OPERATIONAL GUIDELINES for

State Programme Implementation Plan

(2012-13)

Jammu and Kashmir

NATIONAL RURAL HEALTH MISSION

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ABBREVIATIONS AYUSH AD ASHA ANC ANM AFHC AWC AWW ADMO BMO BPL BAM BB BM&EO BSU CHC CMO DHS DIO DMEIO DPMU DPM DAM D M& EO FBNC FRU FMPHW HBNC HMIS ICDS IMR IUCD JSY Ayurveda, Yoga & Naturopathy, Unani, Siddha and Homeopathy Allopathic Dispensary/ New Type PHC Accredited Social Health Activist Antenatal Checkup Auxiliary Nurse Midwife Adolescent Friendly Health Centre Anganwadi Centre Anganwadi Worker Assistant District Medical officer (AYUSH) Block Medical Officer Below Poverty Line Block Accounts Manager Blood Bank Block Monitoring & Evaluation Officer Blood Storage Unit Community Health Centre Chief Medical Officer District Health Society District Immunization Officer District Mass Education and Information Officer District Programme Management Unit District Programme Manager District Accounts Manager District Monitoring & Evaluation Officer Facility Based Newborn Care. First Referral Unit Female Multi Purpose Health Worker Home Based Newborn Care Health Management Information System Integrated Child Development Services Infant Mortality Rate Intra Uterine Contraceptive Device Janani Suraksha Yojana
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JSSK MCTS MMA MMR MAC MVA NBCC NBSU NMR NRC NRHM NPCC PHC PRIs PIP PNC RCH RKS ROP SHS SDH SC SNCU TFR VHND VHSNC WIFS

Janani Shishu Suraksha Karyakaram Mother and Child Tracking System Medical Methods of Abortion Maternal Mortality Rate Medical AID Centre/ Sub Centre Manual Vacuum Aspiration Newborn Care Corner Newborn Stabilization Unit Neonatal Mortality Rate Nutrition Rehabilitation Centre National Rural Health Mission National Programme Co-ordination Committee Primary Health Centre Panchayati Raj Institutions Programme Implementation Plan Postnatal Checkups Reproductive & Child Health Programme Rogi Kalyan Samiti Record of Proceedings State Health Society Sub District Hospital Sub Centre Sick Newborn Care unit Total Fertility Rate Village Health & Nutrition Day Village Health Sanitation & Nutrition Committee Weekly Iron Folic Acid Supplementation

NATIONAL RURAL HEALTH MISSION

National Rural Health Mission (NRHM) was launched at the National Level in April 2005. However, in J&K State it was started in December 2005. The Goal of the Mission is to improve the availability of and access to quality health care by people especially for those living in rural areas. NRHM aims to undertake architectural corrections in the health system enabling it to promote policies that strengthen public health management and service delivery throughout the country with special focus on those States which have weak public health indicators and/ or weak infrastructure. Jammu and Kashmir State is one of the focused States. NRHM is a platform to provide affordable, equitable and accessible health services, especially people residing in rural areas. In the first phase of NRHM (2005-12), the focus was on bridging infrastructure gaps and augmentation of manpower to improve the delivery of health care services. NRHM is now poised to enter the second phase and the focus in this phase would be more on health system reforms for sustainable turnaround of health system in the State. The State would focus on strategies/ interventions which are aligned with key goals of NRHM viz reduction of MMR, IMR and stabilization of TFR.

OBJECTIVES OF NATIONAL RURAL HEALTH MISSION

i. ii. iii. To reduce Maternal Mortality Rate (MMR) To reduce Infant Mortality Rate (IMR) To reduce Total Fertility Rate (TFR)

STRATEGIES
i) Strengthening of the Health Institutions providing Primary Health Care (CHCs, PHCs and Sub Centres) so as to provide all the basic and emergency obstetric care. ii) Strengthening of the Routine Immunization for the vaccine preventable diseases. iii) Improving the health services and the services determining the health of the society viz sanitation and potable drinking water. iv) Decentralizing the health planning and management of the health institutions by way of: Constitution of District Health Missions and District Health Societies for planning and implementing the health related initiatives in the respective districts. Formation of Rogi Kalyan Samitis (RKS) and Village Health Sanitation and Nutrition Committees (VHSNC). v) Bringing all the centrally sponsored Health schemes under the umbrella of NRHM. Programme Action Plan (PIP) for 2012-13 The Ministry of Health and Family Welfare, Govt. of India conveyed administrative approval to the implementation of State PIP for the year 2012-13 for an amount of Rs. 312.54 crores 4

including Supplementary PIP of Rs.41.78 crores. The State PIP has been approved for the components and activities detailed in forthcoming paragraphs subject to compliance of following key conditionalities.

Key Conditionalities
A) Rational and equitable deployment of HR with the highest priority accorded to high focus districts and delivery points. Rational and equitable deployment would include posting of staff on the basis of case load, posting of specialists in teams (e.g. Gynecologist and Anesthetist 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. B) Facility wise performance audit and corrective action based thereon. Performance parameters must include OPD/ IPD/ normal deliveries/ C. Sections (wherever applicable). Non-compliance with either of the above conditionalities given at A and B 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 in 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. F) All buildings/vehicles supported under NRHM should prominently carry NRHM logo in English, Hindi and Regional language.
G) The State has been directed to ensure mandatory disclosure of the following

information on the State website of NRHM: 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.
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 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 kilometers 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. The major heads of operation are:
1. RCH Flexible Pool 2. NRHM Flexible Pool 3. Immunization The detailed district wise/ activity wise budget for the year 2012-13 has already been circulated to the District Health Societies for implementation of the approved activities during the current year. The approval, however, is subject to the compliance of Key Conditionalities given above. The District Health Societies shall furnish the monthly progress report in the format given in Annexure A.

Components under the National Rural Health Mission

MATERNAL HEALTH
Janani Suraksha Yojana (JSY) In order to promote safe Institutional deliveries, the GOI has implemented JSY throughout the country including J&K. Under this scheme, the incentives are being paid to mother beneficiaries at the following norms:
S.No 1 2 3 Area Rural areas Urban areas BPL mothers (aged 19 years and above) delivering at home upto two living children only Incentive for mother beneficiary Rs. 1400.00 Rs. 1000.00 Rs. 500.00

ASHAs will facilitate Antenatal checkups and accompany the mothers to the health institutions for delivery and will get the following incentives:
S.No 1 2 Districts High Focus Districts Other Districts Incentive for ASHA Rs.600.00 Rs.350.00*

*Excluding Rs 250.00 for referral transport which will be borne by JSSK.

JSY cards, MCP cards and broader guidelines of JSY have already been made available to the District Health Societies. NOTE: JSY guidelines to be strictly followed and payments made as per the eligibility criteria. JSY benefit to the mother should be paid at the Health facility immediately after the delivery and before discharge. All payments to be made through crossed cheques / e-banking. The DDO should ensure that the JSY, MCP Card and Discharge slip have been prepared before making payment to the beneficiary as well as ASHA. JSY card and MCP card to be filled at the time of registration of pregnant women and not at the time of disbursement of cheque to the beneficiary and should be followed till the completion of pregnancy. Regular monitoring by Deputy Chief Medical Officers (District Nodal officers) for JSY. Physical verification of JSY beneficiaries to be done by the State and district level health authorities as per the following norms: i) State level officers 2%. ii) Chief Medical Officer 5%. iii) District Nodal Officer (Deputy CMO) 5% iv) Block Medical Officer 10% Accuracy of JSY data reported at the HMIS portal of MOH&FW to be ensured besides furnishing quarterly progress reports to the State Health Society as per the prescribed format for onward transmission to Ministry within the given timeframe. The list of JSY beneficiaries to be displayed at prominent places in the Health facility. Grievance redressal mechanisms as stipulated under JSY guidelines to be activated at the district and State levels. Quarterly reports of complaints received and action taken thereon by the Grievance Redressal Cell to be submitted to the State Health Society.

Mother and Child Health Card (MCP) The State has already initiated Joint MCP card developed by the Ministry of Health & Family Welfare and Social Welfare for monitoring the services of MCH and Nutrition interventions. This card will be filled at the time of first ANC. ASHA incentives and JSY benefits to the mother will be given upon verification and checking the entries in the Joint MCP card prepared by the ANM. Janani Shishu Suraksha Karyakram (JSSK) The Janani Shishu Suraksha Karyakram (JSSK) has been implemented in the State with a view to encourage all pregnant women to deliver in Public Health Facilities and full fill the commitment of achieving cent percent institutional deliveries. All Pregnant women and sick neonates till 30 days after birth who access government Health Institutions including SMGS Hospital, Jammu, Lal Ded Srinagar, G.B. Pant Hospital Srinagar and SKIMS Srinagar shall be entitled for availing following benefits:S. No 1 2 3 4 5 Entitlements for Pregnant Women: Free delivery Free caesarian section Free drugs and consumables Free diagnostics (Blood, Urine tests and Ultrasonography etc.) Free diet during stay (upto 3days for normal delivery and 7days for caesarian section) Free provision of blood (Relatives and attendants should be encouraged to donate blood for replacement) Free transport from home to health institution, between health institutions in case of referrals and drop back home Exemption from all kinds of user charges Entitlements for Sick Newborn till 30 days after birth Free and zero expense treatment. Free drugs &consumables. Free diagnostics. Diet for mother during the stay of sick children in hospital for 5 days. Free provision of blood. (Relatives and attendants should be encouraged to donate blood for replacement) Free transport from home to health institution, between health institutions in case of referrals and drop back home. Exemption from all kinds of user charges.

NOTE: JSSK entitlements to be ensured to all pregnant women and sick newborns accessing Govt. health institutions. Drop back to be ensured to at least 70% of pregnant women delivering in the public health facilities. Effective IEC to be ensured.
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 Grievance Redressal Cells constituted for JSY shall also look into the Grievances for JSSK. Submission of Quarterly Reports to be ensured. Accredited Social Health Activist (ASHA) ASHA is the first port of call for any health related demands of deprived sections of the population, especially women and children, who find it difficult to access health services. She is a trained female health activist in the community who creates awareness on health and its social determinants and mobilizes the community towards local health planning and increased utilization and accountability of the existing health services. She is a good promoter of health practices. Criteria for selection of ASHA One ASHA has to be in place for a population of 1000. ASHA must be a woman resident of the village--- Married/Widow/Divorced and preferably in the age group of 25 to 45 yrs. She should be a literate woman with formal education up to Eighth Std. In case the special circumstances require relaxation of the educational qualification of ASHA, the District Health Society needs to send the proposal to the State Health Society with full justification for seeking approval from Ministry of Health and Family Welfare, Government of India. She should have effective communication skills, leadership qualities and be able to reach out to every section of the community. Adequate representation from disadvantaged population groups should be ensured to serve such groups better. 10000 ASHAs have been engaged in the State so far. However during the year 2012-13, engagement of 2000 additional ASHAs has been approved in the Programme Implementation Plan (PIP). ASHAs are in place in majority of the villages and have been trained in module I to V. In the year 2012-13, the ASHAs will be trained in Module VIVII. Uniforms to ASHA in High Focus Districts @ Rs. 1000.00 and in other districts @ Rs. 750.00. The amount has to be e-transferred to the account of ASHA. All payments to ASHAs be made through payees account Cheque/ electronic transfer on 10th of every month.

ASHAs are not paid any fixed monthly remuneration. However, they are paid performance based incentives. Incentives for ASHAs:
S.No 1 Activity Incentive for full ANC Amount of Incentive Rs 250/- per case Approved with the condition of registration of PW within 12 wks, completion of 4 ANC, testing for Hemoglobin, Routine urine, 100 IFA and TT injection. The payment would be made after entry in joint MCP card and verified by the ANM/SN/MO. Incentive under JSY Rs.350/- per delivery Rs.600/-per delivery in HFDs (with conditions of JSY) Incentive for HBNC Rs 250/- on completion of six visits (3rd, 7th, 14th, 21st, 28th and 42nd day) in case of institutional deliveries and seven visits ((1st,3rd,7th ,14th ,21st ,28th and 42nd day) in case of home deliveries subject to certification by ANMs. Incentive for full immunization per Rs 100 per child for full immunization in 1st year of child(upto 1 year age) age Incentive for full immunization per child Rs 50 per child for ensuring complete immunization upto 2 years age(all vaccination received upto 2nd year of age of Child. between 1st and 2nd year age after completing full immunization at 1 year age) Mobilizing Drop out Children for Rs 150 /- subject to the condition that no drop out Immunization Sessions on VHND child is left without immunization in her area. Incentive for facilitating the monthly Rs. 150/meeting of VHSNC followed by the meeting of the Women and Adolescent Girls Incentive for birth registration Rs 50/Incentive for death registration Rs 50/Incentive for events reporting (diarrhea, Rs 100/epidemic, accidents, etc ) Maternal Death Reporting Rs 100/Infant Death Reporting Rs 100/Incentive to ASHA for Roster duty at Rs. 100 for 8 hours duty on rotation basis. ASHA help desk in selected Delivery points. (Annexure B)

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6 7

8 9 10 11 12 13

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S.No 14 15 16 17

Activity Reimbursement for Mobile user charges for ASHA ASHA incentive for sale of 50 sanitary napkins packs. ASHA incentives for testing 50 salt samples per month in endemic districts Early case detection of Leprosy MB PB Motivation of any beneficiary tubectomy/laproligations Motivation vasectomy of any beneficiary for for

Amount of Incentive Rs. 100 per month Rs. 50/Rs. 25/- per month

500/300/Rs 150 /- per operation Rs 200 /- per operation Rs 250 /- on completion of treatment Rs 75 /- x 3 days = Rs 225

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Providing DOTS to the TB. Patients Pulse Polio Day

Job functions of ASHA Activities as mentioned in the table above and mobilizing the Pregnant Ladies for Antenatal checkups/dropouts for immunization. Accompanying the pregnant ladies to the institution for delivery. Tracking of Pregnant women from early registration in the first trimester upto post natal care after delivery in her respective areas. Tracking of Children upto full immunization stage Maintenance of ASHA Diary Record of house hold visits, under one year children, pregnant ladies and the eligible couple register. Assisting the FMPHWs and AWWs in organizing Village Health & Nutrition Days. Facilitating the monthly meeting of VHSNC followed by the meeting of women and adolescent girls. Maintenance of register in which all the services provided viz registration of pregnant women, ANC, immunization, Oral pills, IUCD, sterilization- Male female, referral of sick newborns/children/ infants, spacing methods etc. are recorded with signature of the concerned health person. Monthly reports generated by ASHA as per her diary is to be consolidated at SC level. ASHA is a main service provider for Home Based Neonatal Care. She has to provide newborn care through a series of home visits which include the skills for weighing the newborn, measuring newborn temperature, ensuring warmth, promoting hand
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washing, providing skin, cord & eye care, supporting exclusive breast feeding, accessing low birth weight babies through the use of protocols and managing such babies through various means like monitoring weight supporting / counseling etc., detect signs and symptoms of sepsis, recognize post partum complications in the mother and refer appropriately etc. ASHA Diary ASHA has to record and track the pregnant women upto 42 days postnatal period and has also to follow the children till they are fully immunized. Besides, she has to attend Village Health and Nutrition Days for mobilizing women and children to avail health services being provided on VHN Day. She has also to facilitate holding of meeting of the Village Health Sanitation and Nutrition Committees (VHSNCs) and maintain records of untied funds of VHSNCs. All these activities need to be recorded for tracking them later on. The State Health Society is providing the diary to the District Health Society for distribution among ASHA for this purpose.

Drug kit for ASHA

ASHA have been provided drug kit in the previous year which will be replenished by the Block Medical Officer out of the available stock of medicines. Home Based Newborn Care (HBNC) Kit will be provided to ASHAs for Home Based Newborn Care. The contents of the kits will be as under:
S.No. 1 2 3 Equipment Baby weighing scale with sling Digital thermometer Digital watch/Timer device Consumables 4 5 6 7 8 Cotton Gauze Soap & Soap Case Baby Blankets, Locally made and Locally Procured Spoon-stainless steel 2 1 No. 1 1 1

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ASHA Help Desk/ASHA Greh (New Activity)

Escorting pregnant women to the hospital for institutional delivery is one of the important activities that an ASHA performs. The ASHA has to escort the pregnant women even during the odd hours which necessitates for keeping a provision of Help desk-cum-rest room at the hospitals which would provide space to the ASHAs for freshening up and taking rest for some time. Besides, it will also act as a help desk to provide required information to ASHAs. To begin with, this has to be initiated and operationalized in 30 health institutions including District Hospitals and few CHCs on the basis of delivery load given in Annexure C ASHA GREH will be having one room with attached toilet and bathroom facility, having proper electrical fittings like light, fan or heater etc. The room should have a provision of at least two beds with all other accessories like bed sheets, bed covers, pillows, drinking water facility etc. Relevant informative documents on health issues shall remain available in ASHA GREH for reference. The room should be exclusively used by ASHAs and accessible for use on 24x7 basis. The management of ASHA GREH shall be assigned to ASHAs selected on the basis of performance and belonging to the nearby locality. Each selected ASHA shall be assigned the task of managing ASHA GREH on daily rotation basis. A roster duty register shall be maintained to record the use of the facility and performance of the duty by ASHAs. ASHAs will receive incentives for performing duty on roster basis. The overall management of ASHA GREH will be under the control of Rogi Kalyan Samiti (RKS) of the concerned health institution. ASHA shall be given incentive of Rs. 100 / day for performing roster duty for 8 hours. ASHAs from the adjoining areas will be called for roaster duty to be prepared by the concerned Block Medical Officer and submitted to the Medical Superintendent of the concerned Hospital. The incentives to ASHA for performing roaster duty shall be paid by the concerned Block Medical Officer. Cost of Operationalization of ASHA HELP DESK/ASHA GREH will be Rs. 10, 000/facility as per the breakup given below:
S.No. Items 1 Two wooden Beds @ Rs. 1500/2 Bedding and Linen @ Rs. 1500/ Upto a maximum of Rs. 3000/Rs 3000/-

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3 4

Fan and Heater Table and Chair Total

Rs 2000/Rs. 2000/Rs.10,000/-

Delivery points
At present there are 133 functional delivery points (Annexure D) in the State as per the benchmark set by GoI i.e. i. SCs conducting > 3 deliveries/ month. ii. PHCs/Non-FRUs conducting > 10 deliveries/month. iii. FRUs conducting >20 deliveries/ month. iv. District Hospitals conducting >50 deliveries/ month. Services to be provided in these Delivery Points: A) All District Hospitals and other similar district level facilities to provide the following services: 24x7 service delivery for CS and other Emergency Obstetric Care. 1st and 2nd trimester abortion services. Facility based MDR. Essential newborn care and facility based care for sick newborns. Family planning and adolescent friendly health services RTI/STI services. Functional Blood Storage Unit / Blood Bank. B) 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 as the district hospitals. C) 24x7 PHCs and Non FRUs to provide the following services: 24x7 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 and facility based care for sick newborns. Family planning D) All identified SCs/ facilities will: Conduct Delivery by SBAs.
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Provide IUD Services Provide Essential New born care services. Provide ANC, PNC and Immunization services. Provide Nutritional and Family planning counseling. Conduct designated VHND and other outreach services.

Maternal Death Review (MDR) Under NRHM, various attempts are being made to reduce Maternal Mortality by improving quality of maternal health care delivery and stepping up monitoring. Government of India has decided to take up Community based maternal death review (CBMDR) and the Facility based maternal death review (FBMDR) which would help in identifying the gaps in the existing health care delivery systems, prioritizing and planning for intervention strategies and to reconfigure health services. The Maternal Death Review will be taken up both at Facility level and Community level in all Districts of the State. Community-Based MDR Community based MDR using a verbal autopsy format is a method of finding out the medical causes of death and ascertaining the personal, family or community factors that may have contributed to the death. The verbal autopsy consists of interviewing people who are knowledgeable about the events leading to the death such as family members, neighbors and traditional birth attendants. Community based reviews must be taken up for all deaths that occurred in the specified geographical area, irrespective of the place of death, be it at home, facility or in transit. Procedure for Community-Based Verbal Autopsy i) The ASHA/AWW/ANM will inform/intimate all women deaths in the age group of 15 to 49 years from her area by telephone to the BMO within 24 hour. The local panchayats and other relevant persons/ groups may also be encouraged to inform the BMO about womens death in their area. ii) The ASHA/AWW/ANM will fill up the format for primary informant (Annexure E) for all women deaths (age 15-49) and send the format to the BMO within 24 hours. Format for primary informer gives information whether the death is a suspected maternal death or a non maternal death.

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iii) Line listing of maternal deaths should be submitted to the BMO by the ASHA, by 5th of every month. In case no death has occurred during the month, the ASHA has to submit a Nil report. iv) The ASHA/AWW/ANM should also ensure the presence of the respondents during the visit of the investigation team Facility-Based MDR Facility Based Maternal Death Review will be taken up for all Government hospitals viz. Medical College/DHs/SDHs/CHCs where more than 500 deliveries are conducted in a year. Procedure for Facility-Based Autopsy i) All Maternal deaths occurring in the hospital, including abortions and ectopic gestation related deaths, in pregnant women or within 42 days after termination of pregnancy irrespective of duration or site of pregnancy should be informed immediately by the Medical officer who has treated the mother and was on duty at the time of occurrence of death to the Facility Nodal officer (FNO) ii) The FNO of the hospital should inform the maternal death to the District Nodal Officer (DNO) and State Nodal Officer on telephone within 24 hours of the occurrence of death. iii) The Nodal Officer of the hospital should complete the format for Primary informant Annexure E and send it to the District Nodal Officers within 24hrs of the occurrence of maternal death At the District level the Maternal Death Review is envisaged at two levels. Maternal Death Review under chairmanship of CMO. Maternal Death Review by District Level Committee under chairmanship of District Magistrate. Composition of District Level Committee
District Magistrate Chief Medical Officer Dy. Chief Medical Officer District Nodal Officer (MDR) Facility Based Nodal Officer (MDR) Chairperson Member Secy/ Convener Member Member Member

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Representative of Federation of Obstetric and Gynaecological Society of India (FOGSI)

Member

Committee should meet at least once in a month to review the maternal death cases and should submit the minutes of the meeting and corrective actions taken to reduce the maternal deaths to the State Health Society. The meeting of the District Committee shall be held irrespective of the fact whether any maternal death has occurred in that particular month or not. o Maternal Death Reporting:- A provision of Rs. 100.00 has been kept for reporting maternal death by a community volunteer/ ASHA. The report of such deaths will be submitted to the District Health Society who will take appropriate action. o Maternal Death Investigation (Verbal Autopsy):- An amount of Rs. 250 per investigation shall be provided to Deputy CMO/BMO/MO for Maternal Death Investigation (Verbal Autopsy). Investigation reports are to be furnished to GOI through State Health Society on monthly basis/Quarterly basis.

Road Map for Priority Action on Maternal Health is enclosed as Annexure B CHILD HEALTH
Before launch of NRHM in the State, the Infant Mortality Rate was 52 as per Sample Registration Survey (SRS) 2006. Different strategies have been adopted under NRHM which are directed towards reduction of IMR in the State. As per the targets fixed by MoH&FW, GoI the State has to achieve the following targets by end of March 2013.
Indicator Early Neonatal Mortality Neonatal Mortality Rate (NMR) Infant Mortality Rate (IMR) Under 5 Mortality Current Status Target (SRS 2010) 2012-13 30 24 35 43 48 27 34 37

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With these targets in consideration, the following specific interventions are being taken up in the Districts during the current year: A) Facility Based New born Care:During the current year, emphasis will be laid upon strengthening of existing Facility Based Newborn Care Units viz. SNCUs/NBSUs/NBCCs at different levels, as most of these units have been established but need to be operationalized so as to achieve the desired outputs. Sick Newborn Care Units: - Sick Newborn Care unit (SNCU) is a neonatal unit in the vicinity of labour room at District hospital which would provide level-II care for Sick New Borns. Seven SNCUs have been established till date & eight more are to be established during this year. Please refer Annexure G for list of Hospitals where SNCUs are to be set up. Operational cost has been approved for 5 functional SNCUs @ Rs 10 lakhs and @ Rs. 5 lakhs for the SNCUs which have been established but are yet to be operationalized. Please refer Annexure H for list of Hospitals in this regard. The component wise detail of Operational Cost is given below:
Recurring or running cost per year Consumables Maintenance cost Sub Total Operational cost of Rs. 10.00 Operational cost of Rs. Lakhs (for One Year) 5.00 lakhs (for six months) Rs. 3,50,000 Rs. 6,50,000 Rs. 10,00,000 1,75,000 3,25,000 5,00,000

Consumables for SNCU includes meconium aspirator adaptors, infusion pumps, Cuvettes, Vacuum tubes, lancets, capillary tubes, sealing compound, masks & caps, surgical gloves, suction tubes, feeding tubes, syringes & needles, cotton wool, compress gauze, connectors, disinfectants & antiseptics, adhesive tapes, scalpels, umbilical venous catheters, blood transfusion sets, endotracheal tubes, electrodes for ECG recorder, microscopic slides, paper sheets crepe for sterilization pack, etc. Human Resources approved for this financial year for each SNCU at District Hospitals:1. One Child Specialist. 2. Four Medical Officers (MBBS) to be engaged on contract basis. 3. Five Staff Nurses. 4. One Lab Technician. 5. One Data Entry Operator for ARSH/ SNCU/HMIS at DH.

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Newborn Stabilization Units:- Stabilization unit is facility within or in close proximity of the Maternity ward where sick and low birth weight new born can be cared for short period. 69 NBSUs have been established till date in the State whereas work is in progress in 14 NBSUs. Strengthening of existing NBSUs will be carried out this financial year for which an amount @ Rs 1.75 lakh /unit has been approved as operational cost for 45 functional NBSUs. List annexed as Annexure I.
Recurring or running cost per year Amount in Rupees Consumables Rs.25,000 Maintenance cost Rs. 1,50,000 Sub Total Rs. 1,75,000

Consumables for NBSU includes I/V cannula 24/26 G, mucous extractors, feeding tubes, oxygen cylinder 8 F, suction tubes, Sterile gloves, Cotton wool, Disinfectants etc. Newborn Care Corners: Baby care corners are to be established in the PHCs (Delivery point) in phased manner by way of addition/alternation of the existing space within/ nearer to the labour room for paying special attention to the sick newborn. 269 Newborn Care Corners have been established in the State till date. In the previous years the grant for setting up of NBCC was only Rs. 25000/- & in most of the facilities the equipment purchased includes Oxygen cylinders, Suction apparatus, Laryngoscope etc whereas in many of the Institutions radiant warmers were not purchased. An amount of Rs. 42.50 lakhs @ Rs 85,000 per unit has been approved for procurement of equipments for NBCCs including radiant warmer for 50 delivery points/facilities. List of institutions annexed as Annexure J. List of Equipments for NBCC S No. Item Description Essential/Desirable 1 Open care system: radiant warmer, E fixed height, with trolley, drawers, O2-bottles 2 Resuscitator hand-operated for E neonate, neonate,500ml 3 Weighing Scale, spring E 4 Pump suction, foot operated D 5 Room Thermometer E 6 Light examination, mobile, 220-12 V D

Quantity 1

1 1 1 1 1
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7 8 9 10 11 12 13

Consumables required for NBCC I/V Cannula 24 G, 26 G E Extractor, mucus, 20ml E Towels for drying and E wrapping the baby Sterile equipment for cutting and E tying the cord Tube, feeding, CH07, L40cm, E Oxygen cylinder 8 F D Sterile Gloves E

Moreover, for strengthening of existing NBCCs Operational cost for 200 units @ Rs 20,000/unit has been approved this financial year. List annexed as Annexure K. Amount in Rupees Recurring or running cost per year Consumables Rs.5,000 Maintenance cost Rs. 15000 Sub Total Rs. 20,000 Note: Detailed Guidelines/Toolkit for setting up of SNCUs/ NBSUs/ NBCCs has already been circulated to the districts. These guidelines are also available on website of National Rural Health Mission, J&K www.jknrhm.com. Strengthening of SMGS Hospital Jammu / GB Pant Hospital Srinagar: For tertiary care hospitals Rs 2 Crore each have been approved for Strengthening of the paediatrics department of SMGS Hospital Jammu & GB Pant Hospital Srinagar this financial year. Note: All procurement/purchases should be made as per the rates approved by the Central Purchase Committee. All codal formalities should be observed while making purchases. B. Home Based Newborn Care:Home Based New Born Care is an effective approach for achieving the desired reduction in infant mortality in rural and poor population. 10000 ASHAs are working in the State.
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Training of Module 6 & 7 is being rolled out shortly. By the end of this financial year it is expected that most of the ASHAs will get trained in Module 6 & 7 to implement effectively Home Based New Born Care. Training on MCP cards for HBNC will be imparted to the ASHAs during monthly meetings. HBNC visits will be monitored by the ASHA facilitators, MCP cards will be filled by the ANM in order to ascertain their Home visit & ASHA will be entitled for Rs. 250 on completion of her six visits (Day 3, 7, 14, 21, 28, 42) in case of institutional deliveries and seven visits (Day 1, 3, 7, 14, 21, 28, 42) in case of Home deliveries. C. Janani Shishu Suraksha Karyakram (JSSK) JSSK has been implemented in the State vide Govt. Order No. 516-HME of 2011 free entitlements for sick newborn for 30 days after birth are given at under Maternal Health. D. Nutrition Rehabilitation Centre NRC (New Activity) NRC is a unit in a health facility where children with Severe Acute Malnutrition (SAM) are admitted and managed. Children are admitted as per the defined admission criteria and provided with medical and nutritional therapeutic care. Once discharged from the NRC, the child continues to be in the nutrition rehabilitation program till he/she attains the defined discharge criteria as per the guidelines. Location and size of NRC NRC is a special unit, located in a health facility and dedicated to the initial management and nutrition rehabilitation of children with severe acute malnutrition. The unit should be a distinct area within the health facility and should be in proximity to the pediatric ward/inpatient facility. The NRC should have the following Facilities: Patient area to house 10 beds; in NRC adult beds are kept so that the mother can be with the child. Play and counseling area with toys; audiovisual equipment like TV, DVD player and IEC material. Nursing station Kitchen and food storage area attached to ward, or partitioned in the ward, with enough space for cooking, feeding and demonstration. Attached toilet and bathroom for mothers and children, along with two separate hand washing areas.
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 The approximate covered area of the NRC should be about 150 square feet per bed, plus 30% for ancillary area. A 10 bedded NRC should have a covered area of about 1950 square feet; this will include the patient area, play and counseling area, nursing station, kitchen, storage space, two bathrooms and two toilets. NRC should have a cheerful, stimulating environment; it should be child friendly. Walls can be brightly painted and decorated. Ward should have sufficient space for all mothers/caregivers staying with the children to sit together and be given cooking and feeding demonstration. To begin with, the State will establish two Nutrition Rehabilitation Centres (NRCs). In this financial year one in G.B Pant Hospital, Srinagar and one in SMGS Hospital, Jammu. Rs. 19.6 lakhs have been approved for this activity during this financial year @ Rs. 2 Lakh as establishment cost & Rs. 7.8 lakh as operational cost per unit.
Approved Budget for 10 bedded NRC Items Unit cost

S. no. A. One-time expenditure A1 Civil Work (renovation) 1.1 Ward 1.2 Kitchen 1.3 Bathroom and toilets A2 Cots and Mattresses (10 Cots & mattresses @ Rs 2500 each) A3 Essential Ward equipments A4 Other Ward equipments A5 Kitchen equipments One-time expenditure B. Recurrent expenditure B1 Kitchen Supplies B2 Pharmacy Supplies and Consumables B3 Other Costs Wage Compensation and food for mother/care giver* (Rs 100 X 10 beds X 30days X 12 months) Maintenance of equipments, linen, Cleaning supplies Contingency Subtotal TOTAL COST (A+B)

Total cost

25,000 20,000 15,000 2,500 50,000 35,000 30,000

25,000 20,000 15,000 25,000 50,000 35,000 30,000 2,00,000 1,80,000 1,80,000 3,60,000 42,000 18,000 7,80,000 9,80,000

15,000 (per month) 15,000(per month) Rs.100/day 3,500(per month) 1,500(per month) 64,500

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* The Mother/ Care taker of Child shall prepare special diet for the child as prescribed by the Medical officer under the supervision of Staff Nurse, for this purpose mother of child shall be provided wage compensation/ food @ Rs 100 per day. Medical Superintendent of Hospital shall utilize the services of one Medical Officer (MBBS) and One Staff Nurse from existing hospital staff for providing services in the Nutrition Rehabilitation Centre. The Staff will be trained in facility based management of SAM. Medical Officer shall be the overall in-charge of the unit and will be responsible for clinical management of children admitted in the NRC. The MO will examine each patient every day and will attend to emergency calls as per the need. The nurse posted in the unit will be responsible for the nursing care including weight record; measure, mix and dispense feed; give oral drugs; supervise intra venous fluids; assess clinical signs and fill the multi chart with all the routine information. The nurse will also counsel mothers/caregivers on the emotional needs of their children and encourage them to give sensory stimulation. She will be also in charge of the structured play therapy. Details of equipments and supplies for NRC i. Essential Ward equipments Glucometer (1) Thermometers (preferably low-reading) (2) Weighing scales (Digital) (3: one each to be kept in Ward, OPD and Emergency area) Infantometer (1 each for OPD & NRC) Stadiometer (to measure standing height) (1) Resuscitation equipments Suction equipment (low pressure) ii. Other Ward equipments IV stands Almiras, Shoe racks, Dust bins, Room Heaters IEC Audio/visual materials (TV; DVD player) Toys for structural play Calculator & Clock Reference height and weight charts
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iii. Kitchen equipments Cooking Gas Dietary scales (to weigh to 5 gm.) Measuring jars Electric Blender (or manual whisks) Water Filter Refrigerator Utensils (large containers, cooking utensils, feeding cups, saucers, spoons and jugs, etc.) iv. Drugs and Consumables Antibiotics: (Ampicillin/Amoxicillin/Benzyl penicillin Chloamphenicol Cotrimoxazole Gentamycin Metronidazole Tetracycline or Chloramphenicol eye drops Atropine eye drops ORS Electrolyte and minerals Potassium chloride Magnesium chloride/ Sulphate iron syrup Multivitamin Folic acid vitamin A syrup Zinc Sulfate or dispersible Zinc tablets Glucose (or sucrose) IV fluids (ringers lactate solution with 5% glucose; 0.45% (half normal) saline with 5% glucose; 0.9% saline (for soaking eye pads) Cannulas, IV sets, Pediatric Nasogastric tubes v. Kitchen Supplies Supply for making Starter and Catch up Diet Dried Skimmed Milk Whole dried milk Fresh whole milk Puffed rice vegetable oil Foods similar to those used in home D. Infant and young Child Feeding (IYCF): Beast feeding is to be initiated within one hour after birth of the child. During the current financial year, breast feeding week (17 August 2012) will be organized at all delivery points, block and district headquarters for promoting breast feeding. An amount of Rs.

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5000/- has been approved to be kept at the disposal of the heads of the institutions for carrying out activities like IEC and organizing camps. E. Infant Death Review (IDR) One of the prime objectives of NRHM is to reduce the Infant Mortality Rate (IMR). Various attempts are being made to reduce Infant Mortality by improving quality of child health care delivery through strengthening of Facility Based Newborn Care Units, introduction of Home Based Newborn Care Programme and stepping up monitoring. However, it has been felt that prompt reporting and review of infant Deaths can provide insight into the cause of death and the possible solutions to check the problem. The Infant Death Review will be taken up both at Community level and Facility level in all Districts of the State. Community-Based IDR Community based IDR using a verbal autopsy format is a method of finding out the medical causes of death and ascertaining the personal, family or community factors that may have contributed to the deaths. The verbal autopsy consists of interviewing people who are knowledgeable about the events leading to the death such as family members, neighbors and traditional birth attendants. Community based reviews must be taken up for all deaths that occurred in the specified geographical area, irrespective of the place of death, be it at home, facility or in transit. Procedure for Community-Based Verbal Autopsy i) The ASHA/AWW/ANM will inform/intimate all infant deaths in the age group of 0 to 1 year from her area by telephone to the BMO within 24 hour. The local panchayats and other relevant persons/ groups may also be encouraged to inform the BMO about women deaths in their respective areas. ii) The ASHA/AWW/ANM will fill up the format for primary informer for all infant deaths and send the format to the BMO within 24 hours. iii) Line listing of the infant deaths should be submitted to the BMO by the ASHA, by 5th of every month. In case no death has occurred during the month, the ASHA has to submit a nil report. iv) The ASHA/AWW/ANM should also ensure the availability of the respondents during the visit of the investigation team.

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Facility-Based IDR Facility Based Infant Death Review will be taken up for all Government hospitals including Medical Colleges (District, Sub district, CHCs) where more than 500 deliveries are conducted in a year. Procedure for Facility-Based Autopsy i) All Infant deaths occurring in the hospital, should be reported immediately by the Medical officer who has treated the child and was on duty at the time of occurrence of death to the Facility Nodal officer (FNO) ii) The FNO of the hospital should report the infant death to the District Nodal Officer (DNO) and State Nodal Officer by telephone within 24 hours of the occurrence of death. iii) The Nodal officer of the hospital should complete the primary informant format and send it to the DNO within 24hrs of the occurrence of infant death. At the District level the Infant Death Review is envisaged at two levels. Infant Death Review under chairmanship of CMO. Infant Death Review by District Level Committee under chairmanship of District Magistrate. The District Level MDR Committees shall also review the infant deaths in the District. However, one Pediatrician will be included in the aforesaid committee for review of Infant Deaths. Committee should meet at least once in a month to review the infant death cases and should submit the minutes of the meetings and corrective actions taken to reduce the infant deaths to the State Health Society irrespective of the fact whether any infant death occurred in that particular month or not. Infant Death Reporting: - A provision of Rs.100 has been kept for reporting infant death by a community volunteer/ ASHA. The report of such deaths is to be submitted to the District Health Society who will take appropriate action. Formats for infant death reporting are annexed at Annexure L Infant Death Investigation (Verbal Autopsy):- An amount of Rs. 250 per investigation shall be provided to Deputy CMO/BMO for Infant Death Investigation (Verbal Autopsy).

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Investigation reports are to be furnished to GOI through State Health Society on monthly and quarterly basis Emphasis needs to be given to: Initiation of Breast feeding within one hour after Birth. A minimum stay of 48 hours of the mother & the child after delivery at the Health facility followed by post natal visits by ASHAs/ANMs upto 42 days to monitor the well being of mother & Child. Full immunization of the children as per the Universal Immunization schedule. Proper Facility Based Newborn Care.

Road Map for Priority Action on Child Health is enclosed as Annexure F URBAN RCH
Urban RCH is being implemented in Capital cities of Srinagar & Jammu under NRHM; Urban Health Posts and Urban Health Centres have been established in cities of Srinagar & Jammu. Urban Health Centres Manpower One Medical Officer, Three ANMs and One Helper Urban Health Posts Two ANMs and One Part Time Cleaner Note: Funds under Urban RCH have been approved for six months only. Further approval shall be given subject to the sharing of work done performance of UHCs / UHPs with the Ministry of Health and Family Welfare, GoI. The Chief Medical Officers Jammu / Srinagar shall furnish the progress report of Urban Health Centres / Posts to the State Health Society by 30th September 2012 for its onward transmission and taking up the matter with GoI for sanction of funds for next six months. ROAD MAP FOR PRIORITY ACTION UNDER URBAN RCH 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
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months of 2011-12). State to apprise MoH&FW 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.

TRIBAL RCH
Under Tribal RCH, AMCHI units have been setup under NRHM in District Hospitals, CHCs, PHCs of Leh and Kargil. AMCHI healers are to be engaged in these AMCHI units on contractual basis upto 31st March 2013. Manpower for AMCHI Units Two AMCHI Healers per District Hospital One AMCHI Healer per CHC; and One AMCHI Healer per PHC The medicines have been approved for these AMCHI units at the following rates:
S.No 1 2 3 Activity Unit Cost Procurement of medicines for AMCHI at District 1,00,000/Hospital Procurement of medicines for AMCHI at CHC 75,000/Procurement of medicines for AMCHI at PHC 25,000/-

ROAD MAP FOR PRIORITY ACTION UNDER TRIBAL HEALTH During the year 2012-13 Monitoring progress (physical and financial) 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 the State Health Society for onward transmission to MoHFW. The State shall focus on health entitlements of vulnerable social groups like SCs, STs, OBCs, minorities, women, disabled, migrants etc Establishing Control Room for Ambulances (Toll Free No. 102) The control rooms are being established in each of the District Hospital to regulate and use all ambulances optimally. A toll free number 102 will be obtained for these control
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rooms. These control rooms shall be manned round the clock by operators who shall control and direct the flow of ambulances as per requirement. These are being established to ensure optimal delivery care to the patients/clients calling for help, i.e. stabilization before transport, emergency admission, preparation of the institution to receive a critical patient, etc. Detailed guidelines for operationalizing these control room have been circulated to the Chief Medical Officers. Blood Storage Centre (BSC) 26 Blood Storage Centres, the details of which mentioned in Annexure M, have been approved for the financial year 2012-2013 in the State. Some of these are already in the process of getting licensed and these BSCs need to be strengthened. List of equipments to be procured for such Blood Storage Centres is as follows:
S.No 1 2 3 4 5 6 7 8 9 10 Name of Equipment Blood Bank Refrigerator having capacity of 50 blood units Air Conditioner Autoclave Binocular Microscope Deep Freezer for freezing ice packs Dry Incubator Insulated Blood Bags Containers Table Top Centrifuge Micropippets of different capacities Consumables, reagents, disinfectants Quantity required 01 01 01 01 01 01 01 01 One each As per workload

Special incentives to doctors With a view to ensure the availability of Doctors in remote areas of the State, the Government has approved special incentive of Rs.20,000.00, Rs 15,000 and Rs. 10,000.00 for Allopathic / ISM doctors hired under NRHM and serving in Category A, (inaccessible areas), Category B (very difficult areas) and Category C (difficult areas) respectively. List of health institutions falling in such areas is enclosed as Annexure N. The incentive is an additional lump sump allowance payable over and above the existing pay/salary structure to the Allopathic / ISM doctors working on contractual basis under NRHM. In addition to this, the incentives shall also continued to be paid @ Rs.8000.00 and Rs. 4000.00 per month for MBBS / AYUSH Doctors serving in the areas notified under SRO
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201 of 2006 in respect of Category A (Very difficult) and Category B (Difficult) respectively. The incentive is an additional lump sump allowance payable over and above the existing pay/salary structure to all categories of doctors irrespective of the fact whether they are appointed on regular basis or on adhoc basis or under SRO 255 on contractual basis or under NRHM on contractual basis. The incentive is payable after production of a certificate from CMO/ADMO concerned that his/her performance during the period of report has remained good and has done adequate work in terms of OPD, IPD, immunization antenatal, postnatal checkups and conduct of deliveries (wherever applicable). The incentives should be linked to the place of work and no transfer/shifting should be allowed from the place where the person is getting incentive. Permissible Manpower Sub-Centres During 2011-12, districts were allowed to hire one additional ANM on contractual basis in all the Sub-Centres which shall be continued in the year 2012-13 as well. The local residency of the ANM needs to be given priority while making recruitment. MACs renamed as Sub Centres During 2011-12, districts were allowed to hire one Male Multipurpose Health Worker on contractual basis in all the MACs (renamed as Sub-Centres) which shall be continued in the year 2012-13 as well. The local residency of the MPHW needs to be given priority while making recruitment. 24X7 PHCs In addition to the required Manpower positioned in PHCs as per sanctioned strength, the additional manpower under NRHM is also being provided on contractual basis with the purpose to provide basic obstetric care round the clock in the PHCs designated as 24x7. The category wise maximum permissible limit under NRHM (including already engaged) is as follows: One Medical Officer (MBBS) Two Staff Nurses. One Laboratory Technician.

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At PHC level under NRHM Each PHC has been provided with 1 AYUSH Doctor and 1 AYUSH Pharmacist (Dawasaaz) during the year 2011-12 which shall be continued in the year 2012-13 as well. One Additional MBBS doctor and one additional AYUSH doctor has been provided in PHCs notified as falling in remote areas as per SRO 201 of 2006 from the year 2009-10 which shall be continued in the year 2012-13 as well. FRUs under NRHM In addition to the required Manpower positioned in FRUs as per sanctioned strength, the additional manpower under NRHM is being engaged in CHCs designated as FRUs with the objective to provide Basic and Emergency Obstetric Care round the clock. The Category wise maximum permissible limit under NRHM (including already engaged) is as follows: i. Two Medical Officers (MBBS) ii. Two Staff Nurses iii. Two O.T. Technicians iv. Two X-ray Technicians v. Two Laboratory Technicians vi. Additional 8 Staff Nurses for CHC Kupwara, Magam, Bijbhera, Akhnoor, R S Pura and Ramgarh Newly created District Hospitals The objective of providing manpower in newly created District Hospitals remains to provide the basic and emergency obstetric care round the clock. The Category wise maximum permissible limit in each of the District Hospital of newly created districts under NRHM (including already engaged) is as follows: i. Two MBBS doctors ii. Ten Staff Nurses. iii. Two O.T. Technicians iv. Two X-ray Technicians v. Two Lab. Technicians. Old District Hospitals The objective of providing additional manpower in old District Hospitals remains to provide basic and emergency obstetric care round the clock.
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i. Ten Staff Nurses in Old District Hospitals on contractual basis. ii. However, Govt Hospital, Sarwal, Jammu and G.B.Pant Hospital, Srinagar have also been provided Ten Staff Nurses each on contractual basis on the pattern of District Hospitals. Strengthening of Institutional Mechanism District Health Societies: 22 District Health Societies have been constituted for planning and implementing the health related initiatives in the respective districts. Rogi Kalyan Samitis. 571 RKS have been constituted and registered at the level of District hospital/ CHC/PHC for community management of public hospitals. RKS at the level of new type PHCs are to be constituted on the pattern of PHCs. The District Health Societies shall initiate immediate action on constitution of the RKS for new type PHCs. Sufficient budget is provided to the District Hospitals, CHCs, PHCs and Sub Centres as Corpus fund, Untied fund & Annual Maintenance Grant for improvement and maintenance of physical infrastructure and meeting the day-to-day needs of these institutions. This budget should be utilized after identifying the needs and approval of the RKS/VHSC. The institution wise details of the budget are as under:S.No. Name of the Institution Corpus Fund ( Rs. in Lacs) 5.00 1.00 1.00 1.00 Nil Untied fund (Rs. in Lacs) Nil 0.50 0.25 0.25 0.10 Annual * Maintenance Grant ( Rs. in Lacs) Nil 1.00 0.50 0.50 0.10

1 2 3 4 5

District Hospital Community Health Centres (CHCs) Primary Health Centre (PHC) New Type PHCs Sub Centres (SC) including MACs which have been renamed as Sub Centres

*Annual Maintenance Grant is provided to the institutions located in Govt. building(s) only. NOTE The funds for New Type PHCs shall be utilized only after constitution of RKS. Meetings of RKS should be held as per schedule envisaged in the guidelines. However, incase due to some exigency, the Honble MLA is not in a position to attend the meetings (s), the same may be held under the Chairmanship of any of the members present (preferably CMO/BMO as the case may be) on the schedule date.

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It has further to be ensured that the requisite quorum for the meeting is present and that the minutes of the meeting are properly recorded and circulated among all members including concerned Honble MLA. The guidelines with regard to spending of these grants are annexed as Annexure O

VILLAGE HEALTH SANITATION AND NUTRITION COMMITTEES (VHSNCS) The Ministry of Health and Family Welfare, GoI vide their No. Z.18015/15/2011-NRHM-II dated 25-07-2011 has conveyed instructions to rename Village Health and Sanitation Committees as Village Health Sanitation and Nutrition Committees (VHSNCs). With a view to sensitize the PRIs about various schemes of NRHM, the State Health Society is providing diaries to Sarpanches. The diary also contains guidelines regarding constitution of Village Health Sanitation and Nutrition Committees and the norms for utilization of untied grants eligible for the committees. 1. During the current financial year, ASHAs shall be involved for facilitating meeting of Village Health Sanitation and Nutrition Committee in terms of GoI guidelines, as per the following conditions: i) Making payment of an incentive @ Rs 150/- to each ASHA for facilitating the monthly meeting of VHSNC followed by the meeting of women and adolescent girls. ii) Payment of the incentive should be made out of the untied grants given to each VHSNC under NRHM. iii) ASHAs should coordinate for both VHSNC and monthly meeting of women and adolescent girls. iv) The concerned ANM at Sub-Centre / PHC will certify the conduction of the meeting. 2. Further, the under mentioned guidelines should be followed for convening the meetings of VHSNC:i) The meeting of VHSNC should be followed by the meeting of Women and Adolescent girls where the issues pertaining to Nutrition, Reproduction & Child Health, Sanitation & Hygiene, Breast Feeding, Menstrual Hygiene, Age at Marriage, Contraception, Pre-School Education and Female Literacy etc. should be discussed. ii) The meeting of VHSNCs should be convened every month in consultation with the members of VHSNC and President of Gram Panchayat. iii) ASHAs should make all possible efforts for the sufficient publicity of the meeting so as to ensure wider participation of women and adolescent girls of the village.

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iv) The meeting should be fixed on the date other than that of Village Health & Nutrition Day (VHND).

FAMILY PLANNING
The State has achieved the target of reduction of Total Fertility Rate (TFR) to 2.0 (SRS 2010) against the target of TFR to 2.1by 2012. The State has to achieve the target of 1.8 by the end of 12th Five year Plan. Family Planning Programme is being strengthened by distribution of Condoms/ contraceptives through ASHAs at Village level at the door steps of needy clients. It will not only help in avoiding unwanted pregnancies but also protection against HIV/ AIDS and other Sexually transmitted diseases. The scheme is being implemented as pilot project in 4 districts of Jammu Division viz. Rajouri, Poonch, Udhampur & Doda. The approved activities and the permissible amount are mentioned in the table:S No. 1 Activity World Population Day Celebration: (Such as mobility, IEC activities etc.): funds earmarked for District and block level activities Sterilization Camps a) b) 3 a) b) 4 Male Female Male Female Target One per District Permissible Amount Rs 2,00,000 lakh/ district

One Per District One Per District Targets being given separately in District PIP Targets being given separately in District PIP

Rs. 35000 per camp Rs. 15000 per camp Rs.1500 per case Rs. 1000 per case Rs. 20 per case

Package for Sterilization

Compensation for IUCD service

The permissible budget for Male and Female Sterilization camps is given:
S.No. Heads 1 2 3 4 Camp Management Male Sterilization Transport for service providers team as 8000.00 per actual/entitlement POL / Transport for acceptors 5000.00 Contingency 2000.00 IEC (Newspaper, Handbill, Cable T.V. 20000.00 for Camp Management Female Sterilization 8000.00 5000.00 2000.00 Nil for

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Banners etc) Total

35000.00

15000.00

However, while organizing such camps all efforts should be made to conduct around 100 cases in each of the camp. The guidelines issued by Govt. of India for this component have already been provided to all the Districts. Quality Assurance Committees (QAC) QACs for monitoring family planning activities have been constituted at the District Level. The quarterly meetings of these committees need to be organized for which Rs 5000.00 per quarter are being provided to each of the district. The Districts are required to submit the Minutes of these Meetings to the State Health Society on regular basis. Block Level NRHM Sammelans During the current financial year, the block level NRHM Sammelans shall be organized in each of the block. These Sammelans aim at creating awareness among the PRIs, prominent citizens, NGOs, health functionaries viz CMOs, BMOs/MOs (Block PHCs) and mainly for the field functionaries like Field NGOs, FMPHWs, ASHAs and AWWs who are directly associated with the implementation of various schemes/ programmes under NRHM at the ground level. Rs. 20000/- has been approved for each Sammelan at Block Level. Guidelines for organizing BLOCK Level NRHM Sammelans have been circulated to the districts. Road Map for Priority Action on Family Planning during the year 2012-13 is enclosed as Annexure P

ADOLESCENT HEALTH
Adolescent Reproductive and Sexual Health (ARSH): - Ministry of Health and Family Welfare, Government of India has included Adolescent Reproductive and Sexual Health (ARSH) as a key technical strategy under the National RCH II programme. Mainly strategy focuses on reorganizing adolescent population that will yield dividends in terms of delaying age at marriage, reducing incidence of teenage pregnancy, prevention and management of obstetric complications including access to early and safe abortion services.
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A core package of services that includes preventive, promotive, curative and counselling services will be delivered during routine clinics at District level and further shall extend to sub-centre, PHCs and CHCs, and dedicated adolescent clinics on fixed days and time as well as through outreach activities. Adolescent Clinics: Adolescent Friendly Health Clinics (AFHCs) have been established across all the 22 districts of the state in addition to one clinic each in Govt. Medical College Jammu/ Kashmir at divisional level. In addition, 3 new Adolescent Clinics have been approved to be established one each in Govt. Hospital Sarwal, CHC Akhnoor and CHC Kupwara for which an amount of Rs.100000/- has been approved Manpower: In order to consolidate the role of AFHCs in providing youth friendly services to this high focused group, trained Lady Counselors and Data Entry Operators have been appointed in each Adolescent Clinic except 3 new clinics to be set up in the current financial year. Operating expenses: The existing 24 clinics and the 3 new CHCs approved during 2012-13 will continue to get a recurring amount of Rs. 20,000 per annum for each Adolescent Clinic as operating expenses for printing of the stationery/IEC material/Formats for the clinic @Rs 15000/- and Rs 5000/- as mobility support on account of holding outreach camps/meeting by the counselor in a year. Menstrual Hygiene Programme: A new scheme for promotion of menstrual hygiene among adolescent girls (10-19) in rural areas has been launched under which the sanitary napkins shall be distributed among the school going and out of school adolescent girls. Target districts:- The scheme has been launched on pilot basis in 10 Districts of J&K State where in total 7 districts, namely Rajouri, Poonch, Doda, Kishtwar, Ramban, Udhampur and Kathua are selected in Jammu Division and three districts namely Baramulla, Bandipora & Kupwara in Kashmir Division. Under the scheme, sanitary napkins are being procured by the Ministry of Health & Family Welfare, Govt. of India and supplied under the NRHM brand name Free days. Operationalization:- In the State, the scheme shall be operationalized at two tier level through the wide network of the health care providers at Block/sub health centre level and ASHA as link worker between the service provider and the community at village level. The sanitary napkins shall be supplied directly to the block headquarters from the central supply and further be purchased by the ANM/LHV at Sub- Centre Level from the Block office and shall further be sold to the ASHA for future sale at village level to the adolescent girls falling under both APL/BPL categories.
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The cost of the sanitary napkins has been fixed at Rs.5/- per pack containing six napkins (each pack) and shall be made available to the adolescent girls at the price of Rs. 6/- per pack. Initially, the ASHA will be given Imprest money of Rs. 300/- from the sub centre (untied fund) for purchase of sanitary napkin packs from the ANM at Rs. 5/- per pack and the ASHA will sell the pack to adolescent girl at Rs. 6/- regardless of APL/BPL status. The ASHA will be entitled to retain Re. 1/- as an incentive for sale of each pack of sanitary napkins and rest of Rs. 5/- will be used to purchase sanitary napkin packs for future sale. ASHA will receive one additional sanitary napkin free of cost from ANM each month for her personal usage apart from Re. 1/- as incentive. Further, the storage of the sanitary napkins shall be made at PHC/SC level and in case if additional room for storage is required, it can be taken on rent out of untied funds. Also the revenue generated out of sale of the sanitary napkins shall be deposited by the ANM with the Block Medical Officer who shall further deposit the same into the District Health Society .The District Health Societies shall deposit these to the State Health Society for procurement of the napkins for further supply. SABLA Programme: - SABLA is a new centrally sponsored, comprehensive scheme, called Rajiv Gandhi Scheme for Empowerment of Adolescent Girls or SABLA, merging the erstwhile Kishori Shakti Yojna (KSY) and Nutrition Programme for Adolescent Girls (NPAG) schemes to address the multidimensional problems of Adolescent Girls (AGs). Implementation: - In Jammu & Kashmir, Sabla is being implemented in 5 districts namely - Anantnag, Kupwara, Kathua, Jammu, Leh using the platform of ICDS. Under the scheme, the following services are being provided in convergence with the Departments of Health and Family welfare, Social Welfare Department and State AIDS Control Society: IFA supplementation, including supply of IFA tablets. General health check-up, including recording of height, weight, BMI for all adolescent girls, by the Medical Officer/ANM. Referral to specialized healthcare facilities, as required for conditions like malnutrition, menstrual problems, frequent headaches, prolonged acne, worm infestation, etc. Nutrition and Health Education. Family welfare and ARSH services.

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School Health Programme: - The School Health Programme shall focus on the health needs of the school going children so as to promote the preventive and rehabilitative health in the state of J&K. Target Districts: - The School Health Programme shall be started initially on pilot basis in five SABLA districts in the State viz. Jammu, Kathua in Jammu Division and Anantnag, Kupwara and Leh in Kashmir Division. Operationalization: - Under the programme, the School Health Committees shall be formed which shall be responsible for implementation and monitoring of the programme in all the Govt. and Govt.-Aided schools in the selected districts. The teams shall also conduct check-ups for children below 6 years at AWCs. The programme shall focus on three Ds- Deficiency, Disease and Disability. The referral of children shall be tied up and complete treatment at higher facilities shall be ensured. The nodal teachers from all the Govt. and Govt. aided schools shall be involved. School Health Cards shall be issued and height, weight measurement and BMI calculation shall be part of the School Health Card. In addition, under the school health programme apart from health needs of the school going children, the school health talks on prevention of diseases and promotion of health shall be given by the existing dedicated teams. The School Health Programme shall be carried out by the Directorate of Health services Jammu/Kashmir and the Chief Medical officers of the respective Districts shall send a copy of the monthly compiled report to the Programme Manager in charge School Health Programme. Weekly Iron and Folic Acid Supplementation for adolescents (WIFS) As adolescent anemia is a critical public health problem in the country, the Ministry of Health and Family Welfare, Government of India, based on the empirical evidence generated by these scientific studies, has developed programmatic guidelines for Weekly Iron and Folic Acid Supplementation (WIFS) of adolescent. This scheme is to reduce the prevalence and severity of anemia in adolescent population (10-19 years) and programme to be implemented for the following two target groups in both rural and urban areas: A. Adolescent girls/boys who are school going and are in government/government aided schools from 6th -12th classes. B. Adolescent Girls who are not in school or out of school. The WIFS programme will also cover married non-pregnant adolescent girls in order to increase their pre-pregnancy iron stores and decrease prevalence of anemia among pregnant adolescent girls.
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 Target Districts: - The WIFS programme shall be started in the five Districts on pilot basis which are already selected under SABLA scheme namely Jammu, Kathua in Jammu Division and Anantnag, Kupwara and Leh in Kashmir Division. Operationalization: - The implementation strategy of WIFS programme involves a fixed day approach i.e. Monday for WIFS distribution to ensure high compliance. The programme shall be implemented in both urban and rural areas. Under the programme, the school adolescent population, enrolled in 6th to 12th standard, in rural and urban regions will be reached. The programme shall encourage consumption of weekly IFA tablets and six monthly de-worming tablets through school and ICDS platform. At district level, a monitoring committee comprising Health and Education departments will be formed to monitor the progress of the project and resolve programmatic issues. The meeting could be organized every six months with the participation of health and education block officials. Yearly meeting with nodal teachers could be organized to further streamline the project. Road Map for Priority Action on Adolescent Centric Programmes is enclosed as Annexure Q

PC & PNDT AND GENDER MAINSTREAMING

MISSION: The mission of PNDT programme is to improve the sex ratio at birth by regulating the pre-conception and prenatal diagnostic techniques misused for sex selection. Regulatory Mechanism under PC&PNDT Act STATE LEVEL v State Supervisory Board under the Chairmanship of the Honble Health Minister, J&K and Co-Chairmanship of Honble Minister of State for Health v Mission Director NRHM appointed as State Nodal Officer PC&PNDT for coordination with the Ministry of Health and Family Welfare, GoI. DIVISIONAL LEVEL v Divisional Advisory Committee under the Chairmanship of respective Divisional Commissioner. v Divisional Appropriate Authority ----- Director Health Services, Jammu/ Kashmir. DISTRICT LEVEL
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v District Advisory Committee under the Chairmanship of concerned Deputy Commissioner. v District Appropriate Authority ---- Concerned Chief Medical Officer. DISTRICT ADVISORY COMMITTEE Reconstituted vide Government order No. 502-HME of 2011 dated: 20.09.2011 DISTRICT APPROPRIATE AUTHORITY CMOs have been designated as District Appropriate Authority vide Govt. Order No 609HME of 2011 Dated: 22-11-2011 Composition of District Advisory Committee District Development Commissioner / Dy. Commissioner Chief Medical Officer Medical Supdtt. District Hospital District Information Officer District Social Officer Senior Most Gynecologist of the District Hospital Senior Most Pediatrician of the District Hospital Leading advocate of the District to be nominated by Deputy Commissioner NGO to be nominated by Deputy Commissioner Chairman Member Secretary Member Member Member Member Member Member Member

Deputy Commissioners concerned will co opt at least one peoples representative as a special invitee in the District Advisory Committee FUNCTIONS OF THE DIVISIONAL/DISTRICT ADVISORY COMMITTEES To pay surprise visits or periodic visits to centres, Laboratories and clinics with a view to check compliance of the provision of Act and Rules. To recommend to the appropriate authority cancellation or otherwise of registration of or prosecution against a centre laboratory or clinic. To check and prevent contravention of provision of the Act or Rules in the area of its purview. To advise appropriate authority about implementation of the Act and creation of public awareness on the issue of the sex selection; To seize machine as may be found appropriate. FUNCTIONS OF DIVISIONAL/DISTRICT APPROPRIATE AUTHORITY To grant, suspend or cancel registration of a Genetic counseling Centre, Genetic Laboratory or Genetic Clinics. To enforce standards prescribed for the Genetic Counseling Centre, Genetic Laboratory or Genetic Clinics.

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 To investigate complaints of breach of the provisions of this Act or the rules made there under and take immediate action. To seek and consider the advice of the Advisory Committee, constituted under sub section (5) on application for registration and on complaints for suspension or cancellation of registration To take appropriate legal action against the use of preconception sex selection techniques by any person at any place, brought to its attention or suo motto and also to initiate independent investigation in such matters. To create public awareness against the practice of preconception sex selection or prenatal determination of sex. To supervise the implementation of the provision of the Act and Rules; and To recommend to the State Supervisory Board modifications required in the Act or Rules in accordance with changes in technology or social conditions To recommended to the State Supervisory Board modifications required in the Act or Rules in accordance with changes in technology or social conditions. Composition and functions of State/Divisional level committees are available on website of pcpndt www.pcpndtjk.in REWARD UNDER PC&PNDT A reward scheme has been introduced where under a reward of Rs. 50,000/- is being given to any person who gives information regarding the occurrence of sex-determination / female foeticide and Rs. 25,000/- is being given to any person who gives information about un-registered Ultrasound machine. Online filling of Form F on website of PC-PNDT www.pcpndtjk. 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 manufacturers 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

Road Map for Priority Action on PC & PNDT is enclosed as Annexure R

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TRAININGS
The term training refers to the acquisition of knowledge, skills and competence as a result of the teaching of vocational or practical skills and knowledge that relate to specific useful competencies. The State of Jammu and Kashmir has resolved to go into the PIP for trainings in 2012-13 adhering to the dictum of the right person for the right training at the right place, so that trainings are effective and result-oriented. Trainings /Workshops are an essential activity for updating the knowledge and skills of the workers of any organization. Upgradation of the skills of the health personnel has been taken up on priority basis under NRHM. Aim of Trainings: i) Development of human resource potential in health care for optimum output. ii) Operationalization of health care institutions developed and strengthened as per the requirements of the State, with particular emphasis on maternal and child care units. iii) Up-gradation of current medical knowledge with evidence based inputs in alignment with current health care policies and requirements. iv) Creation of awareness among different stake-holders regarding issues of health and social well-being. The Mission has planned training/workshops National/State/Divisional & District level in: Maternal Health. Child Health. Family Planning. Immunization. Adolescent Health. Urban and Tribal RCH. PC&PNDT Quality Assurance. Gender / Equity. Intersectoral Convergence. Trainings under the Maternal Health Skilled Birth Attendance (SBA) Training: Any pregnancy can develop complications at any stage, so timely provision of obstetric care services is extremely important for management of such cases and as such, every pregnancy needs to be cared for by a
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during

2012-13

at

the

Skilled Birth Attendant (SBA) during pregnancy, childbirth and the post-partum period. GoI considers an SBA to be a person who can handle common obstetric and neonatal emergencies and is able to timely detect and recognize when a situation reaches a point beyond his/her capability, and refers the woman/newborn to an appropriate facility without delay. In order to strengthen the delivery points the Government of India has approved the budget for SBA trainings for ISM Doctors, Staff Nurses, ANMs//LHVs in SBA with the condition that State must ensure SBA training at delivery points first and then other facilities. To ensure safe deliveries, SBA training is being imparted at district headquarters. Following categories of staff will be trained in each district: 4 ISM Doctors 8 Staff Nurses 8 ANMs/LHVs Trainings under Child Health IMNCI Training: Training in Integrated Management of Neonatal and Childhood Illnesses (IMNCI) includes both preventive and curative interventions that aim to improve practices in health facilities, the health system and at home. At the core of the strategy is integrated case management of the most common childhood problems with a focus on common causes of neonatal and child mortality. The following categories of staff will be trained in each district during the current financial year from the designated delivery points and their retention at the facility must be ensured: ANMs/ MPWs/ LHVs -24 per batch (ten districts). Trainings under Adolescent Health 1. ARSH Training for Medical Officers, ANMs/LHVs and AWWs. 2. Capacity building of school teachers (2 teachers from each school) from districts selected under SABLA Programme for School Health Programme. Other Trainings Trainings under Immunization 1. Training of vaccine handlers in cold chain system. 2. Cold chain handlers training for block level cold chain handlers by state and district cold chain officers.

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 1. 2. 3. 4.

Trainings under Family Planning NSV Training. IUD Insertion Training. Post-partum IUCD (PPIUCD) Training. Interval IUCD Training.

General Guidelines: All trainings are aimed at making health care facilities operational. Certain guidelines must be followed while nominating candidates, conducting trainings and following up on their performance: 1. For all technical trainings such as EmOC, LSAS, Blood transfusion, nomination of medical officers should be sought from centres where facilities are available i.e. FRUs/CHCs but specialists are not present. 2. Medical officers from all 24x7 PHCs must be trained in BEmOC, MTP, Safe abortion and IUCD insertion and facilities for the same be provided to them. Paramedical staff at PHCs and SCs must be trained in IUCD insertion. 3. A participant should be nominated for one technical training only. 4. For non interventional trainings like ARSH, IMNCI, Gender equity, infection control, all categories of health care staff- Medical Officers at the divisional level, and paramedical staff (LHVs, ANMs/MPWs) at the district level should be trained. 5. All trainings must begin with a questionnaire for pre-evaluation survey of the existing knowledge of the participants followed by a post-evaluation survey to assess the efficiency of the training. 6. Only trained staff may be used as resource persons for the training. 7. For all trainings, the utilization of funds must be strictly in accordance with the budget guidelines approved by GoI. 8. All DDOs must ask for the attendance of the candidates for the period of training after the candidate rejoins his place of posting. 9. TA/ DA to all nominees is to be paid by the organizers of the training and should not be drawn from the place of posting unless specifically mentioned. 10. Feedback of each training should be sent to the headquarters within a fortnight of the completion of the training. 11. The trained manpower must be posted at suitable institutions in consonance with their expertise, and the necessary facilities be provided to them for the utilization of their services. 12. The performance of all medical and paramedical staff who have undergone technical trainings (SBA, EmOC, BEmOC, LSAS, MTP, MVA, IUD insertion, training in Blood transfusion) must be monitored on monthly basis.
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PROGRAM MANAGEMENT UNITS

The management structure in the form of Programme Management Support Units at State, Division, District and Block Levels have been established as shown below: At the State level, State Programme Management Support Unit has been established headed by the Mission Director and comprising of officers from Finance, Planning, State Programme Manager, Programme Officers of various programmes etc. The State Programme Unit provides technical support to the State Health Society/State Health Mission in formulation and implementation of the planned activities. At the Divisional Level, the Divisional Programme Management Unit is headed by Divisional Nodal Officer and supported by Divisional Accounts Manager, Divisional Monitoring and Evaluation Officer and one Junior Assistant. One Law Officer has also been engaged on contractual basis in the Divisional Nodal office to assist the State Health Society on legal issues. The Divisional Programme Management Unit has to perform all activities in their respective Division pertaining to planning, monitoring and coordinating with Divisional level Directorates / Offices in achievement of the financial and Physical targets set up under NRHM. At the District Level all the 22 Districts are manned with one District Programme Manager, One District Accounts Manager and One District Monitoring and Evaluation Officer. One Data Entry Operator has been placed in all the 22 District Hospitals and one Data Entry Operator for every Deputy CMO office of the district. At the Block Level all the 116 Blocks are manned with one Block Monitoring & Evaluation Officer and one Block Accounts Manager at every Block. Reporting system of Programme Management Units The following monitoring system needs to be ensured: Block Programme Management unit shall report to the BMO as well as to the District Programme Management Unit. District Programme Management Unit shall report to the CMO as well as to the Divisional Programme Management Unit. Divisional Programme Management Unit shall report to the Divisional Nodal Officer as well as to the State Programme Management Unit.
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 The State Programme Management Unit headed by the Mission Director NRHM shall provide feedback to the higher authorities both in the State / GoI. Road Map for Programme Management during the year 2012-13 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.

HMIS / MCTS
HMIS and MCTS are two important online monitoring tools of NRHM.

46

HMIS portal provides all the information uploaded at the facility level thus providing information about the workload of different institutions and the delivery of services provided there. MCTS is useful in tracking the mother and child for their due services. The basic aim of this system is to track and monitor delivery of services given to the mother and child, thus giving a clear picture of the gaps in the service delivery of Health system. In order to provide guidance and monitor implementation of the MCTS at the District level District-e-Mission Team has been constituted vide Govt. order no. 640-HME of 2011 dated 12-12-2011. The Composition and role of District Project e-Mission team is given as under: Composition of District Project e Mission Team District Magistrate/Deputy Commissioner Chairman Chief Medical Officer Member Secretary District Informatics Officer-NIC Member District Programme Manager (NRHM) Member District Monitoring and Evaluation Officer (NRHM) Member Role of District Project e Mission Team a. Overall Responsibility of Project Implementation in the District. b. Close Monitoring of the project. c. Coordination with the concerned agencies. d. Communication and training. Monitoring and Evaluation for HMIS and MCTS State has envisaged following monitoring protocols for Programme Management Units at different levels to ensure proper implementation of HMIS and MCTS data from different level: Block Monitoring and Evaluation Officer shall visit every PHC / CHC and 1/3rd of the Sub Centres once a month. He will submit his tour report to the Block Medical Officer and District Health Society. District Monitoring and Evaluation Officer shall visit every Block Head Quarter, 50% of the PHCs and 25% of the Sub Centres once a month. He will submit his tour report to the Chief Medical Officer and respective Divisional Nodal Officers. Plan for Use and Feedback of HMIS/MCTS Data by the Districts and Blocks CMOs and BMOs shall hold regular monthly meetings to review the progress with regard to uploading of data, registration, updation and authentication of data on HMIS/MCTS portals. The BMOs should share the findings of the observations with the ASHAs / ANMs and take corrective steps for rectifying the errors in the filling of formats by the ANMs. The BMOs shall also ensure that the work plans are generated on monthly basis and provided to ANMs for tracking the pregnant women / children for their due services.
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The progress with regard to follow up by the ANMs as per the work plans shall be reviewed by the BMOs in every meeting. At the District level, the Chief Medical Officers shall also review the progress of the uploading and updation of the MCTS data. This will help in improving the quality of HMIS / MCTS data. Monitoring Mechanisms The State has put in place a proper mechanism to monitor and evaluate physical and financial progress of NRHM periodically. At the State level, the Programme is being reviewed on quarterly basis through meetings under the Chairpersonship of the Honble Chief Minister of J&K. Monthly review meetings are conducted in both the Divisions under the Chairpersonship of the Honble Health Minister. Regular meetings of Governing Body are being held to assess and review the performance of NRHM programmes. Regular meetings of Executive Committee are conducted by Commissioner Secretary Health and Medical Education. The progress is also being reviewed on monthly basis by the Mission Director NRHM. Similarly at the District level Deputy Commissioner (Chairman District Health Society) also reviews the functioning of NRHM. MONITORING PROTOCOLS FOR FIELD LEVEL OFFICERS The following protocols for regular monitoring of field activities are being followed. Monitoring by field level officers Each PHC MO shall visit all Sub Centres in his/her jurisdiction at least once every month to review the functioning of SCs and guide ASHA and ANM on critical aspects of outreach etc. including filling up formats for HMIS / MCTS. Each Block Medical Officer shall visit all PHCs and at least 50% SCs in his/her jurisdiction at least once every quarter to review the functioning and guide the officials. Each District CMO shall visit all CHCs, at least 50% of PHCs and at least 25% of SCs in his/her jurisdiction at least once every quarter. All the visits should be documented in the inspection register to be maintained at level of the facility concerned. As per the above protocol, every SC would receive at least one visit of PHC MO every month, one visit of BMO once every six months and one visit of the CMO once every year. Similarly each PHC would receive at least one visit of the BMO every month and CMO once every six months. Similarly each CHC would receive at least one visit of the CMO every quarter. The members of RKS, civil society, VHSNCs may also accompany on these supervision visits. These visits should be followed up with a tour report which should be compiled at the District Health Society and discussed in the quarterly reviews at the state level by the Mission Director.

48

Monitoring by Programme Management Units Block Monitoring and Evaluation Officer shall visit every PHC /CHC and 1/3rd of the Sub centres once a month. He will submit his tour report to the Block Medical Officer and District Health Society. District Monitoring and Evaluation Officer shall visit every Block Head Quarter once a month and of the PHC and 1/4th of the Sub centres once a month. He will submit his tour report to the Chief Medical Officer and respective Divisional Nodal Officer. Monitoring by District Monitors engaged under NRHM State has hired 8 Monitors (4for each division) who monitor and evaluate the progress of NRHM programmes in the districts assigned to them. Each monitor has to visit the districts allotted to him on regular basis and has to monitor all the activities and evaluate the performance of each District and has to submit a report of their findings on prescribed format to the Mission Director NRHM, J&K. The findings of reports of Monitors are being shared with CMOs, Director Health Services and Administrative Department.
MONITORING PROTOCOLS for State Level Officers.

At the State level, the Programme Mangers are also monitoring the programme related activities. At the Divisional level, the Divisional Nodal Officers are monitoring and supervising all the programmes of NRHM in the Division with the assistance of Divisional Level Monitoring and Evaluation Officer. 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. Programme 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 work plans for service delivery be generated on regular basis and should be distributed to ANMs.
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 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.

IMMUNIZATION
Government of India has declared 2012-13 as Year of Intensification of Routine Immunization. The immunization coverage needs to be strengthened all over the State with a special focus on poor performing Districts. The level of fully immunized children by age of one year (CES 2009) is 66.60 %. Full immunization gives a child one of the best chances for healthy and disease free life. In this connection we need to address the following issues on priority basis:-. The birth dose of immunization should be ensured for all newborns delivered in the institutions, before discharge. Daily Immunisation services should be available in PHCs, CHCs/ DHs. To reach the inaccessible areas by holding special immunization camps, and tracing the dropouts and bringing them to the immunization session by utilizing services of ASHAs. Generating demand through IEC Activities. Holding of VHNDs regularly & supervisory monitoring by BMO/CMO. Focusing upon Name based tracking of Children for immunization. Following activities have been approved in the current year for immunization strengthening. i. Mobility Support for Supervision and Monitoring at district and State level:An amount of Rs. 2,50,000/- has been allotted to each district. The said amount should be allotted for incurring expenditure on POL for the Supervision and Monitoring of immunization programme by the Dy. CMO and DIO. Districts need to provide a minimum of Rs 20,000 to each block for supervision of Immunization activity from Block and PHC. Detailed monthly tour diary should be sent. ii. Focus on Slums & underserved areas in urban areas:The funds under this sub head are meant for hiring of an ANM for providing immunization in the identified slum areas of Jammu (city), Anantnag, Srinagar (city), Baramulla, Leh & Budgam Districts. The ANM has to conduct four sessions of
50

immunization every month for twelve months. The hired ANM is to be paid Rs. 450.00 per session for four sessions per month per slum of ten thousand population and Rs 300.00 per month has been kept as contingency for hiring of room and furniture etc for the sessions. iii. ASHA Incentives under Immunization:ASHA incentive for full immunization per child upto 1 year age= Rs 100. ASHA incentive for full immunization per child upto 2 yrs age = Rs 50. (Provided all vaccines received between 1st & 2nd year of age after completing full immunization at 1 year of age). iv. Support for Computer Assistant. Services of the Computer Assistant engaged under immunization strengthening programme at the State/district level shall be continued based on performance of previous year. v. Quarterly Review meetings:A review meeting has to be held at the district HQs on quarterly basis where in steps to improve the immunization Programme can be discussed. The BMOs, the Dy CMO, DIOs and DMEIOs should attend such meetings. The CDPOs and one medical officer of the PHC on rotation basis have also to be called to attend these meetings. The amount has to be utilized for meeting expenses like light refreshment to the participants and other organizational expenses. It is advised to call 3-4 ANMs from each block by rotation to attend such meetings. Participation of ANMs of Sub Centre should also be made mandatory. The Refrigerator Mechanic should also be invited for attending such meetings. The dates for review meetings be intimated to the State Health Society well in advance so that some officer from this office shall be in a position to attend the meetings. Moreover minutes of the meetings should reach office of State Health Society, J&K on regular basis. vi. Preparation of Microplan:Microplan for immunization has to be prepared right form Sub Centre level. The microplan, besides institutional immunization services should include the outreach and underserved areas where immunization services have to be provided. It should be ensured that neither any outreach area nor any underserved area is left in the microplan. The expenditure to be incurred in preparing Block/PHC levels microplan is Rs.1000.00 each

51

and for sub-center Rs. 100 each. All ANMs, ASHAs and AWWs are to be involved in this activity. vii. POL for vaccine delivery from State to District and from District to PHC/CHC level:This amount is to be utilized for POL charges required for carriage of vaccine under proper cold chain system from State to District and from District to Block Head Quarters. viii. Alternate vaccine Delivery to Session Site:This amount is to be incurred at the rate of Rs. 150.00 per session for delivery of vaccine at session site falling in most difficult and hilly terrains and Rs 75.00 per session for other than difficult areas. Preparation of microplan is mandatory for this activity as stated above. District Health Societies shall identify the sub centres on this basis in their respective district ix. Consumables for computer including provision for internet access for RIMs Rs. 400 per month per district has been approved for this activity. x. Procurement of Plastic bags for Biomedical Waste Disposal:Two bags per session of immunization for every sub-centre functioning in each district have to be procured and issued to the Sub Centres at the earliest. xi. Procurement of Bleach / Hypochlorite Solution for safe disposal of waste (syringes & needles)/Twin buckets:Bleach/hydrochloride solutions are to be procured for every PHC and CHC functioning in each district. Two buckets preferably are to be procured for use of immunization waste for each PHC and CHC (excluding CHCs functioning as District hospitals in newly created districts). The procurement/purchases should be made after fulfilling all codal formalities and as per the rates approved by the Rate Contract Committee. Road Map for Priority Action on Immunization is enclosed as Annexure S

FINANCIAL MANAGEMENT
1. Cash and Bank Books:- All entries must be completed in the Cash Book and Bank Book on daily basis duly signed by the concerned DDOs.
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2. Ledger:- According to the entries of cash & bank books, all entries must be posted in the Ledger. 3. Journal:- Journal Ledger should be complete in all respect. All opening entries must be made in the journal along with adjustment entries as per audit report and Accounts for all the advance adjustment vouchers submitted by the concerned parties. 4. Vouchers:- All vouchers should be serially numbered and filed and kept under safe custody. 5. Bank Reconciliation Statement:- Bank Reconciliation Statement must be prepared to reconcile the Bank Book figures with the Bank statement and all un-reconciled bank entries must be identified and proper entries passed in the books of accounts. Stale cheques should also be identified and reverse entries made in the books of accounts. 6. Preparation of Trial Balance:- It is very important that trial balance to reconcile the ledger balances prepared at State/ District / Block levels. All the opening balances as per Audit Report may also be accounted for in the current financial years Trial Balance. It must be ensured that Trial Balance of the current year is prepared at these levels. 7. Preparation of Receipts and Payment Account, Income and Expenditure Account at each level:- On the basis of final Trial Balance, it is necessary to prepare the final accounts at each level (State/Districts/Blocks) at the close of financial year. 8. Preparation of Action Taken Report (ATR):- Action taken points of Audit Report for the previous years should be discussed in the SHS/DHS meetings and the concerned State/District/ Blocks should prepare the Action Taken Report as per Auditor's and MoH&FW observations. A copy of the Compliance Report must be sent to State Health Society for onwards transmission to Ministry at the earliest. 9. Records Keeping:- All accounts records of NRHM must be kept under lock and key with specific responsibility assigned to concerned official/officers for their proper maintenance at all the levels. All vouchers relating to accounts transactions must be kept year wise in box files or duly bound files after audit. Records, mainly cash book, petty cash book, ledgers and paid vouchers, deposit receipts etc at district/Block level may be kept properly and safely under the custody of the District Chief Medical Officer/Block Medical Officer or by an authorized officer. 10. Reminders for Advance Adjustment:- Age wise analysis of advance must be conducted at all levels and reminders for settlement of advance and refund of unspent balance must be sent to all concerned on a quarterly basis and pursued vigorously. 11. Audit Reports: Audit reports of all previous years must be kept at State and District levels, preferably with soft copies as per retention schedule of the State Govt. The
53

previous audit reports must be scanned and also kept in computers. Action taken points of audit of previous years should be finalized. District Health Societies shall also ensure to undertake monthly District Audit and periodic assessment of the financial system in the subordinate offices. 12. Upkeep of Cheque Books and Cheque Registers:- All cheque books issued by the bank must be entered in a register and kept under safe custody of the concerned officer alongwith unused / cancelled cheques. 13. Cash verification certificate:- Cash verification certificate must be obtained from the concurrent auditor at the end of each month and verified in the presence of Programme officer of the concerned program. 14. Physical verification of Fixed Assets:- All the fixed assets must be physically verified by the designated committee and a physical verification certificate must be kept safely for verification. 15. Stock Registers:- Store keeper of concerned program should maintain/complete the stock registers upto date. 16. Important Agreements/MOUs:- All the important agreements such as EMRI agreement, Rent Agreement, Contractor Agreement, Security Agreement and MOUs duly registered must be kept in safe custody. 17. Income Tax Return:- All the TDS deducted by the District Health Societies must be deposited in time in the bank and quarterly Income tax Return must be filed through NSDL agencies. 18. Concurrent Audit:- The District Health Societies should complete and finalize their concurrent Audit with reports on monthly basis and action taken thereon. 19. Transfer of Funds/ Monitoring of Bank Balance: Regular monitoring of Bank Balances may be ensured for timely and adequate transfer of funds through e-transfer/ Demand Drafts from State to District and District to Block levels in time to ensure the achievement of stipulated targets. Closing bank balance certificate/ bank statement at the end of financial year must be obtained from the Branch Manager of concerned banks. 20. FMR/Statement of Funds Position:- FMR must include all the expenditure of the SHS/DHS and statement of funds position should also show same expenditure as mentioned in the FMR. These statements should be sent in a complete form to the State Health Society by the 5th of every month. 21. Uploading of FMR on HMIS web portal: Every District must ensure that quarterly FMRs are uploaded on HMIS web portal on a regular basis.

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22. Committed and Uncommitted Unspent Balance:- District should also calculate the Committed and Uncommitted Unspent Balance at the end of every financial year under each component. 23. The District Health Societies shall not make any change in allocation among different components/ activities without approval of State Health Society. 24. The accounts of the State Health Societies/District Health Societies/ Implementing agencies grantee institution/ organization shall be open to inspection by the sanctioning authority and Audit by the Comptroller and Auditor General of India under the provisions of CAG(DPC) Act 1971, Internal Audit by Financial Management Group of State Health Society/Principal Accounts Office of the Ministry of Health & Family Welfare. Road Map for Priority Action on Financial Management is enclosed as Annexure T

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ANNEXURES

56

Annexure A
MONTHLY PROGRESS REPORT FOR THE Month _______ OF THE FINANCIAL YEAR 2012-13 District _________ S.No. 1 (A) Cummulative Achievements on Key Startegies As on Date No. of District Health Societies Constituted No. of Rogi Kalyan Samities (RKS) Registered for District Hospital CHCs PHCs ADs Any other Hospital(Mention name) No. of Village Health Sanitation & Nutrition Committees Constituted No. of VHSNCs for which accounts opened No. of CHCs upgraded as FRUs (Give names on separate sheet) No. of PHCs made Operationalized as 24x7 PHCs(Give names on separate sheet) No. of ASHAs engaged No. of ASHAs trained in Module I No. of ASHAs trained in Module II-IV No. of ASHAs trained in Module V SNCUs established No. of Stablization Units established (Give names on separate sheet) No. of Baby Care Corners Established(Give names on separate sheet)

2 I ii iii iv v 3 4 5

6 7 8 9 10 11 12

13

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14 15 i ii 16

No. of Specialists/Doctors/Paramedics engaged No. of Ambulances provided from Regular side NRHM No. of ARSH Clinics Setup

(B)Activity-wise Achievements during the year 2012-13 Ach. During 2011-12 Target 201213 Cummulative Ach. Ending previous month Ach. During the reporting month

S.NO

NAME OF THE ACTIVITY

Total

JSY 1 2 3 4 a i ii b i ii Total Deliveries (Home+ Institutional) Total Institutional deliveries Institutional deliveries escorted by ASHAs Mother beneficiaries given incentive under JSY Home Deleveries Rural Urban Total (a) Institutional Deleveries Rural Urban Total (b) Total (a+b) No. of ASHAs given incentive under JSY i High focus Districts ii Non High focus Districts Maternal Health 1 2 i No. of Maternal Deaths reported in the District No. of Maternal Deaths occurred in Govt. Health Institution

58

ii 3 4

At community level No .of Maternal Death Autopsy conducted by Dy.CMO/ BMO No. of Maternal Death Reviewed by District MDR committee No. of Community based Voluntary Workers/ASHAs given incentive for reporting Maternal Death No. of pregnant women given Iron Sucrose intervention Dose No. of deliveries conducted at home by SBA trained persons No. of SBA trained persons given Incentive for conducting home deliveries in inaccessiable/ Snow bound area of high focus districts

6 7

8 VHSNCs 1 2 3 4 VHNDs 1 2 i ii iii 3 JSSK 1 i ii 2 i ii

No. of VHSNCs meetings held No. of meetings facilitated by ASHA No. of ASHAs given incentives for facilitating meeting of VHSNCs No. of meetings of Women and Adolescent girls held

VHNDs conducted (Nos.) No. of VHNDs supervised by CMOs BMOs Any other Officer (DHO, DMEIO etc.) No. of ASHAs who have attended the monthly meeting at Block level (PHC)

No. of Preganent Women given Drugs and consumables for Normal Deliveries C-Section No. of Preganent Women provided free Diagnostics Blood transfusion

59

3 i ii iii 4 i ii iii 5 7 i ii

No.of Preganent Women provided diet for during Normal Deliveries C-Section During stay of sick childen No. of Preganent Women given free referral transport from Home to facility Drop back facility Referral to higher facility No. of Sick Neonates provided Drugs and consumable No. of Sick Neonates given free referral transport from Home to facility Drop back facility

iii Referral to higher facility Child Health 1 i ii 2 3 No. of Infant deaths reported From Govt. Health Institution At community level Infant Death verbal autopsy conducted by Dy . CMO / BMO No. of Infants deaths reviewd at District Level No. of Community based Voluntary Workers/ASHAs given incentive for reporting Maternal Death No. of ASHA given incentive under Child Health (HBNC) Total number of Sick Neonates admitted in SNCUs Total number of Admissions in Stabilization Units

5 6 7

FAMILY PLANNING No. of meeting held on Quality Assurance (QA) of sterilisation/Family Planning services

60

2 3 4 5 6

Compensation for Female sterilisation(No. of cases) Compensation for Male sterilisation (No. of cases) Male Sterlization Camp (Nos.) Female Sterlization Camp (Nos.) IUD insertion at Health facilities (No. of cases) No. of monitoring visits conducted by Dy. CMO/BMO/Any other officer/official

Menstrual Hygiene Programme 1 2 3 No. of adolescent girls reached by ASHA No. of Free days sanitary napkins received by ASHA No of Free days sanitary napkins sold/ distributed by ASHA No. of free Sanitary Napkins given to ASHA as incentive for sale of Free days sanitary napkins No. of group meeting conducted by ASHA/ANM with Adolescent girls

School Health Programme 1 2 a b 3 4 a b 5 PNDT No. of Govt./Govt. aided schools visited No. of school children examined Boys Girls No. of screening camps held at PHC level falling under Sabla district No. of tablets distributed at school level IFA Deworming No. of Peer educator identified during VHNDs in SABLA Districts

61

No. of Orientations held for programme Manager and series provider on PC and PNDT act No. of Informer given reward for informing about Unregistered Ultrasound machines/Ultrasound Clinics/illegal practice of sex/Female foeticide

ASHAs Incentives 1 2 3 4 i ii iii 5 6 7 IEC/BCC No. of symposium held for female adolescents in high/higher secondary schools and colleges No. of Rallies / Debates /Seminar held in school /colleges No. of Block Sammelans organised No. of Pregnant women facilitated full ANC by ASHA No. of Birth got registered by ASHA No. of Deaths got registered by ASHA No .of ASHAs given incentives for Full ANC Registration of births Registration of deaths No .of ASHAs given incentives for event reporting No. of events reported by ASHAs No. of ASHAs given Incentives for performing roaster duty at ASHA help desk

2 3

Immunization No. of drop out children Mobilised through ASHA on VHNDs/Immunization sessions

62

No. of ASHA given incentive for mobilizing drop out children No. of quality review meeting held exclusively for RI at district level with Block MO, CDPO and other stake holders No. of Quarterly Review meeting held exclusive for R.I. at Block level. No. of ASHAs given incentive for full immunization. No. of children fully immunized (upto 1st year) through ASHA No. of children fully immunized through ASHA (2nd year) No. of children administered BCG No. of children administered DPT III/POLIO III No. of children administered Measles I No. of children administered Measles II

3 4 i ii 5 6 7 8

Trainings 1 i ii iii 2 3 4 5 6 7 Nos. trained in SBA MO(ISM) SNs LHVs/ANMs No. of ANMs/MPWs/LHVs trained in NSSK & IMNCI No. of LHVs/ANMs/SNs/MPWs trained in RTI/STI No. of Mos/LHVs/ANMs trained in IUD Insertion No. of Medical Officers trained in NSV No. of ANMs/ trained in ARSH programme Training of vaccine handlers in cold chain system (No. of persons trained) Orientation training of ANMs/LHVs/Health worker in Immunization(No. of persons trained)

63

Orientation of Medical Officers in Immunization (No. of MOs trained)

No. of Meetings held 1 2 3 4 District Health Mission (No. of meetings) District Health Society (No. of Meetings) District Level Vigilance & Monitoring committees (DLVMC)(Nos.) Rogi Kalyan Samities (No. of meetings)

64

Annexure B
ROAD MAP FOR PRIORITY ACTION: MATERNAL HEALTH

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 (Reproductive Maternal Neonatal and Child Health) services at these facilities. These must be branded and positioned as quality RMNCH 24x7 Service Centres within the current year. The targets for different categories of facilities are: A) All District Hospitals and other similar district level facilities to provide the following services: 24*7 service delivery for CS and other Emergency Obstetric Care. 1st and 2nd trimester abortion services. Facility based MDR. Essential newborn care and facility based care for sick newborns. Family planning and adolescent friendly health services RTI/STI services. Functional BSU/BB. B) 33 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 as the district hospitals. C) 33 24*7 PHCs and Non FRUs 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.
65

 Essential newborn care and facility based care for sick newborns. Family planning D) All identified SCs/ facilities will: Conduct Delivery by SBAs. Provide IUD Services Provide Essential New born care services. Provide ANC, PNC and Immunization services. Provide Nutritional and Family planning counseling. Conduct designated VHND and other outreach services. Commitment No.2- Implementing free entitlements under JSSK A) JSSK entitlements to be ensured to all pregnant women and sick newborns accessing Public health facilities. B) Drop back to be ensured to at least 70% of pregnant women delivering in the public health facilities. C) Effective IEC and grievance redressal to be ensured. Commitment No. 3- Centralized Call Centre and Assured Referral A) To ensure availability of a centralized call centre for referral transport at State or district level as per requirements along with GPS fitted ambulances. B) Response time for the ambulance to reach the beneficiary not to exceed 30 minutes. Commitment No. 4- Essential Drug List A) To formulate an Essential Drug List (EDL) for each level of facility viz. SC, PHCs, CHCs, DHs, and Medical colleges B) Ensure timely procurement and supply linked to case load. C) The EDL should include drugs for maternal and child health, safe abortion services, RTI/STI.

66

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) Training load for skill based trainings to be estimated after gap analysis. D) Certification /accreditation of the training sites is mandatory. E) 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. F) Performance Monitoring during training/post-deployment need to be ensured G) 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 anaemia A) All severely anaemic pregnant woman (2% of the anaemic pregnant woman) to be tracked and line listed for providing timely treatment of anaemia followed by micro birth planning. 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. 8Demarcation /Division of population and job clarity between the two ANMs working at the Sub-centre. Ensuring availability of one ANM at the SC, while the other visits the assigned population/villages. Commitment No. 9-For 12 High Focus States: Pre service Nursing Training A) At least one state Master Nodal centre shall be created and made functional. B) State nursing cell will be created and made functional. Commitment No.10-- Proper implementation of JSY:
67

A) JSY guidelines to be strictly followed and payments made as per the eligibility criteria. B) No delays in JSY payments to the beneficiaries and full amount of financial assistance to be given to the beneficiary before being discharged from the health facility after delivery. C) All payments to be made through cheques and preferably into bank/ post office accounts. D) Strict monitoring and physical (at least 5%) verification of beneficiaries to be done by state and district level health authorities to check malpractices. E) Grievance redressal mechanisms as stipulated under JSY guidelines to be activated at the district and state levels. F) Accuracy of JSY data reported at the HMIS portal of MOHFW to be ensured besides furnishing quarterly progress reports to the Ministry within the prescribed timeframe. 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 . 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.

68

Annexure C Line Listing of ASHA GREH Name of Delivery point DH Doda Gandhi Nagar Hospital Sarwal Hospital DH Kathua DH Kishtwar DH Poonch DH Rajouri DH Reasi DH Samba DH Udhampur DH Ramnan MCCH Ang DH Bandipora D.H. BARAMULLA Distt.Hospital SDH Ganderbal DH Kargil District Hospital DH Handwara SNM Hospital Leh District Hospital PuL District Hospital Shopian JLNM CHC Akhnoor CHC Mendhar CHC Sunderbani CHC Bijbehara MCH sopore CHC Kupwara CHC Disket/Nubra

S.No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30

Name of District Doda Jammu Jammu Kathua Kishtwar Poonch Rajouri Reasi Samba Udhampur Ramnan Anantnag Bandipora Baramulla Budgam Ganderbal Kargil Kulgam Kupwara Leh Pulwama Shopian Srinagar Jammu Poonch Rajouri Anantnag Baramulla Kupwara Leh

69

Annexure D
S.No Indicator Number S.No. 1 2 3 4 5 6 7 8 9 10 11 12 A SC Conducting >3 deliveries/month 26 13 14 15 16 17 18 19 20 21 22 23 24 25 26 1 2 3 4 No. of 24X7 PHCs conducting > 10 deliveries /month 5 28 6 7 8 9 10 11 12 Name of District Kishtwar Rajouri Udhampur Udhampur Name of Delivery Points SC Sigdi SC Tatapani SC Loudra SC Kudwah

Ramban
Anantnag Bandipora Bandipora Bandipora Bandipora Bandipora Bandipora Bandipora Bandipora Baramulla Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Jammu Kishtwar Kishtwar Rajouri Udhampur

SC Jatgali
S/C Dehwatoo S/C Aragam S/C Ahamsharief S/C Watapora S/C Malangam S/C Aloosa S/C Pazalpora S/C Mukdamyari S/C Panzinara SC's Watergam S/C Khurhama S/C Moori S/C Thayan S/C Pathroo S/C Keran bala S/C Zonereshi S/C Farkin S/C Budnambal MAC Putushai MAC Nagsari MAC Machil PHC Pallanwala PHC Chatroo PHC Atholi PHC Manjakote PHC Majalta

Ramban Ramban Ramban

Anantnag Anantnag Anantnag Anantnag

PHC Ukerhal PHC Khari PHC Ramsoo

PHC Achabal PHC Larnoo PHC Aishmuqam PHC Saller

70

S.No

Indicator

Number

S.No. 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 1

Name of District Anantnag Bandipora Baramulla Baramulla Budgam Budgam Ganderbal Ganderbal Kulgam Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Bandipora Kupwara Budgam Budgam

Name of Delivery Points PHC Verinag PHC Hajin PHC BONIYAR PHC DANGIWACHA PHC Khag PHC Soibug PHC Gund PHC Lar PHC Qazigund PHC Kalaroose PHC Chowgal PHC Tarthpora PHC Vilgam PHC Trehgam PHC Drugmulla PHC Panzgam PHC Chantimulla PHC Awoora CHC Chattergam CHC Nagam

No. of any other PHCs conducting > 10 deliveries/ month No. of CHCs ( Non- FRU) conducting > 10 deliveries /month

2 1

1 2 3 4 5 E No. of CHCs (FRU) conducting > 20 deliveries /month 6 47 7 8 9 10 11 12 13 14

Doda Doda Jammu Jammu Jammu Kathua Kathua Poonch Poonch Poonch Rajouri Rajouri Rajouri Rajouri

CHC Bhaderwah CHC Gandoh CHC Akhnoor CHC Bishnah CHC RS Pura CHC Hiranagar CHC Billawar CHC Surankote CHC Mandi CHC Mendhar CHC Sunderbani CHC Kalakote CHC Nowshera CHC Kandi

71

S.No

Indicator

Number

S.No. 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 1

Name of District Rajouri Reasi Reasi Samba Samba Udhampur Udhampur Ramban Ramban Anantnag Anantnag Anantnag Anantnag Bandipora Baramulla Baramulla Baramulla Baramulla Baramulla Budgam Budgam Budgam Budgam Ganderbal Kulgam Kupwara Kupwara Kupwara Kupwara Pulwama Pulwama Shopian Srinagar Doda Jammu Jammu Kathua Kishtwar

Name of Delivery Points CHC Darhal CHC Katra CHC Mahore CHC Ramgarh A/H Vijaypur CHC CHENANI CHC RAMNAGAR

CHC Banihal CHC Batote

CHC Bijbehara CHC Kokernag CHC Seer CHC Shangus CHC Sumbal CHC URI MCH SOPORE CHC KREERI CHC PATTAN CHC TANGMARG CHC Beerwah CHC Chadora CHC Ch.Sharif CHC Magam CHC Kangan CHC D H Pora CHC Kupwara CHC Kralpora CHC Sogam CHC Tangdar SDH Pampore SDH Tral CHC Keller CHC-Gousia Hosital Khanyar DH Doda Gandhi Nagar Hospital Sarwal Hospital DH Kathua DH Kishtwar

No. of DH conducting > 50 deliveries /month

2 23 3 4 5

72

S.No

Indicator

Number

S.No. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23

Name of District Poonch Rajouri Reasi Samba Udhampur Ramnan Anantnag Bandipora Baramulla Budgam Ganderbal Kargil Kulgam Kupwara Leh Pulwama Shopian Srinagar

Name of Delivery Points DH Poonch DH Rajouri DH Reasi DH Samba DH Udhampur DH Ramban MCCH Ang DH Bandipora D.H. BARAMULLA DH Budgam SDH Ganderbal DH Kargil DH Kugam DH Handwara SNM Hospital Leh District Hospital PuL District Hospital Shopian JLNM

G H

Total No. of District Women And Children hospital No. of Medical colleges conducting > 50 deliveries per month

2 3

73

Annexure G
SNCUs in Old District Hospitals
S. no. 1 District 2 Jammu Division Jammu Kathua Udhampur Doda Rajouri Poonch Kashmir Division 7 8 9 10 11 12 13 14 Leh Anantnag Baramulla Budgam Pulwama Srinagar Kupwara Kargil SNM Hospital, Leh District Hospital, Anantnag District Hospital, Baramulla District Hospital, Budgam District Hospital, Pulwama District Hospital, Srinagar District Hospital, Kupwara District Hospital, Kargil Established Established Established To be Established To be Established To be Established To be Established Established District Hospitals 3 Remarks 4

1 2 3 4 5 6

Gandhi Nagar Hospital District Hospital, Kathua District Hospital, Udhampur District Hospital, Doda District Hospital, Rajouri District Hospital, Poonch

Established Established Established To be Established To be Established To be Established

77

Annexure H
List of SNCUs where Operational Cost has to provided
S. no. 1 1 2 3 4 5 District 2 Jammu Kathua Udhampur Leh Anantnag District Hospitals 3 Gandhi Nagar Hospital District Hospital, Kathua District Hospital, Udhampur SNM Hospital, Leh District Hospital, Anantnag

78

Annexure I
Line of Health Institutions having Stabilization Units for whom Operational Cost approved S No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Name of Health Institution District Kishtwar Poonch Poonch Udhampur Udhampur Ramban Ramban Kathua Kathua Doda Doda Jammu Jammu Jammu Rajouri Rajouri Rajouri Rajouri Samba Samba Anantnag Anantnag Anantnag Bandipora Bandipora Baramulla Baramulla Baramulla Baramulla Baramulla Budgam Budgam DH Kishtwar FRU Mendhar FRU Surankote CHC Chenani CHC Ramnagar CHC Banihal CH Batote CHC Billawar CHC Hiranagar CHC Bhaderwah CHC Gandoh CHC Akhnoor CHC RS Pura CHC Bishnah FRU Sunderbani FRU Nowshera FRU Darhal FRU Kalakote CHC Ramgarh DH Samba FRU Brijbehra FRU Shangus FRU Kokernag DH Bandipora CHC Sumbal FRU Tangmarg CHC Pattan CHC Keeri CHC Sopore CHC Uri FRU Beerwa FRU Chadoora 79

S No. 33 34 35 36 37 38 39 40 41 42 43 44 45

Name of Health Institution District Budgam Budgam Ganderbal Kulgam Kupwara Kupwara Kupwara Kupwara Leh Pulwama Pulwama Shopian Srinagar FRU Ch. Sharief FRU Magam FRU Kangan CHC DH Pora FRU Kupwara FRU Sogam FRU Tangdar FRU Kralpora SDH Disket FRU Pampore FRU Tral DH Shopian FRU Khanyar

80

Annexure J

S No. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

Operational cost approved for procurement of equipments in following NBCCs District Health Facility PHC Akingam Anantnag PHC Ashmuqam Anantnag PHC Hapatnar Anantnag PHC Wandevalgam Anantnag PHC Hakoora Anantnag PHC Naidkhai Bandipora PHC Mohra Baramulla PHC Hardpanzoo Budgam PHC Soibugh Budgam PHC Pargwal Jammu PHC Mera Mandrian Jammu Kargil PHC Panikhar PHC Budhi Kathua PHC Dinga amb Kathua PHC Chatroo Kishtwar PHC Atholi Kishtwar PHC Keeru Kishtwar PHC Dachhan Kishtwar PHC Nali Kishtwar Kulgam PHC Qazigund Kulgam PHC Devsar Kulgam PHC Mpora Kulgam PHC K B Pora Kulgam PHC Killam Kulgam PHC Qaimoh PHC Tarthpora Kupwara PHC Trehgam Kupwara PHC Drugmulla Kupwara PHC Kalaroose Kupwara PHC Villagam Kupwara PHC Awoora Kupwara PHC Magam Kupwara PHC Kalamabad Kupwara PHC Machil Kupwara PHC Harrie Kupwara PHC Chushul Leh

81

37 38 39 40 41 42 43 44 45 46 47 48 49 50

Poonch Poonch Poonch Poonch Poonch Poonch Poonch Rajouri Rajouri Rajouri Samba Srinagar Udhampur Udhampur

PHC Dhargloon PHC Hari Marhote PHC Mankote PHC Harni PHC Loran PHC Sawjian PHC Bandichachian PHC Manjakote PHC Dalhori PHC Gambir Mughlan PHC Mansar PHC zadibal PHC Latti PHC Basantgarh

Red Colour indicates Delivery Point

82

Annexure K
List of Health Institutions having NBCC for whom Operational Cost Sanctioned S District Name of Health Institution No. 1 Kishtwar PHC Chatroo 2 Kishtwar PHC Dachan 3 Kishtwar PHC Atholi 4 Kishtwar PHC Nali 5 Kishtwar PHC Keeru 6 Kishtwar PHC Afti 7 Poonch PHC Chandak 8 Poonch PHC Fazalabad 9 Poonch PHC Dhargloon 10 Poonch PHC Loran 11 Poonch PHC Mankote 12 Poonch PHC Sawajian 13 Poonch PHC Bandichachian 14 Poonch PHC Harimarote 15 Poonch PHC Harni 16 Poonch PHC Lassana 17 Poonch PHC Batadhurian 18 Reasi PHC Laiter 19 Reasi PHC Dharmari 20 Reasi PHC Arnas 21 Reasi PHC Pouni 22 Udhampur PHC Sudhmahadev 23 Udhampur PHC Bharnara 24 Udhampur PHC Ghordi 25 Udhampur PHC Bhugtrain 26 Udhampur PHC Majalta 27 Udhampur PHC Tikri 28 Udhampur PHC Basantgarh 29 Udhampur PHC Hartryan 30 Udhampur PHC Pancheri 31 Udhampur PHC Latti 32 Ramban PHC Ukheral 33 Ramban PHC Ramsoo 83

34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71

Ramban Ramban Kathua Kathua Kathua Kathua Kathua Kathua Kathua Kathua Kathua Kathua Kathua Kathua Kathua Kathua Kathua Doda Doda Doda Jammu Jammu Jammu Jammu Jammu Jammu Jammu Jammu Jammu Jammu Jammu Jammu Jammu Jammu Rajouri Rajouri Rajouri Rajouri

PHC Kheeri PHC Mangit PHC Parole PHC Budhi PHC Dingaamb PHC Hutt PHC Ramkote PHC Sandhar PHC Koti Chadyar PHC Macheedi PHC Bhoond PHC Lakhanpur PHC Kough PHC Marheen PHC Sanonghat PHC Lohai PHC Dhani PHC Assar PHC Bhagwah PHC Chinta PHC Sungal PHC Mera Mandrian PHC Kanachak PHC Sai PHC Chowki Choura PHC Arnia PHC Dhanger PHC Rehal PHC Pargwal PHC Dansal PHC Kotbhalwal PHC Pallanwala PHC Ambgarota Gol Gujral PHC Manjakote PHC Budhal PHC Moughla PHC Gambhir Mughlan 84

72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109

Rajouri Rajouri Rajouri Rajouri Rajouri Rajouri Rajouri Rajouri Rajouri Rajouri Rajouri Samba Samba Samba Samba Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Anantnag Bandipora Bandipora Bandipora Bandipora Baramulla

PHC Tralla PHC Upper Hathal PHC Balshama PHC Shadra Sharief PHC Seeri PHC Dalhori PHC Peeri PHC Lamberi PHC Bagla Nadyal PHC Kallar Chattyar PHC Laroka EH Vijaypur PHC Purmandal PHC Sanoora PHC Mansar PHC Sallar PHC D.K.Pora PHC Mattan PHC Srigufwara PHC Larnoo PHC Achabal PHC Verinag PHC Sirhama PHC Nowgam PHC Ashmugam PHC Hakroo PHC Brakpora PHC Sirhama PHC Akingam PHC B. Kalan PHC Sagam PHC Khiram PHC Haptnar PHC Astangoo PHC Badugam PHC Hajin PHC Naidkahi PHC Mora 85

110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 141 142 143 144 145 146 147

Baramulla Baramulla Baramulla Baramulla Baramulla Baramulla Baramulla Baramulla Baramulla Baramulla Baramulla Baramulla Budgam Budgam Budgam Budgam Budgam Budgam Budgam Budgam Budgam Budgam Budgam Ganderbal Ganderbal Ganderbal Ganderbal Ganderbal Ganderbal Ganderbal Ganderbal Kargil Kargil Kulgam Kulgam Kulgam Kulgam Kulgam

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Bijhama Shrakwara GK Kasim Hardbora Kahitangan Fategarh Tujar Shrief Seriwarpora Dangiwacha Boniyar Sheeri Kalantra Kralnewa Khag Soibugh Hardapanzoo OM Pora Poshker Surasyar Lasjan Narbal Hafroo Wadwan Kullan Gund Lar Wussan Babanagri Kachen Wakura Sonamarg Panikhar Sargole Qaimoh Katrasoo Bugam Manzgam Kilam 86

148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185

Kulgam Kulgam Kulgam Kulgam Kulgam Kulgam Kulgam Kulgam Kulgam Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Kupwara Leh Leh Leh Leh Leh Leh Leh Leh Pulwama Pulwama Pulwama Pulwama Pulwama Pulwama

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Frisal Behibagh Tarigam Qazigund Mahnpora Nehma Razloo Devsar Pahloo Drugmulla Trathpora Maidanpora Awoora Keran Cherakote Harie Machil Kalamchakla Kalaroose Chogal Villagam Trehgam Magam Panzgam Nyoma Tangtse Turtuk Bogdang Turtuk Panamik Timisgum Chushul Wuyan Khrew Parigam Kakapora Awantipora Dadsara 87

186 187 188 189 190 191 192 193 194 195 196 197 198 199 200

Pulwama Pulwama Pulwama Pulwama Shopian Shopian Shopian Shopian Srinagar Srinagar Srinagar Srinagar Srinagar Srinagar Srinagar

PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC PHC

Aripal Newa Tahab Ladhoo Sedow Rahmoo Singerwani D. K. Pora Khanmoh Brane Zadibal Narwara SR Gunj Harwan Hazratbal

88

Annexure L

Monthly Infant Death Review Reporting Format Name of the District:Month & Year: April-2012
Sr.no ACTIVITY NUMBERS 1. Number of Infant Deaths Reported during the month 2. Number of Infant Deaths Reported w e f April-2012up to the reporting month 3. Number of Infant Deaths Reviewed by CMO at District Level during the reporting month 4. Number of Infant Deaths Reviewed by CMO at District Level w e f April-2012up to the Reporting Month 5. Total no of Infant Deaths not Reviewed by CMO 6. Causes of Infant Death during the reporting month a. Sepsis b. Birth pneumonia c. Pre-mature birth d. Low birth weight baby e. Asphyxia at Birth f. Birth injury g. Death during referral h. Any other cause 7.
Number of Infant Deaths Reviewed by District Magistrate at District Level during the reporting month

REMARKS

8.

9.

Number of Infant Deaths Reviewed by District Magistrate at District Level w e f April2012up to the Reporting Month Steps taken by the district to improve the reporting of Infant Deaths

89

Annexure M Line listing of Blood Storage Centres S.No Division Name Of FRU 1 FRU Bishnah 2 FRU R.S Pura 3 FRU Chennani 4 FRU Ramgarh 5 FRU Hiranagar 6 FRU Basohli 7 FRU Billawar Jammu 8 FRU Gandoh 9 FRU Thathri 10 FRU Kalakot 11 FRU Thannamandi 12 FRU Banihal 13 FRU Katra 14 FRU Bijbehra 15 FRU Kokernag 16 FRU Magam 17 FRU Ch. Sharief 18 FRU Sogam 19 FRU Tangdhar 20 FRU Kralpora Kashmir 21 FRU Pampore 22 FRU Khalsti 23 FRU Uri 24 FRU Sopore 25 FRU Kreeri 26 FRU Tangmarg

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Annexure-N Jammu Division District wise list of CHCs/PHCs falling in Category A, B and C Areas of Jammu Division
S.No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 25 26 27 28 29 Kishtwar Kathua Doda District Name of Health Institution (CHC/PHC) CHC Gandoh PHC Tipri PHC Bharath PHC Malanoo PHC Changa PHC Bhagwa PHC Goha PHC Gundana PHC Chinta PHC Bhalla PHC Bhella PHC Prem Nagar PHC Aghar Majoor Jammu PHC Dori Dager PHC Kathar PHC Gangal CHC Bani PHC Dhaggar PHC Koti Chandiar PHC Sandroon PHC Malhar PHC Lohai PHC Gudu Phalal PHC Machedi CHC Marwah PHC Wardwan PHC Dachhan PHC Nali PHC Keeru Category B B B B B C C B C C C C C C C C B B B B B B B C A A A A A

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S.No 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66

District

Name of Health Institution (CHC/PHC) PHC Afti PHC Chingaon PHC Chattroo PHC Massu PHC Padder CHC Gool PHC Rajgarh PHC Battani PHC Trigam PHC Ukhral PHC Khari PHC Swajian PHC Loran

Category A A C A A B C B B C C C C B B C C B B C C C C C B C C A A A C C B A C C C

Ramban

Poonch

PHC Bruti PHC Hari Marote PHC Chandimarh PHC Jamola PHC Peeri PHC Androoth PHC Gambir Mogla PHC Budhal PHC Shahdra Sharief PHC Dalouri PHC Upper Hathal PHC Bagla Nadiala PHC Gharan CHC Mahore PHC Lar PHC Bhagodas PHC Tote PHC Dharmari PHC Arnas PHC Panasa PHC Bana PHC Sumbh PHC Rattanpur PHC Landhar

Rajouri

Reasi

Samba Udhampur

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S.No 67 68 69 70 71 72

District

Name of Health Institution (CHC/PHC) PHC Rang PHC Basantgarh PHC Latti PHC Mongari PHC Panchari PHC Joffer

Category B C C C C B

Sd/Director Health Services Jammu

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Annexure-N KASHMIR DIVISION District wise list of CHCs/PHCs falling in Category A, B and C Areas of Kashmir Division
S.No 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Kupwara Shopian Ganderbal Baramulla Kulgam Bandipora District Name of Health Institution (CHC/PHC) CHC Gureez PHC Chantimulla PHC Sheikhpora PHC Budgam PHC K.B.Pora PHC Waltangoo PHC Sultan Daki PHC Danisyedan PHC Warikha PHC Bijhama PHC Panzala PHC Sangarwani PHC Sonamarg CHC Tangdar CHC Zachaldara CHC Kralpora PHC Monbal PHC Ashpora PHC Nowgam PHC Gabra PHC Teetwal PHC Chiterkote PHC Tikkipora PHC Kalaroose PHC Dudi Machil PHC Awoora Category A A A A B B A A B B B A B A B B B B B A A A B B A B

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S.No 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58

District

Name of Health Institution (CHC/PHC) PHC Behnipora PHC Villgam PHC Trathpora PHC Kukroosa PHC Gonipora PHC Drugmulla PHC Nagri PHC Gushi PHC Kandi PHC Panzgam PHC Hari PHC Keran PHC Batpora PHC Magam PHC Churmunjroo

Category B B B B B B B B B B B A B B B B B A A A A A A A A A A A A A A A

Budgam

PHC Kichwarai PHC Poshkar CHC Drass CHC Chiktan CHC Sankoo CHC Padoom PHC Shargoole PHC Panikhar CHC Disket CHC Sukerbachan CHC Khalsti PHC Turtuook

Kargil

Leh

PHC Bogdang PHC Panimak PHC Diggar PHC Tamisgam PHC Saspool

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S.No 59 60 61 62 63 64 65

District

Name of Health Institution (CHC/PHC) PHC Noyama PHC Basgo PHC Shakti PHC Cheushal PHC Thiksay PHC Tangtse PHC Chahool

Category A A A A A A A

Sd/Director Health Services Kashmir

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Annexure-O
GUIDELINES FOR FUNDS OPERATED BY RKS Corpus funds for District Hospitals Objectives of the RKS / HMS The following could be the broad objectives of the HMS i. Ensure compliance to minimal standard for facility and hospital care and protocols of treatment as issued by the Government. ii. Ensure accountability of the public health providers to the community; iii. Introduce transparency with regard to management of funds; iv. Upgrade and modernize the health services provided by the hospital and any associated outreach services; v. Supervise the implementation of National Health Programmes at the hospital and other health institutions that may be placed under its administrative jurisdiction; vi. Organize outreach services / health camps at facilities under the jurisdiction of the hospital; vii. Display a Citizens Charter in the Health facility and ensure its compliance through operationalisation of a Grievance Redressal Mechanism; viii. Generate resources locally through donations, user fees and other means; ix. Establish affiliations with private institutions to upgrade services; x. Undertake construction and expansion in the hospital building; xi. Ensure optimal use of hospital land as per govt. guidelines; xii. Improve participation of the Society in the running of the hospital; xiii. Ensure scientific disposal of hospital waste; xiv. Ensure proper training for doctors and staff; xv. Ensure subsidized food, medicines and drinking water and cleanliness to the patients and their attendants; xvi. Ensure proper use, timely maintenance and repair of hospital building equipment and machinery. FUNCTIONS AND ACTIVITIES To achieve the above objectives, the Society shall direct its resources for undertaking the following activities / initiatives i. ii. iii. Identifying the problems faced by the patients in District Hospital; Acquiring equipment, furniture for the hospital; Expanding the hospital building, in consultation with and subject to any Guidelines that may be laid down by the State Government;
97

iv. v. vi.

vii. viii. ix. x.

Making arrangements for the maintenance of hospital building (including residential buildings), vehicles and equipment available with the hospital; Improving boarding / lodging arrangements for the patients and their attendants; Entering into partnership arrangement with the private sector (including individuals) for the improvement of support services such as cleaning services, laundry services, diagnostic facilities and ambulatory services etc.; Developing / leasing out vacant land in the premises of the hospital for commercial purposes with a view to improve financial position of the Society; Encouraging community participation in the maintenance and upkeep of the hospital; Promoting measures for resource conservation through adoption of wards by institutions or individuals; and, Adopting sustainable and environmental friendly measures for the day-to-day management of the hospital, e.g. scientific hospital waste disposal system, solar lighting systems, solar refrigeration systems, water harvesting and water recharging systems etc.

ACCOUNTS AND AUDIT i. The Society shall cause regular accounts to be kept of all its monies and properties in respect of the affairs of the Society. ii. The accounts of the Society shall be audited annually by a Chartered Accountant firm included in the panel of Chartered Accountants drawn by the designated authority of the State Government. iii. The report of such audit shall be communicated by the auditor to the Society, which shall submit a copy of the Audit Report along with its observation to the District Collector. iv. Any expenditure incurred in connection with such audit shall be payable by the Society to the Auditors. v. The Chartered Accountant or any qualified person appointed by the Govt. of India/State Government in connection with the audit of the accounts of the Society shall have the same rights, privileges and authority in connection with such audit as the Auditor General of the State has in connection with the audit of Government accounts and in particular shall have the right to demand the production of books, accounts, connected vouchers and other necessary documents and papers. BANK ACCOUNT The account of the Society shall be opened in a bank approved by the Governing Body. All funds shall be paid into the Societys account with the appointed bank and shall not be withdrawn except by a cheque, bill note or other negotiable instruments signed by the
98

Member-Secretary of the Society and such one more person from amongst the Executive Committee members as may be decided by the Governing Body. Suggested areas where Corpus funds for District Hospitals may be used include: i. Minor modifications to the DH- curtains to ensure privacy, repair of taps, installation of bulbs, other minor repairs, which can be done at the local level. ii. Patient examination table, delivery table, BP apparatus, Hemoglobin meter, Copper-T insertion Kit, instruments tray, baby tray, weighing scales for mothers and for newborn babies, plastic/rubber sheets, dressing scissors, stethoscopes, buckets, attendance stools, mackintosh sheet. iii. Provision of running water supply. iv. Provision of electricity. v. Adhoc payments for cleaning up the centre, especially after childbirth. vi. Transport of emergencies to appropriate referral centres. vii. Transport of samples during epidemics. viii. Purchase of consumables such as bandages and drugs in the center to be used only to tie over temporary gaps due to logistic failures but not as a regular supply. ix. Purchase of bleaching powder and disinfectants for use in common areas under the jurisdiction of center. x. Labour and supplies for environmental sanitation, such as clearing of larvicidal measures for stagnant water. xi. Payment/reward to ASHA for certain identified activities. xii. Repair/ Operationalizing soak pits. The following nature of expenditure should not be incurred out of the Corpus funds for District Hospitals funds. i. Purchase of Office Stationary & Equipment, training related equipment, vehicles etc. ii. Engagement of full time or part time staff and payment of honorarium/incentives/wages of any kind. iii. Purchase of drugs and consumables in bulk and furniture iv. Payments towards inserting advertisements in any Newspaper/ Journal/Magazine and IEC related expenditure. v. Organising Swasthya Mela or giving stalls in any Mela for ostensible purpose of awareness generation of health schemes/programmes. vi. Payment of incentives to individual/groups in cash/kind.

99

Meeting any recurring non-plan expenditure. i. Taking up any individual based activity except in the case of referral and transport in emergency situations. Funds operated by RKS at CHC Untied funds CHC: ii. CHC untied funds shall be kept in the bank account of the concerned Rogi Kalyan Samiti (RKSs)/ Hospital Management Committee (HMC). CHC level RKS will have the mandate to undertake and supervise the work to be undertaken from Untied funds. These funds will be spent and monitored by RKS. iii. Since there would be substantial fund flow to be utilized for the CHCs under NRHM/RCH-II and other Programmes, the untied funds should not duplicate what is/can be taken up under other programmes. Each activity planned by the CHC should have clear rationale and separate register be maintained in the CHC giving sources of funds clearly for various activities. Suggested areas where untied funds may be used include: i. Minor modifications to the CHC- curtains to ensure privacy, repair of taps, installation of bulbs, other minor repairs, which can be done at the local level. ii. Patient examination table, delivery table, BP apparatus, Hemoglobin meter, Copper-T insertion Kit, instruments tray, baby tray, weighing scales for mothers and for newborn babies, plastic/rubber sheets, dressing scissors, stethoscopes, buckets, attendance stools, mackintosh sheet. iii. Provision of running water supply. iv. Provision of electricity. v. Adhoc payments for cleaning up the centre, especially after childbirth. vi. Transport of emergencies to appropriate referral centres. vii. Transport of samples during epidemics. viii. Purchase of consumables such as bandages and drugs in the center to be used only to tie over temporary gaps due to logistic failures but not as a regular supply. ix. Purchase of bleaching powder and disinfectants for use in common areas under the jurisdiction of center. x. Labour and supplies for environmental sanitation, such as clearing of larvicidal measures for stagnant water. xi. Payment/reward to ASHA for certain identified activities. xii. Repair/ Operationalizing soak pits.
100

The following nature of expenditure should not be incurred out of the untied funds. i. Purchase of Office Stationary & Equipment, training related equipment, vehicles etc. ii. Engagement of full time or part time staff and payment of honorarium/incentives/wages of any kind. iii. Purchase of drugs and consumables in bulk and furniture iv. Payments towards inserting advertisements in any Newspaper/ Journal/Magazine and IEC related expenditure. v. Organising Swasthya Mela or giving stalls in any Mela for ostensible purpose of awareness generation of health schemes/programmes. vi. Payment of incentives to individual/groups in cash/kind. Meeting any recurring non-plan expenditure. i. Taking up any individual based activity except in the case of referral and transport in emergency situations. B. Annual Maintenance Grant CHC: i. CHC AMG shall be kept in the bank account of the concerned Rogi Kalyan Samiti(RKS)/Hospital Management Committee (HMC). CHC level RKS will have the mandate to undertake and supervise the work to be undertaken from Annual Maintenance Grant . These funds will be spent and monitored by RKS. ii. Since there would be substantial fund flow to be utilized for the CHCs under NRHM/RCH-II and other Programmes, the AMG funds should not duplicate what is/can be taken up under other programmes. Each activity planned by the CHC should have clear rationale and separate register be maintained in the CHC giving sources of funds clearly for various activities. The Annual Maintenance Grant for CHCs may be utilized for the purpose subject to the following conditions. i. That there is no duplication of funds already permissible for repair/renovation under RCH. ii. The repairs and renovations are carried out on the basis of facility Survey. iii. There should be proper scrutiny of estimates/accounts by the competent authority. iv. The progress of work should be monitored by the Rogi Kalyan Samities. The following nature of expenditure should not be incurred out of the AMG funds.

101

i. Purchase of Office Stationary & Equipment, training related equipment, vehicles etc. ii. Engagement of full time or part time staff and payment of honorarium/incentives/wages of any kind. iii. Purchase of drugs and consumables in bulk and furniture iv. Payments towards inserting advertisements in any Newspaper/ Journal/Magazine and IEC related expenditure. v. Organising Swasthya Mela or giving stalls in any Mela for ostensible purpose of awareness generation of health schemes/programmes. vi. Payment of incentives to individual/groups in cash/kind. C. Corpus Fund CHC: Objectives of the RKS/HMS The following could be the broad objectives of the HMS. i. Ensure compliance to minimal standard for facility and hospital care and protocols of treatment as issued by the Government. ii. Ensure accountability of the public health providers to the community. iii. Introduce transparency with regard to management of funds. iv. Upgrade and modernize the health services provided by the hospital and any associated out of services. v. Supervise the implementation of National Health Programmes at the hospital and other health institutions that may be placed under its administrative jurisdiction. vi. Organize outreach services/health camps at facilities under the jurisdiction of the hospital. vii. Display a Citizens Charter in the Health facility and ensure its compliance though operationalisation of a Grievance Redressal Mechanism. viii. Generate resources locally through donations, user fees and other means. ix. Establish affiliations with private institutions to upgrade services. x. Undertake construction and expansion in the hospital building. xi. Ensure optimal use of hospital land as per government guidelines. xii. Improve participation of the Society in the running of the hospital. xiii. Ensure scientific disposal of hospital waste. xiv. Ensure proper training for doctors and staff. xv. Ensure subsidized food, medicines and drinking water and cleanliness to the patients and their attendants.

102

xvi.

Ensure proper use, timely maintenance and repair of hospital building equipment and machinery.

FUNCTIONS AND ACTIVITIES To achieve the above objectives, the Society shall direct its resources for undertaking the following activities Initiatives. i. Identifying the problems faced by the patients in CHC. ii. Acquiring equipment, furniture for the hospital. iii. Expanding the hospital building, in consultation with and subject to any Guidelines that may be laid down by the State Government. iv. Making arrangements for the maintenance of hospital building (including residential buildings), vehicles and equipment available with the hospital. v. Improving boarding/lodging arrangements for the patients and their attendants vi. Entering into partnership arrangement with the private sector (including individuals) for the improvement of support services such as cleaning services, laundry services, diagnostic facilities and ambulatory services etc. vii. Developing/leasing out vacant land in the premises of the hospital for commercial purposes with a view to improve financial position of the Society. viii. Encouraging community participation in the maintenance and upkeep of the hospital. ix. Promoting measures for resource conservation through adoption of wards by institutions or individuals. x. Adopting sustainable and environmental friendly measures for the day-to-day management of the hospital, e.g. scientific hospital waste disposal system, solar lighting systems, solar refrigeration systems, water harvesting and water recharging systems etc.

103

Annexure P ROAD MAP FOR PRIORITY ACTION: FAMILY PLANNING MISSION: The mission of the national Family Planning Programme 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 sterilization (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
104

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 e. % post-partum sterilisation against total female sterilisations f. % of male sterilisation out of total sterilisations conducted g. % facilities delivering FDS services against planned h. % of personnel trained against planned i. % point decline in unmet need j. point decline in TFR k. % utilisation of funds against approved

105

Annexure Q ROAD MAP FOR PRIORITY ACTION: ADOLESCENT HEALTH 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. II. 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.
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 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. III. Menstrual Hygiene Scheme (MHS): 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. Ensure that monitoring mechanism as outlined in the operational framework (Shared with the States during the National Adolescent Health Workshop) is put in place across levels and departments.
107

Annexure R ROAD MAP FOR PRIORITY ACTION: PNDT MISSION: The mission of PNDT programme is to improve the sex ratio at birth by regulating the pre-conception and prenatal diagnostic techniques misused for sex selection. Guiding Principle: Deterrence for unethical practice sex selection to ensure improvement in the child sex ratio STRATEGIES: 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
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 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 programme managers Appropriate Authorities Advisory committee members Nodal officers both State and District Sensitisation and Alliance building with Judiciary 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

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Annexure S Priority Actions to be carried out by state for Immunization 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. Daily Immunisation services should be available in PHCs, CHCs, SDHs/DHs. 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. For sub centres without ANMs, special strategy should be formulated. 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. MCTS should be made full use of for generating due lists for ANMs, sending SMS alerts to beneficiaries and maintaining actual service delivery. 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 emphasized 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.

110

11. Special micro plans are to be developed for inaccessible, remote areas and urban slums. The micro plans developed under polio programme must be utilized and special focus should be given to the migrant population (Refer to guidelines).

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Annexure T Priority Actions to be carried out by state for Financial Management 1. Quality FMRs must be submitted on time with both physical and financial progress fully reflected. 2. State is to ensure that states outstanding share is deposited. Further, with effect from 2012-13, States share would be 10%. 3. Release of 100% of funds for the year 2012-13 would be contingent on the state providing Utilisation certificates upto 2010-11. 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 a must for release of 2nd tranche of funds. 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 should provide a confirmation of submission of Action Taken Report/ Compliance Report on the FMR Analysis (2011-12) and Audit Report Analysis for FY 2010-11. 8. State needs to prioritise the internal control procedures for all transactions. 9. State should ensure proper maintenance of books of accounts at all districts and blocks within the State. 10. Appointment of Auditor for the year 2011-12 is pending and must be completed in the first quarter of 2012-13. 11. 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.

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Format of Financial Management Report to be submitted by the District to the State Health Society ("Name of the District") District Health/RCH Society____________________________________________ FINANCIAL REPORT FOR THE QUARTER/MONTH/ENDING _____________________________of the Financial Year 2012-13 Physical Progress Permisible as per Budget Sheets (2012-13) {col (1>=2+3)} Balance as on 01-04-2011 Target (for the year) Achievements ** Previous Cumulative Reporting Qtr. M1 3 M2 4 M3 5 Funds Received 2012-13 From SHS 3 From Dir.HS/Oth er Agencies 4 Financial Progress Total Expenditure (Col. 5+6+7+8) Closing Balance {Col.( 2+3+4)(9+10)} 11 Expenditure ** Previous Cumulative Expenditure Reporting Qtr. Month 1 6 Month 2 7 Month 3 8

FMR Code

Activities

A. RCH Flexipool Maternal Health Janani Suraksha Yojana / JSY Incentives to Mothers (Home Delivery) Rs.500/- per delivery Incentives to Mothers (Institutional Delivery) Rural (Rs. 1400/- per delivery Incentives to Mothers (Institutional Delivery) Urban(Rs. 1000/- per delivery) Performance Related incentive to ASHAs under JSY (Rs 350/-) Performance Related incentive to ASHAs under JSY(High Focus) (Rs 600/-) A.1.4.4 Sub Total (JSY) Maternal Death Audit
-

A.1.4.1 A.1.4.2. a A.1.4.2. b A.1.4.4

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Refund (if any) 10 -

A.1.5

Maternal Death Autopsy by Dy.CMO/BMO@ 250/- for autopsy Incentive to community Based Volunteers for reporting maternal Death@ 100/- per report

A.1.5 Sub Total (Maternal Death Audit) A.1.6 i) ii) Other Activities Ironsucrose Intervention(3 doses Approved) Mobility Support for District Nodal Officers for monitoring JSSK Mobility Support for District Nodal Officers for monitoring JSSK in high focus Mobility support for Block level officers for monitoring JSSK Mobility support for Block level officers for monitoring JSSK in high foucs Incentive to SBAs for conducting home deliveries in inaccessible/snow bound areas of high focus districts as a pilot project Printing of MCP cards Printing of Safe motherhood booklet Mobility support for State level officers for monitoring JSSK (Lumpsum) Sub Total (Other Activities) Janani Shishu Suraksha Karyakram(JSSK)
-

iii) iv)

v)

vi) vii) viii)

-

ix)

A.1.7

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A.1.7.1. 1 A.1.7.1. 2 A.1.7.2 A.1.7.3 A.1.7.4 A.1.7.4

Drugs and Consumables for Normal Deliveries Drugs and Consumables for Caesarean Deliveries Diagnostic Blood Transfusion Diet (3 days for Normal Delivery) Diet (7 days for Caesarean) Diet for mother during the stay of sick children in hospital for five days Referral Transport For pregnant women

A.1.7.4 A.1.7.5

i) ii) iii)

Home to facility Drop Back faciliity Facility to Higher Facility Sub Total (JSSK) G.Total Maternal Health (Including JSY)

A.2 A.2.3 i) ii) A.2.4 i)

CHILD HEALTH Home Based Newborn Care/HBNC Printing of Guidelines for HBNC Printing of Guidelines for FBNC @ Rs. 100/Infant and Young Child Feeding/IYCF Prepare and disseminate guidelines for IYCF.(Breast Feeding

115

Awareness Week) Prepare detailed operational plan for care of sick children and severe malnutrition at FRUs, across districts ( cost of plan meeting should be kept). One time cost for establishing new NRC Operational cost for existing + new NRCs per year Infant Death Audit Infant Death verbal Autopsy by Dy.CMO/BMO@ 250/Incentive to community Based Volunteers for reporting infant Death@ 100/- per report ii) A.2.9 A.2.10 A.2.10. 1 A.2.10. 2 A.2.10. 3 Incentive to ASHA under child health (HBNC) JSSK(For Sick Neonates upto 30 days) Drugs & Consumables(Other than reflected in Procurement)@ Rs 200/= Diagnostics Free Referral Transport for Sick Neonates @ Rs. 250 Second Referral Level 3 MCH centres located within a distance of 50 to 100 Kms Level 3 MCH centres located within a distance of 100 to 200 Kms
-

A.2.5.1 i) ii) A.2.8 i)

i) ii)

116

iii) iv)

Level 3 MCH centres located within a distance of more than 200 kms Drop Back Facility for Sick Neo nates @ Rs. 250 Sub Total (Child Health) FAMILY PLANNING Orientation workshop and dissemination of manuals on FP standards & quality assurance of sterilisation services @ Rs. 2000/meeting Compensation Compensation for female sterilization @ Rs. 1000/- per case Compensation for NSV Acceptance @ Rs. 1500/- per case Organising Sterilization (Male) NSV camps (1/per district) @ Rs. 35000.00 per camp
-

A.3.1.1

A.3.1.4 A..3.1.4

A.3.1.3 Organising Sterilization (Female) (1/per district) camps @ Rs. 15000.00 per camp. Provide IUD services at health facilities / compensation Monitor progress, quality and utilisation of services (both terminal and spacing methods) including complications / deaths / failure cases. Performance reward Rs. 50000/per district , one in each of the Division
-

A.3.1.2 A.3.2.2. 1

A.3.5.1

A.3.5.2

117

A.3.5.2

Performance reward Rs. 25000/per Block , Two Block in each of the Division World Population fortnight celebration (such as mobility, IEC activities etc.): funds earmarked for district and block level activities Sub Total (Family Planning) ADOLESCENT REPRODUCTIVE AND SEXUAL HEALTH (ARSH) Establishment of new clinics at CHC/PHC level @100000/= i) Govt Hospital Sarwal, Jammu ii) CHC Akhnoor, Jammu iii) SDH Kupwara Operating expenses for existing clinics@20000/= Other strategies/activities (please specify)@50000/= Details of the Menstrual Hygiene project to be provided and budgeted under this head Sub Total (ARSH) School Health Programme One Day Workshop for orientation for capacity building of School teachers Financial Assistance for treatment of complicated diseases among childrens and adolescent under School Health Programme
-

A.3.5.3

A.4

A.4.1.3 A.4.1.3. 1
-

A.4.3

A.4.2

A.4.2

118

A.4.2.1

Prepare and disseminate guidelines for School Health Programme. Implementation of School Health Programme by districts. Screening Camps at PHC Level twice a year falling under Sabla Districts

A.4.2.3 Monitor progress and quality of services. (Mobility support) for Deputy CMO's as District Nodal Officers/per annum Printing of cards etc. under school health programme activities falling under Sabla Districts Sub Total (School Health) G.Total ARSH PNDT & Sex Ratio Orientation of programme managers and service providers on PC & PNDT Act at District Level Orientation of programme managers and service providers on PC & PNDT Act at Divisional Level @20000/=for Batch of 125 persons Reward to informer for giving information regarding unregistered ultrasound machine Reward to informers for intimating the illegal practice of sex selection and selective female foeticide Sub Total (PNDT & Sex Ratio) A.5 URBAN RCH
-

A.4.2.4

A.4.2.4
-

A.7.1.2

A.7.1.2

A.7.2

A.7.2

119

i) ii) iii) iv)

Urban RCH Services Rent for urban health post @ Rs.2000/month per UHP Hiring part time cleaner @ Rs.1000/per month per UHP Rent for urban health center @ Rs.12000 / month per UHC . ANM Urban Health Centre@ Rs. 10800.00/Month ( 3 per UHC) and Urban Health Posts ( 2 per UHP)

v) vi) vii) viii) Helper Urban Health Centre@ Rs. 6000/ month per UHC Link Worker Urban Health Centre Hon. Rs. 2000/ month per UHC Medical Officers Urban Health Centre ( 1 per Urban Center) Sub Total (Urban RCH) A.6 TRIBAL HEALTH Engagement of AMCHI Healers @9000/=PM (26 AMCHI Healers) District Hospital 2, CHC -7, PHCs- 15 Sub Total of Tribal Health Human Resource A.8.1.1 A.8.1.1 A.8.1.1 A.8.1.1 Additional ANM at S/C Staff Nurse at FRU Level Staff Nurse at PHC/CHC Level Staff Nurse at District Level
-

A.6.1.3

120

A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.2 A.8.1.3 A.8.1.5 A.8.1.5 A.8.1.5 A.8.1.5 A.8.1.6 A.8.1.9 A.8.1.9 A.8.1.9 A.8.1.9 A.8.1.9

OT Technicians at FRU Level OT Technicians at DH Level X- Ray Technicians at FRU Level X- Ray Technicians at CHC Level X- Ray Technicians at PHC Level X- Ray Technicians at DH Level Lab Technicians at PHC Level Lab Technicians at FRU Level Lab Technicians at CHC Level Lab Technicians at DH Level MMPHW Specialists MBBS Doctors at PHC level MBBS Doctors at CHC level MBBS Doctors at FRU level MBBS Doctors DH Incentive to Doctors Serving in Difficult Areas Sister Tutor Lady Councellor PHN AMT Schools Lady Councellor Staff for SNCU

121

A.8.1.9

Data Entry Operator for SNCU/HMIS/ARSH for all the 22 DH + 2 SMGS, Lal Ded (1 each) + 3 New ARSH Clinics Sub Total (HR)
-

A.10 A.10.2 A.10.2 A.10.2 A.10.2 A.10.2

PROGRAMME MANAGEMENT District Programme Manager @ Rs. 19800/-Month District Accounts Manager @ Rs. 15840/- Month District Monitoring & Evaluation Officer @ Rs. 13200 O.E. for District Health Socities Mobility of District Health Socities ( including DPMU) Sub Total (DPMU)
-

A.10.3 A.10.3 A.10.3 A.10.3

Block Accounts Managers Block M&E Officer O.E. For BPMU Mobility of Blocks ( including BPMU) Grand Total (BPMU)
-

A.10.6 A.10.6

Concurrent Audit Fee Tally ERP 9 Trainings Maternal Health Trainings Training of ISM doctors in SBA

A.9.3 A.9.3.1

122

A.9.3.1. 3 A.9.3.1. 4 A.9.3.2 A.9.3.3

Training of Staff Nurses in SBA Training of ANM/LHVs in SBA Training of Medical Officers in EmOC Training of Medical Officers in life saving Anaesthesia skills Safe abortion services training (including MVA/ EVA and Medical abortion) Training of laboratory technicians in RTI/STI Training of Medical Officers in RTI/STI Training of ANMs / LHVs in RTI/STI/SHP BEmOC training Other Maternal Health Trainings Orientation of CMOs/BMOs/Mos for implentation guidelines under MDR/IDR Training on Blood Transfusion MO and Lab Technicians Sub Total (Maternal Health Trainings) Child Health Trainings IMNCI Training for ANMs / LHVs (District level) F-IMNCI Training for Medical Officers, staff nurse and Nursing tutors F-IMNCI Training for Staff nurse
-

A.9.3.4 A.9.3.5. 2 A.9.3.5. 3 A.9.3.5. 5 A.9.3.6 A.9.3.7

A.9.3.7 A.9.3.7

A.9.5 A.9.5.1. 2 A.9.5.2. 2 A.9.5.2. 3

123

Other Child Health training A.9.5.5. 2 Training of staff of Nutritional Rehabilitatio Centre Sub Total (Child Health Trainings) Family Planning Trainings A.9.6.1. 2 A.9.6.2. 1 A.9.6.2 A.9.6.2. 1 A.9.6.3 A.9.6.4. 1 A.9.6.4. 2 A.9.6.6 A.9.6.6 Laparoscopic sterilisation training for doctors TOT on Minilap Minilap training for medical officers TOT on NSV NSV Training of medical officers in NSV camps TOT for IUD insertion Training of Medical officers in IUD insertion IUD insertion Kits Other Family Planning Trainings Sub Total (Family Planning Trainings) ARSH Orientation training of State and District Programme Managers@61500/= ARSH training for Medical Officers @69400/= ARSH training for ANMs / LHVs @83475/= ARSH training for AWWs
-

A.9.7.2 A.9.7.3 A.9.7.4 A.9.7.5

124

@150000/= Sub Total (ARSH) Programme Management Trainings Refresher training of State, Divisional , District and Block Accounts Manager under NRHM (Divisional level) Quarterly review meetings of Programme management unit (divisional/district/block) Training of DPMSU staff Training in Planning process fro DHAPs 2013-14 Other Trainings Training of vaccine handler in cold chain system Orientation training of ANM/LHV/Health Assistant/BEE in Immunization Orientation training of MO's in Immunization Workshop on Disaster Management Workshop on Quality Assurance Workshop on BioMedical Waste One day workshop for orientation of CMOs/BMOs/MO's regarding MDR/IDR guidelines implementation Workshop on Medicolegal Issue Sub Total (Programme Management Trainings)
-

A.9.8.1

A.9.8.1

A.9.8.2

A.9.9

i) ii) iii) iv) v)

vi) vii)

125

A.9.10. 2 i)

New Training Institutions/School PG Diploma in Health Management Training in Quality Assurance through AHA (Distant learning mode with 2 content programmes of one week each) @ Rs. 70000 per candidate inclusive of TA DA

ii) Orientation and Induction of MOs for Financial Management (Institute of Management and Public Adminstration Jammu/Srinagar) iii) iv) v) Training of Mos in Infection Control Programme Training of Staff Nurses in Infection Control Programme (New training) Capacity building of Supervisory Staff (CHO, health educator, LHV) for different programmes under NRHM Sub Total (New Training Institutions/School) Grand Total (Trainings) Activities which are not mentioned above (Plz specify the activity)
-

vi)

Grand Total (Flexipool) Mission Flexipool

126

B.1 B.1.1.1

ASHA Selection & Training of ASHA Training on HBNC for State Trainers (round 3rd) (7 participants) Training on HBNC for ASHA DRP (round 2nd ) (9 batches 25 participants per batch) Training of ASHA Facilitator Round 2nd (16 batches 30 participants per batch) Training of ASHA on HBNCRound 1 (part 1 & 2) (97 Batches 25 per batch) Training of ASHA on HBNC Round 2 (400 Batches 25 per batch) Procurement of ASHA Drug Kit Procurement of HBNC Kit for ASHA Incentive to ASHA for full ANC Incentive for registration of Births Incentive for registration of Deaths Incentive to ASHA for event reporting Incentive to ASHA for Roster duty at ASHA help desk @ Rs. 100 for 8 hours duty for 365 days (365X100X3) ASHA help desk cum rest room in 30 level 3 MCH facilities

i)

ii)
-

iii)

iv)

v) vi) vii) B.1.1.3 i) ii) iii)

iv) v)

127

Uniforms to ASHA (2 sets of uniform, I-card, 1 sweater, 1 shawl in high focus districts @ Rs.1000.00 vi) Uniforms to ASHA ( 2 sets of uniforms, 1 sweater and I-card in other districts @ Rs. 750.00) vii) viii) ASHA Diary Sub total ASHA Untied Funds B.2.1 CHCs Untied Fund for 3 Hospitals (Rajiv Gandhi Jammu, MGM Kathua and MCH Anantnag) B.2.1 B.2.2 B.2.2 B.2.3 B.2.3 B.2.4 PHCs ADs/New type PHCs Sub Centers MACs/ SCs VHSC Sub Total (Untied funds) B.3 B.3.1 Annual Maintenance Grants CHCs AMG for 3 Hospitals (Rajiv Gandhi Jammu, MGM Kathua and MCH Anantnag) B.3.1 B.3.2 B.3.2 B.3.3 PHCs ADs/New type PHCs Sub Centers
-

128

B.3.3

MACs/ SCs Sub Total (Annual Maintenance Grants) Hospital Strengthening

B.4.2 B.4.2 B.4.2 B.4.2 B.4.2

Blood Storage Centre (BSC) SNCUs Operational cost of SNCU Operational cost of Stabilazation Operational cost of NBCC Sub Total (Hospital Strengthening) Corpus grant to HMS/RKS District Hospitals RKS for Govt. Hospitals (Sarwal Hospital Jammu ) CHCs RKS for 3 Hospitals (Rajiv Gandhi Jammu, and MGM Kathua ) PHCs ADs/New type PHCs Sub Total (Corpus grant)
-

B.6 B.6.1 B.6.1 B.6.2 B.6.2 B.6.3 B.6.3

B.9 B.9.1 B.9.2 B.9.3

Mainstreaming of AYUSH AYUSH Doctors at PHC level AYUSH Dawasaaz at PHC level AYUSH Doctors at difficult area

129

Sub Total (AYUSH) IEC-BCC NRHM Display of four video spots on different NRHM components from 4 local cable networks 2 each cable @ Rs. 10000/- per month per cable per channel ( State Level) Display of 2 video spots on all components of NRHM on rotational basis from district cable networks in 20 districts @ Rs. 5000/- per district per month (excluding Leh and Kargil). Broadcast of video spots on NRHM components from Radio Kashmir Jammu and Srinagar in Hindi and Kashmiri @ Rs. 578043.00 per month for both stations ( State Level) Procurement and display of two hoardings per district @ Rs. 13000/each (one each for Maternal and Child Health activity) Procurement and display of Hoardings on National Highway from Lakhanpur to Leh ten each division @ Rs.13000 ( State Level) Production and procurement of video spots on NRHM components for display on local cable networks B.10.2.2 Organizing of symposium for female adolescents in high / higher secondary schools and colleges for 110 institutions @ Rs. 8000/- each 5 each districts

B.10.2.1

B.10.2.1

B.10.2.1

B.10.2.1

B.10.2.1
-

B.10.2.2

130

B.10.2.2

B.10.2.2

Organisation of Rallies, debates and seminars for schools / colleges @ 5 per district costing Rs. 10,000/each Issue of press advertisement in print media through Information Department (Lumpsum) ( State Level) Display of scroll with nine slogans from 4 cable networks of Jammu & Srinagar cities with atleast 30 displays per day @ Rs.8000/- per scroll per month. ( State Level) Organisation of District / Block Sammelans Printing of modules / brouchers in regional languages as per GoI guidelines (lumpsum) ( State Level)

B.10.5
-

B.10.5

B.10.5 Display and procurement of documentary films for DD Kendra / Cable network (lumpsum) ( State Level) Miscellaneous IEC / BCC activities (State Level) Sub Total (IEC-BCC) Mobile Medical Units (Including recurring expenditures) Recurring cost for 11 MMUs procured in the current year Sub Total (Mobile Medical Units) Planning, Implementation and Monitoring Quality Assurance
-

B.10.5 B.10.5

B.11 B.11

131

B.15.2

For completion of accrediation of ongoing hospital projects Sub Total (Qualilty Assurance)
-

B.15.3.2 i) ii) iii) iv) v) vi) vii)

Monitoring and Evaluation HMIS Fellows at Divisional level Mobility for M&E officers at state level Mobility for M&E officers at divisional level Mobility for M&E officers at district level Mobility for M&E officers at block level 1 Printer / Scanner / Projector for 22 Districts Internet connectivity State level Internet connectivity divisional level (one each for DNO, Div.MEO and Div.Acct.Mgr) Internet connectivity district level (One each for DPM, DMEO and DAM Internet connectivity block level (one each for BMEO and BAM) Internet connectivity SMGS/Lal Ded/ District Hospitals/sarwal hospital Annual Maintenance of equipments Operational Costs (consumables etc) Consumables at State level Consumables at Divsional level Other M & E

viii)

ix) x)

xi) xii)

i) ii) B.15.3.3

132

i)

ii)

iii)

iv)

v)

Printing of new registers approved by GoI Mobile charges for ANM at subcentres (Regular ANMs) for tracking of pregant women and children/mointoring & Rs 100/respctively per month) Reimbursement of Mobile user charges of ASHA @ Rs 100 per month Capity bulidings of CMOs / BMOs / DPMUs / BPMUs at Division level for re-orienation of HMIS and MCTS 14 batches (25 paticipants per batch) Capity bulidings of ANMs / LHVs / Staff Nurses at Block level for reorienation of HMIS and MCTS 116 batches (35 participants each batch) Ongoing review of MCH tracking activities (2 Review meeting to be held after 6 months for both the Divisions headed by Secreatry / Mission Director to review HMIS / MCTS in both the Divisions ) Sub Total of Planning Implementation and Monitoring PROCUREMENT Procurement of Equipment

vi)

B.16.1.2

Procurement of equipment: CH (NBCC @ Rs. 85000 X 50) Procurement of equipment: CH for strengthening of the paediatrics department SMGS hospital Jammu and GB Pant Hospital Srinagar (Training Centre) project submitted

B.16.1.2

133

B.16.2.1

Procurement of Drugs and supplies Drugs & supplies for MH Diagnostic kits/disposable syringes gloves/cotton/ anti spasmodic/ anti alergic tablets under RTI/STI Drug Kit 1 to 7 Drugs & supplies for CH IFA tablets to students of primary schools IFA tablets to students and teachers School Health Deworming tablets under School Health Iron Folic under SABLA Scheme Deworming tablets under SABLA Scheme Drugs & supplies for FP IUD Insertion Kits Minilap Sets Drugs for AMCHI Procurment of medicines for AMCHI at PHC level @ Rs. 25000 per annum Procurment of medicines for AMCHI at CHC level @ Rs. 75000 per annum Procurment of medicines for AMCHI at district hospital @ Rs. 100000 per annum Sub Total (PROCUREMENT) Research, Studies, Analysis

B.16.2.1 B.16.2.1 B.16.2.2 i) ii) iii) iv) v) B.16.2.3 i) ii)

iii)

iv)

v)

B.20

134

B.20

Evaluation study of components of NRHM through NHSRC Sub Total (Research, Studies) Activities which are not mentioned above (Plz specify the activity)

Grand Total (Mission Flexipool)

Immunization C.1.a C.1.b Mobility Support for supervision for district level officers. Mobility support for supervision at State level 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

C.1.c C.1.d

C.1.e C.1.e C.1.g

135

C.1.h C.1.i C.1.j C.1.k

Mobilization of children through ASHA or other mobilizers (Rs 150/per session for 9 sessions) 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 (Rs 1000/- per block/PHC and Rs 2000/- per district) POL for vaccine delivery from State to district and from district to PHC/CHCs (Rs 1.00 Lakh /year/district) Consumables for computer including provision for internet access for RIMs (Rs 400/-month/distt) Red/Black plastic bags etc. Hub Cutter/Bleach/Hypochlorite solution/ Twin bucket Teeka Express (Operational Cost) Computer Assistants support for State level (Rs 12000/ per month) Computer Assistants support for District level (Rs 10800/- per month)

C.1.l

C.1.m

C.1.n C.1.o C.1.p C.1.s C.2.a

C.2.b

136

C.3.a

Three day training including Hep B, Measles & JE(wherever required) of Medical Officers of RI using revised MO training module) One day cold chain handlers traning for block level cold chain hadlers by State and district cold chain officers Cold chain maintenance ASHA incentive for full Immunization (Rs 100/- for 1st year of life & Rs 50/- for 2nd year) Total (Immunization)
-

C.3.d C.4

C.5

Pulse Polio Operational cost Bank Interest (DHS) Bank Interest (Blocks/ other agencies) other Disease Control Programmes

Grand Total (A+B+C+PPI+Others+DCP)

137

List of Officers/ officials working in the State Health Society / State Programme Management Unit S. No 1 Name and Designation of Key Strategies / Functions of unit the Officer Mission Director Dr.Yashpal Sharma, 94191-80709 mdnrhmjk@gmail.com Joint Director (P&S) Mrs. Satvir Kour 94191-83118 jdpnrhm@gmail.com FA&CAO Sh. Rajesh Talwar 94191-41294 fmgjammukashmir@gmail.com 1. Delivery Points / MCH Centres. Programme Manager: Dr. Harjeet Rai, Divisional 2. JSY Nodal Officer, 3. ASHA Component Jammu (M). 9419134458 4. JSSK dnonrhmjammu@gmail.co 5. MDR m 6. Referral Transport 7. Safe Abortion Services. Dr. Asmat Jan (Facilitator) 8. Supervision of work of District Monitors of Jammu Associate Programme Maternal Health Division, timely submission of Manager: pmmhnrhmjk@gmail.com their reports and follow up Dr. Rohit Abrol actions on their reports/ (M). 9419155351 recommendations 9. IEC / BCC 10. M&E. Dr. Asmat Jan will look after the Maternal Health Programme including all components from serial no. 1 to 10. 1. Child Health. Programme Manager: Dr. Mushtaq Ahmed Dar, 2. Immunization Divisional Nodal Officer, 3. HBNC / FBNC Kashmir 4. NRC (M) 94194-41180 5. IDR Child Health dnokashmir@gmail.com 6. IYCF pmchnrhmjk@gmail.com 7. SNCUs / Stab. Units / Baby Associate Programme Care Corners. Manager: 8. Supervision of work of District Dr. Younis Mushtaq Monitors of Kashmir Division, (M) 9018948862 138 Unit

S. No

Unit

Name and Designation of the Officer

Key Strategies / Functions of unit timely submission of their reports and follow up actions on their reports/ recommendations 9. IEC / BCC 10. M&E. 1. ARSH 2. School Health 3. RTI / STI 4. Menstrual Hygiene 5. Gender Equity. 6. IEC / BCC 7. M & E. 8. Review Meeting of J&K Rural Health Mission, Governing Body, Executive Committee & High level Monitoring Committee for IMR, Monthly Review Meetings by HHM and Preparation of action taken report thereof. 1. MNGO Scheme 2. Family Planning 3. PC&PNDT 4. IEC / BCC 5. M & E 1. Administrative matters pertaining to training. 2. Organizing and managing all types of trainings after getting inputs from concerned division. 3. Generation of Data base for State and District level trainings. 4. IEC/BCC 5. M & E. 1. RNTCP 2. NVBDCP 3. NLEP 4. NIDDCP 5. NCD 6. NPCB 7. Review of monthly District level meetings and monitoring 139

Adolescent and School Health pmarshnrhmjk@gmail.com

Programme Manager: Dr. Manoj Bhagat (M) 94191-15413 drmanojbhagat@gmail.com Associate Programme Manager: Dr. Meenakshi Verma (M) 9697124144

Programme Manager: Dr. B.B. Sharma, Family Planning and (M) 94191-85245 PC&PNDT Assistant: pmpcpndtnrhmjk@gmail.com Mr. Sumit Khajuria, Law Officer Programme Manager: Dr. Robinder Khajuria, (M) 9419149925 Assistant: Trainings Mr. Rakesh Sharma, pmtrgnrhmjk@gmail.com DMEIO

National Disease Control Programme pmndcdnrhmjk@gmail.com

Programme Manager: Dr. Dhruv Ji Raina (M) 9419144066

S. No

Unit

Name and Designation of the Officer

Key Strategies / Functions of unit and vigilance Committees of Jammu Division. 8. IEC/BCC 9. M & E.

Programme Manager: Dr. Kewal Krishan Pandita (M) 94197-81592 National Disease Control Programme & Bio Medical Waste Management pmbmwmnrhmjk@gmail.com

10

1. 2. 3. 4. 5. 6. 7.

Biomedical Waste IDSP Mental Health NPPCF IEC/BCC M & E. RNTCP, NVDCP, NLEP, NIDDCP, NCD, NPCB for Kashmir Division 8. Review of monthly District level meetings and monitoring and vigilance Committees of Kashmir Division. 1. 2. 3. 4. 5. 6. Tribal RCH Mainstreaming of AYUSH. Urban RCH IEC/BCC M&E. Adoloscent and School Health Programme in respect of Kashmir Division Health Management Information System (HMIS) Mother and Child Tracking System (MCTS) Preparation of Data base of all other Programmes in both the divisions and regular feedback to various Units. IEC/BCC M&E. In addition to above Assistant Programme Manage will look after Trainings and Quality Assurance in respect of Kashmir Division.

Tribal & Urban RCH / Mainstreaming of AYUSH pmrchnrhmjk@gmail.com 11

Programme Manager: Dr. Farooq Iqbal (M) 9596391445

Programme Managers Mr. Misba-ul-Hassan, State Programme Manager (M) 9906573180, Mr. Kapil Ghai, State M&E Officer (M) 9419183592 12 HMIS / MCTS pmmctsnrhmjk@gmail.com Assistant Programme Manager Mr. Junaid Ahmed Zaroo Assistants Assistant M&E Officer. HMIS Fellows.

1. 2. 3.

4. 5.

140

S. No

Unit Quality Assurance / Blood Banks pmqabbnrhmjk@gmail.com

13

Name and Designation of the Officer Programme Manager: Dr. T.R Raina (M) 9419132100 Programme Manager: Sh. A.U.Bhatt (IEC Consultant) (M) 94191-92632 Assistant: Sh. Sadiq Khan, DMEIO

Key Strategies / Functions of unit 1. Quality Assurance 2. Strengthening of Blood Bank / Units / Laboratories. 3. IEC/BCC 4. M & E. 1. IEC/BCC 2. M & E.

IEC/BCC 14 pmiecnrhmjk@gmail.com

141