03 visakhapatnam

NATIONAL RURAL HEALTH MISSION

VISAKHAPATNAM DISTRICT

(ANDHRA PRADESH STATE)

DISTRICT HEALTH ACTION PLAN 2012-13

Table of Contents

S N Name of the Scheme / Intervention Page No.

1 Executive Summary

2 Process of Plan Preparation

3 Situation Analysis

4 PART-A: Reproductive & Child Health

a) Maternal Health

b) Child Health

c) Family Planning Strategy

d) ARSH Strategies & School Health Programme

e) Urban Health

f) Tribal Health

g) PNDT & Sex Ratio

h) Infrastructure & Human Resources

i) Training Strategy

j) Programme Management

k) Vulnerable Groups

l) Budget Abstract for RCH Flexible Pool

5 PART-B: Mission Flexible Pool

6 PART-C: Strengthening of Immunization

7 Budget Abstract for NRHM PIP 2012-13

DISTRICT HEALTH ACTION PLAN 2012-13

EXECUTIVE SUMMARY Introduction about the District:

Visakhapatnam District is one of the North Eastern Coastal districts of Andhra Pradesh. It is bounded on the North partly by the Orissa State and partly by Vizianagaram District, on the South by East Godavari District, on the West by Orissa State and on the East by Bay of Bengal.

The population of the district is 42.88 lakhs as per census 2011 and this

constituted 5.0% of the population of the state while the Geographical area of the District is 11161 Sq. KM. which is only 4.1% of the area of the State. Out of the total population 21.41 lakhs are Males and 21.47 lakhs are Females. The Sex Ratio is 1003 Females per 1000 Males. The District has Density of population of 384 per Sq.Km. Agency area shows lesser Density and plain area higher density. 39.90% of the population resides in the 10 Hierarchic urban settlements while rest of the population is distributed in 3082 villages. Scheduled Castes constituted 7.60% of the population while Scheduled Tribes account for 14.55% of the population of the district.

The district consists of 43 mandals covering with 3 divisions

(Visakhapatnam, Paderu and Narsipatnam). The District has a Road length of 7336 kms. of which the National Highway16 runs to a length of 134.28 KMs., State Highways at a length of 277 KMs. and the balance forms the roads maintained by Roads and Buildings, Zilla Praja Parishad and Mandal Praja Parishads. The District Health Action Plan (DHAP) for the year 2012-13 has been prepared using decentralized planning process. Health status of the District:

Visakhpatnam district having 11 Tribal mandals with hill top areas, inaccessible,

interior areas and 1 Greater Visakhapatnam Municipal Corporation and 2 Municipalities (Anakapalli and Bheemunipatnam) in urban area.

Regarding Medical facilities, there are 584 Sub centres, 85 Primary Health

Centres, 13 Community Health Centrs, 1 Rural Health Centre , 1 Area Hospital, 1 District Hospital, 7 Teaching Hospitals, 8 CEMONC centres, 4 Birth waiting Homes, 4 Urban Health Centres, 11 Urban Family Welfare Centres, 1 Medical College and 2 First referral Units and 15 commity Health & Nutrition clusters established in the district.

Demographical Profile & Health Indicators of the District: Estimated Population as per census 2011 42,88, 113

Male : 2140872 Female: 2147241

0-6 years children 4,29,234 Sex Ratio per 1000 Males 1003 Female Density of population ... 384 per sq.km Literacy Rate (Census 2011)

Male 75.56% Female 60.00%

Infant Mortality Rate IMR (2008) : 47 per 1000 Live Births Maternal Mortality Rate MMR (2008) : 154 per 1.00lakh Live births Total Fertility Rate TFR : 1.98 per woman Decadal Growth Rate DGR-2011 : 11.89 Antenatal per 1000 population : 20.2 Crude Birth Rate CBR : 18.0 Crude Death Rate CDR : 8.8 Couple Protection Rate CPR : 73 % Institutional Deliveries : 88.59 %

Infant Mortality Rate: The census figure normally shows an underestimate and was prorated to State level IMR of 49 for the year 2011. The estimated IMR for Visakhapatnam district for the year 2012 is 25 per 1000 live births which is lower than the State average of IMR. If the NRHM goal of reducing IMR to 25 per 1000 live births by 2012 to be achieved than the infant deaths be prevented between 2009 and 2012 for the district is 428 annually.

Child Health Profile

a) 100% immunization against seven vaccine preventable diseases (%)

97.77 %

b) Vitamin-A administration (%) 97.77 % Infant Mortality Rate per 1000 live births 47

Maternal Mortality Ratio: The Maternal Mortality Ratio (MMR) is defined as number of maternal deaths during pregnancy, during delivery, or within 42 days of termination of pregnancy per 100,000 live births during the year. Several indirect methods are available to estimate MMR. The institutional deliveries can be taken as proxy variable to estimate MMR using log linear model (IIHFW, Annual report 2002-03, Murthy, Health Action September, 2007). The MMR for the district 2011-12 is 152 per 100,000 live births.

1. Complete antenatal checkup 2. Identification of high risk pregnant women 3. All pregnant women should delivery in institution. 4. Follow up of post-partum women up to 42 days.

Maternal Health Profile

a) Ante-Natal care registration (%) 101.3 b) TT Immunization (%) 101 c) IFA tablets (%) 101.3 d) 4 Ante-Natal Care check-ups (%) 65.67 e) Attendance by skilled personnel at delivery (%) 76.79 f) High Risk ANC 4.21 g) Institutional delivery (%) 88.59 h) Post-Natal Care (%) 80.95 Estimated Maternal Mortality rate ( 1 lakh live births ) 152

Total Fertility Rate (TFR): The Total Fertility Rate (TFR) is defined as the number of children born per woman in her reproductive period of (15-49 years). NRHM goals, stipulated that the TFR should be 1.5 per woman by 2012. The Visakhapatnam district has registered TFR of 1.98 per woman during 2005-06 (NFHS-3 while it is 1.79 per woman (NFHS-3) at state level. Intensive promotion of family planning methods, particularly spacing and targeting younger eligible couples with parity 1 or 2 is indicated if TFR is to reduce further. Institutional Deliveries: It is evident that delivery of pregnant women at health institutions has a great positive impact on maternal and child health survival. The percentage of institutional deliveries in the district during 2011-12 was 88.59 for the Visakhapatnam district. The action items to increase institutional deliveries. Immunization Status: The percentage of full immunized children in the district for the year 2011-12 was 97.77 %. In order to reach 100 percent coverage of immunization as early as possible, the district immunization officer should focus on PHCs where the performance is poor and also to monitor the under served population and inaccessible areas including tribal areas. The present fixed day approach which is twice a week need to be continued. It is also suggested that some random sample surveys need to be conducted in order to know whether the coverage of the service statistics is over estimated or not. This is essential as various agencies are reporting various coverage rates for each district. Past six years experience in implementation of NRHM :

Visakhapatnam District has successfully managed to gear its efforts towards improving service provisions at the grass roots level in spite of its limitations, in terms of availability of skilled manpower and difficult geographical terrain. With ASHA in place demand for service has certainly increased. District has seen a remarkable shift from domiciliary to institutional delivery which created an atmosphere in reducing IMR & MMR. During the financial year the focus is to reduce IMR from 47 to 25 and MMR from 152 to 100.

The Govt. has decided to rationalize the existing Health system to provide health services in grass root level. After rationalization Visakhapatnam District will have 584 Sub centres, 85 Primary Health Centres, 13 Community Health Clusters, 1 Rural Health Centre , 1 Area Hospital, 1 District Hospital, 7 Teaching Hospitals, 2 MM Units under NRHM, 8 CEMONC centres, 4 Birth waiting Homes, 4 Urban Health Centres, 11 Urban Family Welfare Centres, 1 Medical College and 2 First referral Units, 15 Community Health & Nutiriation Clusters established Visakhapatnam district has already selected and completed trainings to ASHAS at present 5734 ASHAS are working out of 6188. ASHA kits were supplied to 5734. During the current financial year the aim is to give refresher training to ASHAs to upgrade their skills and also to fill the drop out position. ASHA day is being observed on first Tuesday of every month to monitor the ASHAs and NRHM activities as well. Janani Suraksha Yojana is one of the major interventions under NRHM. JSY amount is being paid to the BPL pregnant women. Pregnant women who undergone Private Institution delivaries were also benefited this scheme upto August 2009. To encourage, Government institution deliveries, this scheme closed for private deliveries. So far around 110796 mothers benefited in this scheme for the past 5 years. Janani Sishu Suraksha Karyakramam (JSSK) introduced during this year to encourage institution delivaries. In our district this programme has not yet been started as the budget was released recently and hope this scheme improves the percentage of Institution delivaries. The plan has put emphasis on inter sectoral convergence with line departments like ICDS , RVM, RWS, DPO and Zilla Parishad .The highlight is convergence with women and child department for provision of nutrition food to the pregnant, lactate and children at the same time to register ANC. Family Welfare and NRHM activities are interlinked with ICDS department in reducing IMR & MMR in the District. Convergence with District Panchayat Raj institutions helps in monitoring of village health situations for providing healthy atmosphere. Convergence with RVM and RWS helps in monitoring the health status of School children between the age group of 6-14 years and water & sanitation problems. On the supply side, Human resource at SC/PHC / CHC / AH/DH in the district has many gaps ( not according to the sanctioned posts ) and need to fill the vacant position atleast by hiring key staff including doctors, specialists on contract basis to strengthen the institutions especially first referral units (FRUs) for providing better health services to the community. In the district, out of 584 subcentres, only 79 SCs are having own buildings and 89 subcentres were sanctioned in the year 2009-10,2010-11 & 2011-12 and rest of them are in rented building which is not creating patient friendly atmosphere. During the year. at PHCs / CHCs / AHs also needs to be strengthened with the proper utilization of one time grants and other locally available resources. Institutional delivery attention has been given to functioning of 24x7 PHCs in phased manner. In our district, 35 PHCs are functioning as 24 x 7 PHCs. Average delivaries per month is 13 in all PHCs. During the current financial year, All these PHCs will be displayed EDD and ensure normal deliveries from 13-25 and refer high

risk cases. If we propose incentives from class IV to Medical Officers, for conducting deliveries at 24 X 7 hospitals, institution deliveries rate may be increased. Under NRHM special focus has been given to Village Health Water and Sanitation Committees, Rogi kalayan samiti committees, upgradation of health facilities as per IPHS, selection and training of ASHA, functioning of quality assurance committee, infrastructure development etc.

Other national programmes i.e. National Disease Control Programme include RNTCP, leprosy control programme, Malaria control programme, Blindness control programme, vector born disease, integrated disease surveillance and iodine deficiency disorder etc.. also implementing in the district.

PROCESS OF PLAN PREPARATION Received guidelines on 03.12.2011 on preparation of DHAP 2012-13 from the

Commissioner of Health & Family Welfare, AP, hyd.

The District Medical & Health Officer & DPO attended for the DHAP 202-13 preparatory workshop on 16.12.2011 conducted under the guidance of the

Mission Director, NRHM at IIHFW by all joint directors in Commissioner of

Health & Family Welfare,Hyd.

Started preparation of DHAP 2012-13 from 18th December 2011 onwards at district level

Conducted meeting with SPHOs , Programme Offcers , Statistics Officers and other staff in the Office and explained about preparation of DHAP 2012-13.

Circulated formats to all concerned including AYUSH, APVVP and DME control institutions.

Information received from SPHOs , APVVP and some of DME controlled institutions.

SITUATION ANALYSIS

Regarding Medical facilities, there are 584 sub centres (378 are in Plain

area & 195 are in Agency area), 76 Primary Health Centres( 43 are in Plain area

& 33 are in Agency area), 1 Rural Health Centre, 11 Community Health

Centers, 4 Govt. Dispensaries, 1 Area Hospital, 1 District Hospital, 7 Teaching

Hospitals, 8 MM Units (6 Govt & 2 under NRHM), 8 CEMONC centres, 4 Birth

waiting Homes, 4 Urban Health Centres, 11 Urban Family Welfare Centres, 1

Medical College and 2 First referral Units.

The Govt. has decided to rationalize the existing Health system to provide

health services in grass root level. After rationalization Visakhapatnam District

will have 584 Sub centres, 85 Primary Health Centres, 13 Community Health

Clusters, 1 Rural Health Centre , 1 Area Hospital, 1 District Hospital, 7

Teaching Hospitals, 2 MM Units under NRHM, 8 CEMONC centres, 4 Birth waiting

Homes, 4 Urban Health Centres, 11 Urban Family Welfare Centres, 1 Medical

College and 2 First referral Units.

Slno Mandal P.H.Centre

01 Ravikamatham Kothakota

02 Pedagantyada Pedagantyada

03 Makavarapalem Burugupalem

04 Kotavuratla KV Puram

05 Anakapalli Thagarampudi

06 Araku Sunkarametta

07 V Madugula Kinthali

08 Muchingput Kilagada

09 GK Veedhi RV Nagar

10 GK Veedhi Seeleru

Sl no NameoftheCHNC

01 Bheemunipatnam

02 Chodavaram

03 Gopalapatnam

04 Yelamanchili

05 VMadugula

06 Anakapalli

07 Aganampudi

08 Kotavuratla

09 Nakkapalli

10 Narsipatnam

11 KKotapadu

12 Chinthapalli

13 Araku

14 Paderu

15 Munchingput

New Primary Health Centers Sanctioned C.H.N.Cs

VISAKHAPATNAM DITRICT MAP WITH HEALTH INSTITUTIONS

District Profile

S N Source

1 Total population 4288113 Census 2011

2 Population of Males 2140872 Census 2011

3 Population of Females 2147241 Census 2011

4 Population of Children less than 1 year 73895 Census 2011

5 Population of Children 1 to 6 years 429234 Census 2011

6 Population density (per sq.km.) 384 Census 2011

7 Urban population (%) 41.22 Census 2011

8 Rural population (%) 58.78 Census 2011

9 Scheduled Caste population (%) 7.60 Census 2011

10 Scheduled Tribes population (%) 14.55 Census 2011

11 No. of Villages 3294 Hand book of statastics

17 Size of Village (1-500 population) 2373 Hand book of statastics



20 Size of Village (5000+ population) 59 Hand book of statastics

13 No. of Villages without roads

14 No. of Villages without electricity 207

12 No. of Gram Panchayats

944 ( 244 Tribal &

700 Plain

Area)

Hand book of statastics

15 No. of Municipal Corporations 1 Hand book of statastics

16 No. of Municipalities 2 Hand book of statastics

VITAL STATISTICS

17 Expected no. of Maternal Deaths 123

18 Maternal Mortality Ratio 152/per

1000 live birth

19 Expected no. of Infant Deaths 3916

20 Infant Mortality Rate 47/1000L.B

21 Total Fertility Rate 1.98

22 Full Immunization (%) 97.77 As per District

S N Source

Inofrmation

23 3 Antenatal Care visits (%) 72.87

24 Institutional Deliveries (%) 88.59

25 Home Deliveries (%) 11.40

26 Crude Birth Rate 18.50

27 Crude Death Rate 7.6

28 Malaria Mortality Reduction Rate 0.0001 Based on MOs report

29 Dengue Mortality Reduction Rate 0.0002 Based on MOs report

30 Leprosy Prevalence Rate 0.46 District Report

31 Tuberculosis cure rate 90 Based on Dist Qtr Report

32 Tuberculosis detection rate 84 Based on Dist Qtr Report

33 Sex Ratio (females per 1000 males) 1003 As per Cences 2011

34 0-6 Years Sex Ratio 961 As per Cences 2011

SOCIO-ECONOMIC PROFILE

35 Literacy Rate (overall) 67.70 As per Cences 2011

36 Literacy Rate (males) 75.47 As per Cences 2011

37 Literacy Rate (female) 60.00 As per Cences 2011

38 Number of BPL Households 665252

39 % Below Poverty Line population 60%

Health Institutions S N Health Institution / Facilities Govt. Private Total

1 Specialty Hospitals 7 25 32

2 Medical Colleges 1 0 1

3 Maternity Hospitals 1 75 76

4 District Hospitals 1 1

5 Area Hospitals 1 1

6 Community Health Centres 13 13

7 Primary Health Centres 85 85

8 Sub-centre 584 584

9 AYUSH Dispensaries 20 20

10 Blood Banks 5 6 11

11 Blood Storage Centres 4 0 4

S N Health Institution / Facilities Govt. Private Total

12 Total Private Hospitals 0 67 67

13 Beds in Govt. Hospitals 2482 2482

14 Beds in Private Hospitals 0 3624 3624

15 Ultrasound Clinics (Registered) 8 243 251

16 Ultrasound Clinics (Un-Registered)

Status of Health Facilities:

S N Health facility Number Remarks

1 Sub-centres in own building 79

2 Sub-centres in Panchayats / other Govt. buildings

65

3 Sub-centres in rented buildings 351

4 Sub-centres without electricity 218

5 Sub-centres without water supply 294

6 Sub-centres without Toilets 300

7 Sub-centres with Staff Quarters 15

Primary Health Centres

8 PHCs in own building 73

9 PHCs in rented buildings 2

10 PHCs without electricity 2

11 PHCs without water supply 27

12 PHCs without Toilets 1 (Lungaparthi)

13 PHCs with Staff Quarters 0

14 Total beds in PHCs 528 (73 PHCs X6 + 3 PHCs X 30)

15 No. of deliveries conducted in 2010-11

72709

16 No. of OPD cases during 2010-11 3536697

17 No. of IP during 2010-11 26770

18 Rogi Kalyana Samithies functioning 73

Community Health Centres

19 CHCs in own building 11

20 CHCs in rented buildings -

21 CHCs without electricity -

22 CHCs without water supply -

23 CHCs without Toilets -

24 CHCs with Staff Quarters 4 (Paderu,Araku,Aganampudi,

S N Health facility Number Remarks

Munchingput)

25 Total beds in CHCs 390 ( 8 CHCs X 30 + 3 CHC s X 50)


4680


28 No. of IP during 2010-11 30202


Area Hospitals

30 Total beds in Area Hospitals 100


2469


33 No. of IP during 2010-11 12045


District Hospital

35 Total beds in District Hospital 200


3221


38 No. of IP during 2010-11 17487


No.of buildings required New construction / Repairs / Expansions:

S N Type of facility Required new constructions

Required repairs

Required expansion

1 Sub-centres 416 79 * 59 **

2 Primary Health Centres 09 -- --

3 Community Health Centres 02 (Kotauratla & Munchingput)

-- 3 (Bheemili, Chodavaram & Gopalapatnam)

4 Area Hospitals -- -- --

5 District Hospitals -- -- --

*Compound wall required for all govt. buildings of sub centres for protection. ** Sub center buildings required expansion as per the norms to conduct deliveries where home deliveries occurred especially in tribal areas.

Demographic Performance since 2008-09

S N Indicators 2008-09 2009-10 2010-11

1 Antenatal cases registered 89239 87315 84039

2 T.T. for Pregnant Women 85847 50503 75412

3 IFA Tablets Distributed 89239 43204 82614

4 Institutional Deliveries 68761 33388 64417

5 Infants given BCG 73543 43054 71397

6 Infants given OPV 73754 42386 69928

7 Infants given DPT 73754 42386 69928

8 Infants given Hepatitis-B 73754 42386 69928

9 Infants given Measles 75270 41903 68799

10 Full Immunization 75270 41903 68769

11 Infants given Vit-A (1st) 75359 35808 63944

12 Sterilisations performance 32255 29642 21896

13 Vasectomies Performance 3814 1946 1106

14 I.U.D. Insertions 20032 23135 16136

15 OP Users 15392 19917 13024

16 CC Users (Nirodh Users) 41179 46958 36801

17 Infant Deaths & IMR 694/9.3 708/9.5 707/9.9

18 Maternal Deaths & MMR 38/50.8 64/85.7 62/86.6

19 Deliveries conducted in 24x7 PHCs 3235 5369 5965

20 Total JSY beneficiaries 23842 217704 31383

21 Rural JSY beneficiaries 21698 9474 11553

22 Urban JSY beneficiaries 6777 3394 2609

23 Beneficiaries benefited in Compensation for sterilization (Female)

24790 5148 16905

24 Beneficiaries benefited in Compensation for sterilization NSV (Male)

2713 331 1263

25 No. of patients undergoing DOTS therapy 5678 5706 5824

26 No. of new leprosy cases reported 384 369 361

27 No. of slides examined for malaria 706313 838262 813709

28 No. of notified malaria cases 4949 5863 12815

29 No. of microfilaria cases reported 2478 2451 2652

30 No. of JE cases reported 0 0 0

31 No. of cataract operations 37097 37061 37099

32 No. of schools covered under School Health 0 0 3603

33 No. of school children screened 0 0 335031

PART A

Reproductive & Child Health

A - RCH Flexible Pool OVERVIEW OF RCH-NRHM PERFORMANCE (2005-12): FACILITY OPERATIONALISATION AND TRAINED SERVICE PROVIDERS

Number of facilities/HR Area Indicator Planned

(2005-12) Achmt.

(2005-12) till

30.11.11)

% achmt. Plan for 2012-13

No. of FRUs Operationalised

13 5 38% 8

No. of 24x7 PHCs Operationalised

41 34 82% 7

No. of sub-centres operationalised as delivery points

-- -- -- --

No. of SNCUs operationalised

4 1 25% 3

Facility Operationalisation

No. of NBSUs operationalised

5 0 0 5

EmOC training -- -- -- -- LSAS training -- -- -- --

Capacity Building

SBA 750 191 25% 559

Service utilization (average per month per facility/ trained provider)

Area Indicator

Services Based on performance

during Apr-Nov 2011

Projection for

2012-13

C-sections 1328 1461 MTPs -- -- Male sterilizations 1230 1353

No. of FRUs Operationalised

Female sterilizations 11066 -- Normal deliveries 3645 7158 MTPs -- -- Male sterilizations 196 240 Female sterilizations 3378 3425

No. of 24x7 PHCs Operationalised

IUD insertions 1901 2010 Normal deliveries -- -- No. of sub-centres

operationalised as delivery points

IUD insertions -- --

No. of SNCUs operationalised

Newborns treated -- --

Facility Operationalisation

No. of NBSUs operationalised

Newborns treated -- --

ANNEX 3b MONITORABLE INDICATORS (1)

2012-13 SN. INDICATOR 2011-12

(Apr-Nov 2011)

Q1 Q2 Q3 Q4 Total

A Maternal Health A.1 Service Delivery

A.1.1 % Pregnant women registered for ANC in the quarter

105.97 111.35 107.18 106.89 104.95 100%

A.1.2 % PW registered for ANC in the first trimester, in the quarter

80.95 83.66 81.93 80.98 81.74 92.12

A.1.3 Institutional deliveries (%) in the quarter

96.60 23.96 30.36 27.42 16.00 97.74

A.2 Quality A.2.1 % unreported deliveries in the

quarter -- -- -- -- -- --

A.2.2 % high risk pregnancies identified 4.21 3.91 3.82 3.75 3.95 4.11 (a) % women having hypertension 4.01 3.61 3.75 3.82 3.45 4.03 (b) % women having low Hb level 4.11 3.80 3.75 3.68 3.32 4.01 A.2.3 % of Home Delivery by SBA (i.e.

assisted by doctor/ nurse/ ANM) 76.79 12.82 11.21 13.04 12.95 50.02

A.2.4 C-sections performed (%) (a) in Public facilities 9.45 9.52 9.61 9.72 9.81 10.00 (b) in private accredited facilities 3.98 3.71 3.65 3.55 3.78 4.01 A.2.5 % of deliveries discharged after at

least 48 hours of delivery (out of public institution deliveries)

85.75 86.81 86.75 87.43 88.62 89.01

A.2.6 % of still births 1.50 1.12 1.41 1.34 1.62 1.75 A.2.7 %age of maternal deaths audited 98.25 98.13 98.01 98.03 98.05 98.15 A.3 Outputs

A.3.1 % of 24x7 PHCs operationalised as per the GoI guidelines

34 15 15 10 11 51

A.3.2 % of FRUs operationalised as per the GoI guidelines

A.3.3 % of Level 1 MCH centres operationalised

56 20 23 16 20 79


9 22 13 21 20 76


73 5 -- -- -- 5

A.3.6 % ANMs/ LHVs/ SNs trained as SBA

-- --- - --- -- --

A.3.5 % doctors trained as EmOC -- -- -- -- -- -- A.3.6 % doctors trained as LSAS 0 5% 15% 10% 10% 40% A.4 HR productivity -- -- -- -- -- --

A.4.1 % of LSAS trained doctors giving spinal anaesthesia

-- -- -- -- -- --

A.4.2 Average no. of c-sections assisted by LSAS trained doctors

-- -- -- -- -- --

A.4.3 % of EmOC trained doctors conducting c-sections.

-- -- -- -- -- -

A.4.4 Average no. of c-sections performed by EmOC trained doctor

-- -- -- -- -- --

A.4.5 Average no. of deliveries performed by SBA trained SN/LHV/ANM

-- -- -- -- -- --

2012-13 SN. INDICATOR 2011-12 (Apr-Nov 2011)

Q1 Q2 Q3 Q4 Total

A.4.6 % of SBA trained ANMs conducting deliveries

A.5 Facility utilization A.5.1 % of FRUs conducting C-section 27% 8.42 6.74 7.65 9.94 32.75 A.5.2 Average no. of c- sections per

FRU 266 292 295 295 297 300

A.5.3 Average no. of MTPs performed in FRUs

-- -- -- -- -- --

A.5.4 Average no. of deliveries per 24x7 PHCs

13 15 15 15 15 15

A.5.5 Average no. of MTPs performed per 24x7 PHC

- -- -- -- -- --

A.5.6 % of SC conducting at least 5 deliveries per month

0 -- -- -- -- --

B.1 Service Delivery B.1.1 Children 9-11 months age fully

immunised (%) 102.5% 100 108 102 101

B.1.2 % children breastfed within 1 hour of birth

100% 100% 100% 100% 100% 100%

B.1.3 % of low birth weight babies 10% 12% 14% 15% 13% 15% B.2 Quality B.2.1 %age of women receiving PP

check up to 48 hrs to 14 days 100% 100% 100% 100% 100% 100%

B.2.3 % drop out from BCG to measles 3% 2% 2% 2% 2.5% 2% B.3 Outputs B.3.1 % of SNCUs operationalised -- 100% 100% 100% 100% 100% B.3.2 % of stabilisation units

operationalised -- 100% 100% 100% 100% 100%

B.3.3 % of new born baby care corners operationalised

-- 100% 100% 100% 100% 100%

B.3.4 % of personnel trained in IMNCI -- -- -- -- -- -- B.3.5 % of personnel trained in F-

IMNCI -- -- -- -- -- --

B.3.6 % of personnel trained in NSSK 69% 100% 100% 100% 100% 100%

B.4 Facility utilization -- -- -- -- --- -- B.4.1 Average no. of children treated in

SNCUs -- -- -- -- -- --

B.4.2 Average no. of children treated in NBSUs

-- -- -- -- -- --

C Family Planning C.1 Service Delivery C.1.1 % of total sterilisation against ELA 61.48% 75% 75% 75% 75% 75% C.1.2 % post partum sterilisation 30.97% 46% 48% 64% 62% 55% C.1.3 % male sterilizations 3.36% 25% 40% 25% 30% 30% C.1.4 % of IUD insertions against planned 100% 100% 100% 100% 100% 100% C.1.5 % IUD retained for 6 months 35% 64% 68% 64% 64% 65% C.1.6 % Sterilization acceptors with 2

children 84% 15% 17% 15% 17% 16%

C.1.7 % Sterilisation acceptors with 3 or more children

26% 12.5% 15.5% 15% 13% 14%

C.2 Quality C.2.1 % of complications following

sterilisation 0% 2% 3% 1% 2% 2%

C.3 Outputs

2012-13 SN. INDICATOR 2011-12 (Apr-Nov 2011)

Q1 Q2 Q3 Q4 Total

C.3.1 % doctors trained as minilap -- -- -- -- -- -- C.3.2 % doctors trained as NSV -- -- -- -- -- -- C.3.3 % doctors trained as laparoscopic

sterilisation -- -- -- -- -- --

C.3.4 % ANM/LHV/SN/MO trained in IUD insertion

C.4 HR productivity C.4.1 Average no. of NSVs conducted by

trained doctors

C.4.2 Average no. of minilap sterilisations conducted by minilap trained doctors

C.4.3 Average no. of laparoscopic sterilisations conducted by lap sterilisation trained doctors

C.4.4 Average no. of IUDs inserted by MO trained in IUD insertion

C.4.5 Average no. of IUDs inserted by MO trained in IUD insertion

C.4.6 Average no. of IUDs inserted by SN/ LHV/ ANM trained in IUD insertion

C.5 Facility utilisation C.5.1 Average no. of sterilizations

performed in FRUs

C.5.2 Average no. of sterilizations performed in 24x7 PHCs

A1: Maternal Health Objectives: The objectives of interventions for improved maternal health include:

To ensure access to quality comprehensive (basic and emergency) maternal and reproductive health care to women.

To ensure access to comprehensive family planning services by emphasizing on age at marriage, delayed first child birth, spacing methods and male sterilization.

To provide a comprehensive package of maternal and nutritional health services to the tribal, scheduled caste, coastal fishers, migrant labour and other identified marginalized vulnerable women.

Gaps identified:

Need to strengthen the capacities of all staff Required motiviation and awareness to commuicty for improving institional

Delivers. Lack of Mobility to the Medical Officers for field visits.

Proposed schemes under Maternal Health: 1) 24x7 Primary Health Centres: a) Existing 24x7 Primary Health Centres:

Staff Nurses under NRHM

Contingent workers under NRHM

S N

Name of the 24x7 PHC

Deliveries conducted

during 2010-11

C-Sections during

2010-11

No.of Staff Nurse working

(Regular+ NRHM)(Total)

Required Working Required Working

1 Anandapuram 402 -- 2 0 1 -- 2 2 Atchutapuram 153 -- 3 0 2 -- 2 3 Cheedikada 86 -- 2 1 1 -- 2 4 Chowduwada 63 -- 2 0 1 -- 2 5 Chuchukonda 25 -- 1 2 0 2 6 Devarapalli 153 -- 2 0 1 -- 2 7 Godicherla 452 -- 1 1 0 -- 2 8 Golugonda 155 -- 2 1 1 -- 2 9 K.J. Puram 218 -- 2 0 1 -- 2

10 Kasimkota 104 -- 2 0 1 -- 2 11 Madhurawada 218 -- 2 1 1 -- 2 12 Makavarapalem 124 -- 2 1 1 -- 2 13 Nathavaram 159 -- 2 0 1 -- 2 14 Parawada 149 -- 2 0 1 -- 2 15 Penugollu 251 -- 2 1 1 -- 2 16 Rambilli 136 -- 1 1 0 -- 2 17 Ravikamatham 240 -- 1 1 0 -- 2 18 Revidi 195 -- 2 0 1 -- 2 19 Rolugunta 661 -- 1 1 0 -- 2 20 Sarvasiddi 120 -- 1 1 0 -- 2 21 Sreeramapuram 187 -- 3 0 2 -- 2 22 Thummapala 90 -- 3 0 2 -- 2 23 Turakalapudi 108 -- 1 1 0 -- 2 24 Vemulapudi 152 -- 2 1 1 -- 2 25 Munchingput 195 -- 2 0 1 -- 2

26 Ananthagiri 98 -- 2 0 1 -- 2 27 Darakonda 61 -- 3 0 2 -- 2 28 Dumbriguda 70 -- 2 0 2 -- 2 29 G.Madugula 113 -- 3 0 2 -- 2 30 Gannela 92 -- 5 0 2 -- 2 31 Lothugadda 293 -- 4 0 1 -- 2 32 Pedabayalu 52 -- 3 0 2 -- 2 33 Pedavalasa 87 -- 3 0 2 -- 2 34 Pinakota 140 -- 3 0 2 -- 2 35 R.J Palem 163 -- 3 0 1 -- 2

b) Proposed 24x7 Primary Health Centres:

Staff Nurses Contingent workers

S N

Name of the 24x7 PHC

Deliveries

conducted

during 2011-12

up to Nov 2011

C-sections during

2010-11

No.of Staff

Nurse working Required

Working on

contract Required

Working on

contract

1 Regupalem 103 -- 1 2 0 2 0 2 Pendurty 95 -- 6 2 0 2 0 3 Sabbavaram 116 -- 5 2 0 2 0 4 Labburu 27 -- 2 0 2 0 5 Hukumpeta 82 -- 2 0 2 0 6 Kilagada 79 -- 2 0 2 0

31 Gemmili 2 -- 1 2 0 2 0 32 Uppa 22 -- 0 2 0 2 0 33 Hukumpeta 27 -- 5 2 0 2 0 34 Minimuluru 23 -- 1 2 0 2 0 35 G.K.Veedhi 26 -- 0 2 0 2 0 36 Korukonda 15 -- 1 2 0 2 0 37 Jerrila 0 -- 0 2 0 2 0 38 Thajangi 5 -- 1 2 0 2 0 39 Sapparla 7 -- 0 2 0 2 0 40 Sileru 0 -- 0 2 0 2 0 41 R.V.Nagar 0 -- 0 2 0 2 0 42 Lambasingi 60 -- 1 2 0 2 0 43 Bheemavaram 18 -- 1 2 0 2 0 44 Lungaparthi 26 -- 1 2 0 2 0 45 Killoguda 10 -- 1 2 0 2 0 46 Madagada 16 -- 1 2 0 2 0 47 Sunkarametta 0 -- 0 2 0 2 0 48 Gomangi 5 -- 0 2 0 2 0 49 Kilagada 0 -- 0 2 0 2 0 50 Labburu 29 -- 1 2 0 2 0 51 Rudakota 24 -- 1 2 0 2 0

2) CEMONC centres:

S N

Name of the CEMONC

Deliveries conducted

during 2010-11

C-Section during

2010-11

Area (Urban / Rural / Tribal /

In-accessible)

Total OBG Spl. Working

OBG Spl. Working

under NRHM

Total Anaes.

Working

Total Staff

Nurses working

Staff Nurses

working under

NRHM

1 Narsipatnam 2469 304 Rural 2 0 1 24 2 2 Anakapalli 2347 799 Urban 2 0 2 22 2 3 Aganampudi 363 225 Rural 3 0 1 10 1 4 Paderu 657 0 Tribal 0 0 0 10 2 5 Aruku 1094 0 Tribal 0 0 0 9 1 6 Chintapalli 300 0 Tribal 0 0 0 12 2 7 V.Madugula 25 0 Rural 0 0 0 8 2 8 Yelamanchili 109 0 Rural 0 0 0 7 1

3) Janani Suraksha Yojana Scheme:

Expected Deliveries S N

Area of operation

Estimated Population

Female population Home

deliveries Institutional

deliveries

Expected BPL

Deliveries 1 Rural area 2304366 1153909 4263 38367 25578 2 Urban area 1349433 675729 2496 22468 14978 3 Tribal area 634314 317632 2934 8800 7040 Total 4288113 3147270 9693 69635 47596

Institutional Deliveries: S N

Area of operation

Beneficiaries benefited

under JSY during 2010-

11

Expected beneficiaries

for the current

financial year

No. of beneficiaries

benefited upto Nov-

2011

No. of JSY beneficiaries assisted by

ASHA

No. of JSY benefited mothers

undergone C-Section

1 SCs in Urban 84 145 56 45 --

2 SCs in Rural 1289 2189 860 688 --

3 STs in Urban 339 576 226 158 --

4 STs in Rural 2128 3615 1419 1335 --

5 Others in Urban 3936 6686 3498 2448 --

6 Others in Rural 9185 15600 5248 4199 --

Total 16961 28811 11307 8673 --

4) Janani Shishu Suraksha Karyakram (JSSK): S N

Indicator Expected number

Source / Remarks

1 Expected no. of Pregnant Women in Tribal area

11082 HMIS 2010-11

2 Expected no. of Pregnant Women in Plan area

58431 HMIS 2010-11

3 No. of delivery kits required in addition to regular supply for JSSK scheme

52000

4 No. of delivery kits required for C-Section in addition to regular supply for JSSK scheme (20% on Total Deliveries)

10400

5 Expected no. of ANCs for JSSK 86218 HMIS 2010-11 6 Expected no. of complicated cases

required Blood under JSSK (30% on Total Deliveries)

15600

Budget Proposed under Maternal Health Strategy for 2012-13 FMR code

Activity Unit Rate (Rs/Unit)

No.of posts / units /

quantity

Annual total

(Rupees)

1 2 3 4 5 6 1 24-hours MCH Centres

A.1.6 Dietary support to Maternity Waiting homes in PHCs (41 PHCs X 10 Deliveries X 12 Months)

1 case 50 4920 246000

Total 246000 2 Janani Suraksha Yojana

A.1.4.2.a Total Rural BPL deliveries Beneficiaries 700 25578 17904600 A.1.4.2.b Total urban BPL deliveries Beneficiaries 600 14978 8986800 A.1.4.3 5% Administrative expenses 1344570

FMR code



quantity

Annual total

(Rupees)

1 2 3 4 5 6 A.1.4.4 ASHA Performance Based

incentives for Pregnant Women having Institutional Deliveries in Govt. Hospital / PHC

Incentives 200 40556 cases

8111200

Total 36347170 3 Maternal Death

Review(MDR):

A.1.5 Maternal Death Audit: Monitoring & Review mechanism

Review 600 62 37200

Total 37200 4 Janani Shishu Suraksha

Karyakram

a) Diet for Pregnant Women & Attendant of Tribal area (36 PHC s X 10 Del X 12 Months)

Beneficiaries 50 x 5 days

4320 1080000

b) Diet for Pregnant Women & Attendant of Plain area (49 PHCs X 25 Del X12 Months)

Beneficiaries 50 x 3 days

14700 2205000

c) Delivery kits & Drugs for normal delivery

Kits 60 52000 3120000

d) Delivery kits & Drugs for C-Section

Kits 200 4106 821200

e) Diagnosis (Hb%, Urine for Albumin, Blood grouping)

Expected ANCs

10 86218 862180

f) Blood for complicated deliveries (30% on Total Deliveries)

Deliveries 300 15600 4680000

Total 12768380 Maternal Health Total 49398750

A2: Child Health Objectives: The objectives for child health interventions include:

Universal access to quality comprehensive neonatal services to all newborns. Provision of comprehensive health and nutritional services to all infants. Access to comprehensive health and nutritional services to 1-5 year old children. Special health and nutrition package of services to the tribal, Schedule Caste and

other vulnerable children. Situation Analysis and Current Status:

Mortality Indicators Expected / Reported

Source

Neonatal Mortality Rate 33 HMIS REPORT Infant Mortality Rate 47/1000 LB Under Five Mortality -- Child Mortality -- Process Indicators Percentage of children (under 5 years) of age with anemia

Children under 3 years breastfed within one hour of birth

Children age 6 months and above exclusively breastfed for at least 6 months

35.1 DLHS-3

Children aged 6-24 months received solid/ semisolid foods and are still breastfed

97.9 DLHS-3

Children aged 0-5 months exclusively breastfed

51.6 DLHS-3

Children with Diarrhea in the last two weeks who received ORS

60.1 DLHS-3

Children with Diarrhea in the last 2 weeks who were given treatment in any facility

75.1 DLHS-3

Children with ARI or fever in the last two weeks who were given treatment at facilities

67.1 DLHS-3

Expected Children: S N

Area of operation

Estimated infants

Estimated no.of

children 1-2 years

Estimated no.of

children at 5 years

Estimated no.of

children at 10 years

Estimated no.of

children at 16 years

1 Rural area 41589 41479 46087 57609 69131 2 Urban area 29375 24290 26989 33736 40483 3 Tribal area 11586 11418 12686 15858 19029 Total 82550 77187 85762 107203 128643

Gaps identified: Budget Proposed under Child Health Strategy for 2012-13 FMR code



quantity

Annual total (In/Rupees)

1 2 3 4 5 6 1 SNCUs in Other Areas

A.2.2 Maintenance & consumables

Maintenance 1000000 1 10,00,000

2 SNCUs in Teaching Hospitals

A.2.2 Maintenance & consumables

Maintenance 1000000 1 10,00,000

FMR code



quantity


1 2 3 4 5 6 3 SNCUs in Tribal Areas

A.2.2 Maintenance and consumables

Maintenance 500000 2 10,00,000

4 New Born Stabilization Units (NBSU)

A.2.2 Maintenance Maintenance 175000 5 8,75,000 5 New Born Care

Corners

20000 100 20,00,000

A.2.2 Maintenance Maintenance 20000 6 Infant Death Review:

A.2.8 Infant Death Audit: Monitoring & Review mechanism

Review 300 707 2,12,100

Child Health Total 60,87,100

A3: Family Planning Objective:

Strengthening the facility based human resource and infrastructure to Shift the Camp sterilization approach to fixed day approach at facility level.

Intensive Campaign to promote age at marriage. Proper spacing and limitation of Births by providing Sex Education / Education

of parenthood & Nutrition to the acceptors and special focus on IUCD. Increasing the male participation from current level 4% to 5%. Safety & Quality assurance to the Family Planning acceptors. Insurance coverage to the acceptors and service providers to improve the

confidence among the acceptors. Addressing the problem of Infertility. Monitoring & Evaluation for effective implementation.

Situation Analysis and Current Status: As per 2011 census, the population of Visakhapatnam district was 4288113 with decadal growth of 11.89, it accounts for _______% of Andhra Pradesh population. District Family Planning indicators DLHS-2 Vs DLHS-3:

Indicator DLHS-2 (2002-04)

DLHS-3 (2007-08)

Family Planning Any method (%) 65.9 61.8 Any modern method (%) 65.6 61.4

Female sterilization (%) 52.5 38.4 Male sterilization (%) 11.2 19.8 Gaps identified:

Shortage of DPL&NSV Surgeons Regular flow of FP Incentives to service centers

Key Strategies of the programme: FMR Code



quantity

Annual total (In/

Rupees) 1 2 3 4 5 6 1 FAMILY PLANNING

MANAGEMENT

A.3.1.1 Review meetings on Family Planning performance and initiatives at the district level

Bi-monthly meetings

10000 6 60000

Sub-Total 60000 2 TERMINAL/LIMITING

METHODS (Providing sterilization services in districts)

A.3.1.4 Compensation for sterilization (Female)

Compensation 1000 23900 23900000

A.3.1.5 Compensation for sterilization NSV (male)

Compensation 1500 4500 6750000

A.3.1.6 Accreditation of NGOs / Voluntary Organizations for sterilization services

Compensation 1500 1600 2400000

Sub-Total 33050000 3 SPACING METHOD

A.3.2.1 IUC camps 10 camps per CHNC p.a.

2000 15 CHNCs

300000

A.3.2.2 IUD services at health facilities in district

Incentives to health facility

20 17750 355000

Sub-Total 655000 A.3.3 POL for Family Planning /

Others POL 25000 12

Months 300000

A.3.5 Compensation to ASHA for 100% retention of IUD by clients

Incentives 100 14200 1420000

Sub-Total 1720000 Family Planning Total 35431000

A4: ARSH Strategies & School Health Programme

A4.1 ARSH Strategies Objectives: 1. Influencing the health seeking behaviour of the adolescents through existing Public health system and services & Achieving the following

To provide services to all school going and out of the school children. Reducing the age at marriage. Reducing the teen age pregnancies To facilitate them in reducing the MMR and TFR. Reducing the incidence of nutrition related diseases eg: Anaemia. Reducing the incidence of STI RTI and HIV & AIDS in adolescents.

Gaps identified: Key Strategies of the programme: FMR code



quantity

Annual total

(In/Rupees)

1 2 3 4 5 6 A.4.1 Fixed Day Health Clubs with

Specialist Services & Consellers (58 X 12 Months X 100)

Clinics 100 58 69600

Swasthh: School Water and Sanitation towards Health & Hygiene

IEC 1000 3945 3945000

A.4.1 Menstrual Hygiene 10 133602 1336020 A.4.1 TA & DA 100000 1 100000 A.4.1 Vehicle decoration 50000 1 5000 A.4.1 Hiring of the Vehicle / POL 50000 2 100000

Total 5555620 ARSH Total 5555620

A4.2 School Health Programme Objectives:

Early detection and care of students with health problems Development of healthy attitude and behaviour amongst the students Ensure a healthy environment for children at school Prevention of communicable diseases Increased learning capabilities because of good health and nutrition

Situation Analysis and Current Status: S N Coverage Planned

coverage during

2010-11

Actual coverage during

2010-11

Planned coverage during

2011-12 (upto Nov-

2011)

Actual coverage during

2011-12 (upto Nov-

2011) 1 No. of schools 3945 3603 3945 3603 2 No. of students 393769 335031 393769 335031

S N Annual Health Screening No. detected No. referred

1 Any level of anaemia 11750 0 2 Severe Anaemia 632 75 3 Body Mass Index in the underweight range 0 0 4 Body Mass index in the normal range 0 0 5 Body Mass index in the overweight range 0 0 6 Refractory errors 1857 22 7 Night blindness 0 0 8 Other eye problems 0 8 9 Ear discharge & Hearing problems 1225 63

10 Dental problems 19562 915 11 Skin problems 32526 20 12 Heart defects 1 1 13 Other disabilities 556 170

Gaps identified:

Urban & Rural Mobility needed, demand from PHC MOs Computer Assistant & Computer with printer and other accessories Office furniture as per requirement Enhancement of mobility budget to District Coordinator Lack of proper Training to Teachers.

Key Strategies of the programme:

FMR code


No.of posts / units / quantity


1 2 3 4 5 6 A.4.2 Travel cost for

referral (0.1% of all screened)

Mobility 100.00 1278 127800-00

A.4.2 School Health Program Mobility support to Medical Teams

Mobility 700 per week x 40

weeks

103 (PHCs+RHC+Urban Health Centres)

2884000-00

A.4.2 Specialist Camps at the Divisional level

Camps 25000 3 camps in each division 225000

School Health Total

3236800-00

A5: Urban Health Objectives:

To provide an integrated and sustainable system for primary health care services in the urban slum areas, with emphasis on preventing and controlling communicable diseases;

To promote reproductive and child health among the urban population, especially the urban poor and the slum migrant population.

To increase availability and utilization of Health Services in urban slum areas. To build up an effective referral system from the Urban Health Centres to the

FRUs. To achieve 90% coverage of all pregnant women with comprehensive ante-natal

services such as TT immunization, regular periodical check-up, administration of vitamin & iron supplements, counseling about nutrition, screening of high risk cases etc.

To increase coverage of children upto 100% with immunization against the seven vaccine preventable diseases and administration of VitaminA.

To bring an increase in the age at marriage of girls in the jurisdiction of the UHC to at least 18 years of age for at least 80% of the total marriages.

To increase overall health awareness and better health-seeking-behaviour among the slum dwellers reflected in reduced morbidity pattern, better management of diarrhea and acute respiratory infections in children in the slum areas.

Gaps identified:

Inadequate of ANMS in urban slums Key Strategies of the programme:

FMR code



quantity

Annual total

(Rs/lakhs)

1 2 3 4 5 6 A.5 Medical Officer Salary 16000 4 7.68 A.5 ANMs (3) Salary 5200 12 7.49 A.5 Laboratory Technician (1) Salary 6500 4 3.12 A.5 Community Organizer (1) Salary 4500 4 2.16 A.5 Assisting Staff (3) Salary 3900 12 5.62 A.5 Project Coordinator to NGO

(1) Salary 3000 4 1.44

A.5 Contingencies Contingencies 3000 4 1.44 A.5 Drugs & Consumables Drugs 10000 4 4.80 A.5 Community & Staff Training Training 24000 4 11.52 A.5 Rents, Water & Electricity

charges Others 4000 4 1.92

Urban Health Total 47.19

A6: Tribal Health Objectives:

To implement an integrated and sustainable system for primary health care services delivery in the nine ITDA areas.

To provide, food & stay facility and compensation of loss of daily wages for the tribal pregnant women to encourage institutional deliveries by strengthening birth waiting homes.

Strengthening of primary health centers by providing with necessary equipment in addition to those provided regularly to make 24 x 7 services effective.

BCC & IEC in local tribal languages in to wean them from superstitious health seeking behavior.

Inter department coordination, functional convergence with tribal welfare department, and WDCD departments and establishment of special Tribal health project monitoring units at The State and ITDA level.

To encourage the MPHA (F) for conduction of deliveries in remote and un-reached sub center areas.

Provision of mobility to the PHC medical officers. Situation Analysis and Current Status:

Gaps identified:

Vacancies of Medical Officers to be filled with regular Doctors so as to monitor NRHM funds utilizations properly.

Mobility for all Medical officer Strengthing of Sub center indentified to conduct delivers. Infrastructure :- Electrification, Running Water, Equipment HR:- Minium 2 ANMS, 1 Class IV / attender, 1 Watchman Mobility in casew os Emergency Imprest money in case of paying Doli /Horse etc charges.

Key Strategies of the programme:

FMR code



quantity

Annual total

(Rs/lakhs)

1 2 3 4 5 6 A.6 Traveling for drop back the

patient at home Transport 200 8800 1760000

A.6 Bi-monthly Specialist camps in CHCs (4 CHCs x 6 camps)

Camps

55000 4 1320000

A.6 Emergency Visits to Hostels in Tribal Area by MO (36 phcs X 2 visits per month X 12 months X Rs. 100/-

Incentive 100 864 visits

86400

Tribal Health Total 4385200

A7: PNDT & Sex Ratio Situation Analysis and Current Status: S N Sex Ratio 1981

census 1991

census 2001

census 2011

census 1 General Sex Ratio 975

Female per 1000 male

985 Female per 1000 male

1003 Female per 1000 male

2 0-6 years Child sex Ratio 976 Girls per 1000 Boys

961girls per 1000 Boys

Lowest Sex-Ratio Mandals (10 to 15 mandal) as per 2001 Census with reasons S N Name of Mandal General

sex ratio as per 2001

census

0-6 years child sex ratio as per 2001 census

Reasons for low Sex ratio

1 Pedagantyada 929 1387 2 Gajuwaka 944 30456 3 Sabbavaram 963 6455 4 Paravada 965 6413 5 Payakaraopeta 973 9118 6 Padmanabam 975 5404 7 G.Madugula 977 5520 8 Chintapalli 977 7014 9 Golugonda 978 5548

10 Ananthagiri 978 4813 11 Pendurthi 980 11599 12 Anandapuram 981 6047 13 Hukumpeta 983 5458 14 Rambilli 984 5447 15 Koyyuru 987 5710

S N Type of facility Registrations Renewals Cancellation Suspensions 1 Genetic Counseling

Centres 5 4 -- --

2 Genetic Laboratories 12 7 -- -- 3 Genetic Clinics 4 2 -- -- 4 Ultra Sound Clinics /

Imaging Centers 215 76 -- --

5 Jointly as Genetic Counselling Centre / Genetic Laboratory / Genetic Clinic or any combination thereof

5 3 -- --

6 Mobile Clinics (Vehicle) 7 2 -- -- 7 Other Bodies like IVF

Centers/Infertility Cure Centers/Fertility Centers etc., using

3 3 -- --

Equipments/Techniques capable of making sex selection before or after conception

8 Fertility Clinics -- -- -- -- Total 251 97 -- --

Case Details

S N Case details Remarks 1 Prosecutions in 2007 --- 2 Prosecutions in 2008 --- 3 Prosecutions in 2009 --- 4 Prosecutions in 2010 --- 5 Prosecutions in 2011 --- Total Prosecutions ---

6 No cases filed against the clinics Identified By NIMC

---

7 Convictions in 2007 --- 8 Convictions in 2008 --- 9 Convictions in 2009 ---

10 Convictions in 2010 --- 11 Convictions in 2011 ---

Total Convictions --- 12 Imprisonment --- 13 Fine/ imprisonment --- 14 Fine --- 15 Number of Doctors convicted --- 16 Cases in Appeal --- 17 Cases Closed/ disposed --- Action Taken against the Doctors

S N Case details Remarks 1 No. of Doctors whose licenses got

Cancelled ---

2 No. of Doctors whose licenses got Suspended

---

FIR Details

S N Case details Remarks 1 FIR Filed --- 2 Arrests ---

Details of Machines sealed & De-sealed / Released

S N Case details Remarks 1 Machine sealed 2007 --- 2 Machine sealed 2008 --- 3 Machine sealed 2009 --- 4 Machine sealed 2010 --- 5 Machine sealed 2011 ---

Total Machine sealed --- 6 Machine de-sealed 2007 --- 7 Machine de-sealed 2008 --- 8 Machine de-sealed 2009 --- 9 Machine de-sealed 2010 ---

10 Machine de-sealed 2011 --- Total machines De-sealed /

Released ---

Budget proposed for PC&PNDT for 2012-13 FMR code



quantity

Annual total

(Rs/lakhs)

1 2 3 4 5 6 A.7.1 Support to PNDT cell A.7.1.1 Legal Consultant (Part time) Salary 10000 1 120000 A.7.1.2 Computer Operator Salary 10000 1 120000 A.7.1.3 Contingency 1000 12000 A.7.2 Other PNDT activities A.7.2.1 IEC activities IEC 300000 300000 A.7.2.2 Monitoring Sex ratio at birth

places

a) Survey Survey per quarter

5000 1 20000

b) Inspections Per quarter

10000 1 40000

c) Search & Seizure procedure 15000 15000 d) Usage of Decoy customers

(2 persons @ 250 each) 500 100 50000

A.7.2.3 District Advisory committee meetings

Meetings p.a.

1000 6 meetings

6000

Total 683000

A8: Infrastructure & Human Resources FMR code

Activity Name of the

scheme

Rate (Rs/Unit)

No.of posts proposed

Annual total

(In/Rupees) 1 2 3 4 5 6

A.8.1.1 ANMs and Staff Nurses

a) Staff Nurses ( 8 centers X 3 SN X 12 Months)

CEMONC 12910 24 3718080

b) Staff Nurses ( 85 PHCs X 2 SN)

24x7 PHC 12910 170 26336400

c) Staff Nurses SNCU in Other area

12910 3 464760

d) Staff Nurses SNCU in Teaching Hospitals

12910 3 464760

e) Staff Nurses SNCU in Tribal area

12910 6 929520

f) Staff Nurses ( 3 SN X 5 centers x 12 months)

NBSU 12910 15 2323800

g) Staff Nurses ( 12 SN X 12 Months X 12910)

Tribal Health

12910 12 1859040

h) Staff Nurses Vulnerable groups

12910 12 1859040

i) Second ANMs Second ANM

10200 390 47736000

A.8.1.2 Laboratory Technicians

a) Lab Technician SNCU in Other area

9000 1 108000

b) Lab Technician SNCU in Teaching Hospitals

9000 1 108000

c) Lab Technician SNCU in Tribal area

9000 2 2016000

A.8.1.3 Specialists a) Specialist in Small

towns CEMONC 38000 18 (6

OBG,6Anes,6Prd) for 2 centers

8208000

b) Specialist Remote & Interior rural areas

CEMONC 45000 9 (3 OBG,3Anes,3Prd for 1 center

4860000

c) Specialist Tribal areas

CEMONC 50000 27 (9 OBG,9Anes,9Prd for 3 center (Paderu,Araku, chintapalli)

16200000

d) Honorarium to Anesthetist for

CEMONC 1000 1500 C-sections

1500000

FMR code


scheme

Rate (Rs/Unit)


Annual total

(In/Rupees) 1 2 3 4 5 6

conducting C-Sections

e) Pediatricians (5 Nos X 12 months)

SNCU in Other area

50000 5 (VGH) 3000000

f) Pediatricians (5 Nos X 12 Months)

SNCU in Teaching Hospitals

40000 5 (KGH) 2400000

g) Pediatricians (3 in Paderu, 3 in Chintapalli)

SNCU in Tribal area

90000 6 6480000

h) Specialist Services (4 CHNCs X 3 Nos X 12 Months)

Tribal Health

45000 12 6480000

A.8.1.4 PHNs at CHC/ PHC level

-- --

A.8.1.5 Medical Officers at PHCs and CHCs

a) Medical Officer Vulnerable groups

30000 12 4320000

A.8.1.6 Additional Allowances/ Incentives to MOs of PHCs and CHCs

-- --

A.8.1.7 Others - Computer Assistants/ BCC Coordinator etc.

a) Salaries to Theatre Assistants

CEMONC 6700 16 1286400

b) Contingent Workers 24x7 PHC 4900 170 9996000 c) Data entry operator SNCU in

Other area 9500 1 114000

d) Support Staff SNCU in Other area

6700 4 321600

e) Security SNCU in Other area

6700 3 241200

f) Data entry operator SNCU in Teaching Hospitals

9500 1 114000

g) Support Staff SNCU in Teaching Hospitals

6700 1 321600

h) Security SNCU in Teaching Hospitals

6700 1 321600

i) Data entry operator SNCU in Tribal area

9500 2 228000

j) Support Staff SNCU in Tribal area

6700 8 643200

k) Security SNCU in Tribal area

6700 6 482400

FMR code


scheme

Rate (Rs/Unit)


Annual total

(In/Rupees) 1 2 3 4 5 6

A.8.1.8 Incentive/ Awards etc. to SN, ANMs etc.

A.8.1.9 Human Resources

Development (Other than above)

-- -- -- --

A.8.1.10 Other Incentives Schemes (Pl. Specify)

-- -- -- --

Special performance based incentives for MO, SN, ANMs for conducting deliveries above base line of 10 cases

Tribal Health

200 26 Tribal PHCs x 10

624000

Cash award for best performing MO/SN/ANMs Rs 4000/each selected from each CHNC

Tribal Health

12000 15 CHNCs 180000

For ensuring Hospital delivery and to stay in Birth waiting Homes(BWH) for 5 days for ANCs ( 20 DEL X 12 Months X 4 BWH X Rs 100 X 5days)

Tribal Health

100 960 expected births in BWH

4,80,0000

a) Incentives for MCH services beyond benchmarks: PHCs in High Focus Districts

High Focus Districts

2000 _____ no.of PHCs --

b) Incentives for MCH services beyond benchmarks: CHCs in High Focus Districts


5000 _____ no.of CHCs

--

c) Incentives for MCH services beyond benchmarks: Area Hospitals in High Focus Districts


7500 _____ no.of AHs --

Grand Total

161045400

A9: Trainings Training Situation : No.of MOs, Staff Nurses, ANMs and ASHA with training status S N Type of training No. working No. completed

training No. on training

MEDICAL OFFICERS

1 Induction Training 138 2 BEMOC 138 3 EMOC 138 4 LSAS 138 5 SBA Trained 138 6 NSSK Trained 138 96 7 Basic IMNCI 138 8 F-IMNCI 138 9 ARSH 138 14

10 IUCD 138 11 RTI/STI 138 12 NSV 138 13 DPL 138 14 MTP 138 15 Minilap 138 21 16 Cold chain Training 138 116 0 17 Malaria 138 29(2009),25(2010) 18 RNTCP 138 19 NLEP 138 20 HIV/AIDS 138 18 STAFF NURSES 139

1 SBA Trained 139 144 2 NSSK Trained 139 126 3 Basic IMNCI 139 4 F-IMNCI 139 5 ARSH 139 8 6 IUCD 139 7 RTI/STI 139 8 MTP 139 9 Minilap 139 18

10 Cold chain Training 139 0 0 11 Malaria 139 12 RNTCP 139 13 NLEP 139 14

HIV/AIDS 139 42(2010-11)

ANM / MPHA(F)

1 SBA Trained 611 47 2 NSSK Trained 611 3 Basic IMNCI 611 4 ARSH 611 3 5 IUCD 611 6 RTI/STI 611 7 Cold chain Training 611 78 8

Malaria 611 103(2009,86-

2010)

9 RNTCP 611 10 NLEP 611 32 11 HIV/AIDS 611 346 400 ASHAs

1 Training in modules 1-5 5734 4244 (21 days) &

1633 (1 day)

2 Training in modules 6&7 5734 Not yet started 3 Menstrual Hygiene 5734 4

Malaria

5734 1766(491-2009,875-2010,400-2011)

5 RNTCP 5734 6 NLEP 5734 7 HIV/AIDS 5734

A10: Programme Management FMR code

Activity Mode of appointment

Rate (Rs/Unit)


quantity

Annual total

(Rs/lakhs)

1 2 3 4 5 6 District Program

Management Unit

A.10.2 District Project Officer Deputation A.10.2 District School Health

Coordinator Deputation 50,962 1 6.11

A.10.2 IMNCI Coordinator Deputation A.10.2 Asst. District Project Officer Contractual 30,000 1 3.60 A.10.2 Accountant Contractual 22,000 1 2.64 A.10.2 MIS Assistant Contractual 16,500 1 1.98 A.10.2 Computer Assistant Contractual 11,000 1 1.32 A.10.2 Office Subordinate Contractual 6,700 2 1.61 A.10.2 Hiring of vehicles Hiring 20,000 3 7.20 A.10.2 Administrative Overheads 15,000 1.80 Community Health &

Nutrition Clusters (CHNC)

A.10.3 MIS Assistant Contractual 8,000 15 14.40 A.10.3 Accounts Assistant Contractual 8,000 15 14.40 A.10.7 Hiring of vehicle Hiring 20,000 15 36.00

Project Management Unit for ITDA Areas

A.10.4 ITDA Program Manager Contractual 30,000 1 3.60 A.10.4 Supporting Staff Contractual 8,400 1 1.01 A.10.7 Hiring of vehicles Hiring 20,000 1 2.40 A.10.4 Administrative Overheads 10,000 1.20 Total 99.27

A11: Vulnerable Groups Major Gaps identified: Information, Education and Communication Strategy (IEC): The success of any programme depends on IEC component. The district extension and media officer (DEMO) at district level should play crucial role in creating awareness about different health programmes using different channels of media like electronic, print and other traditional methods etc. He/ She also should get support and guidance for the activities done / propose at district level while implementing any national health program. He/she can use cable channel for effective communication. He/she has to concentrate more on the areas where the performance of different programmes is low with the help of Dy. DEMO at district level, Multipurpose Health Extension officer (MPHEO) at PHC level. The DEMO should quickly respond to any item that has an adverse effect on health situation and give a rejoinder .He/she should be the single point of contact person (SPOC) for all the health activities at the district level. There are 15 NGOs working in the health sector. However, it has been observed that all seven NGOs are working in the area of HIV/AIDS. Convergence among various departments: The department of Health Medical and Family Welfare was successful in having good convergence model among various departments in Pulse Polio Immunization programme (PPI). Also CARE AP had implemented Integrated Nutrition Health Programme (INHP) in selected districts with the convergence between department of Health and Women Development and Child Welfare (WDCW) This project was aimed at having a fix day service by anganwadi worker like (1) distribution of supplementary nutrition among pregnant women and lactating mothers, (2) Weighing the Child etc., and the ANM to provide the services like Antenatal checkups, distribution of IFA tablets and immunization to children to below 1 year. The same model of fixed day approach of providing the services can be followed by the two departments. Presently, the Krishna district is experimenting this model of convergence between the department of health and WDCW. The DM & HO and Project Director, WDCW need to give clear instructions to their staff. Also the department of health should work in close coordination with the department of Panchayat Raj on rural water supply. This is essential to reduce the incidence of various seasonal diseases. Though these types of cooperation is available but the implementation is not being monitored properly. The action items are described in Box item-3. Capacity Building: Under department of Health Medical and Family Welfare various training programmes were conducted independently by District Training Team (DTT), district TB, Malaria and Leprosy/ AIDs officers etc. These independent training programmmes would hamper service delivery at PHC level. Hence it is suggested to have a integrated training programme at the district level. It is suggested that a workshop may be held among different officers to develop an Integrated Training Calendar

for the year. It is also essential that the PHC staff particularly Medical Officer and Lab technician need to be trained in blood slide examination under malaria particularly those working in tribal areas. Monitoring & Evaluation The success of any programme depends on Monitoring and Evaluation. At present data is being generated at PHC level for different programmes. The reports are sent on monthly basis to DM&HO. However, not much of analysis of this information is being done at district level. The statistical unit of DM & HO sends a consolidated report to State Headquarters either to Commissioner Family Welfare, or Director of Health. According to a study, . Only 3 PHCs were using computers for data entry, and generation of reports. The reason for the low utilization is (i) no regular data entry operator (ii) no customized software to enter the data and, (iii) the systems are not functioning due to certain hardware problems. It is suggested that these problems be rectified and reports be sent without fail to the server located at CFW or by e-mail to DM & HO, so that everybody can have access to the data. Centralized data centre will enable data flow from PHC level onwards. It is felt that secondary and tertiary level of Health facilities like CHC, Area hospitals, District hospitals, and Teaching Hospitals should come into the ambit of the centralized data centre. This would enable them capture the entire data of the district by developing a common format on important parameters like Vital Events, Family Welfare Programs, NRHM indicators etc. Also, the personnel handling the data at district and State level need to be trained in analytics for better decision making and proper utilization of data. Using the present server located at CFW office, the information relating to NRHM goals can be updated on day-to-day basis as per fig-1. The ASHA worker can call toll free number from her mobile or landline to inform any vital event, like births, deaths, either infant or maternal deaths and other important health emergency information. The information will be captured in the server located at CFW office. The data manager compiles the necessary information and generates the reports. The data manager should send fortnightly reports to all districts along with PHC wise data. A pilot study needs to be carried out before scaling up to State level. Key Strategies of the programme: Generic Issues Drugs and materials should continuous as the interruption for some period of time will give wrong feelers to the community that the drugs and materials are not available in the public institutions. This should be done through out the Service Chain i.e., from Sub center to Tertiary. (There are some incidences where some material and drugs are available in PHCs where there utility almost nil and same drugs are not available in CHCs/FRUs) For this emergency procurement facility should available for the institutions instead of waiting for the material supply from the centralized point (District/State) HR RKSs should be empowered to take the services of locally available technically qualified people who are very essential for the MCH services like Lab Technicians. (There are some 24x7 PHCs with out lab technician for years. At the time of ANMs/Staff Nurses on maternity ) HR Incentives HR incentives is very important to strengthen the MCH services. This may be in line of Arogya Sree where per case base incentive is paid to all the staff involved in it. The incentive should be not only encouraging but also inspirational. (For all Public institution deliveries all the staff in the Service Chain should be paid incentive as per their capacity in the service delivery i.e.,ASHA>ANM>Class IV of the PHC>LT>SN>MO of PHC/CHC>FRU staff& specialists

Monitoring Mobility/Fixed Monitory allowance may be provided to MOs and other supervising officers. Delivery Points Regular refresher trainings should be provided to the 24x7 staff. Post training evaluation of skill utilsatiion is to be done. Re mapping of FRUs and 24x7 PHCs should be done.(A proposal may be sent for upgrading the 24x7 PHC Mothkur to CHC and any other such institutions from PHC to 24x7 PHC and 24x7 PHC to CHC and CHC to FRU else where in the district) Trainings Post training evaluation of acquired skills utilization should be done continuously. (Most of the MOs after the IMNCI, NSSK etc., trainings they are not utilizing the skills and for number sake they are being trained. SNs and ANMs are not utilizing their skills after SBA training. LHV are not functioning as service providers they are delivering only monitoring services after their LHV training and promotion MPHS(F) Specific The only factor which plays major role to improve the performance of any health facility is the CONFIDENCE of the community to utilize the services from that health facility. For confidence building the health facilities should be strengthened, monitored and capacities should be improved. Facility Strengthening Performance

MonitoringCapacitybuilding

Subcenter

All sub centers should providedwithbuildings which should be accessibletothecommunity(Athoughtmaybegiven to construction of Sub centerand Anganwadi center at onepremisesinfuture)

Qualitymonitoringsystem in vogueshould befallowedscrupulously

Periodictrainingtothesubcenter staff in all nationalprogrammes in generaland MCH programmes inparticular.

24x7PHCs

NBCCs,Neonatalresuscitationkitsasin NSSK, provision of uninterruptedpower supply, Water supply, Toilets,Sufficient bed space (In old patternPHCbuildingsthereisnoward)Spacefor stayof attendants. Strengtheningof the lab andun interrupted supplyof labconsumablesand reagents.Uninterrupted supply of consumablesanddrugsrequiredfordeliveries.

Qualitymonitoring andfacility surveysystem in vogueshould befallowedscrupulously withaddition of PHCfunctioningelementsinit.

MOs and SNs should begiven periodic andreorientaionaltrainingandpost training evaluationshouldbedone

FRU The FRU is the strongest link in theMCH service chain. If the FRUfunctions as per the norms thenumberofdeliveries in thePHCswillincrease. FRU should support thePHCs as trouble shooter in casemanagement. Specialty man powershouldbe increased to three folds inexistingheavilywork loaded FRUs.A

Monitoring ofMCH activitiesunder oneumbrella atdistrict and subdistrict level mayimprove theperformance

Each district may beattached to a MedicalCollege and regular CMEsto theFRU specialistsmayorganized. A calendar tothis extent shall beprepared and fallowed.Life saving Anesthesia(LSAs) and EmOC training

team of Gynecologist, Anesthetist,and Pediatrician should be availableround the clock. (Not ON CALL)Theyshould be appointed exclusively forMCHservicesandshouldnotbegivenany routine MLC duties etc. Thespecialist post can be made moreremunerative by paying case basedincentives to the staffworking in thefacility. If no one is appointed athoughtshouldbegiventoleasingouttheMCHbedtothe IMAorFIOGSaspart of PPP.Model can be drawn tothisextent.

to the basic Medicalgraduates. Periodic andrefresher training to theMOsandSNs

If SWOT analysis of existing system is done in the context of MCH services, some gaps(Weaknesses and threats) can be found and rectified accordingly Facility/Service

providerStrengths Weaknesses Opportunities Threats

ASHA Member of thecommunityPre inductiontraining

Cannot be paidmore incentiveeven if providesservice formorethan 1000population

SupportfromANM,LHV,SHGsofthecommunity

IncentivismVsTradeunionism(Volunteernotanemployee)Sociopoliticalsituationinthecommunities

Subcenter Qualified, trainedstaffNRHMsupport

Lack of subcenter buildingfacilitiesOver burdenedby NRHM fiscalactivitiesStaffnot stayingatworkplace

StrengthenedPHCsInservicetrainingsCooperationoflinedepts.SupportfromSHGsandNGOs

UnethicalpracticesinMCHbythequacksandencouragingpvtpracticefortheirownmileage.Afflictionofcommunitytopvtpracticewiththemarketingstrategiesofthepvtpractitioners.

PHC Equipped facilitywith qualifiedpersonnel.NRHMsupport

Absenteeism ofstaffnonstayatworkplaceVacanciesInterruption insuppliesMOs burdenedby NRHM fiscalactivities(MObecame afinancialmanager than aclinician)No proper

Cooperationfromlinedepts.WellestablishedSHGnetworkSupportfromNGOs

QuacksCommunityafflictiontoPvtpracticeMarketingstrategiesofPvt/CorporateHospitals

monitoring

FRU Equipped facilitywith qualifiedpersonnel.NRHMsupport

Absenteeism ofstaffVacanciesInterruption insupplies andservicesErroneouspostings ofspecialistsSupdts,who areCSSs hasbecomeadministratorsthan specialistscliniciansNon availabilityof Gyn andAnesth roundtheclockSpecialists overburdened byMLC and othernonMCHwork

Availabilityofpvt.specialistsNGOssupport(RedCrossBloodBanks)

QuackeryCommunityafflictiontopvtpractice.MarketingstrategiesofPvt/corporatehospitals

Strategies should be developed to convert the weaknesses in to strengths and the strategic utilization of the opportunities to strengthen the system by curtailing the threats by statutory sanctions. FRU support is the main stray of the improving the MCH services. As the dual administration is in vogue, the blame game has become the escapist strategy. If round the clock specialist services are available at FRU, the PHC can dare to take some risk and if PHC monitors and supports the sub center basic MCH services can be given at the community level only. Due to non functioning of the PHCs and FRUs as per the objectives of the NRHM, the BPL and lower middle and middle class people are forced to spend from out of the pocket by financial over heads in the shapes of selling the movable/immovable assets or entering in to the vicious cycle of the debts. The marginalized and under served population like migratory workers are more affected by the poor MCH services in the public sector. There are many instances where delivery cases (the migratory worker) referred out from FRU and lands in pvt hospital and spends huge amount for C section by which lion share of the earnings are spent for a delivery.

Budget Abstract for 2012-13 of RCH Fixible Pool

(in Rupees)

S N Intervention Budget proposed for 2012-13

1 Maternal Health 49398750

2 Child Health 6087100

3 FAMILY PLANNING 35431000

4 ARSH 5555620

5 School Health 3236800

6 Urban Health 4719000

7 Tribal Health 4385200

8 PC & PNDT 683000

9 Infrastructure & Human Resources

161045400

10 Programme Management

9927000

280468870

PART B

Mission Flexible Pool

B - MISSION FLEXI POOL B.1 ASHA:

ASHA Incentives: The rural Visakhapatnam district consists of 944 Gram Panchayats,3294 Revenue Villages and 3108 Habitations. 5734 ASHAs have been positioned during the first three years of the Mission as Health Resource Persons, who constitute the first call of the community for all maternal and child health services, disease prevention and health promotion activities. Of the 5734 ASHAs, 2229 are in the rural areas, 3200 in the tribal areas and 305 in the peri-urban / urban areas of the district.

ASHA will be rewarded for good performance on the maternal and child health and disease prevention front. The best ASHA will be identified for each PHC, Community Health and Nutrition Cluster, district and state levels and will be rewarded with cash grant at the annual Health Day. Any ASHA failing to ensure cent per cent ANCs, PNCs, Immunization, and failure to take measures to prevent and report any case of IMR / MMR will be censured, including removal if the failure is gross or willful. The details of budget requirement for the payment of incentives under Maternal Health to ASHAs are as follows:

Expected No. of Pregnant women to be registered 86218 Expected No. of live births 78718 Expected No. of Institutional deliveries 77596 Expected No. of Inst. deliveries in Govt. hospitals 48018 Expected No. of Private accredited hospitals 21254 Expected No. of Home Deliveries 9446 Expected No. of PNC cases 78718

Expected no.of BPL cases

Expected No. of BPL Pregnant women to be registered 51731 Expected No. of BPL ANC cases 51731 Expected No. of BPL Inst. deliveries in Govt. hospitals 28811 Expected No. of BPL Private accredited hospitals 12752 Expected No. of BPL PNC cases 47231

Budget proposed for ASHA activities 2012-13 FMR Code


No.of units /

quantity

Annual total

(In/Rupees) 1 2 3 4 5 6 1 ASHA Incentives

Registration of early pregnancy Incentives 30 86218 2586540 Completion of 4 ANCs and

ensuring TT & IFA tablets Incentives 120 86218 10346160

B1.1.3.a Postnatal Care & Newborn care for mother and neonate

Incentives 150 78718 11807700

Referral of Post-Partum Complication to a CEMONC centre

Incentives 50 7942 362125

Providing health and nutrition counseling to the parents and family members in close coordination with the Anganwadi worker and ensuring the child completes 12 months of age in a health state ( 5734 X 12 months X 50)

Incentives 50 5734 3440400

B1.1.3.d Referral of Severely Acute Malnutrition cases to Nutrition Rehabilitation Centres &follow-up


B1.1.3.e Maternal Death Reporting to Sub centre & PHC


B1.1.3.f Infant Death Reporting to Sub Centre and PHC


Organization of Monthly Village Health & Nutrition Day( 5734 X 12 months x50)

Incentives 50 5734 3440400

Incentives to the ASHA for promoting Institutional delivery in tribal areas

Incentives 600 8800 52,80,000

Reporting of new born child with birth weight of less than 2,000 grams to the sub-centre and PHC (Rs 25); and follow-up progress on weekly basis in coordination with Anganwadi until the weight-for-age stabilizes

Incentives 100 6801 680100

Total 38148425 2 Best ASHA Awards

B1.1.4.b PHC Level Best Performer Awards 1000 85 85000 B1.1.4.c Cluster Level Best Performer Awards 2000 15 15000 B1.1.4.d District Level Best Performer Awards 5000 1 5000 Total 105000

3 ASHA Day review & others B1.1.4.f ASHA Conventions Conventions 100 5734 6880800 B1.1.4.f Providing Saree to ASHAs (2

sarees) Saree 200 5734 2293600

Total 9174400 ASHA Total 47427825

B.2 Village Health and Sanitation Committee:

Activity Cumulative Achievements so far

No. of Revenue Villages 3294 No. of Gram Panchayats 944 Number of Village Health & Sanitation committees constituted 944 No. of Joint Account opened 944 Budget proposed for VHSC Strengthening 2012-11 FMR code


No.of VHSCs

proposed


1 2 3 4 5 6 B2.4 Cash Grant of Rs 10,000 for

each Gram Panchayats 1 10000 944 9440000-00

B8.3 Awards for best performance (No.of CHNCs x Rs.10,000/-)

1 10000 15 150000-00

Total 9590000-00 B.3 Untied Funds:

(In/Rupees) Facility level Number of

facilities Total amount released so far

Total amount utilized

Unspent balance

Untied Fund for SCs 584 5840000 4406474 1433526 Untied Fund for PHCs 85 2353000 1671388 681622 Untied Fund for CHCs 13 Untied Fund for DH 1 0 0 0 Budget proposed for Untied Funds - 2012-13

FMR Code


No.of centres

Annual total

(In/Rupees) 1 2 3 4 5 6

B2.1 Community Health Centers 1 CHC

50000 13 650000-00

B2.2 Primary Health Centres 1 PHC

25000 85 2125000-00

B2.3 Sub Centres 1 SC

10000 584 5840000-00

Total 8615000-00

B.4 Annual Maintenance Grants:

(In/Rupees) Facility level Number of

facilities Total

amount released so

far

Total amount utilized

Unspent balance

AMG for SCs 79 AMG for PHCs 73 3407027 12,13,000 2193372 AMG for CHCs AMG for DH

S N Type Facility No. of facilities

No. of facilities functioning in Govt. Building

1 Sub Centres 584 79 2 Primary Health Centres 85 73 3 Community Health Officeer 13 13

Budget proposed for Annual Maintenance Grants - 2012-13

FMR Code


No.of Govt.

buildings

Annual total

(In/Rupees) 1 2 3 4 5 6

B.3.1 Community Health Officeer 1 CHC

100000 13 1300000

B.3.2 Primary Health Centres 1PHC 50000 73 3650000 B.3.3 Sub Centres 1 S/C 10000 79 790000 Total 5740000

B.5 Rogi Kalyan Samithies: Budget proposed for HDS - 2012-13

FMR Code


No.of facilities


1 2 3 4 5 6 B6.1 District Hospitals 1 500000 1 500000-00 B6.2 Community Health Officer 1 100000 13 1300000-00 B6.3 Primary Health Centres 1 100000 85 8500000-00 B6.4 Area Hospitals 1 100000 1 100000-00

Total 1,04,00,000-00

B.6 HEALTH CARE INFRASTRUCTURE: Sub-centre wise Building status and priority for construction of Sub-centre building S N

Name of the PHC

Name of the Sub-centre

New construction / dilapidated

Remarks for priority (priority should be

given to Tribal facilities)

1 G.Madugula Nurmathi New construction Tribal 2 Pulusumamidi New construction Tribal 3 Edulapalem Kakki New construction Tribal 4 Uppa Gedhalapadu New construction Tribal 5 G.K.Veedhi Ebulam New construction Tribal 6 Sapparla Kongapakalu New construction Tribal 7 Bheemavaram Pedrba New construction Tribal 8 Lungaparthi Valasi New construction Tribal 9 Pynampadu New construction Tribal

10 Vengada New construction Tribal 11 Kiloguda Sovva New construction Tribal 12 Gomangi Lingeti New construction Tribal 13 Boyrajula New construction Tribal 14 Boyrajula New construction Tribal 15 Kilagada Kulabeeru New construction Tribal 16 Pedaguda New construction Tribal 17 Vamabhasing New construction Tribal 18 Labburu Vamugummala New construction Tribal 19 Rangabayulu New construction Tribal 20 Lakshmipuram New construction Tribal 21 Barada New construction Tribal 22 Rudakota Gunjuvada New construction Tribal 23 E.Kumada New construction Tribal 24 Busuputtu New construction Tribal 25 Pinakota Jalada New construction Tribal PHC wise Building status and priority for construction of PHC building S N

Name of the CHNC Name of the PHC

New construction / dilapidated

Remarks for priority (priority should be given

to Tribal facilities)

1 CHNC Aruku Sunkarametta New construction Tribal 2 CHNC Narasipatnam U.Cheedipalem New construction Tribal 3 Sileru New construction Tribal 4 Korukonda New construction Tribal 5

CHNC Chintapalli

Pedavalasa dilapidated Tribal 6 CHNC Anakapalli Tagarampudi dilapidated Plain 7 CHNC

Bheemunipatnam Maduruwada dilapidated Plain

CHC wise Building status and priority for construction of CHC building

S N

Name of the CHNC Name of the CHC New construction

/ dilapidated

Remarks for priority (priority should be

given to Tribal facilities)

1 CHNC Kotavurtla CHC Kotavurtla Dilapidated Plain 2 CHNC

Munchingput CHC Munchingput New

Constrictions Tribal

Budget proposed for the Construction of Health Facility buildings - 2012-13 FMR Code


No.of buildings proposed

Annual total

(In/Rupees) 1 2 3 4 5 6

B5.3 Sub Centres (propose only 20 to 25 only)

Construction 900000 25 22500000

B5.2 Primary Health Centres (propose only 5 to 7 only)

Construction 4000000 7 28000000

B5.1 Community Health Centres

Construction 7500000 2 15000000

Others (if any) Construction -- Total 65500000 B.7 SALARY TO NURSE PRACTITIONER FMR Code


No.of posts

Annual total

(In/Rupees) 1 2 3 4 5 6

B.18.2 Salaries of Nurse Practitioners Salary 12910 -- -- B.8 MAINSTREAMING OF AYUSH FMR Code


No.of posts

Annual total

(In/Rupees) 1 2 3 4 5 6

B9.1 AYUSH Medical Officers Salary 18030 -- -- B9.2 AYUSH Compounders Salary 9200 -- -- B9.2 AYUSH S.N.Os Salary 6700 -- --

BUDGET ABSTRACT FOR MISSION FLEXIBLE POOL

(In/Rupees) S N Activity Budget

proposed 2012-13

1 Strengthening the Role of ASHA

a) ASHA Performance Based Incentives 38148425

b) Best ASHA Awards 105000

c) ASHA Conventions 6880800

d) Providing Saree to ASHAs (2 sarees) 2293600

2 Village Health Sanitation Committees 9590000

3 Untied funds

a) Sub Centres 5840000

b) Primary Health Centres 2125000

c) Community Health centers 650000

4 Annual Maintenance Grants

a) Sub Centres 790000

b) Primary Health Centres 3650000

c) Community Health Officeer 1300000

5 Hospital Development Societies (HDS)

a) Primary Health Centres 8500000

b) Community Health Officeer 1300000

c) Area Hospitals 100000

d) District Headquarters Hospitals 500000

6 Construction of Health Facility Buildings 65500000

7 Salaries of Nurse Practitioners --

8 Mainstreaming of AYUSH --

Mission Flexible Pool Total 147272825

PART C

Immunization Activities

C IMMUNIZATION ACTIVITIES Objective:

To reduce the drop-outs. To achieve 100% coverage in all VPDs Ensure regular supply of Vitamin-A. Surveillance of VPDs To improve reporting of AEFI cases

C.1. Details of pregnant women and children :

Target S N Beneficiaries

2010-11 2011-12 2012-13 1 Pregnant Women 81821 81279 81645 2 0 to 1 year Infants 70371 70059 70412 3 1-2 years children 61566 64354 64525 4 5 years children 90065 65061 65714 5 10 years children 113334 68220 68418 6 16 years children 81915 73319 73615

C.2 Details of Routine Immunization Sessions :

S N Routine Immunization Sessions 2010-11 2011-12 2012-13

1 Total Sessions planned 2957 2987 2987

2 Total Sessions Held 2957 2987* -

3 No. of Outreach Sessions 1204 1324 1324

4 No. of Fixed site sessio

03 visakhapatnam

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