NPCC

APPROVAL OF STATE PROGRAMME IMPLEMENTATION PLAN 2012-13: TAMIL NADU
May 2012
MINISTRY OF HEALTH & FAMILY WELFARE GOVERNMENT OF INDIA
Preface
I truly believe that the National Rural Health Mission affords us a unique opportunity to be aspirational and to bring about transformational change. This document evolves out of a shared vision about where the State of Tamil Nadu must reach and the path to be traversed. Strides in the right direction get the State more money while there is danger too of losing funds for slippages. As NRHM embarks on the second phase of its journey, let us be inspired by what Mahatma Gandhi said A small body of determined spirits fired by an unquenchable faith in their mission can alter the course of history. Let us believe in ourselves and our ability to make a difference.
Anuradha Gupta Additional Secretary & Mission Director, NRHM
No. 10 (11)/2012-NRHM-1 Government of India Ministry of Health and Family Welfare (National Rural Health Mission) Nirman Bhavan, New Delhi Dated: May 31, 2012 The Mission Director, (NRHM) State Health Society, Government of Tamil Nadu 5th Floor, DMS Complex, Tenopate, 359, Anna Salai, Chennai 600006 Subject: Approval of NRHM State Programme Implementation Plan for the year 2012-13 This refers to the Programme Implementation Plan (PIP) for the year 2011-12 submitted by the State and subsequent discussions in the NPCC meeting held on May 10, 2012 at New Delhi. 2. Against a resource envelope of Rs 1363.93 crores, the administrative approval of the PIP for your State is conveyed for an amount of Rs 1080.35 crores. Details are provided in Table A, B and C below: TABLE-A Rs. crores 206.62 867.98 289.33 1363.93
Uncommitted Unspent Balance available under NRHM as on 01.04.2012 GOI Resource Envelope for 2012-13 under NRHM 25% State Share (2012-13) Total TABLE-B Break up of total resources under NRHM (Rs. crores) Sr. Programme Uncommitted GoI Resource No. Unspent balance Envelope available as on under NRHM 01.04.2012 1 RCH Flexible Pool 151.14 220.48 2 NRHM Flexible Pool 55.48 273.93 3 Immunization (from RCH 0 10.78 Flexible Pool)
Total
371.62 329.41 10.78
4 5 6 7 8 9 10 11 12
NIDDCP 0 IDSP 0 NVBDCP 0 NLEP 0 NPCB 0 RNTCP 0 Direction & Administration 0 PPI Operation Cost 0 25% State Share Total Resource Envelope Committed Unspent Balance up to 2011-12 to be revalidated in 2012-13
0.24 1.10 9.08 2.28 24.47 17.71 298.14 9.77 289.33 1363.93 Rs. 215.34 crores
0.24 1.10 9.08 2.28 24.47 17.71 298.14 9.77 289.33
TABLE-C Sr. No. 1 2 3 4 5 6 7 8 9 10 Scheme /Programme RCH Flexible Pool NRHM Flexible Pool Immunization and PPI operation cost NIDDCP IDSP NVBDCP NLEP NPCB RNTCP Infrastructure maintenance(Treasury route) Total Approved Amount (Rs. In Crores) 362.14 342.56 15.41 0.43 4.47 9.4 2.28 24.47 21.05 298.14 1080.35 Annex ref 1 2 3 4A 4B 4C 4D 4E 4F
Thus, there is a cushion of Rs. 283.58 crores (Rs. 1363.93 less Rs.1080.35 crores) for which, State is advised to send a supplementary PIP urgently. Targets, conditionalities and road map 3. State has been assigned mutually agreed goals and targets. The state is expected to achieve them, adhere to key conditionalities introduced this year and implement the road map provided in each of the sections of the approval document. 4. District resource envelope as indicated in the PIP should be respected by the State
5. All buildings/vehicles supported under NRHM should prominently carry NRHM logo in English/ Hindi & regional languages.
Mandatory disclosures 6. In addition, the State is directed to ensure mandatory disclosure on the state NRHM website of the following: Facility wise deployment of all contractual staff engaged under NRHM with name and designation. MMUs- total number of MMUs, registration numbers, operating agency, monthly schedule and service delivery data on a monthly basis. Patient Transport ambulances and emergency response ambulances- total number of vehicles, types of vehicle, registration number of vehicles, service delivery data including clients served and kilometres logged on a monthly basis. All procurements- including details of equipments procured (as per the directions of CIC which have been communicated to the States by this Ministry vide letter 'No.Z.28015/162/2011-H' dated 28th November 2011) Buildings under construction/renovation total number, name of the facility/hospital along with costs, executing agency and execution charges (if any) date of start & expected date of completion
Release of second tranche of funds 7. Action on the following issues would be looked at while considering the release of second tranche of funds: Compliance with conditionalities. Physical and financial progress made by the State. It is expected that 25% of the State share, based on release of funds by Government of India is credited to the account of the State Health Society as early as possible. Timely submission of Statutory Audit Report for the year 2011-12 is a must for release of 2nd tranche of funds. Before the release of funds up to 100% of BE of your state for the year 2012-13, State needs to provide Utilization Certificates against the grant released to the State up to 2010-11 duly signed by Mission Director and Auditor.
Monitoring requirements 8. State shall ensure submission of quarterly report on progress against targets and expenditure including an analysis of adverse variances and corrective action proposed to be taken. 9. All approvals are subject to the observations made in this document.
10. The State shall not make any change in allocation among different budget heads without approval of GoI. 11. The accounts of State/ grantee institution/ organization shall be open to inspection by the sanctioning authority and audit by the Comptroller& Auditor General of India under the provisions of CAG (DPC) Act 1971 and internal audit by Principal Accounts Officer of the Ministry of Health & Family Welfare. 12. State shall ensure submission of details of unspent balance indicating inter alia, funds released in advance & funds available under State Health Societies. The State shall also intimate the interest amount earned on unspent balance. This amount can be spent against activities already approved.
Yours faithfully,
(Dr. Suresh K. Mohammed) Director (NRHM - I)
APPROVAL OF STATE PROGRAMME IMPLEMENTATION PLAN, 2012-13: TAMIL NADU Table of Contents
SUMMARY ....................................................................................................................................... 11 SERVICE DELIVERY TARGETS: ......................................................................................................... 2 FINANCE: KEY ISSUES AND GUIDING PRINCIPLES ............................................................................ 4 ROAD MAP FOR PRIORITY ACTION ................................................................................................. 6 PROGRAMME WISE BUDGET ....................................................................................................... 10 SUMMARY BUDGET 12-13: TAMIL NADU ..................................................................................... 13 REPRODUCTIVE AND CHILD HEALTH ................................................................................................ 15 MATERNAL HEALTH ..................................................................................................................... 15 CHILD HEALTH & IMMUNIZATION................................................................................................ 27 FAMILY PLANNING....................................................................................................................... 43 ADOLESCENT HEALTH .................................................................................................................. 52 URBAN RCH ................................................................................................................................. 58 TRIBAL HEALTH ............................................................................................................................ 60 PC-PNDT ...................................................................................................................................... 63 HUMAN RESOURCES AND PROGRAM MANAGEMENT.................................................................. 66 MISSION FLEXI POOL (MFP) ............................................................................................................. 78 ASHA ........................................................................................................................................... 79 UNTIED FUNDS/ RKS/ AMG .......................................................................................................... 82 NEW CONSTRUCTIONS/ RENOVATION AND SETTING UP.............................................................. 84 PROCUREMENT ........................................................................................................................... 86 MOBILE MEDICAL UNIT (MMU) ................................................................................................... 90 REFERRAL TRANSPORT................................................................................................................. 92 AYUSH ......................................................................................................................................... 94 IEC/BCC ....................................................................................................................................... 96 MONITORING AND EVALUATION (HMIS)/ MCTS .......................................................................... 98 OTHERS ..................................................................................................................................... 102 NATIONAL DISEASE CONTROL PROGRAMMES (NDCP) ................................................................... 111 NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP) .......................... 112 INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP) ....................................................... 116 NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME .................................................... 121
NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) ........................................................... 131 NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB) ................................................. 135 REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME ..................................................... 138 ANNEXURE .................................................................................................................................... 144 DETAILED BUDGET: REPRODUCTIVE AND CHILD HEALTH (RCH FLEXIPOOL) ................................ 145 DETAILED BUDGET: MISSION FLEXIPOOL (MFP) ......................................................................... 173 DETAILED BUDGET: IMMUNIZATION AND PPI OPERATION COST ................................................ 195 DETAILED BUDGET: NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP) .................................................................................................................................................. 199 DETAILED BUDGET: INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP) ......................... 201 DETAILED BUDGET: NATIONAL VECTOR BORNE DISEASES CONTROL PROGRAMME (NVBDCP) ... 205 DETAILED BUDGET: NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) ............................ 213 DETAILED BUDGET: NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB) .................. 216 DETAILED BUDGET: REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME ...................... 218
SUMMARY
STATE-SPECIFIC GOALS
The following are the goals and service delivery targets specifically laid out for the state of Tamil Nadu: INDIA INDICATOR Current status RCH II/ NRHM (2012) goal TAMIL NADU Trend (year & source) STATE TARGETS / ELA 2011-13 2013-15 2015-17
MATERNAL HEALTH Maternal Mortality Ratio (MMR) CHILD HEALTH Under 5 Mortality 59 (SRS 2010) Infant Mortality Rate (IMR) 47 (SRS 2010) Neonatal Mortality Rate (NMR) Early NMR 33 (SRS 2010) 25 (SRS 2010) FAMILY PLANNING Total Fertility Rate (TFR) 2.5 (SRS 2010) 2.1 1.7 1.7 1.7 (SRS 2010) Maintain <30 36 33 27 (SRS 2010) 24 (SRS 2010) 16 (SRS 2010) 13 (SRS 2010) 7 6 5 10 8 6 15 12 9 212 (SRS 07-09) <100 134 111 97 83 71 60
(SRS 01-03) (SRS 04-06) (SRS 07-09) 2013 17 2014 14 2015 11
(SRS 2008) (SRS 2009) 31 28
(SRS 2008) (SRS 2009) 21 18
(SRS 2008) (SRS 2009) 15 13
(SRS 2008) (SRS 2009)
(SRS 2008) (SRS 2009)
Approval of Programme Implementation Plan Tamil Nadu 2012-13
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SERVICE DELIVERY TARGETS: Indicators DLHS-2 DLHS-3 (2002-04) (2007-08) Maternal Health CES (2009) State Targets/ ELA 2012-13 2013-14 2014-15
Mothers who had 3 or more Ante Natal Check-ups (%) Institutional delivery (%) in public health institutions (as proportion of the total estimated live births) Line listing and follow up of Severely Anaemic pregnant women (numbers) Child Health Full Immunisation (%) Line listing and follow up of Low Birth Weight babies Nos; (%) Family Planning Female sterilisations (lakhs) 3.25 (HMIS 1011) 2.83 (HMIS, 1011) 0.02 (HMIS: 1011 3.5 (HMIS, 1011) Disease Control ABER for malaria (%) API for malaria (per 1000 population) Annualized New Smear Positive Detection Rate of TB (%) Success Rate of New Smear Positive Treatment initiated on DOTS (%) Cataract operations(lakhs) 77.3
77
79
82
15411
15493
15576
90
27535 (5%)
95
38550 (6%)
100
52317 (9%)
3.5
3.55
3.6
Post-Partum sterilizations (lakhs)
2.9
2.95
3.0
Male sterilisations (lakh)
0.03
0.04
0.05
IUD insertions (lakhs)
3.6
3.8
4.0
<11% 0.3 60%-70%
86%-88%
6.5 NGO - 5
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KEY CONDITIONALITIES AND INCENTIVES As agreed, the following key conditionalities would be enforced during the year 201213. a) Rational and equitable deployment of HR with the highest priority accorded to high focus districts and delivery points1. b) Facility wise performance audit and corrective action based thereon2. Non-compliance with either of the above conditionalities may translate into a reduction in outlay upto 7 % and non-compliance with both translating into a reduction of upto 15%. c) Gaps in implementation of JSSK may lead to a reduction in outlay upto 10%. d) Continued support under NRHM for 2nd ANM would be contingent on improvement on ANC coverage and immunization as reflected in MCTS. e) Vaccines, logistics and other operational costs would also be calculable on the basis of MCTS data. INCENTIVES Initiatives in the following areas would draw additional allocations by way of incentivisation of performance: a) Responsiveness, transparency and accountability (upto 8% of the outlay). b) Quality assurance (upto 3% of the outlay). c) Inter-sectoral convergence (upto 3% of the outlay). d) Recording of vital events including strengthening of civil registration of births and deaths (upto 2% of the outlay). e) Creation of a public health cadre (by states which do not have it already) (upto 10% of the outlay) f) Policy and systems to provide free generic medicines to all in public health facilities (upto 5% of the outlay) Note: The Framework for Implementation of NRHM to be strictly adhered to while implementing the approved PIP.
1
Rational and equitable deployment would include posting of staff on the basis of case load, posting of specialists in teams (eg. Gynaecologist and Anaesthetist together), posting of EmOC/ LSAS trained doctors in FRUs,optimal utilization of specialists in FRUs and above and filling up vacancies in high focus/ remote areas.
2
Performance parameters must include OPD/ IPD/ normal deliveries/ C. Sections (wherever applicable).
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FINANCE: KEY ISSUES AND GUIDING PRINCIPLES
1. 15% State share Contribution status :
Year
Amounts required on basis of releases 96.45 88.52 112.78 123.90 135.01 556.66
Amount credited in SHS Bank A/C (Rs. in Crore) 0 58.02 95.92 162.00 117.67 433.61
(-) Excess/ (+)Shortfall (Rs. In Crore) 96.45 30.50 16.86 -38.10 17.34 123.05
2007-08 2008-09 2009-10 2010-11 2011-12 Total
State is to ensure that outstanding states share is deposited into bank account of State Health Society at the earliest. Further with effect from 2012-13, States share would be 25%. 2. Before the release of funds upto 100% of BE of your state for the year 2012-13, State needs to provide Utilization Certificates against the grant released to the State up to 2010-11 and audit report and U/C for 2011-12. The details for such pending U/Cs is as under : (Rs. in Crore) Year RCH-II Mission Flexipool 2007-08 0.00 Nil 2008-09 0.00 Nil 2009-10 9.45 0.00 2010-11 163.08 98.22 Total 172.53 98.22
3. Release of 100% of funds for the year 2012-13 would be contingent on the state providing utilisation certificates of 2009-10 and 2010-11 and audit report and U/C for 2011-12. 4. The appointment of Concurrent Auditor for the year 2012-13 is a prerequisite for release of 2nd tranche of funds. 5. Timely submission of Statutory Audit Report for the year 2011-12 is must for release of 2nd tranche of funds.
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6. State is required to comply with the instructions and/or guidelines issued for maintenance of bank account vide D. O. No. G-27017/21/2010-NRHM-F dated January 23, 2012. 7. State needs to prioritise the internal control procedures for all transactions. 8. The state must ensure due diligence in expenditure and observe, in letter and spirit, all rules, regulations, and procedures to maintain financial discipline and integrity particularly with regard to procurement; competitive bidding must be ensured and only need-based procurement should take place. 9. Ensure that the Mission Director and the Director (Finance) / Chief Accounts Officer, should not be holding any additional charges / dual charges. 10. Ensure not to keep high balances of advances and ensure timely settlement of advances. State shall carry out age-wise analysis of outstanding advances every month. 11. Ensure to provide a defined action plan to monitor the utilisation of Untied Fund, RKS Fund and AMG fund, so that high unspent balance of these funds can be avoided. 12. State Finance officials viz. SFM/ SAM invariably shall make a plan for field visit of districts and below that, at least nine days in a month with a view to monitoring and improving the financial management system and gearing up the pace of funds utilization and to submit a monitoring report to Mission Director. 13. The state shall ensure timely submission of FMR& SFP covering all NDCPs and MIS reports both monthly and quarterly including HR position. 14. The state shall make a plan for training of the Block and District accounts personnel in operational guidelines for financial management and share the same with FMG-NRHM. 15. Appointment of the statutory auditor for the year 2011-12 is pending and must be completed in the first quarter of 2012-13.
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ROAD MAP FOR PRIORITY ACTION
NRHM must take a systems approach to Health. It is imperative that States take a holistic view and work towards putting in place policies and systems in several strategic areas so that there are optimal returns on investments made under NRHM. For effective outcomes, a sector wide implementation plan would be essential. Some of the key strategic areas in this regard are outlined below for urgent and accelerated action on the part of the State: S. NO. STRATEGIC AREAS ISSUES THAT NEED TO BE ADDRESSED
PUBLIC HEALTH PLANNING & FINANCING 1. Planning and financing Mapping of facilities, differential planning for districts / blocks with poor health indicators; resources not to be spread too thin / targeted investments; at least 10% annual increase in state health budget (plan) over and above State share to NRHM resource envelope; addressing verticality in health programmes; planning for full spectrum of RCH services; emphasis on quality assurance in delivery points
2.
Management strengthening Full time Mission Director for NRHM and a full-time Director/ Jt. Director/ Dy. Director Finance, not holding any additional responsibility outside the health department; fully staffed programme management support units at state, district and block levels; training of key health functionaries in planning and use of data. Strong integration with Health & FW and AYUSH directorates Developing a strong Public Separate public health cadre, induction training for all key cadres; Health focus public health training for doctors working in health administrative positions; strengthening of public health nursing cadre, enactment of Public Health Act
3.
HUMAN RESOURCES 4. HR policies for doctors, nurses paramedical staff and programme management staff Minimising regular vacancies; expeditious recruitment (e.g. taking recruitment of MOs out of Public Service Commission purview); merit based and transparent selection; opportunities for career progression and professional development; rational and equitable deployment; effective skills utilization; stability of tenure; sustainability of contractual human resources under RCH / NRHM and plan for their inclusion in State budget Facility based monitoring; incentives for both the health service provider and the facility based on functioning; performance appraisal against benchmarks; renewal of contracts/ promotions based on performance; incentives for performance above Page 6
5.
HR Accountability
S. NO.
STRATEGIC AREAS
ISSUES THAT NEED TO BE ADDRESSED benchmark; incentives for difficult areas
6.
Medical, Nursing and Paramedical Education (new institutions and upgradation of existing ones)
Planning for enhanced supply of doctors, nurses, ANMs, and paramedical staff; mandatory rural posting after MBBS and PG education; expansion of tertiary health care; use of medical colleges as resource centres for national health programmes; strengthening/ revamping of ANM / GNM training centres and paramedical institutions; re-structuring of pre service education; developing a highly skilled and specialised nursing cadre
7.
Training building
and
capacity Strengthening of State Institute of Health & Family Welfare (SIHFW)/ District Training Centres (DTCs); quality assurance; availability of centralised training log; monitoring of post training outcomes; expanding training capacity through partnerships with NGOs / institutions; up scaling of multi skilling initiatives, accreditation of training
STRENGTHENING SERVICES 8. Policies on drugs, Articulation of policy on entitlements on free drugs for out / in procurement system and patients; rational prescriptions and use of drugs; timely logistics management procurement of drugs and consumables; smooth distribution to facilities from the district hospital to the sub centre; uninterrupted availability to patients; minimisation of out of pocket expenses; quality assurance; prescription audits; essential drug lists (EDL) in public domain; computerised drugs and logistics MIS system; setting up dedicated corporation e.g.: TNMSC Equipments Availability of essential functional equipments in all facilities; regular needs assessment; timely indenting and procurement; identification of unused/ faulty equipment; regular maintenance and MIS/ competitive and transparent bidding processes and Universal availability of GPS fitted ambulances; reliable, assured free transport for pregnant women and newborn/ infants; clear policy articulation on entitlements both for mother and newborn; establishing control rooms for timely response and provision of services; drop back facility; a prudent mix of basic level ambulances and emergency response vehicles New infrastructure, especially in backward areas; 24x7 maintenance and round the clock plumbing, electrical, carpentry services; power backup; cleanliness and sanitation; upkeep of toilets; proper disposal of bio medical waste; drinking water; water Page 7
9.
10.
Ambulance Services Referral Transport
11.
New infrastructure and Maintenance of buildings; sanitation, water, electricity, laundry, kitchen,
S. NO.
STRATEGIC AREAS facilities for attendants
ISSUES THAT NEED TO BE ADDRESSED in toilets; electricity; clean linen; kitchens, facilities for attendants Rational prescription of diagnostic tests; reliable and affordable availability to patients; partnerships with private service providers; prescription audits, free for pregnant women and sick neonates
12.
Diagnostics
COMMUNITY INVOLVEMENT 13. Patients feedback grievance redressal and Feedback from patients; expeditious grievance redressal; analysis of feedback for corrective action
14.
Community Participation
Active community participation; empowered PRIs; strong VHSNCs; social audit; effective Village Health & Nutrition Days (VHNDs), strengthening of ASHAs, policies to encourage contributions from public/ community Comprehensive communication strategy with a strong behaviour change communication (BCC) component in the IEC strategy; dissemination in villages/ urban slums/ peri urban areas
15.
IEC
CONVERGENCE, COORDINATION & REGULATION 16. Inter Sectoral convergence Effective coordination with key departments to address health determinants viz. water, sanitation, hygiene, nutrition, infant and young child feeding, gender, education, woman empowerment, convergence with SABLA, SSA, ICDS etc. NGO/ Civil Society Mechanisms for consultation with civil society; civil society to be part of active communitisation process; involvement of NGOs in filling service delivery gaps; active community monitoring
17.
18.
Private Public Partnership Partnership with private service providers to supplement (PPP) governmental efforts in underserved and vulnerable areas for deliveries, family planning services and diagnostics Regulation of services in the Implementation of Clinical Establishment Act; quality of services, private sector e.g. safe abortion services; adherence to protocols; checking unqualified service providers; quality of vaccines and vaccinators, enforcement of PC-PNDT Act
19.
MONITORING & SUPERVISION 20. Strengthening data 100% registration of births and deaths under Civil Registration Page 8
S. NO.
STRATEGIC AREAS capturing, validity triangulation
ISSUES THAT NEED TO BE ADDRESSED / System (CRS); capturing of births in private institutions; data collection on key performance indicators; rationalising HMIS indicators; reliability of health data / data triangulation mechanisms Effective supervision of field activities/ performance; handholding; strengthening of Lady Health Visitors (LHVs), District Public Health Nurses (DPHNs), Multi Purpose Health Supervisors (MPHS) etc. Regular meetings of State/ District Health Mission/ Society for periodic review and future road map; clear agenda and follow up action; Regular, focused reviews at different levels viz. Union Minister/ Chief Minister/ Health Minister/ Health Secretary/ Mission Director/ District Health Society headed by Collector/ Officers at Block/ PHC level; use of the HMIS/ MCTS data for reviews; concurrent evaluation Quality assurance at all levels of service delivery; quality certification/ accreditation of facilities and services; institutionalized quality management systems Epidemiological surveillance; maternal and infant death review at facility level and verbal autopsy at community level to identify causes of death for corrective action; tracking of services to pregnant women and children under MCTS Use of GIS maps and databases for planning and monitoring; GPS for tracking ambulances and mobile health units; mobile phones for real time data entry; video conferencing for regular reviews; closed user group mobile phone facility for health staff; endless opportunities- sky is the limit!
21.
Supportive Supervision
22.
Monitoring and Review
23.
Quality assurance
24.
Surveillance
25.
Leveraging technology
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PROGRAMME WISE BUDGET
APPROVED BUDGET (BY PROGRAM), 2012-13: Rs. 108035 LAKHS
Infrastructure Maintenance, 29814.00 National Disease Control Programmes, 6210.47 Immunisation, 1540.92
RCH, 36213.58341
MFP, 34256.23987
FUNCTIONAL HEAD-WISE BUDGET Rs. 108035 LAKH
Financial Aid/Grants to Institutions (NDCPs) Other NDCPs PPI Operational Cost (NDCPs) Other Mission Activities PPP/NGO
Infrastructure Maintenance
Human Resources
Training Infrastructure
JSSK
JSY Procurements ASHA Referral Transport RKS Sterlization IEC/BCC Untied Funds
Other RCH Activities
Vulnerable Group
Page 10
Programme Management 6% Training 5%
RCH FLEXIBLE POOL BUDGET Rs. 36226 lakh
Maternal Health 33% Infrastructure & HR 39% ARSH 3% Family Planning 9% Child Health 3%
Tribal RCH 1%
Urban RCH 1%
MISSION FLEXIBLE POOL BUDGET Rs. 34256.24 LAKH

Support services 3% Planning, Implementation and Monitoring 5% Innovations 5% PPP/ NGOs 1% Referral Transport 5% Mobile Medical units IEC/BCC 3% 2% Mainstreaming of AYUSH 5% Corpus Grants to HMS/RKS 5% ASHA 1%
Untied Funds 8% Annual Maintenance Grants Hospital 5% Strengthening 18%
Procurement 14%
New Constructions and setting up 20%
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IMMUNISATION BUDGET Rs. 1540.92 Lakhs
Pulse Polio Operational Cost (Tentative) 63%
RI Strengthninig 32%
Salary of Contractual Staffs 2% Cold chain maintenance 1% ASHA incentive for full Immunization 2%
DISEASE CONTROL BUDGET Rs. 6310.51 lakhs
NLEP 4% NIDDCP 1% NVBDCP 15% RNTCP 35%
IDSP 7% NPCB 39%
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SUMMARY BUDGET 12-13: TAMIL NADU

S. No. Budget Head 1. RCH A1 A2 A3 A4 A5 A6 A7 A8 A9 A10 A11 A12 A13 Maternal Health Child Health Family Planning ARSH Urban RCH Tribal RCH PNDT & Sex Ratio Infrastructure & HR Training Programme Management Vulnerable groups Total Base Flexi Pool JSY Sterilisation & IUD Compensation, and NSV Camps Total Demand Side Total RCH Flexi Pool 2. MFP B1 B2 B3 B4 B5 B6 B7 B8 B9 B10 B11 B12 B13 B14 B15 B16 ASHA Untied Funds (ongoing) Annual Maintenance Grants (ongoing) 2044.50 Hospital Strengthening New Constructions/ Renovation and Setting up Corpus Grants to HMS/RKS (ongoing) District Action Plans (including block, village) Panchayati Raj Initiative Mainstreaming of AYUSH IEC-BCC NRHM Mobile Medical Units (Including recurring expenditures) Referral Transport PPP/ NGOs Innovations (if any) Planning, Implementation and Monitoring Procurement 7083.41 6910.79 2470.00 20.00 3517.09 527.36 1859.81 3859.04 447.50 2256.45 2047.63 5243.89 1828.38 6114.41 6910.79 1541.46 20.00 1640.09 527.36 1159.81 1726.00 447.50 1627.25 1628.30 4888.497 607.11 3081.65 278.7075 2624.38 FY 2012-13 Budget ( Rs lakhs ) Proposed Approved %
14046.54 2829.62 560.315 0.00 379.86 1004.24 0.00 15071.07 2411.21 2562.12 0.00 38864.98 3353.28 2391.20 5744.48
44609.46
8297.39 1239.82 206.36 1186.69 379.86 357.60 0.00 14119.27 1857.73 1970.91 0.00 29847.30 3572.48 3025.48 6366.28
36213.58
7.68 1.15 0.19 1.10 0.35 0.33 0.00 13.07 1.72 1.82 0.00 27.63 3.31 2.80 5.89 33.52 0.26 2.43 1.69 5.66 6.40 1.43 0.02 0.00 1.52 0.49 1.07 1.60 0.41 1.51 1.51 4.52 Page 13
S. No. B17 B18 B19 B20 B21 B22 B23 Budget Head Regional drugs warehouses New Initiatives Health Insurance Scheme Research, Studies, Analysis State level Health Resources Center Support Services Other Expenditures (Power Backup, Convergence etc) TOTAL MFP RI strengthening project (Review meeting, Mobility support, Outreach services etc) Salary of Contractual Staffs Training under Immunisation Cold chain maintenance ASHA Incentive Total Immunization C6 4. Pulse Polio Operational Cost Total RI & PPO costs NATIONAL DISEASE CONTROL PROGRAMMES 4A. National Iodine Deficiency Disorders Control Programme (NIDDCP)
FY 2012-13 Budget ( Rs lakhs ) Proposed Approved %
20.00 100.00 1464.30
20.00 100.00 1173.31
0.00 0.00 0.00 0.02 0.09 1.09 0.00
43560.53
34256.24
31.71
3.
IMMUNIZATION C1
1285.62 28.32 0.00 11.26 31.80 1357.00 1357.00
492.87 28.32 0.00 11.26 31.80 564.25 976.67 1540.92
C2 C3 C4 C5
0.46 0.03 0.00 0.01 0.03

0.52
0.90
1.43
47.50 4B. 4C. 4D. 4E. 4F. Integrated Disease Surveillance Programme(IDSP) National Vector Borne Disease Control Programme (NVBDCP) National Leprosy Eradication Programme (NLEP) National Programme for control of Blindness (NPCB) Revised National Tuberculosis Control Programme (RNTCP) Total NDCP Total Infrastructure Maintenance GRAND TOTAL 511.95 918.00 493.83 5484.00 2653.08 10108.36 29814.00 129449.35
43.17 446.87 940.00 228.26 2447.00 2105.17 6210.47 29814.00 108035.21
0.04 0.41 0.87 0.21 2.27 1.95

5.75 27.60 100.00
5.
INFRASTRUCTURE MAINTENANCE
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REPRODUCTIVE AND CHILD HEALTH MATERNAL HEALTH
Page 15
GOALS AND SERVICE DELIVERY TARGETS: MATERNAL HEALTH
Maternal Health: Goals and Targets for 2012-13 Indicator Maternal Mortality Ratio Target 83 per 100000 live births (2010-12) 71 per 100000 live births (2013-15) 4 ANCs Institutional Deliveries (out of the total estimated deliveries) to be conducted in Public health institutions from 72% in 2010-11 to 77% in 2012-13 Caesarean Section rate * in public health facilities from 17% in 2010-11 to 17% in 2012-13 Severely Anemic Pregnant Women** out of total anemic pregnant women (@2% ) **As per WHO standards less than 10% CS rate is indicative of gaps in EmOC. **At the rate of 2% of pregnant anemic women; this is critical for timely identification and management of severely anemic pregnant woman. Trainings: Training LSAS EmOC BEmOC SBA MTP RTI/STI Delivery Points: Level of Facility DHs and other similar district level facilities like District women and children hospitals FRUs-(CHCs and other health facilities at sub district level) PHCs and Non FRU-CHCs SCs Target 38 130 785 All identified SC Level delivery points Target 96 48 372 182 177 MOs, 279 SNs 65MOs ,65 Nurses ,65 LTs 15411 in 2012-13 154338 in 2012-13 1042917 in 2012-13 908404 in 2012-13
Page 16
ROAD MAP FOR PRIORITY ACTION
Commitment No. 1- Operationalizing Delivery Points Gaps in the identified delivery points to be assessed and filled through prioritized allocation of the necessary resources in order to ensure quality of services and provision of comprehensive RMNCH services at these facilities. The targets for different categories of facilities are: A) All District Hospitals and other similar district level facilities(e.g. District women and children hospital) to provide the following services: 24*7 service delivery for CS and other Emergency Obstetric Care. 1st and 2nd trimester abortion services. Conduct Facility based MDR. Essential newborn care and facility based care for sick newborns. Family planning and adolescent friendly health services RTI/STI services. Have functional BSU/BB.
B) 130 CHCs and other health facilities at sub district level (above block and below district level) functioning as FRUs to provide the same comprehensive RMNCH Services. C) 785 PHCs and Non FRU-CHCs to provide the following services: 24*7 BEmOC services including conducting normal delivery and handling common obstetric complications. 1st trimester safe abortion services. ( MVA upto 8 weeks and MMA upto 7 weeks) RTI/STI services. Essential newborn care. Family planning
D) All identified SC Level delivery point facilities will provide the following services : Delivery by SBAs. IUD insertion Essential new born care. ANC, PNC and Immunization. Nutritional and Family planning counselling. VHND and other outreach services on designated days.
Page 17
Commitment No. 2- Implementing free entitlements under JSSK A) JSSK entitlements to be ensured to all PW and sick newborns accessing Public health facilities. B) At least 70% drop back to be ensured to PW delivering in the PHFs.
Commitment No. 3- Centralized Call Centre and Assured Referral Every State needs to ensure availability of a centralized call centre for referral transport at State or district level as per requirements along with GPS fitted ambulances. Response time for the ambulance to reach the beneficiary not to exceed 30 minutes.
Commitment No. 4- Essential Drug List A) Every State to have an Essential Drug List (EDL) for SC, PHCs, CHCs, DHs, and Medical colleges and ensure timely procurement and supply to Sub centres, PHCs, CHCs, DHs and MCs. B) The EDL should include drugs for maternal and child health including drugs for safe abortion services, RTI/STI. C) Differential distribution of types and quantities of drugs to performing and non performing facilities.
Commitment No. 5- Capacity Building A) Delivery points to be first saturated with trained HR. High focus/ remote areas to be covered first. B) Shortfall in trained human resource at delivery points particularly sub centres and those in HFDs/ tribal/ remote areas to be addressed on priority. C) Shortfall in trained human resource at delivery points particularly sub centres in HFDs to be addressed on priority. D) Training load for skill based trainings to be estimated after gap analysis. E) Certification /accreditation of the training sites is mandatory. F) Training plan to factor in reorientation training of HR particularly for those posted at non functional facilities and being redeployed at delivery points. Orientation training of field functionaries on newer interventions e.g. MDR/ HBNC etc. G) Performance Monitoring during training/post-deployment needs to be ensured H) Specific steps to strengthen SIHFW/ any other nodal institution involved in planning, implementation, monitoring and post training follow up of all skill based trainings under NRHM.
Commitment No. 6 Tracking severe anemia
Page 18
A) All severely anemic pregnant women (2% of the anemic pregnant women) to be tracked and line listed for providing treatment of anemia. Commitment No. 7 For High Focus Districts A) The State to make use of the MCH sub plans made for these districts in the recent past and develop and operationalise the identified facilities as delivery points. B) At least 25% of all sub centres under each PHC to be made functional as delivery points in the HFDs. Commitment No. 8- Job clarity of both ANMs working at the Sub-centre to ensure availability of one ANM at the SC and the other for outreach activities for the geographically demarcated population.
Commitment No. 9: Pre service Nursing Training (For 12 High Focus States) At least one state Master Nodal centre shall be created and made functional. State nursing cell will be created and made functional.
Commitment No. 10: State, district and regional quality assurance committees to be made functional. Commitment No. 11: Strengthening Mother & Child Tracking System
A) State level MCTS call centre to be set up to monitor service delivery to pregnant women
and children.
B) MCTS to be made fully operational for regular and effective monitoring of service delivery
including tracking and monitoring of severely anaemic women, low birth weight babies and sick neonates.
Page 19
DETAILED BUDGET: MATERNAL HEALTH FMR Code A.1 A.1.1 A.1.1.1 Physical Target BUDGET (Rs. Lakhs) Proposed Approved Remarks
Budget Head MATERNAL HEALTH Operationalise facilities Operationalise FRUs (Operationlisation of Blood storage centres) Fuel charges
Unit cost
A.1.1.1 .1 A.1.1.1 .2 A.1.1.2 A.1.1.2 .1
Rs.15000/ generator Rs.1000/ camp
Camp arrangement
268 generato rs 2 camps/3 85 blocks 20000 cases
40.20 40.20
Approved
7.70 7.70
Approved
Operationalise 24x7 PHCs Hiring of specialists Rs.1000/ case 200.00 0.00 Not approved. Super-specialist services cannot be made available at the Primary level Health facility. Such high risk cases are few in number and should be timely detected and referred. Similarly routine lab facilities should be available in house and for specialized services. The cases can be timely referred.
A.1.1.2 .2
Hiring of diagnostic services
Rs.500/ case
20000 cases
100.00 0.00
A.1.1.3 A.1.1.4 A.1.1.5 A.1.2 A.1.3 A.1.4 A.1.4.1 A.1.4.2 A.1.4.2
MTP services at health facilities RTI/STI services at health facilities Operationalise Sub-centres Referral Transport Integrated outreach RCH services Janani Suraksha Yojana / JSY Home Deliveries Institutional Deliveries Rural
Rs.500/ delivery Rs.700/
500 deliveries 335189
2.50 2.50
Approved
2346.32 2346.32
Approved Page 20
FMR Code .a A.1.4.2 .b A.1.4.2 .c A.1.4.3 A.1.4.4 A.1.4.4 .1 A.1.4.4 .2 A.1.5 A.1.5.1 Urban
Budget Head
Unit cost delivery Rs.600/ delivery
Physical Target deliveries 140796 deliveries
BUDGET (Rs. Lakhs) Proposed Approved
Remarks
844.78 844.78
Approved
C-sections Administrative expenses Incentive to ASHAs Rural & Urban Tribal Areas Maternal Death Review Regional workshop 159.68 159.68 Rs.200/ woman Rs.200/ woman Rs.150000/ workshop Rs.10/bulle tin/m 67200 women 42400 women 8 worksho ps 20000 bulletin/ m 900 deaths 134.40 84.80 Approved Approved. Shifted from MFP Approved. Shifted from MFP Approved
12.00 12.00
A.1.5.2
Monthly bulletin
24.00 8.00
A.1.5.3
MD audit expenditure
Rs.10000/d eath
90.00 0.00
Approved for quarterly printing of bulletin and not monthly. Not Approved. Honorarium to experts, POL, and incidental expenses do not conform with GOI Guidelines on MDR. Budget for TA /DA can be utilized out of comprehensive monitoring fund. Honorarium for RCH activities should not exceed its norm.
A.1.6 A.1.6.3
Other strategies/ activities Printing of safe motherhood booklet
Rs.10/ booklet
1500000 booklets
150.00 150.00
Approved
Page 21
FMR Code A.1.6.4
Budget Head Establishment Centre of
Unit cost JSSK 1)Telephon e 2)Recharge charges 3) Salary for call centre staff 4)Awarene ss workshop for JSSK 5)Display board
Physical Target 1) Rs.7.25 L 2)Rs.17.4 0L 3)Rs.6 L 4) Rs.42 L 5)Rs.67.5 0L
BUDGET (Rs. Lakhs) Proposed Approved 140.15 29.04
Remarks
A.1.6.5
A.1.6.6 A.1.7.1 A.1.7.1 A.1.7.1 .1.1
Funds for Diet and refreshments for High Risk Mothers Incidental expenditure to Staff Nurses Janani Shishu Suraksha Karyakram Drugs and Consumables Drugs and Consumables for Normal Deliveries
Rs.160 mother Rs.100/ mother
57000 mothers 57000 mothers
912.00 0.00
1) & 2) Approved for JSSK Grievance redressal at district level @ Rs 6000/m for 12 months x 32 districts = Rs 23.04 lakhs 3) Rs 6.00 lakhs approved at State level Call centre for Salary for Call centre staff of 4 in no. @ Rs 12,500/m x 4 staff for 12 months = Rs.6.00 lakhs 4) IEC should be district specific Can be approved for Rs 1 lakh per district x 32 districts = 32 lakhs. This needs to be shifted to MFP. 5) Not approved. The cost is on higher side. State to plan for comprehensive IEC /BCC for all MH /RCH activities and budget accordingly under IEC. Not approved
57.00 0.00
Not approved
Rs.350/ ND
478000 NDs
1673.00 2677.50
Approved for 7.65 lakh NDs. Separate approval will not be given for drugs and kits for different levels of facilities. However utilization will be as per differential EDL. Page 22
FMR Code A.1.7.1 .1.2
Budget Head Drugs and Consumables for Caesarean Deliveries
Unit cost Rs.1600/ CSec
Physical Target 91553 CSecs
Remarks
Approved for1.35 lakh C-Secs. Separate approval will not be given for drugs and kit However utilization will be as per differential EDLs.
A.1.7.2 A.1.7.3 A.1.7.4 A.1.7.4 .1 A.1.7.4 .2 A.1.7.4 .3 A.1.7.5 A.1.7.5 .1 A.1.7.5 .2 A.1.7.6
Diagnostic Blood Transfusion Diet Dietary charges for normal Rs.80/ND/ deliveries day Dietary charges for LSCS Rs.80/Cdeliveries Sec/day Dietary charges for women Referral Transport Pick up of AN mothers Drop back of PN mothers AN Rs.25/PW 288000 NDs for 3 days 5000 CSecs for 7 days 975000 PW 334000 PW 668000 PW 109400 PW 691.20 691.20 Approved
28.00 28.00
Approved
243.75 243.75
Approved
Rs.954/ PW Rs.900/ PW
3133.89 2250.00 4860.00 218.80 0.00 Approved for 9 lakh PW @ Rs 250 /PW Not approved
A.9.3 A.9.3.1 A.9.3.2 A.9.3.2 .1 A.9.3.2 .2 A.9.3.2 .3
Janani Shishu Suraksha Rs.200/ PW Karyrakram (JSSK) incidental charges Sub-total Maternal Health (excluding JSY) Sub-total JSY Maternal Health Training Skilled Birth Attendance / Rs.1.03 SBA training L/batch Comprehensive EmOC training (including c-section) EmOC Training-MO Rs.5.14 L/batch Exam cost Rs.2.5 L Existing FOGSI
14046.54 3353.28 182 batches
8297.39 3572.48 Approved
187.65 187.65
6 batches
30.82 30.82 2.50 2.50 32.00 32.00
Approved Approved Approved
Page 23
FMR Code A.9.3.2 .4
Budget Head Establishment 3 tertiary training centres
Unit cost Rs.53.91 L/centre
Physical Target 3 centres
Remarks
A.9.3.2 .5 A.9.3.3 A.9.3.3 .1 A.9.3.3 .2
Refresher training for EmOC Life saving Anaesthesia skills training Exam cost Comprehensive Monitoring Cost
Rs.27310 /batch Rs.3.34 /batch Rs.2.8 L Rs.11.70 L
17 batches 12 batches
4.64 4.64 40.07 40.07 2.80 2.80 11.70 11.70
Approved. Additional tertiary centres can be approved subject to a separate training proposal on this for considering by GoI. State to send a detailed proposal separately. However the lump sum budget can be approved, subject to submission of the proposal on the above suggested line. Approved Approved Approved Approved. May budget for comprehensive monitoring of all activities at one place. Rs 11.70 lakhs can be approved for monitoring of all MH /RCH Trainings
A.9.3.4
A.9.3.5 A.9.3.5 .1 A.9.3.5 .2 A.9.3.5 .3 A.9.3.6 A.9.3.6 .1
Safe abortion services training (including MVA/ EVA and Medical abortion) RTI / STI training RTI/STI Training MOs RTI/STI Training SNs RTI/STI Training LTs BEmOC training AMTSL ( 2 ND SPELL BEmONC - MO) and SN
Rs.45350 /MO Rs.24132/S N Rs.21070/L T Rs.25850 /batch
65 MOs 65 SNs 65 LTs
29.48 29.48 15.69 15.69 13.70 13.70
175
45.24 0.00
Not approved
Page 24
FMR Code A.9.3.6 .2
Budget Head BEmONC (3rd spell)-MO
Unit cost Rs.43395 /batch
Physical Target 372 batch
Remarks
The BeMOC Training for Medical Officers is of 10 days duration as per GoI guidelines and State is requested not to carry out part by part trainings. Hence Rs 74.00 lakhs approved for training of 370 MOs in a batch size of 5 per batch. Training and expenditure may be done as per GoI norms. Approved
A.9.3.7
B15.3.1 .3
Other MH training (Blood Rs.99638 storage Training) /batch Sub-total training (Maternal Health) MCTS State MCTS Cell {1-Joint Director @ Rs. 50,000 per month 1-Assistant Director@ Rs. 35,000 per month and 1-IT Coordinator@ 16,500 per month} 50000 p.m
18 batches
17.93 17.93 624.71
14.40 14.40
Approved
35000 p.m. (- AD, 16500 p.m. - IT Coordinato r)
1+1
6.18 6.18
Approved
B16 B16.1 B16.1.1 B16.1.1 .1
Own a Laptop sharing 20% of the cost to strengthen MCTS sub total Procurement Procurement of Equipment Procurement of Equipment for MH Equipment for FRUs
200.00 0.00
Not approved
226.06 26.06
1471.85 1471.85
Approved. The State is to provide a list of all the facilities along with the equipments to be procured and no additional funds for procurement of equipments will be Page 25
FMR Code
Budget Head
Unit cost
Physical Target
Remarks
asked for these facilities. B16.2 B16.2.1 B16.2.1 .1 B16.2.1 .2 B16.2.1 .3 Procurement of Drugs and supplies Procurement of supplies for MH Iron sucrose Maternal Anaemia Albendazole for Antenatal mothers Gestational Diabetes Sub-total Procurement for Maternal Health Grand total Maternal Health
1428932 doses 1190777 1612
429.00 429.00 8.34 8.34 161.20 161.20 2070.39 14591.03
Page 26
CHILD HEALTH & IMMUNIZATION
Page 27
TARGETS: CHILD HEALTH AND IMMUNIZATION A OUTCOME INDICATORS Current Status SRS 2013 (SRS 2010) 13 7
SRS 2014 6
SRS 2015 5
Early Neonatal Mortality Early neonatal deaths estimated NMR Neonatal deaths Estimated IMR Infant deaths Estimated U5MR Under 5 deaths Estimated in an year
14,222 16 17,504 24 26,256 27 29,538
7,658 10 10,940 15 16,410 17 18,598
6,564 8 8,752 12 13,128 14 15,316
5,470 6 6,564 9 9,846 11 12,034
B 1
3 4 5 6 7
8 C 1
Establishment & operationalisation of SNCUs Establishment & operationalisation of NBSU NBCC at delivery points Establishment of NRCs Personnel trained in IMNCI (ANM+LHV) Personnel trained in F-IMNCI (MO+SN) Personnel trained in NSSK (MO+ANM+SN) ASHA trained in Module 6&7 New borns visited by ASHA (as per HBNC guidelines) New borns breastfed with one hour of birth (CES 2009) LBW children (state
Target for 20122013-14 13 KEY PERFORMANCE INDICATORS (CUMULATIVE) 44 61
Current Status
2014-15
164^
164
1488 0 No. % No. % No. % 10712 60% 0 0% 8092 61%
1727* 2 17001 94% 3125 59% 10242 77% *subject to approval in NPCC ^ built from assistance of World Bank
No. 0 6850 % 0% 100% KEY PERFORMANCE INDICATORS (NON CUMULATIVE) No. 0 656400 929900 % 0 60% 85% No. % 427754 39.10% 711100 65% 929900 85%
1094000 100% 1094000 100%
No.
101742
43760
21880
0 Page 28
HMIS) D 1
% 9% 4% 2% 0% KEY PERFORMANCE INDICATORS- IMMUNIZATION (NON CUMULATIVE) Fully immunized No. 845662 984600 1039300 1094000 children by age of % 77.30% 90% 95% 100% 12-23 months (CES 2009) DPT-3 coverage for No. 859884 984600 1039300 1094000 12-23 months (CES % 78.60% 90% 95% 100% 2009) DPT 1st booster in No. 863166 984600 1039300 1039300 children aged 18% 78.90% 90% 95% 95% 23months (CES 2009) Sessions held No. 110357 452712 500000 500000 (HMIS) % 98% 100% 100% 100%
*Operationalisation under process from 2011-12 onwards. PIP 12-13 enlists them as being under process.
Note: The targets are calculated for achieving MDG by 2015 and have been aligned with funds recommended for approval in FY 2012-13
Page 29
ROAD MAP FOR PRIORITY ACTION: CHILD HEALTH AND IMMUNIZATION
A. Priority Actions to be carried out by state for Child Health Interventions
1. All the delivery points should have a functional Newborn Care Corner consisting of essential equipment and staff trained in NSSK. The staff must be trained in a 2 days NSSK training package for skills development in providing Essential Newborn Care. 2. Special Newborn care Units (SNCU) for care of the sick newborn should be established in all Medical Colleges and District Hospitals. All resources meant for establishment of SNCUs should be aligned in terms of equipment, manpower, drugs etc. to make SNCUs fully operational. 3. SNCUs are referral centres with provision of care to sick new born the entire district and relevant information must be given to all peripheral health facilities including ANM and ASHA for optimum utilisation of the facility. Referral and admission of out born sick neonates should be encouraged and monitored along with inborn admissions. 4. NBSUs being set up at FRUs should be utilised for stabilization of sick newborns referred from peripheral units. Dedicated staff posted to NBSU must be adequately trained and should have the skills to provide care to sick newborns. 5. All ASHA workers are to be trained in Module 6 & 7 (IMNCI Plus) for implementing Home Based Newborn Care Scheme. The ASHA kit and incentives for home visits should be made available on a regular basis to ASHAs who have completed the Round 1 of training in Module 6 6. All ANMs are to be trained in IMNCI. 7. All Medical Officers and Staff Nurses, positioned in FRUs/DH and 24x7 PHCs should be prioritised for F-IMNCI training so that they can provide care to sick children with diarrhoea, pneumonia and malnutrition. 8. Infant and Under fives Death Review must be initiated for deaths occurring both at community and facility level. 9. In order to promote early and exclusive breastfeeding, the counselling of all pregnant and expectant mothers should be ensured at all delivery points and breastfeeding initiated soon after birth. At least two health care providers should be trained in Lactation Management at District Hospitals and FRUs; other MCH staff should be provided 2 days training in IYCF and growth monitoring. 10. Nutrition Rehabilitation Centres are to be established in District Hospitals (and/or FRUs), prioritising tribal and high focus districts with high prevalence of child malnutrition. The optimum utilisation of NRCs must be ensured through identification and referral of Severe Acute Malnutrition cases in the community through convergence with Anganwadi workers under ICDS scheme. 11. Line listing of newly detected cases of SAM and Low birth weight babies must be maintained by the ANM and their follow-up must be ensured through ASHA. 12. In order to reduce the prevalence of anaemia among children, all children between the ages of 6 months to 5 years must receive Iron and Folic Acid tablets/ syrup (as appropriate) as a preventive measure for 100 days in a year. Accordingly appropriate formulation and logistics
Page 30
must be ensured and proper implementation and monitoring should be emphasised through tracking of stocks using HMIS. 13. Use of Zinc should be actively promoted along with use of ORS in cases of diarrhoea in children. Availability of ORS and Zinc should be ensured at all sub-centres and with ASHAs. 14. Data from SNCU, NBSU and NRC utilisation and child health trainings (progress against committed training load) must be transmitted on a regular basis to the Child Health Division.
B. Priority Actions to be carried out by state for Immunisation
1. The year 2012 has been declared as the Year of Intensification of Routine Immunisation. Therefore, state must prepare a detailed district plan for Intensification of Routine Immunization with special focus on districts with low coverage. 2. The birth dose of immunisation should be ensured for all newborns delivered in the institutions, before discharge. 3. A dedicated State Immunisation Officer should be in place. District Immunisation Officer should be in place in all the districts. The placement of ANMs at all session sites must be ensured. 4. Due list of beneficiaries must be available with ANM and ASHA and village wise list of beneficiaries should be available with ASHA after each session. 5. The immunisation session must be carried out on a daily basis in District Hospitals and FRUs/ 24x7 PHCs with considerable case load in the OPD. 6. Cold chain mechanics must be placed in every district with a definite travel plan so as to ensure that at least 3 facilities are visited every month as a preventive maintenance of cold chain equipment. 7. The paramedic person instead of a clerical staff should be identified as the Cold Chain Handler in all cold chain points and their training must be ensured along with one more person as a backup. 8. It has been observed that the coverage of DPT 1st booster and Measles 2nd dose to be given at the age of 18 months is less than 50% across the country. Therefore coverage of DPT 1st booster and measles 2nd dose must be emphasised and monitored. 9. District AEFI Committees must be in place and investigation report of every serious AEFI case must be submitted within 15 days of occurrence. 10. Rapid response team should be in place in priority districts of the states to identify pockets of low immunization coverage and to respond to any threat of polio. 11. Special micro plans are to be developed for inaccessible, remote areas and urban slums. The micro plans developed under polio programme must be utilised and special focus should be given to the migrant population
Page 31
DETAILED BUDGET: CHILD HEALTH & IMMUNIZATION FMR Code A.2 A.2.1 A.2.1.1 Budget Head CHILD HEALTH IMNCI Prepare detailed Rs.1000/vis operational plan for it IMNCI across districts (Supplies, Logistics, Supportive supervision at the District level ) Implementation of IMNCI activities in districts Monitor progress against Rs.25000/ plan; follow up with m training, procurement, etc (State Level IMNCI cell) Pre-service IMNCI activities in medical colleges, nursing colleges, and ANMTCs Facility Based Newborn Care/FBNC (SNCU, NBSU, NBCC) Essential Newborn care Rs.20000/ (Operational cost NBCC (existing + new ) NBCCs) Sick Newborn Care Rs.1.75 Operational cost for L/NBSU NBSUs (existing + new) NBSU 4 visit /month x 30 district x 12 months 14.40 14.40 Approved Unit cost Physical Target BUDGET (Rs. In lakh) Proposed Approved Remarks
A.2.1.2 A.2.1.3
1 meeting/ m
3.00 3.00
Approved
A.2.1.4
A.2.2 A.2.2.1
1606 NBCCs 156 NBSUs
321.20 0.00
Not approved.
A.2.2.2
273.00 202.80
A.2.2.3
A.2.2.4
A.2.2.5
A.2.3
Up gradation of Existing NBSU at Sec Health Care System Operational cost for SNCUs (existing + upgradation proposed ) Up gradation of Existing SNCUs in 20 Centers(17 Dist Hospitals and 3 Med College - Hospitals Home Based Newborn Care/HBNC
Rs.2 L/NBSU Rs.10 L/SNCU Rs.15 L/SNCU
114 NBSUs 61 SNCUs
228.00 0.00
Approved for 9 months only. 42 units under process & 114 units to be established with support from World Bank. Not approved.
610.00 525.00
20 SNCUs
300.00 255.00
Approved for 44 units for 1 year and 17 units for 6 months Approved at 7 DHQ +10 SDH only. SNCU at 3 medical colleges in Chennai not approved.
Page 32
FMR Code A.2.4 A.2.5
Budget Head
Unit cost
Physical Target
BUDGET (Rs. In lakh) Proposed Approved
Remarks
A.2.5.1. A.2.5.2 A.2.6
A.2.7 A.2.7.1
A.2.7.2
Infant and Young Child Feeding/IYCF Care of Sick Children and Severe Malnutrition at facilities (e.g. NRCs, CDNCs etc.) Establishing new NRC Rs.2L/NRC Operational cost for new Rs.7.8 L NRCs Management of Diarrhoea, ARI and Micronutrient Malnutrition Other Activities Rapid Assessment of Rs.15000/v SNCUs by Core group isit committee State Level Quarterly Rs.5000/vis reviews of SNCU it activities in the Districts
2 NRCs 2 NRCs
4.00 4.00 15.60 7.80
Approved Approved for 6 months only
12 visits
1.80 1.80
Approved
A.2.7.3
A.2.7.4
A.2.7.5
Establishment of Early Intervention center for Children with developmental disorder in PPP mode Prenatal Screening to detect fetal anomaly in PPP mode cost for online auditing and software Conduction of well baby clinic in PHCs by Peadiatrician in NICU in 10 high IMR blocks
Rs.3.93 L/centre
43 visits to 43 SNCUs every quarter 8 centres
8.60 8.60
Approved
31.42 31.42
Approved
Rs.95000/f acility
232 facilities
220.40 0.00
Not approved
Rs.6000/cli nic/m
10 clinics
7.20 0.00
Not approved. As per the comments received from the state, clinics are to be held at PHCs and not at NICU. It is proposed that doctors from these PHCs be trained in F-IMNCI so that specialised care is available to the children throughout the year rather than on a monthly basis. Page 33
FMR Code A.2.7.6
Budget Head Workshop on Customization of teleradiology enabled modules for training in Ultrasonagram to detect foetal anomaly Infant Death Audit Infant Death Audit of case sheets and preconference workshop Infant Death Audit at Facility level
Unit cost Rs.1 L/worksho p
Physical Target 2 workshop s
BUDGET (Rs. In lakh) Proposed Approved 2.00 0.00
Remarks To be mobilised from IEC budget
A.2.8 A.2.8.1
A.2.8.2
Rs.1.50 L/worksho p Rs.1000/de ath
4 workshop s 15000 deaths
6.00 6.00
Approved
150.00 0.00
Not approved as cost proposed is too high. Facility based audit should not be linked to incentives as these are to be carried out by the hospital staff /administration.
A.2.9 A.2.10
A.2.10.1
Incentive to ASHA under Child Health JSSK- Janani Shishu Surakhsha Karyakram (for Sick neonates upto 30 days) Drugs & Consumables Rs.5939/ne onate Diagnostic Referral Subtotal Child Health Child Health Training IMNCI Training General IMNCI - TOT Monitoring cost Refresher General IMNCIVHN/SHN/CHN Refresher General IMNCIAWW Rs.70535/ batch Rs.20000/ batch Rs.32580/ batch Rs.27405/ batch
10658 neonates
633.00 180.00
Approved for 90,000 sick neonates @ Rs.200/sick neonate.
A.2.10.2 A.2.10.3 A.9.5 A.9.5.1 A.9.5.1.1 A.9.5.1.2 A.9.5.1.3 A.9.5.1.4
2829.62
1239.82
8 batches 1 batch 202 batches 300 batches
5.64 0.20 65.81 82.22
5.64 Approved 0.20 Approved 65.81 Approved. 0.00 Not approved. Training should be planned with DWCD and funds mobilised from DWCD.
A.9.5.2
F-IMNCI training
Page 34
FMR Code A.9.5.2.1 A.9.5.2.2
Budget Head FIMNCI-Pvt Students SNCU - Refresher Training
Unit cost Rs.1500/ student Rs.2.22 L/batch
Physical Target 350 students 9 batches
BUDGET (Rs. In lakh) Proposed 5.25 20.00
Remarks Approved 5.25 Approved 0.00 Not approved. It is proposed that for the existing staff nurses who have already been trained skills assessment for each one of them be done by the SNCU doctors and on the job skill enhancement be provided. 13.33 Approved condition to Observership plan being provided by the state. 17 SNCUs x 10 SN in each=170, 6 batches approved. The remaining nurses (1 for each SNCU =44+17=61) who are supposed to provide counseling should be trained accordingly (e.g.; in IYCF, management of LBW babies, advise on follow up and so on). 0.00 To be included in FIMNCI training load 0.00
A.9.5.2.3
SNCU - Newer Training
Rs.2.22 L/batch
9 batches
20.00
A.9.5.2.4 A.9.5.2.5 A.9.5.3 A.9.5.4
NBSU - MO NBSU - SN Home Based Newborn Care training Care of Sick Children and severe malnutrition training SAM TOT Monitoring cost SAM - MO/SN SAM - CHN/SHN/VHN
Rs.2.9 L/batch Rs.2.24 L/batch
43.50 26.86
A.9.5.4.1 A.9.5.4.2 A.9.5.4.3 A.9.5.4.4
Rs.89400/ batch Rs.20000/ batch Rs.35325/ batch Rs.18500/ batch
1 batch 1 batch 21 batches 95 batches
0.89 0.20 7.42 17.58
0.89 Approved 0.20 Approved 7.42 Approved 17.58 Approved
Page 35
FMR Code A.9.5.5 A.9.5.5.1 A.9.5.5.2 A.9.5.5.3 A.9.5.5.4 A.9.5.5.5 A.9.5.5.6 A.9.5.5.7
Budget Head Other CH training (pls specify) NSSK (ANM-Urban) NSSK (ANM/VHN) Orientation IYCF - TOT Monitoring cost Orientation IYCF - MO Orientation IYCF CHN/SHN/VHN USG - MO 78 CEmONC
Unit cost
Physical Target
Remarks
Rs.35690/ batch Rs.32240/ batch Rs.74675/ batch Rs.20000/ batch Rs.24050/ batch Rs.10000/ batch Rs.31200/ batch
5 batches 66 batches 9 batches 1 batch 341 batches 448 batches 20 batches
1.78 21.28 6.72 0.20 82.01 44.80 6.24
1.78 Approved 21.28 Approved 6.72 Approved 0.20 Approved 82.01 Approved 44.80 Approved 0.00 Not approved. GoI is still in the process of finalising curriculum for ultrasonography training. 0.00 0.00 273.11 106.00 Approved. The State may give incentives to ASHAs only after training of ASHAs as per GoI guidelines. 3.31 Approved
A.9.5.5.8 A.9.5.5.9
USG - MO 154 CHC Refresher training to detect foetal anomaly Sub-total CH training ASHA Home Based Newborn Care (new)
Rs.31200/ batch Rs.7600/ batch
12.17 4.86 475.63
B1 B1.1.3.1.i
250
2650*16
106.00
B1.1.3.1.ii
B1.1.3.1.iii B1.1.3.1.vi B1.1.3.1.vii
B7
Reporting of Infant Deaths and children in 5 years (new) Village Health and Nutrition Days (ongoing) Immunization activity (new) Incentives for Vitamin A and Deworming campaign (ongoing) Sub-total ASHA (Child Health) District Plans
25
2650*5
3.31
100 100 p m 200 each
2650*12 2650 2 sessions each
31.80 31.80 21.20
31.80 Approved 0.00 Approved 21.20 Approved
194.11
162.31
Page 36
FMR Code
Budget Head Save the Girl child scheme (new) Sub-total
Unit cost
Physical Target
BUDGET (Rs. In lakh) Proposed 20.00 20.00 Approved 20.00 20.00
Remarks
B10 B10.2.2 B10.2.2.1
BCC / IEC IEC - IEC/BCC Activities for CH a. EMRI boards for Neonatal transport, b.SNCU boards, c.LBW protocols etc
75000/ district, 25000/ center, 1500/ center, 500/ center
29 47 1612 8706
101.21
101.21 Approved
B14 B14.4
INNOVATIONS Congenital and Developmental Defects (new) Congenital and Developmental Defects and Follow Up - Phase I Congenital and Developmental Defects and Follow Up - Phase II Congenital and Developmental Defects and Follow Up - Phase III Sub-total IEC/BCC Procurement Procurement of Equipment Procurement of Equipment: CH Equipment for SNCU @ 10 lakhs Equipment for Sick newborn transport system @ 4.5 lakhs Equipment for new born corner for 73 new PHCs, 31 level 1 MCH centre
B14.4.1
126.32
126.32 Approved
B14.4.2
300.00
300.00 Approved
B14.4.3
56.42
56.42 Approved
583.95
583.95
B16 B16.1 B16.1.2 B16.1.2.1 B16.1.2.2
10 lakh 4.5 lakh
20 29
200.00 130.50
170.00 Approved for 17 units 0.00 Not approved
B16.1.2.3
85000
239
203.15
203.15 Approved
Page 37
FMR Code
Budget Head and 135 UPHCs @ Rs.85000/Equipment, medication and consumable for ASHA home based new born care in 2650 tribal and 4200 program specific VHVs @ Rs. 2000 per VHV Equipment for training for prenatal screening to detect fetal anomalies in 78 CEmONC centers and 154 PHCs Desktop and Accessories @ Rs.11000/-
Unit cost
Physical Target
Remarks
B16.1.2.4
1500
6850
137.00
0.00 Not approved
B16.1.2.5
B16.1.2.5.i
Rs. 35000 for desktops and 11000 for accessories
232
106.72
106.72 Approved
Sub-total procurement B13 B13.2.1 PPP /NGOs Pilot Project on Management of Children affected with Muscular Dystrophy Disorder Home Based Newborn Care Project in PPP mode - for identification, referral, follow-up and ensuring survival in low birth babies - based on Gadchiroli model Sub-total PP/ NGOs Grand total Child Health
777.37
479.87
125.50
125.50 Approved
B13.2.4
3200 per VHV
1500
72.00
72.00 Approved
197.5 5585.18
197.5 2956.56
Page 38
Part C Immunization FMR Code C.1 c.1.a Activities( As proposed by the State) Unit Cost (wherever applicable) Physical Target Amount Proposed Amount Approved Remarks
RI Strengthening Project (Review meeting, Mobility Support, Outreach services etc Mobility Support for Rs.50000/ supervision for district Year /district 16.00 level officers. level officers. Mobility support for supervision at state level Rs. 100000 per year.
16.00
c.1.b
3.00
1.00
All activities related to mobility support and monitoring projected under state specific activities are recommended but are to be met from the amount recommended under c.1.a and c.1.b
c.1.c
c.1.d
c.1.e
c.1.f
c.1.g
Printing and dissemination of Immunization cards, tally sheets, monitoring forms etc. Support for Quarterly State level review meetings of district officer Quarterly review meetings exclusive for RI at district level with one Block MOs, CDPO, and other stake holders Quarterly review meetings exclusive for RI at block level Focus on slum & underserved areas in urban areas/alternative vaccinator for slums
Rs. 5 beneficiaries 211.61 119.80
10.00
4.80
24.36
24.36
Page 39
FMR Code c.1.h
Activities( As proposed by the State) Mobilization of children through ASHA or other mobilizers Alternative vaccine delivery in hard to reach areas Alternative Vaccine Delivery in other areas To develop microplan at sub-centre level For consolidation of microplans at block level
Unit Cost (wherever applicable) Rs. 150 per session Rs. 100 per session Rs. 50 per session @ Rs 100/per subcentre Rs. 1000 per block/ PHC and Rs. 2000 per district Rs100,000/ district/year @ 400/ month/ district Rs. 2/bags/sessi on Rs. 900 per PHC/CHC per year
Physical Target
Amount Proposed
Amount Approved
Remarks
c.1.i
452.71 -
226.36 -
c.1.j c.1.k
c.1.l
c.1.m
POL for vaccine delivery from State to district and from district to PHC/CHCs Consumables for computer including provision for internet access for RIMS Red/Black plastic bags etc. Hub Cutter/Bleach/Hypochlori te solution/ Twin bucket Safety Pits State specific requirement C.1-Sub Total
14.00
14.00
c.1.n
c.1.o
c.1.p
263.17
46.51
c.1.q c.1.r
290.77 1,285.62 40.04 492.87
C.2 c.2.a
Salary of Contractual Staffs -Sub Total Computer Assistants Rs.12000support for State level 15000 per person per month
1.44
1.44
Page 40
FMR Code c.2.b
Activities( As proposed by the State) Computer Assistants support for District level C.2-Sub Total
Unit Cost (wherever applicable) 8000-10000 per person per month
Physical Target
Amount Proposed
Amount Approved
Remarks
26.88
26.88 28.32
28.32 C.3 c.3.a Training under Immunization District level Orientation training including Hep B, Measles & JE(wherever required) for 2 days ANM, Multi Purpose Health Worker (Male), LHV, Health Assistant (Male/Female), Nurse Mid Wives, BEEs & other staff ( as per RCH norms) Three day training including Hep B, Measles & JE(wherever required) of Medical Officers of RI using revised MO training module) One day refresher training of distinct Computer assistants on RIMS/HIMS and immunization formats One day cold chain handlers training for block level cold chain handlers by State and district cold chain officers One day training of block level data handlers by DIOs and District cold chain officer C.3-Sub Total
c.3.b
c.3.c
c.3.d
c.3.e
Page 41
FMR Code C.4
Activities( As proposed by the State) Cold chain maintenance
Unit Cost (wherever applicable)
Physical Target
Amount Proposed
Amount Approved
Remarks
Rs.500/PHC/ CHCs per year District Rs.10000/yea r C.5 ASHA incentive for full Immunization
11.26
11.26
31.80
C.6
Total Pulse Polio Operational Cost (Tentative) Total
1,357.00 1,357.00
To be factored into part C from part B. Rs 31.8 lakhs recommended . However the 31.80 incentive is to be given as per Rs 100 for every child fully immunized under 1 year. 564.25 976.67 1,540.92
The projected amount is lower than the recommended amount because of provisioning of Pulse Polio Operational Cost
Activities under state specific requirement include Hiring of alternate vaccinators in rural areas
Page 42
FAMILY PLANNING
Page 43
ROAD MAP FOR PRIORITY ACTION: FAMILY PLANNING MISSION: The mission of the national Family Planning Program is that all women and men (in reproductive age group) in India will have knowledge of and access to comprehensive range of family planning services, therefore enabling families to plan and space their children to improve the health of women and children. GUIDING PRINCIPLES: Target-free approach based on unmet needs for contraception; equal emphasis on spacing and limiting methods; promoting children by choice in the context of reproductive health. STRATEGIES: 1. Strengthening spacing methods: a. Increasing number of providers trained in IUCD 380A b. Strengthening Fixed Day IUCD services at facilities. Increased focus on IUCD services at subcentres for at least 2 fixed days a week c. Introduction of Cu IUCD 375 d. Delivering contraceptives at homes of beneficiaries (in pilot states/ districts) 2. Emphasis on post-partum family planning services: a. Strengthening Post-Partum IUCD (PPIUCD) services at least at DH level b. Promoting Post-partum sterilisation (PPS) c. Establishing Post-Partum Centers at women & child hospitals at district levels d. Appointing counsellors at high case load facilities 3. Strengthening sterilization service delivery a. Increasing pool of trained service providers (minilap, lap & NSV) b. Operationalising FDS centers for sterilisation c. Holding camps to clear back log 4. Strengthening quality of service delivery: a. Strengthening QACs for monitoring b. Disseminating/ following existing protocols/ guidelines/ manuals c. Monitoring of FP Insurance 5. Development of BCC/ IEC tools highlighting benefits of Family Planning specially on spacing methods 6. Focus on using private sector capacity for service delivery (exploring PPP availability): 7. Strengthening programme management structures: a. Establishing new structures for monitoring and supporting the programme b. Strengthening programme management support to state and district levels KEY PERFORMANCE INDICATORS: a. % IUD inserted against ELA b. % PPIUCD inserted against total IUCD c. % PPIUCD inserted against institutional deliveries d. % of sterilisations conducted against ELA Approval of Programme Implementation Plan Tamil Nadu 2012-13 Page 44
e. f. g. h. i. j. k.
% post-partum sterilisation against total female sterilisations % of male sterilisation out of total sterilisations conducted % facilities delivering FDS services against planned % of personnel trained against planned % point decline in unmet need point decline in TFR % utilisation of funds against approved CONDITIONALITIES FOR FP PIP: 2012-13
Target / ELAMinimum Level of Achievement By Sep. 2012 Remarks By March 2013
SN.
Indicator 2012-13
1 1.1 2 2.1 2.1.1 2.1.2 2.2 2.2.1 2.2.2 2.2.3 3 3.1 3.1.1 3.1.2 3.2 3.2.1
Goal (target): Reduction in TFR 2013 Service delivery (ELA): IUCD: Post-partum IUCD Interval IUCD Sterilisation: Tubectomy Post-partum sterilisation (subset of tubectomy) Vasectomy Training of personnel (target): Post-partum IUCD MO SN/ ANM interval IUCD MO 54 14 41 1464 366 0 1098 0 Not proposed 350000 290000 4000 105000 87000 1200 280000 232000 3200 30000 320000 12000 128000 27000 288000 Maintain TFR level NA NA Current TFR - 1.7 (SRS 2010)
Page 45
Target / ELASN. Indicator 2012-13 3.2.2 3.2.3 3.3 3.4 3.5 4 4.1 SN ANM/ LHV Minilap NSV Laparoscopic Others (target): Appointment of FP Counsellors Regular reporting of the scheme of home delivery of contraceptives by ASHAs 100% DH 1240 1860 664 192 44
Minimum Level of Achievement By Sep. 2012 310 465 166 48 11 Remarks By March 2013 930 1395 498 144 33 107 trained 117 trained
100% DH Monthly reporting till Sep 12
NA Quarterly reporting after Sep 12
172 FP Counsellors Scheme is not under implementation in the state State has mentioned that services would be provided as mandated; however, number of facilities have not been provided
4.2
Regular reporting
4.3
Fixed Day Services for IUCD
Wkly once - HSC, PHC, UFWC, HPC. Daily - PPCs
NA
100%
4.4
Fixed Day Services for Sterilisation
F.S: 639 facilities M.S: 97 facilities
NA
100%
5 YEARS PROJECTION OF KEY INDICATORS

SN. 1 1.1 1.2 1.3 2 Indicator Goal Indicators: Total Fertility Rate (TFR) Contraceptive Prevalence Rate (CPR) Unmet Need Service delivery: 1.7 (SRS 2010) 57.8 (DLHS-3) 19.4 (DLHS-3) Maintain 65.0 14.0 70.0 12.0 72.5 11.0 75.0 9.0 80.0 8.0 Current Status Target/ ELA 2014-15 2015-16
2012-13
2013-14
2016-17
Page 46
SN. 2.1 2.2 2.3 2.4 2.5 3 3.1 3.1.1
Indicator IUCD - Total Post-partum IUCD (subset of IUCD-total) Female Sterilisation Post-partum sterilisation (subset of tubectomy) Male sterilisation Input/ facility operationalization: Fixed Day service delivery: IUCD (daily at DH, SDH, CHC)
Current Status 349654 (HMIS: 2010-11)
2012-13 350000 30000
2013-14 375000 40000 355000 295000 5000
Target/ ELA 2014-15 2015-16 400000 55000 360000 300000 6500 435000 70000 365000 305000 9000
2016-17 460000 90000 370000 310000 10000
325090 (HMIS: 2010-11) 283058 (HMIS: 20101-11) 2172 (HMIS0: 2010-11)
350000 290000 4000
Wkly once - HSC, PHC, UFWC, HPC. Daily - PPCs F.S: 639 facilities M.S: 97 facilities
Weekly @ PHC + CHC
3.1.2
Sterilisation
All DH
3.2
Appointment of FP counsellors
172 counsellors
All DH
Weekly @ PHC + CHC DH + 1 SDH/ FRU per dist DH + 1 SDH/ FRU per dist
Weekly @ PHC + CHC DH + all FRU per dist DH + all FRU per dist
Weekly @ PHC + CHC DH + all FRU + 25% PHC per dist DH + all FRU per dist
All SHC DH + all FRU + 50% PHC per dist DH + all FRU per dist
Page 47
DETAILED BUDGET: FAMILY PLANNING FMR Code A.3 A.3.1 Physical Target BUDGET (Rs. Lakhs) Proposed Approved
Budget Head FAMILY PLANNING
Unit cost
Remarks
Terminal/Limiting Methods Orientation workshop and dissemination of manuals on FP A.3.1.1 standards & quality assurance of sterilisation services Prepare operational plan for provision of sterilisation services at A.3.1.1.1 facilities (fixed day) as well as camps , review meetings Organise female sterilisation camps
Rs. 25000/ district
32 districts
8.00 8.00
Approved
Rs. 50009000/ meeting Rs.15000/ca mp
24 meetings
1.60 1.60
Approved
A.3.1.2
252 (12 camps / yr x 21 Blocks)
37.80 37.80
Organise NSV camps
Rs.35000/ca mp
192 camps
67.20 67.20
A.3.1.3
Approved As per the GoI norm at least 100 sterilisations to be conducted at each camp. Approved As per the GoI norm at least 50 sterilisations to be conducted at each camp. Approved
A.3.1.4
Compensation for female sterilisation Compensation for NSV Acceptance
Rs.1000/steri lisation Rs.2000/steri lisation
219000 sterilisatio ns 3200 sterilisatio ns
2190.00 2190.00
64.00 48.00
A.3.1.5
1. State has proposed Rs. 2000/ NSV which is against the GoI approved norm of Rs. 1500/ male sterilisation. 2.Budget has been accordingly Page 48
FMR Code
Budget Head
Unit cost
Physical Target
Remarks revised and approved
A.3.1.6 A.3.2 A.3.2.1 A.3.2.2
Accreditation of private providers to provide sterilisation services Spacing Methods IUD camps
Rs.1500/steri 40000 lisation Sterilisatio ns Rs.2000/cam p 624 camps
600.00
Approved. Shifted from MFP Approved
12.48 12.48
Implementation of IUD services by districts (including fixed day services at SHC and PHC) Provide IUD services at health A.3.2.2.1 facilities / compensation A.3.2.2.2 PPIUCD services Accreditation of private providers to A.3.2.3 provide IUD insertion services Social Marketing of contraceptives (including delivery of contraceptive by ASHA at door step) Propagate information on IUCD insertion through VHAs as well as incentivise them for brining IUCD cases @ Rs. 100.
Rs.20/IUD insertion
350000 IUDs
70.00 70.00
Approved
Rs.100/VHV
1639 VHV x 5 IUCD = 8195 IUCD insertions
8.20 0.00
A.3.2.4
(1) Not approved. State may do so with its own funds. (2)State has proposed to propagate information on IUCD insertion through VHAs as well as incentivise them for bringing IUCD cases @ Rs. 100. (3) GoI only provides Rs. 20/ IUCD and no separate budgetary provision may be approved. Page 49
FMR Code A.3.2.5 A.3.3
Budget Head Contraceptive Update seminars POL for Family Planning/ Others (including additional mobility support to surgeon's team if req) Repairs of Laparoscopes
Unit cost
Physical Target
Remarks
A.3.4
Single puncture Rs. 35000 Double Puncture- Rs. 65000
Single puncture77 Double Puncture25
43.20 43.20 Approved
A.3.5
A.3.5.1
Other strategies/activities (please specify): Monitor progress, quality and utilisation of services (both terminal and spacing methods) including complications / deaths / failure cases. Note: cost of insurance / failure and death compensation NOT to be booked here Performance reward if any
Rs. 8000/ dist
32 districts
2.56 2.56
Approved
2.00 2.00
A.3.5.2
(1) Best 3 districts, 3 PHCs, 3 Govt. Hospital, 3 Voluntary organizations in sterilization Performance & 3 districts in NSV performances. Ist prize (Rs.15000), IInd prize (Rs.10,000) & IIIrd Prize (Rs. 8000). Conducting the ward function @ Rs.35000. (2) State needs to develop minimum benchmark Page 50
FMR Code
Budget Head
Unit cost
Physical Target
Remarks over and above which awards would be given. (3) Approved
A.3.5.3
World Population Day celebration (such as mobility, IEC activities etc.): funds earmarked for district and block level activities Printing of Forms and Registers
17.00
Approved. Shifted from MFP Approved. State has planned to print Sterilisation Consent Forms along with Checklist, Sterilisation Registers, IUD Registers, MTP Registers, Consolidation Registers & Monthly Reporting format from HSC to PHC and from Institution to DFWB. Approved @ Rs. 100/ per case. Shifted from MH. Not approved
Rs. 1 L/distt
32 districts
32.00 32.00
A.3.5.4
A.3.5.5
Dietary charges for beneficiaries who underwent sterilisation
Rs.400/case
100000 cases
400.00 100.00
IUCD Camps in tribal areas A.3.5.6
Rs.2000/cam p
624 camps
12.48 0.00 560.32 206.36 2391.20 3025.48
Sub-total Family Planning (excluding compensation) Sub-total Sterilisation and IUD compensation & NSV camps
Page 51
ADOLESCENT HEALTH
Page 52
ROAD MAP FOR PRIORITY ACTION: ADOLESCENT HEALTH Priority Actions to be carried out by the State: SETTING UP OF AH CELL A unit for adolescent health at state level with a nodal officer supported by four consultants one each for ARSH, SHP, Menstrual hygiene and WIFS; one nodal officer (rank of ACMHO) for all the components of Adolescent Health at district level to take care of Adolescent health programme including the SHP. PROGRAMME SPECIFIC ESSENTIAL STEPS FOR IMPLEMENTATION: I. Adolescent Reproductive Sexual Health (ARSH) Programme Clinics Number of functional clinics at the DH, CHC, PHC and Medical Colleges (dedicated days, fixed time, trained manpower). Number of clinics integrated with ICTCs Quarterly Reporting from the ARSH clinics to be initiated to GoI. Establish a Supportive supervision and Monitoring mechanism Outreach Utilisation of the VHND platform for improving the clinic attendance. Demand generation in convergence with SABLA and also through Teen Clubs of MOYAS Capacity Building/Training: Calculation of the training load and development of training plans/ refresher trainings. Deployment of trained manpower at the functional clinics. School Health Programme: GoI Guidelines including terms of reference of stakeholders adapted by States and operational plan in place. School health committee with diverse stakeholders beyond the health department; this committee with representation of academia will be responsible for implementation and monitoring of the programme. Involvement of nodal teachers from schools in the programme (Screening and communication - preventive and promotive) is to be ensured. Height / weight measurement and BMI calculation should be part of School Health Card. All children in government and government aided schools should be covered. The programme should focus on three Ds- Deficiency, Disease and Disability. Referral of children must be tied up and complete treatment at higher facilities to be ensured. An effort should be made to have dedicated teams for school health. The teams should also conduct health check- ups for children below 6 years at AWCs.
II.
III. Menstrual Hygiene Scheme (MHS): Approval of Programme Implementation Plan Tamil Nadu 2012-13 Page 53
Formation of State and district level steering committees. Training / re-orientation of service providers(MOs, ANMs, ASHAs) Monthly meeting with BMO. Regular feedback on quality of sanitary napkins to be sent to GoI Identification of appropriate storage place for sanitary napkins. Mechanism of distribution of SN right upto the user level. Reporting and accounting system in place at various levels. Utilizing MCTS for service delivery by checking with ASHAs and ANMs about supply chain management of IFA tabs and Sanitary napkins. Distribution of Sanitary Napkins to school going adolescent girls to be encouraged in schools and preferably combined with Weekly Iron Folic Acid Supplementation (WIFS).
IV. Weekly Iron and Folic Acid Supplementation programme (WIFS): Procurement policy in place for procurement of EDL including IFA and deworming tablets. Establish Monday as a fixed day for WIFS. Plan for training and capacity building of field level functionaries of concerned Departments (i.e. Department of Women and Child Development and Department of Education) and plan for sensitization of Programme Planners on WIFS. Programme Planners on WIFS. Ensure that monitoring mechanism as outlined in the operational framework (Shared with the States during the National Adolescent Health Workshop) are put in place across levels and departments.
Page 54
DETAILED BUDGET: ADOLESCENT HEALTH FMR Code A.4 Unit cost Physical Target BUDGET (Rs. Lakhs) Proposed Approved
Budget Head ADOLESCENT REPRODUCTIVE SEXUAL HEALTH (ARSH) Adolescent services at health facilities School Health Programme Implementation of School Health Programme by districts. Developing and printing of HEAL modules for Middle/High/Hr.sec Schools with TANSAC training material included Monitor progress and quality of services. Other strategies/activities (please specify) Details of the Menstrual Hygiene project to be provided and budgeted under this head
Remarks
A.4.1 A.4.2 A.4.2.1
0.00 911.47
Shifted from E 2.3. Approved
A.4.2.2
0.00 163.65
Shifted from E 2.1. Approved
A.4.2.3 A.4.3
0.00 111.57
Shifted from E 2.3.Approved
Sub-total ARSH
0.00 1186.69
Page 55
DETAILED BUDGET: SCHOOL HEALTH FMR Code Activity Unit Rate (Rs.) Physical Target/ Expected Output BUDGET 12-13 (Rs. Remarks Lakhs) Proposed Approval
Under RCH flexipool A 4.2.1 Prepare and disseminate guidelines for School Health Programme. Developing and Rs.1500/ printing of HEAL - per unit modules for Middle/High/Hr.sec Schools with TANSAC training material included A 4.2.2 Prepare detailed operational plan for School Health Programme across districts (cost of plan meeting should be kept) A 4.2.3 Implementation of School Health Programme by districts. 1 Replenishment of fund 1000 to Health Promotion committee in each school
10910 Heal 163.65 module and DVD sets (9918 schools+992 buffer=10,910)
163.65
Recommended for approval under FMR A 4.2.1, In the state budget this is projected under E 2.1
911.47
911.47
42769
Appraisal register to 100 each school
Referral register each school
to 100
Transport charges for 100 referred studentonetime payment
47046 (42,769+4,277 buffer = 47046) 47046 (42,769+4,277 buffer = 47046) 34000
Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.2. Please add details of expenditure under this head for FY 2011-12 Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.3. Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.3. Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.4. Page 56
FMR Code
Activity
Unit Rate (Rs.)
Health Kiosk (One 8000 Kiosk / PHC) @ Rs.8000/- kiosk Question Box / School 500
Physical Target/ Expected Output 1773 (1612+161)
BUDGET 12-13 (Rs. Remarks Lakhs) Proposed Approval Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.6. Recommended for approval under FMR A 4.2.3, In the state budget this is projected under E 2.7. 111.57 111.57 Recommended for approval under FMR A 4.2.4, In the state budget this is projected under E 2.3. Recommended for approval under FMR A 4.2.4, In the state budget this is projected under E 2.8. 1186.69 1186.69
42769
A 4.2.4 1
Monitor progress and quality of services. Printing of SH cards for 6 1st & 6th std students
Online data package
entry 400000
1792811 (16,29,828 1,62,983 Buffer) 1
Subtotal Health A8
Adolescent
A9
Infrastructure & HR (Contractual) Hiring of Doctors One 10000 Doctor / PHC for 10 months @ Rs.1000/- visit Training Training for Teachers & Health Personnel
1612
161.20
161.20
Recommended for approval under FMR A 8, In the state budget this is projected under E 2.5. Recommended for approval under FMR A 9, In the state budget this is projected under E 2.1. State to give number of participants, batch size and unit cost of batch
15.21
15.21
Grand total for Adolescent Health
1363.1
1363.1
Page 57
URBAN RCH
Page 58
ROAD MAP FOR PRIORITY ACTION: URBAN RCH Priority Actions to be carried out by the State: Carry out a comprehensive third party evaluation of UHCs/ NGO performance including an assessment of reasons for low expenditure (9.6 % in the first 9 months of 2011-12). State to apprise MoHFW of action taken on the basis of the findings of the evaluation by September 2012. Monitor performance of UHCs/NGOs against targets. Staffing at UHCs to be linked to case load. BUDGET: URBAN RCH FMR Code A.5.1 A.5.1.1 Physical Target BUDGET (Rs. Lakhs) Proposed Approved
Budget Head URBAN RCH Establishment of 75 Urban Health Center Staff salary Rent for UPHC Furniture ,Stores & equipments, Computer Accessories
Unit cost
Remarks
A.5.1.2 A.5.1.3 A.5.1.4
Rs.4000/ m Rs.1.46 L/UHC
62 UPHCs 75 new UPHCs
550.80 29.76 109.50
Total 690.06 Amount already sanctioned under supplementary budget (RoP 11-12) 310.20 Amount proposed (2012-13) 379.86 379.86 The total proposed budget for Urban RCH is Rs.690.06 lakhs, but State has Rs.310.20 lakhs as sanctioned amount for this activity hence has proposed Rs. 379.86 lakhs only, which has been approved accordingly.
Page 59
TRIBAL HEALTH
Page 60
ROAD MAP FOR PRIORITY ACTION: TRIBAL HEALTH Priority Actions to be carried out by the State: State to closely monitor progress (physical, expenditure) on all health activities in notified tribal areas. On a quarterly basis, a progress report, including constraints faced and action proposed to be sent to MoHFW. The State shall focus on health entitlements of vulnerable social groups like SCs, STs, OBCs, minorities, women, disabled, migrants etc. BUDGET FMR Code A.6 A.6.1 A.6.1.1 A.6.1.2 A.6.1.3 A.6.1.4 A.6.1.5 Physical Target BUDGET (Rs. Lakhs) Proposed Approved
Budget Head TRIBAL RCH Birth Waiting Room in 17 Tribal PHCs Contingency Electricity Charges POL charges Honorarium to CHN Honorarium to Sanitary Worker Tribal MMU Salary for Doctors POL charges
Unit cost
Remarks
Rs.2500/ unit/m Rs.2500/ unit/m Rs.8000/ unit/m Rs.500/ unit/m Rs.500/ worker/m
17 units for 8 months 17 units for 8 months 17 units for 8 months 17 units for 8 months 51 workers for 8 months 21 doctors 21 MMU
3.40 3.40 10.88 0.68 2.04
3.40 Approved 3.40 Approved 10.88 Approved 0.68 Approved 2.04 Approved
A.6.2 A.6.2.1 A.6.2.2
Rs.40000/ m Rs.18000/ m/MMU
85.68 45.36
0.00 Approved under HR 43.20 Approved only for existing 20 MMUs. 0.00 New Procurement of MMU vehicles for tribal areas not approved, since already Page 61
A.6.3 A.6.3.1
Referral Services Operational cost for the Rs.1 proposed 24 new four L/vehicle/ wheel drive for referral m services
24 vehicles for 6 months
144.00
FMR Code
Budget Head
Unit cost
Physical Target
Remarks
A.6.3.2
A.6.3.3
A.6.3.4
A.6.4 A.6.4.1
A.6.4.2
Operational cost for the existing 24 four wheel drive for referral services Procurement / fabrication of 24 new four wheel drive Procurement of 13 new four wheel drive vehicles @ 7.6 lakhs (MMU outreach services by NGO) Other Activities Grant In Aid(Bed Grant) for 4 Hospitals in 3 district through PPP mode (Through NGO) Tribal counselors in Govt. Institutions
Rs.1 L/vehicle/ m Rs.11.5 L/vehicle Rs.7.6 L
24 vehicles for 12 months 24 vehicles
288.00
every block has MMU. MMUs from some of the better performing non-tribal blocks, can be diverted, if required. 288.00 Approved
276.00
0.00 Not approved.
13
98.80
0.00 Not approved.
Rs.10 L/hospital
4 hospitals
40.00
0.00 Not approved
Rs.5000/ counselor/ m
10 counselors
6.00
Sub total Tribal Health
1004.24
6.00 Approved subject to State providing list of facilities where the counselors would be placed and those facilities should not have any other counselor viz. FP and/or ARSH counselor. 357.60
Page 62
PC-PNDT
Page 63
ROAD MAP FOR PRIORITY ACTION: PNDT Priority Actions to be carried out by the State: Strengthening programme management structures: Appointment of Nodal officer Strengthening of Human resource Formation of PNDT Cell at state and district level Establishment of statutory bodies under the PC&PNDT Act Constitution of 20 member State Supervisory Board Reconstitution every three years (other than ex-officio members) Four meetings in a year Notification of three members Sate Appropriate Authority, Constitution of 8 member State Advisory Committee Reconstitution in every 3 years At least 6 meetings in a year Notification of District Appropriate Authorities Constitution of 8 member district Advisory Committees Reconstitution in every 3 years At least 6 meetings in a year Strengthening of monitoring mechanisms Monitoring of sex ratio at birth through civil registration of birth data Formulation of Inspection and Monitoring committees Increasing the monitoring visits Review and evaluation of registration records Online availability of PNDT registration records Online filling and medical audit of form Fs Ensure regular reporting of sales of ultrasound machines from manufactures Enumeration of all Ultrasound machines and identification of un-registered ultrasound machine Ensure compliance for maintenance of records mandatory under the Act Ensure regular quarterly progress reports at state and district level Capacity building and sensitisation of program managers Appropriate Authorities Advisory committee members Nodal officers both State and District Sensitisation and Alliance building with Judiciary Page 64
Medical Council / associations Civil society Development of BCC/ IEC/ IPC Campaigns highlighting provisions of PC& PNDT Act and promotion of Girl Child Convergence for Monitoring of Child sex Ratio at birth
KEY PERFORMANCE INDICATORS: Improvement in child sex ratio at birth % of civil registration of births Statutory bodies in place % registrations renewed Increase in inspections and action taken No. of unregistered machines identified % of court cases filed % of convictions secured No. of medical licences of the convicted doctor cancelled or suspended NO BUDGET HAS BEEN PROPOSED BY THE STATE
Page 65
HUMAN RESOURCES AND PROGRAM MANAGEMENT
Page 66
ROAD MAP FOR PRIORITY ACTION: HUMAN RESOURCES Priority Actions to be carried out by the State: A comprehensive HR policy to be formulated and implemented; to be uploaded on the website too. Underserved facilities particularly in high focus districts/ areas, to be first strengthened through contractual staff engaged under NRHM. Similarly high case load facilities to be supplemented as per need All appointments under NRHM to be contractual; contracts to be renewed not routinely but based on structured performance appraisal Decentralized recruitment of all HR engaged under NRHM by delegating recruitment process to the District Health Society under the chairpersonship of the District Collector/ Rogi Kalyan Samitis. Preference to be given to local candidates to ensure presence of service providers in the community. Residence at place of posting to be ensured. Quality of HR ensured through appropriate qualifications and a merit- based transparent recruitment process. Vacant regular posts to be filled on a priority basis: at least 75% by March 2013. It has been observed that contractual HR engaged under NRHM i.e. Specialists, Doctors (both MBBS and AYUSH), Staff Nurses and ANM are not posted to the desired extent in inaccessible/hard to reach areas thereby defeating the very purpose of the Mission to take services to the remotest parts of the country, particularly the unserved and under-served areas. It must therefore be ensured that the remotest SubCentres and PHCs are staffed first. Contractual HR must not be deployed in better served areas until the remotest areas are adequately staffed. No Sub-Centre in remote/difficult to reach areas should remain without any ANM. No PHC in these areas should be without a doctor. Further, CHCs in remote areas must get contractual HR ahead of District Hospitals. Compliance with these conditionalities will be closely monitored and salaries for contractual HR dis-allowed in case of a violation. Details of facility wise deployment of all HR engaged under NRHM to be displayed on the state NRHM web site. For SHCs with 2 ANMs, population to be covered to be divided between them. Further, one ANM to be available at the sub-centre throughout the day while the other ANM undertakes field visits; timings for ANMs availability in the SHC to be notified. AYUSH doctors to be more effectively utilised e.g. for supportive supervision, school health and WIFS. All contractual staff to have job descriptions with reporting relationships and quantifiable indicators of performance. Performance appraisal and hence increments of contractual staff to be linked to progress against indicators. Page 67
Staff productivity to be monitored. Continuation of additional staff recruited under NRHM for 24/7 PHCs/FRUs/SDH, etc, who do not meet performance benchmarks, to be reviewed by State on a priority basis. All performance based payments/ difficult area incentives should be under the supervision of RKS/ Community Organizations (PRI).
DETAILED BUDGET: HUMAN RESOURCES FMR Code A.8 A.8.1. 1 Physical Target BUDGET (Rs. Lakhs) Proposed Approved
Budget Head INFRASTRUCTURE & HUMAN RESOURCES ANMs, supervisory nurses, LHVs
Unit cost
Remarks
A.8.1. 2
Laboratory Technicians, MPHWs
SNs: Ph1 @Rs.6000/ m Ph2 @ Rs.5000/m PPC @ Rs.4000/m Ambulance @ Rs.6000/m SNCU/NICU @ Rs.6000/m Tribal MMU@ Rs.10000/ m MCH L1@ Rs.11000/ m MCH L2@ Rs.4500/m Rs.6000/m
Ph1-4263 Ph2-354 PPC-172 Ambulanc e-24 SNCU/NIC U -781 Tribal MMU-20 MCH L1-93 MCH L2378
4881.64 3966.3
State has not provided details of staff required in the FMR format; further, the same items seem to have been proposed under both RCH and MFP. For 2012-13, the state's HR has been approved at the same level (reflected in Unit rate and Physical targets) as in ROP 2011-12. 0 11.52
20
A.8.1. 3
Specialists (Anaesthetists, Paediatricians, Ob/Gyn, Surgeons, Physicians, Dental Surgeons, Approval of Programme Implementation Plan Tamil Nadu 2012-13 Page 68
FMR Code
Budget Head Radiologist, Sonologist, Pathologist, Specialist for CHC )
Unit cost
Physical Target
Remarks
A.8.1. 4 A.8.1. 5 A.8.1. 6
PHNs at CHC/ PHC level Medical Officers at PHCs and CHCs Additional Allowances/ Incentives to M.O.s of PHCs and CHCs (Mobility support for emergency call (5 calls per month)) Others - Computer Assistants/ BCC Coordinator etc Rs.38000/ m Rs.500/call 783 existing 931 calls/m/30 dists 1189.94 2997.18 139.65 139.65
A.8.1. 7
Systems Systems manager manager @Rs.25000 24 /m Security Security services services @ 129 Rs.4000/m staff at staff at ICTC -399 ICTC @ Housekeep Rs.29114/ ing staffm 183 Housekeep Driver for ing services outreach @ MMU-385 Rs.2500/m Driver for Driver for tribal outreach MMU-20 MMU @ Driver for Rs.4000/m Ambulanc Driver for e services tribal MMU for @ emergency Rs.8000/m transport Driver for of mothers Ambulance and services for childrenemergency 24 transport Cleaner for of mothers MMU-385 and SW for children @ MCH L1-93
1835.95
Page 69
FMR Code
Budget Head
Unit cost
Physical Target
Remarks
Rs.4500/m Pharmacist Cleaner for for MCH MMU @ L2-42 Junior Rs.3000/m SW for Asstt. MCH L2-42 MCH L1@ Rs.2500/m Hospital Pharmacist Workers for MCH for MCH L2 @ L2-42 SW for Rs.21000/ m MCH L2-42 Junior Asstt. MCH L2@ Rs.11000/ m Hospital Workers for MCH L2 @ Rs.7500/m SW for MCH L2 @ Rs.7500/m A.8.1. 7.1 A.8.1. 7.2 A.8.1. 7.3 A.8.1. 7.4 A.8.1. 7.5 A.8.1. 8 A.8.1. 8.1 A.8.1. 8.4 A.8.1. 8.5 Staff for NRC Staff Nurse for NRC Nutrition Counselor Cook cum Care taker Attendant Incentive/ Awards etc. to SN, ANMs etc. Honorarium to hired Obstetrician for emergency LSCS Mobility support (for more than 8 km travel) Honorarium to hired Anesthetist for Rs.7500/m Rs.15000/ m Rs.5000/m Rs.5000/m 48 SNs 12 Counselors 12 cooks 24 attendants 3.06 5.92 1.53 0.51 1.02 Approved Approved Approved Approved
3500
32800
520.00 100.00
500 2250
16400 32800
82.00 342.00
1) Approved only for the Incentives to LSAS & EmOC trained doctors @ Rs 2000 fixed and Rs 400 per case upto max of 5000 to 7000 cases. Total Page 70
FMR Code
Budget Head emergency LSCS
Unit cost
Physical Target
Remarks budget approved lumpsum is Rs 50.00 lakhs. 2) Mobility support @ Rs 500 can be approved as lump sum for Rs 50.00 lakhs. 3) Not approved for calling experts from Private sector since State has enough number of regular and trained doctors.
A.8.1. 8.8 A.8.1. 8.9 A.8.1. 8.12 A.8.1. 8.13 A.8.1. 8.16 A.8.1. 8.17
A.8.1. 8.19 A.8.1. 8.20
A.8.1. 8.22 A.8.1. 8.23 A.8.1. 8.26 A.8.1. 8.27 A.8.1. 8.29 A.8.1. 8.30
Mobility support (for more than 8 km travel) Incentive to EmOC trained doctor for emergency LSCS Mobility support (for more than 8 km travel) Incentive to LSAS trained doctor for emergency LSCS Mobility support (for more than 8 km travel) Additional services by Govt specialists (Obstetrician )for Emergency LSCS Mobility support (for more than 8 km travel) Additional services by Govt specialists (Anaesthetist )for Emergency LSCS Mobility support (for more than 8 km travel) Honorarium to hired pediatricians Mobility support (for more than 8 km) Additional services by Govt paediatricians for emergency MCH care Mobility support (for more than 8 km) Delivery incentive to VHN
500 750
16400 2750
82.00 8.25
500 750
1375 2750
6.88 8.25
500 500
1375 10000
6.88 50.00
500 500
5000 10000
25.00 50.00
500 750 500 500
5000 9000 4500 5000
25.00 27.50 22.50 25.00
500 Rs.25/mot her
2500 288000 mothers
12.50 72.00 72.00 Approved subject to registration within 12 weeks, provision of full ANC, maintaining partographs of each case, giving birth dose of OPV, BCG, Hep B and Vit K injection.
Page 71
FMR Code A.8.1. 8.31
Budget Head Delivery incentive to ANM/SN
Unit cost Rs.25/mot her
Physical Target 288000 mothers
Remarks Approved condition to registration within 12 weeks, provision of full ANC, maintaining partographs of each case, giving birth dose of OPV, BCG, Hep B and Vit K injection.
A.8.1. 9 A.8.1. 9.1
Human Resources Development (Other than above) HR as per facility.
1)Staff salary Establishm ent of 20 new PHCs @ Rs.270.2 L 2) Staff salary for Operation alisation of 3 new sanctioned PHCs @ Rs.40.53 L 3)Staff salary of 20 new PHCs @ Rs.131.8 L 4) Staff salary for Upgradation of existing PHCs @Rs.390.4 8L 5)Staff salary for Upgradation of
5889.65 4049.32
Proposed under MFP. Approved as per RoP 11-12
Page 72
FMR Code
Budget Head
Unit cost
Physical Target proposed PHCs @ Rs.325.4 L 6)Human resources for new PHCs @ Rs.2242.08 L 7) Human resources for new UG PHCs @ Rs.2489.16 L
Remarks
A.8.1. 9.2
A.8.1. 9.3 A.8.1. 9.4
Hiring of Doctors One Doctor / PHC for 10 months @Rs.1000/visit for SHP Salary of FP Counselors in PPCs Salary for the Staff Nurses of the training team Provision of EmOC trained doctors to MCH for observation of High Risk Mothers
RS.1000/ visit
1612 visits/mon th for 10 months 172 counselors 770 SNs
161.20 161.20
Approved.
131.58 131.58
Rs.7500/m Rs.22000/ m
863.94 506.88
A.8.1. 9.5
Rs.38000/ m
36 doctors for 6 months (salary proposed at 85%)
69.77 69.77
A.8.1. 9.6
MPA on Contract basis at 44 existing SCNU
Rs.5000/m
132 MPA for 6
39.60 0.00
Approved. Only 85 % of salary requirement is budgeted. Approved for 6 Staff Nurses per district (32 Distts) to cover 12 block in each district. Medical Colleges is not generally a part of the NRHM. However, the Medical Colleges are high delivery points. 2 M.O per Institution x 6 months x Rs 38,000 P.M. x 18 Institutions x 85 %=69.77 lakhs approved. Name-wise list along with delivery load and C section to be shared. Not approved as No provision under Page 73
FMR Code
Budget Head
Unit cost
Physical Target months 60 MPA for 6 months 183 MPA for 12 months 69 MPA for 6 months 42 MPA for 9 months 31 SW for 9 months
Remarks operational guidelines ; Should be provided from state budget.
A.8.1. 9.7 A.8.1. 9.8 A.8.1. 9.9 A.8.1. 9.10 A.8.1. 9.11
MPA -Male on contract basis at 20 SNCU taken up for upgradation MPA- Female at 44 Existing NICU MPA -Male on contract basis at 20 SNCU taken up for upgradation Multipurpose Assistant for MCH L2 Sanitary Worker Salary Sub total Infrastructure and HR Mainstreaming of AYUSH
Rs.5000/m
18.00 0.00
RS.3500/m
76.86 0.00
RS.3500/m
14.49 0.00
Rs.5000/m
18.90 0.00
RS.2500/m
6.97 0.00 15071.07 14119.27
Already approved under A.8.1.7
B9
B9.1
Human Resources (ongoing) Sub-total HR including AYUSH
475 units (300 set up in 2009-10 and 175 set-up in 2010-11)
1519.09 16590.09
1519.09 Approved 15638.36
Page 74
ROAD MAP FOR PRIORITY ACTION: PROGRAMME MANAGEMENT A full time Mission Director is a prerequisite. Stable tenure of the Mission Director should also be ensured. A regular full time Director/ Joint Director/ Deputy Director (Finance) (depending on resource envelope of State), from the State Finance Services not holding any additional charge outside the Health Department must be put in place, if not already done, considering the quantum of funds under NRHM and the need for financial discipline and diligence. Regular meetings of state and district health missions/ societies must take place. Key technical areas of RCH to have a dedicated / nodal person at state/ district levels; staff performance to be monitored against targets and staff sensitised across all areas of NRHM such that during field visits they do not limit themselves only to their area of functional expertise. Performance of staff to be monitored against benchmarks; qualifications, recruitment process and training requirements to be reviewed. Delegation of financial powers to district/ sub-district levels in line with guidelines should be implemented. Funds for implementation of programmes both at the State level and the district level must be released expeditiously and no delays should take place. Evidence based district plans prepared, appraised against pre determined criteria; district plans to be a live document. Variance analysis (physical and financial) reports prepared and discussed/action taken to correct variances. Supportive supervision system to be established with identification of nodal persons for districts; frequency of visits; checklists and action taken reports. Remote/ hard to reach/ high focus areas to be intensively monitored and supervised. An integrated plan and budget for providing mobility support to be prepared and submitted for review/approval; this should include allocation to State/ District and Block Levels.
Page 75
DETAILED BUDGET: PROGRAMME MANAGEMENT FMR Code A10 A.10.1 Physical Target BUDGET (Rs. Lakhs) Proposed Approved
Budget Head PROGRAMME MANAGEMENT SPMU
Unit cost
Remarks
791.75 594.97
A.10.2
DPMU
803.94 508.94
A.10.3
BPMU
942.13 845.40
No unit wise breakup provided only lumpsum amounts proposed. Approval restricted to last years level of Rs.645 lakhs less 50.03 lakhs - 25 % of mobility support approved on interim basis. State to provide integrated mobility support plan and budget Proposed amount is 17.7% higher than approved amount in 11-12. Reasons for increase not clear. Approved at last yrs level of Rs.682.82 lakhs less Rs.173.88 lakhs which is 25% of mobility support approved on interim basis. State to provide integrated mobility support plan and budget. Amount as per RoP 11-12 levels. Proposed amount is 11 % higher than approved amount in 1112. Reasons for increase not clear.
A.10.4
Other : Hiring of contractual staff for Maternal Health Wing A.10.4.1 Expert Advisor A.10.4.2 Health Officer / Medical Officer A.10.4.3 Assistant Director(Statistics) A.10.4.4 Maternal and Child Health Officer A.10.4.5 Honorarium for involving experts in MCH activities
Rs.85000 /m Rs. 38000/m Rs.35000 /m Rs.24000 /m Rs.20000 /m
1 for 9 months 2 for 9 months 1 for 9 months 1 for 9 months 1 for 9 months
7.65 7.65 6.84 6.84 3.15 3.15 2.16 2.16 1.80 1.80
Approved Approved Approved Approved Approved
Page 76
FMR Code
Budget Head
Unit cost
Physical Target
Remarks Not approved. Outsourcing not allowed. State has sufficient resources.
A.10.4.6 Office contingency Rs.30000 1 for 9 including /m months Outsourcing of DEO Sub total Programme Management
2562.12 1970.91
Page 77
MISSION FLEXI POOL (MFP)
Page 78
ASHA TARGETS: S. No. 1. 2. Activity ASHAs with Drug kits ASHAs trained in 6th and 7th modules ROAD MAP FOR PRIORITY ACTION: ASHA Clear criteria for selection of ASHA Well functioning ASHA support system including ASHA days, ASHA coordinators Performance Monitoring system for ASHAs designed and implemented (including analysis of pattern of monthly payments; identification of non/under-performing ASHAs and their replacement; and reward for well performing ASHAs). State to report on a quarterly basis on ASHAs average earnings/ range per month. Timely replenishment of ASHA kits. Timely payments to ASHAs and move towards electronic payment. Detailed data base of ASHAs created and continuously updated; village wise name list of ASHA to be uploaded on website with address and cell phone number Targets 4611 6250
DETAILED BUDGET: Unit Cost (wherever applicable) Physical target/ Deliverables
FMR Code B1 B1.1. B1.1.1
Activity ASHA ASHA Cost Selection and Training of ASHA Procurement of ASHA Drug Kit (ongoing)
Amount Amount Proposed Approved Remarks
B1.1.2
Drug Kit for 2650 ASHAs Training and drug kit for dropout ASHA Training and drug kit for 4200 ASHAs
600
2650
15.90
Approved for replenishment @ Rs. 350 per 9.28 ASHA
6750+600
320
35.20
6750+600
4200
208.20
23.52 Approved. Only replenishment 14.70 of drug kits is Page 79
FMR Code
Activity
Physical target/ Deliverables
Amount Amount Proposed Approved Remarks approved
B1.1.3
B1.1.3.1
Performance Incentives/ Other Incentives to ASHAs ASHAs in Tribal, Hilly, Difficult and Hard to reach areas(2650) Approved. The State may give incentives to ASHAs only after training of ASHAs as per GoI 106.00 guidelines.
B1.1.3.1.i
B1.1.3.1.ii
B1.1.3.1.iii
B1.1.3.1.iv
Home Based Newborn Care (new) Reporting of Infant Deaths and children in 5 years (new) Village Health and Nutrition Days (ongoing) Attending PHC monthly review meeting (ongoing) Adolescent Anemia Control Programme (ongoing)
250
2650*16
106.00
25
2650*5
3.31
3.31 Approved
100
2650*12
31.80
31.80 Approved
100 100 twice a year 100 p m
2650*12
63.60
31.80 Approved
B1.1.3.1.v B1.1.3.1.vi
2650 2650
5.30 31.80
5.30 Approved 0.00 Approved
Immunization activity (new) Incentives for Vitamin A and Deworming B1.1.3.1.vii campaign (ongoing) Surveillance and reporting of fever, ARI, AGE, Jaundice, B1.1.3.1.viii etc (ongoing)
200 each
2 sessions each
21.20
21.20 Approved
100 pm
2650
31.80
31.80 Approved
Page 80
FMR Code
Activity
B1.1.3.1.ix
B1.1.3.2
Family Welfare Services(Motivation of Eligible couples for female and male sterilisation) ASHA (Programme specific) incentive for 4200 non tribal and plains for MCH activities) Sub-total ASHA Incentives
Rs. 100 per case of female sterilisation and Rs. 250 per case of male sterilisation 2650*(10+4)
Amount Amount Proposed Approved Remarks Not approved as this is already a part of the compensation package budgeted under Family 53.00 0.00 Planning
16325
4200
0.00 347.81 0.00
0.00 231.21 0.00
B1.1.4
B1.1.5 B1.1.5.1 B1.1.5.2 B1.1.5.3 B1.1.5.4
Awards to ASHAs/ link Workers ASHA Resource Centre/ ASHA Mentoring Group Supportive Supervision (new activity) VHV Coordinator at State Level VHV Coordinator at District Level Block Level At PHC Level Sub-total supportive supervision of ASHA Sub-total 1103000 276000 386400 21000 1 33 112 336
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
0 607.11
0 278.71
Page 81
UNTIED FUNDS/ RKS/ AMG ROAD MAP FOR PRIORITY ACTION FOR UNTIED FUNDS/ RKS/ AMG: Timely release of untied funds to all facilities; differential allocation based on case load. Funds to be utilized by respective RKS only and not by higher levels. Well functioning system for monitoring utilization of funds as well as purposes for which funds are spent. Plan for capacity building of RKS members developed and implemented. RKS meetings to take place regularly. Audit of all untied, annual maintenance grants and RKS funds. The State must take up capacity building of Village Health & Sanitation Committees Rogi Kalyan Samitis and other community/ PRI institutions at all levels The State shall ensure regular meetings of all community Organizations/ District / State Mission with public display of financial resources received by all health facilities The State shall also make contributions to Rogi Kalyan Samitis
BUDGET: Unit Cost Physical (wherever target/ Amount applicable) Deliverables Proposed
FMR Code B2
Activity Untied Fund Untied funds to CHCs(385) and PHCs(65) offering with CHC services Untied funds to PHCs Untied funds to HSCs
Amount Approved
Remarks
B2.1 B2.2 B2.3
50000 25000 10000
450 1162 8706
225.00 290.50 870.60
Village Health, Water, Sanitation and B2.4 Nutrition Committee B2.5 Others B2.5.1 Untied funds to DHs B2.5.2 Untied funds to SDHs B2.5.3 Untied funds to UPHCs Total Annual Maintenance B3 Grants(AMG) AMG to CHCs(385) and PHCs(65) offering with B3.1 CHC services B3.2 AMG to PHCs
10000 100000 50000 25000
15158 31 230 135
1515.80 31.00 115.00 33.75 3081.65
154.09 Approved 290.50 Approved 788.84 Approved Approved. Funds for training of VHSNC members available in 1275.95 the State. 0.00 Not approved 115.00 Approved 0.00 Not approved 2624.38
100000 50000
450 1162
450.00 581.00
233.39 Approved 838.32 Approved Page 82
FMR Code B3.3 B3.4 B3.4.1 B3.4.2 B3.4.3
Activity AMG to HSCs Others AMG to DHs AMG to SDHs AMG to UPHCs AMG to Medical Colleges and attached B3.4.4 institutions Total B6 B6.1 Patients Welfare Society (PWS) Funds to DHs Funds to CHCs(385) and PHCs(65) offering with CHC services
Unit Cost Physical (wherever target/ Amount applicable) Deliverables Proposed 10000 6510 651.00 100000 100000 50000 31 230 135 31.00 230.00 67.50
Amount Approved Remarks 526.67 Approved 0.00 Not approved 230.00 Approved 0.00 Not approved
100000
34
34.00 2044.50
0.00 Not approved 1828.38
500000
31
155.00
155.00 Approved
B6.2
100000
450
450.00
B6.3 B6.4
Funds to PHCs Others
100000
1162
1162.00
214.61 Approved Approved for 1139 functional PHCs and 3 new PHCs which are proposed for operationalization = 1162.00 1142 PHCs.
B6.4.1 Funds to SDHs Funds to CEmONC (as B6.4.2 add on fund) B6.4.3 Funds to UPHCs Funds to Medical B6.4.4 College Hospitals Funds to attached B6.4.5 Hospitals under DME Funds to attached B6.4.6 Institutions under DME Total
100000 100000 100000 1000000 500000 100000
230 103 135 17 12 5
230.00 103.00 135.00 170.00 60.00 5.00 2470.00
9.85 Approved 0.00 Not Approved. 0.00 Not Approved. 0.00 Not Approved. 0.00 Not Approved. 0.00 Not Approved. 1541.46
Page 83
NEW CONSTRUCTIONS/ RENOVATION AND SETTING UP All newly constructed SCs to be strengthened with 2 ANMs and service delivery closely monitored. ROAD MAP FOR PRIORITY ACTION: Works must be completed within a definite time frame. For new constructions upto CHC level, a maximum of two years and for a District Hospital, a maximum period of 3 years is envisaged. Renovation/ repair should be completed within a year. Requirement of funds should be projected accordingly. Funds would not be permissible for constructions/ works that spill over beyond the stipulated timeframe. Progress of works being executed to be closely monitored Standardized drawing/ detailed specifications and standard costs must be evolved keeping in view IPHS. Third party monitoring of works through reputed institutions to be introduced to ensure quality. Information on all ongoing works to be displayed on the NRHM website Approved locations for constructions/ renovations will not be altered All government health institutions in rural areas should carry a logo of NRHM as recognition of support provided by the Mission in English/ Hindi & Regional languages.
BUDGET: Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved
FMR Code
Activity New Constructions/ Renovation and Setting - up Strengthening of FRUs
Remarks
B5 B5.7
B5.7.1
B5.7.2
B5.7.3
Infrastructure Upgradation In FRUs (new) Civil Works Equipment for Medical Colleges (new) Center of Excellence in Reproductive and Child Health in
40
1920.00
Approved. 40% of the total cost is proposed and approved for this 1920.00 year.
965.61
965.61 Approved
512200000
3000.00
3000.00 Approved. Page 84
FMR Code
B5.7.4
Activity Madurai and Salem Medical colleges (new) Comprehensive Emergency Management Centre (new activity) Establishment of skill laboratories in all the GNM schools I (new) Sub-total Health Infrastructure
Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved
Remarks
5437000
14
761.18
761.18 Approved.
B5.10.1
1100000
24
264.00 6910.79
264.00 Approved 6910.79
Page 85
PROCUREMENT ROAD MAP FOR PRIORITY ACTION - PROCUREMENT: Strict compliance of procurement procedures for purchase of medicines, equipments etc as per state guidelines. Competitive bidding through open tenders and transparency in all procurements to be ensured. Only need based procurement to be done strictly on indent/requisition by the concerned facility. Procurement to be made well in time & not to be pushed to the end of the year. Audit of equipment procured in the past to be carried out to ensure rational deployment. Annual Maintenance Contract (AMC) to be built into equipment procurement contracts. A system for preventive maintenance of equipment to be put in place.
BUDGET: Unit Cost (wherever applicable) Physical target/ Deliverables
FMR Code B16 B16.1 B16.1.1
Activity Procurement Procurement of Equipment Procurement of Equipment for MH
Amount Proposed
Amount Approved
Remarks
B16.1.1.1 B16.1.2 B16.1.2.1
Equipment for FRUs Procurement Equipment: CH of
1471.85
Approved. The State is to provide a list of all the facilities along with the equipments to be procured and no additional funds for procurement of equipments will be asked for these 1471.85 facilities.
Equipment for SNCU @ 10 lakhs
10 lakh
20
200.00
Approved for 17 170.00 units
Page 86
FMR Code
Activity Equipment for Sick newborn transport system @ 4.5 lakhs Equipment for new born corner for 73 new PHCs, 31 level 1 MCH centre and 135 UPHCs @ Rs.85000/Equipment, medication and consumable for ASHA home based new born care in 2650 tribal and 4200 program specific VHVs @ Rs. 2000 per VHV Equipment for training for prenatal screening to detect fetal anomalies in 78 CEmONC centers and 154 PHCs
Amount Proposed
Amount Approved
Remarks
B16.1.2.2
4.5 lakh
29
130.50
0.00 Not approved
B16.1.2.3
85000
239
203.15
203.15 Approved
B16.1.2.4
1500
6850
137.00
0.00 Not approved
B16.1.2.5
B16.1.2.5.i B16.1.3 B16.1.3.1 B16.1.3.3 B16.1.3.5
Desktop Accessories Rs.11000/Procurement of equipment: FP NSV Kit Minilap sets Kelly's Forceps
and @
Rs. 35000 for desktops and 11000 for accessories
232
106.72
106.72 Approved
1000 3500 2700 10% of the total procurement cost
1000 400
10.00 15.00 10.08
B16.1.5
Annual Maintenance contract / Maintenance and repair for Equipment Sub-total (equipment) Procurement of Drugs and supplies
800.00 3084.30
800.00 Approved 2786.80
B16.2
Page 87
FMR Code B16.2.1 B16.2.1.1 B16.2.1.2 B16.2.1.3 B16.2.3
Activity Procurement of supplies for MH Iron sucrose Maternal Anaemia Albendazole for Antenatal mothers Gestational Diabetes FW Drugs and equipments General drugs and supplies for health facilities Procurement of drugs under ARSH for WIFS Procurement of IFA
Amount Proposed
Amount Approved
Remarks
1428932 doses 1190777 1612
429.00 8.34 161.20 0.00
429.00 Approved 8.34 Approved 161.20 Approved 0.00
B16.2.5
B16.2.5.1
B16.2.5.1. 1 B16.2.5.1. 2 B16.2.5.2 Procurement of Albendazole Modified School Health Programme Drugs for Urban Health post for medical college hospitals @ 2.5 Lakh per centre Drugs and consumables for 75 municipalities @ Rs. 2.35 Lakhs
0.13 0.70
5864754 5864754 20000000
396.46
Approved. State needs to ensure that although not budgeted in this activity, all the school boys are also provided with weekly iron/ folic acid 396.46 supplementation. 82.11 Approved
140.00
0.00
B16.2.5.3
16 centers
40.00
40.00 Approved
B16.2.5.4
75 centers
176.25
176.25 Approved
Page 88
FMR Code
Activity
Amount Proposed
Amount Approved
Remarks
B16.2.5.5 B16.2.5.6
First aid kits for schools Disposable syringes Provision of gloves and syringes for NCD screening program (Phase I and Phase II) Sub total (drugs) Sub-total
100 per kit
42769 3 Cr
42.77 300.00
B16.2.5.7
465.57 2159.59 5243.89
465.57 Approved 2101.70 4888.50
Page 89
MOBILE MEDICAL UNIT (MMU) ROAD MAP FOR PRIORITY ACTION: Route chart to be widely publicised GPS to be installed for tracking movement of vehicles Performance of MMUs to be monitored on a monthly basis (including analysis of number of patients served and services rendered). MMUs to be well integrated with Primary Health Care facilities and VHND. Engagement with village panchayats / communities for monitoring of services AWCs to be visited for services to children below 6 years of age AWCs to maintain record of services rendered Service delivery data to be regularly put in public domain on NRHM website. A universal name Rashtriya Mobile Medical Unit to be used for all MMUs funded under NRHM. Also uniform colour with emblem of NRHM (in English/ Hindi & Regional languages), Government of India and State Government to be used on all the MMUs.
BUDGET: Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved
FMR Code B11 B11.1 B11.2 B11.3 B11.4 B11.5 B11.6
Activity MOBILE MEDICAL UNITS Medical Officer Staff nurse Driver Cleaner Lab technician AVLT system Vehicle maintenance per annum POL Contingency per annum Mobile Medical Unit Drugs to PHCs Lab reagents for MMU
Remarks
456000 96000 48000 36000 30000 35000
385 385 385 385 385 385
44.26 169.59 56.90 24.71 98.18 134.75
44.26 169.59 56.90 24.71 98.18 134.75
Approved Approved Approved Approved Approved Approved
B11.7 B11.8 B11.9
5000 10000 10000
385 4620 385
19.25 92.42 38.50
B11.10 B11.11
100000 25000
385 385
385.00 96.25
Page 90
FMR Code
Activity New Vehicles for replacement of old vehicles Total
Remarks
B11.12
700000
100
700.00 1859.81
Page 91
REFERRAL TRANSPORT ROAD MAP FOR PRIORITY ACTION: Free referral transport to be ensured for all pregnant women and sick neonates accessing public health facilities. Universal access to referral transport throughout the State, including to difficult and hard to reach areas, to be ensured. A universal toll free number to be operationalized and 24x7 call centre based approach adopted. Vehicles to be GPS fitted for effective network and utilization. Rigorous and regular monitoring of usage of vehicles to be done Service delivery data to be regularly put in public domain on NRHM website.
FMR Code
Activity EMERGENCY REFERRAL TRANSPORT EMRI
Physical target/ Amount Deliverables Proposed
Amount Approved Remarks
B12 B12.1
B12.1.1 B12.1.2 B12.1.3
Reach Ambulance modification Non-recurring cost infrastructure Vehicle replacement Procurement for 29 new vehicles of sick newborn transport system @ Rs. 12 lakhs per vehicle Operating cost Operational Cost a. Operational Cost for UNICEF vehicle for transport of sick new born.
2 @ Rs. 2.7 lakh (neonatal), 28 @ Rs. 0.25 lakh for minor modification, 76 @ Rs. 3.75 lakh for modification
106
0.00 0.00 1250.00
0.00 Not approved 0.00 Not approved 0.00 Not approved
12.5 lakh
100
B12.1.4 B12.2 B12.2.1
12 lakh
29
348.00
0.00 Not approved 20% of total OP 1726.00 cost approved.
1726.00 Rs 1 lakh / Vehicle / month x 12 months
B12.2.2
6 Ambulances
72.00
0.00 Not Approved Page 92
FMR Code
Activity
Unit Cost (wherever applicable) Rs 1 lakh / Vehicle / month x 12 months
Physical target/ Amount Deliverables Proposed 29 Vehicle with sick new born transport
b.Operational cost for Existing 29 vehicle with Neonatal B12.2.3 Support System. d.Operational cost for the 29 new vehicle proposed for transport of sick new B12.2.4 born Training on Emergency transport of Maternal and B12.2.5 Infants - EMRI Staff Training on Emergency transport of Maternal and Infants - District level B12.2.6 staff Training on Emergency transport of Maternal and Infants - EMRI B12.2.7 Technician Total
348.00
0.00 Not Approved
Rs 1 lakh / Vehicle / month x 3 months
29
87.00
0.00 Not Approved
Rs.25860/batch
4 batches
1.03
0.00 Not approved
Rs.73360/batch
2 batches
1.47
0.00 Not approved
Rs.63860/batch
40 batches
25.54 3859.04
Page 93
AYUSH ROAD MAP FOR PRIORITY ACTION: State to co-locate AYUSH in district hospitals and provide post graduate doctors for at least two streams: Ayurveda and homoeopathy (or Unani, siddha, Yoga as per the local demand). Panchakarma Unit should also be considered. OPD in AYUSH clinics will be monitored along with IPD/OPD for the facility as a whole. The AYUSH pharmacist/compounder to be engaged only in facilities with a minimum case load. Adequate availability of AYUSH medicines at facilities where AYUSH doctors are posted to enable them to practice their own system of Medicine without difficulty. At CHCs and PHCs any one system viz., Homeopathy/Ayurveda/ Unani/Sidha to be considered depending on local preference. At CHC/PHC level, Post-Graduate Degree may not be insisted upon. District Ayurveda Officer should be a member of District Health Society in order to participate in decision making with regard to indent, procurement and issue of AYUSH drugs. Infrastructure at facilities proposed to be collocated would be provided by Department of AYUSH. Those PHC/CHC/Sub-Divisional hospitals which have been identified as delivery points under NRHM should be given priority for collocation of AYUSH as these are functional facilities with substantial footfalls. AYUSH medical officers should increasingly be involved in the implementation of national health programmes and for the purpose of supportive supervision and monitoring in the field. They should be encouraged to oversee VHND and outreach activities and in addition programmes such as school health, weekly supplementation of iron and folic acid for adolescents, distribution of contraceptives through ASHA, menstrual hygiene scheme for rural adolescent girls etc. AYUSH medical officer should also be member of the RKS of the facility and actively participate in decision making. AYUSH doctors need to be provided under NRHM first in the remotest locations and only thereafter in better served areas.
Page 94
BUDGET: Unit Cost Physical (wherever target/ Amount applicable) Deliverables Proposed
FMR Code B9
Activity Mainstreaming of AYUSH
Human Resources B9.1 (ongoing) B9.3 Other activities B9.3.1 IEC (new) Training of all VHNs in Yoga and B9.3.2 Naturopathy (new) Provision of kit of medicines to pregnant mothers during antenatal and postnatal B9.3.3 period. (new)
475 units (300 set up in 2009-10 and 175 set-up in 2010-11)
1519.09 34.00
87.00
87.00 Approved
450 per patient
429.00
Provision of medicines to ISM B9.3.4 wings (new) Networking the Commissionerate with DSMOs and B9.3.5 the Colleges. (new) Sub total Mainstreaming of AYUSH
3 lakh per annum
475
1423.00
0.00 Not Approved. Not approved. Financial assistance may be sought from the Department of AYUSH. State Government is requested to liquidate the pending UCs and forward the proposals with AYUSH PIP as per the scheme 0.00 guidelines.
25.00
0.00 Not approved
3517.09
1640.09
Page 95
IEC/BCC ROAD MAP FOR PRIORITY ACTION: Comprehensive IEC/ BCC strategy prepared. IPC given necessary emphasis and improved inter-sectoral convergence particularly with WCD. Details of activities carried out to be displayed on the website
BUDGET: Unit Cost (wherever applicable) Physical target/ Deliverables
FMR Code B10 B10.2 B10.2.2
Activity BCC / IEC Implementation of BCC and IEC strategy IEC - IEC/BCC Activities for CH
Amount Proposed
B10.2.2.1 B.10.2.3 B.10.2.4
a. EMRI boards for Neonatal transport, b.SNCU boards, c.LBW protocols etc BCC/IEC activities for FP BCC/IEC activities for ARSH
29 47 1612 8706
101.21 34.60
101.21 Approved 34.60 Approved Approved
Printing of posters to B.10.2.4.1 each VHN Printing of IEC materials to ICTC counselors and NCD B.10.2.4.2 staff nurses IEC material to ICDS B.10.2.4.3 centers B10.2.5 Other activities B10.2.5.1 B10.2.5.2 BCC / IEC Activities in RCH / NRHM Activities IEC/BCC- School Health Programme
100
9576
9.58
9.58 Approved
100 250
1049 59672
1.05 149.18
100.00
100.00 Approved
Page 96
FMR Code
Activity
Amount Proposed
B10.2.5.3
Printing of IEC Materials - Middle /High/ Hr.sec Schools
10910 sets with DVDs ( 9918 720 per schools+992 schools buffer=10,910) 3000 per kit 1773 (1612 PHC+ 161 buffer= 1773)
78.55
78.55 Approved
B10.2.5.4
IEC kit for PHC Sub-total
53.19 527.36
53.19 Approved 527.36
Page 97
MONITORING AND EVALUATION (HMIS)/ MCTS ROAD MAP FOR PRIORITY ACTION: Data is uploaded, validated and committed; data for the month available by the 15th of the following month. Uploading of facility wise data by the first quarter of 2012-13. Facility based HMIS to be implemented. HMIS data to be analysed, discussed with concerned staff at state and district levels and necessary corrective action taken. Program managers at all levels use HMIS for monthly reviews. MCTS to be made fully operational for regular and effective monitoring of service delivery including tracking and monitoring of severely anemic women, low birth weight babies and sick neonates. Pace of registration under MCTS to be speeded up to capture 100% pregnant women and children Service delivery data to be uploaded regularly. Progress to be monitored rigorously at all levels MCTS call centre to be set up at the State level to check the veracity of data and service delivery.
BUDGET: Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved Remarks
FMR Code
B15 B15.1
Activity Planning, Implementation and Monitoring Community Monitoring Statewide project for community monitoring and village plan development (new)
B15.1.1
5 lakh
36
180.00
180.00 Approved
B15.1.2
Continuation of support for Community Action for Health (CAH) in 6 HUDs. (new)
50
300.80
300.80 Approved Page 98
FMR Code
B15.2 B15.3
Activity Quality Assurance (Additional Manpower (Regional NRHM consultants)) Monitoring and Evaluation Monitoring and Evaluation/ HMIS/ MCTS State level and regional level workshop / review meeting Strengthening of HMS in District / Sub District Hospitals MCTS State MCTS Cell {1-Joint Director @ Rs. 50,000 per month
Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved Remarks
Rs.35000/m
6 for 9 months
18.90
Not 0.00 approved
B15.3.1
B15.3.1.1
5.48
5.48 Approved
B15.3.1.2 B15.3.1.3
50000 p.m
14.40
14.40 Approved
1-Assistant Director@ Rs. 35,000 per month and 1-IT Coordinator@ 16,500 per month} Own a Laptop sharing 20% of the cost to strengthen MCTS sub total Computerization/ HMIS and e-governance, ehealth Computers and networking for District Hospitals (31 x 20 x 44200)
35000 p.m. (- AD, 16500 p.m. - IT Coordinator)
1+1
6.18
6.18 Approved Not 0.00 approved 26.06
200.00 226.06
B15.3.2
B15.3.2.1
274.04
274.04 Approved
Page 99
FMR Code
Activity Computers and networking for Sub District Hospitals (230 x 7 x 44200)` IT coordinator IT coordinator Comprehensive Networking of all sections of DPH, DMS and DFW Computers (DGS&D Rate for 358 numbers) (i3 processor with OS, antivirus and other necessary software) UPS (10 x 110000) Provision of LAN connectivity (including OFC cable linking) Server (DGS&D Rate for 4 server) (Dell-R710 64GB RAM 1 TB HDD)
B15.3.2.2 B15.3.2.3 B15.3.2.4
16500 pm Rs.16500/ month x 2
42
711.62 62.37 2.97
B15.3.2.5
B15.3.2.6 B15.3.2.7
35000
358
127.09 11.00
Not 0.00 approved. Not 0.00 approved. Not 0.00 approved.
B15.3.2.8
42.22
B15.3.2.9
20.00
Not 0.00 approved.
Computers (DGS&D Rate for 23 numbers) (i3 processor with OS, antivirus and other B15.3.2.10 necessary software) Up-gradation of existing LAN network setup at Directorate of B15.3.2.11 Medical Education sub-total B15.3.3 Other M&E activities 4 Review cum workshop and review meeting for DTT MOs
Rs. 35,500/-
23
8.17
8.05 Approved
52.90 1312.38
52.90 Approved 1111.95
B15.3.3.1
129250
5.17
5.17 Approved
Page 100
FMR Code B15.3.3.2
Activity Quarterly Review meeting of DDHSs sub-total Sub total Monitoring and Evaluation Sub total Planning, Implementation and Monitoring
Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved Remarks 1.08 4 4.32 9.49 1547.93 4.32 Approved 9.49 1147.50
2047.63
1628.30
Page 101
OTHERS BUDGET: HOSPITAL STRENGTHENING Unit Cost (wherever applicable) Physical target/ Deliverables
FMR Code B4
B4.1 B4.1.1 B4.1.2 B4.1.3
B4.1.3.1
Activity Hospital Strengthening Upgradation of CHCs, PHCs, District Hospitals District Hospitals CHCs PHCs Up-gradation of PHCs Existing (new)
B4.1.3.1.i
Civil Works (new)
7000000
24
1680.00
Other infrastructure B4.1.3.1.ii (new) Up-gradation of PHCs Proposed (new) B4.1.3.2 B4.1.3.2.i Civil Works
1500000
24
360.00
Approved. A comprehensive plan for upgradation of each of the PHCs is to be prepared by the State. New OT constructions are to be done only for the PHCs where there are no OTs. The activity is to be completed in 1680.00 2012-13 itself. Approval is pended till details of 'other infrastructure' is provided by the state for each of 0.00 these PHCs.
7500000
20
0.00
0.00 Page 102
FMR Code
Activity Other B4.1.3.2.ii infrastructure Infrastructure up gradation in HSCs to facilitate the stayal of VHN in B4.1.4 villages (new) B4.2 Strengthening of PHCs (new) Establishment of 20 new PHCs sanctioned by GoTN (new activity) Civil Works (new) Other infrastructure (new) Establishment of 20 other new PHCs (new) Civil Works (new) Other infrastructure (new) Operationalisation of 3 new PHCs sanctioned - other infrastructure (new activity) Additional fund for increased cost for construction work (ongoing activity)
Unit Cost (wherever applicable) 1500000
Physical target/ Deliverables 20
Amount Amount Proposed Approved Remarks 300.00 0.00 Not Approved. Approved. The activity is to be completed in this 2100.00 year itself.
5000000
42
2100.00
B4.2.1 B4.2.1.1
2500000
20
500.00
500.00 Approved.
B4.2.1.2
295000
20
59.00
59.00 Approved
B4.2.2 B4.2.2.1
2500000
20
200.00
0.00 Not Approved.
B4.2.2.2
295000
20
59.00
0.00 Not Approved.
B4.2.3
215000
6.45
6.45 Approved
B4.2.4
B4.2.4.1
PHCs
39
214.50
Approved. All the pending works are to be completed by the State in 2012-13 and no further funds shall be 214.50 provided in the Page 103
FMR Code
Activity
Amount Amount Proposed Approved Remarks next years.
B4.2.4.2
UG PHCs Construction of New buildings for 9 old PHCs (new) Adoption of Kasthuriba Gram Hospital in Erode District (new)
12
204.00
204.00 Approved for the 7 facilities which are delivery 175.00 points.
B4.2.5
2500000
225.00
B4.2.5.1
1946000
19.46
B4.2.6
Maintenance and repairs of HSCs (new)
5000000
42
500.00
19.46 Approved The State has a balance of Rs. 16 Crores which is permitted to be used for plugging the infrastructure gaps in HSCs. Additional requirement of Rs. 5 Crores is approved. Number of HSCs with locations are to be provided by the State before incurring expenditure against this 500.00 approval.
Upgradation of existing Blood storage centre to Blood Bank
lumpsum
25.00
Approved (shifted from 25.00 RCH)
Page 104
FMR Code
Activity Establishment of Blood storage centres in MCH wings of Medical College Hospitals
Rs.4 L/facility
18 facilities
72.00
B4.3
B4.4.1
B4.4.2
B4.4.3
Sub-Centre Rent and Contingencies (ongoing) Outsourcing of House keeping and cleaning Services in Hospitals (new) Outsourcing of hospital services to be continued in Cuddalore, Pudukottai, Tiruppur, Tambaram Hospitals for 2012-13 @ 10% increase over previous year's cost (ongoing) Outsourcing of cleaning, sanitation and certain other hospital services in CEmONC hospitals (new) Sub total Hospital Strengthening
1000 p.m
2173
0.00
Approved (shifted from 72.00 RCH) Fund is available with the State. The norm is Rs. 3000 p/a for rent and Rs. 3200 p/a for contingencies 0.00 per SHC.
5 Lakh p.m.
40
100.00
100.00 Approved.
55 Lakh
250.00
250.00 Approved
17 CEMONC centers + 1 lakh advertisement p.m. (Rs. 5 lakh)
209.00
209.00 Approved
7083.41
6114.41
BUDGET: DISTRICT HEALTH PLANS
Page 105
FMR Code B7
Activity District Plans Save the Girl child scheme (new) Sub-total
Unit Cost Physical (wherever target/ Amount applicable) Deliverables Proposed
20.00 20.00
20.00 Approved 20.00
BUDGET: PPP/ NGOS FMR Code B13 B13.2 Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved
Activity PPP /NGOs Pilot Project on Management of Children affected with Muscular Dystrophy Disorder Palliative care (new) includes setting-up of Palliative care centers for 25.6 lakh in each district including drugs and support services, training, IEC activity and incentives to VHVs. Anaemia Control Programme by PPP mode - (new) - to be run with DHAN Foundation in 50 blocks of the State Home Based Newborn Care Project in PPP mode - for identification, referral, follow-up and ensuring survival in low birth babies based on Gadchiroli model Sub-total
Remarks
B13.2.1
125.50
125.50 Approved
B13.2.2
30
5 districts
150.00
150.00 Approved
B13.2.3
100.00
100.00 Approved
B13.2.4
3200 per VHV
1500
72.00 447.50
72.00 Approved 447.50
Page 106
BUDGET: INNOVATIONS FMR Code B14 Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved
Activity INNOVATIONS Quality Management System in Public Health Care (new)
Remarks
B14.1
B14.1.1 State level B14.1.2 District level B14.1.3 Grading of PHCs sub-total Quality Management System Strengthening of Dental Services (ongoing)
0.00 0.00 0.00 0.00
0.00 0.00 0.00 0.00
B14.2
Establishment and operation of 65 new B14.2.1 dental units Operation cost for 230 B14.2.2 existing dental units sub-total Accreditation of Government Hospitals B14.3 (new) B14.3.1 Non recurring B14.3.2 Recurring sub-total Congenital and Developmental B14.4 Defects (new) Congenital and Developmental Defects and Follow Up B14.4.1 - Phase I Congenital and Developmental B14.4.2 Defects and Follow Up
65 230
271.70 396.05 921.95
271.70 Approved 396.05 Approved 667.75
350000
78
226.75 52.50 279.25
126.32
126.32 Approved
300.00
FMR Code
Activity - Phase II
Remarks
Congenital and Developmental Defects and Follow Up B14.4.3 - Phase III Sub-total Screening for oral Cancer in Tamil Nadu B14.5 (new) Prevention and Control of Silicosis B14.6 (new) Sub - Total innovations
56.42 731.42
56.42 Approved 356.42
300.00
300.00 Approved
23.83 2256.45
23.83 Approved 1627.25
BUDGET: IMPACT ASSESSMENT OF NRHM FMR Code Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved Remarks
B20
Activity Impact Assessment of NRHM Component Impact assessment of NRHM and various components (new) Sub-total
20.00 20.00
BUDGET: STATE HEALTH SYSTEMS RESOURCE CENTRE FMR Code Unit Cost Physical (wherever target/ Amount Amount applicable) Deliverables Proposed Approved Remarks
B21
Activity State Health Systems Resource Centre Capacity building for State Health Systems Resource
100.00
FMR Code
Activity Centre
Sub-total BUDGET: SUPPORT SERVICES FMR Code B22
100.00
100.00
Activity Support Services Support for B22.3 NVBDCP
770.88
B22.4 Support for RNTCP Other NDCP support B22.6 programmes IDSP Establishment of 24 District Public Health Laboratories Operational cost existing 6 DPHL
99.91
577.00 Approved Activities: a) State level logistics for STDC / IRL / SDS, Furnishing of STDC for training. RNTCP. Approved amount: 6,08,000 Comment: May be approved as there is no provision in RNTCP b) NGO Payment (Pending payment) Approved Amount: 93,83,400 Comment: May be approved. Pendency of payment is seriously affecting NGO involvement in Tamil 99.91 Nadu
1788000 816000
24 6
429.12 65.28
Approved by IDSP 429.12 Division Approved by IDSP 65.28 Division
Page 109
FMR Code
Activity Provision New Computers for existing DSUs & Medical Colleges Inclusion of Urban Surveillance in Major Corporations Training programme on epidemic prevention, control, investigation and management under NRHM NLEP - NRHM Internet facilities at districts Total
64.17
0.00 Not approved
845000
8.45
0.00 Not approved
111312
22
24.49
0.00 Not approved Approved as recommended by the 2.00 division 1173.31
25
2.00 1464.30
Page 110
NATIONAL DISEASE CONTROL PROGRAMMES (NDCP)
Page 111
NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP)
TARGETS: Bring the prevalence of IDD to below 5% by 2017 To ensure 100% consumption of adequately iodated salt (15ppm) at the household level. ROAD MAP FOR PRIORITY ACTION (NIDDCP) Establishment of State IDD Cell for implementation programme activities. Establishment of State IDD monitoring laboratory for conducting quantitative analysis of iodated salt and urine for iodine content and urinary iodine excretion. All the sanctioned posts i.e. Technical Officer, Statistical Assistant, LDC/DEO, Lab Technician and Lab Assistant of State IDD Cell and State IDD Monitoring Laboratory filled on regular/contractual basis. Supply, availability and consumption of adequately iodated salt in the state monitored. District IDD survey/re-surveys undertaken as per NIDDCP guidelines to assess the magnitude of IDD in the respective districts as approved in the PIP and reports accordingly submitted. Use of Salt testing kits by ASHA/Health Personnel in the endemic districts for creating awareness & monitoring of iodated salt consumption at household level monitored and monthly reports submitted as per the prescribed proforma. ASHA incentives Rs. 25/- per month for testing 50 salt samples per month in endemic districts made available on regular basis to ASHA. Health education and publicity conducted with more focus in the endemic districts with emphasis on IDD and promotion of consumption of adequately iodated salt. Global IDD Celebrations on 21st October conducted and report submitted. State Govt to complete IDD Survey of four districts and send the reports.
Page 112
DETAILED BUDGET: (Rs. In lakhs) Remarks
FMR Code
Activity
Unit cost (wherever applicable)
Physical target
Amount Proposed
Amount Approved
D D.1
IDD Establishment of IDD Control CellImplementation & monitoring of the programme 1 1 10.00 10.00
The sanctioned vacant posts i.e. Statistical Assistant & LDC should be filled up on regular/contract basis on priority. State Govt. may conduct and coordinate approved programme activities and furnish quarterly financial & physical achievements as per prescribed format.
D.1.a D.1.b
Technical Officer Statistical Assistant LDC Typist
D.1.c
D.2
Establishment of IDD Monitoring Lab-
Monitoring of district level iodine content of salt and urinary iodine excretion as per Policy Guidelines. 1 1
5.00
The sanctioned posts of Lab Technician & Lab Asst. should be filled up on regular/ contract basis on priority. State Govt. may conduct quantitative analysis of salt & urine as per NIDDCP Guidelines and furnish
D.2.a D.2.b
Lab Technician Lab. Assistant
Page 113
FMR Code
Activity
Physical target
Amount Proposed
Amount Approved
Remarks
monthly/quarterly statements. D.3 Health Education & Publicity Increased awareness about IDD and iodated salt. 21.00 7.00 IDD publicity activities including Global IDD Day celebrations at various level. State. Govt. may under take 4 districts IDD survey as per guidelines and furnish report. State Govt. to monitor the qualitative analysis of iodated salt by STK through ASHA in 21 endemic districts i.e. Trichrapalli Dindigul, Madurai, Coimbatore, Ramananthapuram , The Nilgiris, Thiruvarur, Salem, Virudhnagar, Villupuram, Kanyakumari, Dharmapuri, Pudukottai, Namakkal, Nagapattanum, Erode, Perambalur, Tuticoran, Approval of Programme Implementation Plan Tamil Nadu 2012-13 Page 114
D.4
IDD Survey/Resurveys
Rs. 50,000 per district
4 districts
10.50
2.00
D.5
Salt Testing Kits supplies by GOI inform of kind grant for 21 endemic districts ASHA Incentive
12 STK per annum per ASHA
Creating iodated salt demand and monitoring of the same at the community level. 50 salt samples per month per ASHA in 21 endemic districts 19.17
D.6
Rs. 25/- per month for testing 50 salt samples/ month
FMR Code
Activity
Physical target
Amount Proposed
Amount Approved
Remarks
Thanjavur, Chennai, Cuddlore TOTAL 47.50* 43.17
Including Rs. 5.00 lakh for mobility and Rs. 1.00 lakh for procurement of equipment which are not allowed under the programme.
(*) The total fund proposed includes printing, supply of Health workers manual on NIDDCP, formats & reports,g lab consumable, organisation of workshops/seminars/meetings which are not allowed under the Programme.
Page 115
INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP)
ROAD MAP FOR PRIORITY ACTION: There are 32 vacant posts of technical contractual staff (31 Epidemiologists, 1 Entomologist) under IDSP in the State as on March 2012. The State needs to expedite the recruitment of these staff by September 2012. The training of Master trainers (ToT) and 2-week FETP for District Surveillance Officers under IDSP has been completed for the State/Districts. However, the State may give the additional list of participants to be trained for ToT and 2-week FETP. Presently only 81% of all the Reporting Units are reporting weekly surveillance data in Pform through IDSP Portal. The State needs to ensure regular weekly reporting of all surveillance data (S, P, L) by all the Reporting Units of all Districts through IDSP Portal. The State has to ascertain regular reporting from all districts in 2012-13.
The State has to ensure consistent reporting of L form in portal by the district priority labs at Cuddalore and Ramanthapuram. The Referral Lab Network needs to be utilized for etiological confirmation of epidemic prone diseases. Appropriate clinical samples need to be sent for the required lab investigations for more number of disease outbreaks. In 2011, clinical samples were sent for laboratory investigation for only 72% of the disease outbreaks in which 31% were lab confirmed. The State needs to send full investigation report for each disease outbreak. Presently, such investigation reports are available for only a few outbreaks. Reply of state on Observations made by auditors for 2010-11 is pending. In few districts the separate Fixed Assets Register of IDSP is not maintained. State has to ensure timely submission of quarterly Financial monitoring Report and annual audit report.
Page 116
DETAILED BUDGET: FMR Code Activity Unit Cost (whereever applicable) Amount Amount Proposed (Rs. in Approved lakhs) (Rs in lakhs) Comments
E.1 E.1.4
Operational Cost Field Visits 78.144 (4.22 78.15 Rs 2,40,000 [SSU] + 59.276 Office Expenses Broad Band per District [DSU] + 4.088 Surveillanc [Newly Formed expenses e Unit per Districts] + 10.56 Outbreak investigations annum [Medical including Collection Colleges]) and Transport of Rs 5,00,000 samples State Review Meetings Surveillanc e Unit per annum Sub 78.15 78.15 The operational cost for Medical Colleges will be borne by the district where they are located.
E.1.3
Total Laboratory Support District Priority Lab Rs. 4,00,000 per district priority lab per annum Referral Network Rs. Lab 5,00,000 per referral lab per annum District Public Health Rs. Labs* 2,00,000 per annum for consumabl es Sub Total Human Resources Remuneration Epidemiologists 8.00 (4.00 2) 8.00 (4.00 2)
40.00 (5.00 8)
40.00 (5.00 8)
29.52 (for 6 0.00 District PH Labs)
Funds will be approved once the labs are functional.
77.52
48.00
E.2 E.2.1
of Rs.25,000 - 153.60 ([40,000 153.60 Rs. 40,000/ 2 12] + ([40,000 2 per month [40,000 30 12] + Page 117
FMR Code
Activity
Unit Cost (whereever applicable)
Amount Amount Proposed (Rs. in Approved lakhs) (Rs in lakhs) 12]) [40,000 30 12])
Comments
E.2.2
Remuneration Microbiologists
E.2.3
Remuneration Entomologists Veterinary Consultant
of Rs. 25,000 Rs. 40,000 (Medical Graduates) Rs. 15,000 Rs. 25,000 (Others) of Rs. 15,000 Rs. 25,000 Rs. 25,000 Rs.40,000 Rs. 14,000
27.00 ([25,000 27.00 3 12] + [25,000 ([25,000 3 6 12]) 12] + [25,000 6 12])
3.00 (25,000 1 3.00 (25,000 12) 1 12) 4.80 (40,000 1 0.00 12) 1.68 (14,000 1 12) 3.36 (28,000 1 12) 51.90 ([14,000 1 12] + [13,500 31 12]) 49.98 (8,500 49 12) 290.52
E.3 E.3.1 E.3.2
Consultant-Finance/ Procurement Consultant-Training/ Technical Data Manager
1.68 (14,000 1 12) Rs. 28,000 3.36 (28,000 1 12) Rs. 14,000 51.90 ([14,000 (State) 1 12] + [13,500 Rs. 13,500 31 12]) (District) Rs. 8,500 Sub 49.98 (8,500 49 12) 295.32
E.3.3
Data Entry Operator
E.8
Total Training
As per NRHM Guidelines
One day training of Hospital Doctors
One day training of Hospital Pharmacist / Nurses
One day training of Medical College
Rs. 5.617 lakhs (for 32 batches [640 persons] @ Rs. 17555/- per batch) Rs. 10.1312 lakhs (for 64 batches [1280 persons] @ Rs. 15830/per batch) Rs. 2.38 lakhs Rs. 1.60 (for 16 batches lakhs (for 80
Training of RRT is undertaken by Central Unit. Rs. 1.10 Surveillance lakhs (for Additional List of trainees 100 persons may be sent to CSU. @ Rs. 1100/per person) Rs. 3.75 lakhs (for 500 persons @ Rs. 750/per person)
Page 118
FMR Code
Activity
Amount Amount Proposed (Rs. in Approved lakhs) (Rs in lakhs) [336 persons] @ Rs. 14875/- per batch) Rs. 15.20 lakhs approx (for 96 batches @ Rs. 15830/per batch) Rs. 2.28 lakhs approx (for 13 batches @ Rs. 17555/per batch) Rs. 0.79 lakhs approx (for 5 batches @ Rs. 15830/per batch) 36.39925 persons @ Rs. 2000/per person) Rs. 3.00 lakhs (for 300 persons @ Rs. 1000/per person) 0.00
Comments
Doctors
One day training for Data Entry and analysis for Block Health Team Rapid Team Response
One day training of DM & DEO
Sub E7 Total ID Hospital Network
Rs. 0.75 lakhs (for 50 persons @ Rs. 1500/per person) 10.20 3.00 (1 3.00)
Rs. 3.00 (1 3.00) 3,00,000/per annum for IDH Surveillance in Rs. 14.56 Metro Cities 10,000,00 /per annum per metro city New formed Rs. 3,50, 7.00 (3.50 2) Districts 000/- per newly formed district Total 511.95
10.00
7.00 (3.50 The amount to be utilized 2) for procurement of ICT equipments under IDSP as per program guidelines. 446.87
Page 119
Proposal under Additionalities FMR Code Activity Unit Cost (where-ever applicable) 17.88 Amount Proposed 429.12 Amount Approved 429.12 Comment
Establishment of 24 District Public Health Laboratories
Operational DPHL
cost
existing
8.16
65.28
65.28
Provision of New Computers for Existing DSUs & Medical Colleges AND provision of 1 Data Entry Operator & Computer with Accessories for 12 Addl. HUDs Budget under NRHM support for provision of Data Entry Operator & New Computer with Accessories for 5 Major Corporations Training programme on epidemic prevention, control, investigation and management under NRHM TOTAL
64.17
May be approved; Procurement of equipment and civil works may be done as per NRHM guidelines. May be approved; Procurement of equipment and civil works may be done as per NRHM guidelines. Not Approved
8.45
8.45
Not Approved
24.49
Not Approved .
591.51
494.40
# FMR Code not allotted. Comments: 1. The following heads will be approved / modified once approval from EFC is obtained. Remuneration of Veterinary Consultant @ Rs. 25,000 - Rs.40, 000. 2. Based on past trend, Rs 110.00 lakhs has been approved for Tamil Nadu State under IDSP for 2012-13. However, if there is increase in expenditure by State as per IDSP approved norm, the budget for State could be increased at RE stage
Page 120
NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME
ROAD MAP FOR PRIORITY ACTION:
State Specific Goal Sr. No. 1 Physical Targets Indicator Annual Blood Examinate Rate (ABER) i.e. % of population screened annually for Malaria Annual Parasite Incidence (API) i.e. Malaria cases per 1000 population annually Sentinel Surveillance Hospital made functional for Dengue & Chikungunya Sentinel Surveillance Hospital made functional for JE 2010 11.44% 2011 11.42% 2012 <11% Remarks
0.25
0.32
0.3
13
27
30
No. of districts with less than 1% Mf rate
20
20
7 2 additional sentinel sites proposed are already functioning for dengue & chikungunya. Their functionality needs to be ensured for JE also 20
Priority Area for Focussed Attention 1 2 3 Malaria in Rameshwaram Island and Chennai need to be contained. JE affected areas like Trichy, Thiruvallur,Thiruvarur and Madurai need attention. Mf rate has been continuously below 1% hence validation process to be started.
Essential Conditionality 1 Two review meetings in a year under the Chairmanship of Principal Secretary (Health)/Mission Director may be conducted - one before transmission period and second during transmission period. Page 121
DesirableConditionality 1 The proposal for recruitment of regular human resource like regular MPW and Lab Technician required for NVBDCP should be initiated by end of 1st quarter. Post 1 Multipurpose Health Supervisor (Male) MPWs District wise goals (To be done by State) Name of Districts 1 2 3 Road Map: Surveillance & monitoring under NVBDCP is done throughout the year. Following salient points are to monitor the implementation of programme activities in different quarters. April to June - 1st round spraying and observance of anti-malaria month to be ensured and accordingly funds availability at districts to be ensured July to Sept. - 2nd round of spray and observance of anti-dengue month. Preparatory activities for stoppage of Mass Drug Administration towards filaria elimination to be started. Oct. to Dec.-Review and Monitor physical and financial performance and preparation of next annual plan. Jan. to March - Consolidation of previous year's physical and financial achievement and plan for next year. Sanctioned 5700 In Vacant position 3101 Target for 2012-13
2605 Priority to be accorded for filling of these posts
Sr. No.
ABER 2011 2012
API 2011 2012
Deaths 2011 2012
Mf Rate 2011 2012
Page 122
BUDGET: Sr.No. Component Unit Cost Physical (wherever target/ applicable) Deliverables Amount Proposed Amount Approved Remarks
F.1 F.1.1 F.1.1.a F.1.1.a.i F.1.1.a.ii F.1.1.a.iii F.1.1.a.iv
F.1.1.b F.1.1.c. F.1.1.c.i F.1.1.c.ii F.1.1.c.iii F.1.1.d
F.1.1.e
DBS (Domestic Budgetary Support) Malaria Contractual Payments MPW contractual Lab Technicians ( against vacancy ) VBD Technical Supervisor (one for each block) District VBD Consultant (one per district) (NonProject States) State Consultant (Non Project States), - VBD Consultant (preferably entomologist) ASHA Incentive Operational Cost Spray Wages Operational cost for IRS Impregnation of Bed nets- for NE states Monitoring , Evaluation & Supervision & Epidemic Preparedness including mobility IEC/BCC
9.99
15.00
97.82
75.00
29.69
35.00 may be used for other VBDs activites
F.1.1.f
F.1.1.g
PPP / NGO and Intersectoral Convergence Training / Capacity Building
22.31
35.00 may be used in an integrative manner for other VBDs also
F.1.1.h F.1.1.i
Zonal Entomological units Biological and Environmental Approval of Programme Implementation Plan Tamil Nadu 2012-13 Page 123
Sr.No.
Component
Unit Cost Physical (wherever target/ applicable) Deliverables
Amount Proposed
Amount Approved
Remarks
Management through VHSC F.1.1.j Larvivorous Fish support Total : Malaria F.1.2 Dengue and Chikungunya F.1.2.a Strengthening surveillance (As per GOI approval) F.1.2.a(i) Apex Referral Labs recurrent F.1.2.a(ii) Sentinel surveillance Hospital recurrent F.1.2.a(iii) ELISA facility to sentinel surveillance labs F.1.2.b Test kits (Nos.) to be supplied by GoI (kindly indicate numbers of ELISA based NS1 kit and Mac ELISA Kits required separately) F.1.2.c Monitoring and evaluation F.1.2.d Epidemic containment F.1.2.e Case management F.1.2.f Vector control & environmental management F.1.2.g IEC BCC for Social Mobilization F.1.2.h Inter-sectoral convergence F.1.2.i Training including operational research Total : Dengue/Chikungunya F.1.3 AES/JE F.1.3.a Diagnostics and Case Management F.1.3.b IEC/BCC specific to J.E. in endemic areas F.1.3.c Capacity Building
159.81
160.00
21.37
29.00
0.00
178.82
171.00
Funds allocated as per Mid Term Plan strategy. State to implement as per guidelines of Mid Term Strategy.
200.19
200.00
66.04 48.87 3.94
120.00 10.00 10.00 Page 124
Sr.No.
Component
Amount Proposed
Amount Approved
Remarks
F.1.3.d F.1.3.e F.1.3.f F.1.3.g F.1.3.h F.1.3.i
F.1.3.j F.1.3.k F.1.3.l
F.1.4 F.1.4.a
F.1.4.b F.1.4.c
Monitoring and supervision Technical Malathion Fogging Machine Operational costs for malathion fogging Operational Research Rehabilitation Setup for selected endemic districts ICU Establishment in endemic districts ASHA Insentivization for sensitizing community Other Charges for Training /Workshop Meeting & payment to NIV towards JE kits at Head Quarter Total : JE Elimination of Lymphatic Filariasis State Task Force, State Technical Advisory Committee meeting, printing of forms/registers, mobility support, district coordination meeting, sensitization of media etc., morbidity management, monitoring & supervision and mobility support for Rapid Response Team and contingency support Microfilaria Survey (Night Survey) Monitoring & Evaluation (Assessment)/by Medical College/ Regional Institutions
4.39 36.76 0.00 0.00 0.00 0.00
10.00 10.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00
160.00
160.00
53.00
53.00
10.00 3.00
10.00 3.00
Page 125
Sr.No.
Component
Amount Proposed
Amount Approved
Remarks
F.1.4.d
F.1.4.e
F.1.4.f
F.1.4.g
F.1.4.g.i F.1.4.g.ii F.1.4.g.iii F.1.4.h
F.1.4.i F.1.5 F.1.5 F.1.5.a F.1.5.b
F.1.5.c F.1.5.d F.1.5.e F.1.5.f
F.2 F.2.a
Training of District Officers, PHC MOs, Paramedical staff, drug distributors etc. Specific Advocacy/IEC/BCC including centre, state, district/PHC, sub centre Honorarium for Drug Distribution including ASHAs and supervisors Verification and validation for stoppage of MDA in LF endemic districts a) Additional MF Survey (Night Survey) b) ICT Survey c) ICT Cost Verification of LF endemicity in nonendemic districts Post-MDA surveillance Total : ELF Kala-azar Case search/ Camp Approach Spray Pumps & accessories Operational cost for spray including spray wages Mobility/POL/supervision Monitoring & Evaluation Training for spraying IEC/ BCC/ Advocacy Total Kala-azar Total (DBS) Externally aided component World Bank support for
21.00
21.00
84.00
74.00
14.00 30.00 15.00
14.00 30.00 15.00
0.00 230.00
0.00 220.00
Not Not Applicable Applicable
0.00 750.00
0.00 740.00
Page 126
Sr.No.
Component
Amount Proposed
Amount Approved
Remarks
F.2.b F.2.c F.2.d
F.2.e F.2.f F.2.g F.3 F.3.a
F.3.b F.3.c
F.3.d
F.3.e
Malaria Human Resource Training /Capacity building Mobility support for Monitoring Supervision & Evaluation including printing of format & review meetings, Reporting format (for printing formats) Kala-azar World Bank assisted project Human resource Capacity building Mobility GFATM support for Malaria Project Management Unit including human resource of N.E. states Training/Capacity Building Planning and Administration( Office expenses recurring expenses, Office automation , printing and stationary for running of project) Monitoring Supervision (supervisory visits including travel expenses, etc) including printing of format and review meetings, IEC / BCC activities as per the project
Page 127
Sr.No.
Component
Amount Proposed
Amount Approved
Remarks
F.3.f
F.4 F.5
F.6
F.6.a F.6.b F.6.c F.6.d F.6.e F.6.f F.6.g F.6.h
F.6.i
F.6.j F.6.k F.6.l F.6.m
Operational cost for treatment of bednet and Infrastructure and Other Equipment (Computer Laptops, printers, Motor cycles for MTS ) Total : EAC component Any Other Items ( Please Specify) Operational costs ( mobility, Review Meeting, communication, formats & reports) Grand Total for cash assistance under NVBDCP Assistance required for decentralized commodities Chloroquine tablets Primaquine 7.5 mg tablets Primaquine 2.5 mg tablets Quinine sulphate tablets Quinine Injections DEC 100 mg tablets Albendazole 400 mg tablets NS1 Dengue Ag Kit (ELISA based) under Dengue/Chikungunya Temephos, Bti (AS) / Bti (wp) (for polluted & non polluted water) Pyrethrum Extract 2% ACT ( For Non Project states) RDT Malaria bi-valent (For Non Project states) Any Other Items ( Please
0.00 0.00 0.00
0.00 0.00 0.00
750.00
740.00
1.16 2.50 0.00
200.00
30.53
132.70 1.11
Page 128
Sr.No.
Component
Amount Proposed
Amount Approved
Remarks
Specify) Total for Decentralized Commodities Grand Total for grant-inaid under NVBDCP Commodity Grants Total NVBDCP Cash + Commodity Cash Assistance required under NRHM Flexi Fund Proposal for Anti Malaria activity in Rameswaram Island, Ramanathapuram District Contractual Mazdoors for IRS & Anti larval operation in Malaria in Endemic District 28.20 28.00 168.00 918.00 0.00 918.00 200.00 940.00
940.00
19.12
19.00
60.00
Tent-type mosquito Net for Rameswaram Island Wages for Temporary mazdoors in Rameswaram Island Scrub Typhus Vector control activity with less than 1 lakh population Purchase of Bti. for vector control activities under NFCP
8.24
0.00 May be met from state resources as an innovative trial considering the feasibility of use of nets being a seashore area with heavy sea breeze during evening. 8.00
122.24 222.03
0.00 Not under NVBDCP 222.00
311.05
300.00 Should be shown under decentralized commodity, however, may be Page 129
Sr.No.
Component
Amount Proposed
Amount Approved
Remarks
approved from NRHM additionality as this year's proposal Total under NRHM Flexi Fund 770.88 577.00
Page 130
NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) TARGETS FOR 2012-13:
S.No
1 2 3 4 5 6 7 8 9 10
Goals & Target

Elimination at Sate level Elimination at District level Case detection through ASHA Special activity plan in 6 blocks MCR footwear procurement & supply RCS Development of leprosy expertise Treatment Completion Rate assessment for 2011-12 Audited Report for the year 2011-12 Expenditure incurred against approved plan budget
September'12
NA NA 500 6 Blocks 7500 55 50% of Plan Completed Completed 50%
March 2013
NA NA 1000 Complete 6 Blocks 15700 110 100% of Plan 100%
Page 131
DETAILED BUDGET: (Rs. In Lakh) FMR code G 1. G 1.1 G1.1 a G 1.2 G2 Activity proposed Improved early case detection Incentive to ASHA Sensitization of ASHA Specific -plan for High Endemic Distrcts Improved case management DPMR Services, (MCR footwear, Aids and appliances, Welfare allowance to BPL patients for RCS, Support to govt. institutions for RCS) Urban L:eprosy Control, (Mega city - 1 , Medium city (1) -4 , Med. City (2)-1 Township -22) Unit Cost (In Rupees) Physical Targets Amount proposed Amount approved Remarks
MB PB 1D
500 300 50 1.92/block
400 600 6 blocks
7.50 6.00 140.16
2.00 1.80 11.52
G 2.1
MCR - 250/Aids/Applian ce -12500 Welfare/RCS - 10,000 Meg -280000 Med (1)120000 Med. (2) 236000 Town 57000
15700 30 110
47.10 7.20 11.00
39.25 3.75 11.00
G 2.2
1 4 1 22
5.60 9.60 4.72 25.08
2.80 4.80 2.36 12.54
G 2.3
Material & Supplies Supportive drugs, lab. reagents & equipments and printing works NGO - SET Scheme Stigma Reduced Mass media, Outdoor media, Rural media, Advocacy media Development of Leprosy Expertise sustained Training of new MO Refresher training of MO Training to New H.S/H.W. Other training 50,000 30 30.00 15.00 52,000 30 24.00 15.60
G 2.3 a G 2.4 G3
500000
G 3.1 G 4. G 4.1 G 4.2 G 4.3 G 4.4
60000 40000 30000 30000
900 1200 150
29.80 20.16 2.52
12.00 12.00 1.50
As NLEP rates are very low, higher rates agreed in keeping with other programmes
Page 132
FMR code G 4.5 G 4.6
Activity proposed Physiotherapist Training to Lab. Tech. Management training for District Nucleus Team Monitoring, Supervision and Evaluation System improved Travel Cost and Review Meeting travel expenses Contractual Staff at State level travel expenses Contractual Staff at District level Review meetings Office Operation & Maintenance Office operation - State Cell Office operation - District Cell Office equipment maint. State Consumables State Cell District Cell Vehicle Hiring and POL State Cell District Cell Programme Management ensured Contractual Staff at State level SMO BFO cum Admn. Officer Admn. Asstt. DEO Driver Contractual Staff at Disrrict level 1 1 1 1 1
Unit Cost (In Rupees) 30000 30000
Physical Targets 300 150
Amount proposed 5.04 5.40
Amount approved 3.00 1.50
Remarks
G 5. G 5.1
70000
1.00
0.70
G 5.1 i
15000
30
7.50
4.50
G 5.1 ii G 5.1 iii G 5.2 G 5.2 i G 5.2 ii G 5.2 iii G 5.3 G 5.3 i G 5.3 ii G 5.4 G 5.4 i G 5.4 ii G 6. G 6.1 G 6.1 i G 6.1 ii G 6.1 iii G 6.1 iv G 6.1 v G 6.2
25000
2.00
1.00
38000 18000 30000
1 30 1
0.75 10.50 0.50
0.38 5.40 0.30
28000 14000 85000 75000
1 30 2 vehicle 30
0.50 9.00 2.00 45.00
0.28 4.20 1.70 22.50
40000 30000 16000 12000 11000
x12 x12 x12 x12 x12
4.80 3.60 1.92 1.44 1.32
4.80 3.60 1.92 1.44 1.32
Page 133
FMR code G 6.2 i G 6.2 ii G 7.
Activity proposed Driver Contractual Staff in selected States, NSM Others Travel expenses for regular staff for specific programme / training need, awards etc TOTAL Additionality in Annual Plan NRHM - Internet facilities at dsitricts WHO/ILEP/ICMR/Others 15
Physical Targets x12
Amount proposed 21.12 -
Amount approved 19.80 -
Remarks
2.00 493.83 228.26
G 7.1
Added as essential requirement
25
2.00
2.00
Page 134
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB)
ROAD MAP FOR PRIORITY ACTION:
1. The emphasis will be on primary health care all vision centers will be established 2. 3. 4.
immediately after receipt of grant with PMOA is in position to facilitate eye care delivery at the primary health centre. Eye Bank to be established only in Government Hospital and Government Medical College. The names and address may be furnished in the reports submitted to GOI. The amount will not be split up to more than 1 eye bank. Management of Health Society be restricted within Rs.14 lakh only. Payment of Rs.750/- will be made to NGO per operated case if the NGO has used all facilities of their own like Drugs & Consumables, Sutures, Spectacles, Transports/POL, organization and publicity and IOL, Viscoelastics & addl. Consumables including their own Eye Hospital and Doctors. For organizing and motivating identified persons & transporting them to Govt. / NGO fixed facilities, the NGO would be eligible for support not exceeding Rs.175/- per operated case. (Transport/POL and organization & publicity.) No payment will be released towards reimbursement to be made to NGOs w.e.f. 01.04.2012 if data entry on Management Information System (MIS) is not completed by them. Full details of the NGO funded be provided including the facilities created and the free operations being done by them in lieu thereof. The amount will be released for only one NGO and amount will not be split up into more than one NGO.
5. 6. 7.
Page 135
Budget: NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS GRANT-IN-AID TO STATES/UTS FOR VARIOUS Physical Target Funds Requested Funds Approved As Per Guidelines Remarks
Sl.No. H1 H 1.1
Recurring Grant-in-aid For Free Cataract Operation @ Rs.750/- per case 650000 NGO-500000 1000 50000 385 3750.00 2114.00 Approved on reimburseme nt basis Approved Approved Not Approved Approved Approved Not approved Approved Approved Approved for PMOA and MIS training for 1 time Approved for 1 lac per distt. and 2 lac for state Through NRHM flexipool Approved Through NRHM flexipool Approved for 1 MC Approved for 10 Vision Centre
H 1.2 H 1.3 H 1.4 H 1.4 H 1.5
Other Eye Diseases@ Rs.1000/School Eye Screening Programme@ Rs.200/- per case Blindness Survey Private Practitioners @as per NGO norms Management of State Health Society and Distt. Health Society Remuneration (salary , review meeting, hiring of vehicle and Other Activities & Contingency) @ Rs.14 lakh/ Rs.7 lakh depending on the size of state Recurring GIA to Eye Donation Centers @ Rs.1000/per pair Eye Ball Collection by Eye Bank @ Rs.1500/- per pair Training PMOA and MIS training
10.00 100.00 577.50 5.00 14.00 128.00
10.00 100.00 0 5.00 14.00 0.00
SBCS-1 DBCS-32 (2 new distt. formed) 200 eye 6000eyes 404
H 1.6 H 1.7 H 1.9
1.00 45.00 50.00
1.00 45.00 15.00
H 1.10
IEC, Eye Donation Fortnight, World Sight Day & awareness programme in state & districts etc
32 lump sum for the state
10.00
31.00
H 1.11
Procurement of Ophthalmic Equipment (foldable IOL @ Rs.500 per IOL) Maintenance of Ophthalmic Equipments Non Recurring Grant-in-aid For RIO (new services Lasik) Starting new zonal centres@Rs.40 lakh For Medical College@ Rs.40 lakh For vision Centre @ Rs.50000/-
15 Medical College@1000 per annum
75.00
H 1.12 H.2 H.2.1
6.00 1 5 2 10 200.00 200.00 80.00 5.00
6.00 0
H.2.2 H.2.3
40.00 5.00
Page 136
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS GRANT-IN-AID TO STATES/UTS FOR VARIOUS
Physical Target
Funds Requested
H.2.4
For Eye Bank @ Rs.15 lakh
30.00
Funds Approved As Per Guidelines 15.00
Remarks
H.2.5 H.2.6 H.2.7
For Eye Donation Centre @ Rs.1 lakh For NGOs @ Rs.30 lakh For Eye Wards and Eye OTS @ Rs.75 lakh
2.00 0.00 150.00
1.00 0.00 0.00
Approved for 1 Eye Bank in Govt. Hospital Approved for 1 EDC Through NRHM flexipool
H.2.8
H.3 H.3.1 H.3.2 H.3.3
0.00 0.00 0.00 0.00 0.00 0.00 5484.00 2447.00 * The unutilized funds in any of the above said recurring components may be used in any other recurring component.
For Mobile Ophthalmic Units with tele-network @ Rs.60 lakh Grant-in-aid for strengthening of Distt. Hospitals @ Rs.20 lakh Grant-in-aid for strengthening of Sub Divisional. Hospitals@ Rs.5 lakh Contractual Man Power Ophthalmic Surgeon@ Rs.25000/- p.m Ophthalmic Assistant @ Rs.8000/- p.m Eye Donation Counsellors @ Rs.10000/- p.m.
0.00 2 1 40.00 5.00 40.00 5.00 Approved Approved
15 20 20
Page 137
REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME TARGETS Target for Annualized New Smear Positive Case Detection rate per lakh population (April 2012 to September 2012 ) 60% Target for Annualized New Smear Positive Case Detection rate per lakh population (October 2012 to March 2013 ) 70% Target for Target for Treatment Treatment Success rate Success rate (April 2012 to (October 2012 to September 2012 ) March 2013 ) 86% 88%
ROAD MAP FOR PRIORITY ACTION: S.No 1 Indicators Annual Suspects Examined Per Lakh Population Annual Smear Positive Case Notification Rate (%) Treatment Success Rate among new smear positive cases Default Rate among New Smear Positive TB cases Treatment Success rate among Smear Positive Re-treatment cases 2011 234 2012 234
60%
70%
86%
88%
6%
4%
60%
85&
Conditionality: All the Key RNTCP contractual staff positions at State/Districts should be filled and ensuring timely payment of salaries The State level RNTCP review meetings to be chaired by Health Secretary/Mission Director (NRHM) at least once in a quarter To conduct State TB control society meeting, State Coordination committee meeting (TBHIV) atleast once in a quarter Scaling up of DOTS Plus services as per the State DOTS Plus action plan Conduct ACSM/Training activities at State/Districts as per the State annual action plan To involve Private Practitioners and NGOs in the RNTCP Timely payment of DOT Providers honorarium at Districts Strengthening Supervision and Monitoring at all levels The state could be approved more funds based on expenditure pattern in the first six months Page 138
BUDGET: RNTCP
FMR Code
Activity
Unit cost (wherever applicable) As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP
Physical target/ expected output
Estimated Budget
Approved Budget
Remarks
I.1
Civil works
1) Civil work Up gradation and maintenance completed as planned 56.11 1) Sputum of TB Suspects Examined per lac population per quarter; 2) All districts subjected to IRL On Site Evaluation and Panel Testing in the year; 3) IRLs accredited and functioning optimally 56.11
Approved 100%. Approved 3 DOTS Plus sites, new constriction of DTC
I.2
Laboratory materials
Approved 65% of the amount.
136.40
90.00
I.3.a
Honorarium
As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP
1) All eligible Community DOT Providers are paid honorarium in all districts in the FY 77.87 1) All IEC/ACSM activities proposed in PIP completed; 2) Increase in case detection and improved case holding 31.15
Approved amount based on the utilization.
I.4
IEC/ Publicity
68.41
Approved amount based on the utilization. The remuneration for the 6 communication facilitators should be 40.61 met from this head. Page 139
FMR Code
Activity
Unit cost (wherever applicable) As per Revised Norms and Basis of Costing for RNTCP
Estimated Budget
Approved Budget
Remarks
I.5
Equipment maintenance
1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as planned; 2) All BMs are in functional condition
Approved amount permissible as per the norm. Not approved the proposal for TV and A/C maintenance . 35.66 25.00
I.6
Training
As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP
1) Induction training, Update and Re-training of all cadre of staff completed as planned 1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained
Approved amount permissible as per the norm. 56.17 45.00
I.7
Vehicle maintenance
Approved amount based on the utilization.. 88.50 60.00
1) Increase in supervisory visit of DTOs and MOTCs; 2) Increase in case detection and improved case holding 1) Increase in number of NGOs/PPs involved in signed schemes Approved amount based on the utilization. 115.13 36.00 Approved amount based on the utilization. *If the state is anticipating deficit in 100.00 laboratory capacity to Page 140
I.8
Vehicle hiring
I.9
NGO/PPP support
As per Revised Norms and Basis of Costing for
241.70
FMR Code
Activity
Unit cost (wherever applicable) RNTCP
Estimated Budget
Approved Budget
Remarks conduct C&DST test, then state may budget for funds under C&DST scheme in the NGO /PP head as the RNTCP guidelines for NGO and PPs, as a priority.
of RNTCP; 2) Contribution of NGOs/PPS in case detection and provision of DOT
I.10
Miscellaneous
1) All activities proposed under miscellaneous head in PIP completed 144.95 1) All contractual staff appointed and paid regularly as planned 108.79
Approved amount permissible as per norm.
I.11
Contractual services
1260.71 As per Revised Norms and Basis of 1) All printing activities at state and district level completed as
Approved amount permissible as per norm. The remuneration for communication facilitators, should be met form the amount approved for IEC activities. The salary budgeted for the new TBHVs is approved only for 10 months, considering the delay in approval and appointment. 1182.26 Approved amount based on the 30.00 utilization. Page 141
I.12
Printing
50.85
FMR Code
Activity
Unit cost (wherever applicable) Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP
Estimated Budget
Approved Budget
Remarks
planned
I.13
Research and studies
1) Proposed Research has been initiated or completed in the FY as planned; 2) Funds in the head utilized against approved amount 1) All activities proposed under Medical Colleges head in PIP completed; 2) Funds in the head utilized against approved amount 1) Procurement of vehicles completed as planned; 2) Funds in the head utilized against approved amount
Approved the proposal for studying the prevalence of TB as this is a CTD priority.
20.00
10.00
I.14
Medical Colleges
As per Revised Norms and Basis of Costing for RNTCP
Procurement vehicles I.15
Approved 100% of the budgeted amount
Four wheeler Two Wheeler As per Revised Norms and Basis of Costing for 1) Procurement of equipments completed as planned 23.50 23.50
I.16
Procurement equipment
20.88
10.80
Approved amount permissible as per the norm.
Page 142
FMR Code
Activity
Unit cost (wherever applicable) RNTCP
Estimated Budget
Approved Budget
Remarks
17
Tribal Action Plan Total (A) Additionality funds from NRHM (B) TOTAL (A+B) 2653.08 2105.17
18
99.91
99.91
Rs. 2205.08
Budget approved under NRHM additionalities 2012-13
Activity State level logistics for STDC / IRL / SDS Furnishing of STDC for training. NGO Payment (Pending payment) Grand Total
Proposed amount
Approved amount
Remarks Approved
6.08 93.83 99.91
6.08 93.83 Approved 99.91
Page 143
ANNEXURE
Page 144
Annex 1 DETAILED BUDGET: REPRODUCTIVE AND CHILD HEALTH (RCH FLEXIPOOL)
FMR Code A.1 A.1.1 A.1.1.1
Budget Head MATERNAL HEALTH Operationalise facilities Operationalise FRUs (Operationlisation of Blood storage centres) Fuel charges Camp arrangement
Unit cost
Physical Target
BUDGET (Rs.Lakhs) Proposed Approved
Remarks
A.1.1.1.1 A.1.1.1.2
Rs.15000/ generator Rs.1000/c amp
268 generators 2 camps/385 blocks 20000 cases
40.20 40.20 7.70 7.70
Approved Approved
A.1.1.2 A.1.1.2.1
Operationalise 24x7 PHCs Hiring of specialists Rs.1000/c ase 200.00 0.00 Not approved. Super-specialist services cannot be made available at the Primary level Health facility. Such high risk cases are few in number and should be timely detected and referred. Similarly routine lab facilities should be available in house and for specialized services. The cases can be timely referred.
A.1.1.2.2
Hiring of services
diagnostic
Rs.500/ca se
20000 cases
100.00 0.00
A.1.1.3 A.1.1.4 A.1.1.5 A.1.2 A.1.3
MTP services at health facilities RTI/STI services at health facilities Operationalise Subcentres Referral Transport Integrated outreach RCH services Approval of Programme Implementation Plan Tamil Nadu 2012-13 Page 145
FMR Code A.1.4 A.1.4.1 A.1.4.2 A.1.4.2.a A.1.4.2.b A.1.4.2.c A.1.4.3 A.1.4.4 A.1.4.4.1 A.1.4.4.2 A.1.5 A.1.5.1
Budget Head Janani Suraksha Yojana / JSY Home Deliveries Institutional Deliveries Rural Urban C-sections Administrative expenses Incentive to ASHAs Rural & Urban Tribal Areas Maternal Death Review Regional workshop
Unit cost
Physical Target
Remarks
Rs.500/de livery Rs.700/de livery Rs.600/de livery
500 deliveries 335189 deliveries 140796 deliveries
2.50 2.50
Approved
2346.32 2346.32 844.78 844.78
Approved Approved
159.68 159.68 Rs.200/w oman Rs.200/w oman Rs.150000 /worksho p Rs.10/bull etin/m 67200 women 42400 women 8 workshops 20000 bulletin/m 134.40 84.80
Approved Approved. Shifted from MFP Approved. Shifted from MFP Approved
12.00 12.00
A.1.5.2
Monthly bulletin
24.00 8.00
A.1.5.3
MD audit expenditure
Rs.10000/ death
900 deaths
90.00 0.00
Approved for quartely printing of bulletin and not monthly. Not Approved. Honorarium to experts, POL, and incidental expenses do not conform with GOI Guidelines on MDR. Budget for TA /DA can be utilized out of comprehensive monitoring fund. Honorarium for RCH activities should not exceed its norm.
A.1.6 A.1.6.3
Other strategies/ activities Printing of safe
Rs.10/boo
1500000
150.00 150.00
Approved Page 146
FMR Code
Budget Head motherhood booklet Establishment of JSSK Centre
Unit cost klet 1)Telepho ne 2)Recharg e charges 3) Salary for call centre staff 4)Awarne ss workshop for JSSK 5)Display board
Physical Target booklets 1) Rs.7.25 L 2)Rs.17.40 L 3)Rs.6 L 4) Rs.42 L 5)Rs.67.50 L
Remarks
A.1.6.4
140.15 29.04
A.1.6.5
A.1.6.6 A.1.7.1 A.1.7.1
Funds for Diet and refreshments for High Risk Mothers Incidental expenditure to Staff Nurses Janani Shisu Suraksha Karyakram Drugs and Consumables
Rs.160/m other Rs.100/m other
57000 mothers 57000 mothers
912.00 0.00
1) & 2) Approved for JSSK Grievance redressal at district level @ Rs 6000/m for 12 months x 32 districts = Rs 23.04 lakhs 3) Rs 6.00 lakhs approved at State level Call centre for Salary for Call centre staff of 4 in no. @ Rs 12,500/m x 4 staff for 12 months = Rs.6.00 lakhs 4) IEC should be district specific Can be approved for Rs 1 lakh per district x 32 districts = 32 lakhs. This needs to be shifted to MFP. 5) Not approved. The cost is on higher side. State to plan for comprehensive IEC /BCC for all MH /RCH activities and budget accordingly under IEC. Not approved
57.00 0.00
Not approved
Page 147
FMR Code A.1.7.1.1. 1
Budget Head Drugs and Consumables for Normal Deliveries
Unit cost Rs.350/N D
Physical Target 478000 NDs
BUDGET (Rs.Lakhs) Proposed Approved 1673.00 2677.50
Remarks Approved for 7.65 lakh NDs . Separate approval will not be given for drugs and kits for different levels of facilities. However utilization will be as per differential EDL. Approved for1.35 lakh C-Secs.Separate approval will not be given for drugs and kit However utilization will be as per differential EDLs.
A.1.7.1.1. 2
Drugs and Consumables for Caesarean Deliveries
Rs.1600/C -Sec
91553 CSecs
1464.85 2160.00
A.1.7.2 A.1.7.3 A.1.7.4 A.1.7.4.1
Diagnostic Blood Transfusion Diet Dietry charges for normal delivereis Dietry charges for LSCS delivereis Dietry charges for AN women Referral Transport Pick up of AN mothers Drop back of PN mothers Rs.80/ND/ day Rs.80/CSec/day Rs.25/PW 288000 NDs for 3 days 5000 CSecs for 7 days 975000 PW 691.20 691.20 Approved
A.1.7.4.2
28.00 28.00
Approved
A.1.7.4.3 A.1.7.5 A.1.7.5.1 A.1.7.5.2 A.1.7.6
243.75 243.75
Approved
A.2 A.2.1
Janani Shishu Suraksha 109400 PW Karyrakram (JSSK) incidental charges Sub-total Maternal Health (excluding JSY) Sub-total JSY CHILD HEALTH IMNCI
Rs.954/P W Rs.900/P W Rs.200/P W
334000 PW 668000 PW
3133.89 2250.00 4860.00 218.80 0.00 Approved for 9 lakh PW @ Rs 250 /PW Not approved
14046.54 3353.28
8297.39 3572.48
Page 148
FMR Code A.2.1.1
Budget Head
Unit cost
Physical Target
Remarks Approved
A.2.1.2 A.2.1.3
A.2.1.4
A.2.2 A.2.2.1
A.2.2.2
Prepare detailed Rs.1000/vi 4 visit operational plan for sit /month x IMNCI across districts 30 district x (Supplies, Logistics, 12 months Supportive supervision at the District level ) Implementation of IMNCI activities in districts Monitor progress against Rs.25000/ 1 plan; follow up with m meeting/m training, procurement, etc (State Level IMNCI cell) Pre-service IMNCI activities in medical colleges, nursing colleges, and ANMTCs Facility Based Newborn Care/FBNC (SNCU, NBSU, NBCC) Essential Newborn care Rs.20000/ 1606 (Operational cost NBCC NBCCs (existing + new ) NBCCs) Sick Newborn Care Rs.1.75 156 NBSUs Operational cost for L/NBSU NBSUs (existing + new) NBSU
3.00 3.00
Approved
321.20 0.00
Not approved.
273.00 202.80
A.2.2.3
A.2.2.4
A.2.2.5
Up gradation of Existing NBSU at Sec Health Care System Operational cost for SNCUs (existing + upgradation proposed ) Up gradation of Existing SNCUs in 20 Centers(17 Dist Hopsitals and 3 Med Coll Hospitals Home Based Newborn Care/HBNC Infant and Young Child Feeding/IYCF
Rs.2 L/NBSU Rs.10 L/SNCU Rs.15 L/SNCU
114 NBSUs
228.00 0.00
Approved for 9 months only. 42 units under process & 114 units to be established with support from World Bank. Not approved.
61 SNCUs
610.00 525.00
20 SNCUs
300.00 255.00
Approved for 44 units for 1 year and 17 units for 6 months Approved at 7 DHQ +10 SDH only. SNCU at 3 medical colleges in Chennai not approved.
A.2.3 A.2.4
Page 149
FMR Code A.2.5
Budget Head
Unit cost
Physical Target
Remarks
A.2.5.1. A.2.5.2 A.2.6
A.2.7 A.2.7.1
A.2.7.2
Care of Sick Children and Severe Malnutrition at facilities (e.g. NRCs, CDNCs etc.) Establishing new NRC Rs.2L/NRC Operational cost for new Rs.7.8 L NRCs Management of Diarrhoea, ARI and Micronutrient Malnutrition Other Activities Rapid Assessment of Rs.15000/ SNCUs by Core group visit committee State Level Quarterly Rs.5000/vi reviews of SNCU sit activities in the Districts Establishment of Early Intervention center for Children with developmental disorder in PPP mode Prenatal Screening to detect fetal anomaly in PPP mode cost for online auditing and software Conduction of well baby clinic in PHCs by Peadiatrician in NICU in 10 high IMR blocks Rs.3.93 L/centre
2 NRCs 2 NRCs
4.00 4.00 15.60 7.80
Approved Approved for 6 months only
12 visits
1.80 1.80
Approved
A.2.7.3
43 visits to 43 SNCUs every quarter 8 centres
8.60 8.60
Approved
31.42 31.42
Approved
A.2.7.4
Rs.95000/ facility
232 facilities
220.40 0.00
Not approved
A.2.7.5
Rs.6000/cl inic/m
10 clinics
7.20 0.00
Not approved. As per the comments received from the state, clinics are to be held at PHCs and not at NICU. It is proposed that doctors from these PHCs be trained in FIMNCI so that specialised care is available to the children throughout the year rather than on a monthly basis.
Page 150
FMR Code A.2.7.6
Budget Head Workshop on Customization of teleradiology enabled modules for training in Ultrasonagram to detect foetal anamoly Infant Death Audit Infant Death Audit of case sheets and preconference workshop Infant Death Audit at Facility level
Unit cost Rs.1 L/worksho p
Physical Target 2 workshops
Remarks To be mobilised from IEC budget
A.2.8 A.2.8.1
A.2.8.2
Rs.1.50 L/worksho p Rs.1000/d eath
4 workshops 15000 deaths
6.00 6.00
Approved
150.00 0.00
Not approved as cost proposed is too high. Facility based audit should not be linked to incentives as these are to be carried out by the hospital staff /administration.
A.2.9 A.2.10
A.2.10.1
Incentive to ASHA under Child Health JSSK- Janani Shishu Surakhsha Karyakram (for Sick neonates upto 30 days) Drugs & Consumables Rs.5939/n eonate Diagnostic Referral Sub total Child Health FAMILY PLANNING Terminal/Limiting Methods Orientation workshop and dissemination of manuals on FP standards & quality assurance of sterilisation services Prepare operational plan for provision of sterilisation services at facilities (fixed day) as well as camps , review meetings
10658 neonates
633.00 180.00
Approved for 90,000 sick neonates @ Rs.200/sick neonate.
A.2.10.2 A.2.10.3 A.3 A.3.1
2829.62
1239.82
A.3.1.1
Rs. 25000/ district
32 districts
8.00 8.00
Approved
A.3.1.1.1
Rs. 50009000/ meeting
24 meetings
1.60 1.60
Approved
Page 151
FMR Code
Budget Head Organise female sterilisation camps
Unit cost Rs.15000/ camp
Physical Target 252 (12 camps / yr x 21 Blocks)
Remarks Approved As per the GoI norm at least 100 sterilisations to be conducted at each camp. Approved As per the GoI norm at least 50 sterilisations to be conducted at each camp. Approved
A.3.1.2
Organise NSV camps A.3.1.3
Rs.35000/ camp
192 camps
67.20 67.20
A.3.1.4
Compensation for female sterilisation Compensation for NSV Acceptance
Rs.1000/s terilisatio n Rs.2000/s terilisatio n
219000 sterilisatio ns 3200 sterilisatio ns
2190.00 2190.00
64.00 48.00
A.3.1.5
A.3.1.6 A.3.2 A.3.2.1
Accreditation of private providers to provide sterilisation services Spacing Methods IUD camps Implementation of IUD services by districts (including fixed day services at SHC and PHC) Provide IUD services at health facilities / compensation PPIUCD services Accreditation of private providers to provide IUD insertion services
Rs.1500/s terilisatio n Rs.2000/c amp
40000 Sterilisatio ns 624 camps
600.00
1. State has proposed Rs. 2000/ NSV which is against the GoI approved norm of Rs. 1500/ male sterilisation. 2.Budget has been accordingly revised and approved Approved. Shifted from MFP
12.48 12.48
Approved
A.3.2.2
A.3.2.2.1 A.3.2.2.2 A.3.2.3
Rs.20/IUD insertion
350000 IUDs
Page 152
FMR Code
Budget Head Social Marketing of contraceptives (includng delivery of contraceptive by ASHA at door step) Propagate information on IUCD insertion through VHAs as well as incentivise them for brining IUCD cases @ Rs. 100.
Unit cost Rs.100/VH V
Physical Target 1639 VHV x 5 IUCD = 8195 IUCD insertions
Remarks (1) Not approved. State may do so with its own funds. (2)State has proposed to propagate information on IUCD insertion through VHAs as well as incentivise them for bringing IUCD cases @ Rs. 100. (3) GoI only provides Rs. 20/ IUCD and no separate budgetary provision may be approved.
A.3.2.4
A.3.2.5
A.3.3
Contraceptive Update seminars POL for Family Planning/ Others (including additional mobilty support to surgeon's team if req) Repairs of Laparoscopes
A.3.4
Single punctur Rs. 35000 Double PunctureRs. 65000
Single puncture77 Double Puncture25
A.3.5
A.3.5.1
Other strategies/activities (please specify): Monitor progress, quality and utilisation of services (both terminal and spacing methods) including complications / deaths / failure cases.Note: cost of insurance / failure and death compensation NOT to be booked here
Rs. 8000/ dist
32 districts
2.56 2.56
Approved
Page 153
FMR Code
Budget Head Performance reward if any
Unit cost
Physical Target
Remarks (1) Best 3 districts, 3 P.H.Cs, 3 Govt. Hospital, 3 Voluntary organizations in sterilization Performance & 3 districts in NSV performances. Ist prize (Rs.15000), IInd prize (Rs.10,000) & IIIrd Prize (Rs. 8000). Conducting the ward function @ Rs.35000. (2) State needs to develop minimum benchmark over and above which awards would be given. (3) Approved
A.3.5.2
A.3.5.3
World Population Day celebration (such as mobility, IEC activities etc.): funds earmarked for district and block level activities Printing of Forms and Registers
17.00 Approved. Shifted from MFP
Rs. 1 L/distt
32 districts
32.00 32.00
A.3.5.4
A.3.5.5
Dietary charges for beneficiaries who underwent sterilisation
Rs.400/ca se
100000 cases
400.00 100.00
Approved. State has planned to print Sterilisation Consent Forms along with Checklist, Sterilisation Registers, IUD Registers, MTP Registers, Consolidation Registers & Monthly Reporting format from HSC to PHC and from Institution to DFWB. Approved @ Rs. 100/ per case. Shifted from MH.
Page 154
FMR Code A.3.5.6
Budget Head IUCD Camps in tribal areas
Unit cost Rs.2000/c amp
Physical Target 624 camps
Remarks NOT APPROVED. Already approved under A.3.2.1.
A.4
A.4.1 A.4.2 A.4.2.1
A.4.2.2
A.4.2.3 A.4.3
Sub-total Family Planning (excluding compensation) Sub-total Sterilisation and IUD compensation & NSV camps ADOLESCENT REPRODUCTIVE SEXUAL HEALTH (ARSH) Adolescent services at health facilities School Health Programme Implementation of School Health Programme by districts. Developing and printing of HEAL modules for Middle/High/Hr.sec Schools with TANSAC training material included Monitor progress and quality of services. Other strategies/activities (please specify) Details of the Menstrual Hygiene project to be provided and budgeted under this head Sub-total ARSH
560.32 206.36 2391.20 3025.48
0.00 911.47
Shifted from E 2.3. Approved Shifted from E 2.1. Approved
0.00 163.65
0.00 111.57
Shifted from 2.3.Approved
0.00 1186.69
Details of School Health Programme available in Annexure 1.
A.5.1 A.5.1.1 A.5.1.2 A.5.1.3 A.5.1.4
URBAN RCH Establishment of 75 Urban Health Center Staff salary Rent for UPHC Furniture ,Stores &
Rs.4000/ m Rs.1.46
62 UPHCs 75 new
550.80 29.76 109.50 Page 155
FMR Code
Budget Head equipments, Computer Accessories
Unit cost L/UHC
Physical Target UPHCs
Remarks
Total 690.06 Amount already sanctioned under supplementary budget (RoP 11-12) Amount proposed (2012-13) 379.86 379.86
310.20 The total proposed budget for Urban RCH is Rs.690.06 lakhs, but State has Rs.310.20 lakhs as sanctioned amount for this activity hence has proposed Rs. 379.86 lakhs only, which has been approved accordingly.
A.6 A.6.1 A.6.1.1 A.6.1.2 A.6.1.3 A.6.1.4 A.6.1.5
TRIBAL RCH Birth Waiting Room in 17 Tribal PHCs Contingency Electricity Charges POL charges Honorarium to CHN Honorarium to Sanitary Worker Tribal MMU Salary for Doctors POL charges Referral Services Operational cost for the proposed 24 new four wheel drive for referral services
Rs.2500/u nit/m Rs.2500/u nit/m Rs.8000/u nit/m Rs.500/un it/m Rs.500/w orker/m
17 units for 8 months 17 units for 8 months 17 units for 8 months 17 units for 8 months 51 workers for 8 months 21 doctors 21 MMU
3.40 3.40 3.40 3.40 10.88 10.88 0.68 0.68 2.04 2.04
Approved Approved Approved Approved Approved
A.6.2 A.6.2.1 A.6.2.2 A.6.3 A.6.3.1
Rs.40000/ m Rs.18000/ m/MMU Rs.1 L/vehicle/ m
85.68 0.00 45.36 43.20
Approved under HR Approved only for existing 20 MMUs. New Procurement of MMU vehicles for tribal areas not approved, since already every block has MMU. MMUs from some of the Page 156
24 vehicles for 6 months
144.00 0.00
FMR Code
Budget Head
Unit cost
Physical Target
Remarks better performing non-tribal blocks, can be diverted , if required.
A.6.3.2
A.6.3.3
A.6.3.4
A.6.4 A.6.4.1
A.6.4.2
Operational cost for the existing 24 four wheel drive for referral services Procurement / fabrication of 24 new four wheel drive Procurement of 13 new four wheel drive vehicles @ 7.6 lakhs (MMU outreach services by NGO) Other Activities Grant In Aid(Bed Grant) for 4 Hospitals in 3 district through PPP mode (Through NGO) Tribal counsellors in Govt. Institutions
Rs.1 L/vehicle/ m Rs.11.5 L/vehicle Rs.7.6 L
24 vehicles for 12 months 24 vehicles
288.00 288.00
Approved
276.00 0.00
Not approved.
13
98.80 0.00
Not approved.
Rs.10 L/hospital
4 hospitals
40.00 0.00
Not approved
Rs.5000/c ounsellor/ m
10 counsellors
6.00 6.00
Approved subject to State providing list of facilities where the counsellors would be placed and those facilities should not have any other counsellor viz. FP and/or ARSH counsellor. Not proposed
Sub total Tribal Health A7 A.8 PNDT & Sex Ratio INFRASTRUCTURE & HUMAN RESOURCES
1004.24 357.60
Page 157
FMR Code A.8.1.1
Budget Head ANMs,supervisory nurses, LHVs
Unit cost
Physical Target
Remarks
A.8.1.2
Laboratory Technicians, MPHWs
SNs: Ph1-4263 Ph1 Ph2-354 PPC-172 @Rs.6000 /m Ambulance Ph2 @ -24 Rs.5000/ SNCU/NICU m -781 PPC @ Tribal Rs.4000/ MMU-20 m MCH L1-93 Ambulanc MCH L2e@ 378 Rs.6000/ m SNCU/NIC U@ Rs.6000/ m Tribal MMU@ Rs.10000/ m MCH L1@ Rs.11000/ m MCH L2@ Rs.4500/ m Rs.6000/ 20 m
0 11.52
State has not provided details of staff required in the FMR format; further , the same items seem to have been proposed under both RCH and MFP. For 2012-13, the state's HR has been approved at the same level (reflected in Unit rate and Physical targets) as in ROP 2011-12.
A.8.1.3
A.8.1.4 A.8.1.5
Specialists (Anaesthetists, Paediatricians, Ob/Gyn, Surgeons, Physicians, Dental Surgeons, Radiologist, Sonologist, Pathologist, Specialist for CHC ) PHNs at CHC/ PHC level Medical Officers at PHCs and CHCs
Rs.38000/ m
783 existing
1189.94 2997.18
Page 158
FMR Code A.8.1.6
Budget Head Additional Allowances/ Incentives to M.O.s of PHCs and CHCs (Mobility support for emergency call (5 calls per month)) Others - Computer Assistants/ BCC Coordinator etc
Unit cost Rs.500/cal l
Physical Target 931 calls/m/30 dists
Remarks
A.8.1.7
Systems manager @Rs.2500 0/m Security services @ Rs.4000/ m staff at ICTC @ Rs.29114/ m Housekee ping services @ Rs.2500/ m Driver for outreach MMU @ Rs.4000/ m Driver for tribal MMU @ Rs.8000/ m Driver for Ambulanc e services for emergenc y transport of mothers and
Systems manager 24 Security services 129 staff at ICTC -399 Housekeep ing staff183 Driver for outreach MMU-385 Driver for tribal MMU-20 Driver for Ambulance services for emergency transport of mothers and children-24 Cleaner for MMU-385 SW for MCH L1-93 Pharmacist for MCH L2-42 Junior Asstt. MCH L2-42 Hospital Workers for MCH L2-42
1835.95
Page 159
FMR Code
Budget Head
Unit cost children @ Rs.4500/ m Cleaner for MMU @ Rs.3000/ m SW for MCH L1@ Rs.2500/ m Pharmacis t for MCH L2 @ Rs.21000/ m Junior Asstt. MCH L2@ Rs.11000/ m Hospital Workers for MCh L2 @ Rs.7500/ m SW for MCH L2 @ Rs.7500/ m
Physical Target SW for MCH L2-42
Remarks
A.8.1.7.1 A.8.1.7.2 A.8.1.7.3
Staff for NRC Staff Nurse for NRC Nutrition Councellor
Rs.7500/ m Rs.15000/ m Rs.5000/ m Rs.5000/ m
48 SNs 12 Councellor s 12 cooks 24 attenders
3.06 5.92 1.53
Approved Approved
A.8.1.7.4 A.8.1.7.5 A.8.1.8
Cook cum Care taker Attender Incentive/ Awards etc. to
0.51 1.02
Approved Approved
Page 160
FMR Code
Budget Head SN, ANMs etc. Honarorium to hired Obstetrician for emergency LSCS Mobility support (for more than 8 km travel) Honarorium to hired Anaesthetist for emergency LSCS Mobility support (for more than 8 km travel) Incentive to EmOC trained doctor for emergency LSCS Mobility support (for more than 8 km travel) Incentive to LSAS trained doctor for emergency LSCS Mobility support (for more than 8 km travel) Additional services by Govt specialists (Obstetrician )for Emergency LSCS Mobility support (for more than 8 km travel) Additional services by Govt specialists (Anaesthetist )for Emergency LSCS Mobility support (for more than 8 km travel) Honarorium to hired pediatricians Mobility support (for more than 8 km) Additional services by Govt paediatricians for emergency MCH care Mobility support (for more than 8 km)
Unit cost
Physical Target
Remarks
A.8.1.8.1
3500
32800
520.00 100.00
A.8.1.8.4 A.8.1.8.5
500 2250
16400 32800
82.00 342.00
A.8.1.8.8 A.8.1.8.9
500 750
16400 2750
82.00 8.25 1) Approved only for the Incentives to LSAS & EmOC trained doctors @ Rs 2000 fixed and Rs 400 per case upto max of 5000 to 7000 cases. Total budget approved lumpsum is Rs 50.00 lakhs. 2) Mobility support @ Rs 500 can be approved as lump sum for Rs 50.00 lakhs. 3) Not approved for calling experts from Private sector since State has enough number of regular and trained doctors.
A.8.1.8.1 2 A.8.1.8.1 3 A.8.1.8.1 6 A.8.1.8.1 7
500 750
1375 2750
6.88 8.25
500 500
1375 10000
6.88 50.00
A.8.1.8.1 9 A.8.1.8.2 0
500 500
5000 10000
25.00 50.00
A.8.1.8.2 2 A.8.1.8.2 3 A.8.1.8.2 6 A.8.1.8.2 7 A.8.1.8.2 9
500 750 500 500
5000 9000 4500 5000
25.00 27.50 22.50 25.00
500
2500
12.50
Page 161
FMR Code A.8.1.8.3 0
Budget Head Delivery incentive to VHN
Unit cost Rs.25/mot her
Physical Target 288000 mothers
Remarks Approved subject to registration within 12 weeks, provision of full ANC, maintaining partographs of each case, giving birth dose of OPV, BCG, Hep B and Vit K injection. Approved condition to registration within 12 weeks, provision of full ANC, maintaining partographs of each case, giving birth dose of OPV, BCG, Hep B and Vit K injection.
A.8.1.8.3 1
Delivery incentive to ANM/SN
Rs.25/mot her
288000 mothers
72.00 72.00
A.8.1.9
A.8.1.9.1
Human Resources Development (Other than above) HR as per facility.
1)Staff salary Establishm ent of 20 new PHCs @ Rs.270.2 L 2) Staff salary for Operationa lisation of 3 new sanctioned PHCs @ Rs.40.53 L 3)Staff salary of 20 new PHCs @ Rs.131.8 L 4) Staff salary for
5889.65 4049.32
Proposed under MFP. Approved as per RoP 11-12
Page 162
FMR Code
Budget Head
Unit cost
Physical Target Upgradation of existing PHCs @Rs.390.4 8L 5)Staff salary for Upgradation of proposed PHCs @ Rs.325.4 L 6)Human resources for new PHCs @ Rs.2242.08 L 7) Human resources for new UG PHCs @ Rs.2489.16 L 1612 visits/mont h for 10 months 172 councellors 770 SNs
Remarks
A.8.1.9.2
A.8.1.9.3
Hiring of Doctors One Doctor / PHC for 10 months @Rs.1000/- visit for SHP Salary of FP Counsellors in PPCs Salary for the Staff Nurses of the training team
RS.1000/v isit
161.20 161.20
Approved.
Rs.7500/ m Rs.22000/ m
131.58 131.58
A.8.1.9.4
863.94 506.88
Approved. Only 85 % of salary requirement is budgeted. Approved for 6 Staff Nurses per district (32 Distts) to cover 12 block in each district.
Page 163
FMR Code A.8.1.9.5
Budget Head Provision of EmOC trained doctors to MCH for observation of High Risk Mothers
Unit cost Rs.38000/ m
Physical Target 36 doctors for 6 months (salary proposed at 85%)
Remarks Medical Colleges is not generally a part of the NRHM. However, the Medical Colleges are high delivery points. 2 M.O per Institution x 6 months x Rs 38,000 P.M. x 18 Institutions x 85 %=69.77 lakhs approved. Namewise list along with delivery load and C section to be shared.
A.8.1.9.6
MPA on Contract basis at 44 existing SCNU MPA -Male on contract basis at 20 SNCU taken up for upgradation MPA- Female at 44 Existing NICU MPA -Male on contract basis at 20 SNCU taken up for upgradation Multipurpose Assistant for MCH L2 Sanitary Worker Salary
Rs.5000/ m Rs.5000/ m RS.3500/ m RS.3500/ m
A.8.1.9.7
132 MPA for 6 months 60 MPA for 6 months 183 MPA for 12 months 69 MPA for 6 months
39.60 0.00
18.00 0.00 Not approved as No provision under operational guidelines ; Should be provided from state budget.
A.8.1.9.8
76.86 0.00
A.8.1.9.9
14.49 0.00
A.8.1.9.1 0 A.8.1.9.1 1 A9 A.9.1
Rs.5000/ 42 MPA for m 9 months RS.2500/ 31 SW for 9 m months Sub total Infrastructure and HR
18.90 0.00 6.97 0.00 15071.07 14119.27 Already approved under A.8.1.7
A.9.1.1
TRAINING Strengthening of Training Institutions (SIHFW, ANMTCs, etc.) Infrastructure strengthening of Training Centres
Rs.3.5 L/centre
8 centres
28.00 28.00
A.9.1.2
Centre for Advanced
Rs.24.50
2 centres
49.00 49.00
Approved condition to State specifying location of these RTCs since State already has 3 HFWTCs, 9 ANMTCs and 3 MPW. Aprroved Page 164
FMR Code
Budget Head Midwifery Training Development of training packages Maternal Health Training Skilled Birth Attendance / SBA training Comprehensive EmOC training (including csection) EmOC Training-MO Exam cost Existing FOGSI Establishment 3 teritiary training centres
Unit cost L/centre
Physical Target
Remarks
A.9.2 A.9.3 A.9.3.1 A.9.3.2
Rs.1.03 L/batch
182 batches
187.65 187.65
Approved
A.9.3.2.1 A.9.3.2.2 A.9.3.2.3 A.9.3.2.4
Rs.5.14 L/batch Rs.2.5 L Rs.53.91L/ centre
6 batches
30.82 30.82 2.50 2.50 32.00 32.00 161.73 161.73
Approved Approved Approved Approved. Additional tertiary centres can be approved subject to a separate training proposal on this for considering by GoI. State to send a detailed proposal separately. However the lump sum budget can be approved, subject to submission of the proposal on the above suggested line. Approved Approved Approved Approved. May budget for comprehensive monitoring of all activities at one place. Rs 11.70 lakhs can be approved for monitoring of all MH /RCH Trainings
3 centres
A.9.3.2.5 A.9.3.3 A.9.3.3.1 A.9.3.3.2
Refresher training for EmOC Life saving Anaesthesia skills training Exam cost Comprehensive Monitoring Cost
Rs.27310/ batch Rs.3.34/b atch Rs.2.8 L Rs.11.70 L
4.64 4.64 40.07 40.07 2.80 2.80 11.70 11.70
Page 165
FMR Code A.9.3.4
Budget Head Safe abortion services training (including MVA/ EVA and Medical abortion) RTI / STI training RTI/STI Training MOs RTI/STI Training SNs RTI/STI Training LTs BEmOC training AMTSL ( 2 ND SPELL BEmONC - MO) and SN BEmONC (3rd spell)-MO
Unit cost
Physical Target
Remarks
A.9.3.5 A.9.3.5.1 A.9.3.5.2 A.9.3.5.3 A.9.3.6 A.9.3.6.1 A.9.3.6.2
Rs.45350/ MO Rs.24132/ SN Rs.21070/ LT Rs.25850/ batch Rs.43395/ batch
65 MOs 65 SNs 65 LTs
29.48 29.48 15.69 15.69 13.70 13.70
175 372 batch
45.24 0.00 161.43 74.00
Not approved The BeMOC Training for Medical Officers is of 10 days duration as per GoI guidelines and State is requested not to carry out part by part trainings. Hence Rs 74.00 lakhs approved for training of 370 MOs in a batch size of 5 per batch. Training and expenditure may be done as per GoI norms. Approved
A.9.3.7 A.9.4 A.9.5 A.9.5.1 A.9.5.1.1 A.9.5.1.2 A.9.5.1.3
Other MH training (Blood storage Training) IMEP Training Child Health Training IMNCI Training General IMNCI - TOT Monitoring cost Refersher General IMNCIVHN/SHN/CHN
Rs.99638/ batch
18 batches
17.93 17.93
Rs.70535/ batch Rs.20000/ batch Rs.32580/ batch
8 batches 1 batch 202 batches
5.64 5.64 0.20 0.20 65.81 65.81
Approved Approved Approved.
Page 166
FMR Code A.9.5.1.4
Budget Head Refersher General IMNCIAWW
Unit cost Rs.27405/ batch
Physical Target 300 batches
Remarks Not approved. Training should be planned with DWCD and funds mobilised from DWCD. Approved Not approved. It is proposed that for the existing staff nurses who have already been trained skills assessment for each one of them be done by the SNCU doctors and on the job skill enhancement be provided. Appoved condition to Observership plan being provided by the state. 17 SNCUs x 10 SN in each=170, 6 batches approved. The remaining nurses ( 1 for each SNCU =44+17=61) who are supposed to provide counselling should be trained accordingly (eg; in IYCF, management of LBW babies, advise on follow up and so on). To be included in FIMNCI training load
A.9.5.2 A.9.5.2.1 A.9.5.2.2
F-IMNCI training FIMNCI-Pvt Students SNCU - Refersher Training
Rs.1500/s tudent Rs.2.22 L/batch
350 students 9 batches
5.25 5.25 20.00 0.00
A.9.5.2.3
SNCU - Newer Training
Rs.2.22 L/batch
9 batches
20.00 13.33
A.9.5.2.4 A.9.5.2.5 A.9.5.3 A.9.5.4
NBSU - MO NBSU - SN Home Based Newborn Care training Care of Sick Children and severe malnutrition training
Rs.2.9 L/batch Rs.2.24 L/batch
43.50 0.00 26.86 0.00
Page 167
FMR Code A.9.5.4.1 A.9.5.4.2 A.9.5.4.3 A.9.5.4.4 A.9.5.5 A.9.5.5.1 A.9.5.5.2 A.9.5.5.3 A.9.5.5.4 A.9.5.5.5 A.9.5.5.6 A.9.5.5.7 A.9.5.5.8 A.9.5.5.9 A.9.6 A.9.6.1 A.9.6.2 A.9.6.3 A.9.6.3.1
Budget Head SAM TOT Monitoring cost SAM - MO/SN SAM - CHN/SHN/VHN Other CH training (pls specify) NSSK (ANM-Urban) NSSK (ANM/VHN) Orientation IYCF - TOT Monitoring cost Orientation IYCF - MO Orientation IYCF CHN/SHN/VHN USG - MO 78 CEmONC USG - MO 154 CHC Refresher training to detect foetal anomoly Family Planning Training Laparoscopic Sterilisation training Minilap training NSV training TOT on NSV
Unit cost Rs.89400/ batch Rs.20000/ batch Rs.35325/ batch Rs.18500/ batch
Physical Target 1 batch 1 batch 21 batches 95 batches
BUDGET (Rs.Lakhs) Proposed Approved 0.89 0.89 0.20 0.20 7.42 7.42 17.58 17.58
Remarks Approved Approved Approved Approved
Rs.35690/ batch Rs.32240/ batch Rs.74675/ batch Rs.20000/ batch Rs.24050/ batch Rs.10000/ batch Rs.31200/ batch Rs.31200/ batch Rs.7600/b atch
5 batches 66 batches 9 batches 1 batch 341 batches 448 batches 20 batches 39 batches 64 batches
1.78 1.78 21.28 21.28 6.72 6.72 0.20 0.20 82.01 82.01 44.80 44.80 6.24 0.00 12.17 0.00 4.86 0.00
Approved Approved Approved Approved Approved Approved Not approved. GoI is still in the process of finalising curriculum for ultrasonography training.
1.00 0.98
Rs. 14000/bat ch
21 (7 Batches)
State has proposed ToT for NSV @ Rs. 14000/ batch; however, total amount has wrongly been put as Rs. 1.00 lakhs. As per the rate actual amount is Rs. 0.98 lakhs, accordingly revised Page 168
FMR Code
Budget Head
Unit cost
Physical Target
Remarks and approved
A.9.6.3.2
NSV training for Medical Officers IUD Insertion training TOT for IUD insertion Training of Medical officers in IUD insertion
Rs. 12250/bat ch
192 (64 batches), 5 Days
7.84 7.84
Approved
A.9.6.4 A.9.6.4.1 A.9.6.4.2
A.9.6.4.3
Training of staff nurses in IUD insertion Training of ANMs / LHVs in IUD insertion
Rs. 32000/M O Monitorin g - Rs. 2.00 lakhs Rs. 46000/bat ch Rs. 46000/bat ch Rs. 20000/bat ch
19.28 19.28 54 MOs
Approved
A.9.6.4.4
A.9.6.5
Contraceptive Update training
1240 SNs (62 batches) 1860 ANM/LHV (93 batches) 124 batches12400 service providers
28.52 28.52
Approved
17.78 17.78
Approved
24.80 24.80
Approved
A.9.6.6 A.9.6.6.1
Other FP training (pls specify) Training on CuT-375 IUD
A.9.6.6.2 A.9.6.6.3 A.9.7
TOT on PPIUCD Training on MOs in PPIUCD insertion Adolescent Reproducti-
Rs.40500/ batch Rs.22700/ batch
TOT-60 Doctors & 60 SNs 2000 Doctors 3000 SNs &6000 ANMs 33 doctors (3 batches) 1464 (122 Batches)
41.28 41.28
Approved
1.21 1.21 27.70 27.70
Approved Approved
Page 169
FMR Code
Budget Head veand Sexual Health/ARSH Training ARSH training for medical officers ARSH training for VHN/SHN/CHN ARSH training for ICTC Counselor and SN Training for Teachers & Health Personnel under SHP Programme Management Training SPMU Training DPMU Training Other training (pls specify) Training on Comprehensive package to acclerate the reduction of IMR & MMR - State level Training on Comprehensive package to acclerate the reduction of IMR & MMR-District level MCH Skill lab training MO MCH Skill lab training SN/ANM Gender Training Sensitisation by State Task Force Gender Trg- TOT Gender Trg - MOs Gender Trg VHN/SHN/SNs Risk identification and management among AN mothers
Unit cost
Physical Target
Remarks
A.9.7.1 A.9.7.2 A.9.7.3 A.9.7.4
Rs.50925 /batch Rs.64438/ batch Rs.85375/ batch
30 batches 50 batches 35 batches
15.28 15.28 32.22 32.22 29.88 29.88 15.21 15.21
Approved Approved Approved Approved
A.9.8 A.9.8.1 A.9.8.2 A.9.9 A.9.9.1
Rs.3. 04 L/batch
1batch
3.04 3.04
A.9.9.2
Rs.33750/ batch
32 batches
10.80 10.80
Approved condition to linkage with performace indicators.
A.9.9.6 A.9.9.7 A.9.9.8 A.9.9.8.1 A.9.9.8.2 A.9.9.8.3 A.9.9.8.4 A.9.9.9
Rs.91392/ batch Rs.74062/ batch Rs.15 L Rs.1.18 L/batch Rs.1.29 L/batch Rs.94500/ batch Rs.17700/ batch
30.16 30.16 51.84 51.84
Approved Approved
1 meeting 5 batches 50 batches 30 batches 316 batches
1.50 0.00 5.90 5.90 64.25 64.25 28.35 28.35 55.93 0.00
Not approved Approved Approved Approved Not approved
Page 170
FMR Code A.9.9.10 A.9.9.10. 1 A.9.9.10. 2
Budget Head CENTRE OF ADVANCE MIDWIEFERY TRAINING CAMT-Master Trainer Training - Tot From Medical Colleges CAMT-Master Trainer Training - For Faculty Of Nurshing Colleges And Gnm Schools Training on leadership and motivation - MOs Training on leadership and motivation ANM/VHN Training of block training team PROGRAMME MANAGEMENT SPMU
Unit cost
Physical Target
Remarks
Rs.1.93 L/batch Rs.4.95 L /batch
1 batch
1.93 1.93
Approved
8 batches
39.59 39.59
Approved
A.9.9.10. 3 A.9.9.10. 4 A.9.9.10. 5 A10 A.10.1
Rs.1.19 /batch Rs.62500/ batch
166.32 166.32 218.75 218.75
Approved Approved
Rs.1.03 156 /batch batches Sub total Training
160.85 0.00 2411.21 1857.73
Not approved.
791.75 594.97
A.10.2
DPMU
803.94 508.94
No unit wise breakup provided only lumpsum amounts proposed. Approval restricted to last years level of Rs.645 lakhs less 50.03 lakhs - 25 % of mobility support approved on interim basis.State to provide integrated mobility support plan and budget Proposed amount is 17.7% higher than approved amount in 11-12. Reasons for increase not clear. Approved at last yr's level of Rs.682.82 lakhs less Rs.173.88 lakhs which is 25% of mobility support approved on interim Page 171
FMR Code
Budget Head
Unit cost
Physical Target
Remarks basis. State to provide integrated mobility support plan and budget.
A.10.3
BPMU
942.13 845.40
Amount as per RoP 11-12 levels. Proposed amount is 11 % higher than approved amount in 11-12. Reasons for increase not clear.
A.10.4
A.10.4.1 A.10.4.2 A.10.4.3 A.10.4.4 A.10.4.5 A.10.4.6
Other : Hiring of contractual staff for Maternal Health Wing Expert Advisor Health Officer / Medical Officer Assistant Directotr(Statistics) Maternal and Child Health Officer Honorarium for involving experts in MCH activities Office contingency including Outsourcing of DEO
Rs.85000/ m Rs. 38000/m Rs.35000/ m Rs.24000/ m Rs.20000/ m Rs.30000/ m
1 for 9 months 2 for 9 months 1 for 9 months 1 for 9 months 1 for 9 months 1 for 9 months
7.65 7.65 6.84 6.84 3.15 3.15 2.16 2.16 1.80 1.80 2.70 0.00
Approved Approved Approved Approved Approved Not approved. Outsourcing not allowed. State has sufficient resources.
Sub total Programme Management A.11 A.11.1 VULNERABLE GROUPS Implementation of RCH activities Total RCH II Base Flexi Pool Total RCH II Demand Side GRAND TOTAL RCH II
2562.12 1970.91 Not proposed
38864.98 29847.30 5744.48 6366.28 44609.46 36213.58
Page 172
Annex-2 DETAILED BUDGET: MISSION FLEXIPOOL (MFP)
FMR Code B1 B1.1. B1.1.1
Activity ASHA ASHA Cost Selection and Training of ASHA Procurement of ASHA Drug Kit (ongoing) Drug Kit for 2650 ASHAs Training and drug kit for dropout ASHA Training and drug kit for 4200 ASHAs Performance Incentives/ Other Incentives to ASHAs ASHAs in Tribal, Hilly, Difficult and Hard to reach areas(2650)
Amount Proposed
Amount Approved
Remarks
B1.1.2
600 6750+600
2650 320
15.90 35.20
Approved for replenishment @ 9.28 Rs. 350 per ASHA 23.52 Approved. Only replenishment of drug kits is 14.70 approved
6750+600
4200
208.20
B1.1.3
B1.1.3.1
B1.1.3.1 .i B1.1.3.1 .ii B1.1.3.1 .iii B1.1.3.1 .iv
Home Based Newborn Care (new) Reporting of Infant Deaths and children in 5 years (new) Village Health and Nutrition Days (ongoing) Attending PHC monthly review meeting (ongoing)
250
2650*16
106.00
Approved. The State may give incentives to ASHAs only after training of ASHAs as per GoI 106.00 guidelines.
25
2650*5
3.31
3.31 Approved
100
2650*12
31.80
31.80 Approved
100
2650*12
63.60
FMR Code B1.1.3.1 .v B1.1.3.1 .vi
Activity Adolescent Anemia Control Programme (ongoing) Immunization activity (new) Incentives for Vitamin A and Deworming campaign (ongoing) Surveillance and reporting of fever, ARI, AGE, Jaundice, etc (ongoing)
Unit Cost (wherever applicable) 100 twice a year 100 p m
Amount Proposed
Amount Approved
Remarks
2650 2650
5.30 31.80
B1.1.3.1 .vii
200 each
2 sessions each
21.20
21.20 Approved
B1.1.3.1 .viii
100 pm
2650
31.80
31.80 Approved
B1.1.3.1 .ix
B1.1.3.2
Family Welfare Services(Motivation of Eligible couples for female and male sterilisation) ASHA (Programme specific) incentive for 4200 non tribal and plains for MCH activities) Sub-total ASHA Incentives
Rs. 100 per case of female sterilisation and Rs. 250 per case of male sterilisation
2650*(10+4)
53.00
Not approved as this is already a part of the compensation package budgeted under Family 0.00 Planning
16325
4200
0.00 347.81 0.00
0.00 231.21 0.00
B1.1.4
B1.1.5 B1.1.5.1 B1.1.5.2 B1.1.5.3
Awards to ASHAs/ link Workers ASHA Resource Centre/ ASHA Mentoring Group Supportive Supervision (new activity) VHV Coordinator at State Level VHV Coordinator at District Level Block Level 1103000 276000 386400 1 33 112
0.00 0.00 0.00
0.00 0.00 0.00 Page 174
FMR Code B1.1.5.4
Activity At PHC Level Sub-total supportive supervision of ASHA Sub-total Untied Fund Untied funds to CHCs(385) and PHCs(65) offering with CHC services Untied funds to PHCs Untied funds to HSCs Village Health, Water, Sanitation and Nutrition Committee Others Untied funds to DHs Untied funds to SDHs Untied funds to UPHCs Total Annual Maintenance Grants(AMG) AMG to CHCs(385) and PHCs(65) offering with CHC services AMG to PHCs AMG to HSCs Others AMG to DHs AMG to SDHs AMG to UPHCs
Unit Cost (wherever applicable) 21000
Physical target/ Deliverables 336
Amount Proposed 0.00 0 607.11
Amount Approved 0.00 0 278.71
Remarks
B2
B2.1 B2.2 B2.3
50000 25000 10000
450 1162 8706
225.00 290.50 870.60
154.09 Approved 290.50 Approved 788.84 Approved Approved. Funds for training of VHSNC members available in the 1275.95 State. 0.00 Not approved 115.00 Approved 0.00 Not approved 2624.38
B2.4 B2.5 B2.5.1 B2.5.2 B2.5.3
10000 100000 50000 25000
15158 31 230 135
1515.80 31.00 115.00 33.75 3081.65
B3
B3.1 B3.2 B3.3 B3.4 B3.4.1 B3.4.2 B3.4.3
100000 50000 10000 100000 100000 50000
450 1162 6510 31 230 135
450.00 581.00 651.00 31.00 230.00 67.50
233.39 Approved 838.32 Approved 526.67 Approved 0.00 Not approved 230.00 Approved 0.00 Not approved
Page 175
FMR Code
Activity AMG to Medical Colleges and attached institutions Total Hospital Strengthening Upgradation of CHCs, PHCs, District Hospitals District Hospitals CHCs PHCs Up-gradation of PHCs Existing (new)
Amount Proposed
Amount Approved
Remarks
B3.4.4
100000
34
34.00 2044.50
B4
B4.1 B4.1.1 B4.1.2 B4.1.3 B4.1.3.1
B4.1.3.1 .i
Civil Works (new)
7000000
24
1680.00
B4.1.3.1 .ii
B4.1.3.2 B4.1.3.2 .i B4.1.3.2 .ii
Other infrastructure (new) Up-gradation of PHCs Proposed (new) Civil Works Other infrastructure
1500000
24
360.00
Approved. A comprehensive plan for upgradation of each of the PHCs is to be prepared by the State. New OT constructions are to be done only for the PHCs where there are no OTs. The activity is to be completed in 20121680.00 13 itself. Approval is pended till details of 'other infrastructure' is provided by the state for each of 0.00 these PHCs.
7500000 1500000
20 20
0.00 300.00
0.00 0.00 Not Approved.
Page 176
FMR Code
B4.1.4 B4.2
Activity Infrastructure up gradation in HSCs to facilitate the stayal of VHN in villages (new) Strengthening of PHCs (new) Establishment of 20 new PHCs sanctioned by GoTN (new activity) Civil Works (new) Other infrastructure (new) Establishment of 20 other new PHCs (new) Civil Works (new) Other infrastructure (new) Operationalisation of 3 new PHCs sanctioned - other infrastructure (new activity) Additional fund for increased cost for construction work (ongoing activity)
Amount Proposed
Amount Approved
Remarks
5000000
42
2100.00
Approved. The activity is to be completed in this 2100.00 year itself.
B4.2.1 B4.2.1.1 B4.2.1.2
2500000 295000
20 20
500.00 59.00
500.00 Approved. 59.00 Approved
B4.2.2 B4.2.2.1 B4.2.2.2
2500000 295000
20 20
200.00 59.00
0.00 Not Approved. 0.00 Not Approved.
B4.2.3
215000
6.45
6.45 Approved
B4.2.4
B4.2.4.1 B4.2.4.2
PHCs UG PHCs Construction of New buildings for 9 old PHCs (new)
39 12
214.50 204.00
Approved. All the pending works are to be completed by the State in 201213 and no further funds shall be provided in the 214.50 next years. 204.00 Approved for the 7 facilities which are 175.00 delivery points.
B4.2.5
2500000
225.00
Page 177
FMR Code
B4.2.5.1
Activity Adoption of Kasthuriba Gram Hospital in Erode District (new)
Amount Proposed
Amount Approved
Remarks
1946000
19.46
B4.2.6
Maintenance and repairs of HSCs (new)
5000000
42
500.00
19.46 Approved The State has a balance of Rs. 16 Crores which is permitted to be used for plugging the infrastructure gaps in HSCs. Additional requirement of Rs. 5 Crores is approved. Number of HSCs with locations are to be provided by the State before incurring expenditure against 500.00 this approval.
B4.2.7
Upgradation of existing Blood storage centre to Blood Bank Establishment of Blood storage centres in MCH wings of Medical College Hospitals
lumpsum
25.00
25.00 Approved
B4.2.8
Rs.4 L/facility
18 facilities
72.00
B4.3
Sub-Centre Rent and Contingencies (ongoing)
1000 p.m
2173
0.00
72.00 Approved Fund is available with the State. The norm is Rs. 3000 p/a for rent and Rs. 3200 p/a for contingencies per 0.00 SHC.
Page 178
FMR Code
Activity Outsourcing of House keeping and cleaning Services in Hospitals (new) Outsourcing of hospital services to be continued in Cuddalore, Pudukottai, Tiruppur, Tambaram Hospitals for 201213 @ 10% increase over previous year's cost (ongoing) Outsourcing of cleaning, sanitation and certain other hospital services in CEmONC hospitals (new) Sub total - Hospital Strengthening New Constructions/ Renovation and Setting - up Strengthening of FRUs
Amount Proposed
Amount Approved
Remarks
B4.4.1
5 Lakh p.m.
40
100.00
100.00 Approved.
B4.4.2
55 Lakh
250.00
250.00 Approved
B4.4.3
1 lakh p.m.
17 CEMONC centers + advertisement (Rs. 5 lakh)
209.00 7083.41
209.00 Approved 6114.41
B5 B5.7
B5.7.1
B5.7.2
B5.7.3
Infrastructure Upgradation In FRUs (new) Civil Works Equipment for Medical Colleges (new) Center of Excellence in Reproductive and Child Health in Madurai and Salem Medical colleges (new)
40
1920.00
Approved. 40% of the total cost is proposed and approved for this 1920.00 year.
965.61
965.61 Approved
512200000
3000.00
3000.00 Approved.
Page 179
FMR Code
B5.7.4
B5.10.1
Activity Comprehensive Emergency Management Centre (new activity) Establishment of skill laboratories in all the GNM schools I (new) Sub-total Health Infrastructure
Amount Proposed
Amount Approved
Remarks
5437000
14
761.18
761.18 Approved.
1100000
24
264.00 6910.79
264.00 Approved 6910.79
B6 B6.1
Patients Welfare Society (PWS) Funds to DHs Funds to CHCs(385) and PHCs(65) offering with CHC services 500000 31 155.00 155.00 Approved
B6.2
100000
450
450.00
B6.3 B6.4 B6.4.1 B6.4.2 B6.4.3 B6.4.4
Funds to PHCs Others Funds to SDHs Funds to CEmONC (as add on fund) Funds to UPHCs Funds to Medical College Hospitals Funds to attached Hospitals under DME Funds to attached Institutions under DME Total District Plans
100000
1162
1162.00
214.61 Approved Approved for 1139 functional PHCs and 3 new PHCs which are proposed for operationalization 1162.00 = 1142 PHCs.
100000 100000 100000 1000000
230 103 135 17
230.00 103.00 135.00 170.00
9.85 Approved 0.00 Not Approved. 0.00 Not Approved. 0.00 Not Approved.
B6.4.5
500000
12
60.00
0.00 Not Approved.
B6.4.6 B7
100000
5.00 2470.00
0.00 Not Approved. 1541.46
Page 180
FMR Code
Activity Save the Girl child scheme (new) Sub-total
Amount Proposed 20.00 20.00
Amount Approved
Remarks
B9
Mainstreaming of AYUSH 475 units (300 set up in 200910 and 175 set-up in 2010-11)
B9.1 B9.3 B9.3.1
Human Resources (ongoing) Other activities IEC (new) Training of all VHNs in Yoga and Naturopathy (new) Provision of kit of medicines to pregnant mothers during antenatal and postnatal period. (new)
1519.09 34.00
B9.3.2
87.00
87.00 Approved
B9.3.3
450 per patient
429.00
B9.3.4
Provision of medicines to ISM wings (new) Networking the Commissionerate with DSMOs and the Colleges. (new)
3 lakh per annum
475
1423.00
0.00 Not Approved. Not approved. Financial assistance may be sought from the Department of AYUSH. State Government is requested to liquidate the pending UCs and forward the proposals with AYUSH PIP as per the scheme 0.00 guidelines.
B9.3.5
25.00
0.00 Not approved
Page 181
FMR Code
B10 B10.2 B10.2.2
Activity Sub total Mainstreaming of AYUSH BCC / IEC Implementation of BCC and IEC strategy IEC - IEC/BCC Activities for CH
Amount Proposed
Amount Approved
Remarks
3517.09
1640.09
B10.2.2. 1 B.10.2.3 B.10.2.4 B.10.2.4 .1
a. EMRI boards for Neonatal transport, b.SNCU boards, c.LBW protocols etc BCC/IEC activities for FP BCC/IEC activities for ARSH Printing of posters to each VHN Printing of IEC materials to ICTC counselors and NCD staff nurses IEC material to ICDS centers Other activities BCC / IEC Activities in RCH / NRHM Activities IEC/BCC- School Health Programme
29 47 1612 8706
101.21 34.60
101.21 Approved 34.60 Approved Approved
100
9576
9.58
9.58 Approved
B.10.2.4 .2 B.10.2.4 .3 B10.2.5 B10.2.5. 1 B10.2.5. 2
100 250
1049 59672
1.05 149.18
100.00
100.00 Approved
B10.2.5. 3
Printing of IEC Materials - Middle /High/ Hr.sec Schools
10910 sets with DVDs ( 9918 schools+992 720 per schools buffer=10,910)
78.55
78.55 Approved
Page 182
FMR Code B10.2.5. 4
Activity
Physical target/ Deliverables 1773 (1612 PHC+ 161 buffer= 1773)
Amount Proposed
Amount Approved
Remarks
IEC kit for PHC Sub-total MOBILE MEDICAL UNITS Medical Officer Staff nurse Driver Cleaner Lab technician AVLT system Vehicle maintenance per annum POL Contingency per annum Mobile Medical Unit Drugs to PHCs Lab reagents for MMU New Vehicles for replacement of old vehicles Total EMERGENCY REFERRAL TRANSPORT EMRI
3000 per kit
53.19 527.36
53.19 Approved 527.36
B11 B11.1 B11.2 B11.3 B11.4 B11.5 B11.6
456000 96000 48000 36000 30000 35000
385 385 385 385 385 385
44.26 169.59 56.90 24.71 98.18 134.75
44.26 169.59 56.90 24.71 98.18 134.75
Approved Approved Approved Approved Approved Approved
B11.7 B11.8 B11.9 B11.10 B11.11
5000 10000 10000 100000 25000
385 4620 385 385 385
19.25 92.42 38.50 385.00 96.25
19.25 Approved 92.42 Approved 38.50 Approved 385.00 Approved 96.25 Approved
B11.12
700000
100
700.00 1859.81
B12 B12.1
B12.1.1
Reach Ambulance modification
2 @ Rs. 2.7 lakh (neonatal), 28 @ Rs. 0.25 lakh for minor modification, 76 @ Rs. 3.75 lakh for modification
106
0.00
0.00 Not approved
Page 183
FMR Code B12.1.2 B12.1.3
Activity Non-recurring cost infrastructure Vehicle replacement Procurement for 29 new vehicles of sick newborn transport system @ Rs. 12 lakhs per vehicle Operating cost Operational Cost a. Operational Cost for UNICEF vehicle for transport of sick new born. b.Operational cost for Existing 29 vehicle with Neonatal Support System. d.Operational cost for the 29 new vehicle proposed for transport of sick new born Training on Emergency transport of Maternal and Infants - EMRI Staff Training on Emergency transport of Maternal and Infants - District level staff Training on Emergency transport of Maternal and Infants - EMRI Technician Total
Amount Approved
Remarks
12.5 lakh
100
0.00 Not approved 0.00 Not approved
B12.1.4 B12.2 B12.2.1
12 lakh
29
348.00
0.00 Not approved 20% of total OP 1726.00 cost approved.
1726.00 Rs 1 lakh / Vehicle / month x 12 months Rs 1 lakh / Vehicle / month x 12 months Rs 1 lakh / Vehicle / month x 3 months
B12.2.2
6 Ambulances
72.00
0.00 Not Approved
B12.2.3
29 Vehicle with sick new born transport
348.00
0.00 Not Approved
B12.2.4
29
87.00
0.00 Not Approved
B12.2.5
Rs.25860/batc h
4 batches
1.03
0.00 Not approved
B12.2.6
Rs.73360/batc h
2 batches
1.47
0.00 Not approved
B12.2.7
Rs.63860/batc h
40 batches
25.54 3859.04
0.00 Not approved 1726.00 Page 184
FMR Code B13 B13.2
Activity PPP /NGOs Pilot Project on Management of Children affected with Muscular Dystrophy Disorder Palliative care (new) - includes setting-up of Palliative care centers for 25.6 lakh in each district including drugs and support services, training, IEC activity and incentives to VHVs. Anaemia Control Programme by PPP mode - (new) - to be run with DHAN Foundation in 50 blocks of the State Home Based Newborn Care Project in PPP mode - for identification, referral, follow-up and ensuring survival in low birth babies - based on Gadchiroli model Sub-total INNOVATIONS Quality Management System in Public Health Care (new)
Amount Proposed
Amount Approved
Remarks
B13.2.1
125.50
125.50 Approved
B13.2.2
30
5 districts
150.00
150.00 Approved
B13.2.3
100.00
100.00 Approved
B13.2.4 B14
3200 per VHV
1500
72.00 447.50
72.00 Approved 447.50
B14.1
B14.1.1
State level Approval of Programme Implementation Plan Tamil Nadu 2012-13
0.00
0.00 Page 185
FMR Code B14.1.2 B14.1.3
B14.2
Activity District level Grading of PHCs sub-total Quality Management System Strengthening of Dental Services (ongoing) Establishment and operation of 65 new dental units Operation cost for 230 existing dental units sub-total Accreditation of Government Hospitals (new) Non recurring Recurring sub-total Congenital and Developmental Defects (new) Congenital and Developmental Defects and Follow Up - Phase I Congenital and Developmental Defects and Follow Up - Phase II Congenital and Developmental Defects and Follow Up - Phase III Sub-total Screening for oral Cancer in Tamil Nadu (new)
Amount Approved 0.00 0.00
Remarks
0.00
0.00
B14.2.1
65
271.70
271.70 Approved
B14.2.2
230
396.05 921.95
396.05 Approved 667.75
B14.3 B14.3.1 B14.3.2
350000
78
226.75 52.50 279.25
B14.4
B14.4.1
126.32
126.32 Approved
B14.4.2
300.00
300.00 Approved
B14.4.3
56.42 731.42
56.42 Approved 356.42
B14.5
300.00
300.00 Approved
Page 186
FMR Code
B14.6
Activity Prevention and Control of Silicosis (new) Sub - Total innovations Planning, Implementation and Monitoring Community Monitoring Statewide project for community monitoring and village plan development (new) Continuation of support for Community Action for Health (CAH) in 6 HUDs. (new) Quality Assurance (Additional Manpower (Regional NRHM consultants)) Monitoring and Evaluation Monitoring and Evaluation/ HMIS/ MCTS State level and regional level workshop / review meeting Strengthening of HMS in District / Sub District Hospitals MCTS
Amount Proposed
Amount Approved
Remarks
23.83 2256.45
23.83 Approved 1627.25
B15 B15.1
B15.1.1
5 lakh
36
180.00
180.00 Approved
B15.1.2
50
300.80
300.80 Approved
B15.2 B15.3
Rs.35000/m
6 for 9 months
18.90
0.00 Not approved
B15.3.1
B15.3.1. 1 B15.3.1. 2 B15.3.1.
5.48
5.48 Approved
Page 187
FMR Code 3
Activity State MCTS Cell {1Joint Director @ Rs. 50,000 per month 1-Assistant Director@ Rs. 35,000 per month and 1-IT Coordinator@ 16,500 per month} Own a Laptop sharing 20% of the cost to strengthen MCTS sub total Computerization/ HMIS and egovernance, ehealth Computers and networking for District Hospitals (31 x 20 x 44200) Computers and networking for Sub District Hospitals (230 x 7 x 44200)` IT coordinator IT coordinator Comprehensive Networking of all sections of DPH, DMS and DFW Computers (DGS&D Rate for 358 numbers) (i3 processor with OS, antivirus and other necessary software)
Amount Proposed
Amount Approved
Remarks
50000 p.m
14.40
14.40 Approved
35000 p.m. (AD, 16500 p.m. - IT Coordinator)
1+1
6.18
6.18 Approved
200.00 226.06
B15.3.2
B15.3.2. 1
274.04
274.04 Approved
B15.3.2. 2 B15.3.2. 3 B15.3.2. 4
711.62 16500 pm Rs.16500/ month x 2 42 62.37 2.97
B15.3.2. 5
B15.3.2. 6
35000
358
127.09
0.00 Not approved. Page 188
FMR Code B15.3.2. 7
Activity UPS (10 x 110000) Provision of LAN connectivity (including OFC cable linking) Server (DGS&D Rate for 4 server) (DellR710 64GB RAM 1 TB HDD) Computers (DGS&D Rate for 23 numbers) (i3 processor with OS, antivirus and other necessary software) Up-gradation of existing LAN network setup at Directorate of Medical Education sub-total Other M&E activities 4 Review cum workshop and review meeting for DTT MOs Quarterly Review meeting of DDHSs sub-total Sub total Monitoring and Evaluation Sub total Planning, Implementation and Monitoring Procurement Procurement of Equipment Procurement of Equipment for MH
Amount Proposed 11.00
Amount Approved
Remarks
0.00 Not approved.
B15.3.2. 8
42.22
0.00 Not approved.
B15.3.2. 9
20.00
0.00 Not approved.
B15.3.2. 10
Rs. 35,500/-
23
8.17
8.05 Approved
B15.3.2. 11
52.90 1312.38
52.90 Approved 1111.95
B15.3.3
B15.3.3. 1 B15.3.3. 2
129250 1.08
4 4
5.17 4.32 9.49
1547.93
1147.50
2047.63
1628.30
B16 B16.1 B16.1.1
Page 189
FMR Code
Activity
Amount Proposed
Amount Approved
B16.1.1. 1 B16.1.2 B16.1.2. 1 B16.1.2. 2
Equipment for FRUs Procurement Equipment: CH of
1471.85
Remarks Approved. The State is to provide a list of all the facilities along with the equipments to be procured and no additional funds for procurement of equipments will be asked for these 1471.85 facilities.
Equipment for SNCU @ 10 lakhs Equipment for Sick newborn transport system @ 4.5 lakhs Equipment for new born corner for 73 new PHCs, 31 level 1 MCH centre and 135 UPHCs @ Rs.85000/Equipment, medication and consumable for ASHA home based new born care in 2650 tribal and 4200 program specific VHVs @ Rs. 2000 per VHV Equipment for training for prenatal screening to detect fetal anomalies in 78 CEmONC centers and 154 PHCs
10 lakh
20
200.00
Approved for 17 170.00 units
4.5 lakh
29
130.50
0.00 Not approved
B16.1.2. 3
85000
239
203.15
203.15 Approved
B16.1.2. 4
1500
6850
137.00
0.00 Not approved
B16.1.2. 5
Page 190
FMR Code
Activity
Unit Cost (wherever applicable) Rs. 35000 for desktops and 11000 for accessories
Amount Proposed
Amount Approved
Remarks
B16.1.2. 5.i B16.1.3 B16.1.3. 1 B16.1.3. 3 B16.1.3. 5
Desktop Accessories Rs.11000/Procurement of equipment: FP NSV Kit Minilap sets
and @
232
106.72
106.72 Approved
1000 3500 2700
1000
10.00 15.00
B16.1.5
Kelly's Forceps Annual Maintenance contract / Maintenance and repair for Equipment Sub-total (equipment) Procurement of Drugs and supplies Procurement of supplies for MH Iron sucrose Maternal Anaemia Albendazole for Antenatal mothers Gestational Diabetes FW Drugs and equipments General drugs and supplies for health facilities Procurement of drugs under ARSH for WIFS
400
10.08
10% of the total procurement cost
800.00 3084.30
800.00 Approved 2786.80
B16.2 B16.2.1 B16.2.1. 1 B16.2.1. 2 B16.2.1. 3 B16.2.3
1428932 doses 1190777 1612
429.00 8.34 161.20 0.00
429.00 Approved 8.34 Approved 161.20 Approved 0.00
B16.2.5 B16.2.5. 1
Page 191
FMR Code
Activity Procurement of IFA
Amount Proposed
Amount Approved
B16.2.5. 1.1 B16.2.5. 1.2 B16.2.5. 2 Procurement of Albendazole MSHP Drugs for Urban Health post for medical college hospitals @ 2.5 Lakh per centre Drugs and consumables for 75 municipalities @ Rs. 2.35 Lakhs First aid kits for schools Disposable syringes Provision of gloves and syringes for NCD screening program (Phase I and Phase II) Sub total (drugs) Sub-total Impact Assessment of NRHM Component Impact assessment of NRHM and various components (new) Sub-total
0.13 0.70
5864754 5864754 20000000
396.46
Remarks Approved. State needs to ensure that although not budgeted in this activity, all the school boys are also provided with weekly iron/ folic acid 396.46 supplementation. 82.11 Approved
140.00
0.00
B16.2.5. 3
16 centers
40.00
40.00 Approved
B16.2.5. 4 B16.2.5. 5 B16.2.5. 6
75 centers
176.25
176.25 Approved
100 per kit
42769 3 Cr
42.77 300.00
B16.2.5. 7
465.57 2159.59 5243.89
465.57 Approved 2101.70 4888.50
B20
20.00 20.00
20.00 Approved 20.00 Page 192
FMR Code
B21
B22 B22.3
Activity State Health Systems Resource Centre Capacity building for State Health Systems Resource Centre Sub-total Support Services Support for NVBDCP
Amount Proposed
Amount Approved
Remarks
100.00 100.00 770.88
100.00 Approved 100.00 577.00 Approved Activities: a) State level logistics for STDC / IRL / SDS, Furnishing of STDC for training.RNTCP. Approved amount : 6,08,000 Comment: May be approved as there is no provision in RNTCP b) NGO Payment (Pending payment) Approved Amount: 93,83,400 Comment: May be approved. Pendency of payment is seriously affecting NGO involvement 99.91 in Tamil Nadu
B22.4 B22.6
Support for RNTCP Other NDCP support programmes IDSP Establishment of 24 District Public Health Laboratories Operational cost existing 6 DPHL
99.91
1788000 816000
24 6
429.12 65.28
Approved by IDSP 429.12 Division Approved by IDSP 65.28 Division
Page 193
FMR Code
Activity Provision New Computers for existing DSUs & Medical Colleges Inclusion of Urban Surveillance in Major Corporations Training programme on epidemic prevention, control, investigation and management under NRHM NLEP - NRHM Internet facilities at districts Total NRHM GRAND TOTAL
Amount Proposed
Amount Approved
Remarks
64.17
0.00 Not approved
845000
8.45
0.00 Not approved
111312
22
24.49
0.00 Not approved Approved as recommended by 2.00 the division 1173.31 34256.24
25
2.00 1464.30 43560.53
Page 194
Annex 3 DETAILED BUDGET: IMMUNIZATION AND PPI OPERATION COST
FMR Code C.1 c.1.a
Activities( As proposed by the State)
Physical Target
Amount Proposed
Amount Approved
Remarks
RI Strengthninig Project (Review meeting, Mobility Support, Outreach services etc Mobility Support for Rs.50000/ Year supervision for distict level /district level 16.00 officers. officers. Mobility support for supervision at state level Rs. 100000 per year.
16.00
c.1.b
3.00
1.00
All activities related to mobility support and monitoring projected under state specific activities are recommended but are to be met from the amount recommended under c.1.a and c.1.b
Printing and dissemination Rs. 5 of Immunization cards, tally beneficiaries sheets, monitoring forms etc. c.1.d Support for Quarterly State level review meetings of district officer c.1.e Quarterly review meetings exclusive for RI at district level with one Block Mos, CDPO, and other stake holders Quarterly review meetings exclusive for RI at block level Focus on slum & underserved areas in urban areas/alternative vaccinator for slums
c.1.c
211.61
119.80
10.00
4.80
c.1.f
c.1.g
24.36
24.36
Page 195
FMR Code c.1.h
Activities( As proposed by the State) Mobilization of children through ASHA or other mobilizers Alternative vaccine delivery in hard to reach areas Alternative Vaccine Deliery in other areas To develop microplan at sub-centre level For consolidation of microplans at block level
Unit Cost (whereever applicable) Rs. 150 per session Rs. 100 per session Rs. 50 per session @ Rs 100/- per subcentre Rs. 1000 per block/ PHC and Rs. 2000 per district Rs100,000/ district/year @ 400/ - month/ district Rs. 2/bags/session
Physical Target
Amount Proposed
Amount Approved
Remarks
c.1.i
452.71 -
226.36 -
c.1.j c.1.k c.1.l
POL for vaccine delivery c.1.m from State to district and from district to PHC/CHCs c.1.n Consumables for computer including provision for internet access for RIMs Red/Black plastic bags etc.
14.00
14.00
c.1.o
c.1.p
Hub Rs. 900 per Cutter/Bleach/Hypochlorite PHC/CHCper year solution/ Twin bucket Safety Pits State specific requirement C.1-Sub Total Salary of Contractual Staffs -Sub Total Computer Assistants Rs.12000-15000 support for State level per person per month Computer Assistants support for District level 8000-10000 per person per month
263.17
46.51
c.1.q c.1.r C.2 c.2.a
290.77 1,285.62
40.04 492.87
1.44
1.44
c.2.b
26.88
26.88
Page 196
FMR Code
Activities( As proposed by the State) C.2-Sub Total
Physical Target
Amount Proposed 28.32
Amount Approved 28.32
Remarks
Traininng under Immunization District level Orientation training including Hep B, Measles & JE(wherever required) for 2 days ANM, Multi Purpose Health Worker (Male), LHV, Health Assistant (Male/Female), Nurse Mid Wives, BEEs & other staff ( as per RCH norms) c.3.b Three day training including Hep B, Measles & JE(wherever required) of Medical Officers of RI using revised MO training module) c.3.c One day refresher traning of distict Computer assistants on RIMS/HIMS and immunization formats c.3.d One day cold chain handlers traning for block level cold chain hadlers by State and district cold chain officers One day traning of block level data handlers by DIOs and District cold chain officer C.3-Sub Total Cold chain maintenance
C.3 c.3.a
c.3.e
C.4
11.26 Rs.500/PHC/CHCs per year District Rs.10000/year
11.26
Page 197
FMR Code C.5
Activities( As proposed by the State) ASHA incentive for full Immunization
Physical Target
Amount Proposed
Amount Approved
Remarks
31.80
C.6
Total Pulse Polio Operational Cost (Tentative) Total
1,357.00 1,357.00
To be factored into part C from part B. Rs 31.8 lakhs recommended. However the 31.80 incentive is to be given as per Rs 100 for every child fully immunized under 1 year. 564.25 976.67 1,540.92
The projected amount is lower than the recommended amount because of provisioning of Pulse Polio Operational Cost
Activities under state specific requirement include Hiring of alternate vaccinators in rural areas
Page 198
Annex 4A DETAILED BUDGET: NATIONAL IODINE DEFICIENCY DISORDERS CONTROL PROGRAMME (NIDDCP) ( Rs. In lakhs) Activity Unit cost Physical target Amount Amount Remarks (wherever Proposed Approved applicable) The sanctioned vacant IDD posts i.e. Statistical Assistant & LDC Establishment of Implementation & 10.00 10.00 should be filled up on IDD Control Cellmonitoring of the regular/contract basis programme on priority. Technical Officer 1 State Govt. may Statistical 1 conduct and coAssistant ordinate approved LDC Typist 1 programme activities and furnish quarterly financial & physical achievements as per prescribed format. Establishment of IDD Monitoring LabMonitoring of district level iodine content of salt and urinary iodine excretion as per Policy Guidelines. 1 1 5.00 The sanctioned posts of Lab Technician & Lab Asst. should be filled up on regular/ contract basis on priority. State Govt. may conduct quantitative analysis of salt & urine as per NIDDCP Guidelines and furnish monthly/quarterly statements. IDD publicity activities including Global IDD Day celebrations at various level. State. Govt. may under take 4 districts Page 199
FMR Code
D D.1
D.1.a D.1.b D.1.c
D.2
D.2.a D.2.b
Lab Technician Lab. Assistant
D.3
Health Education & Publicity
D.4
IDD Survey/Resurveys
Rs. 50,000 per district
Increased awareness about IDD and iodated salt. 4 districts
21.00
7.00
10.50
2.00
FMR Code
Activity
Physical target
Amount Proposed
Amount Approved
Remarks
D.5
D.6
Salt Testing Kits supplies by GOI inform of kind grant for 21 endemic districts ASHA Incentive
12 STK per annum per ASHA
Rs. 25/- per month for testing 50 salt samples/ month
Creating iodated salt demand and monitoring of the same at the community level. 50 salt samples per month per ASHA in 21 endemic districts
19.17
IDD survey as per guidelines and furnish report. State Govt. to monitor the qualitative analysis of iodated salt by STK through ASHA in 21 endemic districts i.e. Trichrapalli Dindigul, Madurai, Coimbatore, Ramananthapuram, The Nilgiris, Thiruvarur, Salem, Virudhnagar, Villupuram, Kanyakumari, Dharmapuri, Pudukottai, Namakkal, Nagapattanum, Erode, Perambalur, Tuticoran, Thanjavur, Chennai, Cuddlore
TOTAL
47.50*
43.17
Including Rs. 5.00 lakh for mobility and Rs. 1.00 lakh for procurement of equipment which are not allowed under the programme.
(*) The total fund proposed includes printing, supply of Health workers manual on NIDDCP, formats & reports,G lab consumable, organisation of workshops/seminars/meetings which are not allowed under the Programme.
Page 200
Annex 4B DETAILED BUDGET: INTEGRATED DISEASE SURVEILLANCE PROGRAMME (IDSP) FMR Code Activity Unit Cost (whereever applicable) Amount Amount Proposed (Rs. in Approved lakhs) (Rs in lakhs) Comments
E.1 E.1.4
Operational Cost Field Visits Rs 2,40,000 Office Expenses Broad Band per District Surveillanc expenses e Unit per Outbreak investigations annum including Collection and Transport of Rs 5,00,000 samples State Review Meetings Surveillanc e Unit per annum Sub 78.144 (4.22 78.15 [SSU] + 59.276 [DSU] + 4.088 [Newly Formed Districts] + 10.56 [Medical Colleges]) The operational cost for Medical Colleges will be borne by the district where they are located.
E.1.3
78.15
78.15
Total Laboratory Support District Priority Lab Rs. 4,00,000 per district priority lab per annum Referral Network Rs. Lab 5,00,000 per referral lab per annum District Public Health Rs. Labs* 2,00,000 per annum for consumabl es Sub Total Human Resources 8.00 (4.00 2) 8.00 (4.00 2)
40.00 (5.00 8)
40.00 (5.00 8)
29.52 (for 6 0.00 District PH Labs)
Funds will be approved once the labs are functional.
77.52
48.00
E.2
Page 201
FMR Code
Activity
E.2.1
Remuneration Epidemiologists
Unit Cost (whereever applicable) of Rs.25,000 Rs. 40,000/ per month
Amount Amount Proposed (Rs. in Approved lakhs) (Rs in lakhs) 153.60 ([40,000 2 12] + [40,000 30 12])
Comments
E.2.2
Remuneration Microbiologists
E.2.3
Remuneration Entomologists Veterinary Consultant
153.60 ([40,000 2 12] + [40,000 30 12]) of Rs. 25,000 - 27.00 ([25,000 27.00 Rs. 40,000 3 12] + [25,000 ([25,000 3 (Medical 6 12]) 12] + Graduates) [25,000 6 Rs. 15,000 12]) Rs. 25,000 (Others) of Rs. 15,000 - 3.00 (25,000 1 3.00 (25,000 Rs. 25,000 12) 1 12) Rs. 25,000 - 4.80 (40,000 1 0.00 Rs.40,000 12) Rs. 14,000 1.68 (14,000 1 12) Rs. 28,000 3.36 (28,000 1 12) Rs. 14,000 51.90 ([14,000 (State) 1 12] + [13,500 Rs. 13,500 31 12]) (District) Rs. 8,500 Sub 49.98 (8,500 49 12) 295.32 1.68 (14,000 1 12) 3.36 (28,000 1 12) 51.90 ([14,000 1 12] + [13,500 31 12]) 49.98 (8,500 49 12) 290.52
E.3 E.3.1 E.3.2
Consultant-Finance/ Procurement Consultant-Training/ Technical Data Manager
E.3.3
Data Entry Operator
E.8
Total Training
As per NRHM Guidelines Rs. 5.617 lakhs (for 32 batches [640 persons] @ Rs. 17555/- per batch) Rs. 10.1312 lakhs (for 64 batches [1280 persons] @ Rs. 15830/per batch)
One day training of Hospital Doctors
One day training of Hospital Pharmacist / Nurses
Training of RRT is undertaken by Central Unit. Rs. 1.10 Surveillance lakhs (for Additional List of trainees 100 persons may be sent to CSU. @ Rs. 1100/per person) Rs. 3.75 lakhs (for 500 persons @ Rs. 750/per person)
Page 202
FMR Code
Activity
Amount Amount Proposed (Rs. in Approved lakhs) (Rs in lakhs) Rs. 2.38 lakhs (for 16 batches [336 persons] @ Rs. 14875/- per batch) Rs. 15.20 lakhs approx (for 96 batches @ Rs. 15830/per batch) Rs. 2.28 lakhs approx (for 13 batches @ Rs. 17555/per batch) Rs. 0.79 lakhs approx (for 5 batches @ Rs. 15830/per batch) 36.39925 Rs. 1.60 lakhs (for 80 persons @ Rs. 2000/per person) Rs. 3.00 lakhs (for 300 persons @ Rs. 1000/per person) 0.00
Comments
One day training of Medical College Doctors
One day training for Data Entry and analysis for Block Health Team Rapid Team Response
One day training of DM & DEO
Sub E7 Total ID Hospital Network
Rs. 0.75 lakhs (for 50 persons @ Rs. 1500/per person) 10.20 3.00 (1 3.00)
Rs. 3.00 (1 3.00) 3,00,000/per annum for IDH Surveillance in Rs. 14.56 Metro Cities 10,000,00 /per annum per metro city New formed Rs. 3,50, 7.00 (3.50 2) Districts 000/- per newly formed district Total 511.95
10.00
7.00 (3.50 The amount to be utilized 2) for procurement of ICT equipments under IDSP as per program guidelines. 446.87
Page 203
Proposal under Additionalities FMR Code Activity Unit Cost Amount (where-ever Proposed applicable) Establishment of 24 District 17.88 429.12 Public Health Laboratories Amount Approved 429.12 Comment
Operational cost existing 6 DPHL
8.16
65.28
65.28
Provision of New Computers for Existing DSUs & Medical Colleges AND provision of 1 Data Entry Operator & Computer with Accessories for 12 Addl. HUDs Budget under NRHM support for 8.45 provision of Data Entry Operator & New Computer with Accessories for 5 Major Corporations Training programme on epidemic prevention, control, investigation and management under NRHM TOTAL
64.17
May be approved; Procurement of equipment and civil works may be done as per NRHM guidelines. May be approved; Procurement of equipment and civil works may be done as per NRHM guidelines. Not Approved
8.45
Not Approved
24.49
Not Approved .
591.51
494.40
# FMR Code not allotted. Comments: 3. The following heads will be approved / modified once approval from EFC is obtained. Remuneration of Veterinary Consultant @ Rs. 25,000 - Rs.40, 000. 4. Based on past trend, Rs 110.00 lakhs has been approved for Tamil Nadu State under IDSP for 2012-13. However, if there is increase in expenditure by State as per IDSP approved norm, the budget for State could be increased at RE stage Approval of Programme Implementation Plan Tamil Nadu 2012-13 Page 204
Annex 4C DETAILED BUDGET: NATIONAL VECTOR BORNE DISEASES CONTROL PROGRAMME (NVBDCP) Rs. In Lakh FMR Code Component Unit Cost Physical (wherever target/ applicable) Deliverables Ammount Proposed Ammount Approved Remarks
F.1 F.1.1 F.1.1.a F.1.1.a.i F.1.1.a.ii F.1.1.a.iii F.1.1.a.iv
F.1.1.b F.1.1.c. F.1.1.c.i F.1.1.c.ii F.1.1.c.iii F.1.1.d
F.1.1.e
DBS (Domestic Budgetary Support) Malaria Contractual Payments MPW contractual Lab Technicians ( against vacancy ) VBD Technical Supervisor (one for each block) District VBD Consultant (one per district) (NonProject States) State Consultant (Non Project States), - VBD Consultant (preferably entomologist) ASHA Incentive Operational Cost Spray Wages Operational cost for IRS Impregnation of Bed nets- for NE states Monitoring , Evaluation & Supervision & Epidemic Preparedness including mobility IEC/BCC
9.99
15.00
97.82
75.00
29.69
35.00 may be used for other VBDs activites
F.1.1.f
F.1.1.g
PPP / NGO and Intersectoral Convergence Training / Capacity Building
22.31
35.00 may be used in an Page 205
FMR Code
Component
Ammount Proposed
Ammount Approved
Remarks
integrative manner for other VBDs also F.1.1.h Zonal Entomological units F.1.1.i Biological and Environmental Management through VHSC F.1.1.j Larvivorous Fish support Total : Malaria F.1.2 Dengue and Chikungunya F.1.2.a Strengthening surveillance (As per GOI approval) F.1.2.a(i) Apex Referral Labs recurrent F.1.2.a(ii) Sentinel surveillance Hospital recurrent F.1.2.a(iii) ELISA facility to sentinel surveillance labs F.1.2.b Test kits (Nos.) to be supplied by GoI (kindly indicate numbers of ELISA based NS1 kit and Mac ELISA Kits required separately) F.1.2.c Monitoring and evaluation F.1.2.d Epidemic containment F.1.2.e Case management F.1.2.f Vector control & environmental management F.1.2.g IEC BCC for Social Mobilization F.1.2.h Inter-sectoral convergence F.1.2.i Training including operational research
159.81
160.00
21.37
29.00
0.00
178.82
171.00
Funds allocated as per Mid Term Plan strategy. State to implement as per guidelines of Mid Term Strategy.
Page 206
FMR Code
Component
Ammount Proposed
Ammount Approved
Remarks
F.1.3 F.1.3.a F.1.3.b F.1.3.c F.1.3.d F.1.3.e F.1.3.f F.1.3.g F.1.3.h F.1.3.i
F.1.3.j F.1.3.k F.1.3.l
F.1.4 F.1.4.a
Total : Dengue/Chikungunya AES/JE Diagnostics and Case Management IEC/BCC specific to J.E. in endemic areas Capacity Building Monitoring and supervision Technical Malathion Fogging Machine Operational costs for malathion fogging Operational Research Rehabilitation Setup for selected endemic districts ICU Establishment in endemic districts ASHA Insentivization for sensitizing community Other Charges for Training /Workshop Meeting & payment to NIV towards JE kits at Head Quarter Total : JE Elimination of Lymphatic Filariasis State Task Force, State Technical Advisory Committee meeting, printing of forms/registers, mobility support, district coordination meeting, sensitization of media etc., morbidity management, monitoring & supervision and mobility support for
200.19
200.00
66.04 48.87 3.94 4.39 36.76 0.00 0.00 0.00 0.00
120.00 10.00 10.00 10.00 10.00 0.00 0.00 0.00 0.00
0.00 0.00 0.00
0.00 0.00 0.00
160.00
160.00
53.00
53.00
Page 207
FMR Code
Component
Ammount Proposed
Ammount Approved
Remarks
Rapid Response Team and contingency support
F.1.4.b F.1.4.c
F.1.4.d
F.1.4.e
F.1.4.f
F.1.4.g
F.1.4.g.i F.1.4.g.ii F.1.4.g.iii F.1.4.h
F.1.4.i F.1.5 F.1.5 F.1.5.a
Microfilaria Survey (Night Survey) Monitoring & Evaluation (Assessment)/by Medical College/ Regional Institutions Training of District Officers, PHC MOs, Paramedical staff, drug distributors etc. Specific Advocacy/IEC/BCC including centre, state, district/PHC, sub centre Honorarium for Drug Distribution including ASHAs and supervisors Verification and validation for stoppage of MDA in LF endemic districts a) Additional MF Survey (Night Survey) b) ICT Survey c) ICT Cost Verification of LF endemicity in nonendemic districts Post-MDA surveillance Total : ELF Kala-azar Case search/ Camp Approach Spray Pumps &
10.00 3.00
10.00 3.00
21.00
21.00
84.00
74.00
14.00 30.00 15.00
14.00 30.00 15.00
0.00 230.00
0.00 220.00
Page 208
FMR Code
Component
Ammount Proposed
Ammount Approved
Remarks
F.1.5.b
F.1.5.c F.1.5.d F.1.5.e F.1.5.f
F.2 F.2.a F.2.b F.2.c F.2.d
F.2.e F.2.f F.2.g F.3 F.3.a
F.3.b F.3.c
accessories Operational cost for spray including spray wages Mobility/POL/supervision Monitoring & Evaluation Training for spraying IEC/ BCC/ Advocacy Total Kala-azar Total (DBS) Externally aided component World Bank support for Malaria Human Resource Training /Capacity building Mobility support for Monitoring Supervision & Evaluation including printing of format & review meetings, Reporting format (for printing formats) Kala-azar World Bank assisted project Human resource Capacity building Mobility GFATM support for Malaria Project Management Unit including human resource of N.E. states Training/Capacity Building Planning and Administration( Office expenses recurring expenses, Office automation , printing
0.00 750.00
0.00 740.00
Page 209
FMR Code
Component
Ammount Proposed
Ammount Approved
Remarks
and stationary for running of project)
F.3.d
F.3.e F.3.f
F.4 F.5
F.6
F.6.a F.6.b F.6.c F.6.d F.6.e F.6.f F.6.g
Monitoring Supervision (supervisory visits including travel expenses, etc) including printing of format and review meetings, IEC / BCC activities as per the project Operational cost for treatment of bednet and Infrastructure and Other Equipment (Computer Laptops, printers, Motor cycles for MTS ) Total : EAC component Any Other Items ( Please Specify) Operational costs ( mobility, Review Meeting, communication, formats & reports) Grand Total for cash assistance under NVBDCP Assistance required for decentralized commodities Chloroquine tablets Primaquine 7.5 mg tablets Primaquine 2.5 mg tablets Quinine sulphate tablets Quinine Injections DEC 100 mg tablets Albendazole 400 mg tablets
0.00 0.00 0.00
0.00 0.00 0.00
750.00
740.00
1.16 2.50 0.00 200.00
Page 210
FMR Code
Component
Ammount Proposed
Ammount Approved
Remarks
F.6.h
F.6.i
F.6.j F.6.k F.6.l F.6.m
NS1 Dengue Ag Kit (ELISA based) under Dengue/Chikungunya Temephos, Bti (AS) / Bti (wp) (for polluted & non polluted water) Pyrethrum Extract 2% ACT ( For Non Project states) RDT Malaria bi-valent (For Non Project states) Any Other Items ( Please Specify) Total for Decentralized Commodities Grand Total for grant-inaid under NVBDCP Commodity Grants Total NVBDCP Cash + Commodity Cash Assistance required under NRHM Flexi Fund Proposal for Anti Malaria activity in Rameswaram Island, Ramanathapuram District Contractual Mazdoors for IRS & Anti larval operation in Malaria in Endemic District
30.53
132.70 1.11
168.00 918.00 0.00 918.00
200.00 940.00
940.00
28.20
28.00
19.12
19.00
60.00
Tent-type mosquito Net for Rameswaram Island Approval of Programme Implementation Plan Tamil Nadu 2012-13
0.00 May be met from state resources as an innovative trial considering the feasibility of use of nets being a seashore area with Page 211
FMR Code
Component
Ammount Proposed
Ammount Approved
Remarks
heavy sea breeze during evening. Wages for Temporary mazdoors in Rameswaram Island Scrub Typhus Vector control activity with less than 1 lakh population Purchase of Bti. for vector control activities under NFCP 8.24 8.00
122.24 222.03
0.00 Not under NVBDCP 222.00
311.05
Total under NRHM Flexi Fund
770.88
300.00 Should be shown under decentralized commodity, however, may be approved from NRHM additionality as this year's proposal 577.00
Page 212
Annex 4D DETAILED BUDGET: NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) (Rs. In lakh) FMR code G 1. G 1.1 G1.1 a G 1.2 G2 Activity proposed Improved early case detection Incentive to ASHA Sensitization of ASHA Specific -plan for High Endemic Distrcts Improved case management DPMR Services, (MCR footwear, Aids and appliances, Welfare allowance to BPL patients for RCS, Support to govt. institutions for RCS) Urban L:eprosy Control, (Mega city - 1 , Medium city (1) -4 , Med. City (2)1 Township -22) Unit Cost (In Rupees) Physical Targets Amount proposed Amount approved Remarks
MB PB 1D
500 300 50 1.92/block
400 600 6 blocks
7.50 6.00 140.16
2.00 1.80 11.52
G 2.1
MCR - 250/Aids/Applian ce -12500 Welfare/RCS - 10,000 Meg -280000 Med (1)120000 Med. (2) 236000 Town 57000
15700 30 110
47.10 7.20 11.00
39.25 3.75 11.00
G 2.2
1 4 1 22
5.60 9.60 4.72 25.08
2.80 4.80 2.36 12.54
G 2.3
Material & Supplies Supportive drugs, lab. reagents & equipments and printing works NGO - SET Scheme Stigma Reduced Mass media, Outdoor media, Rural media, Advocacy media Development of Leprosy Expertise sustained Training of new MO Refresher training of MO Training to New H.S/H.W. 50,000 30 30.00 15.00 52,000 30 24.00 15.60
G 2.3 a G 2.4 G3
500000
G 3.1 G 4. G 4.1 G 4.2 G 4.3
60000 40000 30000
900 1200
29.80 20.16
12.00 12.00
As NLEP rates are very low, higher rates agreed in keeping with other Page 213
FMR code G 4.4 G 4.5 G 4.6
Activity proposed Other training Physiotherapist Training to Lab. Tech. Management training for District Nucleus Team Monitoring, Supervision and Evaluation System improved Travel Cost and Review Meeting travel expenses Contractual Staff at State level travel expenses Contractual Staff at District level Review meetings Office Operation & Maintenance Office operation - State Cell Office operation - District Cell Office equipment maint. State Consumables State Cell District Cell Vehicle Hiring and POL State Cell District Cell Programme Management ensured Contractual Staff at State level SMO BFO cum Admn. Officer Admn. Asstt. DEO Driver Contractual Staff at Disrrict level 1 1 1 1 1
Unit Cost (In Rupees) 30000 30000 30000
Physical Targets 150 300 150
Amount proposed 2.52 5.04 5.40
Amount approved 1.50 3.00 1.50
Remarks programmes
G 5. G 5.1
70000
1.00
0.70
G 5.1 i
15000
30
7.50
4.50
G 5.1 ii G 5.1 iii G 5.2 G 5.2 i G 5.2 ii G 5.2 iii G 5.3 G 5.3 i G 5.3 ii G 5.4 G 5.4 i G 5.4 ii G 6. G 6.1 G 6.1 i G 6.1 ii G 6.1 iii G 6.1 iv G 6.1 v G 6.2
25000
2.00
1.00
38000 18000 30000
1 30 1
0.75 10.50 0.50
0.38 5.40 0.30
28000 14000 85000 75000
1 30 2 vehicle 30
0.50 9.00 2.00 45.00
0.28 4.20 1.70 22.50
40000 30000 16000 12000 11000
x12 x12 x12 x12 x12
4.80 3.60 1.92 1.44 1.32
4.80 3.60 1.92 1.44 1.32
Page 214
FMR code G 6.2 i G 6.2 ii G 7.
Activity proposed Driver Contractual Staff in selected States, NSM Others Travel expenses for regular staff for specific programme / training need, awards etc TOTAL Additionality in Annual Plan NRHM - Internet facilities at dsitricts WHO/ILEP/ICMR/Others 15
Physical Targets x12
Amount proposed 21.12 -
Amount approved 19.80 -
Remarks
2.00 493.83 228.26
G 7.1
Added as essential requirement
25
2.00
2.00
Page 215
Annex 4E DETAILED BUDGET: NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS (NPCB) NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS GRANT-IN-AID TO STATES/UTS FOR VARIOUS Physical Target Funds Requested Funds Approved As Per Guidelines Remarks
Sl.No. H1 H 1.1
Recurring Grant-in-aid For Free Cataract Operation @ Rs.750/- per case 650000 NGO-500000 1000 50000 385 3750.00 2114.00 Approved on reimburseme nt basis Approved Approved Not Approved Approved Approved Not approved Approved Approved Approved for PMOA and MIS training for 1 time Approved for 1 lac per distt. and 2 lac for state Through NRHM flexipool Approved Through NRHM flexipool Approved for
H 1.2 H 1.3 H 1.4 H 1.4 H 1.5
Other Eye Diseases@ Rs.1000/School Eye Screening Programme@ Rs.200/- per case Blindness Survey Private Practitioners @as per NGO norms Management of State Health Society and Distt. Health Society Remuneration (salary , review meeting, hiring of vehicle and Other Activities & Contingency) @ Rs.14 lakh/ Rs.7 lakh depending on the size of state Recurring GIA to Eye Donation Centers @ Rs.1000/per pair Eye Ball Collection by Eye Bank @ Rs.1500/- per pair Training PMOA and MIS training
10.00 100.00 577.50 5.00 14.00 128.00
10.00 100.00 0 5.00 14.00 0.00
SBCS-1 DBCS-32 (2 new distt. formed) 200 eye 6000eyes 404
H 1.6 H 1.7 H 1.9
1.00 45.00 50.00
1.00 45.00 15.00
H 1.10
IEC, Eye Donation Fortnight, World Sight Day & awareness programme in state & districts etc
32 lump sum for the state
10.00
31.00
H 1.11
Procurement of Ophthalmic Equipment (foldable IOL @ Rs.500 per IOL) Maintenance of Ophthalmic Equipments Non Recurring Grant-in-aid For RIO (new services Lasik) Starting new zonal centres@Rs.40 lakh For Medical College@ Rs.40 lakh
15 Medical College@1000 per annum
75.00
H 1.12 H.2 H.2.1
6.00 1 5 2 200.00 200.00 80.00
6.00 0
H.2.2
40.00 Page 216
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS GRANT-IN-AID TO STATES/UTS FOR VARIOUS
Physical Target
Funds Requested
Funds Approved As Per Guidelines 5.00
Remarks
H.2.3
For vision Centre @ Rs.50000/-
10
5.00
H.2.4
For Eye Bank @ Rs.15 lakh
30.00
15.00
H.2.5 H.2.6 H.2.7
For Eye Donation Centre @ Rs.1 lakh For NGOs @ Rs.30 lakh For Eye Wards and Eye OTS @ Rs.75 lakh
2.00 0.00 150.00
1.00 0.00 0.00
1 MC Approved for 10 Vision Centre Approved for 1 Eye Bank in Govt. Hospital Approved for 1 EDC Through NRHM flexipool
H.2.8
H.3 H.3.1 H.3.2 H.3.3
0.00 0.00 0.00 0.00 0.00 0.00 5484.00 2447.00 * The unutilized funds in any of the above said recurring components may be used in any other recurring component.
For Mobile Ophthalmic Units with tele-network @ Rs.60 lakh Grant-in-aid for strengthening of Distt. Hospitals @ Rs.20 lakh Grant-in-aid for strengthening of Sub Divisional. Hospitals@ Rs.5 lakh Contractual Man Power Ophthalmic Surgeon@ Rs.25000/- p.m Ophthalmic Assistant @ Rs.8000/- p.m Eye Donation Counsellors @ Rs.10000/- p.m.
0.00 2 1 40.00 5.00 40.00 5.00 Approved Approved
15 20 20
Page 217
Annex 4F DETAILED BUDGET: REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME Unit cost (wherever applicable) As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP I.2 Laboratory materials Physical target/expected output 1) Civil work Up gradation and maintenance completed as planned 56.11 1) Sputum of TB Suspects Examined per lac population per quarter; 2) All districts subjected to IRL On Site Evaluation and Panel Testing in the year; 3) IRLs accredited and functioning optimally As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP 1) All eligible Community DOT Providers are paid honorarium in all districts in the FY 77.87 1) All IEC/ACSM activities proposed in PIP completed; 2) Increase in case detection and improved case 31.15 Approved amount based on the utilization. The remuneration for the 6 communication facilitators should be 40.61 met from this head. Page 218 56.11
FMR Code
Activity
Estimated Budget
Approved Budget
Remarks
I.1
Civil works
Approved 100%. Approved 3 DOTS Plus sites, new constriction of DTC
Approved 65% of the amount.
136.40
90.00
I.3.a
Honorarium
I.4
IEC/ Publicity
68.41
FMR Code
Activity
Physical target/expected output holding
Estimated Budget
Approved Budget
Remarks
As per Revised Norms and Basis of Costing for RNTCP I.5 Equipment maintenance
1) Maintenance of Office Equipments at State/Districts and IRL equipments completed as planned; 2) All BMs are in functional condition; 3) Funds in the head utilized against approved amount
Approved amount permissible as per the norm. Not approved the proposal for TV and A/C maintenance .
35.66
25.00
I.6
Training
As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP
1) Induction training, Update and Re-training of all cadre of staff completed as planned 1) All 4 wheelers and 2 wheelers in the state are in running condition and maintained
I.7
Vehicle maintenance
Approved amount based on the utilization.. 88.50 60.00
1) Increase in supervisory visit of DTOs and MOTCs; 2) Increase in case detection and improved case
I.8
Vehicle hiring
Approved amount based on the utilization. 115.13 36.00
Page 219
FMR Code
Activity
Physical target/expected output holding
Estimated Budget
Approved Budget
Remarks
I.9
NGO/PPP support
1) Increase in number of NGOs/PPs involved in signed schemes of RNTCP; 2) Contribution of NGOs/PPS in case detection and provision of DOT 1) All activities proposed under miscellaneous head in PIP completed 144.95 1) All contractual staff appointed and paid regularly as planned 108.79
241.70
100.00
Approved amount based on the utilization. *If the state is anticipating deficit in laboratory capacity to conduct C&DST test, then state may budget for funds under C&DST scheme in the NGO /PP head as the RNTCP guidelines for NGO and PPs, as a priority.
I.10
Miscellaneous
Approved amount permissible as per norm.
I.11
Contractual services
1260.71
1182.26
Approved amount permissible as per norm. The remuneration for communication facilitators, should be met form the amount approved for IEC activities. The salary budgeted for the new TBHVs is approved only for 10 months, considering the Page 220
FMR Code
Activity
Physical target/expected output
Estimated Budget
Approved Budget
Remarks delay in approval and appointment.
I.12
Printing
As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP As per Revised Norms and Basis of Costing for RNTCP
1) All printing activities at state and district level completed as planned 50.85 1) Proposed Research has been initiated or completed in the FY as planned 20.00 1) All activities proposed under Medical Colleges head in PIP completed 256.25 1) Procurement of vehicles completed as planned 255.95 10.00 30.00
I.13
Research and studies
Approved the proposal for studying the prevalence of TB as this is a CTD priority.
I.14
Medical Colleges
Approved amount permissible as per the norm.
Procurement vehicles I.15
Approved 100% of the budgeted amount
Four wheeler Two Wheeler I.16 Procurement equipment As per Revised Norms and 1) Procurement of equipments completed as 23.50 23.50 Approved amount 10.80 permissible as per the norm.
20.88
Page 221
FMR Code
Activity
Unit cost (wherever applicable) Basis of Costing for RNTCP
Physical target/expected output planned
Estimated Budget
Approved Budget
Remarks
17
Tribal Action Plan Total (A) Additionality funds from NRHM (B) TOTAL (A+B) 2653.08 2105.17
18
99.91
99.91
Rs. 2205.08
Budget approved under NRHM additionalities 2012-13 Approved amount Activity State level logistics for STDC / IRL / SDS Furnishing of STDC for training. NGO Payment (Pending payment) Grand Total 6.08 93.83 99.91 6.08 93.83 99.91 Approved Proposed amount Remarks Approved
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APPROVAL OF STATE PROGRAMME IMPLEMENTATION PLAN 2012-13: TAMIL NADU

MINISTRY OF HEALTH & FAMILY WELFARE GOVERNMENT OF INDIA

Anuradha Gupta Additional Secretary & Mission Director, NRHM

371.62 329.41 10.78

0.24 1.10 9.08 2.28 24.47 17.71 298.14 9.77 289.33

(Dr. Suresh K. Mohammed) Director (NRHM - I)

(SRS 01-03) (SRS 04-06) (SRS 07-09) 2013 17 2014 14 2015 11

(SRS 2008) (SRS 2009) 31 28

(SRS 2008) (SRS 2009) 21 18

(SRS 2008) (SRS 2009) 15 13

(SRS 2008) (SRS 2009)

(SRS 2008) (SRS 2009)

Approval of Programme Implementation Plan Tamil Nadu 2012-13

Post-Partum sterilizations (lakhs)

Male sterilisations (lakh)

IUD insertions (lakhs)

<11% 0.3 60%-70%

Approval of Programme Implementation Plan Tamil Nadu 2012-13

Approval of Programme Implementation Plan Tamil Nadu 2012-13

FINANCE: KEY ISSUES AND GUIDING PRINCIPLES

1. 15% State share Contribution status :

2007-08 2008-09 2009-10 2010-11 2011-12 Total

Approval of Programme Implementation Plan Tamil Nadu 2012-13

Approval of Programme Implementation Plan Tamil Nadu 2012-13

ROAD MAP FOR PRIORITY ACTION

Approval of Programme Implementation Plan Tamil Nadu 2012-13

ISSUES THAT NEED TO BE ADDRESSED benchmark; incentives for difficult areas

Ambulance Services Referral Transport

Approval of Programme Implementation Plan Tamil Nadu 2012-13

STRATEGIC AREAS facilities for attendants

Approval of Programme Implementation Plan Tamil Nadu 2012-13

STRATEGIC AREAS capturing, validity triangulation

Monitoring and Review

Approval of Programme Implementation Plan Tamil Nadu 2012-13

PROGRAMME WISE BUDGET

APPROVED BUDGET (BY PROGRAM), 2012-13: Rs. 108035 LAKHS

FUNCTIONAL HEAD-WISE BUDGET Rs. 108035 LAKH

Other RCH Activities

Approval of Programme Implementation Plan Tamil Nadu 2012-13

Programme Management 6% Training 5%

RCH FLEXIBLE POOL BUDGET Rs. 36226 lakh

MISSION FLEXIBLE POOL BUDGET Rs. 34256.24 LAKH

Untied Funds 8% Annual Maintenance Grants Hospital 5% Strengthening 18%

New Constructions and setting up 20%

Approval of Programme Implementation Plan Tamil Nadu 2012-13

IMMUNISATION BUDGET Rs. 1540.92 Lakhs

Pulse Polio Operational Cost (Tentative) 63%

DISEASE CONTROL BUDGET Rs. 6310.51 lakhs

NLEP 4% NIDDCP 1% NVBDCP 15% RNTCP 35%

IDSP 7% NPCB 39%

Approval of Programme Implementation Plan Tamil Nadu 2012-13

SUMMARY BUDGET 12-13: TAMIL NADU

Approval of Programme Implementation Plan Tamil Nadu 2012-13

FY 2012-13 Budget ( Rs lakhs ) Proposed Approved %

20.00 100.00 1464.30

20.00 100.00 1173.31

0.00 0.00 0.00 0.02 0.09 1.09 0.00

1285.62 28.32 0.00 11.26 31.80 1357.00 1357.00

492.87 28.32 0.00 11.26 31.80 564.25 976.67 1540.92

0.46 0.03 0.00 0.01 0.03

43.17 446.87 940.00 228.26 2447.00 2105.17 6210.47 29814.00 108035.21

0.04 0.41 0.87 0.21 2.27 1.95

Approval of Programme Implementation Plan Tamil Nadu 2012-13