District Health Plan

2009-2010

District Health Society, Gaya

1
Foreword

NRHM was launched in April 2005. The State Health Society (Bihar) and the District Health Societies (Gaya) were formed by end of 2005.
The recruitment of Block level managers and other staff were completed by May 2007. The data centre was established by 2006, which
worked on outsourced mode. However, a new system replaced the out sourced mode and the data centres were put in place by 2008.

Public health system has witnessed an increased utilization of services in 2008 reflected by an increased number of persons being
provided every type of service that is available- be it outpatient care, inpatient care, institutional delivery services or emergency services,
or surgical services, or laboratory services. The strategy of revitalizing the BPHC and District hospital has shown results. Human
resources and Quality of services remains an issue that needs to be addressed.

The District Health Planning in Gaya used a situational analysis form focusing on areas in health covered by NRHM viz; RCH, NRHM
Additionalities, Immunization, Disease control, and Convergence. This DHAP has been evolved through a participatory and consultative
process, wherein community, NGO and other stakeholders have participated and deliberated on the specific health needs.

I need to congratulate the SHS Bihar for its dynamic leadership and enthusiasm provided to district level so that the plan is made. We are
grateful to Mr. Prasanth K S, NHSRC, New Delhi, for providing the necessary technical support and guidance in making the District Plan.
We also acknowledge PHRN (NGO partner) for organizing the capacity building programme for the preparation of District Health Action
Plan.
This District Health Action Plan (DHAP) is one of the key instruments to achieve NRHM goals. This plan is based on health needs of the
district. The documentation will be an opportunity for other districts to learn from Gaya experience.

Mr. Sanjay Kumar Singh

(DM) Gaya, Bihar.
2
 About the Profile
Health Action Plan of Gaya district has been prepared under the National Rural Health Mission. The plan recommends on how existing
resources of manpower and materials can be optimally utilized and critical gaps identified and addressed. It looks at how the facilities at
different levels can be structured and reorganized.

The focus of the plan has been on the health care needs of rural poor especially women and children, preventive and promotive
interventions, barriers in access to health care and human resources catering health needs in the district. The focus has also been given
on current availability of health care infrastructure in pubic/NGO/private sector.

The information related to data and others used in this action plan is authentic and correct according to my knowledge as this has been
provided by the concerned medical officers of every block. I appreciate the tremendous effort put in by the district planning team in making
this District Health Action Plan of Gaya District.

I am sure that this attempt will incite the leaders and administrators of the primary health care system in the district, enabling them to go
into the district health plan. I hope that this District Health Action Plan will ably contribute to the State Programme Implementation Plan.

Dr. Prakriti Gupta

Civil Surgeon, Gaya
Bihar.

3
TABLE OF CONTENTS
 INTRODUCTION

 PLANNING PROCESS

 PART A. RCH

 PART B. NRHM Additionalities

 PART C. Immunization

 PART D. Disease control

 PART E. Convergence

 Annexure: TABLES

 BUDGET

4
 INTRODUCTION
Gaya District is situated in the Southern part of Bihar. It has an average elevation of 111 metres (364 ft). The Dist has 24 blocks & 35
Police Stations & 4 Subdivisions. The total land area of the district is 4937.75 sq/km. which is about 5% of the total area of Bihar.

As of 2001 India census, Gaya had a population of 3,473,428. Males constitute 53% of the population and females 47%. Gaya has an
average literacy rate of 51.07%, lesser than the national average of 59.5%; male literacy is 63.81%, and female literacy is 37.40%.

Gaya Historical
Gaya has experienced the rise and fall of many dynasties in the Magadh Region. From the 6 th century BC to the 18 th century AD, about
2300-2400 years, Gaya has been occupying an important place in the cultural history of the region. It opened up with the Sisunaga
dynasty founded by Sisunaga, who exercised power over Patna and Gaya around 600 BC. Bimbisara, fifth in line, who lived and ruled
around 519 BC, had projected Gaya to the outer world. Having attained an important place in the history of civilization, the area
experienced the bliss of Gautam Buddha and Bhagwan Mahavir during the reign of Bimbisara. After a short spell of Nanda dynasty, Gaya
and the entire Magadh region came under the Mauryan rule with Ashoka (272 BC – 232 BC) embracing Buddhism. He visited Gaya and

5
built the first temple at Bodh Gaya to commemorate Prince Gautama's attainment of supreme enlightenment. Gaya then passed on to the
Pala dynasty with Gopala as the ruler. It is believed that the present temple of Bodh Gaya was built during the reign of Dharmapala, son
of Gopal Gaya finds mention in the great epics, Ramayana and Mahabharata. Rama alongwith Sita and Lakshmana visited Gaya for
offering PINDDAN to their father Dasharath. In Mahabharat, the place has been identified as Gayapuri. About the origin of the name
‘Gaya' as referred to in Vayu Purana is that Gaya was the name of a demon (Asura) whose body was pious after he performed rigid
penance and secured blessings from Vishnu. Bodhgaya, where Lord Buddha has achieved enlightenment, is now a international heritage
centre.

Gaya formed a part of the district of Bihar and Ramgarh till 1864. It was given the status of independent district in 1865. Subsequently, in
May 1981, Magadh Division was created by the Bihar State Government with the districts of Gaya, Nawada, Aurangabad and Jehanabad.

Modern History
Gaya has also immensely contributed in the Indian Independence Movement. It has also been a place of the Gandhian leader Bihar
Bibhut Dr.Anugrah Narayan Sinha. During the independence movement,the All india session of the Congress was held under the
presidency of Deshbandhu Chittaranjan Das in 1922, which was attended by great illumanaries and prominent leaders of the Indian
Independence Movement, such as Mahatma Gandhi, Rajendra Prasad, Anugrah Narayan Sinha , Sardar Patel, Maulana Azad, Nehru
and Sri Krishna Sinha. Jai Parkash Narayan spend months in patluka village in Barachatti when he flew from Hazaribagh jail in 1942. One
of the finely run PHCs in Gaya is in Barachatti.

Transportation
Gaya is well connected to the rest of India and the world by roadways, railways and airways.The Grand Trunk Road (NH-2, which is
undergoing a revival under The Golden Quadrilateral project) is about 30 km. from Gaya city. Gaya has the second most important railway
station in Bihar after Patna. It is a junction and is connected to the all the four metropolis New Delhi, Kolkata, Mumbai and Chennai
through Important Broad Gauge Routes (direct trains). Now it is also directly connected to Guwahati(N-E India) including the Grand Chord
line. There is a direct non-stop train, the Mahabodhi Express from New Delhi to Gaya daily. It takes around 16 hours to reach Gaya from

6
New Delhi through train. Gaya Airport is the only international airport in Bihar and Jharkhand taken together. It is an international airport
connected to Colombo, Sri Lanka, Bangkok, Thailand, Singapore, and Bhutan.

Communication Map of Gaya

Delicacies
Gaya has been the origin of several sweet delicacies popular in the whole of Bihar, Jharkhand and the rest of India. Tilkut, Kesaria Peda,
Lai, Anarsa of Ramana road and tekari road are the most popular sweets that bear the trademark of Gaya.Tilkut being the most popular of
7
them is prepared using til or sesame seeds (Sesamum Indicum) and jaggery or sugar. It is a seasonal (winter) sweet and only the karigars
(workers) from Gaya are believed to impart the real taste of Tilkut. One can find Tilkuts carrying the label "Ramna, Gaya" even in far flung
places like Kolkata and Delhi. Ramna and Tekari Road are the areas in the city where every other house is a Tilkut factory. Kesaria peda
is yet another delicious sweet prepared from khoya (solid milk cream) and kesar (saffron). The Chowk area of the city specializes in
Kesaria Peda production. Anarsa is also based on khoya, but is deep fried and processed with sugar. Anarsa comes in two shapes 'thin
disk' and 'spherical'. The sweet is finally embedded with til (sesame) toppings.

These sweets are dry and hence easily packagable, preserved, and transported, unlike the bengali sweets which are soaked in sugar
syrups. There is a tradition among the residents to gift the visitors with these sweets when they depart, as a token of love. Most of these
sweets are but made and dispensed in places which are not so hygienic and hence posing an issue of food safety.

Education
The only university at Gaya is Magadh University established by eminent educationist and then Education Minister. Late Satyendra
Narayan Sinha in 1962, located near Bodhgaya. Gaya has several colleges with graduate and post-graduate courses offered in sciences,
arts, commerce, management and Computer Application. Anugraha Narayan Magadh Medical College and Hospital (ANMMCH) is the
medical college in Gaya.

The planning process

The District Programme Implementation Plan has evolved through a consultative process wherein Health Managers, Medical Officers,
PRIs and NGOs have been involved. A capacity building programme had been organized for the district planning team prior to the
consutative process. A preliminary draft was prepared by 24th January 2009 and by 27th January 2009 the first version was prepared and
submitted to SPMU for inputs and positive inclusion into the State Programme Implementation Plan. After incorporating the inputs the
current version is made.

The budget line prepared from the list of activities proposed under the respective strategies followed the FMR guideline. Budget head on
infrastructure, human resource, infection control & environmental plan, logistic management, HMIS, Monitoring evaluation, training, IEC
8
/BCC, procurement, strengthening of services, AYUSH & initiative for quality improvement have been incorporated along the respective
programme heads (A to E).

DISTRICT PROFILE

No. Variable Data

1. Total area 4937.75 SQ. KM

2. Total no. of blocks 24

3. Total no. of Gram Panchayats 333

4. No. of villages 2925

5. No of PHCs 22+2

6. No of APHCs 46+56

7. No of HSCs 439+204

8. No of Sub divisional hospitals 0

9. No of referral hospitals 2

10. No of Doctors 116R+69C

11. No of ANMs 531R+300C

12. No of Grade A Nurse 17R+80C

13. No of Paramedicals 53

14. Total population 3464983 (CENSUS-2001)

15. Male population 1789231 (CENSUS-2001)

16. Female population 1675752 (CENSUS-2001)

9
17. Sex Ratio 973/1000

18. No of Eligible couples 892759

19. Children (0-6 years) 527708 (ESTIMATED POPULATION)

20. Children (0-1years) 123864

21. SC population 788293

22. ST population 1468

23. BPL population 24.6

24. No. of primary schools 2221

25. No. of Anganwadi centers 3334

26. No. of Anganwadi workers 3334

27. No of ASHA 2780

28. No. of electrified villages 24.4%

29. No. of villages having access to safe drinking water 4.2%

30. No of villages having motorable roads 7.6%

10
 Part A. RCH II

MATERNAL HEALTH
Objectives
1. To reduce MMR
2. To increase institutional deliveries
3. To increase access to emergency obstetric care
4. To reduce anaemia among pregnant mothers
5. To reduce incidence of RTI/STI cases

Objective. 1
 To reduce MMR (target - 200/1000 live births by 2010)
Strategies 1&2
 Increase 3 ANC coverage
 To increase birth assisted by trained health personnel

Activities

11
 1. Improve Access of ANC Care by Organising fixed day ANC clinic
2. Ensure quality service and Monitoring of ANC Care by checking of ANMs duty rooster and visits of LHVs and MOs.
3. Refresher training of ANMs on ANC care
4. Proper maintenance of ANC Register and Eligible couple register
5. Ensure safe delivery at Home
6. Provision of Disposable delivery kits with ANMs and LHVs

7. Training of ANMs on SBA

8. VHND services to be provided through Mahila Mandal meetings

Strategy

 To increase the coverage of Post Natal Care

Activities
 Ensuring proper practice of PNC services and follows ups at the health facility level. Currently the percentage of mothers visited by
health worker during the first week after delivery is low (range: 5-52%).

 Refresher sessions for all ANMs on guidelines to be followed for PNC care
 Ensuring follow up PNC care through out reach services (ANM) for delivery cases where the patient does not return to
facility for follow up check ups.
 Referral of all complicated PNC cases to FRU level.
 LHV and MO to monitor and report on PNC coverage during their filed visits
 Utilizing the ASHA network to strengthen the follow up of PNC services through tracking of cases, mobilization to
facilities and providing IPC based education / counselling.

12
  ASHA to make 3 PNC visits - for home delivery cases (1st within 2 days, 2nd within 4 days and 3rd within 42 days of
delivery) and 2 follow up visits for institutional delivery cases. She will also make visits (3 times) during post natal
period.
 Counselling of all pregnant women on ANC and PNC during monthly meetings of Mahila Mandal / VHND Meetings.
 Linking of ASHA’s incentives on institutional deliveries to completion of the PNC follow-ups.
 ASHA should be able to report maternal deaths directly to district level though an SMS service, which will be stored in
the DHS database. This will facilitate maternal death audit.

Objective : 2
To reduce anaemia among pregnant mothers
Strategies
 Increase the consumption of IFA tablets
 IEC
Activities
1. distributed door to door esp. to all teenage pregnancy cases. Ensure timely supply of IFA Tablets to the Health
Institutions. The tablets may be
2. Awareness generation for consumption of IFA Tablets among Pregnant mothers by ASHA and AWW
3. District to purchase IFA tablets in the case of stock out
4. Convergence with ICDS for regular supply of IFA tablets through AWWs
5. Half yearly de-worming of all adolescent girls.
6. Necessary training and logistics for ASHA in adolescent health / family
7. Ensure referral of severely Anaemic Pregnant Mothers to higher centres
8. IEC on consumption of locally available iron rich foodstuffs
13
 Objectives .3 &4
 To increase institutional deliveries
 To increase access to emergency obstetric care for complicated delivery.
Strategies
 JSY
 Operationalisation of Health Facilities (Upgrading BPHCs/CHCs in to FRUs, Operationalising 24*7 PHCs,
Operationalising Sub Centres)
 Provision of Referral Support system
Activities
For JSY the State Health Society entered into an agreement with SBI for transfer of funds electronically to respective DHS
account. The SBI will release funds against an advice issued by DHS. But since SBI is not having braches in every block, the
fund is released to Punjab National Bank. This process causes delay and in most of the blocks a delay of around 1-2 months
results. Another issue is that since release of fund from SHS level is dependent upon utilization certificate, unless a UC
showing 60% funds being spend, is produced, a further release will not be made. Since DHS is not able to send the SOE in
time, a this delay often results. Presently SHS has released funds to clear the back log.
Another issue is to give maximum support to pregnant mothers by way of disbursing some advance money before she
reaches institution. From the Rs.1400/- which is being paid to mothers Rs.500/- can be given during ANC registration and the
rest of the money can be paid once institutional delivery occurs. This will ensure pregnant women have some money at hand
for emergencies before she reaches institution for delivery. Yet another issue is regarding the role of ASHA in activities where
she is not being paid (e.g. postnatal visits). Appropriate mechanism needs to be devised so that ASHA is motivated to do the
complete range of MCH services, whether she is paid for all such services or not.
 Increase beneficiary choice for institutional delivery through IEC campaign complimented by network of link workers
working on incentive basis for each institutional delivery achieved.

14
 The IEC would focus on communicating the benefits of institutional delivery, benefits under JBSY scheme, danger signs to be
taken note of and location of functioning FRUs where such cases can be treated.

 Equip the ASHA network to reinforce the IEC messages through IPC interventions at village / community level.

 Provide incentives to ASHA for every institutional delivery achieved in her village / designated area.

 Involvement of PRIs for JBSY scheme to monitor and generate awareness for institutional delivery.

 Home deliveries are still prevailing in villages where untrained traditional dais are involved. These deliveries seldom get reported
also. The Dai delivery kit will be provided to all dais who will be identified through ASHAs. All home deliveries will be reported by
ASHA to ANM.

Operationalisation of FRUs

As of now two FRUs are existing in Gaya; one in Shergatti and another in Dumaria. The FRU in Sherghati is functional but the one
in Dumaria is defunct. Again, Dumaria is a place where access is difficult because of poor condition of roads and infestation of
naxals. It is hence proposed that; one, the FRU in Shergatti be strengthened and second; the Lady Elgin hospital, which is located
in Gaya be developed as FRU.

Please refer to table on FRU in Tables list.

For each facility an additional HR requirement as per table below is proposed.

HR Additional
Requirement
(2010) IPHS norms
Doctors (MBBS) 4 to be fulfilled
Paediatrician 2 by 2012
Gynaecologist 2
Anaesthetist 2

15
 ANM 6
Staff Nurse A grade 4

Activities

 The grade A nurses for Sherghati FRU will be mobilised from Dobhi PHC. For Lady Elgin new recruitment would
be required. Equipments for Blood Storage centre has already been purchased in Sherghati, Lady Elgin and
Pilgrim hospital. The unit will run through PPP.
 Private Anaesthetist will also be brought in to serve in FRUs.
 Currently C-sections are conducted only in Lady Elgin. But infection control protocols needs to be strengthened.
 All complicated delivery cases gets referred to medical college. The FRUs will be strengthened to cater to
complicated cases also.
 Training of Lab technicians / staff nurse in blood storage, grouping, cross matching and management of
transfusion reactions.
 Construction work in Shergatti is going on. In Lady Elgin lot of renovation work needs to be done. The running
water supply and functioning of toilets are primary. (So in budget renovation is shown only for Lady Elgin). Both
the centres require to buy equipments for labour room and operation theatre.
 Blood is to be made available free of cost to all pregnant women
 Health facilities may be graded as women and child friendly hospitals
 Community mobilization for voluntary blood donation –– ASHA Diwas / meeting / Mahila Mandal meeting / PRI
meetings will be used for dissemination of information – NGO partners in awareness campaign as well as
mobilising the voluntary donors.

Operationalisation of 24x7 facility at the PHC level

16
As of now 17 PHCs are offering 24*7 services. In 2010 we propose to operationalise 5 more PHCs and 2 APHCs to be offering
24*7 services.
Activities
 Training of MOs and Staff Nurses of PHCs in EmOC
 Appointment of at least 3 Staff Nurse in each PHCs
 Repair and renovation of PHCs
 Timely supply of PHC kits
 Training of ANMs on SBA
 Provision of labour room, ward and lab facility
Deleted: ¶
 Training of MOs / staff nurse on BEmOC Repair and renovations
 Appointment of lady MO, and Staff Nurses

HR requirement for running 24*7 BPHCs

HR Requirement per Total For the posts of Surgeon, paediatrician,

PHC requirement IPHS gynaecologist and anaesthetist sanctioned
(2010) for 22 PHCs norms to posts are currently been filled by general

EmOC trained 3 66 be fulfilled MBBS, since specialist are not available. PHC

doctor by 2012 level Panchayat Committee will be encouraged

Trained Anaesthetist 1 22 to participate in the functioning of 24 x 7 PHC.

ANM 6 132 Since it will tax much to have residential

buildings available in every PHC, it is proposed

17
that a rest cum relax room for duty staff be provided in the premises. However, provision for residential facility is
recommended for Paraiya, Fatehpur, Dumariya, Imamganj, Wazirganj & Atri.
Inorder to operationalise APHCs, one AYUSH doctor per APHC needs to be appointed. The medical doctor who is currently in
APHCs can be deployed in BPHCs.
Operationalise Sub Centres
Residential quarters for ANM are preliminary for strengthening of sub centre. Currently none of these exist. Another
requirement is that the ANM should be available either in Sub Centre or in the village 6 days a week. A chart of the daily work
expected out of ANM would be printed and pasted on the Sub Centre. Ensuring availability of adequate drugs is another
issue. ANM and ASHA, with the active support of PRI will conduct councelling services in the village on various health and
nutrition issues, hygienic practices, environmental sanitation, primary health care etc. In Gaya VHND are not conducted.
Mahila Mandal meetings are conducted where VHND services are being provided. A calendar of Mahila Mandal meetings will
be planned in advance for the year (third Friday every month). ASHA will do priority mapping on pregnant women,
malnourished children, newborns, Mahadalit Tola etc. and focus will be laid on those areas.

Safe abortion services at health facilities

Activities
 To prepare E-list of MTP practitioners.
 Support for IEC /BCC mobilisation
 Training of MO and ANM
 Awareness drives will be undertaken in the community regarding availability of MTP services, consequences of
sex selective abortions and PNDT act.
 Drugs & procurement for MTP will be provided.
 To built awareness on MTP a co ordination programme in rural and urban areas will be conducted.
 A quality improvement programme to strengthening the societies for MTP
18
  It is proposed that the facility be made available at District hospital & FRU Sherghati. Those will be developed to
be model centres.
 Strengthening of Comprehensive abortion care services of Sadar hospital. Currently no centre in Gaya is
providing MTP services.
 Training to include MTP, legal operation aspect of MVA etc.
 Formation of District level committee to accredit private providers /sites
 Exploring possibilities on PPP mode for Safe Abortion Services esp. in hard to reach areas like Dumaria, Tikari
etc. Private providers will be accredited who will then provide abortion services.
 Develop reporting system from public sector as well as private.
 Pregnancy testing services should be provided at all HSCs, and BPHCs. It is done in some APHCs also. This
service may be linked with MTP services as well. ASHA has already been be trained by an NGO called Nishyay.
Referral Support system
 The issue to be addressed is the absence of pick-up service of pregnant women. The women has to make arrangement for
transport and a travel reimbursement Rs.200/- is given irrespective of the actual amount spent on travel.

 Provision of referral transport system to refer patients from home/HSCs/PHCs to referral centres. (102 ambulance service is
available as of now)

 Monitoring of referral transport system

 Development of proper referral system between Health Institutions.

 Fill vacant ANM posts and appoint additional ANMs in a phased manner to achieve GOI norm of one ANM per 5000 population by
the year 2010.

Objective. 5
Reduce incidence of RTI/STI
19
 Now a days this facility is being provided only in Medical colleges and Sadar hospital. The FRUs is presently proposed
to offer these services.
Strategies

 Ensuring early detection through regular screenings and contact surveillance strategies.
 Strengthening the infrastructure, service delivery mechanism and capacity of field level staff for handling of RTI / STI
cases.

Activities

 Early diagnosis of RTI / STI through early detection of potential cases through syndromic approach and referral by ANM
and ASHA.
 Integrated counselling services will be provided
 Conducting VDRL test for all pregnant women as part of ANC services.
 Implementing contact surveillance of at risk groups in convergence with Bihar AIDS Control Society.
 Conducting community level RTI / STI clinics at PHCs
 Training to all MOs at PHC / DH level in Syndromic Management of RTI / STI cases in coordination with Bihar AIDS
control Society
 Training of frontline staff, LHV, ANM and ASHA in identifying suspected cases of RTI / STI in coordination with Bihar
AIDS Control Society.
 Strengthening RTI / STI clinic at the FRUs
 Counsellor and doctor will be required in both FRU. It is proposed to involve specialist doctors in Skin & VD from
private sector, who could offer services in FRUs.
IEC
 Public awareness through IEC in highway (e.g. GT road)
20
  For prevention of RTI/STI condom distribution by ASHA
 Training – Doctors, Para Medical Staff, Counsellors, ANM, ASHA AWW should be trained. Most of the RTI / STI
problem can be then sorted out at village level.
 Procurement of Drugs & Equipment for treatment of RTI/STI
 To improve access to RTI /STI at referral Hospital
 Referral Hospital and District Hospital will be strengthened for diagnosis and treatment of RTI/STI
 At district level RTI/STI management by NACO includes awareness programme by way of Red ribbon express, road
show, etc. A counsellor is provided by BSACS in district hospital, and medical college has facility for ELISA test. The
cases are referred from OPD to VCTC for counselling.

CHILD HEALTH
High levels of maternal malnutrition and low levels of female literacy, particularly in rural areas increase risk of child mortality.
Failure of family to properly plan their family in matters related to delaying and spacing of births leads to significantly high
mortality among children. Failure of programme to effectively promote breastfeeding immediately after birth and exclusive
breastfeeding is yet another factor affecting IMR. A high level of child malnutrition, particularly in rural areas and in children
21
belonging to disadvantaged groups adds to the problem. The Anganwadi centre and Sub Centre often lacks drugs, ORS
packets, weighing scales, etc. The plan for child health takes these factors into consideration.

Objectives
 To reduce IMR (target – from 591 to 45 by 2010)
 To reduce child mortality rate
 To reduce malnutrition among children
 To reduce the prevalence of anaemia among children

Strategies (cross cutting across objectives)

1. Promote immediate and exclusive breastfeeding
2. Appropriate infant and young child feeding
3. IEC
4. To strengthen neonatal care services in all PHCs/CHCs/SDHs
5. Strengthen essential newborn care at home
6. Full immunization of Children
7. To reduce morbidity and mortality among infants due to diarrhoea and ARI
8. Special care neonatal care unit

Strategy
Promote immediate and exclusive breastfeeding
Activities

1
Infant and Child death, District level estimates, PFI, May2008.
22
 1. Use mass media to promote breastfeeding immediately after birth (colostrums feeding) and exclusively till 6 months of
age.
(a) Production and broadcast of radio spots, jingles, folk songs and plays promoting importance of correct
breastfeeding practices
(b) Production and broadcast of TV advertisements and plays on correct breastfeeding practices
(c) Publication of newspaper advertisements, booklets and stories on correct breastfeeding practices
2. For ensuring breast feeding Health Manager would be responsible to monitor every patient before discharge. He /she
would be required to mention the breast feeding status on BHT and in delivery register. Medical Officer will enter status
of mother and baby and status of breast feeding in the delivery register.
3. Involve frontline Health workers, Anganwadi Workers, PRIs, TBAs, local NGOs and CBOs in promoting
correct breastfeeding and complementary feeding through IPC, group meetings, folk media and wall painting.
4. Educate adolescent girls about correct breastfeeding and complementary feeding practices through school -based awareness
campaign.

Strengthening community awareness through IEC/BCC on Malnutrition

1. Regular house visit by ANM / ASHA. A check list will be prepared by PHC and with the help of check list ANM or ASHA
will visit the house, and counsel the pregnant women, eligible couple and lactating mother.
2. Identity the villages where the prevalence of Malnutrition grade III and grade IV are high.
3. Severe Malnourished children will be referred to health facilities by AWW & ASHA
4. During weekly meeting in PHC at least one (on 2nd Tuesday ) meeting in every month would be focused on any health
topic. This will be delivered by the MO and topic will be suggested by Health Manager.
5. Device appropriate interventions like the nutrition requirements of children in the age group of 5 to 6 years and the
possible support being provided by the AWC.

23
 6. With the help of ICDS Officials and PRI BCC Activity would be organized in villages (through posters, banners and wall
writing of the messages)
7. De worming tablets will be distributed among children of Middle School, low socioeconomic area (frequency 6 months)
8. Growth monitoring of each child
(a) Supply of spring type weighing machine and growth recording charts to all ASHAs, AWWs. All ASHAs, Anganwadi
centres and sub centres will have a weighing machine and enough supply of growth recording charts for monitoring
the weight of all children.
(b) Weighing and filling up monitoring chart for each child (0-6 years) every month during VHNDs/Mahila Mandal
Meetings
(c) Each child in the village will be monitored by weight and height and records will be maintained
(d) Training for indications of growth faltering and SOPs for referral to AWWC for nutrition supplementation and to PHC
for medical care.
9. Establishment of Nutrition Rehabilitation Centres (2) in blocks having severe problems of malnutrition. The tendering process for
NRC is on.

Strategy
To strengthen neonatal care services in all PHCs/CHCs/SDHs by setting newborn care centres
Activities
1. Home based neonatal care will be done by ANM of respective HSC. This will be monitored by LHV
2. Build state IMNCI training pool – inadequate monitoring of this activity at field level is an issue. Local Resource Persons
can be roped in to ensure community based monitoring.
3. Care of babies by “MAMTA” and ANM needs to be ensured. Training of MO and staff nurse in IMNCI / operation of
baby warmer machines. Fixing a day in a week for IMNCI related work at HSC level.
4. (Re) train health and ICDS staff in IMNCI protocols
24
 5. Ensure implementation of IMNCI clinical work following training
6. Community Awareness on home-based care of new born (skin-to-skin contact, bathing after a week, not removing
vermix, etc.); early recognition of danger signs - ARI, diarrhoea; proper weaning practice
7. The ASHAs / MPWs / AWWs at every point of contact for ANC and PNC will reinforce tenets of home-based care of
new born as per IMNCI guidelines. The training will be part of IMNCI.
8. Capacity building in the area of facility Based newborn care

Full immunization of Children

1. Ensuring cold chain maintenance
(a) Ensure ILR and Deep Freezer are available in appropriate number in every PHC.
(b) Cold chain handler to ensure by way of regular check up of ILR & Deep freezer.
2. Conduct fixed day and fixed-site immunisation sessions according to district microplans.
3. Update district microplan for conducting routine immunization ( now Muskan Ek Abhiyan) sessions
4. Ensure timely and adequate supply of vaccines and essential consumables such as syringes, equipment for sterilisation, Jaccha-
Baccha immunisation cards (card is issued after registration of pregnant women), and reporting formats at all levels.
5. Supply AD Syringes to conduct outreach sessions in select areas.
6. Enlist help of AWW/ASHA in identification of new-borns and follow-up with children to ensure full immunisation during sessions.
New Born tracking system to be implemented through Muskan by way of tracking register
7. Replace all Cold Chain equipment, which is condemned, or more than five years old in a phased manner and supply new Cold
Chain equipment based on analysis of actual need of the health facilities
8. Build capacity of immunisation service providers to ensure quality of immunization services.
9. Provide comprehensive skill upgradation training to immunisation service providers (LHVs/ANMs), particularly in injection safety,
safe disposal of wastes and management of adverse effects.
10. Conduct training to build capacity of Medical Officers, MOICs and DIOs for effective management, supervision and monitoring of
immunisation services
25
 11. Train Cold Chain handlers for proper maintenance and upkeep of Cold Chain equipment
12. Form inter-sectoral collaboration to increase awareness, reach and utilization of immunisation services
13. Involve Anganwadi Workers and PRIs to identify children eligible for immunisation, motivate caregivers to avail immunisation
services and follow-up with dropouts.
14. ASHA, AWW and ANM will hold meeting with Mahila Mandals at each village monthly for increasing the coverage of Immunization.
Incentive to be provided to ASHA and ANM under RCH and AWW under intersectoral convergence.
15. Involve ICDS and PRI networks in behavior change communication for immunisation.
16. Strengthen Supervision and monitoring of immunization services
o Build capacity of Medical Officers, MOICs and DIOs in supervision and monitoring of implementation of immunisation
services as per the micro-plan.
o Provide mobility support to MOICs and DIOs for supervision and monitoring of implementation of immunisation services.
o Develop effective HMIS to support supervision and monitoring of implementation of immunisation services.
o Coordinate with representatives of PRI to strengthen supervision and monitoring of immunization services.

Strategy
To reduce morbidity and mortality among infants due to Diarrheoa and ARI
Activities
1. Increase acceptance of ORS by awareness generation by ASHA
2. The ASHA drug kit will have ORS (with Zinc) and cotrimoxazole tablets which would be replenished as per need.
Anganwadi centres should also be given ORS. In the absence of ORS, the use of home-based sugar & salt solution will
be encouraged.
3. ASHAs will be specifically trained to identify symptoms of Diarrhea and ARI and to provide home-based care. Danger
signs requiring transportation to seek medical care will also be taught to ASHAs.
4. ASHA and AWW will be trained in providing Home based care. The training will be held at Block PHC level.
5. Strengthening of referral services for infants seeking care for life threatening diarrhoea and ARI

26
6. Vitamin A supplementation, and 6 monthly de-worming

ADOLESCENT HEALTH
Objectives

1. To improve adolescent Health

2. To reduce anaemia.

Strategies
1. Adolescent friendly Health Clinics
2. Increase awareness levels among adolescents on health issues.

Activities
1. Adolescent friendly Health services will be conducted in every PHC
2. MTP services to be provided in both FRUs (Sherghati and Lady Elgin)
3. Integrated councelling on breast feeding, Nutrition, birth preparedness, iodine, HIV, RTI/STI
4. HIV counselling be started with the help of Bihar State AIDS Control Society
5. Mahila Mandal Meeting would also be organised at VHDS. Currently Mahila Mandal Meeting‘s are not following
a structured format. So, it is proposed that topics like Adolescent Health, Nutrition, restriction of under 18
marriage etc. are discussed in such meetings.
6. Organise regular adolescent clinics/counselling camps at SC / PHC / CHC / SDH / DH
7. Adolescent health sessions/clinics will be held in each Sub Centre/ PHC / CHC/SDH and DH with service
delivery & referral support

27
 8. Risk reduction counselling for STI/RTI. ASHA/AWW to act as nodal persons at village level for identifying &
referring adolescents in need of such services.
9. All ASHAs and AWWs will be oriented on problems faced by adolescents, signs and symptoms of the problems
and where to refer the cases.
10. Nukkar Natak – 100 sessions are planned for the year 2009-10.
11. Premarital counselling on reproductive health issues at PHC/RH/SDH/DH
12. IEC / Counselling – on Prevention of adolescent pregnancy, general health, sex, legal age of marriage, anaemia,
and safe abortion services
13. Adolescent pregnancy should be addressed with priority care esp. Eclampsia, provision of IFA tablets, ensuring 3 ANC
visits, conducting institutional delivery, postnatal care etc.

FAMILY PLANNING
Objectives
1. Reduce TFR
2. To increase Contraceptive Prevalence Rate
Strategies
 Permanent methods to be provided in all 24 x 7 PHCs
 Awareness generation in community for small family norm
 Promote male sterilizations
 Promote Spacing Methods
 Promote Post abortion contraception and postpartum tubectomy

Permanent methods to be provided in all 24 x 7 PHCs

28
 Activities
a. Tubectomy & vasectomy services to be provided in every 24 x 7 PHCs.
b. Supplies and equipments for providing permanent method will be purchased.
c. MO- Skill up gradation for permanent method.
d. Private providers are accredited (7) who are currently providing sterilization services

Awareness generation in community for small family norm

Activities
1. Communication materials highlighting the benefits of a small family will be prepared for radio, TV and newspapers.
2. Regularise supply of contraceptives in adequate amounts through proper Indent and supply of contraceptives for all
depots and subcentre/ AWCs and social outlets
3. Each AWC and ASHA will have at least one month’s stock requirement of condoms and OCPs. Sub centres will have
adequate supplies of IUDs also.

Promotion of male sterilizations

Activities

1. NSV /Promotion – Family planning worker will motivate the male for NSV. Where (in Health Sub Centre) Family
planning worker is not available NGO Partners will performs the work. In Gaya District, there are 439 HSC, AND
only 30 Family planning workers are working.
2. NSV camps will be organised in PHC where in NGO / Private Providers cooperation will be invited in conducting
the camps as well as motivating the beneficiary.
29
3. Use of mass media to promote family planning practices
4. Increased demand for NSVs through Village level meetings in which men who already underwent NSV share
experiences to motivate men to undergo NSV. All the GP Villages will be chosen in the district to hold meetings in
which men who have undergone NSV will tell male members of the community about their experience and the
benefits of NSV. These meetings will be repeated every month. NSV will be conducted on the motivated men. The
same men will then be requested to share their experiences in the next batch of five villages for the next three
months.
5. Dissemination of manuals on sterilization standards & quality assurance of sterilization services. The guidelines
will be provided in Hindi.

Strengthening of District Programme Management Unit

 District / Block level managers would take part in the PPP contracts and negotiate on TOR
 Capacity building of District / block managers in epidemiology through distance learning mode
 Networking of all relevant NGO’s in the area will be done by Block level managers
 Exposure visit of DPM/BHM to other districts / states where model facilities are functioning
 Training of district / block health managers on the HMIS format

(Budget given separately)

30
 PART B. Additionalties under NRHM (Mission Flexi Pool)

ASHA is one of the core strategies of National Rural Health Mission implementation plan in Gaya, Bihar. ASHA is the female
health activist who would promote access to improved health care at household level. Selection of Asha started in 2006 and
the total target of selection of Asha was 2997 in the District out of this 2780 have already been selected. Remaining 217 Asha
would be selected in 2009 – 10. The training of 2nd & 3rd Modules would also be completed in 2009 – 10.
Streamlining the working and incentive payment of ASHA
1. For easy identification and authentication, an Identity Card with photograph had been provided to each ASHA.
2. In every PHC of the District Asha Divas is being conducted every month. Asha Divas is conducted twice month i.e. 1st &
3rd Thursday.
3. Various incentives are being given to ASHA on time. i.e. incentives for JBSY, Muskan Ek Abhiyan, motivating for
sterilization, and as Vaccinator in Pulse Polio.
4. Asha is working as a mobilizer to strengthen Institutional delivery.
5. Asha is also working to mobilize the woman (Pregnant) as well as children to increase number of immunization

Untied Fund For HSC

The objective is to facilitate meeting of urgent yet discrete needs that require relatively small sums of money at Health Sub
Center level. In 2009 – 10 Rs. 10000/- will be given to all 439 +102 (new) = 541 health sub centre.
Village health & sanitation committee would be formed in every village in (2009- 10). Guidelines regarding the same would be
made available in each village.
The suggested areas where Untied Funds can be used would be discussed with PRI and ASHA. Block Health Manager would
be entrusted to make sure that the money is spent.
1. Curtains to ensure privacy, repair of taps, installation of bulbs, other minor repairs, which can be done at the local level;

31
2. Ad hoc payments for cleaning up sub center, especially after childbirth; transport of emergencies to appropriate referral
centers;
3. Purchase of consumables such as bandages in sub center;
4. Purchase of bleaching powder and disinfectants
5. Supplies for environmental sanitation (larvicides)
6. Payment/reward to ASHA for certain identified activities.

Untied fund for PHC & APHC

Each PHC & APHC received a sum of Rs.25, 000/- as untied funds which are for being utilized as per need for local health
action in the PHC area. The fund will be routed through RKS.
46 APHC+ 27(New) = 73
24 PHC = 24
Annual Maintenance grant for APHC & PHC & Subcentre
Rs. 50000 will be given to every APHC & PHC (73 APHC + 24 PHC=97) in 2009-2010.
Up gradation of CHC to IPHS
7PHCs would be up graded to Community Health Centre in (2009-10)
Water, Sanitation, Electricity, toilet facilities etc. will be provided in 7 CHC in 2009-10 & the health facilities would be raised to
the standard of IPHS by 2012.
Mobile Medical Unit
Eligibility criteria in appearing for tenders has often found to be a hindrance, for interested parties and hence a relaxation of
this criterion (Financial) may be suitably effected.
Publicity of Mobile Medical Unit services would be done
Requirement of HR (Specialist, MO, Nurse, LT) and giving orientation to these staff is a priority.
Mobile phones have already been given to all MOICs in the PHC.
32
Rogi Kalyan Samiti
RKS have been set up in all the BPHCs. RKS meetings have also been conducted in most of the places except in Mohra, Tan
Kuppa and Town Block. In these 3 facilities, funds were also not been utilised.
(budget given separately)

Part C. IMMUNIZATION
Complete Immunization among children in the age group 12-23 months is 41.4%. The immunization rate among various
categories is given in the table below.

Child Immunization: Gaya2

Category Total Rural Urban

Number of children age 12-23 months 6,967 6,515 452 5

Children 12-23 months fully immunized (%) 41.4 41.4 41.2
Children 12-23 months not received any 16.7 16.7 17.9
vaccination (%)
Children 12-23 months who have received BCG 81.5 81.6 80.4
vaccine (%)
Children 12-23 months who have received 3 54.4 54.5 53.8
doses of DPT vaccine (%)
Children 12-23 months who have received 3 53.1 53.0 54.0

2
DLHS 3
33
doses of polio vaccine (%)
Children 12-23 months who have received 54.2 54.1 55.8
measles vaccine (%)
Children (age 9 months and above) received at 49.9 49.6 53.4
least one dose of vitamin A supplement (%)

Objectives
Reduction in the IMR (target – 593 to 45 per 1000 live births)
100 % Immunization of children

Issues
1. The number of access compromised villages in Gaya would be 241, which is spread in 15 out of the 24 blocks. In such
areas special outreach camps (4 per year) can be organized.
2. Regular & timely supply of vaccines especially at PHC level. (DPT and Polio vaccines are given together. But due to
delay in delivery of DPT vaccines, children end up not having the DPT vaccine. In fact, in a year around 8 to 10 rounds
of Polio (S.N.I.D,&N.I.D) occurs & each polio program takes 5days [I day for A team, 1day for B team, preceded by
15to 20 days of planning (Making of Micro plan, orientation & training of supervisors, training of all vaccinators, Block
level task force meeting, sub divisional task force meeting & finally district task force meeting in the presence of D.M. &
district officers) followed by another 2or 3 days for submission of report & pack-up of the round. This way, on an
average the pulse polio program takes up 224 to 280 days in a year which taxes the available human resources at the

3
Infant and Child Mortality in India, District Level Estimates, PFI, May 2008
34
 district level affecting routine immunization. A plan which makes use of Human resources to the best extent possible
would be to do polio rounds with RI.
3. Release of Fund for Routine Immunization is not regular. Certain months it does not come and yet other times,
DHS receives a lump sum for 3-4 months.
4. Incentive for courier is currently Rs.50/-. Recently this have been raised to Rs.75/-. This was a much awaited
demand.
5. Training of ANM, ASHA, AWW, Health Managers, Cold Chain Handler and MOICs in R.I.
6. Sector wise monitoring for district level by district level officers (Sector in charge DIO, DPO, DMO & DPM).
7. Need of sufficient fund for monitoring.
8. Better Co-ordination between ICDS & Health department.
9. The Muskan programme is going on in Gaya district; two days in a week, (Wednesday in sub centre and on Friday in
the AWC). The role of AWW on immunization day is to collect the mother and child for immunization and complete the
due repot, administered report and summery report for the month. In Mahila Mandal meeting pregnant woman &
lactating women are invited by AWW & ASHA. In that meeting importance of Immunisation, JBSY, FP & services
provided by PHC are discussed. These meeting are held every 3rd Friday of the month.
10. Special focus on Mahadalit Tola
11. In rainy season communication & transport facility are virtually cut of specially in Barachati,
Immamganj,Bakebazar,Pariya,Guraru,Dumariya,Atri,Mohara, and Mohanpur. In order to provide services in this area,
suitable mechanisms will be devised jointly by PRI and NGO partners. Micro plan has already been made is available
with the district.
12. Ensuring availability of vaccine courier, Ice pack, cold box (big& small) AD Syringe, RI card, Banner, Poster, Hubb
cutter, PCN Tablet, ANM KIT, and IFA Tablets (small & large) and cold chain equipments (ILR, Deep freezer, stabilizer
etc).

35
 REMARKS / SUGGESTIONS / ANY OTHER REQUIREMENT

D.F. ILR ILR Cold Box Cold Box Vaccine Vaccine Hub Safefy
Sl LOCATION D.F. Large Stablizer IEC Pack
Small Large Small Large Small Carrier Van Cutter Box
District Head 2 2 2 2 8 12 10 400 4000 2 300 600
1 Quarters
2 Atari 1 0 0 0 1 8 5 300 1000 0 100 152

3 Amas 1 0 0 1 2 4 3 150 500 0 50 80

4 Bodhgaya 1 0 0 0 1 7 8 200 500 0 100 186

5 Belaganj 1 0 0 1 2 6 6 200 1000 0 100 177

6 Barachatti 1 0 0 0 1 5 4 150 500 0 50 112

7 Bankebazar 0 1 0 0 2 5 4 150 500 0 50 100

8
Dumariya 0 1 0 0 1 4 5 100 300 0 50 100

9 Dobhi 0 1 0 0 2 5 4 100 300 0 50 118

10 Fatehpur 1 0 0 0 1 7 7 200 1000 0 100 225

11 Gaya Sadar 0 1 0 1 2 6 5 200 500 0 50 133

12 Gurua 0 1 0 0 1 5 5 150 500 0 50 143

13 Guraru 0 1 0 0 1 4 5 100 500 0 50 112

14 Imamganj 1 1 0 0 1 6 4 150 500 0 50 151

15 Khizasarai 1 0 0 0 1 5 6 200 500 0 100 143

16 Konch 0 1 0 0 1 4 7 150 500 0 50 156

17 Manpur 1 0 0 0 1 5 5 200 500 0 100 109

18 Mohanpur 0 0 0 0 0 6 4 200 500 0 100 161

19 N. Bathani 0 1 0 1 2 4 5 150 500 0 50 79

20 Paraiya 0 1 0 1 2 6 4 200 500 0 100 84

21 Sherghati 0 0 1 0 2 4 6 200 500 0 100 121

36
22
Tekari 1 0 0 0 1 6 4 200 500 0 100 210

23 Wazirganj 1 0 0 0 1 7 7 300 800 0 100 186

Total 13 12 3 7 37 131 123 4350 16400 2 1950 3638

DISTRICT PROGRAMME IMPLEMENTATION PLAN: DISTRICT - GAYA.

RCH PART "C" - YEAR (2009-2010)

1 District Profile

1.11 Total Population: (2008-2009) 4128814 1.12 2009-2010 4232034

Estimated beneficiaries for 2009-2010

a.Pregnant b.Infants a. Pregnant
women (birth-1 year) women b.Infants (birth-1 year)

1.13 Annual 136251 123864 1.14 Monthly 11354 10322

Nagar
panchayat,
24 nagar Nigam,
Nagar
1.15 Total Community development blocks 1.22 Total Urban areas parishad. 4

1.16 Total Sadar Hospitals 3 1.24 Total Urban Hospitals and dispensaries 4

1.17 Total Subdivisonal Hospitals 0 1.25 Total PHC with Cold chain equipment 21

1.18 Total Referral Hospitals 2 1.26 Total PHC with no cold chain equipment 4

1.19 Total ICDS projects 25 1.27 Total Additional PHCs 73

1.2 Total Aganwadi centers 3334 1.28 Total HSCs 541

NGO Hospitals and centres undertaking
1
1.21 RI with Govt vaccines 10 1.29 No of Medical colleges
No fo Govt of India Hospitals (Miltilitary, 3
1.3 Key District functionaries Name 1.292 railway, ESI, CGHS)
37
 Dr. K.P.
Commissioner Ramaiyya
Sri Sanjay Kr.
District Magistrate Singh
Dr. Arun Kr.
RDD (Health) Sinha
Dr. Prakirti No of PHCs with Govt generator in running
0
1.31 Civil Surgeon Gupta 1.51 condition
Dr.
Dinbandhu 20
1.32 Additional Chief Medical Officer Sharma 1.52 No of PHCs with outsourced generator
Dr. Sridhar
6
1.33 District Immunization officer Upadhyaya 1.53 No of PHCs with power supply > 8 hrs daily
Pawan
1.34 District Program Manager Kumar Please give the information below in "Yes" or "No"
Santosh
In Charge
1.35 District Accounts Manager Kumar 1.61 Whether DIO regular or in-charge

1.36 District Data Asisstant Alok Kumar 1.62 Whether Govt Vehicle available for DIO No

1.37 RIMS Data Operator N.A 1.63 Whether vaccine van available for District Yes (Need Reparing)
Dr. Sridhar
No
1.38 Urban RI Nodal officer Upadhyaya 1.64 Whether Vaccine van in fuctional condition

1.39 WIC/WIF store manager N.A 1.65 Whether RIMS data operator available No
Gopal Prasad Whether RIMS data operator received
No
1.4 District Cold chain keeper Gupta 1.66 training
Ashok Kumar
No
1.41 District Cold chain handler Sinha 1.67 Whether RIMS installed and functional

38
 (*Training means formal
organised training on
Immunization as per directions
2 Training in Immunization from SHSB in 2007-2008)

2.1 Trainers
c.Designatio
a.Name of trainers n Whether received training of trainers

2.11 Dr. Madhusudan Prasad MOIC Yes

2.12 Dr. Rajendra Chaudhry MOIC Yes

2.13 Dr. Ijraul haq MO Yes

2.14 Dr. Sridhar Upadhyaya DIO Yes

2.15

2.16

2.2 Trainees
bNm trained
in
aTotal Number in Immunizatio
District n* c.Nm needing training*

Deputy Superintendants 1 0 1

Medical Officers in charge 22 2 20

Medical Officers 116 1 115

Contractual Medical Officers 71 0 71

CDPOs 25 0 25

ICDS Supervisors 15 0 15

Block Health Managers 19 0 19

Total Officers and Managers 269 3 266

39
LHVs 26 15 11

BHWs and other male Health workers 112 68 44

ANM-Regular 539 430 109

ANM-Contractual 338 29 309

Alternate Vaccinators 0 0 0

Total Health workers 1015 542 473

Cold Chain Handlers 25 0 25

ASHA 2997 0 2997

Anganwadi workers 3334 0 3334

Anganwadi Helpers 3334 0 3334

Total Mobilisers 9665 0 9665

40
 Training Budget for (Remaining) Health workers training in
2.3 Immunization
Requirement for
Activity Head Norm year 09-10 Justification / Rationale

2.31 No. of Trainers 3 trainers per district 6 2 Batch Per Day

2.32 No of training batches 30 persons per batch 16 30 x 16 Batches

Honorarium plus TA for
2.33 Participants Rs. 250 for 2-day training 118250

2.34 Honorarium for Trainers Rs. 600 for 2-day training 57600
Rs. 100 participant per day (incl of refreshments,
2.35 Contingency venue, TV/LCD hiring and logistics 94600

Total 270450

4 Budget requirement for Muskaan ek Abhiyaan

Requirement for year
S No Activity Head Norm 2009-2010 Remarks
A Incentive money

Rs 150/- per month per AWC

For ANMs 6001200
for 12 months

Rs 200/- per month per AWC

For AWW 8001600
for 12 months

Rs 200/- per month per AWC

For ASHA 8001600
for 12 months

B Mahila Mandal Rs 250 per AWC 10002000 200 Per AWW As per letter No. 3004, Dated-23.12.08

Total for Muskaan ek Abhiyaan 32006400

41
 5 Budget details and requirement Regular RI

S No Activity Head Norm Requirement for year 09-10 Justification / Rationale

A Printing activities:Reporting and Recording Formats

All RI formats Rs 4 per beneficiary (pregnant women) 545004

B POL for cold chain

At WIC/WIF Rs 600 per day 0

At District Rs 300 per day 109500

At PHC Rs 400 per day 3504000

C Vaccine and Logistics Mobility
Purnea Rs 10000 per month, Bhagalpur ,
For WIC and WIF points Darbhanga, Motihari and Aurangabad Rs 8000/-per 0
month, Sran and Muzaffarpur 6000/- per month
For Districts Rs 5000 per month 60000

For PHC Rs 1500 per month 432000

D Mobility for Supervison
For RDD Rs 5000 per month 60000

Rs 4000 per month if Govt Vehicle is functional , Rs

For DIO 10000 if Govt vehicle is non functional/ not 120000
available

E Usage of Courier
For APHC and HSC Rs 50 per session day per APHC and HSC 322350

For Urban sessions Rs 50 per Vaccinator per session day 168000

Hiring of Computer operator at

F Rs. 5000 * 1 person * per districts 60000
district level for RIMS
G Catch up campaigns( subject to approval by GOI)

42
 Measles Campaign for pilot in
1 Detail annexure 1 4684579
select districts
2 Hard to reach areas strategy Detail annexure 2 12270

Detail annexure 3 2449626

3 RI catch up campaign
H Other separate activities proposed under RI (subject to approval)

1 One day RI training for 500100 Need to training of all AWW

Total Anganwari =3334 AWC *150 = 500100

2 One day RI training for 449550 Need to training of all ASHA

Total ASHA =2997 AWC *150 = 449550

3 One day RI training for 5000 Need to training of all CDPO

Total CDPO =25 CDPO *200 = 5000
Need to training of all Cold
Chain Handler
4 2500
One day RI training for becouse all Handler are
Total Cold Chain Handler =25 CCH *100 = 2500 new.

5 One day RI training for 4400 Need to training of all BHM

Total BHM =22 BHM *200 = 4400
Total for Regular RI activities 13488879
6 Annexures

43
 Annexure 1
(For villages difficult to access all the year through, 4 outreach sessions can be
6B Hard to reach areas strategy planned in a year, additional only mobility support to teams can be budgeted for
this activity and remaining expenses arranged from regular RI funds.)

Number of Access compromised villages 241

Number of Block with Access compromised areas 15

a b c d=bxc
Number needed for 1
Estimated Cost per Unit per day session day in all hard Total costs for 4
Type of Mobility
of use to reach villages sessions
combined
Tractor 650 40 26000
Jeep / vehicle 650 100 65000
Motor Cycle 300 101 30300
Labour 100 14 1400
Total 1700 255 122700

Annexure 2
6C RI catch up campaign Number of Round if any to be decided according to directions of GOI
Activity Norm Expenditure Remarks
No of teams formed 1 vaccinator to form 1 team APHC + HSC = 614
District task force meeting 1 per district Rs 1000 per district 1000
4 icepacks per team for
Ice pack freezing @ Rs 3 per ice-packs 51576 614*7 Days*4*Rs.3
7days
For WIC/ WIF points Rs 5000/- 0
Vaccine & Logistic Mobility For Districts Rs 2500/- 2500
For PHCs Rs 1750/- per PHC 42000 24 PHC*1750
44
Usage of Couriers (Alternate Vaccine 1courier per team for 14
Rs 50 per courier per day 92100 614*7 Days*Rs.50
Delivery) days
Vehicle/boat/tractor/labour for teams 1 vehicle for 2 teams for 4
Rs 650/- per vehicle per day 798200 614/2*4*650
for Hard to reach activity days
(3325+2997)*3Days*
Perdiem for workers and mobilisers 3 days per ASHA and AWW Rs 50 per person per day 949650
Rs. 50
Perdiem for workers and Vaccinators 7 days per trained vaccinator Rs 75 per person per day 322350 614*7 Days.*Rs.75
(614/3) 205
1 supervisor per 3 teams for
Perdiem for Supervisors Rs 100 per person per day 143500 Super.*7Days.*Rs.10
7 days
0
Number of trained manpower
Alternate vaccinators Rs 100 per person per day 0
available Vs shortfall
Net Rs. 1750/- per block and
Miscellenous & Contengencies etc. for entire activity 46750 24 PHC*1750+3000
Rs3000/- district
Total for 1 round of catch up 2449626

45
 PART D. DISEASE CONTROL PROGRAMMES

National Vector Born Diseases Control Programme

Malaria
Malaria is a important public health issue in the district. PHCs like Amas, Mohanpur, Gurua, Barachatti, Sherghati and
Dumaria are the worst affected places. And in those areas cerebral malaria cases have also been reported. Malaria is also
linked to poor sanitary conditions, and lack of DDT Spray. In Some of the areas DDT Spray is being carried out but it requires
intensive intervention. Anti Malarial Drugs are available in the PHCs. During rainy session special camps should be organized
to detect malaria cases so that they may be treated promptly. Lab surveillance needs strengthening and blood slide collection
should be increased.
Malaria scenario:
Item Number
1. No. Of slides collected 15312
2. Blood examination conducted 24186
3. Malaria positive 125
4. Cases treated 119

Activities
Facility Level
 Selective insecticide spray operation in areas having incidence of malaria of 2 or more cases per thousand population
per year for regular rounds of spray.
 Decentralization of malaria laboratories of PHCs for Early Detection & Prompt Treatment of cases.
 Ensuring continuous availability of anti malarial drugs at facility level
46
  Establishment of drug distribution centres & fever treatment depots where anti malarias will be available.
 Provision of disinfectant mosquito nets.
 Blood slide examination of all febrile children with presumptive treatment

Community Level
 Anti malarial drugs shall be made available through Panchayat, Post Offices.
 Eliciting public cooperation through voluntary agencies.
 Initiating trainings & workshops for creating understanding among the community regarding the disease.
 Involving Village health sanitation committee for ensuring cleanliness in the community.
 In endemic areas, most children are anaemic due to repeated bouts of malaria. Any febrile child needs to be checked
for malaria compulsorily.

Filariasis
Filarial cases even though very less, have been reported from Gaya district. As of now a total of 15312 slides have been
collected and 705 cases have been treated.
Early detection and prompt treatment, Mass Drug Administration and appropriate IEC strategies would be helpful in
addressing this menace.
Japanese Encephalitis
JE is the next important public health issue in the Dist. Incidence of JE has been reported in the Gaya Dist. On 10th January
2009, a district level review meeting was convened by ACMO and attended by representatives from WHO, UNICEF, all MOIC,
DIO, DPO DMO, Health managers attended. It was decided that a Micro plan for vaccination of JE would be made by every
PHC.

47
Revised National Tuberculosis Control Programme (RNTCP)
Objectives
1. Case Detection Rate - 70%
2. Cure Rate - 85%
TB is a big public health problem in the district. Poverty, and Crowded areas have added to the increase of prevalence of TB
in the District. Gaya district has been included in the RNTCP program and Anti-TB drugs are available. (Please refer to
table.10 in Annexure). A total of 1567 patients are on the regimen now.

Facility Level
 Ensuring continuous supply of medicines & health education at PHC, CHC & HSC level.
 Making DOTS centres available at underserved areas.
Community Level
 Involvement of PRIs members, religious leader for motivating TB patients for seeking treatment.
 Involvement of NGOs for tracking of suspected TB cases.

National Leprosy Eradication Programme (NLEP)

 Though the number of cases of Leprosy has gone down still Leprosy control program needs to be carried out
intensively. As of now 830 patients are undergoing treatment in Gaya district for leprosy. International Agencies like
DFID & WHO needs to review the progress of the program, laying stress on Drug Compliance as well as rehabilitation
program.
 Gaya District Is implementing the NLEP but an increased level of coordination is required among the NLEP & PHC
staff.

48
  To strengthen the close monitoring and supervision at District & PHC level of the Non-medical Assistant (NLEP) by
Health Managers
 Development of referral system to deal with complication of leprosy also needs to be operationalised.

National Blindness Control Programme (NBCP)

Objective : To reduce prevalence of trachoma / preventable blindness
Facility Level
 Increase Cataract operation performance with priority to bilateral cataract blind patients. A total of 32141 cataract
operations were conducted last year.
 Base Hospital approach
 Strengthening District Hospital FRU by providing equipments, separate ward, operation theatres and OPD facilities.
 Development of permanent eye care centers at PHC, providing diagnostic and operative equipment.
 Mobile Units to serve in underserved areas
 Organization of Eye checkups camps at PHC level.
 Treatment of trachoma cases and BCC on hygiene and eye care
Community Level
 Active involvement of NGOs linking with district Hospitals
 Organization of Eye donation camps with the help of NGOs
 Partnership with Private practitioners for eye checkup camps & cataract operation at PHC level.
 Eye checkup camps at Schools with the help of PRIs, teachers & MO PHCs and Screening for refractive errors of
children along with school health programme

Iodine deficiency diseases control program (IDDCP)

49
Integrated Disease Surveillance Program (IDSP) is intended to be the backbone of public health delivery system in the District.
It is expected to provide essential data to monitor progress of on- going disease control programs and help in optimizing the
allocation of resources. It is intended to detect early warning signals of impending outbreaks and help initiate an effective and
timely response. IDSP will also facilitate the study of disease patterns in the District and identify new emerging diseases. It will
play a crucial role in obtaining political and public support for the health programs in the District.
Activities
 Operationalisation of District Level Task Force under the chairmanship of Civil Surgeon with heads of different
supportive person like ANM, ASHA, and Health Staff.
 Formation of District Level Co-ordination Committee of supportive department like ICDS, Education/General
Administration, NGO.
 Monitoring of Quality of Salt.
 Distribution of Salt Testing Kits (STK).
 Analysis of Iodized Salt Samples tested with STK
(budget given separately)

PART. E CONVERGENCE
Nutrition
Anganwadi Centre (AWC) functions one day in a month as a centre where children (0-6 years) are being provided with
nutrition and health services. The AWC would continue to serve as the focal point for all health and nutrition services.
As part of NRHM, a Health Day is proposed to be fixed every month at the AWC to provide antenatal, postnatal, family
planning and child health services. An ANM and preferably a Medical Officer from the PHC will be available. With
active support from Community Groups such as Self Help Groups (SHGs) to motivate the AWW and ASHA women
and children would be motivated to access services. Services to be provided on the Health Day (by the ANM or PHC
50
 MO) would include ANC, Newborn check up, Postnatal Care, Immunization of mothers and children, IFA and Vitamin A
administration, growth monitoring, treatment for minor ailments, and health education. AWW and ASHA would provide
counselling to the community regarding the importance of institutional deliveries and refer cases requiring expert
management. AWW and ASHA will also counsel communities on the importance of balanced diets and promote the
use of locally available foodstuffs, particularly for micronutrient supplementation. AWW, ASHA & ANM will sit together
with the help of PRI and will device methods & possible interventions towards addressing issues of severe
malnutrition.
Water
In summer water levels in Dumaria, Barachatti, Imamganj, Bankebazar, and Mohanpur blocks goes down and hand
pumps won’t work, and people have to take water from wells, and streams, which are not hygienic. In such areas deep
borewell needs to be made in coordination with PHED. Chlorination of wells in such areas also needs to be made. In
Town areas also water layer comes down and there is electricity problem because of which water could not be pumped.
Water supply needs to be strengthened (higher capacity of tank, alternate electricity source).
Waste management
In three Nagar Panachayats, waste management is proper and the facility is available in Shergatti, Tikari, and Bodh
Gaya. In Gaya urban, Nagar Nigam works. In rest of the places, especially in villages no such arrangement is available.
The responsibility to ensure this rests with Gram Panchayat and under the aegis of VHSC, plans (Shramadhan etc.)
would be devised.
(budget given separately)

51
 FRU: Lady Elgin and Shergati
AVAILABILITY OF SERVICES RELATED TO DELIVERIES
AVAILABLE 24X7 NOT AVAILABLE

Lady Elgin Sherghati AVAILABILITY OF SERVICES RELATED TO

Lady Elgin Sherghati EMERGENCY CARE
NORMAL DELIVERIES √ √

ASSISTED DELIVERIES √ √

CESAREAN SECTION √ √

ADMINISTRATION OF PARENTAL √ √
OXYTOCINS

ADMINISTRATION OF PARENTAL √ √
ANTIBIOTICS

ADMINISTRATION OF MAGNESIUM √ √
SULPHATE INJECTION

MANAGEMENT OF POST PARTUM √ √

HEMORRHAGES

MANAGEMENT OF OTHER DELIVERY √ √

COMPLICATIONS

Lady Elgin Sherghati

BLOOD BANK
No No

BLOOD STORAGE FACILITY No No

ABORTIONS
Lady Elgin Sherghati

MANUAL VACUUM ASPIRATION (MVA) No No

ELECTRIC VACUUM ASPIRATION (EVA) No No
DILATATION AND CURETTAGE (D&C) Yes No

52
RTI/STI TREATMENT AND COUNSELING
Lady Elgin Sherghati

TREATMENT Yes No
COUNSELING Yes No

LABOUR ROOM

INFRASTRUCTURE/ EQUIPMENT IN THE AVAILABLE AVAILABLE NOT AVAILABLE

LABOUR ROOM AND BUT NOT
FUNCTIONAL FUNCTIONAL

Lady Sherghati Lady Sherghati Lady Sherghati

Elgin Elgin Elgin
LABOUR TABLE WITH MCINTOSH SHEET √ √

SUCTION MACHINE √ √

AUTOCLAVE/STERILIZER √ √

OXYGEN CYLINDER WITH FACE MASK, √ √

WRENCH AND REGULATOR

MVA EQUIPMENT WITH ADEQUATE √ √

CANULAS

AVAILABILITY OF FOLLOWING EMERGENCY DRUGS (EMERGENCY DRUG TRAY)

Lady Elgin Sherghati

OXYTOCIN INJECTION Yes Yes

DIAZEPAM INJECTION Yes No

MAGNESIUM SULPHATE No No
INJECTION
LIGNOCAINE HYDROCHLORIDE Yes Yes
INJECTION
NIFEDIPINE TABLET Yes No

53
 Table No. 1
PHC /Referral/SDH/D: Human Resources
Pharmacist
Laboratory Nurses Specialists Storek
Doctors ANM / Dresser
PHC Technician eeper
Popn
/Referral/SDH/DH
Served In San In In San In San In In
Name Sanct Sanc Sanct
Positio ctio Posi Positi ctio Posi ctio Positio Positi
ion tion ion
n n tion on n tion n n on
1 AMAS 126903 3 3 15 14 01 01 01/ 01 01/ 1 0 0 4 2 0
2 ATRI 69000 03 02 20 18 01 0 01/01 0 0 0 4 2 0
3 BANKEY BAZAR 42235 03 01 26 22 01 0 01/01 0 0 0 4 0 0
4 BARACHATTI 111985 03 03 19 19 01 01 01/01 01/01 0 0 4 0 0
03
5 BELAGANJ 243564 03 28 28 01 01 01/01 01 0 0 4 4 0

6 BODHGAYA 221685 03 03 23 23 01 0 01/01 01 0 0 4 4 0

7 DOBHI 117763 03 01 18 15 01 0 01/01 0 0 0 4 4 0
8 DUMARIYA 110000 2 1 2 0 1 1 01/01 0 0 0 4 2 0
9 FATHEPUR 226825 03 03 30 27 0 0 01/01 0 0 0 4 3 0
10 TOWNBLOCK 131000 3 2 20 20 0 0 01/01 0 0 0 0 0 0

11 GURARU 11200 3 2 3 0 0 01/01 0 0 0 4 0 0

3
12 GURUA 169562 3 2 24 23 1 0 01/01 0 0 0 4 2 0
13 IMAMGANJ 168993 3 3 3 2 1 0 01/01 0 0 0 4 1 0
14 KHIJARSARAI 172743 3 2 25 25 01 0 01/01 0 0 0 4 2 0
15 KONCH 208773 3 2 31 29 0 0 01/01 0 0 0 4 2 0
16 MANPUR 108516 3 3 23 23 1 1 01/01 0 0 0 4 4 1
17 MOHANPUR 177844 3 2 25 18 1 0 01/01 0 0 0 4 4 1
18 MOHARA Not functional
15
19 BATHNI 87168 3 02 11 0 0 01/01 0 0 0 4 1 0
2
20 PARIYA 84000 3 3 1 1 0 0 01/01 0 0 0 4 0

21 SHERGHATI 160369 3 3 14 13
541 0 01/01 0 0 0 4 3 0
1 01/01
22 TEKARI 218000 3 3 34 33 0 1 0 0 4 3 0

2 2
23 WAZIRGANJ 178356 3 3 1 0 01/01 0 0 0 4 4 0
 Table No. 2
PHC LEVEL INFRASTRUCTURE, GAYA
S. Buildi Buildi
No. Continu Conditi PHC
ng ng Assured Function
ous Toilet Condition on of Condition Renovatio
PHC/ Referral Populati owner condit running al Functional
power s of labour No. of No. of ward of OT n
Hospital/SDH/D on ship ion water Labour OT
supply (A/NA/ room rooms beds (+++/++ (+++/++/#)
H Name served (Govt/ (+++/+ supply room (A/NA)
(A/NA/I) I) (+++/++/#) /#)
Pan/ +/#) (A/NA/I) (A/NA)
Rent)
1 ATRI 79000 Govt. +++ NA I I A +++ 06 12 A +++ +++ Yes
2 AMAS 126903 Govt. ++ NA A A A # 11 06 A # # Yes
BANKEY-
3 112235 Govt. # A A A NA # 08 06 NA # # No
BAZAR
4 BARACH-ATTI 111985 Govt. +++ A I A A ++ 06 06 A ++ ++ Yes

5 BODH- GAYA 243,564 Govt. + I A A A I 06 06 A +++ # Yes

6 DOBHI 117763 Govt. # NA NA NA NA # 06 06 NA # # No

7 DUMARIA 1,10,000 Govt. ++ NA A NA NA # 03 06 NA ++ # Yes

8 FATEHPUR 226825 Govt. ++ A A A A ++ 08 06 A +++ ++ Yes

9 TOWN BLOCK 131080 Govt. ++ NA NA NA NA # 02 00 NA # # No

10 GURARU 1,12000 Rent # NA A NA NA # 06 05 NA # # No

11 GURUA 167352 Govt. +++ A A NA NA +++ 06 06 A +++ +++ Yes

12 IMAMGANJ 168993 Govt. +++ NA I A A +++ 12 06 A +++ ++ Yes

13
KHIZARSARAI 172743 Govt. +++ A A A A +++ 08 06 A +++ +++ Yes

14 MANPUR 108516 Govt. +++ NA I A A +++ 02 06 A +++ ++ Yes

15 MOHANPUR 177844 Govt. # NA A A NA # 08 06 A ++ ++ Yes

16 BATHANI 87168 Rent. ++ NA I NA NA # 07 06 A ++ ++ No

17 PARAIYA 84000 Govt. # NA NA NA A ++ 07 06 A ++ ++ Yes

18 SHERGHATTI 1,60,369 Govt. ++ A I A A + 26 17 A ++ ++ No

19 TEKARI 218000 Govt. # A NA A A ++ 23 06 A ++ ++ No

20 WAZIRGANJ 178356 Govt. # NA A NA NA ++ 08 06 A ++ ++ Yes

21 KONCH 208753 Govt. # NA NA A A + 08 06 A +++ + Yes

22 BELAGANJ 243564 Govt. ++ A I A A ++ 06 06 A ++ +++ Yes

DUMARIYA
23 110000 Govt. ++ NA A NA NA # 03 17 NA ++ ++ Yes
REFRAL

55
 Table No. 3
Additional Primary Health Centre (APHC) Database: Human Resources

PHC Name Laboratory Accnt/Peons/

Doctors Pharmacists / Nurses
ANM technician Sweeper/Nig Availab
No. dresser A Grade
ht Guards ility of
of
In In In In speciali
APHC Sanct Sanct Sanc Sancti Sancti In
Positi positi positio posit st
ion ion tion on on Position
on on n ion
Atri 2 4 0 4 2 1 0 2/2 0 4 1 (C ) 0 0
Barachatti 1 2 0 2 1 1 0 1/1 0 2 1 (C ) 2 0
Belaganj 5 10 2 10 10 5 0 5/5 0 10 9(C) 0 0
Bodhgaya
2 4 3 4 4 2 0 2/2 0 4 4(C) 3 0

Dobhi 2 4 0 4 4 2 0 2/2 0 4 4(C) 0 0

Dumariya 2 4 0 4 4 0 0 2/2 1 4 3 (C ) 0 0
Fatehpur 4(C)
3 6 3 6 3 3 0 3/3 0 6 0 0
Town Block
1 2 1 2 2 1 0 1/1 0 2 2 (C ) 1 0
Guraru 4(C) 3
2 4 1 4 4 2 0 2/2 0 4 0
Imamganj
2 4 2 4 5 2 0 2/2 0 4 2(C) 3 0
Khizarsarai 0
6 12 3 12 12 6 0 6/6 1 12 10 ( C ) 6
Konch
7 12 2 12 8 6 0 6/6 0 12 6(C) 5 0
Mohanpur
1 2 0 2 1 1 0 1/1 0 2 0 1 0
Mohra
3 6 4 8 7 4 0 4/4 0 6 5(C) 0 0
Tankupa
1 Not Functional
Tekari
5 10 0 10 8 5 1 5/5 1 10 6(C) 0 0

56
 Wazirganj
3 6 4 6 6 2 2 3/3 0 6 5(C) 0 0
Non APHC at Sherghati, Gurua, Nimchak Bathani, Amas, Bankebazar Manpur & Paraiya
Note : C= Contractual

Table No. 4
Additional Primary Health Centre (APHC) Database: Infrastructure
MO
Assured
Building Continuou Toilet Condition Condition of residi Ambula
Populatio Building running No.
PHC Name No. of ownership s power s of Labour No. of residential ng at Status of nce/
n condition water of
APHC (Govt/Pan/ supply (+++/+ room rooms facility APHC furniture vehicle
served (+++/++/#) supply beds
Rent) (A/NA/I) +/+/#) (+++/++/#) (+++/++/+/#) area (Y/N)
(A/NA/I)
(Y/N)

Atri 1 30000 Rent # NA NA ++ ++ 1 6 ++ N NO N

Barachatti 1 13785 Pan. ++ NA NA # # 2 2 # N NO N
Govt.-1 #-1 YES
Belaganj 5 33242 NA NA # # 9 6 # N N
Rent-4 ++-4
Bodhgaya
2 58174 Govt.-2 ++-2 NA NA # # 2 6 # N NO N
Rent-1
Dobhi 2 35850 #, ++ NA NA # # 7 2 # N YES N
Govt.-1
++-1
Dumariya 2 2957 Rent-2 NA NA # # 3 2 # N NO N
#-1
Fatehpur Rent-2 #-1
3 29298 NA NA # # 5 18 # N NO N
Govt.-1 ++-2
Town Block
1 35000 Govt. 1 ++ NA NA # # 3 0 # N YES N
Guraru Govt.-1 #-1
3 97961 NA NA # # 9 4 # Y NO N
Rent -2 ++-2
Imamganj Rent-1 #-1
2 16328 NA NA + # 12 9 # Y YES N
Govt. -1 ++-1
Khizarsarai Rent-5 #-1
6 150000 NA NA # # 15 36 # N YES N
Govt. 1 ++-5
Konch
6 38919 Rent-6 #-1 NA NA # # 12 24 # N YES N
57
 ++-5
Mohanpur
1 35000 Rent-1 # NA NA +++ # 5 6 # N NO N
Rent-1 #-2 YES
Mohra 3 122000 NA NA # # 10 24 # N N
Govt. 2 ++-1
Tekari Rent-2 #-2
5 27784 NA NA # # 14 30 # N NO N
Govt. 3 +-2
Wazirganj Rent-2 +-1 # # #
3 37458 NA NA 5 10 N YES N
Govt. 1 #-2

58
 Table No. 5
Sub Centre Facilities
Pop. No of ANMs ANMs Building ownership Building Assured Cont. ANM Condition of
condition running power residing residential
water supply at HSC facility
supply (A/NA/I) area
Status of

/villages
G. P at

served
S. No. Name of PHC
(R) (C) (R) (C) Govt Pan. Rent +++ ++ + # A NA I A NA I Y N +++ ++ + # furnitures

posted in position
formally
1 Amas 126903 104 10 2 10 2 4 0 8 0 1 3 8 0 12 0 0 12 0 1 11 0 1 0 11 NO

2 Atari 115560 109 18 12 18 12 3 0 17 2 10 4 4 0 11 0 0 11 0 5 25 5 0 0 15 NO

3 Bankebazar 112235 120 13 9 13 9 1 0 10 0 0 0 13 1 12 0 0 13 0 0 0 0 0 13 12 NO

4 Barachatti 111985 105 11 5 11 5 6 0 10 2 3 1 10 1 15 0 1 15 0 4 12 1 15 0 0 Yes

5 Belaganj 243564 244 24 4 25 13 0 0 26 0 0 0 26 5 21 0 2 24 0 26 0 0 0 0 26 NO

6 Bodhgaya 221685 222 21 0 21 8 4 4 13 2 1 1 17 2 19 0 0 21 0 0 21 0 0 1 20 NO

7 Dobhi 117763 118 13 4 14 3 2 7 7 0 0 0 16 1 15 0 0 16 0 16 0 0 1 0 15 Yes

8 Dumariya 110000 111 19 5 1 5 0 0 0 0 0 0 0 0 20 0 0 0 0 0 0 0 0 0 0 NO

9 Fatehpur 226825 227 24 8 24 9 5 8 15 0 0 0 3 15 13 0 0 28 0 0 0 0 0 0 0 NO

10 Guraru 112000 113 7 7 7 7 1 3 3 7 0 0 0 0 7 0 0 7 0 1 6 0 0 0 0 Yes

11 Gurua 169562 170 23 7 23 7 3 0 19 2 0 1 19 0 22 0 0 22 0 0 22 0 0 0 22 NO

12 Imamganj 152186 153 28 0 18 0 6 15 2 2 2 2 18 0 24 0 0 24 0 18 6 0 0 0 24 Yes

13 Khizarsarai 172743 173 24 3 24 3 3 0 25 0 3 0 25 0 28 0 0 28 0 3 25 0 3 0 25 NO

14 Konch 208753 209 28 5 28 6 1 0 29 0 0 1 29 0 30 0 0 30 0 0 30 0 0 0 30 NO

15 Manpur 108516 109 21 21 20 13 5 7 9 0 0 4 16 0 21 0 0 21 0 0 21 0 0 0 21 NO

16 Mohanpur 177844 178 13 6 13 6 2 2 17 1 1 0 19 0 21 0 0 21 0 6 15 0 0 0 21 NO

17 N. Bathani 87168 88 9 8 9 8 3 0 9 2 2 3 5 3 9 0 0 10 2 12 0 3 1 0 8 NO

18 Paraiya 83800 84 15 4 15 4 0 0 15 0 0 0 15 0 15 0 0 15 0 15 0 0 0 0 15 NO

19 Sherghati 160369 161 12 0 17 1 1 0 11 0 1 0 11 4 7 1 0 12 0 0 12 0 0 0 12 Yes

59
 20 Tekari 218000 219 31 15 31 15 3 0 29 1 6 21 4 0 32 0 0 32 0 0 32 0 0 0 32 NO

21 Town Block 133080 158 19 14 19 14 4 8 7 5 0 0 14 0 19 0 0 19 0 0 19 0 0 0 19 NO

22 Wazirganj 178356 159 29 12 18 17 3 3 23 1 3 25 0 0 29 0 0 29 0 0 29 0 0 0 29 Yes

23 Mohra 91775 92 7 4 7 4 1 1 7 0 2 3 4 0 9 0 0 9 0 9 0 0 1 0 8 NO

ANM ( R ) -REGULAR /ANM ( C ) - CONTRACTURAL, GOVT. GOVT. /RENTED REN / PLAN -

PAN - PANCHAYANT OR OTHER DEPT. OWNED GOOD CONDITION +++ / NEEDS MAJOR REPAIRS ++ / NEEDS MINOR REPAIRS LESS THAN RS 10000 +/ NEEDS NEW BUILDING # WATER
SUPPLY,
AVAILABLE - A / NOT AVAILABLE -NA, INTERMITTENTLY AVAILABLE -I

Table No. 6
CHILD IMMUNIZATION
% of children 9-11 months fully immunized % of immunization sessions held
SL Name of PHC
(BCG+DPT123+OPV123+Measles) against planned
1 AMAS 98% 98%
2 ATRI 82% 88%
3 BANKEY BAZAR 90% 90%
4 BARACHATTI 89.65% 96%
5 BELAGANJ 76% 100%
6 BODHGAYA 85% 94%
7 DOBHI 96% 100%
8 DUMARIYA 33% 100%
9 FATHEPUR 91% 68%
10 TOWNBLOCK 81.6% 92.2%
11 GURARU 81% 96%
12 GURUA 82% 97%
60
 13 IMAMGANJ 42.95% 68.30%
14 KHIJARSARAI 53% 100%
15 KOACH 41% 92%
16 MANPUR 90% 90%
17 MOHANPUR 76% 95%
18 MOHARA 72 78%
19 BATHANI 78% 100%
20 PARAIYA 72% 90%
21 SHERGHATI 94.5% 92.1%
22 TEKARI 56% 90%

23 WAZIRGANJ 96% 98%

Table No. 7
Child Health

Number of
Total Number Number of
Total Number children with
% of new % of new number of of children with
Total Total Total number number % of of ARI % of Grade 3 and
borns borns neonatal diarrhea Grade 3 and Number of
no. of no. of of infant of child diarrhea cases ARI Grade 4
S. No. weighted weighting deaths cases Grade 4 undernourished
live still deaths(within deaths cases reported cases undernutrition
within less than (within 1 reported undernutrition children
Birth births 1-12 months) (within treated within treated who received
1week 2500gm month of within who were
1-5 yrs) the year a medical
birth) the year admitted
checkup

Amas 668 NA 48% 38% 2 NA NA NA NA NA NA NA NA NA

Atri 312 8 2% 2% 3 4 6 76 98% 72 98% 264 112 NA

Bankebazar NA NA NA NA NA NA NA 210 100% NA NA 60 NA 250

61
Barachatti 1253 17 100% 3% 6 17 23 49 100% 22 97% 600 20 64
Belaganj 2107 54 75% NA NA NA NA 88 100% 178 98% NA NA NA
Bodh-Gaya 635 0 96% 3% NA NA NA NA NA NA NA NA NA NA
Dobhi NA NA NA NA NA NA NA 196 100% NA NA NA NA NA
Dumariya NA NA NA NA NA NA NA NA NA NA NA NA NA NA
Fatehpur 1710 54 12% 1% NA NA NA NA NA NA NA NA NA NA
Town block 3089 152 43% 7% 28 21 26 113 100% 20 100% 538 10 74
Guraru NA NA NA NA NA NA NA NA NA NA NA NA NA NA
Gurua 702 15 86% 10% 1 2 12 151 100% 155 100% NA NA NA
Imamganj 1367 24 80% 5% 4 NA NA NA NA NA NA NA NA NA
Khizarsarai 2064 24 88% 10% 5 2 3 233 100% NA NA NA NA NA
Konch 1357 14 85% 12% 14 7 6 48 100% 6 100% NA NA NA
Manpur 1653 11 100% 15% NA NA NA 16 100% NA NA NA NA NA
Mohanpur 376 12 100% 30% 7 NA NA 83 100% 849 81% NA NA 171
Mohra 114 4 78% 2% NA NA NA 12 100% 10 NA NA NA NA
Bathani NA NA NA NA NA NA NA 66 100% 123 97% 33 NA 1100
Paraiya 383 21 NA NA NA NA NA NA NA NA NA NA NA NA
Shreghati 1490 44 NA 12% 44 6 2 400 100% 582 100% NA NA NA
Tankuppa NA NA NA NA NA NA NA NA NA NA NA NA NA NA
Tekari 2748 53 86% 12% NA NA NA 60 100% 20 100% NA NA 4109
Wazirganj 3474 112 90% 7% 60 NA NA 25 NA NA NA NA NA NA

Table No. 8

PHC LEVEL MATERNAL CARE, GAYA

62
 PHC Name % of % of % of % of % of % of % of Num Numb Numb % of % of % of % of Numb % of Number
pregna pregna pregnant pregnant pregna pregna pregna ber er of er of C- Pregna institutional home er of mothers of
nt nt women women nt nt nt of Institu home sectio ncy deliveries deliverie delive visited by Materna
wome wome with 3 with any wome wome wome preg tional deliver ns compli in which s in ries health l Deaths
n n ANC ANC n with n who n who nant deliver ies condu cation JBSY which referr worker
registe registe check checkup anaem receiv receiv wom ies condu cted manag funds were JBSY ed during the
red for red for ups ia ed 2 ed 100 en condu cted ed given funds due to first week
ANC ANC TT IFA regis cted by were compl after
in the in the injecti tablets tered SBA given icatio delivery
1st 1st ons for ns
trisem trisem JSY
ester ester
AMAS 1531 96% 94% 94% 3% 81% NA 662 628 0 NA 0 100% 0 5 100% 0
ATRI 364 80% 82% 8% 0% 98% NA 1602 1573 0 NA 99% 100% 0 8 52% 0
BARACHATI 2509 85.6% 51.77% 20% 40% 82% NA 2509 951 0 NA 62% 100% 0 15 5% 0
BELAGANJ 1640 NA 74% NA 56% 86% NA NA 1250 0 NA 75% 100% 0 15 2% 0
BODH-GAYA 2004 NA NA NA NA 48% NA 2432 865 0 NA 0 100% 0 0 0% 0
GURUA
549 56% 25% 56% 15% 93% NA 802 702 0 NA 0 100% 0 26 0% 0
100%
IMAMGANJ 4898 33.41% 100% 40% 100% NA 462 462 0 NA 0% 100% 0 26 0% 0
KHIZERSARAI
2217 40% 33% 53% 15% 83% NA 1340 1340 0 NA 0% 100% 0 20 0% 0

KONCH 2062 11% 43 23% 23% 23% NA 771 771 0 NA 5% 100% 0 7 100% 0

MANPUR 2186 15% 91% 91% 14% 91% NA 1653 1653 0 NA 2% 100% 0 251 15% 2
MOHANPUR
NA NA 59% 100% 49% 41% NA 2987 388 0 NA 2% 100% 0 23 21% 2
BATHANI
2490 80% 70% 90% 10% 81% NA NA NA 0 NA 0% NA 0 0 0% 0
PARAIYA
332 NA NA NA NA 90% NA 383 383 0 NA 0% 100% 0 0 0% 0
SHERGHATI
1977 90% 89% 78% 60% 86% NA 1977 1508 0 NA 0% 100% 0 103 21% 0
TEKARI
1645 33% 65% 73% 50% 50% NA 1700 1753 0 NA 0% 100% 0 0 10% 0
WAZARGANJ
3714 40% 17% NA NA 34% NA 6910 2260 0 NA 12% 46% 0 43 13% 0
FATEHPUR 1883 131 394 NA NA 82% NA 431 1717 0 NA 0% 100% 0 6 0% 0
Note : Bankebazar, Dobhi, Dumariya, Guraru & Town Block PHC is not conducting delivery.

Table No. 9
63
 Number of MTPs
% of couples
conducted % of couples provided
Number of RTI/STI cases provided with
S. No. Name of PHC PHC level with barrier % of female sterlisations
treated permanent
contraceptive methods
methods
1 AMAS 0 0 0 0 13.5%
2 ATRI 0 112 54% 56% 30%
3 BANKEY BAZAR 0 505 0 0 32%

4 BARACHATTI 0 NA 45% 45% 44.8%

5 BELAGANJ 0 NA 53% 56% NA

6 BODHGAYA NA NA NA NA NA

7 DOBHI 0 0 0 0 0

8 DUMARIYA 0 0 0 0 0

9 FATHEPUR 0 0 0 0 42%
14%
10 TOWNBLOCK 0 0 17% 95.4%

11 GURARU NA NA NA NA NA

12 GURUA 0 78 30% 20% 15%

13 IMAMGANJ 0 0 6.2% 0 0

14 KHIJARSARAI 0 0 25% 20% 20%

15 KOACH 0 0 58% 0% 0

64
16 MANPUR 0 0 5% 1% 10%
17 MOHANPUR 0 680 87% 4% 10%

18 MOHARA 0 0 0 60% 24%

19 BATHNI NA NA NA NA NA

20 PARIYA NA NA NA NA NA

21 SHERGHATI 0 0 48% 94% 94%

22 TEKARI 0 0 17% 25% 25%

23 WAZIRGANJ 0 0 80% 20% 0

65
 Table No. 10

Proportion
of New Annual Case Treatment Success Rate (%
% of patients
Sputum Detection Rate (Total of new smear positive
% of TB cases put on
S. Positive out TB cases registered patients who are
Name of PHC suspected out treatment, who
No. of Total for treatment per documented to be cured or
of total OP drop out of
New 100,000 population have successfully completed
treatment
Pulmonary per year) treatment)
Cases
1 AMAS 3% 25% 55% 35% 20%
2 ATRI 0 NA NA NA NA
3 BANKEY BAZAR 1.5% NA NA NA NA
4 BARACHATTI 3% 75% 78% 96% 4%
5 BELAGANJ NA 28% 26.5% 16% NA
6 BODHGAYA NA NA NA NA NA
7 DOBHI NA NA NA NA NA
8 DUMARIYA NA NA NA NA NA
9 FATHEPUR NA 17% NA NA NA
10 TOWNBLOCK 4% 27% 20.5% 15% 0
11 GURARU NA NA NA NA NA
12 GURUA NA 75% .006% 26% 3%
13 IMAMGANJ 6% 10% 13% 40% 0
14 KHIJARSARAI 1.4% 13.5% 10% 93% 3%
15 KOACH 2% 2% 26% 82.6% 5%
16 MANPUR 2.8% 45% 56% 93% 7%
17 MOHANPUR 3% 40% 64% 90% 5%
18 MOHARA Not Functional
19 BATHANI 5% 28% 2.3% 92.8% 7%
20 PARAIYA 6.12% 17.3% NA NA NA
21 SHERGHATI 3% 29% 66 58% 92% NA
22 TEKARI 3% 58% 58% 72% 2%
23 WAZIRGANJ NA NA NA NA NA
N A = Not available
 Table No. 11
Vector Born Disease Control Programme

Number of
Out
Annual patients Number of Number In
Annual Plasmodium patien
S. Blood Slide Positivity receiving patients with of FTDs patent
Name of PHC Parasite Falciparum t
No. Examinatio Rate treatment Malaria and servic
Incidence percentage servic
n Rate for referred DDCs es
es
Malaria

1 AMAS 2 80% 0 2% 28 0 30 4000 3000

2 ATRI 0 0 0 0 110 02 0 1600 1600

3 BANKEY BAZAR 0 0 0 0 0 0 0 452 19500

4 BARACHATTI 12 100% 71% 5% 97 1 0 2005 27110

5 BELAGANJ NA NA NA NA NA NA NA 1840 19097

6 BODHGAYA NA NA NA NA NA NA NA NA NA

7 DOBHI NA NA NA NA NA NA NA NA 797

8 DUMARIYA NA NA NA NA NA NA NA NA NA

9 FATHEPUR 0 0 0 0 2 0 0 0 0

10 TOWNBLOCK 0 0 0 0 10 0 0 0 0

11 GURARU NA NA NA NA NA NA NA NA 28582

12 GURUA 2 NA 0 2% 2 0 0 1371 23132

67
14 KHIZERSARAI NA NA NA NA NA NA NA 0 0

15 KOACH 0 0 0 0 0 0 0 2107 22765

16 MANPUR 0 0 0 0 0 0 0 0 0

17 MOHANPUR 17 91% 3% 2% 39 0 0 789 15078

Not Functional
18 MOHARA
19 BATHNI NA NA NA NA NA NA NA 0 23
20 PARIYA NA NA NA NA NA NA NA 590 16712

21 SHERGHATI 0 86% 8% 3% 31 0 0 2282 42932

100%
22 TEKARI 0 0 0 3224 0 0 0 0

23 WAZIRGANJ 0 0 0 0 0 0 0 0 0

Table No. 12
NATIONAL LEROSY ERADICATION PROGRAMME
Number of
Number of cases Number of Cases Number of default Number of case Number of cases
SL Name of PHC complicated
detected treated cases complete treatment referred
cases
1 AMAS 48 48 0 25 0 0
2 ATRI 32 32 0 20 0 0
BANKEY
3 301 290 NA 290 2 2
BAZAR
4 BARACHATTI 31 31 4 12 3 0
5 BELAGANJ NA NA NA NA 0 0
6 BODHGAYA NA NA NA NA 0 0
7 DOBHI NA NA NA NA NA NA
8 DUMARIYA 41 41 0 39 0 0
9 FATHEPUR NA NA NA NA NA NA

68
10 TOWNBLOCK 40 25 3 15 1 0
11 GURARU 46 46 1 17 0 0
12 GURUA 73 73 0 44 3 1
13 IMAMGANJ 0 52 52 0 42 0
14 KHIZERSARAI NA NA NA NA NA NA
15 KONCH 66 39 3 21 1 0

16 MANPUR 0 68 0 28 0 0

17 MOHANPUR 45 45 10 14 0 0
Not Functional
18 MOHARA

19 BATHANI 23 23 0 10 5 0
20 PARAIYA 21 21 0 10 0 0

21 SHERGHATI 32 32 0 32 0 0

22 TEKARI 38 38 38 2 13 0
23 WAZIRGANJ 43 43 0 36 0 0

Table No. 13
SURGICAL SERVICES

Number of major surgeries Number of minor surgeries conducted

SL Name of PHC
conducted (with Family Planning)

1 AMAS 0 55
2 ATRI 0 0

3 BANKEY BAZAR 0 165

69
4 BARACHATTI 3 232
5 BELAGANJ 0 0
6 BODHGAYA 0 0
7 DOBHI 0 0
8 DUMARIYA 0 0
9 FATHEPUR 0 0
10 TOWNBLOCK 0 0
11 GURARU 0 0
12 GURUA 0 0

13 IMAMGANJ 0 0

14 KHIJARSARAI 0 0
15 KOACH 0 443
16 MANPUR 0 165
17 MOHANPUR 0 254
18 MOHARA Not Functional
19 BATHNI 0 0
20 PARIYA 0 0
21 SHERGHATI 0 374
22 TEKARI 0 0
23 WAZIRGANJ 0 0

70
 Table No. 16
Support Services

S. No PHC Name Food Ambulance House Keeping Lab Services Generator

1 Amas No Yes Yes No Yes

2 Atri No Yes Yes No Yes
3 Bankebazar No No Yes No Yes
4 Barachatti No Yes Yes No Yes
5 Belaganj No Yes Yes No Yes
6 Bodhgaya No Yes Yes No Yes
7 Dobhi No No Yes No Yes
8 Dumariya No No No No Yes
9 Fatehpur Yes Yes Yes No Yes
10 Town Block No No No No No
11 Guraru No Yes Yes No Yes
12 Gurua Yes Yes Yes No Yes
13 Imamganj Yes Yes Yes No Yes
14 Khiersarai Yes Yes Yes No Yes
15 Konch Yes Yes Yes No Yes
16 Manpur No Yes Yes No Yes
17 Mohanpur No Yes Yes No Yes
18 Mohra Not Function
19 Nimchak Bathani No Yes No No No
20 Pariaya No No Yes No Yes
21 Sherghati Yes Yes Yes No Yes
22 Tankupa Not Function
23 Tekari Yes Yes Yes No Yes
24 Wazirganj Yes Yes Yes No Yes

71
 Budget Gaya Dist.

Qty. Yr.
S. No. Budget Head Units Rate Rs. (in lacs) Amount
(9-10)
1 1. MATERNAL HEALTH
Operationalise facilities (details of infrastructure &
human resources, training, IEC/BCC, equipment, drugs
1.1 and supplies in sections
1.1.1 Operationalise Block PHCs /CHCs / SDHs / DHs as FRUs
Blood Storage centre 2 6.2o 12.4
1.1.1.1 Organise dissemination workshops for FRU guidelines
Human Recource 2 FRU 23.76 47.52
Logistic Management 2FRU 1 2
Procurement of Drugs supply 2FRU 20 40

Training for HR as per state norms

1.1.2. Operationalise 24 x 7
Infrastructure
Residence in HSC 17 4 68
Residence in PHC 6 6 36
Human Recource (A Grade nurse) 24 0.9 21.6
Monitoring & Evaluation 24 1.2 28.8
Logistic Management 24 1 24

Training for HR as per state norms

Infrastructure 1 150 150
1.1.2 Operationalise PHCs hour services
Prepare plan for operationalisation across districts
(including staffing, infrastructure, training, equipment,
1.1.2.1 drugs & supplies etc)
Monitor progress against plan (meetings at Dist. Level in
1.1.2.2 every trimester)
72
 Monitor quality of services delivery (printing of
1.1.2.3 monitoring format & registers)
1.1.2.4 Monitoring of activities related to FRUs & 24 x 7 PHCs
1.1.3 Operationalise MTP services at health facilities

Training of MO as per state norms

Monitoring 5 0.5 2.5
159
Training of Asha & AWW BATCH as per state norms
Procurement of MTP Kit 5 2 10
Prepare plan for operationalisation across districts
1.1.3.1 (including training, equipment, drugs & supplies etc)
Monitor progress against plan follow up with training,
1.1.3.2 procurement, etc
Monitor quality of services delivery and including
1.1.3.3 through field visits.
1.1.4 Operationalise RTI/STI services at health facilities
I.E.C for RTI / STI services 2 0.5 1
Ambulance services 2 1.8 3.6
Contigency 2 1.2 2.4
Training of ANM 877 as per state norms
Prepare plan for operationalisation across districts
(including training, equipment, drugs & supplies etc) (it
is planned to provide RTI /STD services from all PHCs and
CHCs for which training will be organized and drugs
1.1.4.1 and medicines @ Rs. 4.5 per district / per annum)
Monitors progress against plan ; follow up with training
1.1.4.2 procurement etc
Monitor quality of services delivery and utilisation
1.1.4.3 including through field visits
Operationalise sub centres

73
 Infrastructure 541 as per state norms
Human Recource 541 3.6 194.76
Logistic Management 541 0.1 54.1
Monitoring & Evaluation 541 0.72 389.52
Untied fund 541 0.6 324.6
Prepare plan for operationalising services at sub centres
(for a range of RCH services including antenatal care
1.1.5.1 and post natal care)
Monitor quality of services delivery and utilisation
1.1.5.2 including through field visits
1.2 Referral Transport
Free dail services 1 5.4 5.4
Ambulance services at PHC & APHC 73 1.8 131.4
Contigency at PHC level 24 1.2 28.8

Prepare and disseminate guidelines for referral transport

1.2.1 for pregnant women and sick newborns children
1.2.2 Implementation by Districts

1.3 Integrated outreach RCH services

Implementation by dist. Of RCH camps in un served /
1.3.1.1 under served areas
1.3.1.2 Monitor quality of services and utilisation
Monthly village health and Nutrition Days at Anganwadi
1.3.2 Centres
Implementation by dist. Of Monthly village health and
1.3.2.1 Nutrition Days at Anganwadi Centres
1.3.2.2 Monitor quality of services and utilisation
Janani Suraksha Yojana / JSY (details of IEC / BCC in
1.4 section 12)
1.4.2 Implementation of JBSY by Districts

74
1.4.2.1 Home deliveries
1.4.2.2 Institutional deliveries 36000 0.02 720
1.4.3 Monitor quality of services and utilisation
Other strategues / activites (please specify - PPP /
Innovations / NGO to be mentioned procurement of
1.5 Dai delivery kit under section 8) 3000 0.005 15
2 2. Child Health
IMNCI (details of training, drugs and supplies, under
2.1 sections 11 and 13)
Training of HR 72 batch 100359 72.5
Contingency for Logistic 72 batch 0.50 batch 3.6
Procurement of Madicine 72 batch 0.15 batch 10.8
A.2.6 NRC 1 centre 29.14
A. 2.4 School Health Programme
323
Health Camp in middle school camp 0.05 16.15
324
Procurement of drugs camp 0.005 1.61
Management of Diarrohea, ARI and Micronutrient
A.2.7 Mahlnutrition
Procurement of drugs equipment
Vehicle for 4 month
A.2.8 IEC / BCC 24 PHC 0.2 4.8
A.2.9 DY. CHILD HEALTH SUPERVISOR 1 0.72 0.72

A. 3.1.2 Female stenilisation camps

100
4 camp in PHC & 4 camp in Dist. camp 1000 / camp 100000
A. 3.1.3 NSV camps
27
NSV camps in every PHC & Dist. Hospital camps 1000/ camp 27
20000
A. 3.1.4 Compensation for females sterilisation person 1000 / person 20
75
 1200
A. 3.1.5 Compensation for male sterilisation person 1500 person 18
1000
A. 3.1.6 Accreditation of private provider for sterilisation services person 1000 person 10
A.3.2.2 IUD services at health facilities
1078
Training of ANM ANM as per state norms
209
Training of Doctors Doctors as per state norms
A.4. ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH /ARSH
Counselling, Nukar Natak, AFH clinic at every PHC 46 APHC 0.15 / PHC 6.9
6000
INSENTIVE TO MAMTA DELIVERY 0.001 /DEL. 6
A.8.3 NGO Programme
Hospital maintancenc, Generator services
2.3.2 Ambulance services in PHC & Dist.
Implementation of HBNC activities in districts. 27 1.8 48.6
Untied fund for Sub centre 541 0.1 54.1
APHC Untied fund 46 0.25 11.5
PHC Untied fund 24 0.25 6
A.13.2.6
RCH KIT 50
A.14 Programme management
Dist. Programe management support unit
DPM 1 2.76 2.76
DAM 1 2.16 2.16
DA 1 1.8 1.8
BHM 24 1.44 34.56
B.A 24 0.96 23.04
A Grade 146 0.9 131.4
ANM ( R ) 541 0.72 389.52

76
 DATA CENTRE OPERATER 28 0.72 20.16
DHS 1 6 6
PHC 24 2.4 57.6
B RCH FLEXI POOL 20
B.4 ASHA DIVAS 2997 0.0072 21.58
B.5 Corpus grant to HMS/RKS
Sadar Hopital 3 5 15
PHC RKS 24 2 48
B.9 Untied Grant for PHC 24 0.25 6
B.11 Maintainance grant to sub centre 541 0.1 54.1
B.12 Maintainance grant to PHC 24 0.5 12
73
B.18 AYUSH Doctor for APHC doctor 2.4 175.2
B.25 Upgradation of PHC to IPHS 10 20 200
B.14 Construction of Sub centre 102 8.48 864.96
B.7 Mobile medical unit 1 40 40
1911 CONTROL ROOM 1 0.96 0.96
B.6 Procurement of ASHA drug kit 2997 0.06 18
Dieases Cotrol Programme
NVBDCP ( 1. Falariya) 19.8
2. Malaria
NLEP (Leprosy) 6.5
NBCP Blindness 3.5
RNTCP 30

77
78