letters - national health mission odisha · 2017. 11. 23. · camp shall include gynaecological...

MMiissss iioonn DDii rreeccttoorraattee National Rural Health Mission, Orissa

Department of Health & Family Welfare, Government of Orissa.

SIH&FW Annex Building, Nayapalli, Bhubaneswar- 751012

Phone : 0674-2392480/88/Fax-2392479- Website: www.orissahealth.org

C:\Documents and Settings\Administrator\My Documents\WEB content\WEB guidelines\camp\letters.doc Page No.:- 1 -

2005-2012

From: S. K. Lohani, IAS Mission Director NRHM, Orissa

To

All Chief District Medical Officers

Sub : Holding of Health Camps under NRHM

Sir,

With reference to the above, I would like to inform that under the NRHM approved

project Implementation Plan 2008-09, the following categories of health have been sanctioned

for your District, the details of which are enclosed as Annexure – A.

A. RCH Camps

Under Maternal Health component of RCH-II, provision has been made for holding the RCH

camps to reach the areas which have low accessibility to health care services. The budget

available for this camp is Rs.25,000/- per camp. The location for organizing the camp should

be finalized in consultation with the Block MOs with the due approval of the District

Collector. The guideline is enclosed at Annexure-B.

B. Swasthya Mela

Under the Tribal Health Mela component of RCH-II provision has been made to improve

health services in the tribal unserved and under served areas. The budget provision is Rs.

10,000/- per camp. These camps are to be organized in Tribal Blocks. The location should be

finalized in consultation with Block MOs with due approval of the District Collector. The

guideline is enclosed at Annexure- C.

C. Tribal RCH Camp

Under the Tribal Health component of RCH-II provision has been made to provide

Reproductive Child Health Services in sub-centre areas of inaccessible tribal blocks. An

amount of Rs. 4,000/- has been budgeted for each camp. The guideline is enclosed at

Annexure -D .

D. Mega Health Mela

Mega Health Mela is to be organized in each Lok Sabha constituency of the State. The

budget for each mela is Rs. 8.00 lakhs. The locations have to be finalized in consultation with

Hon”ble MPs and the District Collector. The guideline is enclosed at Annexure -E






2005-2012

While reviewing the achievements made by the Districts it was found that the

progress in this regard is not satisfactory. The above camps as per the numbers allocated

have to be completed by 31st March’2009. In this regard necessary planning may be

undertaken at your level and a copy of the same may be provided to the undersigned for

information. The fund as earmarked for each of the activities should be released

immediately to the concerned Blocks if not already done so.

Yours faithfully,

Mission Director. NRHM, Orissa.

NRHM, Orissa Memo No……………… Date………………

Copy forwarded to Commissioner-cum- Secretary H&FW for information


Memo No……………… Date……………… Copy forwarded to District Collector for information & for necessary action.


Memo No……………… Date………………

Copy forwarded to the Director of Health Services (O)/ Director Family Welfare

for information & necessary action.







2005-2012

Memo No……………… Date………………

Copy forwarded to all DPMU for information & for taking necessary action. They

are advised to down load the detailed guideline from the web-site if not readily

available and plan the activities to be taken up during this period.







2005-2012

Annexure-"A"

Details of Health Camps to be organized under NRHM 2008-09

Sl.No Districts RCH Camps

Swasthya Mela

RCH Camps in Tribal Blocks

Pending Mega Health Mela

1 Angul 12 0 0 0

2 Balasore 15 4 56 1

3 Bargarh 18 0 0 1

4 Bhadrak 10 0 0 1

5 Bolangir 16 0 0 0

6 Boudh 6 0 0 0

7 Cuttack 14 0 0 1

8 Deogarh 6 0 0 0

9 Dhenkanal 10 0 0 0

10 Gajapati 10 0 0 1

11 Ganjam 24 20 182 1

12 Jagatsinghpur 8 0 0 1

13 Jajpur 12 0 0 1

14 Jharsuguda 10 0 0 0

15 Kandhamal 14 48 290 1

16 Kalahandi 15 8 74 0

17 Kendrapara 9 0 0 1

18 Keonjhar 16 40 500 1

19 Khurda 15 0 0 1

20 Koraput 15 56 532 0

21 Malkangiri 10 28 274 0

22 Mayurbhanj 27 104 510 0

23 Nawarangpur 12 40 506 0

24 Nayagarh 8 0 0 0

25 Nuapada 10 0 0 0

26 Puri 13 0 0 0

27 Rayagada 14 44 406 0

28 Sambalpur 12 12 144 0

29 Sonepur 8 0 0 1

30 Sundergarh 21 68 676 1






2005-2012

Annexure- “B”

Guidelines for Reproductive Child Health Camps

Under RCH-II provision has been made for holding the RCH Camps as a strategy to

reach the areas which have low accessibility to health care services. These areas are to be

identified from the designated unserved and underserved areas of the Districts.

The objective of such camps is to Provide assured services as per a pre-determined calendar

Combine benefits of rural outreach and high quality services

Provide an array of maternal, child health and family planning services under one roof

These camps are to be organized at the CHC / PHC level /Blocks and Sub-blocks level or

by combining a number of villages at one focus point, providing an opportunity to

integrate the efforts of providers and increase access to reproductive health services. Each

camp shall include gynaecological check-ups, child examination and immunization,

family planning counseling and services, transportation for sterilization and treatment of

minor ailments.

The organization of camps should be preceeded by detailed planning relating to publicity,

manpower deployment, camp arrangements, and post-camp services including transportation,

availability of consumables and medical equipment. Each camp should be scheduled in advance

and publicised. Since most of these camps are in remote rural areas, the availability of a team of

surgeons, anaesthetist and preferably female gynecologist has to be ensured from the district

level. Enhanced budget for maintenance and fuel for vehicles is provided so that an adequate

number of vehicles can be deployed to transport doctors to RCH camp sites .

Planning

The RCH camps have to be planned by the district along with the MO in charge, Block

Programme Organizer, AYUSH Doctor, BEE, NGOs RKS members etc. The venue and the date

should be finalized at least 15 days prior to the holding of the camp. Local active NGOs or

FGO/MNGO could be roped in for the purpose. And the services of agencies like Rotary/Lions

Club Public Sector agencies could also be utilized for the purpose. The camps should be

undertaken in areas whose health services are generally not accessible one in areas which are






2005-2012

difficult and hard to reach areas. A list of unserved and underserved areas should be identified

for each district.

Publicity

At least 15 days before the start of the RCH camp, publicity and awareness should be

undertaken through leaflets, wall writing, banners, hired loud speakers on rickshaw or vehicles

etc. All the health functionaries of the area should be informed of the date and venue of the

camp. The ASHA, NGOs of the area also should be informed and be used to mobilize clients for

the camps.

Manpower Deployment

Doctors particularly surgeon, anesthesia, pediatrician & preferably a female gynecologist

should be present in the camp which has to be ensured from the district level. Further paramedics

consisting of ANM/LHV/ Staff Nurse and LTs should be deputed to the camp area to provide the

desired services. Volunteers from ASHA and NGOs can be mobilized from the field for the

camp day.

Camp Arrangement

The camp arrangements should be made so that there is adequate privacy and a minimum

level of hygiene. The area should be easily accessible to the beneficiaries. Simple

meeting/seating arrangement and drinking water arrangement to be made at the camp site. The

camp arrangements could be organized by the local MNGOs/ FNGOs/ RKS/ VHSC of the area

CHC/PHC or any active NGO of the area. The Block Programme Organizer along with the BEE

should conduct all ground work for organizing the camp.

Drug Procurement

Drug procurement budget available for the camp is Rs. 10,000/- which should be judiciously

used. Drug budget may be provided the district from the store or can be procured at the District/

Block level following laid down norms.

Facilities to be provided in the camps:

Ante natal check ups

Identifying High Risk pregnancy

- Anaemia: Treatment and referral






2005-2012

- High BP

- Others

Referral of complicated cases

IUD insertion

Sterilisation motivation and transportation

Family Planning counseling and providing contraceptives

RTI/STI case identification and treatment

Immunisation Services

Acute Respiratory Infection: Identification Treatment and Referral

Diarrhoea : Identification Treatment and Referral

Laboratory services: HB/Blood Grouping/Urine examination/Slides for RTI/STI

Any other services depending on local need like:

TB/Malaria/Worm infestation/Blindness/Leprosy/impairment of limbs/HIV/AIDS/Any

other.

Post Camp Follow-up

The post camp follow-up Format (Annexure-4) should be recorded and case follow-up

should be undertaken by the concerned FNGO or any NGO involved in the camp process.

Further, ASHAs could also be used to follow-up on the cases, particularly the referral cases. All

referral cases should be provided with a referral slip for post camp follow –up.

Documentation

The details of the RCH camp should be recorded in the format attached at Annexure -I. A

short one page report should be generated by the BPO of the Block PHC/ CHC( Annexure-2)

which should be sent to the district along with photographs and the camp format.

Budget

A budget of Rs. 25,000/- is available for each camp the details of which is provided at

Annexure- 3. However, resources could be mobilized from other agencies in cash & kind.

Further, RCH/ FNGOs of either the area have a provision of Rs. 5000/- each for 4 camps during

the year which could be clubbed for the above RCH camp, making the camp output qualitatively

better.






2005-2012

Annexure – I

Format for Monitoring of RCH Camp

Name of the District : _____________________________________

Name of the PHC/CHC : ___________________________________

Location of the Camp : _____________________________________

Name of the NGO/MNGO/FNGO involved : ____________________________________

Sl.No Activities Number

1. ANC

2. High risk pregnancy : - Anaemia - High BP - Others

3. Referral of complicated ANC cases

4. Anaemia - Treated - Referred

5. MTP

6. IUD

7. Sterilization - Tubectomy - Vasectomy

8. Contraceptives - Oral Pill - Condoms - Others

9. RTI/STI - Cases Identified - Cases Treated - Referral






2005-2012

10. Immunization Services - TT for pregnant women - BCG - DPT - OPV - Measles - DT - TT for children

11. Acute Respiratory Infection - Identified - Treated - Referred

12 Diarrhoea - Identified - Treated - Referred

13. Laboratory Services - Hb% - Blood Grouping - Urine examination - Slides for RTI/STI

14. Any other disease 1. TB 2. Malaria 3. Worm Infestation 4. Blindness 5. Leprosy 6. Impairment of limbs 7. Others

To be submitted by BPO to district through the Medical Officer alongwith the one page report.






2005-2012

Annexure – 2

Format for One Page Report

• Name of the District

• Name of the Block PHC/CHC

• Location of the Camp

• No of villages coming under camp

• Total number of beneficiaries veiling services supporting agencies/ collaborative

partners

• Names of doctors attending the camp

• Duration of the camp

• Funds utilized

(Report to be submitted within 15 days of organizing the camp to the district)






2005-2012

BUDGET In (Rs.)

Manpower (Medical Staff)

Gynecologist

Pediatrician

Anesthetist

(MOs, Specialists, other staff in government

service would get DA at their state rates. No

honorarium will be given to them.)

Honorarium as indicated in the next column

will be given only to private specialists)

1000/-

1000/-

1000/-

Total = 3000/-

Publicity

Banners

Loud Speaker

Munadi

I.P.C

2500/-

Camp Arrangements

Layout of Services

Generator

Waiting Area

Tents

Chairs

5000/-

(7000/- in case of camps in buildings other

than PHC)

Transport Provision

POL for transportation of Specialists, District

Officers, Medical Officers, Para Medical Staff

and equipment

2000/-

Medicines / Drugs/ Consumables 10,000/-

Contingency 2500/-

Total

25,000/-






2005-2012

Annexure- 3

Post Camp Follow up Format

Sl.No Services Number of cases Complications Referred

1 MTP

2 IUD

3 Tubectomy

4 Vasectomy/

NSV

5

Diseases

treated

during

Camps

1 Anaemia

2 ARI

3 Diarrhoea

4 RTI/STI

5 TB

6 Malaria

7 Any other






2005-2012

Annexure-“D”

SWASTHYA MELA

Objective :

The objective of the Tribal Swasthya Mela is to improve health services for the tribal

un-served and under served areas. Under RCH-II provision has been made for Tribal

Swasthya Mela for the tribal districts. The Swasthya mela should be organized in a remote

village where the habitants have limited access to health services. The selection of the

village shall be done by the Block with emphasis on poor accessibility and poor service

delivery affected by season/ weather and absence of regular staff. The local NGOs and PRIs

may be consulted collaborated for the purpose. For operational purpose a number of villages

could be clubbed and the camp organized at one focal point. It should be ensured that this

should easily accessible to beneficiaries. The venue should be accessible to the villages and

minimum provision of water & light and cleanliness should be made.

• Planning : The planning for the mela should be undertaken by BPO, BEE in

consultation with the ANM and ASHA of the area. The mela schedule should be made at

least a week in advance and communicated to all concerned. Necessary medicines and

supplies should also be arranged. Local NGOs can also be roped in for the purpose.

• Publicity : Door to door campaign for making people aware about the time venue and

date of the mela should be undertaken. Further the ASHA and ANM would also be used

to mobilize people for the mela.

• Manpower Required : Two Medical Officers for the health mela should be provided.

One health worker(male) ad one Female health worker and one health supervisor should

be deputed to the mela.

• Services to be provided : All general health problems, diseases under the national

programmes shall be treated alongwith Panchabyadhi diseases.

• Camp Arrangement : The camp arrangements shall be made either by the local NGO

or by the ANM & ASHA

• Reporting : After conducting the mela the details of output should be forwarded to the

district in the prescribed format as in Annexure –II.






2005-2012

BUDGET

Publicity

Door to door propaganda regarding the venue & date of the

camp

Rs. 500.00

Medicine Cost

Medicine excluding medicines under National Programmes and Panchabyadhi

Rs. 6000.00

Honorarium

M.Os consultation fee (2 M.O.s) @ Rs. 200.00

* In case MOs are being hired (Rs. 500 can be paid)

Rs. 1400.00

Health Supervisor -1

Health Worker (M) -1 @ Rs. 50.00

Health Worker (F) -1

AWW/ASHA -4

Rs. 350.00

Camp arrangement including mobility Rs. 1000.00

Contingency Rs. 750.00

TOTAL Rs. 10,000.00

(Rupees ten thousand) only






2005-2012

Annexure –I

Tribal Swasthya Mela Report

Name of the District :

Name of the Block PHC/ CHC : Date :

Name of the Village : Venue :

Health Problems No. of Beneficiaries Treated Referred

TOTAL

Signature of Medical Officer






2005-2012

Annexure-“B”

TRIBAL RCH CAMP Objective The objective Tribal RCH camps are to improve the availability of reproductive Child

Health Services in remote, inaccessible and underserved areas, of designated tribal

blocks. These camps have to be organized once in every six months in the sub-centre

area of tribal blocks.

• Planning

The RCH camps have to be undertaken at the block level under the leadership of

Medical Officer I/c, BPO,BEE in consultation with the ANM and ASHA. The camp

information should be made available one week in advance.

• Publicity

Door to door campaign by ASHA, information to the Gaon Kalyan Samitis in the area,

and public display of date and time of the camp in the sub-centre should be

undertaken.

• Manpower

Two Medical Officers for the camp is required and one AYUSH doctor should be

provided. One Health Worker (Male) and One Health Worker (Female) and one health

supervisor should be deputed to the camp.

• Camp Arrangement

The camp arrangements shall be made by either by the local NGO, local Gaon Kalyan

Samiti or by the ANM & ASHA. It should be made preferably in a place available in a

school, Youth Club, NGO or AWC.

• Services to be Provided

Each camp shall provider provision for Gynecological check-up, child examination

immunization, family planning counseling & services & treatment of minor ailments.

• Budget

The details of the expenditure to be made in each camp is placed at Annexure –I

• Reporting






2005-2012

After conducting the camp the details of the output should be forwarded to the block

& district level in the prescribed formal as in Annexure-II.






2005-2012

Annexure - II

Tribal RCH Camp Report

Date :

Name of the District :

Name of the Block PHC/CHC :

Name of the Sub-centre :

Place of Camp :

Health Problems No. of Beneficiaries Treated Referred

TOTAL

Signature of Medical Officer






2005-2012

Annexure-I

BUDGET

• Camp Arrangement & Publicity Door to door propaganda regarding the venue & date of the

camp & camp arrangement including mobility.

Rs. 450.00

• Medicine Cost

Medicine excluding medicines under National Programmes

Rs. 2000.00

• Honorarium

* M.Os consultation fee (2 M.O.s) @ Rs. 200.00

* AYUSH Doctor @ Rs. 200.00

In case MOs are being hired (Rs. 500 can be paid)

Rs. 1200.00

Health Supervisor -1

Health Worker (M) -1 @ Rs. 50.00

Health Worker (F) -1

AWW/ASHA -4

Rs. 350.00

TOTAL Rs. 4000.00






2005-2012

Annexure-“E”

Guideline for Health Mela

In all lok sabha constituencies of Orissa






2005-2012

Plan of action for Health Mela

Attempt will be made to hold Health Melas in all Lok Sabha Constituencies of the

country. • The Health Mela will be held for 3days. • The venue of the Health Mela should be selected so that it is in the vicinity of

a Medical College/ Civil Hospital/ CHC in order to provide facilities of ultra-sound, pathological tests, etc.

• The venue should be centrally located and easily accessible to the general public.

• The venue and dates of the Health Mela shall be selected in consultation with the Member of Parliament, District Magistrate and Chief District Medical Officer.

The venue should be divided into stalls, with clear indication of location of each service like maternal care, child care, family planning, NSV, RCH, blindness control etc. There should be a printed map, indicating the layout of the stalls at the Mela venue. The Health Mela will provide health care services along with the awareness and information at the doorsteps of the people for promoting preventive, curative and rehabilitative health care. National programmes for control of Cancer, HIV/ AIDS, Tuberculosis, Blindness, Malaria and Leprosy and the Directorate of Family Welfare will participate in various Melas. Specific focus would be on ‘Saving the girl child’, and arresting declining sex ratio in the relevant States.

The Health Melas in addition to above, will also have the following components :

• Physical check-up of those who report at the Mela/ Camp, especially eye, ENT, dental, etc. A health card is to be given to each person attending the health camp.

• Investigation like urine, sugar, blood sugar, HB, ECG, sputum test, PAP smear.

• Those requiring further investigations, specialist opinion , admission and reference for surgery need to be referred to higher institutions.

• All referral case must be entered into a register indicating the name of the patient and the hospital where the patient has been referred.

• In case the local Administration feels that some programme needs to be carried on even after the 3-day Mela, appropriate arrangements for the same may be made locally.

• A health promotion and health education campaign by way of health exhibition to be held the Mela.

• For each of the Melas adequate number of medical specialists, surgical specialists, gynecologists, ENT surgeons, eye surgeons, skin specialists, dental surgeons, child specialists, may be drawn from local government hospitals, primary health centres, private doctors and the IMA.






2005-2012

The local Branches of IMA will be fully involved under the guidance of Secretary

General All India IMA.

In each Mela the following subjects are to be taken up for publicity and counseling:

Family Welfare (including immunization & contraceptive services) Counseling for RTI/ STI . Prevention of Blindness. Rehabilitation of the disabled. Leprosy control. TB control. Nutrition. Bad effects of smoking. Cancer control. Personal hygiene, environmental hygiene. Diabetes control. Ill effects of alcohol. Indian System of Medicines etc. IMA local branch, Voluntary Health Association of India and other National

NGOs putup stalls for family welfare and RCH programme with IEC back up. No Scalpel Vasectomy (NSV) stall is put up and NSV conducted with complete

arrangements in consultation with local hospitals.

Information, Education and Communication (IEC) Division will arrange publicity with the Media units of the Ministry of Information and Broadcasting e.g. Song and Drama Division, Directorate of Field Publicity and DAVP for local specific programmes at the Melas.

Nehru Yuvak Kendras and NSS volunteers may also be involved. Information should also be disseminated in respect of

‘Rashtriya Sam Vikas Yojna’ in the districts where it is operational. This Yojana aims to give some catalytic money for acceleration for the development. This scheme lays stress on social infrastructure such as health and education. This would encourage convergence.

FUNDING A grant of Rupees 8 lakhs will be given by Central Government to meet the logistical arrangements, publicity and necessary Drugs, Medicines etc. In order to have a participatory approach, the local MP and the District Administration are requested to mobilize further financial and other supports locally to supplement the Central Government funding. An indicative checklist has been prepared for the activities in organizing the Health Mela, a copy of which is annexed. Local initiative can supplement with further relevant activities.






2005-2012

The Central Government funds will be provided to State Government/ District Magistrate/ CMO or Local branch of IMA whosoever is selected by local MP/ District Administration to organize the Health Mela.

IMPORTANT ITEMS OF WORK TO BE ATTENDED FOR THE PARIVAR

KALYAN AVAM SWASTHYA MELA

1. Publicity:- at least from 15 days before the start of Mela through leaflets, hoarding, posters, wall writing, banners, film slides, video-vans, advertisements in newspapers.

2. Health cards to be printed locally. 3. Duty chart of Doctors and other staff would be made. 4. An enquiry office, with duty chart of doctors and other staff with layout map

should be functional at least from 3 days before start of the Mela. 5. Registration counters should be at least 25 so that the crowd is spread out. 6. There should be at least 40 stalls for different diseases/ disciplines/

exhibitions as listed below. If the stalls are in the open space, each stall may be of size 15’X15’ and should be ready with all furniture, fixtures, posters, equipments etc. one day before the start of Mela.

I. General Medicine(at least 4stalls) II. Maternal Health

III. Child Health IV. Immunisation V. Family Planning, counseling, arrangement for sterilization, if OT is

available VI. Non Scalpel Vasectomy arrangement for operation, if OT is available.

VII. IEC Family Welfare VIII. ENT check up

IX. Dental check up X. Cardiac checkup XI. Skin

XII. Counseling for Nutrition XIII. Counseling for RTI / STI / AIDS Control XIV. Leprosy control XV. TB control

XVI. Malaria XVII. Prevention of blindness(eye checkup)

XVIII. Bad effects of smoking XIX. Cancer control XX. Personal / environmental hygiene

XXI. Diabetics control XXII. Rehabilitation






2005-2012

XXIII. Indian Systems of Medicine Ayurveda, Unani, Homeopathy XXIV. Pathological investigation(urine sugar, blood sugar, HB, Stool, Sputum

test) and arrangement for diagnostic tests(X-ray, Ultra Sound, ECG etc) XXV. Programmes of Song and Drama Division, Directorate of Field Publicity XXVI. DAVP exhibition

7. One page site map showing location of stalls for different disciplines with numbers may be printed in sufficient number for distribution among volunteers and doctors to guide patients.

8. Adequate number of volunteers for guiding the people to the concerned stall. 9. Adequate number of Resident Doctors and Medical Students for manning

these stalls. 10. Medicines for 5 days or full course will be distributed by pharmacists posted

at each stall. Adequate store and distribution facility should be arranged. 11. Directory of functional health institutions should be readily available in the

Health Mela so that the Doctors attending the patients can refer the case for subsequent follow up.

12. Allocation of stalls and duty should be fully explained to the Doctors/ pharmacists/ ANMs and other health staff. A detailed briefing may be given to them about their role/duties.

13. The organizers will take due care of hygiene at the Mela site. Arrangements for drinking water, sanitation at the Mela site should be made.

14. Stalls for quality, hygienic food may be put up for sale at reasonable prices.






2005-2012

Financial Outlay for 3-day Swasthya Mela in each Parliamentary

Constituency

1. Campaign phase Rs 70,000.00 a. Advertisement in Electronic Media b. Posters c) Leaflets d) Hoarding e) Banners f) Intensive Advertisement through Mike

2. Registration & Computerization of Patient Data Rs10,,000.00 3. Diagnostic Services Rs 50,000.00

g) Pathological Investigation h) X-ray i) Ultrasound j)ECG

4. Infrastructure development at venue Rs 1,20,000.00 (Including venue charge , water, electricity etc.)

5. Transport during mela Rs 20,000,00

6. Honorarium &TA of Doctors during mela Rs 72,000.00 @ Rs. 600.00 per doctor, 40 Doctors daily

7. Honorarium & TA of paramedical staff during Mela Rs 30,000.00 @ Rs. 250 per paramedical staff 40 staff daily

8. TA & Honorarium of 50 Volunteers during Mela Rs 15,000.00 @ Rs. 100.00 per volunteer

9. Exhibition, Street Play , Quiz Competition etc during Mela Rs 10,000.00

10. Printing of Certificates, booklets Health cards badges etc. Rs 50,000.00

11. Reporting and Documentation ; Rs 15,000.00

12. Preparatory Meetings : Rs 10,000.00

13. Telephone, Fax Email, Postage & Stationery Rs 18,000.00 14. Contingency Rs 10,000.00 15. Drug,& Surgical Kits, etc Rs 3,00,000.00

TOTAL: Rs 8,000,00.00 (Rupees Eight Lakhs only)






2005-2012

Annexure-I Government of India

Ministry of Health & Family Welfare, IEC DIVISION Subject: Report on Health Mela (Check-ups) held on dated ………………….. Sl. No.

Item No. of people benefited

Remarks

1. Registration 2. Check – up 3. Treatment 4. NSV/ Vasectomy 5. Tubectomy 6. RCH 7. Gyneacology 8. Breast Feeding (Nursing Mothers) 9. Pediatrics 10. RTI/STD Check up 11. Malaria 12. Tuberculosis 13. Leprosy 14. Blindness control 15. Non-Communicable Diseases (Diabetics etc.) 16. HIV/AIDS Counseling 17. Cancer 18. Family Planning Counseling 19. Polio & DPT Vaccination 20. Cardiology 21. Asthma 22. Dental 23. ENT 24. Medicine 25. Surgery 26. Plastic Surgery 27. Skin/ Dermatology 28. Blood Test 29. ECG 30. X-Ray 31. Ultrasound 32. Contraceptive Distributed 33. Ayurveda 34. Unani 35. Siddha 36. Homeopathic 37. Others (please specify)

Total






2005-2012

Annexure-II Government of India

Ministry of Health & Family Welfare, IEC DIVISION Subject: Feedback on Health Mela (Check-ups) held on dated ……………….. i. General Report

Lok Sabha Constituency ………………………………….. Name of District ………………………………………… Name of M. P. …………………………………. Venue of Mela …………………………….. Dates of Mela ……………………………….

ii) Participation Details

1. No. of Doctors ………………… Major Source (s) ………………………. a) General Screening …………………… b) Specialists ……………………… 2. No. of Pharmacists ………………… Major Source(s) 3. No. of other Health Staff (NGO, LHV etc) ……………………… 4. No. of Volunteers ……………….. Major Source (s) ……………….. 5. Name (s) of NGOs who participated and type of participation …………………………………………………………….. 6. Involvement of IMA ……………………………………

iii) Impact Details

1. General impact of IEC publicity material on health care issues …………… 2. Value of medicines / drugs used in the Mela …………………. 3. List the problems faced by the authorities, if any …………….. 4. Suggestions and Remarks ………………………………….

(Signature of Organizing authority with seal) * Annexure-I & II has to be submitted to Govt. of India, OSH & FW Society and Directorate

of family Welfare, Orissa.






2005-2012

Utilization of funds for Swasthya Mela

District : Date : Funds Received for Swasthya Mela Amount Govt. of India (State Health & Family Welfare Society)

MP lad Donations/ Any other sources Total Expinditure Heads Amount Campaign Phase Advertisement I Electronic Media Posters Leaflets Hoarding Banners Intensive Advertisement through Mike Registration & Computerization of Patient Data Diagnostic Services Hiring of Medical Instruments Infrastructure Development of venue Venue Charge Water, Electricity Any other TA & Honorarium Doctor Paramedical Staff Volunteers Transport during mela Exhibition, Street Play, Quiz Competition etc. during Mela

Printing of Certificates, booklets Health cards badges etc.

Reporting and Documentation Preparatory Meetings Telephone, Fax, E-mail, Postage & Stationery Contingency Drug & Surgical Kits, etc. Any other Total Expenditure

CDMO/ADMO(FW)






2005-2012

Utilization Certificate for the year of_____________

I hereby certify that grants placed at my disposal/ at the disposal of ____________in the year__________ for the purpose of ____________________ and the amount available for expenditure during the year as follows : Funds Received Rs.__________________________ Expenditure during the Swasthya Mela Rs.__________________________ Unspent Balance Rs.__________________________ I certify that expenditure of Rs. _____________________in words_______________________ has been expanded solely on_______________ under my charge within the jurisdiction of _______________________ and for no other purpose and that the sum Rs.________________ in words_______________________ shown as balance at the end of year ________________is available for expenditure no part of it has been diverted. CDMO