if any (Specify) 123 Sub Total of PNDT & Sex Ratio - - - - - - - - - - - - - - - - A.8 Human Resources ANMs at Sub Centres Sub Centres Staff Nurses Laboratory Technicians MPWs Specialists (Anaesthetists, Paediatricians, Ob/Gyn, Surgeons, Physicians, Dental Surgeons, Radiologist, Sonologist, Pathologist, Specialist for CHC ) Medical Officers Additional Allowances/ Incentives to M.O.s Radiographers( X-RAY Tech) OT Technicians/assitsants Counsellors ARSH Counselors other Human Resources Development (other than above Data entry operator for ARSH- Approval still pending from GoI Sister Tutors PHNs Cook cum care Taker for 124 NRCs Other if any (Specify) Sub Total (HR) - - - - - - - - - - - - - - - - A.9 Trainings Maternal Health Trainings Training of Staff Nurses in SBA Training of ANM/LHVs in SBA Training of Medical Officers in life saving Anaesthesia skills Orientation of CMOs/BMOs/Mos for implentation guidelines under MDR/IDR SBA for MOs of ISM Deptt IMEP Trainings IMEP Trainings for State & District Programme Managers IMEP Trainings for MOs/SN/ Pharamcist/ANM Sub Total Maternal Health - - - - - - - - - - - - - - - - Child Health Trainings NSSK Trng for MOs/SN/ANM 125 Sub Total Child Health - - - - - - - - - - - - - - - - Family Planning Trainings Laparoscopic sterilisation training for doctors (teams of doctor, SN and OT assistant) Minilap training for medical officers NSV Training of medical officers in NSV camps Contraceptive update/ISD Sub Total Family Planning - - - - - - - - - - - - - - - - ARSH Orientation training of State and District Programme Managers State level/ district level/block level trainners under WIFS Sub Total ARSH - - - - - - - - - - - - - - - - Programme Management Trainings Capacity building of Supervisory Staff (CHO, health educator, LHV) for different programmes under NRHM Training of Accounts Manager regarding Implementation of Tally Sub Total Programme Management - - - - - - - - - - - - - - - - 126 Other Trainings Other if any (Specify) Grand Total ( Trainings) - - - - - - - - - - - - - - - - A.10 PROGRAMME MANAGEMENT District Programme Manager @ Rs. 20790/- Month District Accounts Manager @ Rs. 16632/- Month District Monitoring & Evaluation Officer @ Rs. 13860 O.E. / Mobility ets for District Health Socities Other if any (Specify) Sub Total(DPMU) - - - - - - - - - - - - - - - - BPMUs Block Accounts Managers (@ Rs 13860/month) Block M&E Officer (@ Rs 13860/month) O.E/ Mobility for BPMU (Rs 10358/ block/pa) Other if any (Specify) Sub Total(BPMU) - - - - - - - - - - - - - - - - 127 Concurrent Audit Fee Other if any (Specify) Grand Total (A. Base Flexipool) - - - - - - - - - - - - - - - - B. Mission Flexipool ASHA B1 Selection and Training of ASHA Training of ASHA-Module I- IV Training on HBNC for State Trainers round III Incentive to ASHA for full ANC Incentive to ASHA under HBNC(Approved 50% of the Approved activities) Monthly Meeting of ASHAs(Travel/Refreshment expanses) Incentive for registration of Births Incentive for registration of Deaths Incentive to ASHA for managing ASHA help desk @ Rs. 150 for 8 hours for 365 days (365X150X3)Approved 50% of the Approved 128 activities ASHA Diary ASHA help desk cum rest room in 20 level 3 MCH facilities Uniforms to ASHA (2 sets of uniform, I-card, 1 sweater, 1 shawl in high focus districts @ Rs.1000.00 Uniforms to ASHA ( 2 sets of uniforms, 1 sweater and I-card in other districts @ Rs. 750.00) Other if any (Specify) Sub total (ASHA) - - - - - - - - - - - - - - - - B2 Untied Funds CHCs 4 Hospitals (Rajiv Gandhi Jammu, MGM Kathua and MCH Anantnag, Sopre) PHCs NTPHC-ADs Sub Centers MACs 129 VHSC Sub total Untied funds - - - - - - - - - - - - - - - - B.3 Annual Maintenance Grants CHCs 4 Hospitals (Rajiv Gandhi Jammu, MGM Kathua and MCH Anantnag, Sopre) PHCs NTPHC-ADs Sub Centers MACs Sub Total Annual Maintenance Grants - - - - - - - - - - - - - - - - B.4 Hospital Strengthening B.5 New Constructions B.6 Corpus grant to HMS/RKS District Hospitals CHCs RKS for 4 Hospitals (Rajiv Gandhi Jammu, MGM Kathua and MCH Anantnag, Sopre) PHCs NTPHC-ADs Sub Total (Corpus grant) - - - - - - - - - - - - - - - - B.7 Health Action Plans B.8 Panchyati Raj Initative 130 B9 Mainstreaming of AYUSH AYUSH Doctors at difficult area AYUSH Doctors at 24 X 7 PHC AYUSH Doctors at Non- 24X 7 PHCs AYUSH Doctors at NTPHC AYUSH Dawasaaz at 24 X 7 PHC level AYUSH Dawasaaz at non 24 X 7 PHCs AYUSH Dawasaaz at NTPHC Sub Total (AYUSH) - - - - - - - - - - - - - - - - B10 IEC-BCC NRHM IEC/BCC (Specify the sub heads) Sub Total IEC-BCC NRHM - - - - - - - - - - - - - - - - B.11 Mobile Medical Units B12 Referral Transport/Patient transport System 131 State basic ambulance/102 Opex Sub Total (Referral Tpt) - - - - - - - - - - - - - - - - B.13 PPP/NGOs B14 Innovations B15 Planning, Implementation and Monitoring B15.3 Monitoring and Evaluation Data entry operator at different level Mobility Support for Monitoring Internet connectivity district level (One each for DPM, DMEO and DAM Internet connectivity block level (one each for BMEO and BAM) Internet connectivity SMGS/Lal Ded/ District Hospitals/sarwal hospital B15.3.3 Other M & E Mobile charges for ANM at sub-centres for tracking of pregant women and children/mointoring & Rs 100/- respctively per month) Reimbursement of Mobile user charges of ASHA @ Rs 100 per month 132 Capity bulidings of CMOs / BMOs / DPMUs / BPMUs at Division level for re- orienation of HMIS and MCTS 14 batches (25 paticipants per batch) Sub Total(Planning Implementation and Monitoring) - - - - - - - - - - - - - - - - B.16 PROCUREMENT B16.1 Procurement of Equipment Equipment for ARSH clinics B.16.2 Procurement of Drugs and supplies IFA KID Tablets (Paediatric Syrup Boitels) Procurement of ORS packets Procurement of Zink Tablets Procurement of Vitamin A Syrup B.16.2.6 Drugs & Supplies for WIFS IFAfor 6th to 12 class school goings boys/girls Albendazole- Dewarming for school goings boys & girls Drugs and Supplies for SHP Procurement of ASHA Drug Kit- - Replenishment 133 B.16.2.3 Drugs & supplies for FP NSV Kits IUD Insertion Kits Laproscopes Sub Total PROCUREMENT - - - - - - - - - - - - - - - - B.17 Regional Drugs Warehouses/ logistic sManagement B.18 New Initiatives/Strategic interventions B.19 Health Insurance Scheme B.20 Research, Studies,Analysis B.21 State Level Health Resource Centres (SHSRC) B.22 Support Sevices B23 Other Expenditures (power backup, convergence etc) Strengthening of 2 Regional institute of Health and Family Welfare Nagrota Jammu and Dhobiwan Srinagar (Including HR) Other if any (Specify) Sub Total Other - - - - 134 Expenditures - - - - - - - - - - - - Other if any ( which are not mentioned above) Grand Total ( B. Mission Flexipool) - - - - - - - - - - - - - - - - C. Immunization Mobility Support for supervision for District/Block level officers. @Rs. 42500 each for 22 Districts and @Rs. 39000 each for 117 Blocks Mobility support for supervision at State level (Rs 150 lacs/year) Printing and dissemination of Immunization cards, tally sheets, monitoring forms etc. Support for Quarterly State level review meetings of district officer Quarterly review meetings exclusive for RI at district level with one Block Mos, 135 CDPO, and other stake holders Quarterly review meetings exclusive for RI at block level Focus on slum & underserved areas in urban areas/alternative vaccinator Mobilization of children through ASHA or other mobilizers (Rs 150/- per session for 9 sessions) Alternative vaccine delivery in hard to reach areas (Rs 150/- per session) Alternative Vaccine Deliery in other areas (R75/- per session) To develop microplan at sub-centre level @ Rs. 100 per Sub Centre For consolidation of microplans at block level (Rs 1000/- per block/PHC and Rs 2000/- per district) POL for vaccine delivery from State to district and from district to PHC/CHCs @Rs. 43500 for 22 Districts and @Rs. 20000 for 117 Blocks 136 Consumables for computer including provision for internet access for RIMs (Rs 400/-month/distt) Red/Black plastic bags etc. (Rs 3/-bags/sessions) Safety Pits Rs. 5250 per pit Hub Cutter/Bleach/Hypochlorite solution/ Twin bucket (Rs 1200/ per PHC/CHC/ per year) Teeka Express (Operational Cost) Computer Assistants support for State level (Rs 12600/ per month) Computer Assistants support for District level (Rs 11340/- per month) Technical Officer Routine Immunization ( NEW POSTS)70000/mx2 posts Program cum Computer Assistant 15000/mx2 posts District level Orientation training including Hep B, Measles & JE(wherever required) for 2 days ANM, Multi Purpose Health Worker (Male), LHV, Health Assistant (Male/Female), Nurse Midwives, BEEs & other staff ( as per RCH norms) 137 Three day training including Hep B, Measles & JE(wherever required) of Medical Officers of RI using revised MO training module) One day refresher training of district Computer assistants on RIMS/HIMS and immunization formats Two days cold chain handlers training for block level cold chain handlers by State and district cold chain officers Cold chain maintenance ASHA incentive for full Immunization (proposed) Rs 100 per child for full immunization in first year/Rs 50 per child for ensuring complete immunization upto 2nd year of age Other if any (specify) Grand Total (C. Immunization) - - - - - - - - - - - - - - - - Grand Total (A+B+C) D. Others Pulse Polio Operational 138 cost Bank Interest Disease Control Programmes HDF Other if any (specify) Grand Total (D. Others) - - - - - - - - - - - - - - - - Grand Total (A+B+C+D) - - - - - - - - - - - - - - - - 139 Mission Director Dr.Yashpal Sharma, 94191-80709
[email protected] CAO Sh. Manohar Lal Raina 94191-41294
[email protected] Assistant Director (P&S) Dr. Jyoti Sharma 94192-43905
[email protected] State Programme Management Unit - delegation of the Duties / Responsibilities…Regd. S. No Programme Management Unit Name and Designation of the Officer Key Strategies / Functions of unit 5 Maternal Health
[email protected] Programme Manager: Dr. Harjeet Rai, Divisional Nodal Officer, Jammu (M). 9419134458
[email protected] 1. Delivery Points / MCH Centres. 2. JSY 3. ASHA Component 4. JSSK 5. MDR 6. Referral Transport 7. Safe Abortion Services. 8. Supervision of work of District Monitors of Jammu Division, timely submission of their reports and follow up actions on their reports/ recommendations. 9. Preparation of Record of Proceedings for review meetings. 10. IEC / BCC 11. M&E. Associate Programme Manager: Dr. Younis Mushtaq (M) 9018948862 Dr. P.S. Slathia, District Monitor 6 Child Health
[email protected] Programme Manager: Dr. Mushtaq Ahmed Dar, Divisional Nodal Officer, Kashmir (M) 94194-41180
[email protected] 1. Child Health. 2. Immunization 3. HBNC / FBNC 4. NRC 5. IDR 6. IYCF 7. SNCUs / Stab. Units / Baby Care 140 S. No Programme Management Unit Name and Designation of the Officer Key Strategies / Functions of unit Associate Programme Manager: Dr. Rohit Abrol (M). 9419155351 Dr. Rajinder Singh, District Monitor. Corners. 8. Supervision of work of District Monitors of Kashmir Division, timely submission of their reports and follow up actions on their reports/ recommendations. 9. Preparation of Record of Proceedings for Review meetings. 10. IEC / BCC 11. M&E. 7 Rashtriya Bal Swasthya Karyakram (RBSK)
[email protected] Associate Programme Manager: Dr. Younis Mushtaq (M) 9018948862 Dr. Mohd Shafi, District Monitor 1. Preparation of the Action Plans for rolling out the scheme and all the districts under the supervision of DNO (K). 2. Press & Public Relation Kashmir Division. 8 Urban Health Mission Programme Manager: Dr. Harjeet Rai, (M). 9419134458
[email protected] Dr. Jyoti Sharma Assistant Director (P&S) (M). 94192-43905
[email protected] Dr. Sonaullah, District Monitor 1. Preparation of PIP and the rolling out of the programme in the entire State. 2. Urban RCH. 9 Adolescent and School Health
[email protected] Programme Manager: Dr. B.B. Sharma, (M) 94191-85245 1. ARSH 2. School Health 3. Menstrual Hygiene 4. RTI / STI 5. Gender Equity. 6. IEC / BCC 7. M & E. 8. MNGO scheme Associate Programme Manager: Dr. Meenakshi Verma (M) 9697124144 Dr. Ashok Verma, District Monitor 10 Family Planning and PC&PNDT
[email protected] Programme Managers: Mr. Misba-ul-Hassan Dr. Varun Suthra 1. Family Planning 2. PC&PNDT 3. Gender Equity. 4. IEC / BCC 5. M & E Law Officers: Ms. Richa Sabharwal, Law Officer (Jammu) (M) 9796627006
[email protected]. 141 S. No Programme Management Unit Name and Designation of the Officer Key Strategies / Functions of unit Mr. Tassduq Law Officer (Kashmir) (M) 9419002894. Dr. Mohd Ashraf, District Monitor 11 Trainings
[email protected] Programme Manager: Dr. Dhruv Ji Raina (M) 9419144066 Assistant Programme Manager: Mr. Junaid Ahmed Zaroo (M) 94192-50634
[email protected] 1. Administrative matters pertaining to training. 2. Organizing and managing all types of trainings after getting inputs from concerned division. 3. Generation of Data base for State and District level trainings. 4. IEC/BCC 5. M & E. Assistants: Mr. Rakesh Sharma, DMEIO (M) 94191-02250 ASHA Co-ordinator for Module 6 & 7: Mr. Sadiq Khan Dr. Hamid, District Monitor 12 National Disease Control Programme
[email protected] Programme Manager: Dr. Asmat Jan (Facilitator) (M) 94190-24686. Assistant: Rahul Mahajan ( SAM) 1. Biomedical Waste 2. IDSP 3. Mental Health 4. NPPCF 5. RNTCP 6. NVBDCP 7. NLEP 8. NIDDCP 9. NCD 10. NPCB 11. Review of monthly District level meetings and monitoring and vigilance Committees of Jammu Division. 12. IEC/BCC 13. M & E. 13 Tribal RCH / Mainstreaming of AYUSH
[email protected] Programme Manager: Dr. Farooq Iqbal (M) 9596391445 1. Tribal RCH 2. Mainstreaming of AYUSH. 3. Urban RCH 4. IEC/BCC 5. M&E. 6. Adolescent and School Health Programme in respect of Kashmir Division 142 S. No Programme Management Unit Name and Designation of the Officer Key Strategies / Functions of unit 14 HMIS
[email protected] [email protected] Programme Managers Mr. Kapil Ghai, State M&E Officer (M) 9419183592 Assistants: DMEO, J/K Assistant M&E Officer. HMIS Fellows (J/K) 1. Health Management Information System (HMIS) 2. Preparation of Data base of all other Programmes in both the divisions and regular feedback to various Units. 3. Submission of monthly reports to State Health Society, Administrative Deptt. and MoH&FW, GoI. 4. Trainings at Block level. 5. IEC/BCC. 6. M&E. 15 MCTS
[email protected] Programme Manager: Mr. Misba-ul-Hassan Assistants: DMEO,Jammu/ Kashmir. Assistant M&E Officer. HMIS Fellows (J/K) 1. Mother & Child Tracking System (MCTS). 2. Preparation of Data base of all other Programmes in both the divisions and regular feedback to various Units. 3. Submission of monthly reports to State Health Society, Administrative Deptt. and MoH&FW, GoI. 4. Trainings at Block level. 5. IEC/BCC. 6. M&E. 16 IEC/BCC
[email protected] Programme Managers: Sh. A.U.Bhatt (IEC Consultant) (M) 94191-92632 1. IEC/BCC 2. M & E. 3. Press & Public Relation in Jammu Division. Dr. Varun Suthra (M) 94191-13324 Note: Dr. Manoj Bhagat will be allotted programme on his joining back in State Health Society. 143 APPROVAL OF STATE PROGRAMME IMPLEMENTATION PLAN 2013-14: JAMMU & KASHMIR MINISTRY OF HEALTH & FAMILY WELFARE, GOVERNMENT OF INDIA Preface FY 2012-13 has been a year of intense activity: States have responded very positively to conditionalities and incentives, programme management has been strengthened with the appointment of nodal persons for each thematic area and introduction of Score Cards, JSSK has made further inroads, RBSK has been initiated and the Child Survival Summit at Mahabalipuram provided an opportunity to take stock of our achievements and reflect on the challenges ahead. I suggest that 2013-14 is treated as the “YEAR OF CONSOLIDATION” with focus on increased effectiveness and efficiency. I would also like to draw your attention towards nursing which is the backbone of public health but has remained on the backburner for some time. FY 2013-14 should be “dedicated to strengthening of the nursing cadre”. I would urge you to fill up all the vacant positions of ANMs, Nurses, LHVs and PHNs and ensure that they become an integral part of planning, implementation and monitoring. Effective monitoring and supportive supervision has the potential to yield tangible gains in a relatively short period of time, but is still our weakest link. More meaningful use of the HMIS and MCTS is the way forward. We will be routinely using both HMIS and MCTS including Score Cards for all our reviews. I am confident that under the able leadership of State Health Secretaries and Mission Directors the country would make visible progress in making the goal of “Health for All” a reality. Anuradha Gupta Additional Secretary & Mission Director, NRHM No. 10(26)/2013-NRHM-1 Government of India Ministry of Health and Family Welfare (National Rural Health Mission) Nirman Bhavan, New Delhi Dated: 4 June 2013 The Mission Director National Rural Health Mission Government of Jammu & Kashmir Regional Institute of Health & Family Welfare, Near Sainik School, Nagrota Jammu 181 221 Sub: Approval of NRHM State Programme Implementation Plan for the year 2013-14 Sir, 1. This refers to the Programme Implementation Plan (PIP) for the year 2013-14 submitted by the State of Jammu & Kashmir and subsequent discussions in the NPCC meeting held on May 13, 2013 at New Delhi. 2. Against a resource envelope of Rs 236.01 crores, the administrative approval of the PIP for your State is conveyed for an amount of Rs 207.65 crores. Details are provided in Table A, B and C below. TABLE-A Rs. Crores Uncommitted unspent balance as on 01.04.2013 0.02 GOI Resource Envelope for 2013-14 under NRHM (assuming no reduction on account of conditionalities) 191.15 Assuming 10% incentive based on performance 21.24 10% State Share (2013-14) 23.60 Total 236.01 TABLE-B (Rs. Crores) Sr.No. Programme Uncommitted unspent balance as on 01.04.2013 GoI Resource Envelope under NRHM Total 1 RCH Flexible Pool 0 62.34 62.34 2 NRHM Flexible Pool 0 70.48 70.48 3 Immunization (from RCH Flexible Pool) 0 3.13 3.13 4 NIDDCP 0 0.24 0.24 5 IDSP 0 1.00 1.00 6 NVBDCP 0.01 1.10 1.11 7 NLEP 0.01 1.02 1.03 8 RNTCP 0 9.43 9.43 9 Infrastructure Maintenance including Direction & Administration 0 59.67 59.67 10 PPI Operation Cost 0 3.98 3.98 State Share 23.60 Total Resource Envelope 0.02 212.39 236.01 Committed Unspent Balance: Rs. 99.98 crore TABLE-C SUMMARY OF APPROVAL Sr. No Scheme /Programme Amount Approved (Rs. Crores) Annex ref 1 RCH Flexible Pool 88.12 1 2 Mission Flexible Pool 32.23 2 3 Immunization and PPI operation cost 10.47 3 4 NIDDCP 0.24 4A 5 IDSP 3.52 4B 6 NVBDCP 0.78 4C 7 NLEP 1.1 4D 8 RNTCP 11.52 4E 9 Infrastructure maintenance (Treasury route) 59.67 Total 207.65 3. State to convey the district approvals to the districts within 15 days of receiving the State RoP approvals. High priority districts must receive at least 30% more budgets per capita compared to the other districts. 4. All buildings supported under NRHM should prominently carry NRHM logo in English/ Hindi & regional languages. 5. All ambulances to be branded as ‘National Ambulance Services’ and adhere to the colour, design and logo as communicated by MOHFW. 6. All MMU to be branded as ‘National Mobile Medical Unit’ and adhere to the colour, design and logo scheme as communicated by MOHFW. 7. The State shall not make any change in the names of the National initiatives such as Janani Shishu Suraksha Karyakram, Rashtriya Bal Swasthya Karyakram etc. 8. The support under NRHM is intended to supplement and support and not to substitute State expenditure. All the support for HR will be to the extent of positions engaged over and above the regular positions. Release of funds 9. Action on the following issues would be looked at while considering the release of second tranche of funds: Compliance with conditionalities. Physical and financial progress made by the State as communicated through the FMR. Release of 10% of the State share, based on updated release of funds by Government of India, to the account of the State Health Society. Timely submission of Statutory Audit Report and Utilization Certificates for the year 2011-12 for the release of first installment, Timely submission of Statutory Audit Report for the year 2012-13 for the release of 2 nd installment. Performance on key conditionalities including mandatory disclosures and incentives will determine the final release. Compliance of the provisions of the extant MoU between GOI, MOHFW and the State Government. Other aspects 10. State shall ensure submission of quarterly report on physical progress against targets and expenditure including an analysis of adverse variances and corrective action proposed to be taken. 11. The State shall not make any change in allocation among different budget heads without approval of GoI. 12. The accounts of State/ grantee institution/ organization shall be open to inspection by the sanctioning authority and audit by the Comptroller& Auditor General of India under the provisions of CAG (DPC) Act 1971 and internal audit by Principal Accounts Officer of the Ministry of Health & Family Welfare. 13. State shall ensure submission of details of unspent balance indicating inter alia, funds released in advance & funds available under State Health Societies. The State shall also intimate the interest amount earned on unspent balance. This amount can be spent against approved activities. Yours faithfully (A.C.Verma) Director (NRHM) Administrative Approval Jammu & Kashmir 2013-14 Page - 1 - APPROVAL OF STATE PROGRAMME IMPLEMENTATION PLAN, 2013-14: JAMMU & KASHMIR CONTENTS PAGE NO. SUMMARY State specific goals 4 Key conditionalities and incentives 7 Finance: key issues and guiding principles 10 Road map for priority action 12 Approved budget (by program and function) 17 REPRODUCTIVE AND CHILD HEALTH Maternal Health 22 Child Health, RBSK (SHP) & Immunization 37 Family Planning 60 Adolescent Health 70 Urban RCH 76 Tribal RCH 79 PC-PNDT 81 Human Resources and Program Management 86 MISSION FLEXI POOL ASHA 109 Untied funds/RKS/AMG 114 New constructions/ renovation and setting up 116 Procurement 118 Referral Transport 122 AYUSH 124 IEC / BCC 126 Monitoring and evaluation (HMIS) 129 Others 137 NATIONAL DISEASE CONTROL PROGRAMMES National Iodine Deficiency Disorders Control Programme (NIDDCP) 144 Integrated Disease Surveillance Programme(IDSP) 147 National Vector Borne Disease Control Programme (NVBDCP) 152 National Leprosy Eradication Programme (NLEP) 161 Revised National Tuberculosis Control Programme (RNTCP) 169 Annexure Annex (Detailed budgets) 1. RCH Fl exi bl e Pool 1.A Programme Management 2. Mi ssi on Fl exi bl e pool 2.A Other ASHA I ncenti ves 3. Immunization and PPI Operation Cost 4A National Iodine Deficiency Disorders Control Programme (NIDDCP) 4B Integrated Disease Surveillance Programme (IDSP) Administrative Approval Jammu & Kashmir 2013-14 Page - 2 - 4C National Vector Borne Disease Control Programme (NVBDCP) 4D National Leprosy Eradication Programme (NLEP) 4E Revised National Tuberculosis Control Programme (RNTCP) Administrative Approval Jammu & Kashmir 2013-14 Page - 3 - SUMMARY Administrative Approval Jammu & Kashmir 2013-14 Page - 4 - STATE-SPECIFIC GOALS Jammu & Kashmir’s IMR at 41 (SRS 2011) has decreased from 49 (SRS 2008). TFR has also decreased from 2.2 (SRS 2008) to 1.9 (SRS 2011).The following are the agreed goals and service delivery targets for the State of Jammu & Kashmir: Indicator CURRENT CAD (%) Jammu & Kashmir State Targets India Jammu & Kashmir India Jammu & Kashmir 2013-14 2014-15 Target for 12 th Plan CAD (%) Maternal Health MMR (SRS 07-09) 212 - -5.8 - NA NA NA NA Child Health U5MR (SRS 2011) 55 45 -7.3 -6.5 36 32 -- -10.2 IMR (SRS 2011) 44 41 -6.0 -5.8 33 30 24 -10.2 NMR (SRS 2011) 31 32 -4.0 -6.4 26 23 -- -10.2 Family Planning TFR (SRS 2011) 2.4 1.9 -2.6 -4.8 Maintain TFR level Note CAD: Compounded Annual Decline; MMR from 04-06 to 07-09; U5MR; IMR; NMR and TFR from 2008 to 2011; targets from latest current status to 2015. Administrative Approval Jammu & Kashmir 2013-14 Page - 5 - SERVICE DELIVERY TARGETS Indicators DLHS-2 (2002- 04) DLHS-3 (2007- 08) CES (2009) State Targets 2013-14 Maternal Health ANCs registered within first trimester - - - 133,187 (49.59%) Deliveries taking place in public facilities* 152760 (8 %) Caesarean Section rate in public health facilities 22914 (15 %) Line listing and follow up of Severely Anaemic pregnant women 3127 Child Health Full Immunisation (%) 31.7% 62.5% 66.6% 85% New borns visited by ASHA (as per HBNC guidelines) NA NA NA 122133 (70%)Live Birth Line listing and follow up of Low Birth Weight babies NA NA NA 13068 (70%) Percentage of SNCUs admitting at least 6 babies per month per bed NA NA NA 80% Family Planning Female sterilisations 0.20 (HMIS 2011-12) 25250 Post-Partum sterilizations 0.019 (HMIS 2011-12) 2930 Male sterilisations 0.013 (HMIS 2011-12) 2835 IUD insertions 0.21 (HMIS 2011-12) 30000 Disease Control ABER for malaria (%) >10% API for malaria (per 1000 Population) <0.2 Administrative Approval Jammu & Kashmir 2013-14 Page - 6 - Annualized New Smear Positive Detection Rate of TB (%) 70% Success Rate of New Smear Positive Treatment initiated on DOTS (%) 90% * DLHS and CES data reflect achievement in both public and private facilities. Performance to be assessed on the basis of MCTS and NIKSHAY, where available and on the basis of facility wise HMIS in other cases. High Priority Districts Performance against the above service delivery indicators in the 6 high priority districts (Rajouri, Doda, Ramban, Kishtwar, Punch and Leh) out of a total of 22 districts should be at least, on par with the State average; and subsequently in line with the performance of the top 10% of districts. Administrative Approval Jammu & Kashmir 2013-14 Page - 7 - KEY CONDITIONALITIES AND INCENTIVES Jammu & Kashmir has made significant progress in responding to conditionalities. Following conditionalities shall be adhered to by the States and are to be treated as non-negotiables: Mandatory disclosures 1. The State must ensure mandatory disclosure on the State NRHM website of the following and act on the information: Facility wise deployment of all HR including contractual staff engaged under NRHM with name and designation. Facility wise service delivery data particularly on OPD, IPD, Institutional Delivery, C-section, Major and Minor surgeries etc. MMUs- total number of MMUs, registration numbers, operating agency, monthly schedule and service delivery data on a monthly basis. Patient Transport ambulances and emergency response ambulances- total number of vehicles, types of vehicle, registration number of vehicles, service delivery data including clients served and kilometres logged on a monthly basis. All procurements- including details of equipments procured (as per directions of CIC which have been communicated to the States by this Ministry vide letter No 'No.Z.28015/162/2011-H' dated 28th November 2011.). Buildings under construction/renovation –total number, name of the facility/hospital along with costs, executing agency and execution charges (if any), date of start & expected date of completion. Supportive supervision plan and reports shall be part of mandatory disclosures. Block-wise supervisory plan and reports should be uploaded on the website. NGOs/PPP funded under NRHM would be treated as 'public authority' and will fall under the ambit of the RTI Act 2005 under Section 2(h). Further, details of funds allotted /released to NGOs/PPP to be uploaded on website. 2. State/UT to ensure that JSY payments are made through Direct Benefit Transfer (DBT) mechanism through AADHAAR enabled payment system/Core Banking Solution where DBT mechanism has been rolled out. Further, cash payment or bearer cheque payment is henceforth disallowed across the States. 3. Timely updation of MCTS and HMIS data including facility wise reporting 4. Line listing of high risk pregnant women, including extremely anaemic and Low Birth Weight (LBW) babies. Administrative Approval Jammu & Kashmir 2013-14 Page - 8 - KEY CONDITIONALITIES 5. As agreed, the following key conditionalities would be enforced during the year 2013-14. a) Rational and equitable deployment of HR 1 with the highest priority accorded to high priority districts and delivery points. b) Facility wise performance audit 2 and corrective action based thereon. c) Performance Measurement system set up and implemented to monitor performance of regular and contractual staff. d) Baseline assessment of competencies of all SNs, ANMs, Lab Technicians to be done and corrective action taken thereon. - Approval is being granted for HR of all cadres under NRHM for six months only and its continuation for the next six months would be contingent on compliance of the above four conditionalities. Further, it is expected that the State will henceforth fill up their vacant regular HR positions and will not use NRHM funds to substitute State spending. Therefore, from 1 st October 2013, under NRHM, funds for salary to contractual HR would be granted only to make payments to contractual staff over and above the sanctioned regular positions in the State. e) Gaps in implementation of JSSK may lead to a reduction in outlay upto 10% of RCH base flexipool. INCENTIVES 6. Initiatives in the following areas would draw additional allocations by way of incentivisation of performance: a) Responsiveness, transparency and accountability (upto 8% of the outlay). b) Quality assurance (upto 3% of the outlay). c) Inter-sectoral convergence (upto 3% of the outlay). d) Recording of vital events including strengthening of civil registration of births and deaths (upto 2% of the outlay). e) Creation of a public health cadre (by States which do not have it already) (upto 5% of the outlay) f) Policy and systems to provide free generic medicines to all in public health facilities (upto 5% of the outlay) 1 Many states have put in a place an HR policy which lays down norms of transfer and posting. It is expected that the States would now implement the policy. Rational and equitable deployment would include posting of staff on the basis of case load, posting of specialists in teams (eg. Gynaecologist and Anaesthetist together), posting of EmOC/ LSAS trained doctors in FRUs, optimal utilization of specialists in FRUs and above and filling up vacancies in peripheral facilities in high focus/ remote areas. 2 Facility wise performance audit will also include the facility wise score card being developed. Administrative Approval Jammu & Kashmir 2013-14 Page - 9 - g) Timely roll out of RBSK (upto 5% of the outlay) h) Enacting/adopting a bill like the Clinical Establishment Act, 2010 as per their requirement, to regulate the quality and cost of health care in different public and private health facilities in the State (upto 5% of outlay). i) States providing more than 10% increase in its annual health budget as compared to the previous year will attract additional incentive. j) States to implement the nurse practitioner model to strengthen the nursing services. Note: The Framework for Implementation of NRHM to be strictly adhered to while implementing the approved PIP. State should adhere to the clauses mentioned in the MOU signed and achieve the agreed performance benchmarks. Administrative Approval Jammu & Kashmir 2013-14 Page - 10 - FINANCE: KEY ISSUES AND GUIDING PRINCIPLES 1. Quarterly FMR must be submitted on time with both physical and financial progress duly reflected. 2. State must also furnish a monthly statement of fund position and expenditure in format prescribed in the operational guidelines, as Annexure XXIII and XXIV. 3. Status of Contribution of State share: (Rs. in Crore) Year Amounts required on basis of releases Amount Credited Short/ (Excess) 2007-08 27.64 0.00 27.64 2008-09 12.85 12.46 0.39 2009-10 22.02 0.00 22.02 2010-11 29.82 61.16 -31.34 2011-12 42.89 22.50 20.39 2012-13 22.09 59.15 -37.06 Total 157.31 155.27 2.04 State is to ensure that outstanding state share needs to be deposited in to the Account of State Health Society. It is to be noted that from 2012-13, funding from the Centre and from the States will be in the ratio of 90:10. 1. Release of full funds as per the entitlements for the year 2013-14, would be contingent on the State providing Utilisation Certificate against the grant released to the state up to 2011-12 for all the programmes under NRHM. 2. The appointment of Concurrent Auditor for the year 2013-14 is a prerequisite for release of 2nd tranche of funds. 3. Timely submission of Statutory Audit Report for the year 2012-13 is a must for release of 2nd tranche of funds. 4. State is required to comply with the instructions and/or guidelines issued for maintenance of bank account vide D. O. No. G-27017/21/2010-NRHM-F dated January 23, 2012. 5. State should ensure submission of Action Taken Report/ Compliance Report on the FMR Analysis (2013-14) and Audit Report Analysis for FY 2012-13. 6. State needs to strengthen the internal control procedures/mechanism for all transactions. 7. State should ensure proper maintenance of books of accounts at district and block level as per the operational guidelines for NRHM issued by the Ministry. 8. Appointment of Auditor for the year 2012-13 must be completed in the first quarter of 2013-14 as per the RFP issued by this Ministry. Administrative Approval Jammu & Kashmir 2013-14 Page - 11 - 9. The state must ensure due diligence in expenditure and observe, in letter and spirit, all rules, regulations, and procedures to maintain financial discipline and integrity particularly with regard to procurement; competitive bidding must be ensured and only need-based procurement should take place. 10. State should ensure expenditure of at least 15% by June 2013 and 45% by September 2013 of their approved resource envelope under each pool in the FY 2013-14. 11. Unit Costs in relation to various procurements of equipments and printing etc. are only indicative for the purpose of estimations. However, actual expenditure must be incurred after following rules and due processes”. Administrative Approval Jammu & Kashmir 2013-14 Page - 12 - ROAD MAP FOR PRIORITY ACTION NRHM must take a ‘systems approach’ to Health. It is imperative that States take a holistic view and work towards putting in place policies and systems in several strategic areas so that there are optimal returns on investments made under NRHM. For effective outcomes, a sector wide implementation plan would be essential; states would be expected to prepare such a plan with effect from next year. Some of the key strategic areas in this regard are outlined below for urgent and accelerated action on the part of the State: S. NO. STRATEGIC AREAS ISSUES THAT NEED TO BE ADDRESSED PUBLIC HEALTH PLANNING & FINANCING 1. Planning and financing Mapping of facilities, differential planning for districts / blocks with poor health indicators; resources not to be spread too thin / targeted investments; at least 10% annual increase in State health budget (plan) over and above State share to NRHM resource envelope; addressing verticality in health programmes; planning for full spectrum of health services; emphasis on quality assurance in delivery points 2. Management strengthening Full time Mission Director for NRHM and a full-time Director/ Jt. Director/ Dy. Director Finance, not holding any additional responsibility outside the health department; fully staffed programme management support units at State, district and block levels; selection of staff to key positions such as head of health at the district and block level and facility-in charge to be based on performance; stability of tenure to be assured; training of key health functionaries in planning and use of data. Strong integration with Health & FW and AYUSH Directorates 3. Developing a strong Public Health focus Separate public health cadre, induction training for all key cadres; public health training for doctors Working in health administrative positions; strengthening of public health nursing cadre, enactment of Public Health Act HUMAN RESOURCES Administrative Approval Jammu & Kashmir 2013-14 Page - 13 - S. NO. STRATEGIC AREAS ISSUES THAT NEED TO BE ADDRESSED 4. HR policies for doctors, nurses paramedical staff and programme management staff Minimizing regular vacancies; expeditious recruitment (eg. taking recruitment of MOs out of Public Service Commission purview); merit –based and transparent selection; recruitment rules to be aligned to needs of health human resource; opportunities for career progression and professional development; rational and equitable deployment; effective skills utilization; stability of tenure; sustainability of contractual human resources under RCH / NRHM and plan for their inclusion in State budget; suitable performance measurement mechanism and performance based incentives. 5. HR Accountability Facility based monitoring; incentives for both the health service provider and the facility based on functioning; performance appraisal against benchmarks; renewal of contracts/ promotions based on performance; incentives for performance above benchmark; incentives for difficult areas. 6. Medical, Nursing and Paramedical Education (new institutions and upgradation of existing ones) Planning for enhanced supply of doctors, nurses, ANMs, and paramedical staff; mandatory rural posting after MBBS and PG education; more seats for Government doctors in PG courses particularly in Gynecology, Anesthesia and pediatrics; expansion of tertiary health care; use of medical colleges as resource centres for national health programmes; strengthening/ revamping of ANM / GNM training centres and paramedical institutions; re-structuring of pre service education; developing a highly skilled and specialized nursing cadre; developing good district hospitals as training sites for training nurses, ANMs and paramedics. 7. Training and capacity building Strengthening of State Institute of Health & Family Welfare (SIHFW)/ District Training Centres (DTCs); quality assurance; availability of centralised training log; monitoring of post training outcomes; expanding training capacity through partnerships with NGOs / institutions; up scaling of multi skilling initiatives, accreditation of training STRENGTHENING SERVICES Administrative Approval Jammu & Kashmir 2013-14 Page - 14 - S. NO. STRATEGIC AREAS ISSUES THAT NEED TO BE ADDRESSED 8. Policies on drugs, procurement system and logistics management Articulation of policy on entitlements on free drugs for out / in patients; rational prescriptions and use of dr ugs ; t i mel y pr ocur ement of dr ugs and consumables; smooth distribution to facilities from the district hospital to the sub centre; uninterrupted availability to patients; minimization of out of pocket expenses; quality assurance; prescription audits; facility wise EDL; essenti al drug l i sts (EDL) i n publ i c domai n; computerized drugs and logistics MIS system; setting up dedicated corporation on the lines of eg: TNMSC 9. Equipments Availability of essential functional equipments in all facilities; regular needs assessment; timely indenting and procurement; identification of unused/ faulty equipment; regular maintenance and MIS/ competitive and transparent bidding processes. 10. Ambulance Services and Referral Transport Universal availability of GPS fitted ambulances; reliable, assured free transport for pregnant women and newborn/ infants; clear policy articulation on entitlements both for mother and sick infants; establishing integrated call centres for timely response and effective provision of services; drop back facility; a prudent mix of basic level ambulances and emergency response vehicles. 11. New infrastructure and maintenance of buildings; sanitation, water, electricity, laundry, kitchen, facilities for attendants New infrastructure, especially in backward areas; 24x7 maintenance and round the clock plumbing, electrical, carpentry services; power backup; cleanliness and sanitation; upkeep of toilets; proper disposal of bio medical waste; drinking water; water in toilets; electricity; clean linen; kitchens, facilities for attendants, PPP outsourcing for such services. 12. Diagnostics Rational prescription of diagnostic tests; reliable and affordable availability to patients; partnerships with private service providers; prescription audits, free for pregnant women and sick neonates. COMMUNITY INVOLVEMENT 13. Patient’s feedback and grievance redressal Feedback from patients; expeditious grievance redressal; analysis of feedback for corrective action. Administrative Approval Jammu & Kashmir 2013-14 Page - 15 - S. NO. STRATEGIC AREAS ISSUES THAT NEED TO BE ADDRESSED 14. Community participation Active community participation; empowered PRIs; strong VHSNCs; social audit; effective Village Health & Nutrition Days (VHNDs); strengthening of ASHAs; policies to encourage contributions from public/ community. 15. IEC Comprehensive communication strategy with a strong behaviour change communication (BCC) component in the IEC strategy; dissemination in villages/ urban slums/ peri urban areas. CONVERGENCE, COORDINATION & REGULATION 16. Inter sectoral convergence Effective coordination with key departments to address health determinants viz. water, sanitation, hygiene, nutrition, infant and young child feeding, gender, educati on, woman empowerment, convergence with SABLA, SSA, ICDS etc. 17. NGO/ Civil Society Mechanisms for consultation with civil society; civil society to be part of active communitisation process; involvement of NGOs in filling service delivery gaps; active community monitoring. 18. Private Public Partnership (PPP) Partnership with private service providers to supplement governmental efforts in underserved and vulnerable areas for deliveries, family planning services and diagnostics 19. Regulation of services in the private sector Implementation of Clinical Establishment Act; quality of services, e.g. safe abortion services; adherence to protocols; checking unqualified service providers; quality of vaccines and vaccinators, enforcement of PC-PNDT Act. MONITORING & SUPERVISION 20. Strengthening data capturing, validity / triangulation 100% registration of births and deaths under Civil Registration System (CRS); capturing of births in private institutions; data collection on key performance indicators; rationalizing HMIS indicators; reliability of health data / data triangulation mechanisms. Administrative Approval Jammu & Kashmir 2013-14 Page - 16 - S. NO. STRATEGIC AREAS ISSUES THAT NEED TO BE ADDRESSED 21. Supportive Supervision Effective supervision of field activities/ performance; handholding; strengthening of Lady Health Visitors (LHVs), District Public Health Nurses (DPHNs), Multi Purpose Health Supervisors (MPHS) etc. 22. Monitoring and Review Regular meetings of State/ District Health Mission/ Society for periodic review and future road map; clear agenda and follow up action; Regular, focused reviews at different levels viz. Union Minister/ Chief Minister/ Health Minister/ Health Secretary/ Mission Director/ District Health Society headed by Collector/ Officers at Block/ PHC level; use of the HMIS/ MCTS data for reviews; concurrent evaluation 23. Quality assurance Quality assurance at all levels of service delivery; quality certification/ accreditation of facilities and services; institutionalized quality management systems. 24. Surveillance Epidemiological surveillance; maternal and infant death review at facility level and verbal autopsy at community level to identify causes of death for corrective action; tracking of services to pregnant women and children under MCTS. 25. Leveraging technology Use of GIS maps and databases for planning and monitoring; GPS for tracking ambulances and mobile health units; mobile phones/tablets for real time data entry; video conferencing for regular reviews; closed user group mobile phone facility for health staff; telemedicine and teleeducation; use of ICT technologies in E- Governance; development of Human Resource Information System (HRIS) and Hospital Management Information System endless opportunities-sky is the limit! RMNCHA+ document released in Mahabalipuram Conference should serve as guidance note for integration and betterment of all RMNCH activities. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 17 - PROGRAMME WISE APPROVED BUDGET Mission Flexi Pool 16% RCH Flexi Pool 42% RI and PPI 5% NDCPs 8% Infrastructure Maintenance 29% Approved Budget (by Programme), 2013-14 Total Rs 20765.41 Infrastructure 1% Human Resources (All HR Except HR for MMU/ Ambulances and Quality Assurance) 25% Drugs and Consumables 8% Equipments & Diagnostics 2% Capacity Building 1% Patient Transport Services (including HR) 2% MMU (including HR) 0% Communitization 8% Other RCH Services 19% Supportive Supervision/ Mobility Support 1% Administrative Costs & Office Expenses 0% Health Action Plans 0% IEC/ BCC 1% State Specific Initiatives/ Innovations 0% E- Governance 0% Out Reach Services 0% Quality Assurance (including HR) 0% Support Services 0% Other Important Areas 0% Infrastructure Maintenance 31% Functional Head wise Summary Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 18 - Maternal Health 21% Child Health 4% Family Planning 0% Tribal RCH 0% PNDT & Sex Ratio 0% Infrastructure & HR 41% Training 1% Programme Management 5% JSY 26% Sterilisation & IUD Compensation, and NSV Camps 2% Approved Budget RCH Flexipool, 2013-14: Rs 8812 lacs ASHA 15% Untied Funds 7% Annual Maintenance Grants 4% New Constructions/ Renovation and Setting up 0% Corpus Grants to HMS/RKS 9% Mainstreaming of AYUSH 23% IEC-BCC NRHM 3% Mobile Medical Units 0% Referral Transport 1% PPP/ NGOs 0% Innovations (if any) 0% Planning, Implementation and Monitoring 9% Procurement 22% Regional drugs warehouses 6% New Initiatives 0% Other Expenditures (Power Backup, Convergence etc) 1% Approved Budget Mission Flexi Pool, 2013-14: Rs 3223.44 lacs Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 19 - SUMMARY BUDGET 2013-14: JAMMU & KASHMIR S. No. Budget Head FY 2013-14 Budget ( Rs lakhs ) Proposed Approved % 1. RCH FLEXI POOL A1 Maternal Health 2848 1800 8.67 A2 Child Health 1293 358 1.72 A3 Family Planning 52 37 0.18 A4 ARSH 1293 9 0.04 A5 Urban RCH 255 34 0.16 A6 Tribal RCH 37 16 0.08 A7 PNDT & Sex Ratio 217 1 0.00 A8 Infrastructure & HR 11281 3576 17.22 A9 Training 954 95 0.46 A10 Programme Management 1494 476 2.29 A11 Vulnerable groups 0 0 0.00 Total Base Flexi Pool 19724 6402 30.83 A12 JSY 2371 2240 10.79 A13 Sterilisation & IUD Compensation, and NSV Camps 276 169 0.81 Total Demand Side 2647 2409 11.60 Total RCH Flexi Pool 22372 8812 42.44 2. MISSION FLEXI POOL B1 ASHA 1108.14 483.255 2.33 B2 Untied Funds 1111.85 234.06 1.13 B3 Annual Maintenance Grants 410.5 132.26 0.64 B4 Hospital Strengthening 7,140.00 0 0.00 B5 New Constructions/ Renovation and Setting up 137 0 0.00 B6 Corpus Grants to HMS/RKS 845 277.4573 1.34 B7 District Action Plans 0 0 0.00 B8 Panchayati Raj Initiative 306.86 0 0.00 B9 Mainstreaming of AYUSH 3,480.48 752.96 3.63 B10 IEC-BCC NRHM 394.82 90 0.43 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 20 - S. No. Budget Head FY 2013-14 Budget ( Rs lakhs ) Proposed Approved % B11 Mobile Medical Units 261.25 0 0.00 B12 Referral Transport 1,382.39 16.87 0.08 B13 PPP/ NGOs 0 0 0.00 B14 Innovations (if any) 1,679.04 1 0.00 B15 Planning, Implementation and Monitoring 991.48 279.19 1.34 B16 Procurement 4,055.66 696.3 3.35 B17 Regional drugs warehouses 400 200 0.96 B18 New Initiatives 14.17 14.17 0.07 B19 Health Insurance Scheme 0 0 0.00 B20 Research, Studies, Analysis 28 0 0.00 B21 State level Health Resources Center 0 0 0.00 B22 Support Services 107 0 0.00 B23 Other Expenditures (Power Backup, Convergence etc) 991.92 45.92 0.22 TOTAL MFP 24845.56 3223.4423 15.52 3. IMMUNIZATION C1 RI strengthening project 384.08 363.7 1.75 C2 Salary of Contractual Staffs 116.29 30.15 0.15 C3 Training under Immunisation 95.97 95.97 0.46 C4 Cold chain maintenance 8.68 8.68 0.04 C5 ASHA Incentive 150 150 0.72 Total Immunization 755.02 648.5 3.12 C6 Pulse Polio Operational Cost 394.57 398.07 1.92 Total RI & PPO costs 1149.59 1046.57 5.04 4. NATIONAL DISEASE CONTROL PROGRAMMES 4A National Iodine Deficiency Disorders Control Programme (NIDDCP) 64.5 24 0.12 4B Integrated Disease Surveillance Programme(IDSP) 575.86 352.7 1.70 4C National Vector Borne Disease Control Programme (NVBDCP) 97.2 78.15 0.38 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 21 - S. No. Budget Head FY 2013-14 Budget ( Rs lakhs ) Proposed Approved % 4D National Leprosy Eradication Programme (NLEP) 117.48 109.82 0.53 4E Revised National Tuberculosis Control Programme (RNTCP) 2474.76 1151.73 5.55 Total NDCP 3329.8 1716.4 8.27 5. INFRASTRUCTURE MAINTENANCE Total Infrastructure Maintenance 5967 5967 28.74 GRAND TOTAL 57663.95 20765.4123 100.00 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 22 - MATERNAL HEALTH Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 23 - GOALS AND SERVICE DELIVERY TARGETS: MATERNAL HEALTH Maternal Health: Goals and Targets for 2013-14 Indicator Target MMR and expected Maternal Deaths MMR NA Expected MDs: 31 per month Nos. of Maternal Deaths Reported and Reviewed 9 per month (29.5%) ANCs registered within first trimester 133,187 (49.59%) in 2013-14 Institutional Deliveries (out of the total estimated deliveries) to be conducted in Public health institutions from 67 % in 2012-13 to 67 %. in 2013-14 159337 in 2013-14 Caesarean Section rate in public health facilities from 25% in 2012-13 to 15% in 2013-14 22914 in 2013-14 Severely Anemic Pregnant Women** out of total anemic pregnant women (@2%) 2690 in 2013-14 **At the rate of 2% of pregnant anemic women; this is critical for timely identification and management of severely anemic pregnant woman. DELIVERY POINTS: Level of Facility Target CEmOC(L3) Maintain Levels (65) for next 3 years. BEmOC(L2) 45 per year for next 4 years. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 24 - ROAD MAP FOR PRIORITY ACTION: MATERNAL HEALTH Road Map for essential commitments Commitment No. 1- Operationalizing Delivery Points Gaps in the identified delivery points to be assessed and filled through prioritized allocation of the necessary resources in order to ensure quality of services and provision of comprehensive RMNCH+A services at these facilities as per the levels. MNH toolkit is to be used for planning and operationalizing services at different levels of delivery points. Level 3 should be planned for comprehensive CEmOC and RMNCH+A services and similarly level 2 for BEmOC and RMNCH+A services. The targets for different categories of facilities are: Level 3 delivery points functioning as CEmOC facilities a) District Hospitals and other similar district level facilities (e.g District women and children hospital) b) CHCs and other health facilities at sub district level (above block and below district level) functioning as FRUs To provide the following services: 24*7 service delivery for CS and other Emergency Obstetric Care. 1 st and 2 nd trimester abortion services. Conduct Facility based MDR. Essential newborn care and facility based care for sick newborns. Family planning and adolescent friendly health services RTI/STI services. Have functional BSU/BB. Level 2 delivery points functioning as BEmOC facilities: Non FRU-CHCs, 24*7 PHC and other PHCs To provide the following services 24*7 BeMOC services including conducting normal delivery and handling common obstetric complications. 1st trimester safe abortion services. (MVA upto 8 weeks and MMA upto 7 weeks) RTI/STI services. Essential newborn care. Family planning All identified SC Level delivery point facilities will provide the following services: Delivery by SBAs. IUD insertion Essential new born care. ANC, PNC and Immunization. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 25 - Nutritional and Family planning and Adolescent counselling. VHND and other outreach services on designated days. All identified delivery points should be comprehensively planned for saturating them in terms of HR, Equipment, Capacity building, infrastructural requirements etc. before spreading the resources to other health facilities. Monthly performance monitoring of each delivery point needs to be undertaken and reviewed at District level and quarterly level at State level. Commitment No. 2- Implementing free entitlements under JSSK JSSK entitlements to be ensured to all PW and sick newborns accessing Public health facilities. At least 70% drop back to be ensured to PW delivering in the PHFs. Drop back should be given only after 48 hrs stay in the health facility. Commitment No. 3- Centralized Call Centre and Assured Referral Transport All NRHM Supported Ambulances should be designated as “National Ambulance Service” with GOI prescribed color coding and other details. Every State needs to ensure availability of a centralized call centre with 102 or 108 as Toll Free no. for referral transport at State or district level along with GPS fitted ambulances. Response time for the ambulance to reach the beneficiary not to exceed 30 minutes and should reach the referred facility within next 30 mins. Monthly data on utilization of each ambulance (eg. Trips per day) to be maintained, analyzed and take corrective action if anything to be taken Commitment No. 4- Essential Drug List Every State to have an Essential Drug List (EDL) for SC, PHCs, CHCs, DHs, and Medical colleges and ensure timely procurement and supply to Sub centres, PHCs, CHCs, DHs and MCs. The EDL should include drugs for maternal and child health including drugs for safe abortion services, RTI/STI. Differential distribution of types and quantities of drugs to performing and non performing facilities and also as per level of facility. Procurement should be done through competitive bidding and indent to be taken from each facility based on consumption pattern through computerized inventory management system. All Procurement process including periodic testing of drugs through govt. certified labs be carried out by the process of randomized sampling. All the drugs should have atleast 5/6 th of the shelf life at the time of receiving the durgs at indenting facility. All other govt. procedure for procurement needs to be followed. Commitment No. 5- Capacity Building Shortfall in trained human resource at delivery points particularly sub centres in High focus/ High Priority districts to be addressed on priority. Training load for skill based trainings to be estimated after gap analysis. Certification /accreditation of the training sites is mandatory. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 26 - Training plan to factor in reorientation training of HR particularly for those posted at non functional facilities and being redeployed at delivery points. Orientation training of field functionaries on newer interventions e.g. MDR/ HBNC etc. Performance Monitoring during training/post-deployment needs to be ensured Specific steps to strengthen SIHFW/ any other nodal institution involved in planning, implementation, monitoring and post training follow up of all skill based trainings under NRHM. Commitment No. 6– Tracking severe anemia All severely anemic pregnant women (2% of the anemic pregnant women) to be tracked and line listed for providing treatment of anemia. The line listing should be maintained and followed up at SCs and PHCs. Commitment No. 7– For High Priority Districts The State to make use of the MNH toolkit to operationalize the identified facilities as delivery points. At least 10% of all sub centres under each PHC to be made functional as delivery points in the HPDs. At least one CEmOC CENTRES to be made functional. Planning for operationalizing 10-15 BEmOC Centres in phases. Commitment No. 8— Job clarity of both ANMs working at the Sub-centre to ensure availability of one ANM at the SC and the other for outreach activities for the geographically demarcated population. Commitment No. 9: Pre service Nursing Training (For 12 High Focus States) At least one State Master Nodal centre shall be created and made functional. State nursing cell under the directorate of health should be created and made functional. A road map for strengthening of ANM and GNM schools be prepared as per GoI guidelines. Commitment No. 10: State, district and regional quality assurance committees to be made functional. Commitment No. 11: Establishment of Skill Labs: At least one skill lab to be established and made functional for a group of 4-5 districts as per skill lab operational guidelines. Commitment No. 12: MCH wings All 100 bedded MCH wings should be planned comprehensively as per GoI road map and must include equipments, obstetric ICU, SNCU, OT, labor room, Skill lab, academic wing and other details as per MNH toolkit. The plan for MCH wing should be shared with the MH nodal officer and he should be involved in its monitoring. All the MCH wing must be located within the campus of the existing health facility and completed in 2-3 years. Non-negotiables under Janani Suraksha Yojana: Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 27 - State needs to ensure strict compliance of the following non-negotiable under JSY: 1. State will ensure that JSY guidelines are strictly followed and payments are made as per the eligibility criteria. 2. State will ensure that AADHAAR numbers/EID and bank account details of the JSY beneficiaries are captured in the integrated RCH registers and seeded in the MCTS database. 3. State will ensure that there would be no delays in JSY payments to the beneficiaries and full amount of financial assistance is given to the beneficiary before being discharged from the health facility after delivery. 4. State/UT to ensure that JSY payments are made through Direct Benefit Transfer (DBT) mechanism through AADHAAR enabled payment system/Core Banking Solution where DBT mechanism has been rolled out. In case, Direct Benefit Transfer mechanism is not implemented in the State/UT, JSY payments to be made only through account payee cheques. Compliance of the above is a pre-requisite for JSY releases to the State/UT. 5. State will ensure that strict monitoring and verification of beneficiaries is done by State and district level health authorities to check malpractices. 6. State will ensure that grievance redressal mechanisms as stipulated under JSY guidelines are activated at the district and State levels. 7. State will ensure the accuracy of JSY data reported at the HMIS portal of MOHFW and also furnish the Quarterly progress reports to the Ministry within the prescribed timeframe. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 28 - DETAILED BUDGET: MATERNAL HEALTH FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.1 MATERNAL HEALTH 1502 952 30600 5,219.21 4,040.05 A.1.1 Operationalise Facilities (Any cost other than infrastructure, HR, Training, Procurement, Monitoring etc.) may include cost of mapping, planning- identifying priority facilities,etc) 0 0 - - A.1.1. 1 Operationalise FRUs (Blood bank/BSU - Operational cost) - A.1.1. 2 Operationalise 24x7 PHCs - A.1.1. 3 Operationalise Safe abortion services (including MVA/ EVA and medical abortion)at health facilities - A.1.1. 4 Operationalise RTI/STI services at health facilities - A.1.1. 5 Operationalise sub-centres - A.1.2 Referral Transport - A.1.3 Integrated outreach RCH services (state should focus on facility based services and 232 25000 58 1.37 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 29 - FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) outreach camps to be restricted only to areas without functional health facilities) A. 1.3.1. Oureach camps No. of Outrea ch Camps 232 25000 58 1.37 Approved as per last year expenditure. A.1.3. 2. Monthly Village Health and Nutrition Days A.1.4. Janani Suraksha Yojana / JSY 2325 00 3500 2,371.20 2,240.38 Approved as per last year expenditure. A.1.4. 1 Home deliveries No. 3000 500 15 10.84 Approved for 2168 beneficiaries. A.1.4. 2 Institutional deliveries 1295 00 2400 1,756.20 1,707.31 A.1.4. 2.a Rural No. 1153 00 1400 1,614.20 1,601.19 Approved for 1,14371 beneficiaries. A.1.4. 2.b Urban No. 1420 0 1000 142 106.12 Approved for 1,0612 beneficiaries. A.1.4. 2.c C-sections - A.1.4. 3 Administrative Expenses - A.1.4. 4 Incentives to ASHA 1000 00 600 600 522.23 Approved as per last year expenditure. A.1.5 Maternal Death Review (both in institutions and community) No. of Matern al Deaths review ed 150 450 0.68 0.68 Approved for MDR as per the guidelines. A.1.6 Other strategies/activ ities (please specify) 5003 00 1060 153 60.11 A.1.6. 1 Incentive to SBAs for conducting home deliveries in 300 1000 3 3 Rs 3 lakhs approved as incentives for ANMs /LHVs/SNs for conducting home deliveries in Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 30 - FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) inaccessible/sn ow bound areas of high focus districts as a pilot project inaccessible areas / snow bound areas of high focus areas as a pilot project, subject to simultaneous plans for converting Home deliveries into Institutional deliveries. A.1.6. 2 Printing of MCP cards 2500 00 15 37.5 20 Rs. 20.00 lakhs approved for 133333 cards, subject to printing by competitive bidding. A.1.6. 3 Printing of Safe motherhood booklet 2500 00 45 112.5 37.11 Rs 37.11 lakhs approved for 100300 bookets @ Rs 37 per Safe Motherhood Booklet. A.1.7 JSSK- Janani Shishu Surakhsha Karyakram 7697 70 590 2,636.34 1,737.51 In view of limited resource envelop, currently approved as per last year's expenditure. A.1.7. 1 Drugs and consumables No.of Institut ional Deliveri es 1625 36 873.64 943.17 Approved for 138,155 NDs @ Rs. 350 =Rs 483,54,250 and for 24,381 C sections @ Rs 1600 = Rs 390,09,600. So total approval =Rs 873.64 lakhs. Approved as per last year's expenditure. A.1.7. 2 Diagnostic No.of Institut ional Deliveri es 1625 36 200 325.07 300.41 Rs 325.07 lakhs approved @ Rs 200 for 162,536 p.w. for ensuring free diagnostics for all p.w. accessing Govt. health facilities during ANC, INC & PNC. In view of low expenditure, approved as per last year's expenditure. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 31 - FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.1.7. 3 Blood Transfusion 15% of Institut ional Deliveri es 2438 1 300 73.14 30.19 Rs 73.14 lakhs approved for provision of free blood to all p.w. requiring blood transfusion. In view of low expenditure, approved as per last year's expenditure. A.1.7. 4 Diet (3 days for Normal Delivery and 7 days for Caesarean) No.of Institut ional Deliveri es 2740 36 666.4 226.32 Approved for provision of free diet for pregnant women @ Rs 100 per day for 3 days for 138,155 p.w. = 414,46,500 and @ Rs 1000 for 7 days for 24,381 p.w. = 170,66,700. Total amount being Rs 585, 13,200. Provision of free diet for mothers of sick infants is not under JSSK Programme. However all post natal mothers admitted for management of complications are covered under JSSK. In view of low expenditure, approved as per last year's expenditure. A.1.7. 5 Free Referral Transport No.of Institut ional Deliveri es 1381 55 690.77 230.11 Rs 690.775 lakhs approved for providing free transport for 113,775 p.w. @ Rs 500 =568.875 lakhs and for 24,380 p.w. for referral x 500 = 121.900 lakhs and total approval = 690.775 lakhs as inter facility transfer will entail more distance; subject to ensuring no duplication with Mission Flexible pool Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 32 - FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) and all ambulances linked to a centralised call centre, being GPS fitted and under the banner of NAS. All operational cost for ambulances should be borne out of the RT component sanctioned here and under Child Health. In view of low expenditure, approved as per last year's expenditure. A.1.7. 6 Other JSSK activity 8126 90 7.31 7.31 A.1.7. 6.1 Ironsucrose Intervention (3 doses Approved) No. of Patient s 8126 90 7.31 7.31 Rs 7.31 lakhs approved for IV sucrose subject to IV sucrose being prescribed under the supervision of a Gynecologist at FRU and above. A.1.7. 6.2 Mobility support for State level officers for monitoring JSSK (|Lumpsum) / District Nodal Officers for monitoring JSSK / Block level officers A.1.7. 6.3 - Sub-total Maternal Health (excluding JSY) 1270 452 27100 2,848.01 1,799.67 Sub-total JSY 2325 00 3500 2,371.20 2,240.38 Sub-total 5,219.21 4,040.05 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 33 - FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) Maternal Health A.9.3 Maternal Health Training 135 32985 00 167.17 49.87 Approved lumsum amount as per last year's expenditure. A.9.3. 1 Skilled Attendance at Birth / SBA 92 33905 0 97.16 - A.9.3. 1.1 Setting up of SBA Training Centres - A.9.3. 1.2 TOT for SBA No. of Batche s (30 per batch) 4 13005 0 5.2 A.9.3. 1.4 Training of Staff Nurses in SBA No. of batche s (4 Per Batch) 44 10450 0 45.98 A.9.3. 1.5 Training of ANMs / LHVs in SBA No. of batche s (4 Per Batch) 44 10450 0 45.98 A.9.3. 2 EmOC Training 1 14680 00 14.68 - A.9.3. 2.1 Setting up of EmOC Training Centres - A.9.3. 2.2 TOT for EmOC - A.9.3. 2.3 Training of Medical Officers in EmOC No. of Batche s (8 Person per batch) 1 14680 00 14.68 A.9.3. 3 Life saving Anaesthesia skills training 1 78800 0 7.88 - A.9.3. 3.1 Setting up of Life saving Anaesthesia skills Training Centres - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 34 - FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.9.3. 3.2 TOT for Anaesthesia skills training - A.9.3. 3.3 Training of Medical Officers in life saving Anaesthesia skills No. of batche s (4 Mos per batch) 1 78800 0 7.88 A.9.3. 4 Safe abortion services training (including MVA/ EVA and Medical abortion) 2 98300 1.97 - A.9.3. 4.1 TOT on safe abortion services - A.9.3. 4.2 Training of Medical Officers in safe abortion No. of Batche s (4 Mos per batch) 2 98300 1.97 A.9.3. 5 RTI / STI Training 2 20395 0 4.08 - A.9.3. 5.1 TOT for RTI/STI training - A.9.3. 5.2 Training of laboratory technicians in RTI/STI - A.9.3. 5.3 Training of Medical Officers in RTI/STI No. of Batche s (25 Peson Per batch) 2 20395 0 4.08 A.9.3. 6 BEmOC training for MOs/LMOs No. of Batche s (4 person per batch) 11 74150 8.16 A.9.3. Other maternal 26 32705 33.25 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 35 - FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) 7 health training (please specify) 0 A.9.3. 7.1 Orientation of CMOs / BMOs / Mos for implementatio n of guidelines under MDR and IDR No. of Batche s (100 person per batch) 2 12500 0 2.5 A.9.3. 7.2 Training on Blood Transfusion (Mos / Lab Technicians) - A.9.3. 7.3 SBA for MO (ISM) No. of Batche s (4 Person Per batch) 22 13355 0 29.38 A.9.3. 7.4 TOT for Bemoc No of Batche s (3 per batch) 2 68500 1.37 A.9.3. 8 Blood Storage Unit (BSU) Training - A.9.3. 9 Skill Lab Training - ASHA for MH B1.1.3 .1 Incentive under MH (ANC/PNC) 1000 00 250 250 50 B1.1.3 .1.1 Incentive to ASHA for full ANC No. of Institut ional Deliveri es 1000 00 250 250 50 Approved Rs 50 lakhs @ Rs 50 for 1 lakh pregnant women as Incentive to ASHA for Registration within 12 weeks. Other incentives are a part of the JSY. Procurement of equipment: MH B16.1. 1 Procurement of equipment: MH 0 0 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 36 - FMR. No. Budget Head Unit of Measu re Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) B16.1. 1.1 Equipments for Blood Banks/ BSUs - B16.1. 1.2 MVA /EVA for Safe Abortion services - B16.1. 1.3 Others (please specify) 0 0 - B.16.2 .1 Drugs & supplies for MH 0 0 - B.16.2 .1.3 Others (Please specify) 0 0 - Total Procurement 0 0 Grand Total MH 5,636.38 4,139.92 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 37 - CHILD HEALTH, RBSK & IMMUNIZATION Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 38 - TARGETS: CHILD HEALTH AND IMMUNIZATION Indicator CURRENT CAD (%) State Targets India Jammu & Kashmir India Jammu & Kashmir 2013-14 2014- 15 Target for 12 th Plan (2017) CAD (%) Child Health U5MR (SRS 2011) 55 45 -7.3 -6.5 36 32 -- -10.2 IMR (SRS 2011) 44 41 -6.0 -5.8 33 30 24 -10.2 NMR (SRS 2011) 31 32 -4.0 -6.4 26 23 -- -10.2 Indicators Current Status State Targets 2012-13 2013-14 2014-15 Child Health Line listing and follow up of Low Birth Weight babies {Nos; (%)} HMIS incidence of LBW: 10.7% of Rural Live Birth i.e18669 NA 13068 (70%) 18669 (100%) New borns visited by ASHA (as per HBNC guidelines){Nos; (%)} Rural Live Births: 174475 0 122133 (70%) 174475 (100%) Percentage of SNCUs admitting at least 6 babies per month per bed NA NA 80% 95% TARGETS: CHILD HEALTH AND MMUNIZATION Trend (SRS) Targets (SRS) 2008 2009 2010 2011 2012 2013 2014 2015 2016 NMR 39 37 35 32 29 26 23 21 19 IMR 49 45 43 41 37 33 30 27 24 U5MR 55 50 48 45 40 36 32 29 26 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 39 - PROCESS INDICATORS Current Status Target for 2013-14 KEY PERFORMANCE INDICATORS (CUMULATIVE) 1 Establishment & operationalization of SNCUs (Target 12-13: 15) 10 17 2 Establishment & operationalization of NBSU (Target 12-13: 83 ) 72 72 3 NBCC at delivery points (Target 12-13:273) 273 273 4 Establishment of NRCs (Target 12-13:2 ) 0 2 5 Personnel trained in IMNCI (ANM+LHV) No. 510 528 6 Personnel trained in F-IMNCI (MO+SN) No. 103 64 7 Personnel trained in NSSK (MO+ANM+SN) No. 560 1470 KEY PERFORMANCE INDICATORS (NON CUMULATIVE) 1 New borns visited by ASHA (as per HBNC guidelines) No. 0 122133 % 0 70% Rural Live Birth 2 LBW children tracked(sState HMIS) No. NA 13068 % NA 70% LBW in Rural 3 Percentage of SNCUs admitting at least 6 babies per month per bed % NA 80% Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 40 - ROAD MAP FOR PRIORITY ACTION: CHILD HEALTH Priority Actions to be carried out by State for Child Health Interventions Priority Actions to be carried out by state for Child Health Interventions 1. All the delivery points should have a functional Newborn Care Corner consisting of essential equipment and staff trained in NSSK. The staff must be trained in a 2 days NSSK training package for skills development in providing Essential Newborn Care. 2. Special Newborn care Units (SNCU) for care of the sick newborn should be established in all Medical Colleges and District Hospitals. All resources meant for establishment of SNCUs should be aligned in terms of equipment, manpower, drugs etc. to make SNCUs fully operational. 3. SNCUs are referral centres with provision of care to sick new born the entire district and relevant information must be given to all peripheral health facilities including ANM and ASHA for optimum utilisation of the facility. Referral and admission of out born sick neonates should be encouraged and monitored along with inborn admissions. 4. NBSUs being set up at FRUs should be utilised for stabilization of sick newborns referred from peripheral units. Dedicated staff posted to NBSU must be adequately trained and should have the skills to provide care to sick newborns. 5. All ASHA workers are to be trained in Module 6 & 7 (IMNCI Plus) for implementing Home Based Newborn Care Scheme. The ASHA kit and incentives for home visits should be made available on a regular basis to ASHAs who have completed the Round 1 of training in Module 6 6. All ANMs are to be trained in IMNCI. 7. All Medical Officers and Staff Nurses, positioned in FRUs/DH and 24x7 PHCs should be prioritised for F- IMNCI training so that they can provide care to sick children with diarrhoea, pneumonia and malnutrition. 8. Infant and Under fives Death Review must be initiated for deaths occurring both at community and facility level. 9. In order to promote early and exclusive breastfeeding, the counselling of all pregnant and expectant mothers should be ensured at all delivery points and breastfeeding initiated soon after birth. At least two health care providers should be trained in ‘Lactation Management’ at District Hospitals and FRUs; other MCH staff should be provided 2 days training in IYCF and growth monitoring. 10. Nutrition Rehabilitation Centres are to be established in District Hospitals (and/or FRUs), prioritising tribal and high focus districts with high prevalence of child malnutrition. The optimum utilisation of NRCs must be ensured through identification and referral of Severe Acute Malnutrition cases in the community through convergence with Anganwadi workers under ICDS scheme. 11. Line listing of newly detected cases of SAM and Low birth weight babies must be maintained by the ANM and their follow-up must be ensured through ASHA. 12. In order to reduce the prevalence of anaemia among children, all children between the ages of 6 months to 5 years must receive Iron and Folic Acid tablets/ syrup (as appropriate) as a preventive measure for 100 days in a year. Accordingly appropriate formulation and logistics must be ensured and proper implementation and monitoring should be emphasised through tracking of stocks using HMIS. As per National Iron Plus Initiative, IFA syrup is to be administered in biweekly fashion under supervision from ASHA. 13. Use of Zinc should be actively promoted along with use of ORS in cases of diarrhoea in children. Availability of ORS and Zinc should be ensured at all sub-centres and with ASHAs. 14. Data from SNCU, NBSU and NRC utilisation and child health trainings (progress against committed training load) must be transmitted on a monthly basis to the Child Health Division. 15. Infant Young Child Feeding Practices Guidelines launched by GoI to be implemented in current financial year. Growth monitoring equipments to made available at each Health Facility i.e Sub Centre, PHC, Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 41 - District Hospital. At District Hospitals and high case load facilities, RMNCHA counsellor to undertake IYCF counselling after growth monitoring by Staff Nurse/ANM. IYCF trainings for ASHA/ANM/Staff Nurses to be undertaken. B.Rashtriya Bal Swastha Karyakram (School Health Programme): 1. Rashtriya Bal Swastha Karyakram (RBSK) Guidelines including terms of reference to be adhered for operational plan, implementation and monitoring. School Health programme is now subsumed under RBSK. 2. The programme should focus on four Ds- Defects at birth, Diseases, Deficiencies and Development Delays including Disabilities as detailed in RBSK guideline. 3. All children (below 6 years) registered with Anganwadis to be screened at least twice a year 4. All children (6 years to 18 years) enrolled in government and government aided schools to be screened at least once a year. 5. All designated delivery points (as agreed in annexure of PIP 2013-14) to start New born screening and report findings in monthly monitoring formats 6. Recruitment and training of dedicated teams to complete within the first Quarter of the financial Year. 7. Referral of children must be tied up and complete treatment at higher facilities through District Early Intervention Centres. 8. Planning, implementation, monitoring formats - Health Cards, reporting formats under RBSK is standardized. State to ensure adherence. 9. All approved DEICs to be established with in the current Financial Year. No spill over for infrastructural cost would be allowed in the next year for the same facility. 10. State to establish State/District/Block level RBSK committees and/or submerge within existing NRHM society structure at State/District and block with diverse stakeholders, Department of Woman and Child Development, Department of Education – Sarba Siksha Abiyan, Rashtriya Madhmik Sishkha Abhiyan, Department of Social Justice and empowerment. This committee with representation of academia at State level is responsible for implementation and monitoring of the programme. 11. Involvement of nodal teachers from schools and Anganwadi workers from Anganwadi Centres and State District and Block level supervisory structure in the programme is to be ensured for preventive and promotive Health communication and monitoring. 12. Visibility of Rashtriya Bal Swastha Karyakram (RBSK) with NRHM logo to be made noticeable across programme implementation. In case State has different nomenclature other than Rashtriya Bal Swastha Karyakram (RBSK) for similar programme, for which financial support is approved under PIP 2013-14, RBSK and NRHM to be used as cobranded with local initiative. 13. The New programme would require State/District programme management unit handholding in Physical and Financial achievement. State to support this initiative. 14. Formation of State and district level steering committees. 15. Training / re-orientation of service providers(MOs, ANMs, ASHAs) Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 42 - 16. Monthly meeting with BMO. 17. Regular feedback on quality of sanitary napkins to be sent to GoI 18. Identification of appropriate storage place for sanitary napkins. 19. Mechanism of distribution of sanitary napkins right upto the user level. 20. Reporting and accounting system in place at various levels. 21. Utilizing MCTS for service delivery by checking with ASHAs and ANMs about supply chain management of IFA tabs and Sanitary napkins. 22. Distribution of Sanitary Napkins to school going adolescent girls to be encouraged in schools and preferably combined with Weekly Iron Folic Acid Supplementation (WIFS). C. Priority Actions to be carried out by state for Immunization 1. Immunization weeks should be continued as a part of routine strategy during non – immunization days to improve coverage especially in community where no immunization services are provided or services are deficient or all high risk pockets or migrant population as identified in pulse polio program etc. The available human resources to be redeployed during these weeks for effective implementation 2. The micro plans for routine immunization must be updated on 6 monthly intervals both for Routine Immunization and Immunization weeks, taking into account the information available and information on migrant population/ missed areas covering inaccessible, remote areas and urban slums. The missed areas or migrant population as identified during polio programme or any other source of information must be incorporated in the micro plans and activities carried out as per micro-plan. 3. Full time State Immunisation Officer should be in place. 4. District Immunisation Officer should be in place in all the districts. The placement of ANMs at all session sites must be ensured. 5. Due list of beneficiaries must be available with ANM and ASHA and village wise list of beneficiaries should be available with ASHA after each session and tickler bags should be used for monitoring in addition to the timely and regular updating of information in MCTS portal. 6. The immunisation session must be carried out on a daily basis in District Hospitals and FRUs/ 24x7 PHCs with considerable case load in the OPD. 7. Cold chain mechanics must be placed in every district with a definite travel plan so as to ensure that at least 3 facilities are visited every month as a preventive measure (check-up of equipment). 8. The paramedical staff should be identified as the Cold Chain Handler in all cold chain points and their training must be ensured. In case of non-availability, the responsibility should be given to next para medical staff in position that should be equally trained. 9. The coverage of immunization to children at 18 months of age is very low. The opportunity for Full immunization of the children at 1year and ensuring that these children are also vaccinated at 2nd year of age must be emphasized and monitored. The ASHAs/link workers are especially encouraged by providing financial incentive of Rs 100 and Rs 50 per child to achieve this. 10. District AEFI Committees must be in place and investigation report of every serious AEFI case must be submitted within 15 days of occurrence. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 43 - 11. Rapid response team should be in place in priority districts identified by the states. 12. There should be a regular evening meeting on Immunization days to review the implementation of open vial policy and also reviewing implementation of programmatic gaps. 13. Quarterly review at all levels should be conducted on the issues as identified during evening meetings, for which funds are provided under ROP. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 44 - DETAILED BUDGET: CH, RBSK & IMMUNIZATION FMR No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) A.2. CHILD HEALTH 227540 139300 0 1,293.4 5 358.4 A.2. 1 IMNCI (including F- IMNCI; primarily budget for planning for pre- serviceIMNCI activities in medical colleges, nursing colleges, and ANMTCs) - A.2. 2 Facility Based Newborn Care/FBNC (SNCU, NBSU, NBCC - any cost not budgeted under HR,Infrastructure, procurement, training,IEC etc.) e.g.operating cost rent,electricity etc. imprest money 360 195000 305.6 215.3 A.2. 2.1 SNCU No. of SNCUs 15 125 125 Approved A.2. 2.2 NBSU No. of NBSUs 72 175000 126 63 Approved @ Rs. 87500/- per NBSU. A.2. 2.3 NBCC No. of NBCCs 273 20000 54.6 27.3 Approved @ Rs. 10000/- per NBCC, with the conditionality that the state will first saturate the functional delivery points with NSSK Trained personnel and radiant warmer and utilize the resources optimally A.2. 3 Home Based Newborn Care/HBNC No. of booklet s 2000 50 1 0.53 In view of limited resource envelop, currently approved as per last year's Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 45 - FMR No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) expenditure. A.2. 4 Infant and Young Child Feeding/IYCF No. of Events 150 5000 7.5 5.39 In view of limited resource envelop, currently approved as per last year's expenditure. A.2. 5 Care of Sick Children and Severe Malnutrition (e.g. NRCs, CDNCs etc.) No. of NRCs 2 780000 15.6 0.96 In view of limited resource envelop, currently approved as per last year's expenditure. A.2. 6 Management of diarrhoea & ARI & micronutrient malnutrition No. of batche s 2 200000 4 4 Approved A.2. 7 Other strategies/activities (please specify) No. of batche s 2 200000 4 4 Approved A.2. 8 Infant Death Audit 1500 4.25 0.53 In view of limited resource envelop, currently approved as per last year's expenditure. A.2. 9 Incentive to ASHA under child health - A.2. 10 JSSK (for Sick neonates up to 30 days) 223000 300 947.75 123.94 In view of limited resource envelop, currently approved as per last year's expenditure. A.2. 10.1 Drugs & Consumables (other than reflected in Procurement) No. of Sick Childre n 111500 200 223 9.52 Approved Rs 223.00 lakhs for provision providing free drugs and treatment of sick neonates and infants. This is in addition to funds being proposed & approved for SNCU and NBSU and other drugs and consumables as per their EDL. Currently approved as per last years Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 46 - FMR No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) expenditure. A.2. 10.2 Diagnostics No. of Sick Childre n 111500 100 111.5 32.59 Rs 111.50 lakhs approved. Currently approved as per last year’s expenditure. A.2. 10.3 Free Referral Transport No. of Sick Childre n 111500 @ 500 for pickup from home and drop back and @ Rs 250 for 22300 cases for referrels inbetwe en instituti ons 613.25 81.83 613.25 lakhs approved subject to no duplication under Mission Flexipool. Operational cost for ambulances should be borne out of the RT component sanctioned here and under Maternal Health. In view of limited resource envelop, Currently approved as per last year’s expenditure. A.2. 11 Any other interventions (eg; rapid assessments, protocol development) 524 12650 3.75 3.75 A.2. 11.1 IYCF- Settingup of IYCF Counselling Centres in 22 DHs , 53 CHCs, 6 PHCs and 2 Medical Colleges No. of Counse ling Centres 24 12500 3 3 Approved A.2. 11.2 Printing of IYCF Guidelines 500 150 0.75 0.75 Approved Sub-total Child Health 227540 139300 0 1,293.4 5 358.4 A.9. 5 Child Health Training 593 221592 5 448.98 14.87 Approved lumsum amount as per last year's expenditure. A.9. 5.1 IMNCI Training (pre-service and in- 22 171400 37.71 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 47 - FMR No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) service) A.9. 5.1. 1 TOT on IMNCI (pre- service and in- service) - A.9. 5.1. 2 IMNCI Training for ANMs / LHVs No. of Batche s (24 Person per batch) 22 171400 37.71 A.9. 5.1. 3 IMNCI Training for Anganwadi Workers - A.9. 5.2 F-IMNCI Training 4 202750 8.11 - A.9. 5.2. 1 TOT on F-IMNCI - A.9. 5.2. 2 F-IMNCI Training for Medical Officers No. of Batche s (16 Person Per batch) 4 202750 8.11 A.9. 5.2. 3 F-IMNCI Training for Staff Nurses - A.9. 5.3 Home Based Newborn Care / HBNC 480 58850 282.48 - A.9. 5.3. 1 TOT on HBNC - A.9. 5.3. 2 Training on HBNC for ASHA No. of Batche s (25 Person per batch) 480 58850 282.48 Shifted to MFP under B.1.1.1.3 A.9. 5.4 Care of sick children and severe malnutrition at FRUs 2 76000 1.52 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 48 - FMR No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) A.9. 5.4. 1 TOT on Care of sick children and severe malnutrition No. of Batche s (4 Person per batch) 2 76000 1.52 A.9. 5.4. 2 Training on Care of sick children and severe malnutrition for Medical Officers - A.9. 5.5 Other child health training (please specify) 85 170692 5 119.17 - A.9. 5.5. 1 NSSK Training 46 270900 37.02 - A.9. 5.5. 1.1 TOT for NSSK No. of Batche s (32 per batch) 2 112900 2.26 A.9. 5.5. 1.2 NSSK Training for Medical Officers No. of Batche s (32 per batch) 22 84500 18.59 A.9. 5.5. 1.3 NSSK Training for SNs - A.9. 5.5. 1.4 NSSK Training for ANMs No. of Batche s (32 per batch) 22 73500 16.17 A.9. 5.5. 2 Other Child Health training 39 143602 5 82.15 - A.9. 5.5. 2.a FBNC Training for Pedtrician, Mos and Staff Nurses No. of Batche s (24 Person Per Batch) 4 800000 32 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 49 - FMR No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) A.9. 5.5. 2.b HBNC Round II for DRP No. of Batche s (25 Person Per Batch) 9 174200 15.68 Shifted to MFP B.1.1.1.4.2 A.9. 5.5. 2.c HBNC Round II for ASHA Facilitator No. of Batche s (30 Person Per Batch) 20 137475 27.5 Shifted to MFP B.1.1.1.4.3 A.9. 5.5. 2.d Training of Staff of Nutritional Rehabilitational Centres No. of Batche s (6 per batch) 4 24350 0.97 A.9. 5.5. 2.e TOT on IYCF No. of Batche s (24 Per batch) 2 300000 6 B16. 1.2 Procurement of equipment: CH 0 0 - B16. 1.2. 1 Procurement of equipment: CH (NBCC @ Rs. 85000 X 50) B16. 1.2. 2 Procurement of equipment: CH for strengthening of the paediatrics department SMGS hospital Jammu and GB Pant Hospital Srinagar (Training Centre) project submitted - B.16 .2.2 Drugs & supplies for CH 481140 5 84 387.42 387.42 B.16 .2.2. 1 IFA tablets and De- worm tablets for students studying in primary school 6th to 12th class teachers, General IFA Tablets and - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 50 - FMR No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) Deworming tablets under School health B.16 .2.2. 2 IFA KID tablets 52 doses of 1 ml syrup for each child 164481 3 14 230.27 230.27 Approved B.16 .2.2. 3 Procurement of ORS packets No. of packets 187903 3 2.25 42.28 42.28 Approved B.16 .2.2. 4 Procurement of zinc tablets 125268 9 7.5 93.95 93.95 Approved B.16 .2.2. 5 Procurement of vitamin A syrup No. of bottles 34870 60 20.92 20.92 Approved Total CH 2,129.8 5 760.69 RBSK S. No. Budget Head Unit of Measure Quantit y / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.4. 2 School Health programme 397976 3 3282 05 1,235.34 4.22 Approval as per last year expenditure. The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.4. 2.1 Prepare and disseminate guidelines for School Health Programme. No. of copies 76500 200 153 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 51 - S. No. Budget Head Unit of Measure Quantit y / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.4. 2.2 Prepare detailed operational plan for School Health Programme across districts (cost of plan meeting should be kept) No. of meetings 44 5000 2.2 A.4. 2.3 Mobility support No. of teams x 6 months 2238 2300 0 514.74 A.4. 2.4 Referral support No. of Teams 373 5000 0 186.5 A.4. 2.5 Other strategies for school health 390060 8 2500 05 378.9 - A.4. 2.5. 1 One Day Workshop for orientation for capacity building of School teachers - A.4. 2.5. 2 Financial Assistance for treatment of complicated diseases among childrens and adolescent under School Health Programme for surgical / medical treatment / providing medicine to the ailing children No. of cases 200 1000 00 200 A.4. 2.5. 3 Printing of registers / formats / stock registers / outreach registers for maintenance of record / reporting for 373 school health teams 373 1000 0 37.3 A.4. 2.5. 5 Printing of cards under WIFS for 5 SABLA Districts 120000 0 3 30 A.4. 2.5. 6 Printing of cards etc. under RBSK No. of students + 20 % as buffer stock 270000 0 2.5 67.5 A.4. Printing and 7 1000 8.4 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 52 - S. No. Budget Head Unit of Measure Quantit y / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) 2.5. 7 stationary for DEIC under RBSK 0 A.4. 2.5. 8 Running Cost / contingency / TA DA for DEIC under RBSK 7 3000 0 25.2 A.4. 2.5. 9 Mobility support for Nodal Officers under RBSK 7 5000 0 3.5 A.4. 2.5. 10 Procurement of 2 computers for each of the DEIC under RBSK 14 5000 0 7 B.16 .2.7 Drugs & supplies for SHP No. of districts x 10 months 70 1000 00 70 30 Rs 30 lakhs is approved to procure medicines of Rs 16000 per team and Rs 8000 for once refill. Conditionality State to procure medicines only in accordance to the RBSK EDL to be announced from GoI. Grand Total SHP 1,305.34 34.22 BUDGET: IMMUNIZATION FMR Code BUDGET HEAD Physical target Amount Proposed (Rs in Lakhs) Amount Approve d (Rs in Lakhs) REMARKS C.1 RI Strengthening Project ( Review meetings, Mobility support, Outreach services etc) c.1.a Mobility Support for supervision for district/block level officers. Rs.2,50,000/ Year /district level officers. 22.00 55.00 55.00 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 53 - FMR Code BUDGET HEAD Physical target Amount Proposed (Rs in Lakhs) Amount Approve d (Rs in Lakhs) REMARKS c.1.b Mobility support for supervision at state level Rs. 150000 per year. 2.00 1.50 1.50 c.1.c Printing and dissemination of Immunization cards, tally sheets, monitoring forms etc. Rs. 10 beneficiaries 100000.00 10.00 10.00 c.1.d Support for Quarterly State level review meetings of district officer Rs. 1250/ per participant/da y for 3 persons (CMO/DIO/Dis t. Cold Chain Officer) 8.00 3.30 3.30 State to share the meeting notice and minutes with MOHFW. c.1.e Quarterly review meetings exclusive for RI at district level with one Block MOs, CDPO, and other stake holders Rs. 100/per participant for meeting expenses for 5 persons (lunch, Organization expenses) 88.00 2.86 2.86 State to share the meeting notice and minutes with MOHFW. c.1.f Quarterly review meetings exclusive for RI at block level Rs. 50/ per person as honorarium for ASHA (Travel) and Rs. 25/person at the disposal of MO-IC for meeting expenses (refreshment, stationary and misc. expenses) 117.00 3.59 3.59 State to share the meeting notice and minutes with MOHFW. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 54 - FMR Code BUDGET HEAD Physical target Amount Proposed (Rs in Lakhs) Amount Approve d (Rs in Lakhs) REMARKS c.1.g Focus on slum & underserved areas in urban areas/alternative vaccinator for slums Hiring of ANM@450/se ssion for four session/month /slum of 10000 population and Rs. 300/- per month as contingency per slum i.e. Rs. 2100/- per month per slum of 10000 population 491.00 10.31 10.31 c.1.h Mobilization of children through ASHA or other mobilizers Rs. 150 per session 106666.00 160.00 160.00 c.1.i Alternative vaccine delivery in hard to reach areas Rs. 150 per session 3000.00 4.50 4.50 c.1.j Alternative Vaccine Delivery in other areas Rs. 75 per session 14000.00 10.50 10.50 c.1.k To develop micro plan at sub-centre level @ Rs 100/- per subcentre 2253.00 2.25 2.25 c.1.l For consolidation of micro plans at block level Rs. 1000 per block/ PHC and Rs. 2000 per district 502.00 5.24 5.24 c.1.m POL for vaccine delivery from State to district and from district to PHC/CHCs Rs1,50,000/ district/year 22.00 33.00 33.00 c.1.n Consumables for computer including provision for internet access for RIMs @ 400/ - month/ district 22.00 1.06 1.06 c.1.o Red/Black plastic bags etc. Rs. 3/bags/sessio n 185000.00 5.55 5.55 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 55 - FMR Code BUDGET HEAD Physical target Amount Proposed (Rs in Lakhs) Amount Approve d (Rs in Lakhs) REMARKS c.1.p Hub Cutter/Bleach/Hypoc hlorite solution/ Twin bucket Rs. 1200 per PHC/CHCper year 718.00 8.62 8.62 c.1.q Safety Pits Rs. 5250/pit 35.00 1.84 1.84 c.1.r State specific requirement (Maintainence of WIC in Sri Nagar & Jammu) 1.00 2.00 0.00 The state should engage refrigerator mechanics for this activity and funds for maintainence to be used from cold chain maintenance funds under C.4 c.1.s Teeka Express Operational Cost 44.59 44.59 c.1.t Measles SIA operational Cost 0.00 0.00 Not recommende d, as no planned Measles SIA in F.Y. 2013- 14 c.1.u JE Campaign Operational Cost 0.00 0.00 Not recommende d, as no planned JE Campaign in F.Y. 2013-14 c.1.v Others (IEC activities for Immunisation strengthening activities & Office expenses) 1.00 18.38 0.00 Not recommende d, as activity approved under comprehensi ve IEC plan. C.1-Sub Total 384.08 363.70 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 56 - FMR Code BUDGET HEAD Physical target Amount Proposed (Rs in Lakhs) Amount Approve d (Rs in Lakhs) REMARKS C.2 Salary of Contractual Staffs C.2.1 Computer Assistants support for State level Rs.12000- 15000 per person per month 1.00 1.51 0.75 * Salary is for 6 months * State to provide details of total sanctioned posts, filled up and vacancy. C.2.2 Computer Assistants support for District level 8000-10000 per person per month 22.00 29.94 13.20 * Salary is for 6 months * State to provide details of total sanctioned posts, filled up and vacancy. C.2.3 Others(service delivery staff)- Establishment of State Immunization Cell includes HR and mobility (New Innovation). SEPIO (mobility & logistics support) Already existing 6.00 0.00 Not recommende d Technical Officer Routine Immunization ( NEW POSTS) 70000/m 2 28.80 14.40 * Recommende d. * Salary is for 6 months State Immunization Training Coordinator 60000/m 1 13.20 0.00 Not recommende d Regional Routine Immunization Coordinators 25000/m 2 12.00 0.00 Not recommende d Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 57 - FMR Code BUDGET HEAD Physical target Amount Proposed (Rs in Lakhs) Amount Approve d (Rs in Lakhs) REMARKS State Cold Chain Officer 50000/m 1 12.00 0.00 Not recommende d Technical Assistant Already existing 2.40 0.00 Not recommende d Program cum Computer Assistant 15000/m 3 5.40 1.80 * Recommende d for 2 posts of assistants @ Rs 15,000/m * 6 months * 2 posts * Salary is for 6 months Divisional/Regional Warehouse Vaccine & Logistics Manager 20000/m 2 3.36 0.00 Not recommende d Cold Chain & Vaccine Logistics Helpers 7000/m 2 1.68 0.00 Not recommende d C.2-Sub Total 116.29 30.15 C.3 Training under Immunization C.3.1 District level Orientation training including Hep B, Measles & JE(wherever required) for 2 days ANM, Multi Purpose Health Worker (Male), LHV, Health Assistant (Male/Female), Nurse Midwives, BEEs & other staff ( as per RCH norms) As per revised norms for trainings under RCH 100.00 57.20 57.20 Approved, but expenditure has to be as per NRHM norms. Also, all the trainings should be approved from Immunization division. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 58 - FMR Code BUDGET HEAD Physical target Amount Proposed (Rs in Lakhs) Amount Approve d (Rs in Lakhs) REMARKS C.3.2 Three day training including Hep B, Measles & JE(wherever required) of Medical Officers of RI using revised MO training module) 25.00 27.64 27.64 C.3.3 One day refresher training of district Computer assistants on RIMS/HIMS and immunization formats 2.00 0.39 0.39 C.3.4 Two days cold chain handlers training for block level cold chain handlers by State and district cold chain officers 22.00 10.75 10.75 C.3.5 One day training of block level data handlers by DIOs and District cold chain officer 0.00 0.00 C.3.6 Others 0.00 0.00 C.3-Sub Total 95.97 95.97 C.4 Cold chain maintenance Rs.750/PHC/C HCs per year District Rs.15000/year 718 and 22 Districts 8.68 8.68 Recommende d as per norms, However, the expenditure has to be as per actuals.Also, in case the expenditure exceeds the approved allocation , the state may request to MOHFW for additional allocation by Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 59 - FMR Code BUDGET HEAD Physical target Amount Proposed (Rs in Lakhs) Amount Approve d (Rs in Lakhs) REMARKS reappropriati ng within part C. C.5 ASHA incentive for full Immunization Rs 100 per child for full immunization in first year 100000.00 150.00 150.00 Rs 50 per child for ensuring complete immunization upto 2nd year of age Total ROUTINE IMMUNIZATION 755 648.51 C.6 Pulse Polio Operational Cost (Tentative) 394.57 398.07 Approved, subject to approval for Pulse Polio Cost. Total 1149.59 1046.58 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 60 - FAMILY PLANNING Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 61 - JAMMU & KASHMIR: Projections & Conditionality (2013-14): Projection of Key Indicators (2013-14): Projection of Key Indicators (2013-14): SN. Indicator Current Target/ ELA Status 2013-14 2014-15 2015-16 2016-17 1 Goal Indicators: 1.1 Total Fertility Rate (TFR) 1.9 (SRS 2011) Maintain TFR level 1.2 Contraceptive Prevalence Rate (CPR) 41.2 (DLHS-3) 50.0 41.2 (DLHS-3) 50.0 41.2 (DLHS- 3) 1.3 Unmet Need 21.6 (DLHS-3) 15.0 21.6 (DLHS-3) 15.0 21.6 (DLHS- 3) 2 Service delivery: 2.1 IUCD - Total 19232 (HMIS 2011-12) 30000 35000 38000 40000 2.2 Post-partum IUCD (subset of IUCD-total) 10000 25% of the Public Health Institution Deliveries of that year 2.3 Female Sterilisation 15810 (HMIS 2011-12) 25250 25750 26250 26550 2.4 Post-partum sterilisation (subset of tubectomy) 1588 (HMIS 2011-12) 2930 3295 3676 4063 2.5 Male sterilisation 1064 (HMIS 2011-12) 2835 3251 3684 4125 Total Sterilization 16874 (HMIS 2011-12) 28085 29001 29934 30675 3 Input/ facility operationalization: 3.1 Fixed Day service delivery: 3.1.1 IUCD Twice weekly at SC All SHC All SHC All SHC All SHC Daily at DH, SDH, CHC 480 Facilities Twice/week in CHC’S and FRU’S Weekly @ PHC + CHC Weekly @ PHC + CHC Weekly @ PHC + CHC Weekly @ PHC + CHC 3.1.2 Sterilisation Daily at All DHs & CHC-138 Facilities DH + 1 SDH/ FRU per dist DH + all FRU per dist DH + all FRU + 25% PHC per dist DH + all FRU + 50% PHC per dist 3.2 Appointment of FP counsellors 22 FP counsellors DH + 1 SDH/ FRU per dist DH + all FRU per dist DH + all FRU per dist DH + all FRU per dist Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 62 - Conditionality for 2013-14: Family Planning: SN. Indicator Target/ ELA - 2013-14 Minimum Level of Achievement Remarks By end of Sep. 2013 By end of March 2014 1 Goal (target): 1.1 Reduction in TFR -2013 Maintain TFR level NA NA 1.9 (SRS 2011) 2 Service delivery (ELA): 2.1 IUCD: 30000 12000 27000 2.1.1 PPIUCD 10000 4000 9000 2.1.2 Interval IUCD 20000 8000 18000 2.2 Sterilisation: 28085 8426 22468 2.2.1 Tubectomy 25250 7575 20200 2.2.2 Post-partum sterilisation (subset of tubectomy) 2930 879 2344 2.2.3 Vasectomy 2835 851 2268 3 Training of personnel (target): 3.1 Post-partum IUCD 0 0 0 3.1.1 MO 0 0 3.1.2 SN 0 0 3.2 Interval IUCD 0 0 0 3.2.1 MO 0 0 3.2.2 SN 0 0 3.2.3 ANM/ LHV 0 0 3.3 Minilap 20 5 15 3.4 NSV 44 11 33 3.5 Laparoscopic 15 4 11 15 Trained 4 Others (target): 4.1 Appointment of FP Counsellors 22 FP counsellors Review & Reporting Review & Reporting 4.2 Regular reporting of the scheme of “home delivery of contraceptives by ASHAs” from pilot states Regular reporting Regular reporting Regular reporting 4.3 Fixed Day Services for IUCD 480 Facilities Twice/week in CHC’S and FRU’S NA 100% 4.4 Fixed Day Services for Sterilisation Daily at All DHs & CHC- 138 Facilities NA 100% Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 63 - ROAD MAP FOR PRIORITY ACTION: FAMILY PLANNING MISSION: “The mission of the National Family Planning Program is that all women and men (in reproductive age group) in India will have knowledge of and access to comprehensive range of family planning services, therefore enabling families to plan and space their children to improve the health of women and children”. GUIDING PRINCIPLES: Target-free approach based on unmet needs for contraception; equal emphasis on spacing and limiting methods; promoting ‘children by choice’ in the context of reproductive health. STRATEGIES: 1. Strengthening spacing methods: a. Increasing number of providers trained in IUCD 380A b. Strengthening Fixed Day IUCD services at facilities c. Introduction of Cu IUCD 375 d. Delivering contraceptives at homes of beneficiaries. e. Delaying first pregnancy for at least two years after marriage, spacing of at least three years between first and second child and adoption of permanent method after one or two children ( couples to be motivated by ASHA). 2. Emphasis on post-partum family planning services: a. Strengthening Post-Partum IUCD (PPIUCD) services at least at DH, SDH, FRU, CHC/BPHC level at high case load facilities. b. Promoting Post-partum sterilisation (PPS) c. Establishing Post-Partum Centers at women & child hospitals at district levels d. Appointing counsellors at high case load facilities 3. Strengthening sterilization service delivery a. Increasing pool of trained service providers (minilap, lap & NSV) b. Operationalising FDS centers for sterilisation c. Holding camps to increase accessibility and availability of services. 4. Strengthening quality of service delivery: a. Strengthening QACs for monitoring/review b. Disseminating/ following existing protocols/ guidelines/ manuals c. Monitoring of FP Indemnity scheme 5. Development of BCC/ IEC tools highlighting benefits of Family Planning specially on spacing methods 6. Focus on using private sector capacity for service delivery (exploring PPP availability): 7. Strengthening programme management structures: a. Establishing new structures for monitoring and supporting the programme b. Strengthening programme management support to state and district levels 8. World Population Day Celebrations. KEY PERFORMANCE INDICATORS: Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 64 - a. % IUD inserted against ELA b. % PPIUCD inserted against institutional deliveries c. % PPIUCD inserted against total IUCD d. % of sterilisations conducted against ELA e. % post-partum sterilisations against total female sterilisations f. % of male sterilisations out of total sterilisations conducted g. % facilities delivering FDS services against planned h. % of personnel trained against planned i. % point decline in unmet need j. Point decline in TFR k. % utilization of funds against approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 65 - DETAILED BUDGET: FAMILY PLANNING FMR Code Budget Head Unit of Measur e Quan tity / Targ et Unit Cost ( Rs) Amoun t Propos ed ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks A.3 FAMILY PLANNING 2626 1 137000 327.88 205.99 In view of limited resource envelop, currently approved as per last year's expenditure. A.3.1 Terminal/Limiting Methods 2614 7 22000 279.94 170.17 A.3.1. 1 Orientation workshop,dissemina tion of manuals on FP standards & quality assurance of sterilisation services, fixed day planning meeting No. 96 2000 1.92 0.06 Approved A.3.1. 2 Female sterilisation camps 22 7500 1.65 1.13 Approved for 14 camps, as per last year achievements/expendi ture. A.3.1. 3 NSV camps 12 10000 1.2 0.8 Approved for 8 camps, as per last year achievements/expendi ture. A.3.1. 4 Compensation for female sterilisation 2301 7 1000 230.17 145.68 Approved for 14568 sterilizations, as per last year achievements/expendi ture. A.3.1. 5 Compensation for male sterilization/NSV Acceptance 3000 1500 45 22.5 Approved for 1500 sterilizations, as per last year achievements/expendi ture. A.3.1. 6 Accreditation of private providers to provide sterilisation services - A.3.2 Spacing Methods 0 0 7.84 1.48 A.3.2. 1 IUD camps - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 66 - FMR Code Budget Head Unit of Measur e Quan tity / Targ et Unit Cost ( Rs) Amoun t Propos ed ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks A.3.2. 2 IUD services at health facilities (including fixed day services at SHC and PHC) 7.84 1.48 Approved as per last year expenditure. A.3.2. 2.1 PPIUCD services - A.3.2. 3 Accreditation of private providers to provide IUD insertion services - A.3.2. 4 Social Marketing of contraceptives (includng delivery of contraceptive by ASHA at door step) - A.3.2. 5 Contraceptive Update seminars - A.3.3 POL for Family Planning/ Others (including additional mobilty support to surgeon's team if req) - A.3.4 Repairs of Laparoscopes - A.3.5 Other strategies/activities (please specify): 114 115000 40.1 34.34 Approved as per last year expenditure. A.3.5. 1 Monitor progress and quality,QAC meetings /review of sterilization failures etc. No. of meeting s 92 4.8 Approved A.3.5. 2 Performance reward if any A.3.5. 3 World Population Day’ celebration (such as mobility, IEC activities etc.): funds earmarked for district and block level activities 22 115000 25.3 Approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 67 - FMR Code Budget Head Unit of Measur e Quan tity / Targ et Unit Cost ( Rs) Amoun t Propos ed ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks A.3.5. 4 Other strategies/ activities (such as strengthening fixed day services for IUCD and sterilization etc.) 0 0 10 10 A.3.5. 4.1 Family Planning Indemnity Scheme 10 10 Approved Sub-total Family Planning (excluding Sterilisation Compensation and NSV Camps) 2602 9 12500 51.51 37.01 Sub-total Sterilisation Compensation and NSV Camps 232 124500 276.37 168.98 A.9.6 Family Planning Training 46 301600 17.57 12.35 Approved lumsum amount as per last year's expenditure. A.9.6. 1 Laparoscopic Sterilisation Training 5 57550 2.88 - A.9.6. 1.1 TOT on laparoscopic sterilisation - A.9.6. 1.2 Laparoscopic sterilisation training for doctors (teams of doctor, SN and OT assistant) No. of Batches (3 Person Per Batch) 5 57550 2.88 A.9.6. 2 Minilap Training 8 94650 3.79 - A.9.6. 2.1 TOT on Minilap No. of Person 4 15000 0.6 A.9.6. 2.2 Minilap training for medical officers No. of Batches (4 Person Per Batch) 4 79650 3.19 A.9.6. 3 Non-Scalpel Vasectomy (NSV) Training 11 117750 3.95 - A.9.6. 3.1 TOT on NSV No. of Person 1 87000 0.87 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 68 - FMR Code Budget Head Unit of Measur e Quan tity / Targ et Unit Cost ( Rs) Amoun t Propos ed ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks A.9.6. 3.2 NSV Training of medical officers No. of Batches (4 Person Per Batch) 10 30750 3.08 A.9.6. 4 IUD Insertion 0 0 - - A.9.6. 4.1 TOT for IUD insertion - A.9.6. 4.2 Training of Medical officers in IUD insertion - A.9.6. 4.3 Training of staff nurses in IUD insertion - A.9.6. 4.4 Training of ANMs / LHVs in IUD insertion - A.9.6. 5 Contraceptive update/ISD Training No. of batches (25 per batch) 22 31650 6.96 A.9.6. 6 Other family planning training (please specify) 0 0 - - A.9.6. 6.1 Capacity building of Health Service provider on IUCD and PTC - A.9.6. 6.2 TOT for IUD insertion - A.9.6. 7 PPIUCD insertion training - A.9.6. 8 IUCD 375 insertion training - A.9.6. 9 Training of FP Counselors - A.9.6. 10 Training/ orientation on technical manuals - B16.1 .3 Procurement of equipment: FP 2529 453600 94.94 94.06 B16.1 .3.1 NSV kits 110 1600 1.76 0.88 Approved @ Rs 800 per kit for 110 kits. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 69 - FMR Code Budget Head Unit of Measur e Quan tity / Targ et Unit Cost ( Rs) Amoun t Propos ed ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks B16.1 .3.2 IUCD kits 2409 2000 48.18 48.18 Approved B16.1 .3.3 minilap kits - B16.1 .3.4 laparoscopes 10 450000 45 45 Approved B16.1 .3.5 PPIUCD forceps - GRAND TOTAL FP 440.39 312.4 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 70 - ADOLESCENT HEALTH Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 71 - ROAD MAP FOR PRIORITY ACTION: ADOLESCENT HEALTH SETTING UP OF AH CELL A unit for adolescent health at state level with a nodal officer supported by four consultants one each for ARSH, SHP, Menstrual hygiene and WIFS; one nodal officer (rank of ACMHO) for all the components of Adolescent Health at district level to take care of Adolescent health programme including the SHP. PROGRAMME SPECIFIC ESSENTIAL STEPS FOR IMPLEMENTATION: I. Adolescent Reproductive Sexual Health (ARSH) Programme Clinics - Number of functional clinics at the DH, CHC, PHC and Medical Colleges (dedicated days, fixed time, trained manpower). - Number of clinics integrated with ICTCs - Quarterly Reporting from the ARSH clinics to be initiated to GoI. - Establish a Supportive supervision and Monitoring mechanism Outreach - Utilisation of the VHND platform for improving the clinic attendance. - Demand generation in convergence with SABLA and also through Teen Clubs of MOYAS Capacity Building/Training: - Calculation of the training load and development of training plans! refresher trainings. - Deployment of trained manpower at the functional clinics. II Menstrual Hygiene Scheme (MHS) Formation of State and district level steering committees. Training / re-orientation of service providers(MOs, ANMs, ASHAs) Monthly meeting with BMO. Regular feedback on quality of sanitary napkins to be sent to GoI Identification of appropriate storage place for sanitary napkins. Mechanism of distribution of SN right upto the user level. Reporting and accounting system in place at various levels. Utilizing MCTS for service delivery by checking with ASHAs and ANMs about supply chain management of IFA tabs and Sanitary napkins. Distribution of Sanitary Napkins to school going adolescent girls to be encouraged in schools and preferably combined with Weekly Iron Folic Acid Supplementation (WIFS). II Weekly Iron and Folic Acid Supplementation programme (WIFS) Procurement policy in place for procurement of EDL including IFA and deworming tablets. Establish “Monday” as a fixed day for WIFS. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 72 - Plan for training and capacity building of field level functionaries of concerned Departments (i.e. Department of Women and Child Development and and Department of Education) and plan for sensitization of Programme Planners on WIFS. Ensure that monitoring mechanism as outlined in the operational framework (Shared with the States during the National Adolescent Health Workshop) are put in place across levels and departments. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 73 - DETAILED BUDGET: ADOLESCENT HEALTH FMR . No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.4 ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH / ARSH 398196 8 5990 05 1,292.9 9 8.92 A.4. 1 Adolescent health services 1625 2103 00 52.37 3.8 Approved as per last year expenditure. A.4. 1.1 Disseminate ARSH guidelines. No. of Copies 1000 200 2 A.4. 1.2 Establishment of new clinics at DH level - A.4. 1.3 Establishment of new clinics at CHC/PHC level No. of institu tions 22 1820 00 40.04 A.4. 1.4 Operating expenses for existing clinics No. of institu tions 27 2760 0 7.45 A.4. 1.5 Outreach activities including peer educators No. of outrea ch activiti es 576 500 2.88 A.4. 1.6 Others - - A.4. 3 Other strategies/activities (please specify) 580 6050 0 5.28 0.9 Approved as per last year expenditure. A.4. 3.1 Mobility support for ARSH/ICTC counsellors 576 500 2.88 A.4. 3.2 Menstrual Hygiene (Sanitary napkin procurement to be booked under procurement) No. of meeti ngs 4 6000 0 2.4 A.4. 3.3 WIFS actvity - Sub-total ARSH 398196 8 5990 05 1,292.9 9 8.92 A.9. 7 Adolescent Reproductive and Sexual Health/ARSH #VALU E! 7617 15 217.6 5.8 Approved lumsum amount as per last year's expenditure. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 74 - FMR . No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) Training A.9. 7.1 TOT for ARSH training - A.9. 7.2 Orientation training of state and district programme managers No. of Batch es (30 per batch) 2 6240 0 1.25 A.9. 7.3 ARSH training for medical officers No. of Batch es (30 per batch) 4 9620 0 3.85 A.9. 7.4 ARSH training for ANMs/LHVs - A.9. 7.5 ARSH training for AWWs - A.9. 7.6 Other ARSH training 4 1510 00 3.02 - A.9. 7.6. 1 Two day training of RMNCH / Counselors from existing centres ARSH/ICTC/IYCF (RMNCH) No. of Batch es (30 per batch) 2 7550 0 1.51 A.9. 7.6. 2 Two days training of newly appointed counselors under ARSH/IYCF (RMNCH) No. of Batch es (30 per batch) 2 7550 0 1.51 A.9. 7.6. 1 WIFS training 10 1663 50 8.32 - A.9. 7.6. 1.1 State level/ District Level/ Block Level No. of Batch es (50 per batch) 5 8700 0 4.35 A.9. 7.6. 1.2 refresher training – ANM/MO/ AWW/ Nodal Teacher No. of Batch es (50 per batch) 5 7935 0 3.97 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 75 - FMR . No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.9. 7.6. 2 Menstrual hygiene training - B.16 .2.6 Drugs & supplies for WIFS 646000 00 1 142.4 142.4 B.16 .2.6. 1 IFA No. of tablets + 20% buffer stock 624000 00 0.2 124.8 124.8 Approved B.16 .2.6. 2 Albendazole No. of tablets + 10% buffer stock 220000 0 0.8 17.6 17.6 Approved Grand Total ARSH 1,652.9 9 157.12 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 76 - URBAN RCH Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 77 - ROAD MAP FOR PRIORITY ACTION: URBAN RCH BUDGET: URBAN RCH FMR . No. Budget Head Unit of Meas ure Quantit y / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.5 URBAN RCH (focus on Urban slums) 201 42000 255.48 34.11 Approved Rs. 34.11 lakhs, 50% of the last year expenditure. Annexure shows that 10 out of 47 centres are operational. OPD numbers not shared. State to share the performance of UHPs and propose the rest of the activities under NUHM. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the conditionalities mentioned in the HR head. A.5. 1 Identification of urban areas / mapping of urban slums and planning - A.5. 2 HR for urban health including doctors, ANMs, Lab techs 201 42000 229.8 - A.5. 2.1 Doctors/Mos 10 30000 36 A.5. 3 Operating expenses for UHP and UHC - A.5. 4 Outreach activities - A.5. 5 Others (pl specify) 0 0 25.68 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 78 - A.5. 5.1 Rent for Urban Health Centres / Posts 25.68 Sub-total Urban Health 201 42000 255.48 34.11 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 79 - TRIBAL HEALTH Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 80 - ROAD MAP FOR PRIORITY ACTION: TRIBAL HEALTH State to closely monitor progress (physical, expenditure) on all health activities in notified tribal areas. On a quarterly basis, a progress report, including constraints faced and action proposed to be sent to MoHFW. The State shall focus on health entitlements of vulnerable social groups like SCs, STs, OBCs, minorities, women, disabled, migrants etc. S. No. Budget Head Unit of Meas ure Quan tity / Targ et Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.6. TRIBAL RCH 26 12000 37.44 15.87 A.6. 1 Special plans for tribal areas - A.6. 2 HR for tribal areas (in addition to normative HR) 26 12000 37.44 15.87 Approved 50 % of the last year's expenditure (26 AMCHI Healers). State to conduct the impact evaluation study and share with GoI. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the conditionalities mentioned in the HR head. A.6. 3 Outreach activities - A.6. 4 Other Tribal RCH strategies/activitie s (please specify) 0 0 - - Sub-total Tribal Health 26 12000 37.44 15.87 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 81 - PC-PNDT Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 82 - ROAD MAP: PNDT MISSION: The mission of PNDT program is to improve the sex ratio at birth by regulating the pre- conception and prenatal diagnostic techniques misused for sex selection. Guiding Principle: Deterrence for unethical practice sex selection to ensure improvement in the child sex ratio STRATEGIES: Strengthening programme management structures: > Appointment of Nodal officer > Strengthening of Human resource > Formation of PNDT Cell at state and district level Establishment of statutory bodies under the PC&PNDT Act > Constitution of 20 member State Supervisory Board — Reconstitution every three years (other than ex-officio members) — Four meetings in a year > Notification of three members State Appropriate Authority, > Constitution of 8 member State Advisory Committee — Reconstitution in every 3 years — At least 6 meetings in a year > Notification of District Appropriate Authorities > Constitution of 8 member district Advisory Committees — Reconstitution in every 3 years — At least 6 meetings in a year Strengthening of monitoring mechanisms > Monitoring of sex ratio at birth through civil registration of birth data > Formulation of Inspection and Monitoring committees > Increasing the monitoring visits > Review and evaluation of registration records > Online availability of PNDT registration records > Online filling and medical audit of form Fs > Ensure regular reporting of sales of ultrasound machines from manufactures > Enumeration of all Ultrasound machines and identification of un-registered ultrasound machine > Ensure compliance for maintenance of records mandatory under the Act > Ensure regular quarterly progress reports at state and district level Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 83 - Capacity building and sensitisation of program managers > Appropriate Authorities > Advisory committee members > Nodal officers both State and District • Sensitisation and Alliance building with > Judiciary> Medical Council / associations > Civil society. • Development of BCC/ IEC/ IPC Campaigns highlighting provisions of PC& PNDT Act and promotion of Girl Child • Convergence for Monitoring of Child sex Ratio at birth KEY PERFORMANCE INDICATORS: > Improvement in child sex ratio at birth > % of civil registration of births > Statutory bodies in place > % registrations renewed > Increase in inspections and action taken > No. of unregistered machines identified > % of court cases filed > % of convictions secured > No. of medical licences of the convicted doctor cancelled or suspended Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 84 - DETAILED BUDGET: PNDT S. No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.7 PNDT Activities 2324 2532000 216.64 1.1 Due to limited resource envelop, approved as per last year expenditure. A.7 .1 Support to PNDT cell 2 2200000 44 A.7 .3 Mobility support 22 60000 13.2 A.7 .2 Other PNDT activities (please specify) 2300 272000 159.44 1.1 Due to limited resource envelop, approved as per last year expenditure. A.7 .2.1 Reward to Informers for giving information regarding unregistered ultrasound machine (8); illegal practice of sex selection and selective female foeticide (8) 10 A.7 .2.2 Divisional level workshops 4 200000 8 A.7 .2.3 District level workshops 44 50000 22 A.7 .2.4 State Supervisory board meetings 6 10000 0.6 A.7 .2.5 Divisional Advisory Committee Meetings 12 5000 0.6 A.7 .2.6 District Advisory Committee Meetings 132 2000 2.64 A.7 .2.7 Debates , seminars at Universities/ Colleges 102 15.6 A.7 .2.8 Incentive to parents having two daughters adopting permanent method of family planning 2000 5000 100 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 85 - S. No. Budget Head Unit of Measu re Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) A.7 .2.9 Award to block / panchayat / Village Health Sanitation and Nutrition Committees that reflect reverse trend in the sex ratio (more females and less males) - Sub-total PNDT activities 2324 2532000 216.64 1.1 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 86 - HUMAN RESOURCES & PROGRAMME MANAGEMENT Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 87 - ROAD MAP: HUMAN RESOURCES A comprehensive HR policy to be formulated and implemented; to be uploaded on the website. Underserved facilities particularly in high priority districts, to be first strengthened through contractual staff engaged under NRHM. Similarly high case load facilities to be supplemented as per need All appointments under NRHM to be contractual; contracts to be renewed not routinely but based on structured performance appraisal Decentralized recruitment of all HR engaged under NRHM by delegating recruitment process to the District Health Society under the chairpersonship of the District Collector or Rogi Kalyan Samitis at facility level as applicable. Preference to be given to local candidates to ensure presence of service providers in the community. Residence at place of posting to be ensured. Quality of HR ensured through appropriate qualifications and a merit- based, transparent recruitment process is mandatory. It has been observed that contractual HR engaged under NRHM i.e. Specialists, Doctors (both MBBS and AYUSH), Staff Nurses and ANM are not posted to the desired extent in inaccessible/hard to reach areas thereby defeating the very purpose of the Mission to take services to the remotest parts of the country, particularly the un-served and under-served areas. It must therefore be ensured that the remotest Sub-Centres and PHCs are staffed first. Contractual HR must not be deployed in better served areas until the remotest areas are adequately staffed. No Sub-Centre in remote/difficult to reach areas should remain without any ANM. No PHC in these areas should be without a doctor. Further, CHCs in remote areas must get contractual HR ahead of District Hospitals. Compliance with these conditionalities will be closely monitored and salaries for contractual HR dis-allowed in case of a violation. Details of facility wise deployment of all HR engaged under NRHM to be displayed on the state NRHM web site. For SHCs with 2 ANMs, population to be covered to be divided between them. Further, one ANM to be available at the sub-centre throughout the day while the other ANM undertakes field visits; timings for ANM’s availability in the SHC to be notified. AYUSH doctors to be more effectively utilized eg for supportive supervision, school health and WIFS. All contractual staff to have job descriptions with reporting relationships and quantifiable indicators of performance. Performance appraisal and hence increments of contractual staff to be linked to progress against indicators. Staff productivity to be monitored. Continuation of additional staff recruited under NRHM for 24x7 PHCs, FRUs, SDH, etc, who do not meet performance benchmarks, to be reviewed by State on a priority basis. All performance based payments/difficult area incentives should be under the supervision of RKS/Community Organizations (PRI). Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 88 - DETAILED BUDGET: HUMAN RESOURCES S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.8 Human Resources 6806 99752 0 11,280. 91 3,575.7 4 As agreed, the following key conditionalities would be enforced during the year 2013-14. a) Rational and equitable deployment of HR with the highest priority accorded to high priority districts and delivery points. b) Facility wise performance audit and corrective action based thereon. c) Performance Measurement system set up and implemented to monitor performance of regular and contractual staff. d) Baseline assessment of competencies of all SNs, ANMs, Lab Technicians to be done and corrective action taken thereon. - Approval is being granted for HR of all cadres under NRHM for six months only and its continuation for the next six months would be contingent on compliance of the above four conditionalities. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 89 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) - From 1st October 2013, under NRHM funds for salary to contractual HR would be done only to make payments to contractual staff over and above the sanctioned regular positions in the State. - It is expected that the state will henceforth fill up their vacant regular HR positions and will not use NRHM funds to substitute state spending. A.8.1 Contractual Staff & Services 6806 99752 0 11,280. 91 3,575.7 4 Due to limited resource envelop, approved is being given for in-position staff as per last year's rate (based on the last year expenditure). A.8.1. 1 ANMs,Supervisory Nurses, LHVs, 2909 11100 0 4,428.7 2 1,508.2 2 A.8.1. 1.1 ANMs 2118 36000 3,049.9 2 1,100.1 0 Approved for in- position 1930 ANMs @ last years rate, as per last year achivements/expendit ure. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1. 1.1.a DH - A.8.1. 1.1.b FRUs - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 90 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.8.1. 1.1.c Non FRU SDH/ CHC - A.8.1. 1.1.d 24 X 7 PHC 200 12000 288 A.8.1. 1.1.e Non- 24 X 7 PHCs - A.8.1. 1.1.f Sub Centres No. 1910 12000 2,750.4 0 A.8.1. 1.1.g SNCU/ NBSU/NRC etc No. 8 12000 11.52 A.8.1. 1.1.h Others - A.8.1. 1.2 Staff Nurses 791 75000 1,378.8 0 408.12 Approved for in- position 716 SNs @ last years rate, as per last year achivements/expendit ure. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1. 1.2.a DH 240 15000 432 A.8.1. 1.2.b FRUs 156 15000 280.8 A.8.1. 1.2.c Non FRU SDH/ CHC - A.8.1. 1.2.d 24 X 7 PHC 200 15000 360 A.8.1. 1.2.e Non- 24 X 7 PHCs - A.8.1. 1.2.f SNCU/ NBSU/NRC etc 125 15000 180 A.8.1. 1.2.g Others 70 15000 126 A.8.1. 1.3 LHVs/supervisory nurses 0 0 - - A.8.1. 1.3.a DH - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 91 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.8.1. 1.3.b FRUs - A.8.1. 1.3.c Non FRU SDH/ CHC - A.8.1. 1.3.d 24 X 7 PHC - A.8.1. 1.3.e Non- 24 X 7 PHCs - A.8.1. 1.3.f SNCU/ NBSU/NRC etc - A.8.1. 1.3.g Others - A.8.1. 2.1 Laboratory Technicians 409 48000 581.76 241.7 Approved for in- position 373 LTs @ Rs.10800, as per last year achivements/expendit ure. new posts not approved, state to redeploy. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1. 2.1.a DH 16 12000 23.04 A.8.1. 2.1.b FRUs 168 12000 241.92 A.8.1. 2.1.c Non FRU SDH/ CHC - A.8.1. 2.1.d 24 X 7 PHC 200 12000 288 A.8.1. 2.1.e Non- 24 X 7 PHCs - A.8.1. 2.1.f Others 25 12000 28.8 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 92 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.8.1. 2.2 MPWs 355 12000 511.2 172.37 Approved for in- position 266 MPWs @ Rs.10800, as per last year achivements/expendit ure, new posts not approved. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1. 3 Specialists (Anaesthetists, Paediatricians, Ob/Gyn, Surgeons, Physicians, Dental Surgeons, Radiologist, Sonologist, Pathologist, Specialist for CHC ) 94 48000 0 483.6 110.4 Approved for in- position 46 Specialists @ Rs. 40000/m, as per last year achivements/expendit ure. State to re-deploy existing specialits in FRUs and SNCUs. Approved. State to provide name of the FRU/facility with case load and current staffing. Also as a pre- requisite the EmOC and LSAS trained doctors must be posted at appropriate facilities and perform. None of the specialists is being sanctioned exclusively for conducting training. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 93 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) conditionalities. A.8.1. 3.1 Obstetricians and Gynecologists 15 10000 0 90 A.8.1. 3.1.a DH - A.8.1. 3.1.b FRUs 8 50000 48 A.8.1. 3.1.c Non FRU SDH/ CHC - A.8.1. 3.1.d Others (Please specify) 7 50000 42 A.8.1. 3.2 Pediatricians 22 15000 0 111 A.8.1. 3.2.a DH 7 50000 21 A.8.1. 3.2.b FRUs 8 50000 48 A.8.1. 3.2.c Non FRU SDH/ CHC - A.8.1. 3.2.d Others (Please specify) 7 50000 42 A.8.1. 3.3 Anesthetists 15 10000 0 90 A.8.1. 3.3.a DH - A.8.1. 3.3.b FRUs 8 50000 48 A.8.1. 3.3.c Non FRU SDH/ CHC - A.8.1. 3.3.d Others (Please specify) 7 50000 42 A.8.1. 3.4 Surgeons 0 0 - A.8.1. 3.4.a DH - A.8.1. 3.4.b FRUs - A.8.1. 3.4.c Non FRU SDH/ CHC - A.8.1. 3.4.d Others (Please specify) - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 94 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.8.1. 3.5 Specialists for CH (Paediatrician etc) in SNCU,NBSU,NRC 25 0 120 A.8.1. 3.5.a DH - A.8.1. 3.5.b FRUs - A.8.1. 3.5.c Non FRU SDH/ CHC - A.8.1. 3.5.d Others (Please specify) 15 for 6 mont hs & 10 for 6 mont hs @ Rs. 50000 /- 25 120 A.8.1. 3.6.1 Radiologists 5 50000 30 - Not approved. A.8.1. 3.6.2 Pathologists 5 50000 30 - Not approved. A.8.1. 3.7 Dental surgeons and dentists 7 30000 12.6 - A.8.1. 3.7.a DH 7 30000 12.6 0 The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.8.1. 3.7.b FRUs - A.8.1. 3.7.c Non FRU SDH/ CHC - A.8.1. 5 Medical Officers 565 15000 0 1,948.8 0 750 Approved for in- position 500 MOs @ Rs.25000/-m, as per last year achievements/expendi ture. Approval is being granted for six months only and its continuation for the next six months would Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 95 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) be contingent on compliance of the above mentioned conditionalities. A.8.1. 5.1 DH 16 30000 57.6 A.8.1. 5.2 FRUs 170 30000 612 A.8.1. 5.3 Non FRU SDH/ CHC - A.8.1. 5.4 24 X 7 PHC 275 30000 990 A.8.1. 5.5 Non- 24 X 7 PHCs/ APHCs 6 30000 21.6 A.8.1. 5.7 MOs for SNCU/ NBSU/NRC etc 70 234 A.8.1. 5.8 Other MOs 7 30000 12.6 A.8.1. 5.9 Others 21 21 0 The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.8.1. 6 Additional Allowances/ Incentives to M.O.s 983.08 533.39 Approved Rs. 533.39 lakhs, as per last year expenditure and limited resource envelop. State to share the details of the incentive scheme. It needs to ensure that performance monitoring is done regularly and should be given to those MOs, Specialists , etc. staying at the residential quarters / Headquarter areas. A.8.1. 7 Others - Computer Assistants/ BCC Co- ordinator etc - A.8.1. 7.1 Pharmacist 0 0 - - A.8.1. 7.1.a DH - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 96 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.8.1. 7.1.b FRUs - A.8.1. 7.1.c Non FRU SDH/ CHC - A.8.1. 7.1.d 24 X 7 PHC - A.8.1. 7.1.e Non- 24 X 7 PHCs - A.8.1. 7.1.f Others - A.8.1. 7.2 Radiographers 184 24000 264.96 112.75 Approved for in- position Radiographers @ Rs.10800/-m, as per last year achivements/expendit ure. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1. 7.2.a DH 16 12000 23.04 A.8.1. 7.2.b FRUs 168 12000 241.92 A.8.1. 7.2.c Non FRU SDH/ CHC - A.8.1. 7.2.d 24 X 7 PHC - A.8.1. 7.2.e Non- 24 X 7 PHCs - A.8.1. 7.2.f Other - A.8.1. 7.3 OT technicians/assitsan ts 184 24000 264.96 104.33 Approved for in- position OT Technicians @ Rs.10800/-m, as per last year achivements/expendit ure. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 97 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1. 7.3.a DH 16 12000 23.04 A.8.1. 7.3.b FRUs 168 12000 241.92 A.8.1. 7.3.c Non FRU SDH/ CHC - A.8.1. 7.3.d 24 X 7 PHC - A.8.1. 7.3.e Non- 24 X 7 PHCs - A.8.1. 7.3.f Other - A.8.1. 7.4 School health teams (Exclusively for SH) 1352 10800 0 1,593.9 0 - The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.8.1. 7.4.a MOs 571 30000 1,027.8 0 A.8.1. 7.4.b LTs 7 12000 5.04 A.8.1. 7.4.c Dental Technicians 7 12000 5.04 A.8.1. 7.4.d Ophthalmic Assistants 7 15000 6.3 A.8.1. 7.4.e Staff Nurse 14 15000 12.6 A.8.1. 7.4.f Pharmacists 373 12000 268.56 A.8.1. 7.4.g ANMs 373 12000 268.56 A.8.1. 7.4.h MPW - A.8.1. 7.5 Counsellors 54 24660 73.19 15.55 A.8.1. 7.5.1 RMNCH/FP Counselors 24 32.11 0 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 98 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.8.1. 7.5.2 ARSH Counselors 24 10800 31.1 15.55 Existing ARSH counsellors and 2 nutritional counsellors for NRCs @ Rs. 10800/-. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1. 7.5.3 Honorarium to ICTC counselors for ARSH activities - A.8.1. 7.5.4 Other (please specify) - A.8.1. 7.6 All Technical HR for State Specific Initiatives - A.8.1. 7.7 Others (pl specify) 6 13860 9.98 - Not approved, State to use existing staff regular as well as contractual A.8.1. 7.8 Staff for Training Institutes/ SIHFW/ Nursing Training - A.8.1. 8 Incentive/ Awards etc. to SN, ANMs etc. 10 0 Activity Dropped A.8.1. 9 Human Resources Development (Other than above) 57 83.35 25.34 11 sister tutors @Rs14400 and 22 PHNs @Rs12000 approved. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1. 10 Other Incentives Schemes (Pl.Specify) 672 2000 13.44 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 99 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) A.8.1. 10.1 Honorarium for Pediatric ECO, ENT Specialist, Orthopediatrician, Opthalmologist, Psychatrist 672 2000 13.44 0 The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.8.1. 11 Support Staff for Health Facilities 28 13860 39.95 1.68 A.8.1. 11.a DH No. 22 13860 36.59 A.8.1. 11.b FRUs - A.8.1. 11.c Non FRU SDH/ CHC - A.8.1. 11.d 24 X 7 PHC - A.8.1. 11.e Non- 24 X 7 PHCs - A.8.1. 11.f SNCU/ NBSU/ NBCC/ NRC etc 6 3.36 1.68 Approved for cook and attendant for NRCs. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. Sub-total HR 6806 99752 0 11,280. 91 3,575.7 4 B9 Mainstreaming of AYUSH 1349 96000 3,480.4 8 752.96 B.9.1 Medical Officers at CHCs/ PHCs (Only AYUSH) 712 60000 2,563.2 0 523.008 B.9.1 .1 DH - B.9.1 .2 FRUs - B.9.1 .3 Non FRU SDH/ CHC - B.9.1 .4 24 X 7 PHC 200 30000 720 523.008 Approved for 454 in position AYUSH doctors @ Rs 19,200 B.9.1 Non- 24 X 7 PHCs/ 512 30000 1,843.2 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 100 - S. No. Budget Head Unit of Meas ure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed Remarks (Rs in Lakhs) .5 APHCs 0 per month for 6 months. 90 AYUSH doctors may be engaged under RBSK team. New HR not approved. B.9.2 Other Staff Nurses and Supervisory Nurses/ AYUSH pharmacists (Only AYUSH) 637 36000 917.28 249.48 B.9.2 .1 DH - B.9.2 .2 FRUs - B.9.2 .3 Non FRU SDH/ CHC - B.9.2 .4 24 X 7 PHC 200 12000 288 229.95 Approved 365 in position Dawasaaz @ 10,500 per month for this FY for 6 months. B.9.2 .5 Non- 24 X 7 PHCs 198 12000 285.12 B.9.2 .6 Urban Clinics/ Health Posts - B.9.2 .7 Other 239 12000 344.16 0 New HR not approved. B9.3 Other Activities (Excluding HR) 0 0 - B9.4 Training - Grand Total HR 14761.3 9 4328.7 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 101 - ROAD MAP FOR PRIORITY ACTION: PROGRAMME MANAGEMENT A full time Mission Director is a prerequisite. Stable tenure of the Mission Director (minimum 3 years) should also be ensured. A regular full time Director/ Joint Director/ Deputy Director (Finance) (depending on resource envelope of State), from the State Finance Services not holding any additional charge outside the Health Department must be put in place, if not already done, considering the quantum of funds under NRHM and the need for financial discipline and diligence. Regular meetings of state and district health missions/ societies. Key technical areas of RCH to have a dedicated / nodal person at state/ district levels; staff performance to be monitored against targets and staff sensitized across all areas of NRHM such that during field visits they do not limit themselves only to their area of functional expertise. Performance of staff to be monitored against benchmarks; qualifications, recruitment process and training requirements to be reviewed. Delegation of financial powers to district/ sub-district levels in line with guidelines should be implemented. Funds for implementation of programmes both at the State level and the district level must be released expeditiously and no delays should take place. Evidence based district plans prepared, appraised against pre determined criteria; district plans to be a “live” document. Variance analysis (physical and financial) reports prepared and discussed/action taken to correct variances. Supportive supervision system to be established with identification of nodal persons for districts; frequency of visits; checklists and action taken reports. Remote/ hard to reach/ high focus areas to be intensively monitored and supervised. An integrated plan and budget for providing mobility support to be prepared and submitted for review/approval; this should include allocation to State/ District and Block Levels. All facilities to maintain visitors registers. All supervisors should write their main observations and agreed action/recommendation. Supervisors should sign with their name and post (written legibly) with date of visit. All LHV positions to be filled on a priority basis. The block PHN and DPHN to be part of block and district programme management unit respectively. Similarly a Nursing nodal person to be a part of SPMU. Nursing to be made an integral part of all planning, implementation and monitoring activities. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 102 - DETAILED BUDGET: PROGRAMME MANAGEMENT S. No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) A.10 PROGRAMME MANAGEMENT 1561 213322 1,493.81 476.43 Approval for Programme Management staff is being granted for six months only and its continuation for the next six months would be contingent on compliance of condition that Performance Measurement system is set up and implemented to monitor performance of regular and contractual staff. A.10. 1 Strengthening of State society/ State Programme Management Support Unit 78 110880 382.88 145.84 Contractual Staff for SPMSU recruited and in position 78 110880 382.88 145.84 A.10. 1.1 State Programme Manager 1 31500 3.78 145.84 Due to limited resource envelop, approved is being given only for in- position staff at last year's rate (based on the last year expenditure). Including HR, Management cost, Mobility Support etc.) A.10. 1.2 State Accounts Manager 1 25200 3.02 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 103 - S. No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) A.10. 1.3 State Finance Manager 1 31500 3.78 State may also opt for Associate Programme Manager on deputation. (Assistant Director (P&S) and Administrative Officer may be engaged against the positions approved under Associate programme managers). Director (Planning & Statistics) may be engaged against the position of Facilitators. A.10. 1.4 State Data Manager 1 22680 2.72 A.10. 1.5 Consultants/ Programme Officers (including for MH/CH/FP/ PNDT/ AH including WIFS SHP, MHS etc.) 2 6.8 Approval is being granted for six months only with the above mentioned condition. A.10. 1.6 Programme Assistants 14 73.2 A.10. 1.7 Accountants - A.10. 1.8 Data Entry Operators - A.10. 1.9 Support Staff (Kindly Specify) 32 80.68 A.10. 1.10 Salaries for Staff on Deputation (Please specify) 26 198.6 A.10. 1.11 Others (Please specify) 0 0 10.29 A.10. 1.11. 1 Contractual staff at divisional level 10.29 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 104 - S. No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) A.10. 1.11. 2 Mobility support,OE,TA/DA, Montly Review meeting, Purchase of computers at state level & Divisional level etc A.10. 2 Strengthening of District society/ District Programme Management Support Unit 241 63772 161.65 78.78 Contractual Staff for DPMSU recruited and in position 241 63772 161.65 78.78 A.10. 2.1 District Programme Manager 22 20790 54.89 78.78 Due to limited resource envelop, approved is being given only for in- position staff at last year's rate (based on the last year expenditure). Including HR, Management cost, Mobility Support etc.) A.10. 2.2 District Accounts Manager 22 16632 43.91 A.10. 2.3 District Data Manager 22 13860 36.59 Approval is being granted for six months only with the above mentioned condition. A.10. 2.4 Consultants/ Programme Officers (Kindly Specify) - A.10. 2.5 Accountants - A.10. 2.6 Data Entry Operators 7 11340 4.76 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 105 - S. No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) A.10. 2.7 Support Staff (Kindly Specify) 14 15.03 The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.10. 2.8 Others (Please specify) 0 154 1150 6.47 A.10. 2.8.1 OE, Mobility support for DPMUs A.10. 2.8.2 Mobile Charges for CMO for monitoring @ Rs. 500/month 22 500 1.32 A.10. 2.8.3 Mobile charges for District Nodal Officers for different schemes(Dy. CMO, DHO, DIO) @ Rs. 400 per month 66 400 3.17 A.10. 2.8.4 Mobile Charges for DPMUs @ Rs. 250 per month 66 250 1.98 A.10. 2.8.5 - A.10. 3 Strengthening of Block PMU 1219 28670 424.65 206.72 A.10. 3.1 Block Programme Manager - 206.72 Due to limited resource envelop, approved is being given only for in- position staff at last year's rate (based on the last year expenditure). Including HR, Management cost, Mobility Support etc.) A.10. 3.2 Block Accounts Manager 117 13860 194.59 A.10. 3.3 Block Data Manager 117 13860 194.59 Approval is being granted for six months only with the above mentioned Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 106 - S. No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) condition. A.10. 3.4 Accountants - A.10. 3.5 Data Entry Operators - A.10. 3.6 Support Staff (Kindly Specify) - A.10. 3.7 Others (Please specify) 985 950 35.46 A.10. 3.7.1 OE, Mobility support for BPMUs A.10. 3.7.2 Mobile Charges for BMO for monitoring @ Rs. 400/month No. 117 400 5.62 A.10. 3.7.3 Mobile charges for Incharge MO PHC/AD @ Rs 300/month No. 634 300 22.82 A.10. 3.7.4 Mobile Charges for BPMUs @ Rs. 250 per month No. 234 250 7.02 A.10. 4 Strengthening (Others) 0 0 40 10 A.10. 4.1 Workshops and Conferences - A.10. 4.2 Rent for Divisional Office 40 10 Approved. A.10. 4.3 Tally ERP - A.10. 5 Audit Fees 7.5 7.5 Approved. A.10. 6 Concurrent Audit system 23 10000 27.6 27.6 Approved. A.10. 7 Mobility Support, Field Visits 0 0 449.54 - A.10. 7.1 SPMU/State 250.16 Approved under FMR 10.1 A.10. 7.2 DPMU/District 66 Approved under FMR 10.2 A.10. 7.3 BPMU/Block 133.38 Approved under FMR 10.3 A.10. 7.4 Other Supportive Supervision costs - - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 107 - S. No. Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approve d Remarks (Rs in Lakhs) Sub-total Programme Management 1561 213322 1,493.81 476.43 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 108 - MISSION FLEXIBLE POOL (MFP) Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 109 - ASHA TARGETS: S. No. Activity Targets 1. ASHAs with Drug kits 9500 2. ASHAs trained in 6 th and 7 th modules Round 1: Training being started Target for Round 2- 12000 ASHA ROAD MAP FOR PRIORITY ACTION: Clear criteria for selection of ASHA Well functioning ASHA support system including ASHA days, ASHA coordinators Performance Monitoring system for ASHAs designed and implemented (including analysis of pattern of monthly payments; identification of non/under-performing ASHAs and their replacement; and reward for well performing ASHAs). State to report on a quarterly basis on ASHA’s average earnings/ range per month. Timely replenishment of ASHA kits. Timely payments to ASHAs and move towards electronic payment. Detailed data base of ASHAs created and continuously updated; village wise name list of ASHA to be uploaded on website with address and cell phone number. DETAILED BUDGET: FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B1 ASHA 302144 308600 1,108.14 B 1.1 ASHA Cost: 302144 308600 1108.14 483.255 Approved 50% of the approved activities. I.e. Rs 483.255 lacs. The activities are approved at last year's unit cost. Incentives to ASHA facilitator for conducting cluster meetings, Awards t ASHA/Link Worker, ASHA Resource Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 110 - FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks Center - Not approved. B1.1.1 Selection & Training of ASHA 60 90900 56.22 B1.1.1.1 Module I - IV No of Batches (25 per batch) 60 90900 54.54 Approved with the condition that the training should be 8 days integrated induction module as per the present policy B1.1.1.2 Module V - B1.1.1.3 Module VI & VII - Approved state should share the details of training – no. of days and cost per batch. Shifted from A9.5.3.2 B1.1.1.4 Other Trainings 0 0 1.68 B1.1.1.4. 1 Training on HBNC for State Trainers (round 3rd) (7 participants) # 1.68 Approved B1.1.1.4. 2 Training on HBNC for ASHA DRP (round 2nd ) (9 batches 25 participants per batch) # No. of Batches (25 Person Per Batch) 9 174200 - Approved at last year's unit cost i.e. Rs 106000 per batch. Shifted from A.95.5.2.b B1.1.1.4. 3 Training of ASHA Facilitator Round 2nd (16 batches 30 participants per batch) # No. of Batches (30 Person Per Batch) 20 137475 - Approved at last year's unit cost i.e. Rs 90,000 per batch. Shifted from A.95.5.2.c B1.1.1.4. 4 Training of ASHA on HBNC Round 1 ( part 1 & 2) (125 Batches 25 per batch) - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 111 - FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B1.1.1.4. 5 Training of ASHA on HBNC Round 2 (173 Batches 25 per batch) - B1.1.2 Procurement of ASHA Drug Kit 12000 350 42 B1.1.2.1 New Kits - B1.1.2.2 Replenishment 12000 350 42 Approved under OPD head (B16.2.5.2) of General Drugs and Supplies subject to the condition; “State to replenish the drug kits from the PHC”. B1.1.2.3 Procurement of ASHA HBNC Kit 0 0 - B1.1.2.4 New Kits - B1.1.2.5 Replenishment - B1.1.3 Performance Incentive/Other Incentive to ASHAs (if any) 289687 180350 974.13 B1.1.3.1 Incentive under MH (ANC/PNC) 100000 250 250 B1.1.3.1. 1 Incentive to ASHA for full ANC No. of Instituti onal Deliveri es 100000 250 250 Approved Rs 50 lakhs @ Rs 50 for 1 lakh pregnant women as Incentive to ASHA for Registration within 12 weeks. Other incentives are a part of the JSY. B1.1.3.2 Incentive under CH (HBNC) 100000 250 250 B1.1.3.2. 1 Incentive to ASHA under HBNC No. of children visited by ASHA 100000 250 250 Approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 112 - FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B1.1.3.3 Incentive for FP( PPIUCD/others) 0 0 - B1.1.3.4 Incentive for AH - B1.1.3.5 Other incentive 65550 166250 315.13 B1.1.3.5. 1 Incentive to ASHA for event reporting - B1.1.3.5. 2 Monthly Meeting of ASHAs (Travel Expense/refres hment) 12000 1200 144 Approved at ongoing unit cost i.e. @ 75 per meeting B1.1.3.5. 3 Incentive for registration of Births 50000 100 50 Approved at ongoing unit cost i.e. @ Rs 50 per birth B1.1.3.5. 4 Incentive for registration of Deaths 3000 100 3 Approved at ongoing unit cost i.e. @ Rs 50 per death B1.1.3.5. 5 Incentive to ASHA for managing ASHA help desk @ Rs. 150 for 8 hours for 365 days (365X150X3) 50 164250 82.13 Approved for ongoing 30 ASHA Grehs. B1.1.3.5. 6 Incentive to ASHA Facilitator for conducting cluster meetings 500 600 36 0 Not Approved B1.1.3.6 Other (support provisions to ASHA such as uniform, diary, ASHA Ghar etc) 24137 13600 159 B1.1.3.6. 1 ASHA Diary 12000 100 12 Approved B1.1.3.6. 2 ASHA help desk cum rest room in 20 level 3 MCH facilities 20 10000 2 Approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 113 - FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B1.1.3.6. 3 Uniforms to ASHA (2 sets of uniform, I-card, 1 sweater, 1 shawl in high focus districts @ Rs.1500.00 5000 1500 75 Approved at last year’s unit cost i.e. @ 1000 B1.1.3.6. 4 Uniforms to ASHA ( 2 sets of uniforms and I- card in other districts @ Rs. 1000.00)/ 7000 1000 70 Approved at last year’s unit cost i.e. @ 750 B1.1.4 Awards to ASHA's/Link workers 117 1000 1.17 Not approved B1.1.5 ASHA Resource Centre/ASHA Mentoring Group 280 36000 34.62 Not approved. B1.1.5.1 HR At State Level 2 5.64 Not approved. B1.1.5.2 HR at District Level 22 District Coordin ators 22 24000 5.28 Not approved. B1.1.5.3 HR at Block Level 117 Block Coordin ators 117 12000 14.04 Not approved. B1.1.5.4 Mobility Costs for ASHA Resource Centre/ASHA Mentoring Group (Kindly Specify) 139 9.66 Not approved. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 114 - UNTIED FUNDS/ RKS/ AMG ROAD MAP FOR PRIORITY ACTION: Timely release of untied funds to all facilities; differential allocation based on case load. Funds to be utilized by respective RKS only and not by higher levels. Review of practice of utilising RKS funds for procurement of medicines from commercial medical stores and accordingly revisit guidelines for fund utilisation by RKS. Well functioning system for monitoring utilization of funds as well as purposes for which funds are spent. Plan for capacity building of RKS members developed and implemented. RKS meetings to take place regularly. Audit of all untied, annual maintenance grants and RKS funds. The State must take up capacity building of Village Health & Sanitation Committees Rogi Kalyan Samitis and other community! PRI institutions at all levels The State shall ensure regular meetings of all community Organizations! District ! State Mission with public display of financial resources received by all health facilities The State shall also make contributions to Rogi Kalyan Samitis BUDGET: S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Proposed ( Rs in lacs) Amount Approved Remarks (Rs in Lakhs) B2 Untied Funds 9811 145000 1111.85 234.06 B2.1 Untied Fund for CHCs/SDH 84 50000 42 18.4 Approved for 84 CHCs as per 3rd quarter utilization i.e. 43.82% B2.2 Untied Fund for PHCs 637 25000 159.25 68.71 Approved for 637 facilities as per list provided by State and as per 3rd Quarter utilization i.e. 43.15%. B2.3 Untied Fund for Sub Centres 2265 10000 226.5 58.14 Approved for 2265 facilities as per list provided by State and as per 3rd Quarter utilization i.e. 25.67%. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 115 - B2.4 Untied fund for VHSC 6821 10000 682.1 86.81 Approved for 6062 VHS&NC where joint accounts have been opened As per MIS December 2012 and as per utilization i.e. 14.32%. B2.5 Others 4 50000 2 2 Approved (MCH Sopore is new) B.3 Annual Maintenance Grants 1426 260000 410.5 132.26 B3.1 CHC 83 100000 83 35.84 Approved for 83 CHCs as per RHS 2012 @ 3rd quarter utilization i.e. 43.19%. B3.2 PHCs 474 50000 237 77.91 Approved for 451 facilities (325 PHC and 126 NTPHC) as per 3rd quarter utilization i.e. 34.55% B3.3 Sub Centres 865 10000 86.5 16.78 Approved for 841 facilities (644 SHC and 197 NTSHC) as per 3rd quarter utilization i.e. 19.95% B3.6 Other 4 100000 4 1.73 Approved for 4 Hospitals. New is MCH Sopore B.6 Corpus Grants to HMS/RKS 749 800000 845 277.4573 B6.1 District Hospitals 24 500000 120 46.992 Approved for 22 DH as per 4th quarter utilization i.e. 42.72% B6.2 CHCs 84 100000 84 36.5117 Approved for83 CHC as per 4th quarter utilization i.e.43.99% B6.3 PHCs 637 100000 637 192.2448 Approved for 528 facilities (385 PHCs and 143 NTPHCs) as per 4th quarter utilization i.e.36.41% B6.4 Other or if not bifurcated as above 4 100000 4 1.7088 Approved for 4 hospitals as per 4th quarter utilization i.e. 42.72% B6.5 SDH - Grand Total Funds 2367.35 643.7773 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 116 - NEW CONSTRUCTIONS/ RENOVATION AND SETTING UP ROAD MAP FOR PRIORITY ACTION: Works must be completed within a definite time frame. For new constructions upto CHC level, a maximum of two and a half years and for a District Hospital a maximum period of 3 and a half years is envisaged. Renovation/ repair should be completed within a year. Requirement of funds should be projected accordingly. Funds would not be permissible for constructions/ works that spill over beyond the stipulated timeframe. Standardized drawing/ detailed specifications and standard costs must be evolved keeping in view IPHS. Third party monitoring of works through reputed institutions to be introduced to ensure quality. Information on all ongoing works to be displayed on the NRHM website Approved locations for constructions/ renovations will not be altered All government health institutions in rural areas should carry a logo of NRHM as recognition of support provided by the Mission in English/ Hindi & Regional languages. BUDGET: S. No. Budget Head Unit of Measur e Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks B5 New Constructions (proposed for the coming year) 10 510000 0 137 0 B5.1 CHCs B5.2 PHCs B5.3 SHCs/Sub Centres 7 35 0 Approval pended in view of limited resource envelope Opening of New Sub Centres No. 400 333200 0 Approval pended. State to provide the list of sub Centers. B5.4 Setting up Infrastructure wing for Civil works 0 0 - B5.6 Construction of BEmONC and CEmONC centres 2 510000 0 102 0 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 117 - S. No. Budget Head Unit of Measur e Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks B.5.6.1 Absolutely new SNCU/NBSU/NBC C 2 510000 0 102 0 Not approved in view of limited resource envelope. B.5.10 Infrastructure of Training Institutions -- 0 0 - B.5.11 SDH - B.5.12 DH - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 118 - PROCUREMENT ROAD MAP FOR PRIORITY ACTION: Strict compliance of procurement procedures for purchase of medicines, equipments etc as per state guidelines. Online real time inventory management to be practiced. Competitive bidding through open tenders and transparency in all procurements to be ensured. Only need based procurement to be done strictly on indent/requisition by the concerned facility. Procurement to be made well in time & not to be pushed to the end of the year. Audit of equipment procured in the past to be carried out to ensure rational deployment. Annual Maintenance Contract (AMC) to be built into equipment procurement contracts. A system for preventive maintenance of equipment to be put in place. BUDGET: FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B.16 PROCUREMENT 6941405 3 55453 5 4,055.66 696.3 B16.1 Procurement of Equipment 2578 45445 0 528.84 94.48 B16.1.1 Procurement of equipment: MH 0 0 - B16.1.1.1 Equipments for Blood Banks/ BSUs - B16.1.1.2 MVA /EVA for Safe Abortion services - B16.1.1.3 Others (please specify) 0 0 - B16.1.2 Procurement of equipment: CH 0 0 - B16.1.2.1 Procurement of equipment: CH (NBCC @ Rs. 85000 X 50) B16.1.2.2 Procurement of equipment: CH for strengthening of the paediatrics department SMGS hospital Jammu and GB Pant Hospital Srinagar (Training Centre) - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 119 - FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks project submitted B16.1.3 Procurement of equipment: FP 2529 45360 0 94.94 94.06 B16.1.3.1 NSV kits 110 1600 1.76 0.88 Approved @ Rs 800 per kit for 110 kits. B16.1.3.2 IUCD kits 2409 2000 48.18 48.18 Approved B16.1.3.3 minilap kits - B16.1.3.4 laparoscopes 10 45000 0 45 45 Approved B16.1.3.5 PPIUCD forceps - B16.1.3.6 Other (please specify) 0 0 - B16.1.4 Procurement of equipment: IMEP 0 0 - B16.1.5 Procurement of equipment other than above - B16.1.5.1 Procurement of OT Equipments - B16.1.6 Equipments for ARSH/ School Health 49 850 433.9 0.42 B16.1.6.1 Equipments for ARSH Clinics 49 850 0.42 0.42 Approved B16.1.6.2 Equipments for School Health Equipments for School Health Screening (weighing scale, Height measurement scale and Snellens’ Charts) 433.48 0 RBSK proposal is kept pended in view of limited RE. B16.1.7 Equipments for Training Institutes - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 120 - FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B16.1.8 Equipments for AYUSH - B16.1.9 Procurement of Others/Diagnostic s - B.16.2 Procurement of Drugs and supplies 6941147 5 10008 5 3,526.82 601.82 B.16.2.1 Drugs & supplies for MH 0 0 - B.16.2.1. 3 Others (Please specify) 0 0 - B.16.2.2 Drugs & supplies for CH 4811405 84 387.42 387.42 B.16.2.2. 1 IFA tablets and De-worm tablets for students studying in primary school 6th to 12th class teachers, General IFA Tablets and Deworming tablets under School health - B.16.2.2. 2 IFA KID tablets 52 doses of 1 ml syrup for each child 1644813 14 230.27 230.27 Approved B.16.2.2. 3 Procurement of ORS packets No. of packets 1879033 2.25 42.28 42.28 Approved B.16.2.2. 4 Procurement of zinc tablets 1252689 7.5 93.95 93.95 Approved B.16.2.2. 5 Procurement of vitamin A syrup No. of bottles 34870 60 20.92 20.92 Approved B.16.2.3 Drugs & supplies for FP 0 0 - B.16.2.4 Supplies for IMEP 0 0 100 0 B.16.2.4. 1 For colour bags, bins, needle destroying units, transportation trollies, Hypochlorite solution etc. 100 0 Not Approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 121 - FMR. Code. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B.16.2.5 General drugs & supplies for health facilities 0 0 800 42 Not approved. B.16.2.5. 1 IPD 800 0 Replenishment of ASHA drug kits 42 B.16.2.5. 2 OPD - B.16.2.6 Drugs & supplies for WIFS 6460000 0 1 142.4 142.4 B.16.2.6. 1 IFA No. of tablets + 20% buffer stock 6240000 0 0.2 124.8 124.8 Approved B.16.2.6. 2 Albendazole No. of tablets + 10% buffer stock 2200000 0.8 17.6 17.6 Approved B.16.2.7 Drugs & supplies for SHP No. of districts x 10 months 70 10000 0 70 30 Rs 30 lakhs is approved to procure medicines of Rs 16000 per team and Rs 8000 for once refill. Conditionalit y State to procure medicines only in accordance to the RBSK EDL to be announced from GoI. B.16.2.8 Drugs & supplies for UHCs - B.16.2.9 Drugs & supplies for AYUSH 2,027.00 0 Not approved. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 122 - REFERRAL TRANSPORT ROAD MAP FOR PRIORITY ACTION: Free referral transport to be ensured for all pregnant women and sick neonates accessing public health facilities. Universal access to referral transport throughout the State, including to difficult and hard to reach areas, to be ensured. A universal toll free number to be operationalized and 24x7 call centre based approach adopted. Vehicles to be GPS fitted for effective network and utilization. Rigorous and regular monitoring of usage of vehicles to be done Service delivery data to be regularly put in public domain on NRHM website. All patient/referral transport vehicles engaged under NRHM to be branded as National Ambulance Service and NRHM logo should be used extensively. BUDGET: FMR Code Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B12 Referral Transport/Patient transport System 8 14062 1 1,382.3 9 16.87 Approval Pended subject to State implementing ‘National Ambulance Guidelines’ for all the running ambulances under NRHM B12.1 Ambulance/EMRI Capex 0 0 400 Since there is no further requirement of new ambulances, NPCC has not approved the activity. B12.1. 1 State basic ambulance/ 102 Capex - B12.1. 2 Advanced life support Capex - B12.1. 3 EMRI Capex-BLS 400 B12.1. 4 EMRI Capex-ALS - B12.2 Operating Cost /Opex for ambulance 8 14062 1 982.39 16.87 B12.2. 1 State basic ambulance/102 Opex 1 14062 1 16.87 16.87 Rs 16.87 lakhs is recommended for approval for setting up two Regional Call Centres for 102. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 123 - FMR Code Budget Head Unit of Meas ure Quanti ty / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks (Centralised call centre) subject to sharing the costing details. B12.2. 2 Operating Cost /Opex for ASL ambulance - B12.2. 3 Opex EMRI-BLS 750 B12.2. 4 Opex EMRI-ALS - B12.2. 5 HR Basic ambulance - B12.2. 6 HR advanced life support ambulances - B12.2. 6 Training/orientati on - B12.2. 7 Call centre-capex 30 B12.2. 8 call centre-opex 132 B12.2. 9 Others 7 0 53.52 B12.2. 9.1 Procurement of Ambulances - B12.2. 9.2 Procurement of Boat Ambulances 1 ALS and 1 BLS for providing emergency care services for the people of Dal Lake area No. of Ambul ances 2 48 B12.2. 9.3 HR for Boat Ambulances No. of Perso ns 5 5.52 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 124 - MAINSTREAMING OF AYUSH ROAD MAP FOR PRIORITY ACTION: State to co-locate AYUSH in district hospitals and provide post graduate doctors for at least two streams: Ayurveda and homoeopathy (or Unani, siddha,Yoga as per the local demand). Panchakarma Unit should also be considered. OPD in Ayush clinics will be monitored alongwith IPD/OPD for the facility as a whole. The AYUSH pharmacist/compounder to be engaged only in facilities with a minimum case load. Adequate availability of AYUSH medicines at facilities where AYUSH doctors are posted to enable them to practice their own system of Medicine without difficulty. At CHCs and PHCs any one system viz., Homeopathy/Ayurveda/ Unani/Sidha to be considered depending on local preference. At CHC/PHC level, Post-Graduate Degree may not be insisted upon. District Ayurveda Officer should be a member of District Health Society in order to participate in decision making with regard to indent, procurement and issue of AYUSH drugs. Infrastructure at facilities proposed to be collocated would be provided by Department of Ayush. Those PHC/CHC/Sub-Divisional hospitals which have been identified as delivery points under NRHM should be given priority for collocation of Ayush as these are functional facilities with substantial footfalls. Ayush medical officers should increasingly be involved in the implementation of national health programmes and for the purpose of supportive supervision and monitoring in the field. They should be encouraged to oversee VHND and outreach activities and in addition programmes such as school health, weekly supplementation of iron and folic acid for adolescents, distribution of contraceptives through ASHA, menstrual hygiene scheme for rural adolescent girls etc. Ayush medical officer should also be member of the RKS of the facility and actively participate in decision making. AYUSH doctors need to be provided under NRHM first in the remotest locations and only thereafter in better served areas. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 125 - BUDGET: FMR. Code. Budget Head Unit of Measur e Quanti ty / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approved ( Rs in lacs) Remarks B9 Mainstreamin g of AYUSH 1349 96000 3,480.48 752.96 B.9.1 Medical Officers at CHCs/ PHCs (Only AYUSH) 712 60000 2,563.20 523.008 B.9.1.1 DH - B.9.1.2 FRUs - B.9.1.3 Non FRU SDH/ CHC - B.9.1.4 24 X 7 PHC 200 30000 720 523.008 Approved for 454 in position AYUSH doctors @ Rs 19,200 per month for 6 months. 90 AYUSH doctors may be engaged under RBSK team. New HR not approved. B.9.1.5 Non- 24 X 7 PHCs/ APHCs 512 30000 1,843.20 B.9.2 Other Staff Nurses and Supervisory Nurses/ AYUSH pharmacists (Only AYUSH) 637 36000 917.28 249.48 B.9.2.1 DH - B.9.2.2 FRUs - B.9.2.3 Non FRU SDH/ CHC - B.9.2.4 24 X 7 PHC 200 12000 288 229.95 Approved 365 in position Dawasaaz @ 10,500 per month for this FY for 6 months. B.9.2.5 Non- 24 X 7 PHCs 198 12000 285.12 B.9.2.6 Urban Clinics/ Health Posts - B.9.2.7 Other 239 12000 344.16 0 New HR not approved. B9.3 Other Activities (Excluding HR) 0 0 - B9.4 Training - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 126 - IEC/BCC ROAD MAP FOR PRIORITY ACTION: Comprehensive IEC/ BCC strategy prepared. IPC given necessary emphasis and improved inter- sectoral convergence particularly with WCD. BUDGET: FMR. Code. Budget Head Unit of Measur e Quantit y / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B10 IEC-BCC NRHM 3334 3345 0 394.82 90 B.10 Strengthening of BCC/IEC Bureaus (state and district levels) 0 0 - 90 Rs 90 lacs approved for IEC (Rs 3 lacs/district for 11 districts and Rs 1 lac/district for 12 districts and the same amount at the state level. Activity at FMR A.7.2.7 i.e. Debates, seminars at universities/college s for PNDT approved. B.10.1 Development of State BCC/IEC strategy - B.10.2 Implementatio n of BCC/IEC strategy 3158 2445 0 217.31 B.10.2.1 BCC/IEC activities for MH 654 2315 0 37.03 B.10.2.1. 1 Mass media 150 2250 0 33.75 B.10.2.1. 2 Mid-media 504 650 3.28 B.10.2.2 BCC/IEC activities for CH 2000 650 13 B.10.2.2. 1 Mass media B.10.2.2. 2 Mid-media 2000 650 13 B.10.2.3 BCC/IEC activities for FP 504 650 3.28 B.10.2.3. 1 Mass media B.10.2.3. 2 Mid-media 504 650 3.28 B.10.2.4 BCC/IEC activities for ARSH 0 0 53.62 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 127 - B.10.2.4. 1 Mass media - B.10.2.4. 2 Mid-media 53.62 B.10.2.5 Other activities (please specify) 110.38 B.10.2.6 IPC initiatives/tools - B.10.3 Health Mela - B.10.4 Creating awareness on declining sex ratio issue 53.39 B.10.5 Other activities 176 9000 124.12 B.10.5.1 Printing of MCP cards, safe motherhood booklets etc - B.10.5.2 Printing of WIFS cards etc - B.10.5.3 Other printing 176 9000 124.12 B.10.5.3. 1 Promotion and propagation and AYUSH Units at PHCs & LHTs 20 B.10.5.3. 2 Issue of press Advertisement in print media throught information department 12 B.10.5.3. 3 Display of scroll with nine slogans from 4 cable networks of Jammu & Srinagar cities with atleast 30 displays per day @ Rs.8000/- per scroll per month. 48 9000 4.32 B.10.5.3. 4 NRHM Sammelans at block / Halqa Panchayat levels 128 34.4 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 128 - B.10.5.3. 5 Miscellaneous IEC/BCC activites 53.4 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 129 - MONITORING AND EVALUATION (HMIS)/MCTS ROAD MAP FOR PRIORITY ACTION MONITORING AND EVALUATION HR and Infrastructure. For optimum utilisation of resources, State should integrate manpower, infrastructure, trainings, reviews, field visit etc for HMIS & MCTS since in most cases the persons to be trained, called for reviews and making field visits are same HMIS data reporting, improving data quality and its use State to ensure that 100 % HMIS facility wise data is uploaded, validated and committed; data for the month should be available by the 15 th of the following month Mission Director and Program Managers at all level to use HMIS data for monthly reviews. SAS software may be extensively used for State level analysis and feedback to be shared with GOI Regular field visits for trouble shooting, Data quality checks, clarification of conceptual issues regarding HMIS. Capacity building (Online/offline training, Refreshers training, Workshop etc) to be conducted as proposed in PIP Involvement of Regular Statistical Officials along with contractual staff for monitoring and data quality checks. Regular feedback on HMIS and MCTS to district/Blocks/facilities to be ensured. HMIS formats are under rationalization, so Printing of formats, registers may only be done after consulting MOHFW. Registration of Births and deaths: Strengthen birth and deaths registration and issue birth certificates before discharge from facility and ensure information flow from lower levels to chief registrar of births and deaths Improve reporting of births and deaths (especially deaths) in HMIS portal. MCTS: ROAD MAP FOR PRIORITY ACTION States/ UTs are requested to ensure the implementation of village wise integrated RCH Register from 2013 in the State. The newly designed Register has already been shared with States/UTs. Aadhaar number and bank details of all the pregnant women and health workers (ANM, ASHA) should be captured in MCTS portal for providing the JSY benefits to the beneficiaries. State may establish a dedicated Call Centre for validating the records of the beneficiaries, informing them about Government Schemes and promoting for availing the due services on time. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 130 - State may ensure that all the health facilities are timely receiving the Work-plan for necessary follow-up and providing the services to the beneficiaries accordingly. State may ensure for universal coverage from all the health facilities and private institutions including urban areas on MCTS Portal. Also ensure for 100 % qualitative, timely reporting and updating of services delivery records from all the health institutions including private facilities on MCTS Portal. State may advise DMHO and BMHO for continuous monitoring, field visit and taking of corrective action based on MCTS information and ensure for using of MCTS data for policy formulation, micro planning at different levels and redressal of bottlenecks pertaining to various programs and schemes. BUDGET: FMR Code Budget Head Unit of Measu re Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B15 Planning, Implementation and Monitoring 14574 320240 991.48 279.19 B15.1 Community Monitoring (Visioning workshops at state, Dist, Block level) 0 0 - B15.2 Quality Assurance 0 0 - B15.3 Monitoring and Evaluation 14574 320240 991.48 279.19 B15.3 .1 Monitoring & Evaluation / HMIS /MCTS 152 23940 207.14 51.44 B15.3 .1.1 HR for M&E/HMIS/MCTS 2 12600 3.02 1.44 Approved 1.44 lakhs for 2 HMIS fellow at existing salary @ 12000 per month for six months. B15.3 .1.5 Data Entry Operators 150 11340 204.12 50 the activity of data entry is approved. However, the work is to be carried out on task rate basis and no post is to be created. B15.3 .1.6 Others (Please specify) 0 0 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 131 - FMR Code Budget Head Unit of Measu re Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B15.3 .1.6.1 Boats for mointoring and outreach actvities in Dal Lake- Srinagar - B15.3 .1.6.2 V-Sat for difficult districts where internet connectivity is a problem- Leh, Kargil, Poonch & Rajouri - B15.3 .2 Computerization HMIS and e- governance, e- health 496 50750 366.63 35.05 B15.3 .2.1.a HMIS Operational Cost (excluding HR & Trainings) - B15.3 .2.1.b Procurement of Computers/ printers/ cartridges etc. 139 50000 69.5 0 Approval pended. B15.3 .2.1.c Maintenance of Computers/ AMC/ etc. 2.5 0 Not approved since details like number of computers for which AMC is required, the unit cost of computer & whether these computers are being used for HMIS/MCTS related work have not been provided. B15.3 .2.1.d Other Office and admin expenses 357 750 294.63 35.05 B15.3 .2.1.d .1 Mobility Support for M&E 257.5 2.45 Approved 2.45 lakhs @ Rs 10000 per district and Rs 25000 for State level per annum as per the norms of Mobility Support. Amount approved is indicative figure and actual amount Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 132 - FMR Code Budget Head Unit of Measu re Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks would be based on actual expenditure. Salient observations to be shared with MOHFW. Visits to be undertaken only for HMIS/MCTS related work. B15.3 .2.1.d .2 Internet connectivity 357 750 32.13 32 Approved @ unit cost of 750 per month B15.3 .2.1.d .3 Consumables at State level 2.5 0.3 Approved Rs 0.30 Lakh @ Rs 2500 per month. Procurement should be on the basis of competitive bidding and following Government Protocols B15.3 .2.1.d .4 Consumables at divisional level 2.5 0.3 Approved Rs 0.30 Lakh @ Rs 2500 per month for all Divisions combined. Procurement should be on the basis of competitive bidding and following Government Protocols B15.3 .2.1.d .5 Consumables at PHCs and NTPHCs - B15.3 .2.2.a MCTS Operational Cost (excluding HR & Trainings) 0 0 - B15.3 .3 Other M & E Activities 13926 245550 417.71 192.7 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 133 - FMR Code Budget Head Unit of Measu re Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B15.3 .3.4 Review Meetings for HMIS 2 100000 2 2 Approved for one day combined review for HMIS and MCTS for at least 2 reviews per year at state levels, at least 1 review per quarter at district level and at least 1 review per month at block level. Expenditure will be as per extant rule. State must share the outcomes of the meetings with MoHFW and may involve PRCs in the same B15.3 .3.5 Review Meetings for MCTS - B15.3 .3.6 Data Validation Call Centers - CAPEX B15.3 .3.7 Data Validation Call Centers - OPEX 8.44 0 Not approved. . B15.3 .3.8 e-Governance Initiative - B15.3 .3.9 Hospital Management Softwares 200 0 Pended. Details (features, functionalities, expenditure, outcomes etc.) may be shared. B15.3 .3.10 Others 13924 145550 207.27 190.7 B15.3 .3.10. 1 Printing of new registers approved by GoI 20 20 Approved for printing MCTS (Integrated RCH) register @ Rs 150 per register and not more than 2 registers per ANM and HMIS formats @ 0.40 paisa per page. Amount approved is Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 134 - FMR Code Budget Head Unit of Measu re Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks indicative figure and actual amount would be based on actual expenditure. Printing should be based on competitive bidding following Govt. Protocols. State may share a specimen of MCTS register / HMIS formats with MoHFW before proceeding with printing. B15.3 .3.10. 2 Mobile charges for ANM at sub- centres (Regular ANMs) for tracking of pregant women and children/mointorin g & Rs 100/- respctively per month) 1910 100 22.92 22.92 (On-going activity) Approved subject to the condition that mobile charges should be provided only for those ANMs whose mobile numbers are validated and updated on MCTS portal. Payment should be on the basis of the updation of records done by ANM. State may share the outcomes so far. Note: In future Mobile charge support will be provided to the State for the best performing ANMs only. Evaluation will be done based on the beneficiaries coverage reflected on the MCTS portal. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 135 - FMR Code Budget Head Unit of Measu re Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B15.3 .3.10. 3 Reimbursement of Mobile user charges of ASHA @ Rs 100 per month 12000 100 144 144 (On-going activity) Approved subject to the condition that mobile charges should be provided only for those ASHAs whose mobile numbers are validated and updated on MCTS portal. Payment should be on the basis of the updation of records done by ASHA. State may share the outcomes so far. Note: In future Mobile charge support will be provided to the State for the best performing ASHAs only. Evaluation will be done based on the beneficiaries coverage reflected on the MCTS portal. B15.3 .3.10. 4 Capity bulidings of CMOs / BMOs / DPMUs / BPMUs/ Data Entry Operators at PHC and New Type PHCs at Division level for re- orienation of HMIS and MCTS 28 batches of 35 participants each 14 145350 20.35 3.78 Approved Total cost of training 3 day combined training for HMIS and MCTS @ Rs 300 per day per person for 1 training per person per year. Amount approved is indicative figure and actual amount would be based on actual expenditure. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 136 - FMR Code Budget Head Unit of Measu re Quantity / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approv ed ( Rs in lacs) Remarks B15.3 .3.10. 5 Ongoing review of MCH tracking activities (2 Review meeting to be held after 6 months for both the Divisions headed by Secreatry / Mission Director to review HMIS / MCTS in both the Divisions ) - No budget has been proposed under this activity. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 137 - OTHERS BUDGET: HOSPITAL STRENGTHENING S. No. Budget Head Unit of Measur e Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks B.4 Hospital Strengthening 200 250000 0 7,140.00 0 B.4.1 Up gradation of CHCs, PHCs, Dist. Hospitals 200 250000 0 7,140.00 0 B4.1.1 District Hospitals 15 0 1,750.00 B4.1.1 .1 Additional Building/ Major Upgradation of existing Structure - B4.1.1 .2 Repair/ Renovation - B4.1.1 .3 Spillover of Ongoing Works 15 1,750.00 0 Approval pended. State to project ongoing proposals which were approved last year. B4.1.1 .4 Staff Quarters - B4.1.2 CHCs 39 0 2,218.13 0 B4.1.2 .1 Additional Building/ Major Upgradation of existing Structure 8 601.31 0 Approval pended in view of limited resource envelope. State may submit a comprehensive plan. B4.1.2 .2 Repair/ Renovation - B4.1.2 .3 Spillover of Ongoing Works 31 1,616.82 0 Approval pended. State to project ongoing proposals which were approved last year. B4.1.2 .4 Staff Quarters - B4.1.3 PHCs 35 0 570.5 0 B4.1.3 .1 Additional Building/ Major Upgradation of existing 4 40 0 Approval pended in view of limited resource envelope Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 138 - S. No. Budget Head Unit of Measur e Quantit y / Target Unit Cost ( Rs) Amount Propose d ( Rs in lacs) Amount Approve d (Rs in Lakhs) Remarks Structure B4.1.3 .2 Repair/ Renovation - B4.1.3 .3 Spillover of Ongoing Works 28 440.5 0 Approval pended. State to project ongoing proposals which were approved last year. B4.1.3 .4 Staff Quarters 3 90 0 Approval pended in view of limited resource envelope B4.1.4 Sub Centres 96 0 426.37 0 B4.1.4 .1 Additional Building/ Major Upgradation of existing Structure - B4.1.4 .2 Repair/ Renovation - B4.1.4 .3 Spillover of Ongoing Works 96 426.37 Approval pended. State to project ongoing proposals which were approved last year. B4.1.4 .4 ANM Quarters - B4.1.5 Others (MCH Wings) 15 250000 0 2,175.00 0 B4.1.5 .1 (Absolutely) New / Rented to Own Building 8 2,000.00 0 Activity is pended in view of limited resource envelope. B4.1.5 .2 Additional requirement from previous work - B4.1.5 .3 Carry forward /Spillover of Ongoing Works - B4.1.5 .4 Other construction 7 250000 0 175 0 B4.1.5 .4.1 Civil works for DEIC under RBSK No. 7 250000 0 175 0 RBSK is kept pended in view of limited Resource Envelope. B4.1.6 SDH 0 0 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 139 - BUDGET: HEALTH ACTION PLANS FMR Code Budget Head Quantity / Target Unit Cost ( Rs) Amount Proposed (Rs. In Lakhs) Amount Approved (Rs in Lakhs) Remarks B7 Health Action Plans (Including Block, Village) 0 0 - BUDGET: INNOVATIONS FMR. Code. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approved ( Rs in lacs) Remarks B14 Innovations( if any) 408 358200 1,679.04 1 B14.1 Intersectoral convergence 4 25000 1 1 Approved. B14.2 Community Based Monitoring and Planning (CBMP) B14.3 Distict Based Comprehensive Newborn Care Package - NIPI UNOPS and Government of J&K Collaboration No. of Pilot Districts 4 345.24 0 not recommended keeping in view that state has to utilise the available resources for the existing activities B14.5 Incentive to parents having two daughters adopting permanent method of family planning - B14.6 Incentive to the Village Health Sanitation and Nutrition Committees where the sex - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 140 - FMR. Code. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approved ( Rs in lacs) Remarks ratio at birth is 1:1 B14.7 Opening of New Sub Centres No. 400 333200 1,332.80 0 shifted to B5.3 B14.8 Establishment of PC&PNDT cell at Divisional Level - B14.9 Initiatives under School Health Programme - BUDGET: DRUG WARE HOUSE FMR. Code. Budget Head Unit of Measure Quantit y / Target Unit Cost ( Rs in lacs) Amount Propose d ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B.17 Regional drugs warehouses/Logis tics management 0 0 400 200 B.17.1 Drug warehouses 400 200 Approved 50% of work in view of limited resource envelope. B.17.2 Staff at State level - B.17.3 Staff at District level - B.17.4 Others 0 0 - BUDGET: NEW INITIATIVES FMR. Code. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approved ( Rs in lacs) Remarks Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 141 - B.18 New Initiatives/ Strategic Interventions (As per State health policy)/ Innovation/ Projects (Telemedicine, Hepatitis, Mental Health, Nutrition Programme for Pregnant Women, Neonatal) NRHM Helpline) as per need (Block/ District Action Plans) 0 0 14.17 14.17 B.18.1 Help Lines 14.17 14.17 Approved as an ongoing activity BUDGET: OTHER EXPENDITURE FMR. Code. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approved ( Rs in lacs) Remarks B.23 Other Expenditures (Power Backup, Convergence etc) 0 0 991.92 45.92 B.23.1 Power Backup for Kashmir Divion Office & DHSs - B.23.2 Strengthening of RIHFW 45.92 45.92 Approved as an ongoing activity. B.23.3 Upgradation of 2 Drug Testing Laboratories (Divisional level) 701 0 Approval Pended in view of limited Resource Envelope Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 142 - FMR. Code. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approved ( Rs in lacs) Remarks B.23.4 Running cost for Central Heating System in Leh / Kargil 245 0 Not Approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 143 - NATIONAL DISEASE CONTROL PROGRAMMES (NDCPs) Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 144 - NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP) ROAD MAP Priority Actions to be carried out by State/UTs (i) to achieve goal to bring the prevalence of IDD to below 5% in the entire country by 2017 and (ii) to ensure 100% consumption of adequately iodated salt (15ppm) at the household level under National Iodine Deficiency Disorders Control programme: 1. Establishment of State IDD Cell, if not established in the State/UT for implementation programme activities. 2. Establishment of State IDD monitoring laboratory, if not established in the State/UT for conducting quantitative analysis of iodized salt and urine for iodine content and urinary iodine excretion. 3. All the sanctioned posts i.e. Technical Officer, Statistical Assistant, LDC/DEO, Lab Technician and Lab Assistant of State IDD Cell and State IDD Monitoring Laboratory should be filled on regular/contractual basis on priority for smooth implementation of programme. 4. Supply, availability and consumption of adequately iodized salt in the state should be monitored. 5. District IDD survey/re-surveys should be undertaken as per NIDDCP guidelines to assess the magnitude of IDD in the respective districts as approved in the PIP and reports accordingly submitted. 6. Procurement of salt testing kits for endemic districts by State/UT for use of ASHA/Health Personnel for creating awareness & monitoring of iodated salt consumption at household level. Monthly reports are to be submitted as per the prescribed proforma. 7. ASHA incentives Rs. 25/- per month for testing 50 salt samples per month in endemic districts should be made available on regular basis to ASHA. 8. Health education and publicity should be conducted with more focus in the endemic districts emphasizing about IDD and promotion of consumption of adequately iodized salt. Should observe Global IDD Celebrations on 21 st October by conducting awareness activities at various level and submission of reports. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 145 - DETAILED BUDGET NIDDCP FMR Code BUDGET HEAD Physica l target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS D IDD D.1 IDD Control Cell- Impleme ntation & monitori ng of the program me 15.50 14.00 State Govt. may conduct and co-ordinate approved programme activities and furnish quarterly financial & physical achievements as per prescribed format D.1.a Technical Officer 1 D.1.b Statistical Assistant 1 D.1.c LDC Typist 1 D.2 IDD Monitoring Lab- Monitori ng of distric t level iodine content of salt and urinary iodine excretio n as per Policy Guidelin es. 6.50 6.00 The vacant post of Lab Assistant should be filled up on regular/contractual basis on priority State Govt. may conduct quantitative analysis of salt & urine as per NIDDCP Guidelines and furnish monthly/quarterly statements D.2.a Lab Technician 1 D.2.b Lab. Assistant 1 D.3 Health Education & Publicity Increase d awarene ss about IDD and iodated salt. 2.00 2.00 IDD publicity activities including Global IDD Day celebrations at various level. D.4 IDD Survey/resurve ys Rs. 50,000 per 4 districts 2.00 2.00 State. Govt. may under take 4 districts IDD survey as per guidelines and furnish report. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 146 - district D.5 Salt Testing Kits to be procured by the State Government for 14 endemic districts 12 STK per annum per ASHA Creating iodated salt demand and monitori ng of the same at the commun ity level. ** State Govt. to monitor the qualitative analysis of iodated salt by STK through ASHA in 14 endemic districts i.e. Ananthnag, Badgam, Baramulla, Doda, Jammu, Kargil, Kathau, Kupwara, Ladakh, Pulwama, Pounch, Rajori, Srinagar, Udhampur. D.6 ASHA Incentive Rs.25/- per month for testing 50 salt sample /month 50salt samples per month per ASHA in 14 endemic districts. 36.00 ** TOTAL 64.50 24.00 ** Based on the demand of State/UT Govt. for procuring STK & performance based incentive to ASHA for 14 endemic districts funds will be released through flexi pool of NRHM by GOI. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 147 - INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP) Priority Actions to be carried out by the State: There are 16 vacant posts of technical contractual staff (15 Epidemiologists & 1 Entomologist) under IDSP in the State. The State needs to expedite the recruitment of these staff. The training of Master trainers (ToT) and 2-week FETP for District Surveillance Officers under IDSP has been completed for the State/Districts. However, the State may give the additional list of participants to be trained for ToT and 2-week FETP. Presently 15 of 22 Districts are reporting regularly on IDSP portal. Presently only 36%, 37% and 35% of all the Reporting Units are reporting weekly surveillance data respectively in S, P & L-form through IDSP Portal. The State needs to ensure regular weekly reporting of all surveillance data (S, P, L) by all the Reporting Units of all Districts through IDSP Portal. Districts never reported on the IDSP Portal are Kistwar, Kupwara, Reasi, and Samba. Districts reported irregular on the IDSP portal are Doda, Anantnag, Ganderbal The State has to ensure consistent reporting of L form in portal by the district priority lab at Srinagar. Functionality of Referral lab network is to be established in 2013-14. Appropriate clinical samples need to be sent for the required lab investigations for all outbreaks. In 2012, clinical samples were sent for laboratory investigation for 64% of the disease outbreaks in which 36% were lab confirmed. The State needs to send full investigation report for each disease outbreak. Presently, such investigation reports are not available for outbreaks. 4 th quarter financial monitoring report (FMR) for the year 2012-13 is pending from Jammu division. Non-negotiable IDSP priorities for States: Dedicated State Surveillance Officer (SSO) for implementation of IDSP. All States to provide weekly report on the disease surveillance data on epidemic prone diseases and the weekly outbreak report regularly through portal. All the States to timely submit their Statement of Expenditure, Utilization Certificate and Audit reports. Every State will undertake in-depth review of IDSP at least once in a year and will share the report with Central Surveillance Unit (CSU), IDSP DETAILED BUDGET IDSP Comments from CSU, IDSP on proposed NPCC budget (2013-14) for Jammu Division (JK) Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 148 - No. of District: 10 FMR Code Activity Unit Cost (where-ever applicable) Amount Proposed (Rs. in lakhs) Amount Approved (Rs in lakhs) Remarks E1. Operational Cost 1.1 Field Visits 5.0+ 24.0 (2.40x10) 29.0 1.2 Office Expenses 1.3 Broad Band expenses 1.4 Outbreak investigations including Collection and Transport of samples 1.5 Review Meetings 1.6 Any other Sub Total 29.0 29.0 E2. Laboratory Support 2.1 District Priority Lab 2.2 Referral Network Lab 5.00x1+5 5.0 2.3 District health lab 34.70x4= 138.8 35.8 (non recurring) 143.8 40.8 E3. Human Resources 3.1 Remuneration of Epidemiologists 52.80 33.66 The remuneration for vacant positions has been calculated for 6 months only, and for microbiologist remuneration has been calculated for 9 months. *Medical Epidemiologists, Consultant training and Medical Microbiologists with medical qualifications should be paid higher remuneration than the non-medical epidemiologists, consultant training and microbiologists The microbiologist can be appointed at one of the labs being established under IDSP 3.2 Remuneration of Microbiologists 4.80 3.60 3.3 Remuneration of Entomologists 3.6 - 3.4 Veterinary Consultant - - 3.5 Consultant-Finance/ Procurement 3.78 - 3.6 Consultant-Training/ Technical 4.20 - 3.7 Data Manager 28.22 20.76 3.8 Data Entry Operator 22.91 16.28 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 149 - Sub Total 120.27 74.3 E4. Training As per NRHM Guidelines Training of DM & DEO would be conducted online 4.1 One day training of Hospital Doctors 3,00,000 ( 60,000 x 5 Batches ) 1.0 4.2 One day training of Hospital Pharmacist / Nurses 1,00,000 ( 25,000 x 4 Batches ) 0.50 4.3 One day training of Medical College Doctors 62,000 (31,000 x 2 Batches ) 0.20 4.4 ASHA & MPWs AWW and community volunteers 1,00,000 (25,000 x 4 Batches ) 0.0 4.5 Training of Lab technicians 1,00,000 ( 50,000 x2 batches ) 0.30 4.6 One day training of DM & DEO 88,000 ( 44,000 x 2 Batches ) 0.0 One day training for data entry and analysis for block health team (Including block programme manager 50,000 ( 25,000 x 2 Batches) 0.0 Sub Total 8.0 2.0 E5. Outbreak Investigation & Response E6. Analysis & Use of Data E7. Civil Works E8. Procurement of Computer Hardware E10. New Districts 14.0 14.0 Total (Jammu) 315.07 160.1 Based on past trend, Rs. 100 lakhs has been approved for JK under IDSP for 2013-14. However, if there is increase in expenditure by State as per IDSP approved norm, the budget for State could be increased at RE stage Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 150 - Comments from CSU, IDSP on proposed NPCC budget (2013-14) for Kashmir Division (JK) No of Districts (12) FMR Code Activity Unit Cost (where-ever applicable) Amount Proposed (Rs. in lakhs) Amount Approved (Rs in lakhs) Remarks E1. Operational Cost 1.1 Field Visits Rs 2,40,000 per District Surveillance Unit per annum Rs 5,00,000 State Surveillance Unit per annum 42.00 33.80 1.2 Office Expenses 1.3 Broad Band expenses 1.4 Outbreak investigations including Collection and Transport of samples 1.5 Review Meetings 1.6 Any other Activities Sub Total 42.00 33.80 E2. Laboratory Support 2.1 District Priority Lab Rs. 4,00,000 per district priority lab per annum 4.0 4.0 2.2 Referral Network Lab Rs. 5,00,000 per referral lab per annum 10.0(5.0x2) 10 2.3 District public health lab 2 (Anantnag and Baramulla 46.0(30 non recurring+ 16 recurring) 38.0(30 non recurring+ 8 recurring) Sub Total 60.0 52.0 E3. Human Resources 3.1 Remuneration of Epidemiologists 62.4 45.6 The remuneration for vacant positions has been calculated for 6 months only *Medical Epidemiologists, Consultant training and Medical Microbiologists with medical qualifications should be paid higher remuneration than the non-medical epidemiologists, consultant training and microbiologists 3.2 Remuneration of Microbiologists 9.6 9.6 3.3 Remuneration of Entomologists 3.6 1.80 3.4 Veterinary Consultant 3.6 1.80 3.5 Consultant-Finance/ Procurement 2.40 2.40 3.6 Consultant-Training/ Technical 3.6 1.80 3.7 Data Manager 31.00 22.92 3.8 Data Entry Operator 21.60 18.72 Sub Total 138.0 104.64 E4. Training As per NRHM Guidelines Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 151 - 4.1 One day training of Hospital Doctors 3.60 (.60x 6batches) 1.00 Training of DM & DEO would be conducted online 4.2 One day training of Hospital Pharmacist / Nurses 0.50( .25x2 batches) 0.25 4.3 One day training of Medical College Doctors 0.31 0.16 4.4 One day training for Data Entry and analysis for Block Health Team 0.25(.25x1) 0.13 4.5 One day training of DM & DEO 0.88(.44x2) 0.0 Lab technician training 0.50( .50x1 batches) 0.25 ASHA MPWs AWW and community volunteers 0.75(.25x3) 0.37 Subtotal Total 6.79 2.16 E5. ID Hospital Network E7. New formed Districts(Computer hardware ) 14.0 - Already approved in ROP 2012-13 Total (Kashmir) 260.79 192.6 Total (Jammu) 315.07 160.1 Total (Jammu &Kashmir) 575.86 352.7 Based on past trend, Rs. 100 lakhs has been approved for JK under IDSP for 2013-14. However, if there is increase in expenditure by State as per IDSP approved norm, the budget for State could be increased at RE stage Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 152 - NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME (NVBDCP) Physical Target Sr. No. Indicator 2011 2012 2013 Remarks 1 Annual Blood Examinate Rate (ABER) i.e. persons screened annually for Malaria 8.96% 8.98% >10 % Since this is annual figure the proportionate target for six months by monthly blood examination rate should also be fixed. Surveillance needs to strengthen in the Jammu division. In view of malaria cases reported by Kashmir division surveillance needs to be strengthened in Baramulla and Ramban districts. 2 Annual Parasite Incidence (API) i.e. Malaria cases per 1000 population annually 0.2 0.16 <0.2 Needs to monitor the districts of Jammu division. 3 Sentinel Surveillance Hospital made functional for Dengue & Chikungunya 7 7 7 The functionality to be sustained & ensured and should be monitored by their regular reports Priority areas for focussed attention: 1. Districts of Jammu division need to focus on prevention and control of VBDs with special emphasis on Malaria and Dengue. 2. All the 7 Sentinel Surveillance Hospitals for Dengue and Chikungunya to be equipped with ELISA facility, manpower and diagnostic kits and functionality to be ensured. Essential Conditionality: Post Sanctioned In position Vacant Target for 2013-14 District Malaria Officer (DMO) 6 3 3 The vacant sanctioned post to be recruited on priority. In view of malaria cases reported from the districts of Kashmir division posts for districts in the division need to be processed for sanctioning and to recruit. Two review meetings in a year to be conducted under the Chairmanship of Principal Secretary (Health)/Mission Director - one before transmission period and second during transmission period. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 153 - District wise goals (To be done by State) ABER API Deaths 2013-14 2013-14 2013-14 To be filled and monitored Desirable Conditionality: The vacant regular post for medical and Para medical staff should be filled up so as to strengthen the surveillance in the state Road Map for priority Action: Surveillance & monitoring under NVBDCP is done throughout the year. Following salient points are to monitor the implementation of programme activities in different quarters. 1. April to June - Focal spraying and observance of anti-malaria month to be ensured and accordingly funds availability at districts to be ensured 2. July to Sept. - Focal spraying and observance of anti-dengue month. 3. Oct. to Dec.-Review and Monitor physical and financial performance and preparation of next annual plan. 4. Jan. to March - Consolidation of previous year’s physical and financial achievement and plan for next year. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 154 - DETAILED BUDGET FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks F.1 DBS (Domestic Budget Support) F.1.1 Malaria F.1.1.a Human Resource including MPW contractual Lab Technicians ( against vacancy ) VBD Technical Supervisor (one for each block) District VBD Consultant (one per district) (Non- Project States) State Consultant (Non – Project States) - M& E Consultant (Medical Graduate with PH qualification) - VBD Consultant (preferably entomologist) F.1.1.b ASHA Incentive 5.70 8.00 F.1.1.c Operational Cost Spray Wages 3.00 Recommended for focal spray from NRHM additionalities Operational cost for IRS Impregnation of Bed nets- for NE states F.1.1.d Monitoring , Evaluation & Supervision & Epidemic Preparedness including mobility 4.90 8.00 Recommended F.1.1.e IEC/BCC 10.55 10.00 Recommended F.1.1.f PPP / NGO and Intersectoral Convergence F.1.1.g Training / Capacity Building 9.00 10.00 Recommended F.1.1.h Zonal Entomological units 6.00 Not approved due to budgetary Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 155 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks restriction F.1.1.i Biological and Environmental Management through VHSC F.1.1.j Larvivorous Fish support F.1.1.k Construction and maintenance of hatcheries 12.00 Not Recommended F.1.1.l Contingencies Total Malaria (DBS) 51.15 36.00 F.1.2 Dengue & Chikungunya F.1.2.a Strengthening surveillance (As per GOI approval) F.1.2.a(i) Apex Referral Labs recurrent F.1.2.a(ii ) Sentinel surveillance Hospital recurrent 6.00 7.00 Opertional costs for laboratories as per guidelines to strengthen diagnostic facilities ELISA facility to Sentinel Surv Labs F.1.2.b Test kits (Nos.) to be supplied by GoI (kindly indicate numbers of ELISA based NS1 kit and Mac ELISA Kits required separately) • MAC ELISA kits are GOI supply through NIV, Pune. • ELISA based NS1 kits also decentralized item to be procurred by State out of cash grant under decentralized commodity. F.1.2.c Monitoring and evaluation 2.20 2.20 To improve programme implementatio n and case mangament to F.1.2.d Epidemic containment 1.75 1.25 F.1.2.e Case management 1.00 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 156 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks bring down Dengue Case fatality rate F.1.2.f Vector Control & environmental management 5.00 Essential component, state need to plan source reduction activities as per the Mid Term Plan approved by CoS F.1.2.g IEC BCC for Social Mobilization 2.00 3.00 State to plan the activities as per GoI guidelines F.1.2.h Inter-sectoral convergence 0.50 F.1.2.i Training including Operational Research 0.00 Total Dengue/Chikungunya 11.95 19.95 F.1.3 Acute Encephalitis Syndrome (AES)/ Japanese Encephalitis (JE) F.1.3.a Diagnostics and Case Management including rehabilitation NA NA F.1.3.b IEC/BCC specific to J.E. in endemic areas F.1.3.c Capacity Building F.1.3.d Monitoring and supervision F.1.3.e Technical Malathion Fogging Machine Operational costs for malathion fogging Operational Research Rehabilitation Setup for selected endemic districts ICU Establishment in endemic districts ASHA Insentivization for sensitizing community Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 157 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks Other Charges for Training /Workshop Meeting & payment to NIV towards JE kits at Head Quarter Total AES/JE 0.00 0.00 F.1.4 Lymphatic Filariasis F.1.4.a State Task Force, State Technical Advisory Committee meeting, printing of forms/registers, mobility support, district coordination meeting, sensitization of media etc., morbidity management, monitoring & supervision, mobility support for Rapid Response Team and contingency support Not Applicabl e Not Applicabl e F.1.4.b Monitoring by Microfilaria Survey F.1.4.c Monitoring & Evaluation (Assessment) F.1.4.d Training District Officers, PHC MOs, Paramedical staff, drug distributors F.1.4.e BCC/Advocacy/IEC at state, district/PHC, sub centre F.1.4.f Honorarium for Drug Distribution including ASHAs and supervisors Verification and validation for stoppage of MDA in LF endemic districts a) Additional MF Survey b) ICT Survey c) ICT Cost Verification of LF endemicity in non- endemic districts Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 158 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks a) LY & Hy Survey b) Mf Survey in Non- endemic distt c) ICT survey Post-MDA surveillance Total Lymphatic Filariasis 0.00 0.00 F.1.5 Kala-azar F.1.5 Case search/ Camp Approach Not Applicabl e Not Applicabl e F.1.5.a Spray Pumps & accessories F.1.5.b Operational cost for spray including spray wages F.1.5.c Mobility/POL/supervisio n F.1.5.d Monitoring & Evaluation F.1.5.e Training for spraying F.1.5.f IEC/ BCC/ Advocacy Total Kala-azar 0.00 0.00 Total (DBS) 63.10 55.95 F.2 Externally aided component F.2.a World Bank support for Malaria (Identified state) F.2.b Human Resource Not Applicabl e Not Applicabl e F.2.c Training /Capacity building F.2.d Mobility support for Monitoring Supervision & Evaluation including printing of format & review meetings, Reporting format (for printing formats) Kala-azar World Bank assisted Project F.2.e Human resource Not Applicabl e Not Applicabl e F.2.f Capacity building F.2.g Mobility F.3 GFATM support for Malaria (NE states) Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 159 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks F.3.a Project Management Unit including human resource of N.E. states Not Applicabl e Not Applicabl e F.3.b Training/Capacity Building F.3.c Planning and Administration( Office expenses recurring expenses, Office automation , printing and stationary for running of project) F.3.d Monitoring Supervision (supervisory visits including travel expenses, etc) including printing of format and review meetings, F.3.e IEC / BCC activities as per the project F.3.f Operational cost for treatment of bednet and Infrastructure and Other Equipment (Computer Laptops, printers, Motor cycles for MTS ) Total : EAC component 0.00 0.00 F.4 Any Other Items ( Please Specify) 0.00 0.00 F.5 Operational costs ( mobility, Review Meeting, communication, formats & reports) 0.00 0.00 Grand total for cash assistance under NVBDCP (DBS + EAC) 63.10 55.95 F.6 Cash grant for decentralized commodities F.6.a Chloroquine phosphate tablets 4.00 22.20 The commodities are recommended however it may be F.6.b Primaquine tablets 7.5 mg 0.10 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 160 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks F.6.c Primaquine tablets 2.5 mg 0.00 restricted to budgetary allocation F.6.d Quinine sulphate tablets 0.00 F.6.e Quinine Injections 0.00 F.6.f DEC 100 mg tablets 0.00 F.6.g Albendazole 400 mg tablets 0.00 F.6.h Dengue NS1 antigen kit 0.00 F.6.i Temephos, Bti (AS) / Bti (wp) (for polluted & non polluted water) 24.00 F.6.j Pyrethrum extract 2% for spare spray 6.00 F.6.k Any Other Items ( Please Specify) ACT ( For Non Project states) RDT Malaria – bi-valent (For Non Project states) Total grant for decentralized commodities 34.10 22.20 Grand Total for grant- in-aid under NVBDCP 97.20 78.15 Commodity to be supplied by NVBDCP 0.00 Total NVBDCP Cash + Commodity 97.20 78.15 Cash assistance required under NRHM flexi fund Components Unit Cost (wherever applicable ) Physical target/ Deliverable s Ammoun t Proposed Ammoun t Approve d Remarks Spray Wages 3.00 3.00 Recommended Total (Flexi fund) 3.00 3.00 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 161 - NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) S.No Goals & Target September'13 March 2014 1 Elimination at District level NA NA 2 Case detection through ASHA 50 100 3 Special activity plan in blocks - - 4 MCR footwear procurement & supply 50 100 5 RCS - - 6 Development of leprosy expertise 50% of Plan 100% of Plan 7 Treatment Completion Rate assessment for the year 2013-14 Completed - 8 Audited Report for the year 2013-14 Completed - 9 Expenditure incurred against approved plan budget 50% 100% NA: Not Applicable Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 162 - DETAILED BUDGET- JAMMU DIVISION Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks G1.Case detection & Management 1.1 Specific -plan for High Endemic Districts Block - - - 1.2 Services in Urban Areas Town - Town - 2 2.28 2.28 Med I- Med II- Mega- Med I- Med II- Mega- 1 2.40 2.40 1.3. ASHA Involvement Sensitization 100 600 0.60 0.60 *Incentive to ASHA Detection 250 100 0.25 0.25 PB 400 50 0.20 0.20 MB 600 50 0.30 0.30 1.4 Material & Supplies Supportive drugs, lab. reagents & equipments and printing works District 68,000 10 6.80 6.80 1.5 NGO - Scheme No. 600000 - - - G2. DPMR MCR footwear, Aids and appliances, Welfare allowance to patients for RCS, Support to govt. institutions for RCS MCR - 300/- 100 0.30 0.30 2 pair per person Aids/Appliance - 17000 1 0.17 0.17 Welfare/RCS - 8000 - - - At Institute - 5000 - - - At camps - 10000 G3. ** IEC/BCC Mass media, Outdoor media, Rural media, Advocacy media 98,000 10 9.80 9.80 G4. Human Resources & Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 163 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks Capacity building 4.1 *** Capacity building 11 3.80 3.80 4.2. Human Resources on contract 4.2.1. **** Contractual Staff at State level SMO 1 40000 - - - BFO cum Admn. Officer 1 30000 - - - Admn. Asstt. 1 16000 1 1.92 1.92 DEO 1 12000 1 2.88 1.44 Only one DEO Driver 1 11000 - - - 4.2.2. District Leprosy Consultant 30000 - - - Post of Driver of districts not available Physiotherapist 25000 - - - 4.2.3. Special Provision for selected States NMS No. 25000 - - - 4.2.4. Staff for blocks PMW No. 16000 - - - G5. Programme Management ensured 5.1. Travel Cost travel expenses - Contractual Staff at State level 80000 10 0.60 0.60 travel expenses - Contractual Staff at District level 25000 - - - No Contractual at district 5.2 Review meetings 20000 to 50000 4 1.20 1.20 5.3 Office Operation & Maintenance Office operation - State Cell 1 75000 1 0.75 0.75 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 164 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks Office operation - District Cell No. 35000 10 3.50 3.50 Office equipment maint. State 1 50000 1 0.50 0.50 5.4 Consumables State Cell 1 50000 1 0.50 0.50 District Cell No. 30000 10 3.00 3.00 5.5 Mobility Support State Cell 2 200000 2 2.00 2.00 District Cell 1 150000 10 15.00 15.00 G6 Others travel expenses - Contractual Staff at State level GRAND TOTAL (JAMMU) 58.75 57.31 *Incentive to ASHAs will be given at revised rate subject to the approval by MSG. **The State Leprosy Officer will be able to distribute the total IEC funds on the basis of actual requirements of each district keeping adequate funds at State level under Mass Media and Advocacy meetings. ***Unit cost OF Training to be calculated as per State NRHM norm fixed for all health programmes. **** Remuneration of Contractual staff may be revised keeping in view the prevailing rate of remuneration in other National Health Programmes. NLEP- KASHMIR DIVISION S.No Goals & Target September'13 March 2014 1 Elimination at District level NA NA 2 Case detection through ASHA Target to be given by state 3 Special activity plan in blocks - - 4 MCR footwear procurement & supply 60 121 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 165 - S.No Goals & Target September'13 March 2014 5 RCS 3 7 6 Development of leprosy expertise 50% of Plan 100% of Plan 7 Treatment Completion Rate assessment for the year 2013-14 Completed - 8 Audited Report for the year 2013-14 Completed - 9 Expenditure incurred against approved plan budget 50% 100% NA: Not Applicable DETAILED BUDGET- KASHMIR DIVISION Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks G1.Case detection & Management 1.1 Specific -plan for High Endemic Districts Block - - - 1.2 Services in Urban Areas Town - Town - - - - To be decided Med I- Med II- Mega- Med I- Med II- Mega- - - - 1.3. ASHA Involvement Sensitization 100 - 0.54 0.54 Target not given * Incentive to ASHA Detection 250 PB 400 MB 600 1.4 Material & Supplies Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 166 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks Supportive drugs, lab. reagents & equipments and printing works District 68,000 12 6.24 6.24 1.5 NGO - Scheme No. 600000 - - - G2. DPMR MCR footwear, Aids and appliances, Welfare allowance to patients for RCS, Support to govt. institutions for RCS MCR - 300/- - 7.50 7.00 Execss demand Aids/Appliance - 17000 Welfare/RCS - 8000 At Institute - 5000 At camps - 10000 G3. ** IEC/BCC Mass media, Outdoor media, Rural media, Advocacy media 98,000 12 6.00 6.00 G4. Human Resources & Capacity building 4.1 *** Capacity building 21 7.00 7.00 4.2. Human Resources on contract 4.2.1. **** Contractual Staff at State level SMO 1 40000 - - - BFO cum Admn. Officer 1 30000 1 3.60 3.60 Admn. Asstt. 1 16000 1 2.16 1.92 DEO 1 12000 1 1.92 1.44 Only one DEO Driver 1 11000 1 1.32 1.32 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 167 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks 4.2.2. District Leprosy Consultant 30000 - - - Post of Driver of districts not available Physiotherapist 25000 - - - 4.2.3. Special Provision for selected States NMS No. 25000 - - - 4.2.4. Staff for blocks PMW No. 16000 - - - G5. Programme Management ensured 5.1. Travel Cost travel expenses - Contractual Staff at State level 80000 1 0.80 0.80 travel expenses - Contractual Staff at District level 25000 - - - No Contractual at district 5.2 Review meetings 20000 to 50000 4 2.00 2.00 5.3 Office Operation & Maintenance Office operation - State Cell 1 75000 1 0.38 0.38 Office operation - District Cell No. 35000 12 2.16 2.16 Office equipment maint. State 1 50000 1 0.30 0.30 5.4 Consumables State Cell 1 50000 1 0.28 0.28 District Cell No. 30000 12 1.68 1.68 5.5 Mobility Support State Cell 2 200000 1 0.85 0.85 District Cell 1 150000 12 9.00 9.00 G6 Others Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 168 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks travel expenses - Contractual Staff at State level GRAND TOTAL (KASHMIR) 53.73 52.51 GRAND TOTAL (JAMMU) 58.75 57.31 GRAND TOTAL (JAMMU & KASHMIR) 117.48 109.82 *Incentive to ASHAs will be given at revised rate subject to the approval by MSG. **The State Leprosy Officer will be able to distribute the total IEC funds on the basis of actual requirements of each district keeping adequate funds at State level under Mass Media and Advocacy meetings. ***Unit cost OF Training to be calculated as per State NRHM norm fixed for all health programmes. **** Remuneration of Contractual staff may be revised keeping in view the prevailing rate of remuneration in other National Health Programmes. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 169 - REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME (RNTCP) Targets S.No Indicators 2012 2013-14 1 Case detection rate 49% 70% 2 Treatment success rate 89% 90% 3 MDR TB treatment success rate 60-70% 4 Treatment success rate among new TB patients tribal districts and Poor and Backward districts 88% 5 Number of cases to be put on treatment Increasing trend 6 Default rate among new TB cases <5% 7 Proportion of estimated incident TB cases notified 80% 8 Proportion of TB patients with known HIV status. 90% 9 Proportion of microscopy centres using LED microscopes 9% 10 Proportion of districts TU aligned at block levels with health systems 25% 11 Proportion of Key RNTCP staff in place as per approved ROP 90% 12 Proportion of Key RNTCP staff trained as per approved ROP 90% 13 Proportion of TB patients treated under RNTCP by a community DOT provider 50% 14 Proportion of pediatric cases diagnosed out of new cases 8% Action point for the State under RNTCP during FY 2013-14: All the approved Key RNTCP contractual staff positions at State/Districts should be filled and ensuring timely payment of salaries. All the approved new position will be recruited by September 2013. The State level RNTCP review meetings to be chaired by Health Secretary/Mission Director (NRHM) at least once in a quarter To conduct State TB control society meeting, State Coordination committee meeting (TBHIV) at least once in a quarter. To ensure that District TB Control society meeting and District Coordination committee meetings are conducted in the districts at least once in a quarter Scaling up of DOTS Plus services as per the State DOTS Plus action plan Conduct ACSM/Training activities at State/Districts as per the State annual action plan. To involve Private Practitioners and NGOs in the RNTCP Submission of SOE and UC as per the time lines communicated by MoHFW/CTD. Timely payment of DOT Providers honorarium at Districts . Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 170 - DETAILED BUDGET: RNTCP FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approved Remarks I.1 Civil works As per Revised Norms and Basis of Costing for RNTCP 1) Civil work Up gradation and maintenance completed as planned 137.6 65 Approval for 5 TUs . I.2 Laboratory materials As per Revised Norms and Basis of Costing for RNTCP 1) Sputum of TB Suspects Examined per lac population per quarter; 2) All districts subjected to IRL On Site Evaluation and Panel Testing in the year; 3) IRLs accredited and functioning optimally 32 16.92 As per norms I.3 Honorarium As per Revised Norms and Basis of Costing for RNTCP 1) All eligible Community DOT Providers are paid honorarium in all districts in the FY 9.62 6 As per norms. I.4 ACSM As per Revised Norms and Basis of Costing for RNTCP 1) All IEC/ACSM activities proposed in PIP completed; 2) Increase in case detection and improved case holding; 30.56 15 As per norms. I.5 Equipment maintenance As per Revised Norms and Basis of Costing for RNTCP 1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as planned; 2) All BMs are in functional condition 16 11.07 I.6 Training As per Revised Norms and Basis of Costing for RNTCP 1) Induction training, Update and Re- training of all cadre of staff completed as planned; 53.3 10 As per norms Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 171 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approved Remarks I.7 Vehicle maintenance/ operation As per Revised Norms and Basis of Costing for RNTCP 1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained; 41 23 I.8 Vehicle hiring As per Revised Norms and Basis of Costing for RNTCP 1) Increase in supervisory visit of DTOs and MOTCs; 2) Increase in case detection and improved case holding 22 17.64 I.9 NGO/PP support As per Revised Norms and Basis of Costing for RNTCP 1) Increase in number of NGOs/PPs involved in signed schemes of RNTCP; 2) Contribution of NGOs/PPS in case detection and provision of DOT 28.85 27 I.10 Medical College As per Revised Norms and Basis of Costing for RNTCP 1) All activities proposed under Medical Colleges head in PIP completed 25 22 I.11 Office Operation As per Revised Norms and Basis of Costing for RNTCP 1) All activities proposed under miscellaneous head in PIP completed 12.97 8.17 I.12 Contractual services As per Revised Norms and Basis of Costing for RNTCP 1) All contractual staff appointed and paid regularly as planned 289 160 New position for 6 moths . I.13 Printing As per Revised Norms and Basis of Costing for RNTCP 1) All printing activities at state and district level completed as planned 15 10.26 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 172 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approved Remarks I.14 Research and studies As per Revised Norms and Basis of Costing for RNTCP 1) Proposed Research has been initiated or completed in the FY as planned 2 2 1.15 Procurement of drugs I.16 Procurement – vehicles As per Revised Norms and Basis of Costing for RNTCP 1) Procurement of vehicles completed as planned 103 35.75 Only for 2 wheelers. I.17 Procurement- Equipments As per Revised Norms and Basis of Costing for RNTCP 1)Procurement of equipments completed as planned 13 13 I.18 Patient support & Transportation As per Revised Norms and Basis of Costing for RNTCP Payment of transportation charges to patients 1.4 1.4 I.19 Supervision & Monitoring As per Revised Norms and Basis of Costing for RNTCP Number of evaluation and review meeting done by state 30 20 Subtotal 864.23 464.21 Disease control Flexi pool fund 21 0 GRAND TOTAL (JAMMU) 885.23 464.21 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 173 - DETAILED BUDGET: KASHMIR FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approve d Remarks I.1 Civil works As per Revised Norms and Basis of Costing for RNTCP 1) Civil work Up gradation and maintenance completed as planned 170.05 88.5 Approval is for 11 TU, 9 DMC, 2 DR TB centre+ DDS. I.2 Laboratory materials As per Revised Norms and Basis of Costing for RNTCP 1) Sputum of TB Suspects Examined per lac population per quarter; 2) All districts subjected to IRL On Site Evaluation and Panel Testing in the year; 3) IRLs accredited and functioning optimally 33.66 14.34 As per norms I.3 Honorarium As per Revised Norms and Basis of Costing for RNTCP 1) All eligible Community DOT Providers are paid honorarium in all districts in the FY 3.68 9.05 As per norms I.4 ACSM As per Revised Norms and Basis of Costing for RNTCP 1) All IEC/ACSM activities proposed in PIP completed; 2) Increase in case detection and improved case holding; 32.87 12.61 As per norms I.5 Equipment maintenance As per Revised Norms and Basis of Costing for RNTCP 1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as planned; 2) All BMs are in functional condition 19 15 I.6 Training As per Revised Norms and Basis of Costing for RNTCP 1) Induction training, Update and Re-training of all cadre of staff completed as planned; 60.58 11.44 As per norms . Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 174 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approve d Remarks I.7 Vehicle maintenance/ operation As per Revised Norms and Basis of Costing for RNTCP 1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained; 76 23.02 I.8 Vehicle hiring As per Revised Norms and Basis of Costing for RNTCP 1) Increase in supervisory visit of DTOs and MOTCs; 2) Increase in case detection and improved case holding 76 45.61 I.9 NGO/PP support As per Revised Norms and Basis of Costing for RNTCP 1) Increase in number of NGOs/PPs involved in signed schemes of RNTCP; 2) Contribution of NGOs/PPS in case detection and provision of DOT 24.787 24.78 I.10 Medical College As per Revised Norms and Basis of Costing for RNTCP 1) All activities proposed under Medical Colleges head in PIP completed 247 77.48 Rs 25 lakh approved for Zonal OR Meeting. I.11 Office Operation As per Revised Norms and Basis of Costing for RNTCP 1) All activities proposed under miscellaneous head in PIP completed 21.48 11.3 I.12 Contractual services As per Revised Norms and Basis of Costing for RNTCP 1) All contractual staff appointed and paid regularly as planned 465 255 Nursing + helper position has not been approved I.13 Printing As per Revised Norms and Basis of Costing for RNTCP 1) All printing activities at state and district level completed as planned 17.94588 8 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 175 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approve d Remarks I.14 Research and studies As per Revised Norms and Basis of Costing for RNTCP 1) Proposed Research has been initiated or completed in the FY as planned 17 2 1.15 Procurement of drugs 0 I.16 Procurement – vehicles As per Revised Norms and Basis of Costing for RNTCP 1) Procurement of vehicles completed as planned 150 39 For 2 wheelers I.17 Procurement- Equipments As per Revised Norms and Basis of Costing for RNTCP 1)Procurement of equipments completed as planned 19 17 I.18 Patient support & Transportation As per Revised Norms and Basis of Costing for RNTCP Payment of transportation charges to patients 2.12 2.12 I.19 Supervision & Monitoring As per Revised Norms and Basis of Costing for RNTCP Number of evaluation and review meeting done by state 66 20 Subtotal 1502.52 676.26 Disease control Flexi pool fund 86 11.25 For AIC control gadgets+ 300 MA X ray plant GRAND TOTAL (Kashmir) 1589.53 687.52 GRAND TOTAL (JAMMU) 885.23 464.21 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 176 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approve d Remarks GRAND TOTAL (JAMMU & Kashmir) 2474.76 1151.73 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 177 - ANNEXURE Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 178 - Annexure 1 DETAILED BUDGET REPRODUCTIVE AND CHILD HEALTH (RCH) FLEXIPOOL S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.1 MATERNAL HEALTH 1502952 30600 5,219.2 1 4,040.0 5 A.1.1 Operationalise Facilities (Any cost other than infrastructure, HR, Training, Procurement, Monitoring etc.) may include cost of mapping, planning- identifying priority facilities,etc) 0 0 - - A.1.1.1 Operationalise FRUs (Blood bank/BSU - Operational cost) - A.1.1.2 Operationalise 24x7 PHCs - A.1.1.3 Operationalise Safe abortion services (including MVA/ EVA and medical abortion)at health facilities - A.1.1.4 Operationalise RTI/STI services at health facilities - A.1.1.5 Operationalise sub- centres - A.1.2 Referral Transport - A.1.3 Integrated outreach RCH services (state should focus on facility based services and outreach camps to be restricted only to areas without functional health facilities) 232 25000 58.00 1.37 A. 1.3.1. Oureach camps No. of Outreach Camps 232 25000 58.00 1.37 Approved as per last year expenditure. A.1.3.2. Monthly Village Health and Nutrition Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 179 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks Days A.1.4. Janani Suraksha Yojana / JSY 232500 3500 2,371.2 0 2,240.3 8 Approved as per last year expenditure. A.1.4.1 Home deliveries No. 3000 500 15.00 10.84 Approved for 2168 beneficiaries. A.1.4.2 Institutional deliveries 129500 2400 1,756.2 0 1,707.3 1 A.1.4.2.a Rural No. 115300 1400 1,614.2 0 1,601.1 9 Approved for 1,14371 beneficiaries. A.1.4.2.b Urban No. 14200 1000 142.00 106.12 Approved for 1,0612 beneficiaries. A.1.4.2.c C-sections - A.1.4.3 Administrative Expenses - A.1.4.4 Incentives to ASHA 100000 600 600.00 522.23 Approved as per last year expenditure. A.1.5 Maternal Death Review (both in institutions and community) No. of Maternal Deaths reviewed 150 450 0.68 0.68 Approved for MDR as per the guidelines. A.1.6 Other strategies/activities (please specify) 500300 1060 153.00 60.11 A.1.6.1 Incentive to SBAs for conducting home deliveries in inaccessible/snow bound areas of high focus districts as a pilot project 300 1000 3.00 3.00 Rs 3 lakhs approved as incentives for ANMs /LHVs/SNs for conducting home deliveries in inaccessible areas / snow bound areas of high focus areas as a pilot project, subject to simultaneous plans for converting Home deliveries into Institutional deliveries. A.1.6.2 Printing of MCP cards 250000 15 37.50 20.00 Rs. 20.00 lakhs approved for 133333 cards, subject to printing by competitive bidding. A.1.6.3 Printing of Safe motherhood booklet 250000 45 112.50 37.11 Rs 37.11 lakhs approved for 100300 bookets @ Rs 37 per Safe Motherhood Booklet. A.1.7 JSSK- Janani Shishu Surakhsha Karyakram 769770 590 2,636.3 4 1,737.5 1 In view of limited resource envelop, currently approved as per last year's Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 180 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks expenditure. A.1.7.1 Drugs and consumables No.of Institutio nal Deliveries 162536 873.64 943.17 Approved for 138,155 NDs @ Rs. 350 =Rs 483,54,250 and for 24,381 C sections @ Rs 1600 = Rs 390,09,600. So total approval =Rs 873.64 lakhs. Approved as per last year's expenditure. A.1.7.2 Diagnostic No.of Institutio nal Deliveries 162536 200 325.07 300.41 Rs 325.07 lakhs approved @ Rs 200 for 162,536 p.w. for ensuring free diagnostics for all p.w. accessing Govt. health facilities during ANC, INC & PNC. In view of low expenditure, approved as per last year's expenditure. A.1.7.3 Blood Transfusion 15% of Institutio nal Deliveries 24381 300 73.14 30.19 Rs 73.14 lakhs approved for provision of free blood to all p.w. requiring blood transfusion. In view of low expenditure, approved as per last year's expenditure. A.1.7.4 Diet (3 days for Normal Delivery and 7 days for Caesarean) No.of Institutio nal Deliveries 274036 666.40 226.32 Approved for provision of free diet for pregnant women @ Rs 100 per day for 3 days for 138,155 p.w. = 414,46,500 and @ Rs 1000 for 7 days for 24,381 p.w. = 170,66,700. Total amount being Rs 585, 13,200. Provision of free diet for mothers of sick infants is not under JSSK Programme. However all post natal mothers admitted for management of complications are Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 181 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks covered under JSSK. In view of low expenditure, approved as per last year's expenditure. A.1.7.5 Free Referral Transport No.of Institutio nal Deliveries 138155 690.77 230.11 Rs 690.775 lakhs approved for providing free transport for 113,775 p.w. @ Rs 500 =568.875 lakhs and for 24,380 p.w. for referral x 500 = 121.900 lakhs and total approval = 690.775 lakhs as inter facility transfer will entail more distance; subject to ensuring no duplication with Mission Flexible pool and all ambulances linked to a centralised call centre, being GPS fitted and under the banner of NAS. All operational cost for ambulances should be borne out of the RT component sanctioned here and under Child Health. In view of low expenditure, approved as per last year's expenditure. A.1.7.6 Other JSSK activity 8126 90 7.31 7.31 A.1.7.6.1 Ironsucrose Intervention (3 doses Approved) No. of Patients 8126 90 7.31 7.31 Rs 7.31 lakhs approved for IV sucrose subject to IV sucrose being prescribed under the supervision of a Gynecologist at FRU and above. A.1.7.6.2 Mobility support for State level officers for monitoring JSSK (|Lumpsum) / District Nodal Officers for Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 182 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks monitoring JSSK / Block level officers A.1.7.6.3 - Sub-total Maternal Health (excluding JSY) 1270452 27100 2,848.0 1 1,799.6 7 Sub-total JSY 232500 3500 2,371.2 0 2,240.3 8 A.2. CHILD HEALTH 227540 13930 00 1,293.4 5 358.40 A.2.1 IMNCI (including F- IMNCI; primarily budget for planning for pre-serviceIMNCI activities in medical colleges, nursing colleges, and ANMTCs) - A.2.2 Facility Based Newborn Care/FBNC (SNCU, NBSU, NBCC - any cost not budgeted under HR,Infrastructure, procurement, training,IEC etc.) e.g.operating cost rent,electricity etc. imprest money 360 19500 0 305.60 215.30 A.2.2.1 SNCU No. of SNCUs 15 125.00 125.00 Approved A.2.2.2 NBSU No. of NBSUs 72 17500 0 126.00 63.00 Approved @ Rs. 87500/- per NBSU. A.2.2.3 NBCC No. of NBCCs 273 20000 54.60 27.30 Approved @ Rs. 10000/- per NBCC, with the conditionality that the state will first saturate the functional delivery points with NSSK Trained personnel and radiant warmer and utilize the resources optimally A.2.3 Home Based Newborn Care/HBNC No. of booklets 2000 50 1.00 0.53 In view of limited resource envelop, currently approved as Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 183 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks per last year's expenditure. A.2.4 Infant and Young Child Feeding/IYCF No. of Events 150 5000 7.50 5.39 In view of limited resource envelop, currently approved as per last year's expenditure. A.2.5 Care of Sick Children and Severe Malnutrition (e.g. NRCs, CDNCs etc.) No. of NRCs 2 78000 0 15.60 0.96 In view of limited resource envelop, currently approved as per last year's expenditure. A.2.6 Management of diarrhoea & ARI & micronutrient malnutrition No. of batches 2 20000 0 4.00 4.00 Approved A.2.7 Other strategies/activities (please specify) No. of batches 2 20000 0 4.00 4.00 Approved A.2.8 Infant Death Audit 1500 4.25 0.53 In view of limited resource envelop, currently approved as per last year's expenditure. A.2.9 Incentive to ASHA under child health - A.2.10 JSSK (for Sick neonates up to 30 days) 223000 300 947.75 123.94 In view of limited resource envelop, currently approved as per last year's expenditure. A.2.10.1 Drugs & Consumables (other than reflected in Procurement) No. of Sick Children 111500 200 223.00 9.52 Approved Rs 223.00 lakhs for provision providing free drugs and treatment of sick neonates and infants. This is in addition to funds being proposed & approved for SNCU and NBSU and other drugs and consumables as per their EDL. Currently approved as per last years expenditure. A.2.10.2 Diagnostics No. of Sick Children 111500 100 111.50 32.59 Rs 111.50 lakhs approved. Currently approved as per last year’s expenditure. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 184 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.2.10.3 Free Referral Transport No. of Sick Children 111500 @ 500 for pickup from home and drop back and @ Rs 250 for 22300 cases for referrels inbetwe en institutio ns 613.25 81.83 613.25 lakhs approved subject to no duplication under Mission Flexipool. Operational cost for ambulances should be borne out of the RT component sanctioned here and under Maternal Health. In view of limited resource envelop, Currently approved as per last year’s expenditure. A.2.11 Any other interventions (eg; rapid assessments, protocol development) 524 12650 3.75 3.75 A.2.11.1 IYCF- Settingup of IYCF Counselling Centres in 22 DHs , 53 CHCs, 6 PHCs and 2 Medical Colleges No. of Counselin g Centres 24 12500 3.00 3.00 Approved A.2.11.2 Printing of IYCF Guidelines 500 150 0.75 0.75 Approved A.2.11.3 - A.2.11.4 - A.2.11.5 - Sub-total Child Health 227540 13930 00 1,293.4 5 358.40 A.3 FAMILY PLANNING 26261 13700 0 327.88 205.99 In view of limited resource envelop, currently approved as per last year's expenditure. A.3.1 Terminal/Limiting Methods 26147 22000 279.94 170.17 A.3.1.1 Orientation workshop,disseminat ion of manuals on FP standards & quality assurance of sterilisation services, fixed day planning meeting No. 96 2000 1.92 0.06 Approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 185 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.3.1.2 Female sterilisation camps 22 7500 1.65 1.13 Approved for 14 camps, as per last year achievements/expendi ture. A.3.1.3 NSV camps 12 10000 1.20 0.80 Approved for 8 camps, as per last year achievements/expendi ture. A.3.1.4 Compensation for female sterilisation 23017 1000 230.17 145.68 Approved for 14568 sterilizations, as per last year achievements/expendi ture. A.3.1.5 Compensation for male sterilization/NSV Acceptance 3000 1500 45.00 22.50 Approved for 1500 sterilizations, as per last year achievements/expendi ture. A.3.1.6 Accreditation of private providers to provide sterilisation services - A.3.2 Spacing Methods 0 0 7.84 1.48 A.3.2.1 IUD camps - A.3.2.2 IUD services at health facilities (including fixed day services at SHC and PHC) 7.84 1.48 Approved as per last year expenditure. A.3.2.2.1 PPIUCD services - A.3.2.3 Accreditation of private providers to provide IUD insertion services - A.3.2.4 Social Marketing of contraceptives (includng delivery of contraceptive by ASHA at door step) - A.3.2.5 Contraceptive Update seminars - A.3.3 POL for Family Planning/ Others (including additional mobilty support to surgeon's team if req) - A.3.4 Repairs of Laparoscopes - A.3.5 Other strategies/activities 114 11500 0 40.10 34.34 Approved as per last year expenditure. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 186 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks (please specify): A.3.5.1 Monitor progress and quality,QAC meetings /review of sterilization failures etc. No. of meetings 92 4.80 Approved A.3.5.2 Performance reward if any A.3.5.3 World Population Day’ celebration (such as mobility, IEC activities etc.): funds earmarked for district and block level activities 22 11500 0 25.30 Approved A.3.5.4 Other strategies/ activities (such as strengthening fixed day services for IUCD and sterilization etc.) 0 0 10.00 10.00 A.3.5.4.1 Family Planning Indemnity Scheme 10.00 10.00 Approved Sub-total Family Planning (excluding Sterilisation Compensation and NSV Camps) 26029 12500 51.51 37.01 Sub-total Sterilisation Compensation and NSV Camps 232 12450 0 276.37 168.98 A.4 ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH / ARSH 3981968 59900 5 1,292.9 9 8.92 A.4.1 Adolescent health services 1625 21030 0 52.37 3.80 Approved as per last year expenditure. A.4.1.1 Disseminate ARSH guidelines. No. of Copies 1000 200 2.00 A.4.1.2 Establishment of new clinics at DH level - A.4.1.3 Establishment of new clinics at CHC/PHC level No. of institutio ns 22 18200 0 40.04 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 187 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.4.1.4 Operating expenses for existing clinics No. of institutio ns 27 27600 7.45 A.4.1.5 Outreach activities including peer educators No. of outreach activities 576 500 2.88 A.4.1.6 Others - - A.4.2 School Health programme 3979763 32820 5 1,235.3 4 4.22 Approval as per last year expenditure. The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.4.2.1 Prepare and disseminate guidelines for School Health Programme. No. of copies 76500 200 153.00 A.4.2.2 Prepare detailed operational plan for School Health Programme across districts (cost of plan meeting should be kept) No. of meetings 44 5000 2.20 A.4.2.3 Mobility support No. of teams x 6 months 2238 23000 514.74 A.4.2.4 Referral support No. of Teams 373 50000 186.50 A.4.2.5 Other strategies for school health 3900608 25000 5 378.90 - A.4.2.5.1 One Day Workshop for orientation for capacity building of School teachers - A.4.2.5.2 Financial Assistance for treatment of complicated diseases among childrens and adolescent under School Health Programme for surgical / medical treatment / providing medicine to the ailing children No. of cases 200 10000 0 200.00 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 188 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.4.2.5.3 Printing of registers / formats / stock registers / outreach registers for maintenance of record / reporting for 373 school health teams 373 10000 37.30 A.4.2.5.4 - A.4.2.5.5 Printing of cards under WIFS for 5 SABLA Districts 1200000 3 30.00 A.4.2.5.6 Printing of cards etc. under RBSK No. of students + 20 % as buffer stock 2700000 2.50 67.50 A.4.2.5.7 Printing and stationary for DEIC under RBSK 7 10000 8.40 A.4.2.5.8 Running Cost / contingency / TA DA for DEIC under RBSK 7 30000 25.20 A.4.2.5.9 Mobility support for Nodal Officers under RBSK 7 50000 3.50 A.4.2.5.1 0 Procurement of 2 computers for each of the DEIC under RBSK 14 50000 7.00 A.4.3 Other strategies/activities (please specify) 580 60500 5.28 0.90 Approved as per last year expenditure. A.4.3.1 Mobility support for ARSH/ICTC counsellors 576 500 2.88 A.4.3.2 Menstrual Hygiene (Sanitary napkin procurement to be booked under procurement) No. of meetings 4 60000 2.40 A.4.3.3 WIFS actvity - Sub-total ARSH 3981968 59900 5 1,292.9 9 8.92 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 189 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.5 URBAN RCH (focus on Urban slums) 201 42000 255.48 34.11 Approved Rs. 34.11 lakhs, 50% of the last year expenditure. Annexure shows that 10 out of 47 centres are operational. OPD numbers not shared. State to share the performance of UHPs and propose the rest of the activities under NUHM. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the conditionalities mentioned in the HR head. A.5.1 Identification of urban areas / mapping of urban slums and planning - A.5.2 HR for urban health including doctors, ANMs, Lab techs 201 42000 229.80 - A.5.2.1 Doctors/Mos 10 30000 36.00 A.5.3 Operating expenses for UHP and UHC - A.5.4 Outreach activities - A.5.5 Others (pl specify) 0 0 25.68 - A.5.5.1 Rent for Urban Health Centres / Posts 25.68 Sub-total Urban Health 201 42000 255.48 34.11 Approved Rs. 34.11 lakhs, 50% of the last year expenditure. Annexure shows that 10 out of 47 centres are operational. OPD numbers not shared. State to share the performance of UHPs and propose the rest of the activities under NUHM. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 190 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the conditionalities mentioned in the HR head. A.6. TRIBAL RCH 26 12000 37.44 15.87 A.6.1 Special plans for tribal areas - A.6.2 HR for tribal areas (in addition to normative HR) 26 12000 37.44 15.87 Approved 50 % of the last year's expenditure (26 AMCHI Healers). State to conduct the impact evaluation study and share with GoI. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the conditionalities mentioned in the HR head. A.6.3 Outreach activities - A.6.4 Other Tribal RCH strategies/activities (please specify) 0 0 - - Sub-total Tribal Health 26 12000 37.44 15.87 A.7 PNDT Activities 2324 25320 00 216.64 1.10 Due to limited resource envelop, approved as per last year expenditure. A.7.1 Support to PNDT cell 2 22000 00 44.00 A.7.3 Mobility support 22 60000 13.20 A.7.2 Other PNDT activities (please specify) 2300 27200 0 159.44 1.10 Due to limited resource envelop, approved as per last year expenditure. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 191 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.7.2.1 Reward to Informers for giving information regarding unregistered ultrasound machine (8); illegal practice of sex selection and selective female foeticide (8) 10.00 A.7.2.2 Divisional level workshops 4 20000 0 8.00 A.7.2.3 District level workshops 44 50000 22.00 A.7.2.4 State Supervisory board meetings 6 10000 0.60 A.7.2.5 Divisional Advisory Committee Meetings 12 5000 0.60 A.7.2.6 District Advisory Committee Meetings 132 2000 2.64 A.7.2.7 Debates , seminars at Universities/ Colleges 102 15.60 A.7.2.8 Incentive to parents having two daughters adopting permanent method of family planning 2000 5000 100.00 A.7.2.9 Award to block / panchayat / Village Health Sanitation and Nutrition Committees that reflect reverse trend in the sex ratio (more females and less males) - A.7.2.10 Sub-total PNDT activities 2324 25320 00 216.64 1.10 A.8 Human Resources 6806 99752 0 11,280. 91 3,575.7 4 As agreed, the following key Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 192 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.8.1 Contractual Staff & Services 6806 99752 0 11,280. 91 3,575.7 4 conditionalities would be enforced during the year 2013-14. a) Rational and equitable deployment of HR with the highest priority accorded to high priority districts and delivery points. b) Facility wise performance audit and corrective action based thereon. c) Performance Measurement system set up and implemented to monitor performance of regular and contractual staff. d) Baseline assessment of competencies of all SNs, ANMs, Lab Technicians to be done and corrective action taken thereon. - Approval is being granted for HR of all cadres under NRHM for six months only and its continuation for the next six months would be contingent on compliance of the above four conditionalities. - From 1st October 2013, under NRHM funds for salary to contractual HR would be done only to make payments to contractual staff over and above the sanctioned regular positions in the State. - It is expected that the state will Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 193 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks henceforth fill up their vacant regular HR positions and will not use NRHM funds to substitute state spending. Due to limited resource envelop, approved is being given for in-position staff as per last year's rate (based on the last year expenditure). A.8.1.1 ANMs,Supervisory Nurses, LHVs, 2909 11100 0 4,428.7 2 1,508.2 2 A.8.1.1.1 ANMs 2118 36000 3,049.9 2 1,100.1 0 Approved for in- position 1930 ANMs @ last years rate, as per last year achivements/expendit ure. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1.1.1 .a DH - A.8.1.1.1 .b FRUs - A.8.1.1.1 .c Non FRU SDH/ CHC - A.8.1.1.1 .d 24 X 7 PHC 200 12000 288.00 A.8.1.1.1 .e Non- 24 X 7 PHCs - A.8.1.1.1 .f Sub Centres No. 1910 12000 2,750.4 0 A.8.1.1.1 .g SNCU/ NBSU/NRC etc No. 8 12000 11.52 A.8.1.1.1 Others - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 194 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks .h A.8.1.1.2 Staff Nurses 791 75000 1,378.8 0 408.12 Approved for in- position 716 SNs @ last years rate, as per last year achivements/expendit ure. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1.1.2 .a DH 240 15000 432.00 A.8.1.1.2 .b FRUs 156 15000 280.80 A.8.1.1.2 .c Non FRU SDH/ CHC - A.8.1.1.2 .d 24 X 7 PHC 200 15000 360.00 A.8.1.1.2 .e Non- 24 X 7 PHCs - A.8.1.1.2 .f SNCU/ NBSU/NRC etc 125 15000 180.00 A.8.1.1.2 .g Others 70 15000 126.00 A.8.1.1.3 LHVs/supervisory nurses 0 0 - - A.8.1.1.3 .a DH - A.8.1.1.3 .b FRUs - A.8.1.1.3 .c Non FRU SDH/ CHC - A.8.1.1.3 .d 24 X 7 PHC - A.8.1.1.3 .e Non- 24 X 7 PHCs - A.8.1.1.3 .f SNCU/ NBSU/NRC etc - A.8.1.1.3 .g Others - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 195 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.8.1.2.1 Laboratory Technicians 409 48000 581.76 241.70 Approved for in- position 373 LTs @ Rs.10800, as per last year achivements/expendit ure. new posts not approved, state to redeploy. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1.2.1 .a DH 16 12000 23.04 A.8.1.2.1 .b FRUs 168 12000 241.92 A.8.1.2.1 .c Non FRU SDH/ CHC - A.8.1.2.1 .d 24 X 7 PHC 200 12000 288.00 A.8.1.2.1 .e Non- 24 X 7 PHCs - A.8.1.2.1 .f Others 25 12000 28.80 A.8.1.2.2 MPWs 355 12000 511.20 172.37 Approved for in- position 266 MPWs @ Rs.10800, as per last year achivements/expendit ure, new posts not approved. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 196 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.8.1.3 Specialists (Anaesthetists, Paediatricians, Ob/Gyn, Surgeons, Physicians, Dental Surgeons, Radiologist, Sonologist, Pathologist, Specialist for CHC ) 94 48000 0 483.60 110.40 Approved for in- position 46 Specialists @ Rs. 40000/m, as per last year achivements/expendit ure. State to re-deploy existing specialits in FRUs and SNCUs. Approved. State to provide name of the FRU/facility with case load and current staffing. Also as a pre- requisite the EmOC and LSAS trained doctors must be posted at appropriate facilities and perform. None of the specialists is being sanctioned exclusively for conducting training. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1.3.1 Obstetricians and Gynecologists 15 10000 0 90.00 A.8.1.3.1 .a DH - A.8.1.3.1 .b FRUs 8 50000 48.00 A.8.1.3.1 .c Non FRU SDH/ CHC - A.8.1.3.1 .d Others (Please specify) 7 50000 42.00 A.8.1.3.2 Pediatricians 22 15000 0 111.00 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 197 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.8.1.3.2 .a DH 7 50000 21.00 A.8.1.3.2 .b FRUs 8 50000 48.00 A.8.1.3.2 .c Non FRU SDH/ CHC - A.8.1.3.2 .d Others (Please specify) 7 50000 42.00 A.8.1.3.3 Anesthetists 15 10000 0 90.00 A.8.1.3.3 .a DH - A.8.1.3.3 .b FRUs 8 50000 48.00 A.8.1.3.3 .c Non FRU SDH/ CHC - A.8.1.3.3 .d Others (Please specify) 7 50000 42.00 A.8.1.3.4 Surgeons 0 0 - A.8.1.3.4 .a DH - A.8.1.3.4 .b FRUs - A.8.1.3.4 .c Non FRU SDH/ CHC - A.8.1.3.4 .d Others (Please specify) - A.8.1.3.5 Specialists for CH (Paediatrician etc) in SNCU,NBSU,NRC 25 0 120.00 A.8.1.3.5 .a DH - A.8.1.3.5 .b FRUs - A.8.1.3.5 .c Non FRU SDH/ CHC - A.8.1.3.5 .d Others (Please specify) 15 for 6 months & 10 for 6 months @ Rs. 50000/- 25 120.00 A.8.1.3.6 .1 Radiologists 5 50000 30.00 - Not approved. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 198 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.8.1.3.6 .2 Pathologists 5 50000 30.00 - Not approved. A.8.1.3.7 Dental surgeons and dentists 7 30000 12.60 - A.8.1.3.7 .a DH 7 30000 12.60 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 199 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.8.1.6 Additional Allowances/ Incentives to M.O.s 983.08 533.39 Approved Rs. 533.39 lakhs, as per last year expenditure and limited resource envelop. State to share the details of the incentive scheme. It needs to ensure that performance monitoring is done regularly and should be given to those MOs, Specialists , etc. staying at the residential quarters / Headquarter areas. A.8.1.7 Others - Computer Assistants/ BCC Co- ordinator etc - A.8.1.7.1 Pharmacist 0 0 - - A.8.1.7.1 .a DH - A.8.1.7.1 .b FRUs - A.8.1.7.1 .c Non FRU SDH/ CHC - A.8.1.7.1 .d 24 X 7 PHC - A.8.1.7.1 .e Non- 24 X 7 PHCs - A.8.1.7.1 .f Others - A.8.1.7.2 Radiographers 184 24000 264.96 112.75 Approved for in- position Radiographers @ Rs.10800/-m, as per last year achivements/expendit ure. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1.7.2 .a DH 16 12000 23.04 A.8.1.7.2 FRUs 168 12000 241.92 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 200 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks .b A.8.1.7.2 .c Non FRU SDH/ CHC - A.8.1.7.2 .d 24 X 7 PHC - A.8.1.7.2 .e Non- 24 X 7 PHCs - A.8.1.7.2 .f Other - A.8.1.7.3 OT technicians/assitsant s 184 24000 264.96 104.33 Approved for in- position OT Technicians @ Rs.10800/-m, as per last year achivements/expendit ure. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1.7.3 .a DH 16 12000 23.04 A.8.1.7.3 .b FRUs 168 12000 241.92 A.8.1.7.3 .c Non FRU SDH/ CHC - A.8.1.7.3 .d 24 X 7 PHC - A.8.1.7.3 .e Non- 24 X 7 PHCs - A.8.1.7.3 .f Other - A.8.1.7.4 School health teams (Exclusively for SH) 1352 10800 0 1,593.9 0 - The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.8.1.7.4 .a MOs 571 30000 1,027.8 0 A.8.1.7.4 .b LTs 7 12000 5.04 A.8.1.7.4 .c Dental Technicians 7 12000 5.04 A.8.1.7.4 .d Ophthalmic Assistants 7 15000 6.30 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 201 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.8.1.7.4 .e Staff Nurse 14 15000 12.60 A.8.1.7.4 .f Pharmacists 373 12000 268.56 A.8.1.7.4 .g ANMs 373 12000 268.56 A.8.1.7.4 .h MPW - A.8.1.7.5 Counsellors 54 24660 73.19 15.55 A.8.1.7.5 .1 RMNCH/FP Counselors 24 32.11 0.00 A.8.1.7.5 .2 ARSH Counselors 24 10800 31.10 15.55 Existing ARSH counsellors and 2 nutritional counsellors for NRCs @ Rs. 10800/-. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. A.8.1.7.5 .3 Honorarium to ICTC counselors for ARSH activities - A.8.1.7.5 .4 Other (please specify) - A.8.1.7.6 All Technical HR for State Specific Initiatives - A.8.1.7.7 Others (pl specify) 6 13860 9.98 - Not approved, State to use existing staff regular as well as contractual A.8.1.7.8 Staff for Training Institutes/ SIHFW/ Nursing Training - A.8.1.8 Incentive/ Awards etc. to SN, ANMs etc. 10.00 0.00 Activity Dropped A.8.1.9 Human Resources Development (Other than above) 57 83.35 25.34 11 sister tutors @Rs14400 and 22 PHNs @Rs12000 approved. Approval is being granted for six months only and its continuation for the next six months would be contingent on Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 202 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks compliance of the above mentioned conditionalities. A.8.1.10 Other Incentives Schemes (Pl.Specify) 672 2000 13.44 - A.8.1.10. 1 Honorarium for Pediatric ECO, ENT Specialist, Orthopediatrician, Opthalmologist, Psychatrist 672 2000 13.44 0.00 The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.8.1.11 Support Staff for Health Facilities 28 13860 39.95 1.68 A.8.1.11. a DH No. 22 13860 36.59 A.8.1.11. b FRUs - A.8.1.11. c Non FRU SDH/ CHC - A.8.1.11. d 24 X 7 PHC - A.8.1.11. e Non- 24 X 7 PHCs - A.8.1.11. f SNCU/ NBSU/ NBCC/ NRC etc 6 3.36 1.68 Approved for cook and attendant for NRCs. Approval is being granted for six months only and its continuation for the next six months would be contingent on compliance of the above mentioned conditionalities. Sub-total HR 6806 99752 0 11,280. 91 3,575.7 4 A.9 TRAINING #VALUE! 96108 60 954.10 95.33 In view of limited resource envelop, approval is given inline with the last year expenditure. A.9.1 Strengthening of existing Training Institutions (SIHFW, ANMTCs, etc.) - A.9.2 Development of training packages 0 0 3.00 - A.9.2.1 Development/ translation and - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 203 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks duplication of training materials A.9.2.2 Other activities (pl. specify) 0 0 3.00 - A.9.2.2.1 Procurment of training equipments 3.00 - Not approved. A.9.3 Maternal Health Training 135 32985 00 167.17 49.87 Approved lumsum amount as per last year's expenditure. A.9.3.1 Skilled Attendance at Birth / SBA 92 33905 0 97.16 - A.9.3.1.1 Setting up of SBA Training Centres - A.9.3.1.2 TOT for SBA No. of Batches (30 per batch) 4 13005 0 5.20 A.9.3.1.4 Training of Staff Nurses in SBA No. of batches (4 Per Batch) 44 10450 0 45.98 A.9.3.1.5 Training of ANMs / LHVs in SBA No. of batches (4 Per Batch) 44 10450 0 45.98 A.9.3.2 EmOC Training 1 14680 00 14.68 - A.9.3.2.1 Setting up of EmOC Training Centres - A.9.3.2.2 TOT for EmOC - A.9.3.2.3 Training of Medical Officers in EmOC No. of Batches (8 Person per batch) 1 14680 00 14.68 A.9.3.3 Life saving Anaesthesia skills training 1 78800 0 7.88 - A.9.3.3.1 Setting up of Life saving Anaesthesia skills Training Centres - A.9.3.3.2 TOT for Anaesthesia skills training - A.9.3.3.3 Training of Medical Officers in life saving Anaesthesia skills No. of batches (4 Mos per batch) 1 78800 0 7.88 A.9.3.4 Safe abortion services training 2 98300 1.97 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 204 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks (including MVA/ EVA and Medical abortion) A.9.3.4.1 TOT on safe abortion services - A.9.3.4.2 Training of Medical Officers in safe abortion No. of Batches (4 Mos per batch) 2 98300 1.97 A.9.3.5 RTI / STI Training 2 20395 0 4.08 - A.9.3.5.1 TOT for RTI/STI training - A.9.3.5.2 Training of laboratory technicians in RTI/STI - A.9.3.5.3 Training of Medical Officers in RTI/STI No. of Batches (25 Peson Per batch) 2 20395 0 4.08 A.9.3.6 BEmOC training for MOs/LMOs No. of Batches (4 person per batch) 11 74150 8.16 A.9.3.7 Other maternal health training (please specify) 26 32705 0 33.25 - A.9.3.7.1 Orientation of CMOs / BMOs / Mos for implementation of guidelines under MDR and IDR No. of Batches (100 person per batch) 2 12500 0 2.50 A.9.3.7.2 Training on Blood Transfusion (Mos / Lab Technicians) - A.9.3.7.3 SBA for MO (ISM) No. of Batches (4 Person Per batch) 22 13355 0 29.38 A.9.3.7.4 TOT for Bemoc No of Batches (3 per batch) 2 68500 1.37 A.9.3.8 Blood Storage Unit (BSU) Training - A.9.3.9 Skill Lab Training - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 205 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.9.4 IMEP Training 143 81420 47.94 - Not approved. A.9.4.1 TOT on IMEP - A.9.4.2 IMEP training for state and district programme managers No. of Batches (25 person per batch) 4 48320 1.93 A.9.4.3 IMEP training for medical officers No. of Batches (25 person per batch) 139 33100 46.01 A.9.5 Child Health Training 593 22159 25 448.98 14.87 Approved lumsum amount as per last year's expenditure. A.9.5.1 IMNCI Training (pre- service and in- service) 22 17140 0 37.71 - A.9.5.1.1 TOT on IMNCI (pre- service and in- service) - A.9.5.1.2 IMNCI Training for ANMs / LHVs No. of Batches (24 Person per batch) 22 17140 0 37.71 A.9.5.1.3 IMNCI Training for Anganwadi Workers - A.9.5.2 F-IMNCI Training 4 20275 0 8.11 - A.9.5.2.1 TOT on F-IMNCI - A.9.5.2.2 F-IMNCI Training for Medical Officers No. of Batches (16 Person Per batch) 4 20275 0 8.11 A.9.5.2.3 F-IMNCI Training for Staff Nurses - A.9.5.3 Home Based Newborn Care / HBNC 480 58850 282.48 - A.9.5.3.1 TOT on HBNC - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 206 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.9.5.3.2 Training on HBNC for ASHA No. of Batches (25 Person per batch) 480 58850 282.48 Shifted to MFP under B.1.1.1.3 A.9.5.4 Care of sick children and severe malnutrition at FRUs 2 76000 1.52 - A.9.5.4.1 TOT on Care of sick children and severe malnutrition No. of Batches (4 Person per batch) 2 76000 1.52 A.9.5.4.2 Training on Care of sick children and severe malnutrition for Medical Officers - A.9.5.5 Other child health training (please specify) 85 17069 25 119.17 - A.9.5.5.1 NSSK Training 46 27090 0 37.02 - A.9.5.5.1 .1 TOT for NSSK No. of Batches (32 per batch) 2 11290 0 2.26 A.9.5.5.1 .2 NSSK Training for Medical Officers No. of Batches (32 per batch) 22 84500 18.59 A.9.5.5.1 .3 NSSK Training for SNs - A.9.5.5.1 .4 NSSK Training for ANMs No. of Batches (32 per batch) 22 73500 16.17 A.9.5.5.2 Other Child Health training 39 14360 25 82.15 - A.9.5.5.2 .a FBNC Training for Pedtrician, Mos and Staff Nurses No. of Batches (24 Person Per Batch) 4 80000 0 32.00 A.9.5.5.2 .b HBNC Round II for DRP No. of Batches (25 Person Per Batch) 9 17420 0 15.68 Shifted to MFP B.1.1.1.4.2 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 207 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.9.5.5.2 .c HBNC Round II for ASHA Facilitator No. of Batches (30 Person Per Batch) 20 13747 5 27.50 Shifted to MFP B.1.1.1.4.3 A.9.5.5.2 .d Training of Staff of Nutritional Rehabilitational Centres No. of Batches (6 per batch) 4 24350 0.97 A.9.5.5.2 .e TOT on IYCF No. of Batches (24 Per batch) 2 30000 0 6.00 A.9.6 Family Planning Training 46 30160 0 17.57 12.35 Approved lumsum amount as per last year's expenditure. A.9.6.1 Laparoscopic Sterilisation Training 5 57550 2.88 - A.9.6.1.1 TOT on laparoscopic sterilisation - A.9.6.1.2 Laparoscopic sterilisation training for doctors (teams of doctor, SN and OT assistant) No. of Batches (3 Person Per Batch) 5 57550 2.88 A.9.6.2 Minilap Training 8 94650 3.79 - A.9.6.2.1 TOT on Minilap No. of Person 4 15000 0.60 A.9.6.2.2 Minilap training for medical officers No. of Batches (4 Person Per Batch) 4 79650 3.19 A.9.6.3 Non-Scalpel Vasectomy (NSV) Training 11 11775 0 3.95 - A.9.6.3.1 TOT on NSV No. of Person 1 87000 0.87 A.9.6.3.2 NSV Training of medical officers No. of Batches (4 Person Per Batch) 10 30750 3.08 A.9.6.4 IUD Insertion 0 0 - - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 208 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.9.6.4.1 TOT for IUD insertion - A.9.6.4.2 Training of Medical officers in IUD insertion - A.9.6.4.3 Training of staff nurses in IUD insertion - A.9.6.4.4 Training of ANMs / LHVs in IUD insertion - A.9.6.5 Contraceptive update/ISD Training No. of batches (25 per batch) 22 31650 6.96 A.9.6.6 Other family planning training (please specify) 0 0 - - A.9.6.6.1 Capacity building of Health Service provider on IUCD and PTC - A.9.6.6.2 TOT for IUD insertion - A.9.6.7 PPIUCD insertion training - A.9.6.8 IUCD 375 insertion training - A.9.6.9 Training of FP Counselors - A.9.6.10 Training/ orientation on technical manuals - A.9.7 Adolescent Reproductive and Sexual Health/ARSH Training #VALUE! 76171 5 217.60 5.80 Approved lumsum amount as per last year's expenditure. A.9.7.1 TOT for ARSH training - A.9.7.2 Orientation training of state and district programme managers No. of Batches (30 per batch) 2 62400 1.25 A.9.7.3 ARSH training for medical officers No. of Batches (30 per batch) 4 96200 3.85 A.9.7.4 ARSH training for ANMs/LHVs - A.9.7.5 ARSH training for AWWs - A.9.7.6 Other ARSH training 4 15100 0 3.02 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 209 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.9.7.6.1 Two day training of RMNCH / Counselors from existing centres ARSH/ICTC/IYCF (RMNCH) No. of Batches (30 per batch) 2 75500 1.51 A.9.7.6.2 Two days training of newly appointed counselors under ARSH/IYCF (RMNCH) No. of Batches (30 per batch) 2 75500 1.51 A.9.7.6.1 WIFS training 10 16635 0 8.32 - A.9.7.6.1 .1 State level/ District Level/ Block Level No. of Batches (50 per batch) 5 87000 4.35 A.9.7.6.1 .2 refresher training – ANM/MO/ AWW/ Nodal Teacher No. of Batches (50 per batch) 5 79350 3.97 A.9.7.6.2 Menstrual hygiene training - A.9.7.6.3 SHP training 638 28576 5 201.17 - The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.9.7.6.3 .1 School Health Training -Training of team – technical and managerial No. of Batches (32 per batch) 47 20050 0 94.24 A.9.7.6.3 .2 Training of Nodal teachers - A.9.7.6.3 .3 One day orientation for programme managers/ MO 176 15000 26.40 A.9.7.6.3 .4 Training/Refresher training -ASHA No. of Batches (30 per batch) 15 52085 7.81 A.9.7.6.3 .5 Training/Refresher training -ANM No. of Batches (30 per batch) 400 18180 72.72 A.9.8 Programme Management Training (e.g. M&E, logistics management, HRD 24 55170 0 25.83 10.85 Approved lumsum amount as per last year's expenditure. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 210 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks etc.) A.9.8.1 Training of SPMSU staff - A.9.8.2 Training of DPMSU staff - A.9.8.3 Training of BPMSU staff - A.9.8.4 Other training (pl. specify) 24 55170 0 25.83 9.32 Approved lumsum amount as per last year's expenditure. A.9.8.4.1 Capacity building of supervisory staff for different schemes under NRHM No. of Batches (30 Person Per Batch) 4 99000 3.96 A.9.8.4.2 Training of Medical Officers in financial management and civil conduct rules through IMPA No. of Batches (25 Person Per Batch) 4 17525 0 7.01 A.9.8.4.3 Training of Accounts Managers in NRHM related works No. of Batches (30 per batch) 6 94000 5.64 A.9.8.4.4 Training of Accounts Managers regarding implementation of Tally No. of Batches (30 per batch) 6 94000 5.64 A.9.8.4.5 Training of ISM Doctors in emergency care No. of Batches (25 per batch) 4 89450 3.58 A.9.9.1 PC/PNDT training - A.9.9.2 Others No. of Batches (100 per batch) 2 20000 0 4.00 A.9.10 Training (Nursing) 0 0 - - A.9.10.1 Strengthening of Existing Training Institutions/Nursing School excluding infrastructure and HR. - A.9.10.2 New Training Institutions/School - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 211 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.9.11 Training (Other Health Personnel) 1 22000 00 22.00 1.59 Approved lumsum amount as per last year's expenditure. A.9.11.1 Promotional Training of ANMs to lady health visitor etc. - A.9.11.2 Training of ANMs,Staff nurses,AWW,AWS - A.9.11.3 Other training and capacity building programmes (nursing tutors etc.) - A.9.11.3. 1 PGDHM Courses 8 1 22000 00 22.00 Sub-total Training #VALUE! 96108 60 954.10 95.33 A.10 PROGRAMME MANAGEMENT 1561 21332 2 1,493.8 1 476.43 Approval for Programme Management staff is being granted for six months only and its continuation for the next six months would be contingent on compliance of condition that Performance Measurement system is set up and implemented to monitor performance of regular and contractual staff. A.10.1 Strengthening of State society/ State Programme Management Support Unit 78 11088 0 382.88 145.84 Contractual Staff for SPMSU recruited and in position 78 11088 0 382.88 145.84 A.10.1.1 State Programme Manager 1 31500 3.78 145.84 Due to limited resource envelop, approved is being given only for in- position staff at last year's rate (based on the last year A.10.1.2 State Accounts Manager 1 25200 3.02 A.10.1.3 State Finance Manager 1 31500 3.78 A.10.1.4 State Data Manager 1 22680 2.72 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 212 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.10.1.5 Consultants/ Programme Officers (including for MH/CH/FP/ PNDT/ AH including WIFS SHP, MHS etc.) 2 6.80 expenditure). Including HR, Management cost, Mobility Support etc.) State may also opt for Associate Programme Manager on deputation. (Assistant Director (P&S) and Administrative Officer may be engaged against the positions approved under Associate programme managers). Director (Planning & Statistics) may be engaged against the position of Facilitators. Approval is being granted for six months only with the above mentioned condition. A.10.1.6 Programme Assistants 14 73.20 A.10.1.7 Accountants - A.10.1.8 Data Entry Operators - A.10.1.9 Support Staff (Kindly Specify) 32 80.68 A.10.1.1 0 Salaries for Staff on Deputation (Please specify) 26 198.60 A.10.1.1 1 Others (Please specify) 0.00 0.00 10.29 A.10.1.1 1.1 Contractual staff at divisional level 10.29 A.10.1.1 1.2 Mobility support,OE,TA/DA,M ontly Review meeting, Purchase of computers at state level & Divisional level etc A.10.2 Strengthening of District society/ District Programme Management Support Unit 241 63772 161.65 78.78 Contractual Staff for DPMSU recruited and in position 241 63772 161.65 78.78 A.10.2.1 District Programme Manager 22 20790 54.89 78.78 Due to limited resource envelop, approved is being given only for in- position staff at last year's rate (based on the last year expenditure). Including HR, Management cost, A.10.2.2 District Accounts Manager 22 16632 43.91 A.10.2.3 District Data Manager 22 13860 36.59 A.10.2.4 Consultants/ Programme Officers (Kindly Specify) - A.10.2.5 Accountants - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 213 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.10.2.6 Data Entry Operators 7 11340 4.76 Mobility Support etc.) Approval is being granted for six months only with the above mentioned condition. The RBSK proposal is pended due to limited resource envelop / budgetary constraints. A.10.2.7 Support Staff (Kindly Specify) 14 15.03 A.10.2.8 Others (Please specify) 0 154 1150 6.47 A.10.2.8. 1 OE, Mobility support for DPMUs A.10.2.8. 2 Mobile Charges for CMO for monitoring @ Rs. 500/month 22 500 1.32 A.10.2.8. 3 Mobile charges for District Nodal Officers for different schemes(Dy. CMO, DHO, DIO) @ Rs. 400 per month 66 400 3.17 A.10.2.8. 4 Mobile Charges for DPMUs @ Rs. 250 per month 66 250 1.98 A.10.2.8. 5 - A.10.3 Strengthening of Block PMU 1219 28670 424.65 206.72 A.10.3.1 Block Programme Manager - 206.72 Due to limited resource envelop, approved is being given only for in- position staff at last year's rate (based on the last year expenditure). Including HR, Management cost, Mobility Support etc.) Approval is being granted for six months only with the above mentioned condition. A.10.3.2 Block Accounts Manager 117 13860 194.59 A.10.3.3 Block Data Manager 117 13860 194.59 A.10.3.4 Accountants - A.10.3.5 Data Entry Operators - A.10.3.6 Support Staff (Kindly Specify) - A.10.3.7 Others (Please specify) 985 950 35.46 A.10.3.7. 1 OE, Mobility support for BPMUs A.10.3.7. 2 Mobile Charges for BMO for monitoring @ Rs. 400/month No. 117 400 5.62 A.10.3.7. 3 Mobile charges for Incharge MO PHC/AD @ Rs 300/month No. 634 300 22.82 A.10.3.7. 4 Mobile Charges for BPMUs @ Rs. 250 per month No. 234 250 7.02 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 214 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks A.10.3.7. 5 - A.10.4 Strengthening (Others) 0 0 40.00 10.00 A.10.4.1 Workshops and Conferences - A.10.4.2 Rent for Divisional Office 40.00 10.00 Approved. A.10.4.3 Tally ERP - A.10.4.4 A.10.4.5 - A.10.5 Audit Fees 7.50 7.50 Approved. A.10.6 Concurrent Audit system 23 10000 27.60 27.60 Approved. A.10.7 Mobility Support, Field Visits 0 0 449.54 - A.10.7.1 SPMU/State 250.16 Approved under FMR 10.1 A.10.7.2 DPMU/District 66.00 Approved under FMR 10.2 A.10.7.3 BPMU/Block 133.38 Approved under FMR 10.3 A.10.7.4 Other Supportive Supervision costs - - Sub-total Programme Management 1561 21332 2 1,493.8 1 476.43 A.11 VULNERABLE GROUPS 0 0 - - A.11.1 Planning, including mapping and co- ordination with other departments - A.11.2 Services for Vulnerable groups - A.11.3 LWE affected areasspecial plan - A.11.4 Other strategies/activities (please specify) 0 0 - - Sub-total Vulnerable Groups 0 0 - - TOTAL RCH SUPPLY SIDE 19,724. 35 6,402.5 8 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 215 - S. No. Budget Head Unit of Measure Quantity / Target Unit Cost ( Rs) Amount Propos ed ( Rs in lacs) Amount Approv ed (Rs in Lakhs) Remarks TOTAL RCH DEMAND SIDE 2,647.5 7 2,409.3 6 GRAND TOTAL 22,371. 92 8,811.9 4 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 216 - Annexure 2 DETAILED BUDGET: MISSION FLEXIBLE POOL (MFP) S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B 6974807 7 129916 46 24,845.56 3,223.44 B1 ASHA 302144 308600 1,108.14 B 1.1 ASHA Cost: 302144 308600 1108.14 483.255 Approved 50% of the approved activities. I.e. Rs 483.255 lacs. The activities are approved at last year's unit cost. Incentives to ASHA facilitator for conducting cluster meetings, Awards t ASHA/Link Worker, ASHA Resource Center - Not approved. B1.1. 1 Selection & Training of ASHA 60 90900 56.22 B1.1. 1.1 Module I - IV No of Batches (25 per batch) 60 90900 54.54 Approved with the condition that the training should be 8 days integrated induction module as per the present policy B1.1. 1.2 Module V - B1.1. 1.3 Module VI & VII - Approved state should share the details of training – no. of days and cost per batch. Shifted from A9.5.3.2 B1.1. 1.4 Other Trainings 0 0 1.68 B1.1. 1.4.1 Training on HBNC for State Trainers (round 3rd) (7 participants) # 1.68 Approved B1.1. 1.4.2 Training on HBNC for ASHA DRP (round 2nd ) (9 batches 25 participants per batch) # No. of Batches (25 Person Per Batch) 9 174200 - Approved at last year's unit cost i.e. Rs 106000 per batch. Shifted from A.95.5.2.b B1.1. 1.4.3 Training of ASHA Facilitator Round 2nd (16 batches 30 participants per batch) # No. of Batches (30 Person Per Batch) 20 137475 - Approved at last year's unit cost i.e. Rs 90,000 per batch. Shifted from A.95.5.2.c Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 217 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B1.1. 1.4.4 Training of ASHA on HBNC Round 1 ( part 1 & 2) (125 Batches 25 per batch) - B1.1. 1.4.5 Training of ASHA on HBNC Round 2 (173 Batches 25 per batch) - B1.1. 2 Procurement of ASHA Drug Kit 12000 350 42 B1.1. 2.1 New Kits - B1.1. 2.2 Replenishment 12000 350 42 Approved under OPD head (B16.2.5.2) of General Drugs and Supplies subject to the condition; “State to replenish the drug kits from the PHC”. B1.1. 2.3 Procurement of ASHA HBNC Kit 0 0 - B1.1. 2.4 New Kits - B1.1. 2.5 Replenishment - B1.1. 3 Performance Incentive/Other Incentive to ASHAs (if any) 289687 180350 974.13 B1.1. 3.1 Incentive under MH (ANC/PNC) 100000 250 250 B1.1. 3.1.1 Incentive to ASHA for full ANC No. of Instituti onal Deliveri es 100000 250 250 Approved Rs 50 lakhs @ Rs 50 for 1 lakh pregnant women as Incentive to ASHA for Registration within 12 weeks. Other incentives are a part of the JSY. B1.1. 3.2 Incentive under CH (HBNC) 100000 250 250 B1.1. 3.2.1 Incentive to ASHA under HBNC No. of children visited by ASHA 100000 250 250 Approved B1.1. 3.3 Incentive for FP( PPIUCD/others) 0 0 - B1.1. 3.4 Incentive for AH - B1.1. Other incentive 65550 166250 315.13 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 218 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks 3.5 B1.1. 3.5.1 Incentive to ASHA for event reporting - B1.1. 3.5.2 Monthly Meeting of ASHAs (Travel Expense/refreshmen t) 12000 1200 144 Approved at ongoing unit cost i.e. @ 75 per meeting B1.1. 3.5.3 Incentive for registration of Births 50000 100 50 Approved at ongoing unit cost i.e. @ Rs 50 per birth B1.1. 3.5.4 Incentive for registration of Deaths 3000 100 3 Approved at ongoing unit cost i.e. @ Rs 50 per death B1.1. 3.5.5 Incentive to ASHA for managing ASHA help desk @ Rs. 150 for 8 hours for 365 days (365X150X3) 50 164250 82.13 Approved for ongoing 30 ASHA Grehs. B1.1. 3.5.6 Incentive to ASHA Facilitator for conducting cluster meetings 500 600 36 0 Not Approved B1.1. 3.6 Other (support provisions to ASHA such as uniform, diary, ASHA Ghar etc) 24137 13600 159 B1.1. 3.6.1 ASHA Diary 12000 100 12 Approved B1.1. 3.6.2 ASHA help desk cum rest room in 20 level 3 MCH facilities 20 10000 2 Approved B1.1. 3.6.3 Uniforms to ASHA (2 sets of uniform, I- card, 1 sweater, 1 shawl in high focus districts @ Rs.1500.00 5000 1500 75 Approved at last year’s unit cost i.e. @ 1000 B1.1. 3.6.4 Uniforms to ASHA ( 2 sets of uniforms and I-card in other districts @ Rs. 1000.00)/ 7000 1000 70 Approved at last year’s unit cost i.e. @ 750 B1.1. 4 Awards to ASHA's/Link workers 117 1000 1.17 Not approved B1.1. 5 ASHA Resource Centre/ASHA Mentoring Group 280 36000 34.62 Not approved. B1.1. 5.1 HR At State Level 2 5.64 Not approved. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 219 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B1.1. 5.2 HR at District Level 22 District Coordin ators 22 24000 5.28 Not approved. B1.1. 5.3 HR at Block Level 117 Block Coordin ators 117 12000 14.04 Not approved. B1.1. 5.4 Mobility Costs for ASHA Resource Centre/ASHA Mentoring Group (Kindly Specify) 139 9.66 Not approved. B2 Untied Funds 9811 145000 1111.85 234.06 B2.1 Untied Fund for CHCs/SDH 84 50000 42 18.4 Approved for 84 CHCs as per 3rd quarter utilization i.e. 43.82% B2.2 Untied Fund for PHCs 637 25000 159.25 68.71 Approved for 637 facilities as per list provided by State and as per 3rd Quarter utilization i.e. 43.15%. B2.3 Untied Fund for Sub Centres 2265 10000 226.5 58.14 Approved for 2265 facilities as per list provided by State and as per 3rd Quarter utilization i.e. 25.67%. B2.4 Untied fund for VHSC 6821 10000 682.1 86.81 Approved for 6062 VHS&NC where joint accounts have been opened As per MIS December 2012 and as per utilization i.e. 14.32%. B2.5 Others 4 50000 2 2 Approved (MCH Sopore is new) B.3 Annual Maintenance Grants 1426 260000 410.5 132.26 B3.1 CHC 83 100000 83 35.84 Approved for 83 CHCs as per RHS 2012 @ 3rd quarter utilization i.e. 43.19%. B3.2 PHCs 474 50000 237 77.91 Approved for 451 facilities (325 PHC and 126 NTPHC) as per 3rd quarter utilization i.e. 34.55% Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 220 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B3.3 Sub Centres 865 10000 86.5 16.78 Approved for 841 facilities (644 SHC and 197 NTSHC) as per 3rd quarter utilization i.e. 19.95% B3.6 Other 4 100000 4 1.73 Approved for 4 Hospitals. New is MCH Sopore B.4 Hospital Strengthening 200 250000 0 7,140.00 0.00 B.4.1 Up gradation of CHCs, PHCs, Dist. Hospitals 200 250000 0 7,140.00 0.00 B4.1. 1 District Hospitals 15 0 1,750.00 B4.1. 1.1 Additional Building/ Major Upgradation of existing Structure - B4.1. 1.2 Repair/ Renovation - B4.1. 1.3 Spillover of Ongoing Works 15 1,750.00 0 Approval pended. State to project ongoing proposals which were approved last year. B4.1. 1.4 Staff Quarters - B4.1. 2 CHCs 39 0 2,218.13 0 B4.1. 2.1 Additional Building/ Major Upgradation of existing Structure 8 601.31 0 Approval pended in view of limited resource envelope. State may submit a comprehensive plan. B4.1. 2.2 Repair/ Renovation - B4.1. 2.3 Spillover of Ongoing Works 31 1,616.82 0 Approval pended. State to project ongoing proposals which were approved last year. B4.1. 2.4 Staff Quarters - B4.1. 3 PHCs 35 0 570.5 0 B4.1. 3.1 Additional Building/ Major Upgradation of existing Structure 4 40 0 Approval pended in view of limited resource envelope B4.1. 3.2 Repair/ Renovation - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 221 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B4.1. 3.3 Spillover of Ongoing Works 28 440.5 0 Approval pended. State to project ongoing proposals which were approved last year. B4.1. 3.4 Staff Quarters 3 90 0 Approval pended in view of limited resource envelope B4.1. 4 Sub Centres 96 0 426.37 0 B4.1. 4.1 Additional Building/ Major Upgradation of existing Structure - B4.1. 4.2 Repair/ Renovation - B4.1. 4.3 Spillover of Ongoing Works 96 426.37 Approval pended. State to project ongoing proposals which were approved last year. B4.1. 4.4 ANM Quarters - B4.1. 5 Others (MCH Wings) 15 250000 0 2,175.00 0.00 B4.1. 5.1 (Absolutely) New / Rented to Own Building 8 2,000.00 0 Activity is pended in view of limited resource envelope. B4.1. 5.2 Additional requirement from previous work - B4.1. 5.3 Carry forward /Spillover of Ongoing Works - B4.1. 5.4 Other construction 7 250000 0 175 0 B4.1. 5.4.1 Civil works for DEIC under RBSK No. 7 250000 0 175 0 RBSK is kept pended in view of limited Resource Envelope. B4.1. 6 SDH 0 0 - B5 New Constructions (proposed for the coming year) 10 510000 0 137 0 B5.1 CHCs B5.2 PHCs B5.3 SHCs/Sub Centres 7 35 0 Approval pended in view of limited resource envelope Opening of New Sub Centres No. 400 333200 0 Approval pended. State to provide the list of sub Centers. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 222 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B5.4 Setting up Infrastructure wing for Civil works 0 0 - B5.6 Construction of BEmONC and CEmONC centres 2 510000 0 102 0 B.5.6 .1 Absolutely new SNCU/NBSU/NBCC 2 510000 0 102 0 Not approved in view of limited resource envelope. B.5.1 0 Infrastructure of Training Institutions - - 0 0 - B.5.1 1 SDH - B.5.1 2 DH - B.6 Corpus Grants to HMS/RKS 749 800000 845 277.4573 B6.1 District Hospitals 24 500000 120 46.992 Approved for 22 DH as per 4th quarter utilization i.e. 42.72% B6.2 CHCs 84 100000 84 36.5117 Approved for83 CHC as per 4th quarter utilization i.e.43.99% B6.3 PHCs 637 100000 637 192.2448 Approved for 528 facilities (385 PHCs and 143 NTPHCs) as per 4th quarter utilization i.e.36.41% B6.4 Other or if not bifurcated as above 4 100000 4 1.7088 Approved for 4 hospitals as per 4th quarter utilization i.e. 42.72% B6.5 SDH - B7 Health Action Plans (Including Block, Village) 0 0 - B8 Panchayati Raj Initiative 0 0 306.86 0 B8.1 Constitution and Orientation of Community leader & of VHSC,SHC,PHC,CHC etc 306.86 0 Not approved. B8.2 Orientation Workshops, Trainings and capacity building of PRI at State/Dist. Health Societies, CHC,PHC - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 223 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B8.3 Others 0 0 - B9 Mainstreaming of AYUSH 1349 96000 3,480.48 752.96 B.9.1 Medical Officers at CHCs/ PHCs (Only AYUSH) 712 60000 2,563.20 523.008 B.9.1 .1 DH - B.9.1 .2 FRUs - B.9.1 .3 Non FRU SDH/ CHC - B.9.1 .4 24 X 7 PHC 200 30000 720 523.008 Approved for 454 in position AYUSH doctors @ Rs 19,200 per month for 6 months. 90 AYUSH doctors may be engaged under RBSK team. New HR not approved. B.9.1 .5 Non- 24 X 7 PHCs/ APHCs 512 30000 1,843.20 B.9.2 Other Staff Nurses and Supervisory Nurses/ AYUSH pharmacists (Only AYUSH) 637 36000 917.28 249.48 B.9.2 .1 DH - B.9.2 .2 FRUs - B.9.2 .3 Non FRU SDH/ CHC - B.9.2 .4 24 X 7 PHC 200 12000 288 229.95 Approved 365 in position Dawasaaz @ 10,500 per month for this FY for 6 months. B.9.2 .5 Non- 24 X 7 PHCs 198 12000 285.12 B.9.2 .6 Urban Clinics/ Health Posts - B.9.2 .7 Other 239 12000 344.16 0 New HR not approved. B9.3 Other Activities (Excluding HR) 0 0 - B9.4 Training - B10 IEC-BCC NRHM 3334 33450 394.82 90 B.10 Strengthening of BCC/IEC Bureaus (state and district levels) 0 0 - 90 Rs 90 lacs approved for IEC (Rs 3 lacs/district for 11 districts and Rs 1 lac/district for 12 districts and the same amount at the state level. Activity at FMR B.10. 1 Development of State BCC/IEC strategy - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 224 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B.10. 2 Implementation of BCC/IEC strategy 3158 24450 217.31 A.7.2.7 i.e. Debates, seminars at universities/colleges for PNDT approved. B.10. 2.1 BCC/IEC activities for MH 654 23150 37.03 B.10. 2.1.1 Mass media 150 22500 33.75 B.10. 2.1.2 Mid-media 504 650 3.28 B.10. 2.2 BCC/IEC activities for CH 2000 650 13 B.10. 2.2.1 Mass media B.10. 2.2.2 Mid-media 2000 650 13 B.10. 2.3 BCC/IEC activities for FP 504 650 3.28 B.10. 2.3.1 Mass media B.10. 2.3.2 Mid-media 504 650 3.28 B.10. 2.4 BCC/IEC activities for ARSH 0 0 53.62 B.10. 2.4.1 Mass media - B.10. 2.4.2 Mid-media 53.62 B.10. 2.5 Other activities (please specify) 110.38 B.10. 2.6 IPC initiatives/tools - B.10. 3 Health Mela - B.10. 4 Creating awareness on declining sex ratio issue 53.39 B.10. 5 Other activities 176 9000 124.12 B.10. 5.1 Printing of MCP cards, safe motherhood booklets etc - B.10. 5.2 Printing of WIFS cards etc - B.10. 5.3 Other printing 176 9000 124.12 B.10. 5.3.1 Promotion and propagation and AYUSH Units at PHCs & LHTs 20 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 225 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B.10. 5.3.2 Issue of press Advertisement in print media throught information department 12 B.10. 5.3.3 Display of scroll with nine slogans from 4 cable networks of Jammu & Srinagar cities with atleast 30 displays per day @ Rs.8000/- per scroll per month. 48 9000 4.32 B.10. 5.3.4 NRHM Sammelans at block / Halqa Panchayat levels 128 34.4 B.10. 5.3.5 Miscellaneous IEC/BCC activites 53.4 B11 Mobile Medical Units (Including recurring expenditures) 11 237500 0 261.25 0 Approval Pended subject to State implementing ‘National MMU Guidelines’ for all the running MMUs under NRHM B11. 1.1 Capex 11 237500 0 261.25 0 B11. 1.2 Opex - B11. 1.5 Others - B11. 2 Mobile Medical Vans (smaller vehicles) and specialised Mobile Medical Units 0 0 - B11. 2.4 Training/orientation - B11. 2.5 Others - B12 Referral Transport/Patient transport System 8 140621 1,382.39 16.87 Approval Pended subject to State implementing ‘National Ambulance Guidelines’ for all the running ambulances under NRHM B12. 1 Ambulance/EMRI Capex 0 0 400 Since there is no further requirement of new ambulances, NPCC has not approved the activity. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 226 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B12. 1.1 State basic ambulance/ 102 Capex - B12. 1.2 Advanced life support Capex - B12. 1.3 EMRI Capex-BLS 400 B12. 1.4 EMRI Capex-ALS - B12. 2 Operating Cost /Opex for ambulance 8 140621 982.39 16.87 B12. 2.1 State basic ambulance/102 Opex 1 140621 16.87 16.87 Rs 16.87 lakhs is recommended for approval for setting up two Regional Call Centers for 102. (Centralised call centre) subject to sharing the costing details. B12. 2.2 Operating Cost /Opex for ASL ambulance - B12. 2.3 Opex EMRI-BLS 750 B12. 2.4 Opex EMRI-ALS - B12. 2.5 HR Basic ambulance - B12. 2.6 HR advanced life support ambulances - B12. 2.6 Training/orientation - B12. 2.7 Call centre-capex 30 B12. 2.8 call centre-opex 132 B12. 2.9 Others 7 0 53.52 B12. 2.9.1 Procurement of Ambulances - B12. 2.9.2 Procurement of Boat Ambulances 1 ALS and 1 BLS for providing emergency care services for the people of Dal Lake area No. of Ambula nces 2 48 B12. 2.9.3 HR for Boat Ambulances No. of Persons 5 5.52 B.13 PPP/ NGOs 0 0 - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 227 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B13. 1 Non governmental providers of health care RMPs - B13. 2 Public Private Partnerships (Out Sourcing set up, if applicable for State, to be budgeted under this head) 0 0 - B13. 3 NGO Programme/ Grant in Aid to NGO 0 0 - B14 Innovations( if any) 408 358200 1,679.04 1.00 B14. 1 Intersectoral convergence 4 25000 1 1 Approved. B14. 2 Community Based Monitoring and Planning (CBMP) B14. 3 Distict Based Comprehensive Newborn Care Package - NIPI UNOPS and Government of J&K Collaboration No. of Pilot Districts 4 345.24 0 not recommended keeping in view that state has to utilise the available resources for the existing activities B14. 5 Incentive to parents having two daughters adopting permanent method of family planning - B14. 6 Incentive to the Village Health Sanitation and Nutrition Committees where the sex ratio at birth is 1:1 - B14. 7 Opening of New Sub Centres No. 400 333200 1,332.80 0 shifted to B5.3 B14. 8 Establishment of PC&PNDT cell at Divisional Level - B14. 9 Initiatives under School Health Programme - B14. 10 IYCF Practices - B15 Planning, Implementation and Monitoring 14574 320240 991.48 279.19 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 228 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B15. 1 Community Monitoring (Visioning workshops at state, Dist, Block level) 0 0 - B15. 2 Quality Assurance 0 0 - B15. 3 Monitoring and Evaluation 14574 320240 991.48 279.19 B15. 3.1 Monitoring & Evaluation / HMIS /MCTS 152 23940 207.14 51.44 B15. 3.1.1 HR for M&E/HMIS/MCTS 2 12600 3.02 1.44 Approved 1.44 lakhs for 2 HMIS fellow at existing salary @ 12000 per month for six months. B15. 3.1.5 Data Entry Operators 150 11340 204.12 50 the activity of data entry is approved. However, the work is to be carried out on task rate basis and no post is to be created. B15. 3.1.6 Others (Please specify) 0 0 - B15. 3.1.6 .1 Boats for mointoring and outreach actvities in Dal Lake- Srinagar - B15. 3.1.6 .2 V-Sat for difficult districts where internet connectivity is a problem- Leh, Kargil, Poonch & Rajouri - B15. 3.2 Computerization HMIS and e- governance, e-health 496 50750 366.63 35.05 B15. 3.2.1 .a HMIS Operational Cost (excluding HR & Trainings) - B15. 3.2.1 .b Procurement of Computers/ printers/ cartridges etc. 139 50000 69.5 0 Approval pended. B15. 3.2.1 .c Maintenance of Computers/ AMC/ etc. 2.5 0 Not approved since details like number of computers for which AMC is required, the unit cost of computer & whether these computers are being used for HMIS/MCTS related work have not Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 229 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks been provided. B15. 3.2.1 .d Other Office and admin expenses 357 750 294.63 35.05 B15. 3.2.1 .d.1 Mobility Support for M&E 257.5 2.45 Approved 2.45 lakhs @ Rs 10000 per district and Rs 25000 for State level per annum as per the norms of Mobility Support. Amount approved is indicative figure and actual amount would be based on actual expenditure. Salient observations to be shared with MOHFW. Visits to be undertaken only for HMIS/MCTS related work. B15. 3.2.1 .d.2 Internet connectivity 357 750 32.13 32 Approved @ unit cost of 750 per month B15. 3.2.1 .d.3 Consumables at State level 2.5 0.3 Approved Rs 0.30 Lakh @ Rs 2500 per month. Procurement should be on the basis of competitive bidding and following Government Protocols B15. 3.2.1 .d.4 Consumables at divisional level 2.5 0.3 Approved Rs 0.30 Lakh @ Rs 2500 per month for all Divisions combined. Procurement should be on the basis of competitive bidding and following Government Protocols B15. 3.2.1 .d.5 Consumables at PHCs and NTPHCs - B15. 3.2.2 .a MCTS Operational Cost (excluding HR & Trainings) 0 0 - B15. 3.3 Other M & E Activities 13926 245550 417.71 192.7 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 230 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B15. 3.3.4 Review Meetings for HMIS 2 100000 2 2 Approved for one day combined review for HMIS and MCTS for at least 2 reviews per year at state levels, at least 1 review per quarter at district level and at least 1 review per month at block level. Expenditure will be as per extant rule. State must share the outcomes of the meetings with MoHFW and may involve PRCs in the same B15. 3.3.5 Review Meetings for MCTS - B15. 3.3.6 Data Validation Call Centers - CAPEX B15. 3.3.7 Data Validation Call Centers - OPEX 8.44 0 Not approved. . B15. 3.3.8 e-Governance Initiative - B15. 3.3.9 Hospital Management Softwares 200 0 Pended. Details (features, functionalities, expenditure, outcomes etc.) may be shared. B15. 3.3.1 0 Others 13924 145550 207.27 190.7 B15. 3.3.1 0.1 Printing of new registers approved by GoI 20 20 Approved for printing MCTS (Integrated RCH) register @ Rs 150 per register and not more than 2 registers per ANM and HMIS formats @ 0.40 paisa per page. Amount approved is indicative figure and actual amount would be based on actual expenditure. Printing should be based on competitive bidding following Govt. Protocols. State may share a specimen of MCTS register / HMIS formats with MoHFW before proceeding with Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 231 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks printing. B15. 3.3.1 0.2 Mobile charges for ANM at sub-centres (Regular ANMs) for tracking of pregant women and children/mointoring & Rs 100/- respctively per month) 1910 100 22.92 22.92 (On-going activity) Approved subject to the condition that mobile charges should be provided only for those ANMs whose mobile numbers are validated and updated on MCTS portal. Payment should be on the basis of the updation of records done by ANM. State may share the outcomes so far. Note: In future Mobile charge support will be provided to the State for the best performing ANMs only. Evaluation will be done based on the beneficiaries coverage reflected on the MCTS portal. B15. 3.3.1 0.3 Reimbursement of Mobile user charges of ASHA @ Rs 100 per month 12000 100 144 144 (On-going activity) Approved subject to the condition that mobile charges should be provided only for those ASHAs whose mobile numbers are validated and updated on MCTS portal. Payment should be on the basis of the updation of records done by ASHA. State may share the outcomes so far. Note: In future Mobile charge support will be provided to the State for the best performing ASHAs only. Evaluation will be done based on the beneficiaries coverage reflected on the MCTS portal. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 232 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B15. 3.3.1 0.4 Capity bulidings of CMOs / BMOs / DPMUs / BPMUs/ Data Entry Operators at PHC and New Type PHCs at Division level for re-orienation of HMIS and MCTS 28 batches of 35 participants each 14 145350 20.35 3.78 Approved Total cost of training 3 day combined training for HMIS and MCTS @ Rs 300 per day per person for 1 training per person per year. Amount approved is indicative figure and actual amount would be based on actual expenditure. B15. 3.3.1 0.5 Ongoing review of MCH tracking activities (2 Review meeting to be held after 6 months for both the Divisions headed by Secreatry / Mission Director to review HMIS / MCTS in both the Divisions ) - No budget has been proposed under this activity. B.16 PROCUREMENT 6941405 3 554535 4,055.66 696.30 B16. 1 Procurement of Equipment 2578 454450 528.84 94.48 B16. 1.1 Procurement of equipment: MH 0 0 - B16. 1.1.1 Equipments for Blood Banks/ BSUs - B16. 1.1.2 MVA /EVA for Safe Abortion services - B16. 1.1.3 Others (please specify) 0 0 - B16. 1.2 Procurement of equipment: CH 0 0 - B16. 1.2.1 Procurement of equipment: CH (NBCC @ Rs. 85000 X 50) B16. 1.2.2 Procurement of equipment: CH for strengthening of the paediatrics department SMGS hospital Jammu and GB Pant Hospital Srinagar (Training Centre) project submitted - B16. 1.3 Procurement of equipment: FP 2529 453600 94.94 94.06 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 233 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B16. 1.3.1 NSV kits 110 1600 1.76 0.88 Approved @ Rs 800 per kit for 110 kits. B16. 1.3.2 IUCD kits 2409 2000 48.18 48.18 Approved B16. 1.3.3 minilap kits - B16. 1.3.4 laparoscopes 10 450000 45 45 Approved B16. 1.3.5 PPIUCD forceps - B16. 1.3.6 Other (please specify) 0 0 - B16. 1.4 Procurement of equipment: IMEP 0 0 - B16. 1.5 Procurement of equipment other than above - B16. 1.5.1 Procurement of OT Equipments - B16. 1.6 Equipments for ARSH/ School Health 49 850 433.9 0.42 B16. 1.6.1 Equipments for ARSH Clinics 49 850 0.42 0.42 Approved B16. 1.6.2 Equipments for School Health Equipments for School Health Screening (weighing scale, Height measurement scale and Snellens’ Charts) 433.48 0 RBSK proposal is kept pended in view of limited RE. B16. 1.7 Equipments for Training Institutes - B16. 1.8 Equipments for AYUSH - B16. 1.9 Procurement of Others/Diagnostics - B.16. 2 Procurement of Drugs and supplies 6941147 5 100085 3,526.82 601.82 B.16. 2.1 Drugs & supplies for MH 0 0 - B.16. 2.1.3 Others (Please specify) 0 0 - B.16. 2.2 Drugs & supplies for CH 4811405 84 387.42 387.42 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 234 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B.16. 2.2.1 IFA tablets and De- worm tablets for students studying in primary school 6th to 12th class teachers, General IFA Tablets and Deworming tablets under School health - B.16. 2.2.2 IFA KID tablets 52 doses of 1 ml syrup for each child 1644813 14 230.27 230.27 Approved B.16. 2.2.3 Procurement of ORS packets No. of packets 1879033 2.25 42.28 42.28 Approved B.16. 2.2.4 Procurement of zinc tablets 1252689 7.5 93.95 93.95 Approved B.16. 2.2.5 Procurement of vitamin A syrup No. of bottles 34870 60 20.92 20.92 Approved B.16. 2.3 Drugs & supplies for FP 0 0 - B.16. 2.4 Supplies for IMEP 0 0 100 0 B.16. 2.4.1 For colour bags, bins, needle destroying units, transportation trollies, Hypochlorite solution etc. 100 0 Not Approved B.16. 2.5 General drugs & supplies for health facilities 0 0 800 42 Not approved. B.16. 2.5.1 IPD 800 0 Replenishment of ASHA drug kits 42 B.16. 2.5.2 OPD - B.16. 2.6 Drugs & supplies for WIFS 6460000 0 1 142.4 142.4 B.16. 2.6.1 IFA No. of tablets + 20% buffer stock 6240000 0 0.2 124.8 124.8 Approved B.16. 2.6.2 Albendazole No. of tablets + 10% buffer stock 2200000 0.8 17.6 17.6 Approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 235 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B.16. 2.7 Drugs & supplies for SHP No. of districts x 10 months 70 100000 70 30 Rs 30 lakhs is approved to procure medicines of Rs 16000 per team and Rs 8000 for once refill. Conditionality State to procure medicines only in accordance to the RBSK EDL to be announced from GoI. B.16. 2.8 Drugs & supplies for UHCs - B.16. 2.9 Drugs & supplies for AYUSH 2,027.00 0 Not approved. B.17 Regional drugs warehouses/Logistic s management 0 0 400 200 B.17. 1 Drug warehouses 400 200 Approved 50% of work in view of limited resource envelope. B.17. 2 Staff at State level - B.17. 3 Staff at District level - B.17. 4 Others 0 0 - B.18 New Initiatives/ Strategic Interventions (As per State health policy)/ Innovation/ Projects (Telemedicine, Hepatitis, Mental Health, Nutrition Programme for Pregnant Women, Neonatal) NRHM Helpline) as per need (Block/ District Action Plans) 0 0 14.17 14.17 B.18. 1 Help Lines 14.17 14.17 Approved as an ongoing activity B.19 Health Insurance Scheme - B.20 Research, Studies, Analysis 28 0 Not Approved B.21 State level health resources centre(SHSRC) 0 0 - B.21. 1 SHSRC - HR - B.21. 2 Other cost - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 236 - S. No. Budget Head Unit of Measur e Quantity / Target Unit Cost ( Rs in lacs) Amount Proposed ( Rs in lacs) Amount Approve d ( Rs in lacs) Remarks B22 Support Services 0 0 107 0 B22. 1 Support Strengthening NPCB - B22. 4 Support Strengthening RNTCP 107 0 Not approved B.23 Other Expenditures (Power Backup, Convergence etc) 0 0 991.92 45.92 B.23. 1 Power Backup for Kashmir Divion Office & DHSs - B.23. 2 Strengthening of RIHFW 45.92 45.92 Approved as an ongoing activity. B.23. 3 Upgradation of 2 Drug Testing Laboratories (Divisional level) 701 0 Approval Pended in view of limited Resource Envelope B.23. 4 Running cost for Central Heating System in Leh / Kargil 245 0 Not Approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 237 - Annexure 3 DETAILED BUDGET: IMMUNIZATION FMR Code BUDGET HEAD Physical target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS C.1 RI Strengthening Project ( Review meetings, Mobility support, Outreach services etc) c.1.a Mobility Support for supervision for district/block level officers. Rs.2,50,000/ Year /district level officers. 22.00 55.00 55.00 c.1.b Mobility support for supervision at state level Rs. 150000 per year. 2.00 1.50 1.50 c.1.c Printing and dissemination of Immunization cards, tally sheets, monitoring forms etc. Rs. 10 beneficiaries 100000.00 10.00 10.00 c.1.d Support for Quarterly State level review meetings of district officer Rs. 1250/ per participant/day for 3 persons (CMO/DIO/Dist. Cold Chain Officer) 8.00 3.30 3.30 State to share the meeting notice and minutes with MOHFW. c.1.e Quarterly review meetings exclusive for RI at district level with one Block MOs, CDPO, and other stake holders Rs. 100/per participant for meeting expenses for 5 persons (lunch, Organization expenses) 88.00 2.86 2.86 State to share the meeting notice and minutes with MOHFW. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 238 - FMR Code BUDGET HEAD Physical target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS c.1.f Quarterly review meetings exclusive for RI at block level Rs. 50/ per person as honorarium for ASHA (Travel) and Rs. 25/person at the disposal of MO-IC for meeting expenses (refreshment, stationary and misc. expenses) 117.00 3.59 3.59 State to share the meeting notice and minutes with MOHFW. c.1.g Focus on slum & underserved areas in urban areas/alternative vaccinator for slums Hiring of ANM@450/sess ion for four session/month/ slum of 10000 population and Rs. 300/- per month as contingency per slum i.e. Rs. 2100/- per month per slum of 10000 population 491.00 10.31 10.31 c.1.h Mobilization of children through ASHA or other mobilizers Rs. 150 per session 106666.00 160.00 160.00 c.1.i Alternative vaccine delivery in hard to reach areas Rs. 150 per session 3000.00 4.50 4.50 c.1.j Alternative Vaccine Delivery in other areas Rs. 75 per session 14000.00 10.50 10.50 c.1.k To develop micro plan at sub-centre level @ Rs 100/- per subcentre 2253.00 2.25 2.25 c.1.l For consolidation of micro plans at block level Rs. 1000 per block/ PHC and Rs. 2000 per district 502.00 5.24 5.24 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 239 - FMR Code BUDGET HEAD Physical target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS c.1.m POL for vaccine delivery from State to district and from district to PHC/CHCs Rs1,50,000/ district/year 22.00 33.00 33.00 c.1.n Consumables for computer including provision for internet access for RIMs @ 400/ - month/ district 22.00 1.06 1.06 c.1.o Red/Black plastic bags etc. Rs. 3/bags/session 185000.00 5.55 5.55 c.1.p Hub Cutter/Bleach/Hypochlo rite solution/ Twin bucket Rs. 1200 per PHC/CHCper year 718.00 8.62 8.62 c.1.q Safety Pits Rs. 5250/pit 35.00 1.84 1.84 c.1.r State specific requirement (Maintainence of WIC in Sri Nagar & Jammu) 1.00 2.00 0.00 The state should engage refrigerator mechanics for this activity and funds for maintainence to be used from cold chain maintenance funds under C.4 c.1.s Teeka Express Operational Cost 44.59 44.59 c.1.t Measles SIA operational Cost 0.00 0.00 Not recommended, as no planned Measles SIA in Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 240 - FMR Code BUDGET HEAD Physical target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS F.Y. 2013-14 c.1.u JE Campaign Operational Cost 0.00 0.00 Not recommended, as no planned JE Campaign in F.Y. 2013-14 c.1.v Others (IEC activities for Immunisation strengthening activities & Office expenses) 1.00 18.38 0.00 Not recommended, as activity approved under comprehensive IEC plan. C.1-Sub Total 384.08 363.70 C.2 Salary of Contractual Staffs C.2.1 Computer Assistants support for State level Rs.12000-15000 per person per month 1.00 1.51 0.75 * Salary is for 6 months * State to provide details of total sanctioned posts, filled up and vacancy. C.2.2 Computer Assistants support for District level 8000-10000 per person per month 22.00 29.94 13.20 * Salary is for 6 months * State to provide details of total sanctioned posts, filled up and vacancy. C.2.3 Others(service delivery staff)-Establishment of State Immunization Cell includes HR and mobility (New Innovation). SEPIO (mobility & logistics support) Already existing 6.00 0.00 Not recommended Technical Officer Routine Immunization ( NEW POSTS) 70000/m 2 28.80 14.40 * Recommended . Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 241 - FMR Code BUDGET HEAD Physical target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS * Salary is for 6 months State Immunization Training Coordinator 60000/m 1 13.20 0.00 Not recommended Regional Routine Immunization Coordinators 25000/m 2 12.00 0.00 Not recommended State Cold Chain Officer 50000/m 1 12.00 0.00 Not recommended Technical Assistant Already existing 2.40 0.00 Not recommended Program cum Computer Assistant 15000/m 3 5.40 1.80 * Recommended for 2 posts of assistants @ Rs 15,000/m * 6 months * 2 posts * Salary is for 6 months Divisional/Regional Warehouse Vaccine & Logistics Manager 20000/m 2 3.36 0.00 Not recommended Cold Chain & Vaccine Logistics Helpers 7000/m 2 1.68 0.00 Not recommended C.2-Sub Total 116.29 30.15 C.3 Training under Immunization Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 242 - FMR Code BUDGET HEAD Physical target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS C.3.1 District level Orientation training including Hep B, Measles & JE(wherever required) for 2 days ANM, Multi Purpose Health Worker (Male), LHV, Health Assistant (Male/Female), Nurse Midwives, BEEs & other staff ( as per RCH norms) As per revised norms for trainings under RCH 100.00 57.20 57.20 Approved, but expenditure has to be as per NRHM norms. Also, all the trainings should be approved from Immunization division. C.3.2 Three day training including Hep B, Measles & JE(wherever required) of Medical Officers of RI using revised MO training module) 25.00 27.64 27.64 C.3.3 One day refresher training of district Computer assistants on RIMS/HIMS and immunization formats 2.00 0.39 0.39 C.3.4 Two days cold chain handlers training for block level cold chain handlers by State and district cold chain officers 22.00 10.75 10.75 C.3.5 One day training of block level data handlers by DIOs and District cold chain officer 0.00 0.00 C.3.6 Others 0.00 0.00 C.3-Sub Total 95.97 95.97 C.4 Cold chain maintenance Rs.750/PHC/CH Cs per year District Rs.15000/year 718 and 22 Districts 8.68 8.68 Recommended as per norms, However, the expenditure has to be as Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 243 - FMR Code BUDGET HEAD Physical target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS per actuals.Also, in case the expenditure exceeds the approved allocation , the state may request to MOHFW for additional allocation by reappropriatin g within part C. C.5 ASHA incentive for full Immunization Rs 100 per child for full immunization in first year 100000.00 150.00 150.00 Rs 50 per child for ensuring complete immunization upto 2nd year of age Total ROUTINE IMMUNIZATION 755 648.51 C.6 Pulse Polio Operational Cost (Tentative) 394.57 398.07 Approved, subject to approval for Pulse Polio Cost. Total 1149.59 1046.58 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 244 - Annexure 4A DETAILED BUDGET NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP) FMR Code BUDGET HEAD Physica l target Unit Cost ( Rs) Amount Proposed (Rs in Lakhs) Amount Approved (Rs in Lakhs) REMARKS D IDD D.1 IDD Control Cell- Impleme ntation & monitori ng of the program me 15.50 14.00 State Govt. may conduct and co-ordinate approved programme activities and furnish quarterly financial & physical achievements as per prescribed format D.1.a Technical Officer 1 D.1.b Statistical Assistant 1 D.1.c LDC Typist 1 D.2 IDD Monitoring Lab- Monitori ng of distric t level iodine content of salt and urinary iodine excretio n as per Policy Guidelin es. 6.50 6.00 The vacant post of Lab Assistant should be filled up on regular/contractual basis on priority State Govt. may conduct quantitative analysis of salt & urine as per NIDDCP Guidelines and furnish monthly/quarterly statements D.2.a Lab Technician 1 D.2.b Lab. Assistant 1 D.3 Health Education & Publicity Increase d awarene ss about IDD and iodated salt. 2.00 2.00 IDD publicity activities including Global IDD Day celebrations at various level. D.4 IDD Survey/resurve Rs. 50,000 4 districts 2.00 2.00 State. Govt. may under take 4 districts IDD survey as per Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 245 - ys per district guidelines and furnish report. D.5 Salt Testing Kits to be procured by the State Government for 14 endemic districts 12 STK per annum per ASHA Creating iodated salt demand and monitori ng of the same at the commun ity level. ** State Govt. to monitor the qualitative analysis of iodated salt by STK through ASHA in 14 endemic districts i.e. Ananthnag, Badgam, Baramulla, Doda, Jammu, Kargil, Kathau, Kupwara, Ladakh, Pulwama, Pounch, Rajori, Srinagar, Udhampur. D.6 ASHA Incentive Rs.25/- per month for testing 50 salt sample /month 50salt samples per month per ASHA in 14 endemic districts. 36.00 ** TOTAL 64.50 24.00 ** Based on the demand of State/UT Govt. for procuring STK & performance based incentive to ASHA for 14 endemic districts funds will be released through flexi pool of NRHM by GOI. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 246 - Annexure 4B DETAILED BUDGET INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP) FMR Code Activity Unit Cost (where-ever applicable) Amount Proposed (Rs. in lakhs) Amount Approved (Rs in lakhs) Remarks E1. Operational Cost 1.1 Field Visits 5.0+ 24.0 (2.40x10) 29.0 1.2 Office Expenses 1.3 Broad Band expenses 1.4 Outbreak investigations including Collection and Transport of samples 1.5 Review Meetings 1.6 Any other Sub Total 29.0 29.0 E2. Laboratory Support 2.1 District Priority Lab 2.2 Referral Network Lab 5.00x1+5 5.0 2.3 District health lab 34.70x4= 138.8 35.8 (non recurring) 143.8 40.8 E3. Human Resources 3.1 Remuneration of Epidemiologists 52.80 33.66 The remuneration for vacant positions has been calculated for 6 months only, and for microbiologist remuneration has been calculated for 9 months. *Medical Epidemiologists, Consultant training and Medical Microbiologists with medical qualifications should be paid higher remuneration than the non-medical epidemiologists, consultant training and microbiologists The microbiologist can be appointed at one of 3.2 Remuneration of Microbiologists 4.80 3.60 3.3 Remuneration of Entomologists 3.6 - 3.4 Veterinary Consultant - - 3.5 Consultant-Finance/ Procurement 3.78 - 3.6 Consultant-Training/ Technical 4.20 - 3.7 Data Manager 28.22 20.76 3.8 Data Entry Operator 22.91 16.28 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 247 - the labs being established under IDSP Sub Total 120.27 74.3 E4. Training As per NRHM Guidelines Training of DM & DEO would be conducted online 4.1 One day training of Hospital Doctors 3,00,000 ( 60,000 x 5 Batches ) 1.0 4.2 One day training of Hospital Pharmacist / Nurses 1,00,000 ( 25,000 x 4 Batches ) 0.50 4.3 One day training of Medical College Doctors 62,000 (31,000 x 2 Batches ) 0.20 4.4 ASHA & MPWs AWW and community volunteers 1,00,000 (25,000 x 4 Batches ) 0.0 4.5 Training of Lab technicians 1,00,000 ( 50,000 x2 batches ) 0.30 4.6 One day training of DM & DEO 88,000 ( 44,000 x 2 Batches ) 0.0 One day training for data entry and analysis for block health team (Including block programme manager 50,000 ( 25,000 x 2 Batches) 0.0 Sub Total 8.0 2.0 E5. Outbreak Investigation & Response E6. Analysis & Use of Data E7. Civil Works E8. Procurement of Computer Hardware E10. New Districts 14.0 14.0 Total (Jammu) 315.07 160.1 Based on past trend, Rs. 100 lakhs has been approved for JK under IDSP for 2013-14. However, if there is increase in expenditure by State as per IDSP approved norm, the budget for State could be increased at RE stage Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 248 - Comments from CSU, IDSP on proposed NPCC budget (2013-14) for Kashmir Division (JK) No of Districts (12) FMR Code Activity Unit Cost (where-ever applicable) Amount Proposed (Rs. in lakhs) Amount Approved (Rs in lakhs) Remarks E1. Operational Cost 1.1 Field Visits Rs 2,40,000 per District Surveillance Unit per annum Rs 5,00,000 State Surveillance Unit per annum 42.00 33.80 1.2 Office Expenses 1.3 Broad Band expenses 1.4 Outbreak investigations including Collection and Transport of samples 1.5 Review Meetings 1.6 Any other Activities Sub Total 42.00 33.80 E2. Laboratory Support 2.1 District Priority Lab Rs. 4,00,000 per district priority lab per annum 4.0 4.0 2.2 Referral Network Lab Rs. 5,00,000 per referral lab per annum 10.0(5.0x2) 10 2.3 District public health lab 2 (Anantnag and Baramulla 46.0(30 non recurring+ 16 recurring) 38.0(30 non recurring+ 8 recurring) Sub Total 60.0 52.0 E3. Human Resources 3.1 Remuneration of Epidemiologists 62.4 45.6 The remuneration for vacant positions has been calculated for 6 months only *Medical Epidemiologists, Consultant training and Medical Microbiologists with medical qualifications should be paid higher remuneration than the non-medical epidemiologists, consultant training and microbiologists 3.2 Remuneration of Microbiologists 9.6 9.6 3.3 Remuneration of Entomologists 3.6 1.80 3.4 Veterinary Consultant 3.6 1.80 3.5 Consultant-Finance/ Procurement 2.40 2.40 3.6 Consultant-Training/ Technical 3.6 1.80 3.7 Data Manager 31.00 22.92 3.8 Data Entry Operator 21.60 18.72 Sub Total 138.0 104.64 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 249 - E4. Training As per NRHM Guidelines Training of DM & DEO would be conducted online 4.1 One day training of Hospital Doctors 3.60 (.60x 6batches) 1.00 4.2 One day training of Hospital Pharmacist / Nurses 0.50( .25x2 batches) 0.25 4.3 One day training of Medical College Doctors 0.31 0.16 4.4 One day training for Data Entry and analysis for Block Health Team 0.25(.25x1) 0.13 4.5 One day training of DM & DEO 0.88(.44x2) 0.0 Lab technician training 0.50( .50x1 batches) 0.25 ASHA MPWs AWW and community volunteers 0.75(.25x3) 0.37 Subtotal Total 6.79 2.16 E5. ID Hospital Network E7. New formed Districts(Computer hardware ) 14.0 - Already approved in ROP 2012-13 Total (Kashmir) 260.79 192.6 Total (Jammu) 315.07 160.1 Total (Jammu &Kashmir) 575.86 352.7 Based on past trend, Rs. 100 lakhs has been approved for JK under IDSP for 2013-14. However, if there is increase in expenditure by State as per IDSP approved norm, the budget for State could be increased at RE stage Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 250 - Annexure 4C DETAILED BUDGET NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME (NVBDCP) FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks F.1 DBS (Domestic Budget Support) F.1.1 Malaria F.1.1.a Human Resource including MPW contractual Lab Technicians ( against vacancy ) VBD Technical Supervisor (one for each block) District VBD Consultant (one per district) (Non- Project States) State Consultant (Non – Project States) - M& E Consultant (Medical Graduate with PH qualification) - VBD Consultant (preferably entomologist) F.1.1.b ASHA Incentive 5.70 8.00 F.1.1.c Operational Cost Spray Wages 3.00 Recommended for focal spray from NRHM additionalities Operational cost for IRS Impregnation of Bed nets- for NE states F.1.1.d Monitoring , Evaluation & Supervision & Epidemic Preparedness including mobility 4.90 8.00 Recommended F.1.1.e IEC/BCC 10.55 10.00 Recommended F.1.1.f PPP / NGO and Intersectoral Convergence F.1.1.g Training / Capacity Building 9.00 10.00 Recommended Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 251 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks F.1.1.h Zonal Entomological units 6.00 Not approved due to budgetary restriction F.1.1.i Biological and Environmental Management through VHSC F.1.1.j Larvivorous Fish support F.1.1.k Construction and maintenance of hatcheries 12.00 Not Recommended F.1.1.l Contingencies Total Malaria (DBS) 51.15 36.00 F.1.2 Dengue & Chikungunya F.1.2.a Strengthening surveillance (As per GOI approval) F.1.2.a(i) Apex Referral Labs recurrent F.1.2.a(ii ) Sentinel surveillance Hospital recurrent 6.00 7.00 Opertional costs for laboratories as per guidelines to strengthen diagnostic facilities ELISA facility to Sentinel Surv Labs F.1.2.b Test kits (Nos.) to be supplied by GoI (kindly indicate numbers of ELISA based NS1 kit and Mac ELISA Kits required separately) • MAC ELISA kits are GOI supply through NIV, Pune. • ELISA based NS1 kits also decentralized item to be procurred by State out of cash grant under decentralized commodity. F.1.2.c Monitoring and evaluation 2.20 2.20 To improve programme Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 252 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks F.1.2.d Epidemic containment 1.75 1.25 implementatio n and case mangament to bring down Dengue Case fatality rate F.1.2.e Case management 1.00 F.1.2.f Vector Control & environmental management 5.00 Essential component, state need to plan source reduction activities as per the Mid Term Plan approved by CoS F.1.2.g IEC BCC for Social Mobilization 2.00 3.00 State to plan the activities as per GoI guidelines F.1.2.h Inter-sectoral convergence 0.50 F.1.2.i Training including Operational Research 0.00 Total Dengue/Chikungunya 11.95 19.95 F.1.3 Acute Encephalitis Syndrome (AES)/ Japanese Encephalitis (JE) F.1.3.a Diagnostics and Case Management including rehabilitation NA NA F.1.3.b IEC/BCC specific to J.E. in endemic areas F.1.3.c Capacity Building F.1.3.d Monitoring and supervision F.1.3.e Technical Malathion Fogging Machine Operational costs for malathion fogging Operational Research Rehabilitation Setup for selected endemic districts ICU Establishment in Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 253 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks endemic districts ASHA Insentivization for sensitizing community Other Charges for Training /Workshop Meeting & payment to NIV towards JE kits at Head Quarter Total AES/JE 0.00 0.00 F.1.4 Lymphatic Filariasis F.1.4.a State Task Force, State Technical Advisory Committee meeting, printing of forms/registers, mobility support, district coordination meeting, sensitization of media etc., morbidity management, monitoring & supervision, mobility support for Rapid Response Team and contingency support Not Applicabl e Not Applicabl e F.1.4.b Monitoring by Microfilaria Survey F.1.4.c Monitoring & Evaluation (Assessment) F.1.4.d Training District Officers, PHC MOs, Paramedical staff, drug distributors F.1.4.e BCC/Advocacy/IEC at state, district/PHC, sub centre F.1.4.f Honorarium for Drug Distribution including ASHAs and supervisors Verification and validation for stoppage of MDA in LF endemic districts a) Additional MF Survey b) ICT Survey c) ICT Cost Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 254 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks Verification of LF endemicity in non- endemic districts a) LY & Hy Survey b) Mf Survey in Non- endemic distt c) ICT survey Post-MDA surveillance Total Lymphatic Filariasis 0.00 0.00 F.1.5 Kala-azar F.1.5 Case search/ Camp Approach Not Applicabl e Not Applicabl e F.1.5.a Spray Pumps & accessories F.1.5.b Operational cost for spray including spray wages F.1.5.c Mobility/POL/supervisio n F.1.5.d Monitoring & Evaluation F.1.5.e Training for spraying F.1.5.f IEC/ BCC/ Advocacy Total Kala-azar 0.00 0.00 Total (DBS) 63.10 55.95 F.2 Externally aided component F.2.a World Bank support for Malaria (Identified state) F.2.b Human Resource Not Applicabl e Not Applicabl e F.2.c Training /Capacity building F.2.d Mobility support for Monitoring Supervision & Evaluation including printing of format & review meetings, Reporting format (for printing formats) Kala-azar World Bank assisted Project F.2.e Human resource Not Applicabl Not Applicabl F.2.f Capacity building Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 255 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks F.2.g Mobility e e F.3 GFATM support for Malaria (NE states) F.3.a Project Management Unit including human resource of N.E. states Not Applicabl e Not Applicabl e F.3.b Training/Capacity Building F.3.c Planning and Administration( Office expenses recurring expenses, Office automation , printing and stationary for running of project) F.3.d Monitoring Supervision (supervisory visits including travel expenses, etc) including printing of format and review meetings, F.3.e IEC / BCC activities as per the project F.3.f Operational cost for treatment of bednet and Infrastructure and Other Equipment (Computer Laptops, printers, Motor cycles for MTS ) Total : EAC component 0.00 0.00 F.4 Any Other Items ( Please Specify) 0.00 0.00 F.5 Operational costs ( mobility, Review Meeting, communication, formats & reports) 0.00 0.00 Grand total for cash assistance under NVBDCP (DBS + EAC) 63.10 55.95 F.6 Cash grant for decentralized commodities Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 256 - FMR Code Activity Unit Cost (wherever applicable ) Physical target/ Deliverable s Amount Proposed Amount Approve d Remarks F.6.a Chloroquine phosphate tablets 4.00 22.20 The commodities are recommended however it may be restricted to budgetary allocation F.6.b Primaquine tablets 7.5 mg 0.10 F.6.c Primaquine tablets 2.5 mg 0.00 F.6.d Quinine sulphate tablets 0.00 F.6.e Quinine Injections 0.00 F.6.f DEC 100 mg tablets 0.00 F.6.g Albendazole 400 mg tablets 0.00 F.6.h Dengue NS1 antigen kit 0.00 F.6.i Temephos, Bti (AS) / Bti (wp) (for polluted & non polluted water) 24.00 F.6.j Pyrethrum extract 2% for spare spray 6.00 F.6.k Any Other Items ( Please Specify) ACT ( For Non Project states) RDT Malaria – bi-valent (For Non Project states) Total grant for decentralized commodities 34.10 22.20 Grand Total for grant- in-aid under NVBDCP 97.20 78.15 Commodity to be supplied by NVBDCP 0.00 Total NVBDCP Cash + Commodity 97.20 78.15 Cash assistance required under NRHM flexi fund Components Unit Cost (wherever applicable ) Physical target/ Deliverable s Ammoun t Proposed Ammoun t Approve d Remarks Spray Wages 3.00 3.00 Recommended Total (Flexi fund) 3.00 3.00 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 257 - Annexure 4D DETAILED BUDGET NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks G1.Case detection & Management 1.1 Specific -plan for High Endemic Districts Block - - - 1.2 Services in Urban Areas Town - Town - 2 2.28 2.28 Med I- Med II- Mega- Med I- Med II- Mega- 1 2.40 2.40 1.3. ASHA Involvement Sensitization 100 600 0.60 0.60 *Incentive to ASHA Detection 250 100 0.25 0.25 PB 400 50 0.20 0.20 MB 600 50 0.30 0.30 1.4 Material & Supplies Supportive drugs, lab. reagents & equipments and printing works District 68,000 10 6.80 6.80 1.5 NGO - Scheme No. 600000 - - - G2. DPMR MCR footwear, Aids and appliances, Welfare allowance to patients for RCS, Support to govt. institutions for RCS MCR - 300/- 100 0.30 0.30 2 pair per person Aids/Appliance - 17000 1 0.17 0.17 Welfare/RCS - 8000 - - - At Institute - 5000 - - - At camps - 10000 G3. ** IEC/BCC Mass media, Outdoor media, Rural media, Advocacy media 98,000 10 9.80 9.80 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 258 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks G4. Human Resources & Capacity building 4.1 *** Capacity building 11 3.80 3.80 4.2. Human Resources on contract 4.2.1. **** Contractual Staff at State level SMO 1 40000 - - - BFO cum Admn. Officer 1 30000 - - - Admn. Asstt. 1 16000 1 1.92 1.92 DEO 1 12000 1 2.88 1.44 Only one DEO Driver 1 11000 - - - 4.2.2. District Leprosy Consultant 30000 - - - Post of Driver of districts not available Physiotherapist 25000 - - - 4.2.3. Special Provision for selected States NMS No. 25000 - - - 4.2.4. Staff for blocks PMW No. 16000 - - - G5. Programme Management ensured 5.1. Travel Cost travel expenses - Contractual Staff at State level 80000 10 0.60 0.60 travel expenses - Contractual Staff at District level 25000 - - - No Contractual at district 5.2 Review meetings 20000 to 50000 4 1.20 1.20 5.3 Office Operation & Maintenance Office operation - State Cell 1 75000 1 0.75 0.75 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 259 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks Office operation - District Cell No. 35000 10 3.50 3.50 Office equipment maint. State 1 50000 1 0.50 0.50 5.4 Consumables State Cell 1 50000 1 0.50 0.50 District Cell No. 30000 10 3.00 3.00 5.5 Mobility Support State Cell 2 200000 2 2.00 2.00 District Cell 1 150000 10 15.00 15.00 G6 Others travel expenses - Contractual Staff at State level GRAND TOTAL (JAMMU) 58.75 57.31 *Incentive to ASHAs will be given at revised rate subject to the approval by MSG. **The State Leprosy Officer will be able to distribute the total IEC funds on the basis of actual requirements of each district keeping adequate funds at State level under Mass Media and Advocacy meetings. ***Unit cost OF Training to be calculated as per State NRHM norm fixed for all health programmes. **** Remuneration of Contractual staff may be revised keeping in view the prevailing rate of remuneration in other National Health Programmes. Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks G1.Case detection & Management 1.1 Specific -plan for High Endemic Districts Block - - - 1.2 Services in Urban Areas Town - Town - - - - To be decided Med I- Med II- Mega- Med I- Med II- Mega- - - - Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 260 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks 1.3. ASHA Involvement Sensitization 100 - 0.54 0.54 Target not given * Incentive to ASHA Detection 250 PB 400 MB 600 1.4 Material & Supplies Supportive drugs, lab. reagents & equipments and printing works District 68,000 12 6.24 6.24 1.5 NGO - Scheme No. 600000 - - - G2. DPMR MCR footwear, Aids and appliances, Welfare allowance to patients for RCS, Support to govt. institutions for RCS MCR - 300/- - 7.50 7.00 Execss demand Aids/Appliance - 17000 Welfare/RCS - 8000 At Institute - 5000 At camps - 10000 G3. ** IEC/BCC Mass media, Outdoor media, Rural media, Advocacy media 98,000 12 6.00 6.00 G4. Human Resources & Capacity building 4.1 *** Capacity building 21 7.00 7.00 4.2. Human Resources on contract 4.2.1. **** Contractual Staff at State level SMO 1 40000 - - - BFO cum Admn. 1 30000 1 3.60 3.60 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 261 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks Officer Admn. Asstt. 1 16000 1 2.16 1.92 DEO 1 12000 1 1.92 1.44 Only one DEO Driver 1 11000 1 1.32 1.32 4.2.2. District Leprosy Consultant 30000 - - - Post of Driver of districts not available Physiotherapist 25000 - - - 4.2.3. Special Provision for selected States NMS No. 25000 - - - 4.2.4. Staff for blocks PMW No. 16000 - - - G5. Programme Management ensured 5.1. Travel Cost travel expenses - Contractual Staff at State level 80000 1 0.80 0.80 travel expenses - Contractual Staff at District level 25000 - - - No Contractual at district 5.2 Review meetings 20000 to 50000 4 2.00 2.00 5.3 Office Operation & Maintenance Office operation - State Cell 1 75000 1 0.38 0.38 Office operation - District Cell No. 35000 12 2.16 2.16 Office equipment maint. State 1 50000 1 0.30 0.30 5.4 Consumables State Cell 1 50000 1 0.28 0.28 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 262 - Activity proposed Unit Unit Cost (In Rupees) Physical Targets Amount proposed (Rs. in lakhs) Amount approved (Rs. in lakhs) Remarks District Cell No. 30000 12 1.68 1.68 5.5 Mobility Support State Cell 2 200000 1 0.85 0.85 District Cell 1 150000 12 9.00 9.00 G6 Others travel expenses - Contractual Staff at State level GRAND TOTAL (KASHMIR) 53.73 52.51 GRAND TOTAL (JAMMU) 58.75 57.31 GRAND TOTAL (JAMMU & KASHMIR) 117.48 109.82 *Incentive to ASHAs will be given at revised rate subject to the approval by MSG. **The State Leprosy Officer will be able to distribute the total IEC funds on the basis of actual requirements of each district keeping adequate funds at State level under Mass Media and Advocacy meetings. ***Unit cost OF Training to be calculated as per State NRHM norm fixed for all health programmes. **** Remuneration of Contractual staff may be revised keeping in view the prevailing rate of remuneration in other National Health Programmes. Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 263 - Annexure 4E REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAM (RNTCP) FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amoun t Propos ed Amount Approved Remarks I.1 Civil works As per Revised Norms and Basis of Costing for RNTCP 1) Civil work Up gradation and maintenance completed as planned 137.6 65 Approval for 5 TUs . I.2 Laboratory materials As per Revised Norms and Basis of Costing for RNTCP 1) Sputum of TB Suspects Examined per lac population per quarter; 2) All districts subjected to IRL On Site Evaluation and Panel Testing in the year; 3) IRLs accredited and functioning optimally 32 16.92 As per norms I.3 Honorarium As per Revised Norms and Basis of Costing for RNTCP 1) All eligible Community DOT Providers are paid honorarium in all districts in the FY 9.62 6 As per norms. I.4 ACSM As per Revised Norms and Basis of Costing for RNTCP 1) All IEC/ACSM activities proposed in PIP completed; 2) Increase in case detection and improved case holding; 30.56 15 As per norms. I.5 Equipment maintenance As per Revised Norms and Basis of Costing for RNTCP 1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as planned; 2) All BMs are in functional condition 16 11.07 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 264 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amoun t Propos ed Amount Approved Remarks I.6 Training As per Revised Norms and Basis of Costing for RNTCP 1) Induction training, Update and Re-training of all cadre of staff completed as planned; 53.3 10 As per norms I.7 Vehicle maintenance/ operation As per Revised Norms and Basis of Costing for RNTCP 1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained; 41 23 I.8 Vehicle hiring As per Revised Norms and Basis of Costing for RNTCP 1) Increase in supervisory visit of DTOs and MOTCs; 2) Increase in case detection and improved case holding 22 17.64 I.9 NGO/PP support As per Revised Norms and Basis of Costing for RNTCP 1) Increase in number of NGOs/PPs involved in signed schemes of RNTCP; 2) Contribution of NGOs/PPS in case detection and provision of DOT 28.85 27 I.10 Medical College As per Revised Norms and Basis of Costing for RNTCP 1) All activities proposed under Medical Colleges head in PIP completed 25 22 I.11 Office Operation As per Revised Norms and Basis of Costing for RNTCP 1) All activities proposed under miscellaneous head in PIP completed 12.97 8.17 I.12 Contractual services As per Revised Norms and Basis of Costing for RNTCP 1) All contractual staff appointed and paid regularly as planned 289 160 New position for 6 moths . Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 265 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amoun t Propos ed Amount Approved Remarks I.13 Printing As per Revised Norms and Basis of Costing for RNTCP 1) All printing activities at state and district level completed as planned 15 10.26 I.14 Research and studies As per Revised Norms and Basis of Costing for RNTCP 1) Proposed Research has been initiated or completed in the FY as planned 2 2 1.15 Procurement of drugs I.16 Procurement – vehicles As per Revised Norms and Basis of Costing for RNTCP 1) Procurement of vehicles completed as planned 103 35.75 Only for 2 wheelers. I.17 Procurement- Equipments As per Revised Norms and Basis of Costing for RNTCP 1)Procurement of equipments completed as planned 13 13 I.18 Patient support & Transportation As per Revised Norms and Basis of Costing for RNTCP Payment of transportation charges to patients 1.4 1.4 I.19 Supervision & Monitoring As per Revised Norms and Basis of Costing for RNTCP Number of evaluation and review meeting done by state 30 20 Subtotal 864.23 464.21 Disease control Flexi pool fund 21 0 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 266 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amoun t Propos ed Amount Approved Remarks GRAND TOTAL (JAMMU) 885.23 464.21 DETAILED BUDGET: RNTCP ( all budget in INR lakhs )- KASHMIR FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approve d Remarks I.1 Civil works As per Revised Norms and Basis of Costing for RNTCP 1) Civil work Up gradation and maintenance completed as planned 170.05 88.5 Approval is for 11 TU, 9 DMC, 2 DR TB centre+ DDS. I.2 Laboratory materials As per Revised Norms and Basis of Costing for RNTCP 1) Sputum of TB Suspects Examined per lac population per quarter; 2) All districts subjected to IRL On Site Evaluation and Panel Testing in the year; 3) IRLs accredited and functioning optimally 33.66 14.34 As per norms I.3 Honorarium As per Revised Norms and Basis of Costing for RNTCP 1) All eligible Community DOT Providers are paid honorarium in all districts in the FY 3.68 9.05 As per norms I.4 ACSM As per Revised Norms and Basis of Costing for RNTCP 1) All IEC/ACSM activities proposed in PIP completed; 2) Increase in case detection and improved case holding; 32.87 12.61 As per norms I.5 Equipment maintenance As per Revised Norms and Basis of Costing for 1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as 19 15 Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 267 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approve d Remarks RNTCP planned; 2) All BMs are in functional condition I.6 Training As per Revised Norms and Basis of Costing for RNTCP 1) Induction training, Update and Re-training of all cadre of staff completed as planned; 60.58 11.44 As per norms . I.7 Vehicle maintenance/ operation As per Revised Norms and Basis of Costing for RNTCP 1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained; 76 23.02 I.8 Vehicle hiring As per Revised Norms and Basis of Costing for RNTCP 1) Increase in supervisory visit of DTOs and MOTCs; 2) Increase in case detection and improved case holding 76 45.61 I.9 NGO/PP support As per Revised Norms and Basis of Costing for RNTCP 1) Increase in number of NGOs/PPs involved in signed schemes of RNTCP; 2) Contribution of NGOs/PPS in case detection and provision of DOT 24.787 24.78 I.10 Medical College As per Revised Norms and Basis of Costing for RNTCP 1) All activities proposed under Medical Colleges head in PIP completed 247 77.48 Rs 25 lakh approved for Zonal OR Meeting. I.11 Office Operation As per Revised Norms and Basis of Costing for RNTCP 1) All activities proposed under miscellaneous head in PIP completed 21.48 11.3 I.12 Contractual services As per Revised Norms and Basis of Costing for 1) All contractual staff appointed and paid regularly as planned 465 255 Nursing + helper position has not been approved Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 268 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approve d Remarks RNTCP I.13 Printing As per Revised Norms and Basis of Costing for RNTCP 1) All printing activities at state and district level completed as planned 17.94588 8 I.14 Research and studies As per Revised Norms and Basis of Costing for RNTCP 1) Proposed Research has been initiated or completed in the FY as planned 17 2 1.15 Procurement of drugs 0 I.16 Procurement – vehicles As per Revised Norms and Basis of Costing for RNTCP 1) Procurement of vehicles completed as planned 150 39 For 2 wheelers I.17 Procurement- Equipments As per Revised Norms and Basis of Costing for RNTCP 1)Procurement of equipments completed as planned 19 17 I.18 Patient support & Transportation As per Revised Norms and Basis of Costing for RNTCP Payment of transportation charges to patients 2.12 2.12 I.19 Supervision & Monitoring As per Revised Norms and Basis of Costing for RNTCP Number of evaluation and review meeting done by state 66 20 Subtotal 1502.52 676.26 Disease control Flexi pool fund 86 11.25 For AIC control gadgets+ 300 MA X ray plant Administrative Approval of State PIP 2013-14: Jammu & Kashmir Page - 269 - FMR Code Activity Unit Cost (wherever applicable) Physical target/ Deliverables Amount Proposed Amount Approve d Remarks GRAND TOTAL (Kashmir) 1589.53 687.52 GRAND TOTAL (JAMMU) 885.23 464.21 GRAND TOTAL (JAMMU & Kashmir) 2474.76 1151.73