meghalaya npcc 08 09 pip
TRANSCRIPT
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M E G H A L A Y A
State Implementation Plan
Revised - 2008-09
NPCC Meeting_25/03/08
Government of MeghalayaShillong
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M E G H A L A Y A
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M E G H A L A Y ARCH II GOAL
MEGHALAYA STATE
Current status
(specify year & source)
Target
08-09 09-10
MMR 450 (MIS 2005-06) 400 < 100
IMR 53 (2006 SRS) < 40 < 30
TFR 3.8 (NFHS 3) 3.5 2.1
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M E G H A L A Y ABACKGROUND (2001 Census)
Population of 232 Lakhs
7 Districts
10 Sub Division
39 Community Development Blocks
Population Density is 103 person/Sq.M
Rural Population is 80.4 %
6180 Villages
literacy is 62.6 %
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M E G H A L A Y APlanning Process
Capacity building workshop was held for the state programme officer atGuwahati on 22 to 27 October 2007 regarding planning process.
Similar capacity building workshop with MOs and Programme Manager of all7 districts was held for a week from 26thNovember to 1st December 2007
at Shillong with support from RRC, Guwahati and NHSRC Delhi.
Followed by it was a meeting with the BLOCK CORE GROUPS who werealso involved in the planning process during 2006-07 and the newly
appointedBPMUs. All block plans are available.
At district level the block plans were collated by the District Core Group andthe trained MO on planning process, so that the district plans were made.
State plan is compilation of all the district plans and block plans.
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M E G H A L A Y A
Percentage of children who are given ORS indiarrhoea is 67.7 (NFHS 3). Target revised
2008-2009 70%
2009-2010 75%
2010-2011 85%
2011-2012 95%
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M E G H A L A Y A
RCH Technical Strategies
Part A
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M E G H A L A Y AMaternal Health
Objective: Increase coverage of 3 ANC from 53.4% (NFHS-3) to 75%.
Strategy: Increase accessibility of services at various level.
Activities:
1. Renovation of SCs/PHCs/CHCs.
2. Focus on 38316 VHN Days (3193 AWC*12=38316)
3. Incentives of Rs. 20/- to ASHA per VHN Days.4. Fixed ANC/PNC days in all PHCs & everyday at CHCs
and DHs.
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M E G H A L A Y A
Maternal HealthStrategy: EnsureANC registration in inaccessible and
uncovered areas.
Name of the Sub Centres with difficult area is providedin PIP where the 60 outreach camps will be held.
Strategy: Increase accessibility through institutional
strengthening.
18 PHCs are proposed for 24x7 in 08-09, 8 are already
functioning as 24x7.
POL for ambulances for 24x7 PHCs is budgeted.
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M E G H A L A Y A
Strategy: Promotion of institutional deliveries through cash
incentives by promoting JSY scheme.
Activities:
Monitoring of JSY
Listing of beneficiaries outside PHC/CHC
Monitoring quality of deliveries at Public Health Facilities
Accreditation and monitoring of private facilities are in process
2 days stay after delivery is instituted in PHC and other facilities
Maternal Health
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M E G H A L A Y A
BREAK UP OF INSTITUTIONAL AND HOME
DELIVERIES IN 07-08
Delivery Place Number % Number ofBeneficiary
Payment
Home 36, 671 62 1, 073 5, 36, 500
Institution 22, 899 38 4, 385 36, 99, 500
Total 59, 570 100 5, 458 42, 36, 000
Maternal Health
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M E G H A L A Y A
ESTIMATE CAPACITY FOR INSTITUTIONAL
DELIVERIES IN 08-09.
Delivery Place Number % Number ofBeneficiary
Payment
Home 50, 870 70 16, 278 x 500 90, 68, 800
Institution 21, 801 30 6, 976 x 1300 81, 39, 000
Total 72, 671 100 23, 254 1, 72, 07, 800
Maternal Health
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M E G H A L A Y A
PLAN FOR CAPACITY AUGMENTATION FOR JSYIN 08-09
Increase 3 ANC coverage to 75%
Ensure ANC registration in inaccessible and uncoveredareas.
Increase institutional deliveries to 50%.
26 PHCs to function as 24x7
Strengthening referral transport
Training of SN/ANM on skilled deliveries
Maternal Health
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M E G H A L A Y A
PLAN FOR CAPACITY AUGMENTATION FOR JSY IN 08-09
Promotion of JSY
EmOC at 5 CHC and 3 DH
Multi Skilling of MOs Recruitment of specialists
Incentives to medical officer and specialists
Upgrading facilities to IPH standard.
AmbulancesBlood storage to be operationalized
Monitoring quality of facilities conducting deliveries
Maternal Health
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M E G H A L A Y A
STEPS FOR OPERATIONALISATION OF FRUs
Training of MOs in Obstetric and Anesthesia outside state.
Provision of incentives to specialists
Provision of incentives to MO undergoing multi skilling training
Recruitment of specialists on contract basis
Increase coverage forANC and PNC will reduced complicationsand will lead to timely referrals.
Availability of specialist as criteria for operationalisation of FRUs. Incentives of Rs. 5000/- p.m. to MOs undergoing multi skill
training. 2 MOs from 1st quarter, 6 from 2nd, 6 more from 3rd
quarter and 6 more from 4th quarter, total of 20 doctors in 08-09.
Maternal Health
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M E G H A L A Y A
STATUS OF FRUS DURING 2007-08.
FRU Obstetrician Anesthesia Pediatrician Blood Storage
System
Umsning Yes No Yes
Nongpoh Yes Yes Yes Is being installed
William
Nagar
Yes Yes No
Khliehriat Yes No Yes
Mairang Yes No Yes
Phulbari No No No
Maternal Health
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M E G H A L A Y A
Orientation Of Trained TBAs In 20% Inaccessible Areas.
Activities Number Rate Budget
TA for Dais 1236 200 2, 47, 200
Stay for 5 days at CHCs 1236 1000 12, 36, 000
Training material cost 1236 100 1, 23, 600
Kit Cost 1236 150 1, 85, 400
Honorarium to trainers at 20
CHCs
20 500 10, 000
Total Budget for Dai
Training
18, 02, 200
Maternal Health
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M E G H A L A Y A
Maternal Health
Anemia among women is addressed in objective 6. 1. 1. 5.
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M E G H A L A Y AMH O 9 To increase the coverage of PNC
from 28. 8% (NFHS-3) to 50%.
S 1 Increase accessibility
of PNC services
A1: Repair and renovation ofSCs/PHCs/CHCs andDHs.
A2: Construction of new SCs
A3: Focus on PNC duringVHN days at AWC.
A4: Recruitment of new
ANMs.A5: Fixed PNC days will be
held in all PHCs/CHCsand DHs.
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M E G H A L A Y AMH O 9 To increase the coverage of PNC
from 28. 8% (NFHS-3) to 50%.
S 2 Increase PNC at
inaccessible and
uncovered areas.
A1: 1410 MSS to spreadawareness on post natalcare.
A2:Additional MSS to beformed.
A3: Mobility support forANMs per SCs.
A4: Outreach camps atuncovered and undercovered areas.
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M E G H A L A Y AMH O 9 To increase the coverage of PNC
from 28. 8% (NFHS-3) to 50%.
S 3 Increase awareness
among mothers and
community about need ofPNC services.
A1:ANMS,ASHAs andAWWs will engage incounselling for PNC.
A2: Follow up of deliveriesand referral follow up will
be ensured byANMs andASHAs.
A3: Communication materialon PNC.
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M E G H A L A Y AMH O 9 To increase the coverage of PNC
from 28. 8% (NFHS-3) to 50%.
S 4 Ensure PNC and Post
Partum Care.
A1: PHC & CHC will beupgraded as per IPHstandard.
A2: Staff to be trained inPNC care, referral and PPservices.
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M E G H A L A Y A
Child Health
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M E G H A L A Y AChild HealthObjective 6. 1. 2.(i) 2. Promote exclusive breastfeeding.
Adequate emphasis will be given to 5 districts with low
coverage particularly in Jaintia Hills andWest Khasi Hills.
Objective 6. 1. 2 (i). 5. Improve the coverage of vitamin A
Vitamin A will be administered during VHN Days.
Objective 6. 1. 2 (i). 6. Increase use of ORS among children
with diarrhoea.
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M E G H A L A Y AChild HealthObjective 6. 1. 2.(i) 7.Address underweight children and
assess children for nutritional problem.
S 1- ensure routine check
up of children for bothweight and height for age
A1: assess height and weight of
children below 5 years.A2: underweight child to get
supplementary food from ICDS.
A3:ASHA andANM will
promote child nutrition throughVHN Days.
A4: IEC/BCC on child nutrition
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M E G H A L A Y A
Family Planning
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M E G H A L A Y AFP O 2 To reduce TFR from current 3.8
(NFHS 3) to 3.4 by 2010.
S 3 Organize
contraceptive update
workshop anddissemination of manuals.
A1: One day state levelworkshop oncontraceptive updates and
emergency contraceptive.
A2: Guidelines, manuals willbe disseminated to allfacilities till SC level.
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M E G H A L A Y AFP O 2 To reduce TFR from current 3.8
(NFHS 3) to 3.4 by 2010.
S 4 Enhance capacity of
facilities for taking family
planning activities.
A1: QualityAssuranceCommittee will be formed atdistrict level.
A2: Promotion of contraceptivesby GoM through change indirectives and SO.
A3: Training of manpower inmini laparoscopic surgery
and IUD insertion.A4: Provision of compensation
to people for tubectomies andNSV
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M E G H A L A Y A
FP BUDGET
Activities Rate Budget
Compensation @ Rs. 1500
per sterilization for 2500cases.
37, 50, 000
Total budget 37, 50, 000
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M E G H A L A Y A
Adolescent Reproductive Health
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M E G H A L A Y A
5 days training of adolescent boys and girls need no budget.ASHA/AWW can undertake training atAWC/School.
Similarly follow up training need no budget.
Adolescent clinics are already part of regular clinics at DH. So there is
no additional budget requirement.
75 MOs and 472ANMs will be trained in ARSH.
Orientation of VHSC on adolescent issues can be done during regular
meetings.
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M E G H A L A Y A
Quality Assurance, Monitoring andEvaluation
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M E G H A L A Y A
QUALITY ASSURANCE COMMITTEE ATSTATE
(MD- NRHM, SPM, Consultant MCH&FP,
Consultant HMIS, DHS (MCH&FW), member of
RKS.
QUALITYASSURANCE COMMITTEE AT
DISTRICT
(DHMO, Monitoring officer, DPM, DHE, Member of
RKS)
QUALITYASSURANCE COMMITTEE AT
BLOCK
(MO I/c CHC, BPM, and member of RKS)
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M E G H A L A Y A
Training Plan
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M E G H A L A Y A
Training by skill category, volume, duration and location isprovided in PIP.
Existing MO I/c training will be the nodal person to manage and
coordinate all training in state and will assist the MD NRHM.
Over period till 2011 the SIHFW will be strengthened to undertake
skill based training and will be the nodal agency for planning,
conducting, managing and organizing all state level training.
Training on RTI/STI for 75 MOs is proposed.
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M E G H A L A Y AB
U
D
G
E
T
S
U
MM
A
R
Y
O
F
RCH -II
S.No
Interventions Amount
1 Maternal Health 1, 23, 74, 800
2 Janani Surakhsha Yojana (JSY) 1, 80, 95, 800
3 Child Health 13, 20, 000
4 School Health 83, 90, 000
5 Family Planning 37, 50, 000
6 Adolescent Reproductive Health 36, 51, 000
7 Urban Reproductive Health (URCH) 1, 29, 58, 000
8 Gender and PNDT/Sex Ratio 5, 24, 000
9 Mother NGO Scheme 42, 00, 000
Continues in next page
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M E G H A L A Y AS. No Interventions Amount
10 Infrastructure and Human Resource 2, 23, 28, 400
11 Behaviour Change Communication 1, 39, 78, 000
12 Infection Management & Env. Plan 16, 90, 000
13 QualityAssurance, Monitoring &
Evaluation Cell
1, 87, 08, 000
14 Strengthening of Training Institute 7, 28, 000
15 Central Training Plan 88, 68, 192
16 Programme Management Support
Unit (PMSU)
64, 14, 000
TOTAL RCH II BUDGET 13, 79, 82, 082
B
U
D
G
E
T
S
U
MM
A
R
Y
OF
RCH -II
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M E G H A L A Y A
Unspent amount
as on Dec 2008
Liabilities till
March 2008
Total unspent
balance 07-08
10, 28, 27, 771.99 3, 37, 63, 930.45 6, 90, 63, 841.54
Total
Requirement
Unspent Balance Net Requirement
13, 79, 82, 082 6, 90, 63, 841.54 6, 89, 18, 240.46
B
U
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S
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MM
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OF
RCH -II
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M E G H A L A Y AAnnexure 3 a
Annexure 3 b
Annexure 3 c
Annexure 3 d
Annexure 3 e
Annexure 3 f
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M E G H A L A Y A
Part B: NRHM Initiatives
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M E G H A L A Y A
VHSC Total 4102 VHSC constituted and untied fund has been
released.
Post office option for saving account or other sources will
be explored.
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M E G H A L A Y A
Sub Centres Post office option for saving account or other sources will
be explored.
Procurement of haemoglobinometers for each 401 SCs @
Rs. 600/-
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M E G H A L A Y A
Primary Health Centres Burial pits proposed last year were made.
Procurement of 10 ambulances is proposed.
POL and maintenance for ambulances budgeted @ Rs.
6000/- per month for 20 ambulances.
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M E G H A L A Y ABurial Pits All burial pits proposed last year were made at PHC, CHC
and District Hospital
Strengthening the logistics DrugWarehouse
Transportation cost from State HQ to Districts will be fromstate pool.
Salary of staff in warehouse needed as they will operate
from rented warehouse.
Rent of state warehouse @ Rs. 25, 000/- per monthproposed.
Emergency generator @ 8, 00, 000/- plus POL for
generator @ Rs. 180000 for whole year.
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M E G H A L A Y AStrengthening RIHFW Driver will be made available from state pool.
Specialized care by NEIGRIHMS
2 PHC of diengpasoh and Mawphlang will act as ruralunits for NEIGRIHMS.
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M E G H A L A Y A
New Initiatives
Mobile phone forANMs is removed.
Household cards for records is also removed
Mobility for cold chain mechanic is budgeted under UIP.
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M E G H A L A Y AB
U
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ET
S
U
MM
A
R
Y
OF
NRHM
S.No Interventions Amount
1 ASHAs 61969270
2 VHSCs 61800000
3 Sub Centres 27469840
4 Primary Health Centres 146267000
5 Community Health Centres 42643177
6 District Hospitals 93057000
7 Procurement of essential drugs 52700000
8 Strengthening the logistics 25243004
9 Health Mela 3500000
Continues in next page
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M E G H A L A Y AS. No Interventions Amount
10 Operationalize MMU 542500011 Private Public Partnership 700000
12 Mainstreaming of Ayush 10140000
13 Training of ICD 10 661835
14 Strengthening of RHFW
TC 515939415 Incentives to MOs 2009700
16 Specialized services by NEIGRIHMS 3348990
Sub Total 54, 20, 94, 210
B
U
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ET
S
U
MM
A
R
Y
OF
NRHM
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M E G H A L A Y AS. No Interventions Amount
17 Renovation of TB Hospital 1902210018 National Programme on Prevention &
Control of Deafness (NPPCD)
4000000
19 Strengthening of BMPUs 11232000
20 PHCAccountant 13312000
21 Engineering Cell 1440000
22 StateAccounts Manager 144000
23 Manpower at Mission Directorate 408000
24 Mobility fund and office expenses 6200000
25 Strengthening Immunization
Programme
588000
26 Salary toASHA consultant 240000
Sub Total 5, 65, 86, 100
Grand Total (542094210+56586100) 59, 86, 80, 310
B
U
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A
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OF
NRHM
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M E G H A L A Y A
Unspent amount
as on Dec 2008
Liabilities till
March 2008
Total unspent
balance 07-08
31, 22, 60, 328 7, 02, 10, 569 24, 20, 49, 759
Total
Requirement
Unspent Balance Net Requirement
59, 86, 80, 310 24, 20, 49, 759 35, 66, 30, 551
B
U
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ET
S
U
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NRHM
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M E G H A L A Y A
Part C: Immunization
Universal Immunization Programme
+ Intensive Pulse Polio Immunization
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M E G H A L A Y A
AEFI Committee at State & District
Committee formation and training on AEFI surveillance
is under process.
Budget for Immunization
3, 44, 52, 225
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M E G H A L A Y AIDSP
ICU ward and Vehicle proposed is removed
Budget
1, 10, 42, 070
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M E G H A L A Y ARNTCP
Budget
2, 35, 43, 554
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M E G H A L A Y ANIDDCP
ASHA incentives removed
Training cost removed
Budget
38, 00, 000
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M E G H A L A Y ANLEP
Budget
58, 85, 000
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M E G H A L A Y A
NPPCB
2, 67, 00, 000
Budget
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M E G H A L A Y A
NVBDCB
3, 01, 70, 614
Budget
B
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M E G H A L A Y AS. No Interventions Amount
1 Integrated Disease SurveillanceProgramme (IDSP)
1, 10, 42, 070
2 Revised National Tuberculosis
Control Programme (RNTCP)
2, 35, 43, 554
3 National Iodine Deficiency Disorder
Control Programme (NIDDCP)
38, 00, 000
4 National Leprosy Eradication
Programme (NLEP)
58, 85, 000
5 National Program for Prevention and
Control ofBlindness (NPPCB)
2, 67, 00, 000
6 National Vector Born Disease Control
Programme (NVBDCP)
3, 01, 70, 614
Total of disease control programme 10, 11, 41, 238
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DCP
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M E G H A L A Y A
Part E: Intersectoral Convergence
Budget44, 80, 000
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M E G H A L A Y A
Total Budget for Meghalaya
A. RCH II 13, 79, 82, 082 15.74
B. NRHM Initiatives 59, 86, 80, 310 68.29
C. Immunization (UIP +
IPPI)
3, 44, 52, 225 3.93
D. NDCP 10, 11, 41, 238 11.54
E. Intersectoral
Convergence
44, 80, 000 0.51
Total Budget for Meghalaya 87, 67, 35, 855 100.00
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M E G H A L A Y A
Part Amount Available 2007-08 Expenditure
NRHM 47, 68, 17, 660 16, 45, 57, 332
RCH 13, 75, 90, 344 3, 18, 43, 205
UIP 1, 31, 47, 342 82, 03, 323