meghalaya npcc 08 09 pip

8/8/2019 Meghalaya NPCC 08 09 PIP

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M E G H A L A Y A

State Implementation Plan

Revised - 2008-09

NPCC Meeting_25/03/08

Government of MeghalayaShillong


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M E G H A L A Y A


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M E G H A L A Y ARCH II GOAL

MEGHALAYA STATE

Current status

(specify year & source)

Target

08-09 09-10

MMR 450 (MIS 2005-06) 400 < 100

IMR 53 (2006 SRS) < 40 < 30

TFR 3.8 (NFHS 3) 3.5 2.1


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M E G H A L A Y ABACKGROUND (2001 Census)

Population of 232 Lakhs

7 Districts

10 Sub Division

39 Community Development Blocks

Population Density is 103 person/Sq.M

Rural Population is 80.4 %

6180 Villages

literacy is 62.6 %


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M E G H A L A Y APlanning Process

Capacity building workshop was held for the state programme officer atGuwahati on 22 to 27 October 2007 regarding planning process.

Similar capacity building workshop with MOs and Programme Manager of all7 districts was held for a week from 26thNovember to 1st December 2007

at Shillong with support from RRC, Guwahati and NHSRC Delhi.

Followed by it was a meeting with the BLOCK CORE GROUPS who werealso involved in the planning process during 2006-07 and the newly

appointedBPMUs. All block plans are available.

At district level the block plans were collated by the District Core Group andthe trained MO on planning process, so that the district plans were made.

State plan is compilation of all the district plans and block plans.


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M E G H A L A Y A

Percentage of children who are given ORS indiarrhoea is 67.7 (NFHS 3). Target revised

2008-2009 70%

2009-2010 75%

2010-2011 85%

2011-2012 95%


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M E G H A L A Y A

RCH Technical Strategies

Part A


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M E G H A L A Y AMaternal Health

Objective: Increase coverage of 3 ANC from 53.4% (NFHS-3) to 75%.

Strategy: Increase accessibility of services at various level.

Activities:

1. Renovation of SCs/PHCs/CHCs.

2. Focus on 38316 VHN Days (3193 AWC*12=38316)

3. Incentives of Rs. 20/- to ASHA per VHN Days.4. Fixed ANC/PNC days in all PHCs & everyday at CHCs

and DHs.


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M E G H A L A Y A

Maternal HealthStrategy: EnsureANC registration in inaccessible and

uncovered areas.

Name of the Sub Centres with difficult area is providedin PIP where the 60 outreach camps will be held.

Strategy: Increase accessibility through institutional

strengthening.

18 PHCs are proposed for 24x7 in 08-09, 8 are already

functioning as 24x7.

POL for ambulances for 24x7 PHCs is budgeted.


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M E G H A L A Y A

Strategy: Promotion of institutional deliveries through cash

incentives by promoting JSY scheme.

Activities:

Monitoring of JSY

Listing of beneficiaries outside PHC/CHC

Monitoring quality of deliveries at Public Health Facilities

Accreditation and monitoring of private facilities are in process

2 days stay after delivery is instituted in PHC and other facilities

Maternal Health


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M E G H A L A Y A

BREAK UP OF INSTITUTIONAL AND HOME

DELIVERIES IN 07-08

Delivery Place Number % Number ofBeneficiary

Payment

Home 36, 671 62 1, 073 5, 36, 500

Institution 22, 899 38 4, 385 36, 99, 500

Total 59, 570 100 5, 458 42, 36, 000

Maternal Health


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M E G H A L A Y A

ESTIMATE CAPACITY FOR INSTITUTIONAL

DELIVERIES IN 08-09.

Delivery Place Number % Number ofBeneficiary

Payment

Home 50, 870 70 16, 278 x 500 90, 68, 800

Institution 21, 801 30 6, 976 x 1300 81, 39, 000

Total 72, 671 100 23, 254 1, 72, 07, 800

Maternal Health


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M E G H A L A Y A

PLAN FOR CAPACITY AUGMENTATION FOR JSYIN 08-09

Increase 3 ANC coverage to 75%

Ensure ANC registration in inaccessible and uncoveredareas.

Increase institutional deliveries to 50%.

26 PHCs to function as 24x7

Strengthening referral transport

Training of SN/ANM on skilled deliveries

Maternal Health


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M E G H A L A Y A

PLAN FOR CAPACITY AUGMENTATION FOR JSY IN 08-09

Promotion of JSY

EmOC at 5 CHC and 3 DH

Multi Skilling of MOs Recruitment of specialists

Incentives to medical officer and specialists

Upgrading facilities to IPH standard.

AmbulancesBlood storage to be operationalized

Monitoring quality of facilities conducting deliveries

Maternal Health


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M E G H A L A Y A

STEPS FOR OPERATIONALISATION OF FRUs

Training of MOs in Obstetric and Anesthesia outside state.

Provision of incentives to specialists

Provision of incentives to MO undergoing multi skilling training

Recruitment of specialists on contract basis

Increase coverage forANC and PNC will reduced complicationsand will lead to timely referrals.

Availability of specialist as criteria for operationalisation of FRUs. Incentives of Rs. 5000/- p.m. to MOs undergoing multi skill

training. 2 MOs from 1st quarter, 6 from 2nd, 6 more from 3rd

quarter and 6 more from 4th quarter, total of 20 doctors in 08-09.

Maternal Health


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M E G H A L A Y A

STATUS OF FRUS DURING 2007-08.

FRU Obstetrician Anesthesia Pediatrician Blood Storage

System

Umsning Yes No Yes

Nongpoh Yes Yes Yes Is being installed

William

Nagar

Yes Yes No

Khliehriat Yes No Yes

Mairang Yes No Yes

Phulbari No No No

Maternal Health


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M E G H A L A Y A

Orientation Of Trained TBAs In 20% Inaccessible Areas.

Activities Number Rate Budget

TA for Dais 1236 200 2, 47, 200

Stay for 5 days at CHCs 1236 1000 12, 36, 000

Training material cost 1236 100 1, 23, 600

Kit Cost 1236 150 1, 85, 400

Honorarium to trainers at 20

CHCs

20 500 10, 000

Total Budget for Dai

Training

18, 02, 200

Maternal Health


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M E G H A L A Y A

Maternal Health

Anemia among women is addressed in objective 6. 1. 1. 5.


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M E G H A L A Y AMH O 9 To increase the coverage of PNC

from 28. 8% (NFHS-3) to 50%.

S 1 Increase accessibility

of PNC services

A1: Repair and renovation ofSCs/PHCs/CHCs andDHs.

A2: Construction of new SCs

A3: Focus on PNC duringVHN days at AWC.

A4: Recruitment of new

ANMs.A5: Fixed PNC days will be

held in all PHCs/CHCsand DHs.


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from 28. 8% (NFHS-3) to 50%.

S 2 Increase PNC at

inaccessible and

uncovered areas.

A1: 1410 MSS to spreadawareness on post natalcare.

A2:Additional MSS to beformed.

A3: Mobility support forANMs per SCs.

A4: Outreach camps atuncovered and undercovered areas.


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from 28. 8% (NFHS-3) to 50%.

S 3 Increase awareness

among mothers and

community about need ofPNC services.

A1:ANMS,ASHAs andAWWs will engage incounselling for PNC.

A2: Follow up of deliveriesand referral follow up will

be ensured byANMs andASHAs.

A3: Communication materialon PNC.


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from 28. 8% (NFHS-3) to 50%.

S 4 Ensure PNC and Post

Partum Care.

A1: PHC & CHC will beupgraded as per IPHstandard.

A2: Staff to be trained inPNC care, referral and PPservices.


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M E G H A L A Y A

Child Health


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M E G H A L A Y AChild HealthObjective 6. 1. 2.(i) 2. Promote exclusive breastfeeding.

Adequate emphasis will be given to 5 districts with low

coverage particularly in Jaintia Hills andWest Khasi Hills.

Objective 6. 1. 2 (i). 5. Improve the coverage of vitamin A

Vitamin A will be administered during VHN Days.

Objective 6. 1. 2 (i). 6. Increase use of ORS among children

with diarrhoea.


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M E G H A L A Y AChild HealthObjective 6. 1. 2.(i) 7.Address underweight children and

assess children for nutritional problem.

S 1- ensure routine check

up of children for bothweight and height for age

A1: assess height and weight of

children below 5 years.A2: underweight child to get

supplementary food from ICDS.

A3:ASHA andANM will

promote child nutrition throughVHN Days.

A4: IEC/BCC on child nutrition


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M E G H A L A Y A

Family Planning


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M E G H A L A Y AFP O 2 To reduce TFR from current 3.8

(NFHS 3) to 3.4 by 2010.

S 3 Organize

contraceptive update

workshop anddissemination of manuals.

A1: One day state levelworkshop oncontraceptive updates and

emergency contraceptive.

A2: Guidelines, manuals willbe disseminated to allfacilities till SC level.


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M E G H A L A Y AFP O 2 To reduce TFR from current 3.8

(NFHS 3) to 3.4 by 2010.

S 4 Enhance capacity of

facilities for taking family

planning activities.

A1: QualityAssuranceCommittee will be formed atdistrict level.

A2: Promotion of contraceptivesby GoM through change indirectives and SO.

A3: Training of manpower inmini laparoscopic surgery

and IUD insertion.A4: Provision of compensation

to people for tubectomies andNSV


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M E G H A L A Y A

FP BUDGET

Activities Rate Budget

Compensation @ Rs. 1500

per sterilization for 2500cases.

37, 50, 000

Total budget 37, 50, 000


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M E G H A L A Y A

Adolescent Reproductive Health


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M E G H A L A Y A

5 days training of adolescent boys and girls need no budget.ASHA/AWW can undertake training atAWC/School.

Similarly follow up training need no budget.

Adolescent clinics are already part of regular clinics at DH. So there is

no additional budget requirement.

75 MOs and 472ANMs will be trained in ARSH.

Orientation of VHSC on adolescent issues can be done during regular

meetings.


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M E G H A L A Y A

Quality Assurance, Monitoring andEvaluation


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M E G H A L A Y A

QUALITY ASSURANCE COMMITTEE ATSTATE

(MD- NRHM, SPM, Consultant MCH&FP,

Consultant HMIS, DHS (MCH&FW), member of

RKS.

QUALITYASSURANCE COMMITTEE AT

DISTRICT

(DHMO, Monitoring officer, DPM, DHE, Member of

RKS)

QUALITYASSURANCE COMMITTEE AT

BLOCK

(MO I/c CHC, BPM, and member of RKS)


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M E G H A L A Y A

Training Plan


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M E G H A L A Y A

Training by skill category, volume, duration and location isprovided in PIP.

Existing MO I/c training will be the nodal person to manage and

coordinate all training in state and will assist the MD NRHM.

Over period till 2011 the SIHFW will be strengthened to undertake

skill based training and will be the nodal agency for planning,

conducting, managing and organizing all state level training.

Training on RTI/STI for 75 MOs is proposed.


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M E G H A L A Y AB

U

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F

RCH -II

S.No

Interventions Amount

1 Maternal Health 1, 23, 74, 800

2 Janani Surakhsha Yojana (JSY) 1, 80, 95, 800

3 Child Health 13, 20, 000

4 School Health 83, 90, 000

5 Family Planning 37, 50, 000

6 Adolescent Reproductive Health 36, 51, 000

7 Urban Reproductive Health (URCH) 1, 29, 58, 000

8 Gender and PNDT/Sex Ratio 5, 24, 000

9 Mother NGO Scheme 42, 00, 000

Continues in next page


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M E G H A L A Y AS. No Interventions Amount

10 Infrastructure and Human Resource 2, 23, 28, 400

11 Behaviour Change Communication 1, 39, 78, 000

12 Infection Management & Env. Plan 16, 90, 000

13 QualityAssurance, Monitoring &

Evaluation Cell

1, 87, 08, 000

14 Strengthening of Training Institute 7, 28, 000

15 Central Training Plan 88, 68, 192

16 Programme Management Support

Unit (PMSU)

64, 14, 000

TOTAL RCH II BUDGET 13, 79, 82, 082

B

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RCH -II


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M E G H A L A Y A

Unspent amount

as on Dec 2008

Liabilities till

March 2008

Total unspent

balance 07-08

10, 28, 27, 771.99 3, 37, 63, 930.45 6, 90, 63, 841.54

Total

Requirement

Unspent Balance Net Requirement

13, 79, 82, 082 6, 90, 63, 841.54 6, 89, 18, 240.46

B

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RCH -II


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M E G H A L A Y AAnnexure 3 a

Annexure 3 b

Annexure 3 c

Annexure 3 d

Annexure 3 e

Annexure 3 f


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M E G H A L A Y A

Part B: NRHM Initiatives


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M E G H A L A Y A

VHSC Total 4102 VHSC constituted and untied fund has been

released.

Post office option for saving account or other sources will

be explored.


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M E G H A L A Y A

Sub Centres Post office option for saving account or other sources will

be explored.

Procurement of haemoglobinometers for each 401 SCs @

Rs. 600/-


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M E G H A L A Y A

Primary Health Centres Burial pits proposed last year were made.

Procurement of 10 ambulances is proposed.

POL and maintenance for ambulances budgeted @ Rs.

6000/- per month for 20 ambulances.


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M E G H A L A Y ABurial Pits All burial pits proposed last year were made at PHC, CHC

and District Hospital

Strengthening the logistics DrugWarehouse

Transportation cost from State HQ to Districts will be fromstate pool.

Salary of staff in warehouse needed as they will operate

from rented warehouse.

Rent of state warehouse @ Rs. 25, 000/- per monthproposed.

Emergency generator @ 8, 00, 000/- plus POL for

generator @ Rs. 180000 for whole year.


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M E G H A L A Y AStrengthening RIHFW Driver will be made available from state pool.

Specialized care by NEIGRIHMS

2 PHC of diengpasoh and Mawphlang will act as ruralunits for NEIGRIHMS.


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M E G H A L A Y A

New Initiatives

Mobile phone forANMs is removed.

Household cards for records is also removed

Mobility for cold chain mechanic is budgeted under UIP.


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M E G H A L A Y AB

U

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ET

S

U

MM

A

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Y

OF

NRHM

S.No Interventions Amount

1 ASHAs 61969270

2 VHSCs 61800000

3 Sub Centres 27469840

4 Primary Health Centres 146267000

5 Community Health Centres 42643177

6 District Hospitals 93057000

7 Procurement of essential drugs 52700000

8 Strengthening the logistics 25243004

9 Health Mela 3500000



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10 Operationalize MMU 542500011 Private Public Partnership 700000

12 Mainstreaming of Ayush 10140000

13 Training of ICD 10 661835

14 Strengthening of RHFW

TC 515939415 Incentives to MOs 2009700

16 Specialized services by NEIGRIHMS 3348990

Sub Total 54, 20, 94, 210

B

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NRHM



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17 Renovation of TB Hospital 1902210018 National Programme on Prevention &

Control of Deafness (NPPCD)

4000000

19 Strengthening of BMPUs 11232000

20 PHCAccountant 13312000

21 Engineering Cell 1440000

22 StateAccounts Manager 144000

23 Manpower at Mission Directorate 408000

24 Mobility fund and office expenses 6200000

25 Strengthening Immunization

Programme

588000

26 Salary toASHA consultant 240000

Sub Total 5, 65, 86, 100

Grand Total (542094210+56586100) 59, 86, 80, 310

B

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ET

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OF

NRHM


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M E G H A L A Y A

Unspent amount

as on Dec 2008

Liabilities till

March 2008

Total unspent

balance 07-08

31, 22, 60, 328 7, 02, 10, 569 24, 20, 49, 759

Total

Requirement

Unspent Balance Net Requirement

59, 86, 80, 310 24, 20, 49, 759 35, 66, 30, 551

B

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ET

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NRHM


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M E G H A L A Y A

Part C: Immunization

Universal Immunization Programme

+ Intensive Pulse Polio Immunization


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M E G H A L A Y A

AEFI Committee at State & District

Committee formation and training on AEFI surveillance

is under process.

Budget for Immunization

3, 44, 52, 225


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M E G H A L A Y AIDSP

ICU ward and Vehicle proposed is removed

Budget

1, 10, 42, 070


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M E G H A L A Y ARNTCP

Budget

2, 35, 43, 554


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M E G H A L A Y ANIDDCP

ASHA incentives removed

Training cost removed

Budget

38, 00, 000


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M E G H A L A Y ANLEP

Budget

58, 85, 000


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M E G H A L A Y A

NPPCB

2, 67, 00, 000

Budget


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M E G H A L A Y A

NVBDCB

3, 01, 70, 614

Budget

B


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1 Integrated Disease SurveillanceProgramme (IDSP)

1, 10, 42, 070

2 Revised National Tuberculosis

Control Programme (RNTCP)

2, 35, 43, 554

3 National Iodine Deficiency Disorder

Control Programme (NIDDCP)

38, 00, 000

4 National Leprosy Eradication

Programme (NLEP)

58, 85, 000

5 National Program for Prevention and

Control ofBlindness (NPPCB)

2, 67, 00, 000

6 National Vector Born Disease Control

Programme (NVBDCP)

3, 01, 70, 614

Total of disease control programme 10, 11, 41, 238

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DCP


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M E G H A L A Y A

Part E: Intersectoral Convergence

Budget44, 80, 000


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M E G H A L A Y A

Total Budget for Meghalaya

A. RCH II 13, 79, 82, 082 15.74

B. NRHM Initiatives 59, 86, 80, 310 68.29

C. Immunization (UIP +

IPPI)

3, 44, 52, 225 3.93

D. NDCP 10, 11, 41, 238 11.54

E. Intersectoral

Convergence

44, 80, 000 0.51

Total Budget for Meghalaya 87, 67, 35, 855 100.00


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M E G H A L A Y A

Part Amount Available 2007-08 Expenditure

NRHM 47, 68, 17, 660 16, 45, 57, 332

RCH 13, 75, 90, 344 3, 18, 43, 205

UIP 1, 31, 47, 342 82, 03, 323

meghalaya npcc 08 09 pip

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