Family welfare plan of Odisha state of India - ICOMP

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M.P.H.W.(Male) Training School. 3. Nursing College B.Sc. 1. D. Pharmacy College. 3. Lab Technician Training Centers. 3. Radiographer Training Institutes. 3.
Family  Welfare  Plan  of   Odisha  State  of  India      

 

Chapter  -­‐  4   DETAILED  FAMILY  PLANNING  BUDGET:    2011-­‐  12   Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter   Q-­‐II  

Q-­‐III  

Q-­‐IV  

 Financial  target  for  the  quarter     Total   Target  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

Remarks    

 Amount   (Rs.  Lakhs)    

   

A3.            FAMILY  PLANNING   A3.1  

Terminal/Limiting  Methods  

   

   

A3.1.1  

Dissemination  of  manuals  on   sterilization  standards  &  quality   assurance  of  sterilization  services     Orientation  of  Programme  Officers   (ADMOs-­‐FW,  DPMs  &  RCH   Coordinators)  at  State  level   Orientation  workshop  at  District   level  for  Block  MO  I/C,  empanelled   operating  surgeons  including  that   of  accredited  institutions   Quarterly  Female  Sterilization   Camps  to  address  backlogs  -­‐  one   camp  per  qtr  per  district  in  the  low   performing  zone   NSV  camp  -­‐  one  camp  per  qtr  per   district  in  10  districts  (  Koraput,   Rayagada,  Malkangiri,   Nabarangpur,  Kalahandi,  Nuapada,   Bolangir,  Sonepur,  Mayurbhanj   and  Kandhamal)   Compensation  for  Female   sterilization     Compensation  for  Male   sterilization     Total  of  Sterilization   Budget  for  Sterilization  (85%  of   Total  Sterilization  Budget)  

   

   

Per  Work   Shop    

   

Per  Work   Shop    per   district  

   

Per  camp   per   quarter  

A3.1.1.1  

A3.1.1.2  

A3.1.2  

A3.1.3  

A3.1.4   A3.1.5          

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

              1   100,000    

   

   

   

1  

                      1.00    

                            -­‐        

                                                                                        -­‐         -­‐         1.00    

                  30   15,000    

   

   

   

30  

                      4.50    

                            -­‐        

                                                                                        -­‐         -­‐         4.50    

   

                  30   15,000    

30  

30  

30  

120  

                      4.50    

                      4.50    

                                                  4.50     4.50    

                      18.00    

Per  camp   per   quarter  

   

                  10   35,000    

10  

10  

10  

40  

                      3.50    

                      3.50    

                                                  3.50     3.50    

                          14.00    

Per   Beneficiary   Per   Beneficiary          

   

           1,000     38900  

38900  

38900  

38926  

155626  

   389.00    

1,556.26    

   

   

           1,500    

5300  

5300  

5300  

5320  

21220  

   

       

       

       

       

       

       

       

                                                                                                  79.50     79.50     79.50     79.80     318.30     468.50     468.50     468.50     469.06     1,874.56                                                                                   398.23     398.23     398.23     398.70     1,593.38    

   

389.00    

389.00    

389.26    

       

   

    Based  on  the   previous  year  trend   (last  year  coverage   was  85%)  

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

   

   

   

   

Per  block  

   

   

               

               

               

Per   beneficiary  

   

Per  case  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter  

 Financial  target  for  the  quarter    

Remarks    

Q-­‐III  

Q-­‐IV  

Total   Target  

   

   

   

   

94  

   

   

   

94  

               

               

               

               

               

     20    

39790  

39790  

39790  

39790  

159160  

7.96    

7.96    

7.96    

7.96    

31.83    

Budgeted  for  80%   beneficiaries  

   

     100    

1990  

1990  

1990  

1990  

7960  

1.99    

1.99    

1.99    

         1.99    

7.96    

Per  case  

   

     75    

   

3315  

3315  

3315  

9945  

-­‐        

2.49    

2.49    

2.49    

7.46    

Budgeted  for  5%  of   159160   beneficiaries   Budgeted  for  5%   beneficiaries  

   

   

   

   

   

   

   

   

   

   

   

   

   

Q-­‐II  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

   

   

   

   

 Amount   (Rs.  Lakhs)    

    A3.1.6  

Accreditation  of  private  providers   for  sterilization  services   A3.1.6.1   Accreditation  of  private   institutions  for  Inst.  Del.  &  FP   services  -­‐  Mobility  support  to  the   appraisal  team     Sub-­‐total  A3.1  (excluding  Sterilization  &  NSV)   A3.2   Spacing  Methods   A3.2.1   IUD  Camps   A3.2.2   IUD  services  at  health  facilities/   compensation   A3.2.2.1   For  Beneficiary  (to  be  utilized  to   meet  essential  requirements  on   IUD  services  at  institution  level)   A3.2.2.2   Incentive  to  ASHA  for  ensuring   retention  of  IUD  by  plants  for  1yr     A3.2.3  

A3.2.4   A3.2.4.1  

A3.2.4.2  

A3.3   A3.3.1   A3.3.2   A3.3.3  

Incentive  to  private  accredited   institutions  for  IUD  insertion   services   Social  Marketing  of   contraceptives   One  Day  Contraceptive  update  &   family  planning  guideline  trg.  for   MOs  (District)     Contraceptive  update  Trg.  To   Paramedics  (SN,  LHV,  HWF,  HWM,   HSM)  per  Dist.  One  batch  at   District  level   Sub-­‐total  A3.2   POL  for  FP/Others  -­‐  Trasportation   of  FW  materials   State  to  district   District  to  Block   Block  to  Sector    

                                                          -­‐         -­‐        

9.00                

4.50                

   

                                                                                             -­‐         -­‐         -­‐        

4.50                

4.50                

23.50                

30/batch  

440  

41,025    

5  

5  

5  

3  

18  

   

   

   

   

                               -­‐        

30/batch  

NIL  

 36,525    

5  

5  

10  

10  

30  

   

   

   

   

                               -­‐        

       

       

       

       

       

       

       

       

9.95        

           

           

           

           

           

           

           

           

           

12.43                    

12.43                    

12.43                    

47.25                    

    30%  blocks  having   private  institutions.   Budget  under  Inst.   Strgh.  

               

     Budget  under   training    

        Budget  under  Reg.   Drug  WH  (NRHM   Int.)   State-­‐B21.1.2,  Dist-­‐ B21.2.4  &  Block-­‐

31

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

Physical  Target  for  the  quarter  

 Rate   (Rs./unit)       Q-­‐I  

Q-­‐II  

Q-­‐III  

 Financial  target  for  the  quarter     Total   Target  

Q-­‐IV  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

   

B21.3.4  

A3.4  

Repair  of  laprascopes  

   

   

   

   

   

   

   

   

   

A3.5  

Sub-­‐total  A3.3  &  A3.4   Other  strategies/activities      

       

       

       

       

       

       

       

       

       -­‐            

Strengthening  of  Family  Welfare   Bureau  for  quality   implementation  of  family   planning  program     At  State  level   Manpower     Mobility  cost  for  supportive   supervision   Operational  cost   At  District  level   Manpower    

   

   

   

   

   

   

   

   

   

        Per  month  

           

   

Per  month          

           

                          20,000     10,000            

   

   

   

Per  district   per  month  

   

2,500    

   

   

   

   

A3.5.1  

A3.5.1.1   A3.5.1.1.1   A3.5.1.1.2   A3.5.1.1.3  

A3.5.1.2   A3.5.1.2.1  

A3.5.1.2.2   A3.5.1.2.3  

A3.5.2   A3.5.2.1  

A3.5.2.2  

Mobility  cost  for  supportive   supervision   Operational  cost  for  Dist.  FW   Bureau  for  meeting  exp.,   reporting,  internet,  telephone,   postage  etc.   Operationalization  of  fixed  day   static  services-­‐Family  welfare  day   Mapping  of  availability  of  skilled   human  resources,  regularly   updating  empanel  of  doctors  and   orientation  at  district  level   Minilap  training  for  MO  (Asst   Surgeon  of  L3  &  L2):  twelve   working  days  at  District  level  

3/batch  

154  

   

Remarks    

 Amount   (Rs.  Lakhs)    

   

   

    -­‐        

   

    -­‐        

    -­‐        

   

   

   

   

   

   

   

   

   

   

State  Eqp.  Maint.   Unit  to  look  into    

                               -­‐                    

   

   

       

       

       

       

           

       

       

       

       

        Funded  by  UNFPA                                      -­‐         Budget  under  Prog.  

           

           

           

           

           

           

           

           

           

                               -­‐                

   

   

   

   

   

   

   

   

   

Mgt.  

   

    RCH  Coordinator   will  be  given   additional   responsibility   Budget  under  Prog.   Mgt.  

30  

30  

30  

30  

30  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

To  be  updated  in   regular  monthly   meeting  

   

10  

10  

10  

30  

   

   

   

   

32,580    

                               -­‐        

                               -­‐          Budget  under   training    

32

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter   Q-­‐II  

 Financial  target  for  the  quarter    

Q-­‐III  

Q-­‐IV  

Total   Target  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

 Amount   (Rs.  Lakhs)    

Remarks    

    A3.5.2.3   A3.5.2.4   A3.5.2.5  

A3.5.3  

A3.5.3.1  

A3.5.3.2  

A3.5.4   A3.5.4.1  

A3.5.5   A3.5.5.1   A3.5.5.1.1  

A3.5.5.2   A3.5.5.2.1  

NSV  training  for  MOs  five  working   days.  State    level  TOT   NSV  training  for  MOs  five  working   days.  District    level  

5/batch  

0  

94,188    

   

1  

2  

1  

4  

   

   

   

   

                               -­‐        

5/batch  

62  

27,375    

   

10  

10  

   

20  

   

   

   

   

                               -­‐        

Organisation  of  Fixed  day  -­‐  weekly   Per  fixed   (Contigency  cost  to  L3:145  (100%)   day  weekly   +  L2:  219  (50%))     per  inst.   Promote  postpartum  and  post       abortion  family  planning  services   including  sterilization  in  facilities     having  high  institutional  deliveries       Orientation  cum  review  of  FP   Per   counselors/  Yashodas  supervisor  &   training   SN  (bi-­‐annually)  to  access  &  review   FP  performance  &  providing   handholding  for  improving   performance     Biannual  review  of  PPC  I/c  on  FP       activities  at  divisional  level  for   strengthening  FP  service  in  PP   centers   Promote  Community  Based  family       planning  services    

   

                 200    

300  

350  

364  

364  

1378  

   

   

   

   

                               -­‐        

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

Supported  by   UNFPA  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

Community  based  distribution  of   non-­‐clinical  contraceptives  (piloted   in  Ganjam)  through  ASHAs   Trainings   Laparoscopic  sterilization  training   Laparoscopic  sterilization  training   for  teams  (three  members  :  MO,   SN,  Attendant)  :twelve  working   days  at  Zonal  Level   IUD  insertion  training   Six  days  Dist  level  IUCD  training  for   MO  and  SN    

   

   

   

   

   

   

   

   

   

   

   

 Supported  by   UNFPA    

           

        10  

        10  

        10  

        30  

           

           

           

           

                                       -­‐        

       

    10  

    10  

    10  

    30  

       

       

       

       

                                   -­‐        

   

        3/batch  

        55  

    12/batch  

    378  

   

                          29,360    

    63,755    

Cost  to  be  met   from  RKS  

Budget  under   Training  

33

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter   Q-­‐II  

 Financial  target  for  the  quarter    

Q-­‐III  

Q-­‐IV  

Total   Target  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

 Amount   (Rs.  Lakhs)    

Remarks    

    A3.5.5.2.2   A3.5.5.2.3  

A3.5.5.2.4  

A3.5.6   A3.5.6.1   A3.5.6.2   A3.5.6.3  

A3.5.6.4   A3.5.6.5  

A3.5.6.6  

Six  days  Block  level  IUCD  training   for  ANM,  LHV   Three  Days  Postpartum  IUCD   Training  for  O&G  Spl.,  Staff  Nurses   of  Dist.,  Prof.  &  Asso.  Proff.  (O&G)   of  MCH,  Faculty  of  SIHFW  at  State   Level   Three  days  Postpartum  IUCD   Training  for  O&G  Spl    and  Staff   Nurses  of  Respective  Districts   (5MOs+5SNs)   Printing   Printing  of  sterilization  case  cards     Printing  of    village  wise  EC  register   Printing  of  resource  materials  on   contraceptive  choices  in  local   languages  for  Service  provider   Printing  of  checklist  for  FP   Counselor   Display  boards  depicting  all   benefits,  side  effects  &  contra   indications  of  Contraceptives  to  be   displayed  in  PP  centers   Printing  of    green  cards  

10/batch  

0  

49,950    

   

20  

20  

20  

60  

   

   

   

   

                               -­‐        

25/batch  

0  

114,920    

3  

0  

0  

0  

3  

   

   

   

   

                               -­‐        

10/batch  

0  

   32,225    

4  

10  

10  

6  

30  

   

   

   

   

                               -­‐        

    Per  card   Per   register   Per   material  

           

               10                40    

    180000   60000  

           

           

           

    180000   60000  

           

           

           

           

           

   

   

   

500000  

   

   

   

500000  

   

   

   

   

   

UNFPA  support  

Per   checklist      

   

   

100000  

   

   

   

100000  

   

   

   

   

   

   

   

   

   

   

   

0  

   

   

   

   

   

Per  card  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

Met  from  State   budget      

Budget  under   procurement   (NRHM  Int.)  

A3.5.7  

Procurement  of  equipment  &   instrument  for  operationalisation   of  FP  services  

A3.5.7.1   A3.5.7.2  

NSV  kit   Minilap  kit  

Per  kit   Per  kit  

       

2,500            6,000    

251   541  

       

       

       

251   541  

       

       

       

       

       

A3.5.7.3  

IUCD  kit  

Per  kit  

   

2,000    

899  

   

   

   

899  

   

   

   

   

   

Budget  under   Advocacy  for   NRHM    

34

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter   Q-­‐II  

 Financial  target  for  the  quarter    

Q-­‐III  

Q-­‐IV  

Total   Target  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

Remarks    

 Amount   (Rs.  Lakhs)    

    A3.5.7.4  

A3.5.7.5   A3.5.7.6  

Laparoscope  machine  (Total   requirement  is  42  to   operationalise  all  L3  institutions   having  PPC,  but  fund  request  for   50%  of  it)   Racking  system  at  State  FW  store   Pregnancy  kit  to  be  used  before   sterilization  during  camp  

Per   machine  

   

630,000    

14  

   

   

   

14  

   

   

   

   

   

       

       

2,000,000        

1      

       

       

       

1      

       

       

       

       

       

GoI  supply  

   

A3.5.7.7   A3.5.8  

FW  material   Performance  Based  Awards    

       

       

       

       

       

       

       

       

       

       

       

       

       

A3.5.8.1  

Performance  based  incentives  (3   districts)  to  best  performing   districts   Performance  based  incentives  (3   awards)  to  best  performing   surgeons       Performance  based  incentives   (awards)  to  best  Fixed  Day  Static   Unit  at  district  level     Monitoring   Bi-­‐annual  state  level  QAC  review   meeting  (Integrated  with  general   QAC  meeting)   State  level  quarterly  review   meeting  of  low  performing   districts     Divisional  Bi-­‐annual  Review   meeting  of  ADMO  and  DPM   Bi-­‐annual  review  of  DHIO  &  SA/SI   for  improved  monitoring  at  state   level   District  level  QAC  meeting   (Integrated  with  general  QAC   meeting)  

   

   

              100,000    

   

   

   

   

   

   

   

   

   

   

   

   

              100,000    

   

   

   

   

   

   

   

   

   

   

Per   district  

   

                  20,000    

   

   

   

30  

30  

   

   

   

   

   

    per   meeting  

       

                          5,000    

    1  

       

    1  

       

    2  

       

       

       

       

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

                      1,000    

30  

30  

30  

30  

120  

   

   

   

   

A3.5.8.2  

A3.5.8.3  

A3.5.9   A3.5.9.1  

A3.5.9.2  

A3.5.9.3   A3.5.9.4  

A3.5.9.5  

Per  district   per  quarter  

                                   -­‐        

                               -­‐        

Budget  under  Infr.   &  HR  

    Budget  under  M&E  

UNFPA  support  

Budget  under  M&E  

35

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

   

   

   

   

Lump  sum  

   

   

       

       

   

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter  

 Financial  target  for  the  quarter    

Remarks    

Q-­‐III  

Q-­‐IV  

Total   Target  

   

   

   

   

   

   

   

   

   

   

                                                          -­‐         -­‐        

                                                                                             -­‐         -­‐         -­‐        

       

       

       

       

       

       

       

       

       

       

       

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

       

       

       

       

       

       

       

       

       

       

       

       

       

0  

1  

0  

0  

1  

   

   

   

   

                               -­‐        

 Budget  under   Training    

       

       

       

       

       

-­‐         4.50    

-­‐         4.50    

-­‐         4.50    

                               -­‐         23.50    

   

Q-­‐II  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

   

   

   

 Amount   (Rs.  Lakhs)    

    A3.5.9.6  

Quarterly  family  planning  review   by  District  Authorities  

A3.5.9.7  

Rapid  assessment  cum  validation   of  FP  services  at  all  Fixed  Day   Static  Centres   IEC/BCC   State  Media  Workshop    with  focus   on  FDSA   Mass  media  activities  –  production   &  telecasting/  dissemination  

A3.5.10   A3.5.10.1   A3.5.10.2   A3.5.10.3  

Observation  of  World  Population   Week     A3.5.10.4   PRI  sensitization  on  FP  issues   A3.5.10.5   Create  ‘Enabling  Environment’  in   PPC     A3.5.11   Training  on  effective  Management   of  Pro-­‐Mis  to  Block  level  staff  of   Puri  Dist.  On  Pilot  basis  at  District   level   Sub-­‐total  A3.5   Total  (excluding  Sterilization,  NSV  &  IUD)  

33/batch  

       

NIL  

       

                  34,225    

       

         -­‐            9.00    

   

Met  out  of  Dist.   Level  monthly   meeting  (Inst.   Strg.)   Budget  under     OHSP       Budget  under   IEC/BCC  (NRHM   Int.)  

   

   

             

36

Chapter  –  I   INTRODUCTION  AND  HEALTH  SCENARIO     1.1:  State  Profile:     The   state   of   Odisha   accounts   for   4.74   %   of   India’s   landmass   and   3%   of   country’s   total   population   (population   of   the   state   is   41.94   Million   as   per   Census   2011   flash   report)   of   the   country.   The   state   comprises   3   Revenue   Divisions,   30   Districts,   58   Sub-­‐divisions,   171   Tehsils,   314   CD   Blocks,   6235   Gram   Panchayats   and   51,349   villages.     Because   of   its   tropical   as   well   as   coastal   locations,   Odisha   every   year   gets   affected   with   natural   calamities   such   as   floods,   cyclones,   droughts,   etc   that   severely   ruins   the   socio-­‐economic   status   of   the   state.   The   recurrent  natural  calamities  stand  as  a  barrier  to  overall  progress  of  the  state.  In  Health  sector,   high   maternal   &   child   mortality,   prevalence   of   acute   malnutrition   coupled   with   anaemia   &   malaria  pose  biggest  public  health  challenges  before  the  authorities.  Health  &  Family  Welfare   Department   thus   has   undertaken   several   time-­‐bound   initiatives   in   recent   years   to   address   these   issues   and   curtailing   the   out   of   pocket   expenditure   for   poor   in   availing   health   care   services  so  as  to  ensure  better  health  standards  among  citizens.     Table  1.1:  Orissa  in  Figures   Date  of  formation  of  the  state   State  Capital   Area   Area  under  forest  (total)   Literacy  rate   Per  Capita  Income  (03-­‐04)   No.  of  Districts   Urbanization  Ratio   Religion   Official  Language   Temperature   Annual  average  rainfall  

1st  April  1936   Bhubaneswar   155,707  square  kms   58,136.23  Sq.  Kms   73.45   Rs.6,  487.00   30   14.97%   Hindu,  Muslim,  Christian  and  Buddhist   Oriya   Max  40.0  C  (summer);  Min  7.0  C  (winter)   150  cm  

Population  (2011)   - Male   - Female  

41947358   21201678  (50.54%)   20745680  (49.45%)      

Child  Sex  Ratio  

934/1000  boys     13.97%  

Decadal  Growth  Rate   Density  of  Population   District  Population   - Highest  (Ganjam)   - Lowest  (Deogarh)  

 269  per  Sq.  Km.      

Total  Literacy  Rate   - Male   - Female   Highest  District  Literacy  Rate  (Khurda)  

3520151   312164   73.45%   82.40  %   64.36%    87.5%  

Lowest  District  Literacy  Rate  (Nawarangpur)  

48.2%  

No.  of  C.D.  Blocks   - Tribal   - Non  Tribal  

314   118   196    171  

No.  of  Tehsils   No.  of  Towns   No.  of  Panchayat  

  138    6235  

2

1.2  Salient  Features  of  Odisha’s  Demography:   v

Odisha   is   state   with   sizable   proportion   of   both   Scheduled   Tribe   &   Scheduled   Caste   populations   wherein   ST   &   SC   constitute   around   22.13%   and   16.53%   respectively   of   the   total   population   in   the   state.   Together   they   constitute   38.66%   of   the   state’s   total   population   as   per   Census-­‐2001.   This   is   higher   than   the   national   average   where   SCs   contribute   16.20%   &   STs   contribute   8.19%   to   the   total   population   of   the   country   respectively.    

v

Since   last   few   decades   the   percentage   of   SC   population   to   total   population   has   been   increasing  in  the  state  while  the  ST  population  has  been  declining  marginally.    

v

ST  population  declined  from  22.43%  in  1981  to  22.21%  in  1991  down  to  22.13%  in  2001.     Considering  heavy  concentration  of  ST  and  SC  population  in  as  many  as  13  districts  of   the  state  which  accounts  for  44.70%  of  the  total  area  has  been  declared  as  Scheduled   Area,  as  per  1991  Census.  

1.3  Health  Infrastructure  in  Orissa:     Odisha   has   a   three   tier   infrastructure   such   as   Primary,   Secondary   &  Tertiary.   While   PHCs   along   with   Health   Sub-­‐centers   &   CHCs   serve   as   primary   service   points,   SDH   &   DHH   are   placed   at   secondary   level.   Medical   Colleges   &   Hospitals   which   are   at   tertiary   level   provide   specialized   services  to  the  patients  at  affordable/no  price.     The  table  mentioned  below  shows  the  overall  Health  Infrastructure  of  the  state.   Table  1.2:  Existing  Health  Infrastructure  in  Orissa  (as  on  01.01.2011)   Medical  College  and  Hospitals  (Government)   Dist.  Hospitals  (Capital  Hospital,  &  R.G.H  )    Sub-­‐Divisional  Hospitals   Community  Health  Centers   Primary  Health  Centers  (N)   Rural  Family  Welfare  Centers   Urban  Family  Welfare  Centers   Postpartum  Centers   Sub-­‐Centres   Health  &  Family  Welfare  Training  Centers  (Cuttack  &   Sambalpur)   Rural  Health  Centers  (Jagatsinghpur,  Attabira  &   Digapahandi)   G.N.M  Training  Schools     A.N.M.  Training  Schools   M.P.H.W.(Male)  Training  School   Nursing  College  B.Sc    D.  Pharmacy    College   Lab  Technician  Training  Centers   Radiographer  Training  Institutes   Ayurvedic  Hospitals   Ayurvedic  Dispensaries   Homoeopathic  Hospitals   Homoeopathic  Dispensaries   Unani  Dispensaries  

3   32   26   377   1228   314   10   79   6688   2   3   3   18  (2  approved  by  GoI  in  recent  past)   3   1   3   3   3   5   619   4   560   9  

3

  1.4:  Human  Resource  Position:     Access  to  quality  services  is  largely  dependent  upon  the  availability  of  quality  human  resource   at   health   institutions.   Attempts   have   been   made   by   the   Dept.   to   fulfill   vacancies   in   different   categories.   Contractual   mode   of   appointments   has   been   in   operation   in   many   categories   to   avoid  the  short  fall  in  human  resources.  Similarly  specialized  skill  development  training  is  also   being  imparted  as  part  of  the  government  initiative  for  multi-­‐skilling  the  service  providers.     Table  1.3:  Human  Resource  Position     Human  Resource  Position  (Regular)   Category   Doctors  

Sanction   4385  

Position   3675  

Vacancy   710  

Staff  Nurse   Pharmacist  

2046   1945  

1775   1812  

271   133  

Radiographer  

235  

115  

120  

MPHW(M)   MPHW(F)  

4667   7607  

3083   7072  

1584   535  

LT  

897  

653  

244  

  Concerted   efforts   are   being   made   by   the   state   to   ensure   availability   of   trained   and   quality   health  personnel  to  address  the  gap  and  to  provide  equitable  and  quality  health  care  services   to  the  community  across  the  state  especially  in  the  vulnerable  areas.  Focus  has  been  given  for   making   provisions   for   paramedic   service   providers   like   GNM,   ANM   and   nurses   by   providing   incentives  like  special  scholarship  schemes  both  partial  and  full  scholarships  in  KBK  districts  to   encourage  eligible  students  to  take  on  paramedic  studies.  1690  GNMs,  2005  ANMs,  620  B.Sc   Nursing   students   have   been   enrolled   in   both   private,   public   sector   and   government   schools   as   part  of  these  innovative  schemes.       To   address   the   shortage   of   doctors,   the   state   has   undertaken   proactive   steps   such   as   adhoc   appointments,  contractual  appointments  to  retired  doctors,  streamlining  recruitment  through   Orissa   Public   Service   Commission   and   restructuring   the   promotional   avenues   for   assured   job   satisfaction.   The   scenario   is   changing   fast   and   yielding   positive   results   in   both   retaining   the   doctors  and  streamlining  the  process  of  health  care  services.  .         1.5:  Intervention  Rationale:   In  order  to  intensify  the  efforts  made  during  the  past  years  to  improve  the  reach  and  range  of   health   services   in   the   state,   the   Government   of   Orissa   has   made   special   efforts   to   ensure   quality  services  to  socially,  geographically  and  economically  vulnerable  population.       Need   based   &   locality   specific   interventions   are   designed   based   on   assessments   carried   out   across   the   state   to   grade   vulnerable   areas,   map   vulnerability   of   institutions   based   on   their   4

access   and   performance.   Similarly,   institutions   are   also   identified   at   strategic   locations   for   better   access   to   health   services.   The   NRHM   PIP   introduces   the   concept   of   High   Focus   (most   vulnerable   with   low   health   indicators)   concept   for   effective   implementation   of   the   health   programme.     1.6:    Priority  Areas  for  Improved  Access:   The   current   NRHM   PIP   focuses   on   the   block   as   the   unit   of   implementation.   Considering   the   strong   inter   district   inequalities   prevailing   in   the   state   because   of   geographical   inaccessibility   for   tribal   population   and   left   wing   extremism   activities,   comprehensive   measures   are   being   undertaken   to   ensure   equity-­‐based   health   services   reach   the   community.   Equity   in   health   service  provision  has  been  the  underlying  principle  of  the  NRHM  PIP  for  2011-­‐12.  A  state  level   assessment   was   carried   out   to   map   the   difficult   and   most   difficult   blocks   so   as   to   enable   differential  focus  on  planning  and  programme  interventions.     Table  1.4:  Outcome  

  Most  Difficult  Blocks     Difficult  Blocks     Total  Blocks    

50     46   314  

5

1.7:  RCH  Focus  and  vulnerability  indexing  of  Health  Institutions:    

A  composite  set  of  indicators  were  identified  in  order  to  assess  the  areas  where  RCH  program   implementation  &  results  thereof  are  not  satisfactory.  This  vulnerability  mapping  will  allow  us   to  identify  vulnerable  institutions  and  make  specific  resource  allocation  for  strengthening  RCH   services  in  those  areas.    

1.8  Vulnerable  Institutions:    

Engaging   and   retaining   staff   in   institutions   situated   in   vulnerable   and   difficult   areas   still   remains   a   major   health   challenge   for   the   state.   In   order   to   increase   retention   period   for   the   service   providers,   an   incentive   based   scheme   has   been   launched   the   state   government.   However,   this   scheme   is   based   on   the   extent   of   vulnerability   of   a   particular   institution   in   a   locality.  It  was  in  this  context  that  all  institutions  were  assessed  for  vulnerability  based  on  their   inaccessibility   and   location,   characteristic   of   service   area   and   assessment   of   conflict   situations.   Four  levels  of  institutions  were  identified  based  on  their  vulnerability.   1.9:  Outcome   Total  Districts     High  Focus  Districts     Names  of  Districts     30   18   Angul,  Bargarh,  Bolangir,  Boudh,  Deograh,  Gajapati,   Jharsuguda,    Kalahandi,  Kandhmal  Keonjahr,  Nuapada,   Malkangiri,  Koraput,  Nabarangpur,  Nayagarh,   Rayagada,  Sambalpur  and  Sundergarh        

NAME  OF   DISTRICT   HIGH  FOCUS  DISTRICTS   OTHER  DISTRICTS   GRAND  TOTAL  

TOTAL  VI   629   2291   2920  

HEALTH  INSTITUTIONS   TOTAL  V2   TOTAL  V3   TOTAL  V4   2977   546   177   1742   12   11   4719   558   188  

6

1.6:  Leveling  of  Institutions  for  Facility  Up-­‐gradation       Since  up  gradation  of  all  health  institutions  based  on  composite  indicators  (HR,  Infrastructure,   Equipments,  non-­‐clinical  services)  was  not  possible  at  one  go,  a  mapping  exercise  was  initiated   across   all   districts   wherein   institutions   were   identified   at   strategic   locations   on   the   basis   of   access   and   present   performance   as   important   parameters.   At   least   one   institution   of   any   level   (L1/2/3)  in  that  area  was  identified  to  cater  to  at  least  30,000  populations.   Category     L1   L2   L3  

1.10:  Outcome   Target  By  (2010-­‐11)     781   357   107  

Target  By  (2011-­‐12)     899   438   145  

  Over   the   years,   there   is   gradual   improvement   in   the   health   service   delivery   and   uptake   of   services  in  the  state  .The  major  achievements  are  shown  below     1.11:  Progress  in  the  Health  Scenario  from  2005  onwards:    

State  MMR    has  decreased  from  358  (SRS,  2003)    to  258  (SRS,  2011)  -­‐  100  point  decline   State  IMR    has  decreased  from  95  (SRS  2000)    to  65  (SRS  2009)  -­‐  30  point  decline   Prevalence  Rate  of  Leprosy  is  0.87,  19  districts  sustaining  elimination  level   State  API    for    Malaria    reduced  from  10  to  8.8     Institutional   delivery   coverage     state   is   81%   (HMIS   -­‐2010-­‐2011)against   reported   &   58   %   against  Estimated    Delivery  (HMIS-­‐2010-­‐11)   23.45   lakh   mothers   have   benefited   under   Janani     Surakhya     Yojana   (JSY)   (2006-­‐2010)  [5.33   Lakh  in  2010-­‐11]   Full  immunization  coverage  has  increased  from  53%  (  CES  –  2005)  to  74%      (2006-­‐07)   81   hospitals   upgraded   as   L3   (CEmONC)     institutions   ,   261   hospitals   upgraded   as   L2   (BEmONC)    institutions  ,  617  hospitals  upgraded  as  L1  (SBA)    institutions     16   SNCU-­‐II   units   operational     in   Angul-­‐1,   Balasore-­‐1,   Capital   Hospital-­‐1,   Kandhamal-­‐   1,   Koraput-­‐1,   Mayurbhanj-­‐1,   MKCG   MCH-­‐1,   Nawarangpur-­‐1,   Nuapada-­‐1,   Puri-­‐1,   Rayagad-­‐1,   Sambalpur-­‐1,  SCB,  MCH-­‐1,  SDH,  Jeypore,  Koraput-­‐1,  Sonepur-­‐1,  VSS  MCH-­‐1   50  SNCU-­‐I  made  functional     452  New  born  corners  established  across  the  state   2   No.   of   Nutritional   Rehabilitation   Center   made   functional   (Baripada   &   Bhabanipatna   DH   hospitals)   6  No.  of  Maternity  waiting  Homemade  functional     156  YASHODAs  are  engaged  in  16  districts  to  support  mothers  during  delivery   1806   tribal   residential   school   included   under   Intensive   School   Health   Program   &   57972   schools  included  under  Extensive  School  Health  Program   81   MBBS   Doctors   are   trained   on   Life   saving   Aesthetic   skills   (LSAS)   and   37   MBBS   Doctors   trained  on  Emergency  care  (EmOC).     1263  AYUSH  Doctor,  17  Medical  Officers,  856  Staff  Nurses,  1081  Addl.  ANM  &  112  LTs  are   in  position   421  Ambulances  deployed  across  the  state  for  providing  2nd  referral  transport.     7

304  Janani  Expresses  are  engaged  for  promoting  referral  transport  for  delivery     40,701  ASHA  in  place  against  a  total  target  of  41,102.     249  ASHAs  in  urban  slums  in  position  out  of  458   45,417  GKS  have  been  constituted  in  the  State  (Target  :  46928  )     Mamata   Diwas   (Village   Health   &   Nutrition   Day)   -­‐   619634   sessions   held   out   of   677018   planned  in  2009-­‐10  &  2010-­‐11   203005  Malnourished  Children  treated  through  Pustikar  Diwas  in  2009-­‐10  &  2010-­‐11   IMNCI(   Integrated   Management   of   neonatal   &   Childhood   Illness)implemented   in   20   districts     210  MHUs  operationalised  in  most  inaccessible  areas.   MHU-­‐Arogya+  new  initiatives  in  PPP  mode  for  Naxal  affected  areas.   21  PHC(N)  of  11  districts  are  managed  by  the  NGOs     1.12:    RCH  Outcome  Indicators:   INDICATORS  

ORISSA   Trend  (year  &  source)  

Maternal  Mortality  Ratio  (MMR)   Infant  Mortality  Rate  (IMR)   Total  Fertility  Rate  (TFR)  

358     (SRS  01-­‐03)   83     (SRS  2003)   2.6     (SRS  2003)  

INDIA   Current  status  

258     (SRS  07-­‐09)   65     (SRS  2009)   2.4     (SRS  2007)  

212     (SRS  07-­‐09)   53     (SRS  2008)   2.7     (SRS  2007)  

 

Sl.   No.   1. 2. 3. 4. 5. 6. 7. 8.

 

INDICATORS   Mothers  who  received  3  or  more  antenatal     care  checkups  (%)     Mothers   who  had  full  antenatal  check-­‐up  (%)     Institutional   deliveries  (%)   Children  12-­‐23  months  age  fully  immunized     (%)   Children  age  6-­‐35  months  exclusively     breastfed  for  at  least  6  months  (%)   Children  with  diarrhea  in  the  last  2  weeks     who  received  ORS  (%)   Use  of  any  modern  contraceptive  method     (%)   Total  unmet  need  for  family  planning  -­‐  both     spacing  methods  and  terminal  methods  (%)  

ORISSA  

INDIA*  

DLHS–2   DLHS–3   DLHS–2   DLHS–3   (2002–04)   (2007–08)   (2002–04)   (2007–08)  

41.7  

54.6  

50.4  

51.0  

13.7   30.8  

23.3   44.3  

16.5   40.9  

19.1   47.0  

53.3  

62.4  

45.9  

54.1  

20.7  

42.6  

22.7  

24.9  

48.3  

49.0  

30.3  

33.7  

40.3  

37.8  

45.2  

47.3  

19.8  

24.0  

21.4  

21.5  

 

8

Chapter-­‐  2   SITUATIONAL  ANALYSIS   Orissa   is   a   least   urbanized   (14%   of   the   total   population   lives   in   urban   set   up   as   per   Census-­‐ 2001)  state,  wherein  high  percentage  of  population  lives  below  poverty  line  (46%).  The  state   has   about   38   percent   of   population   belonging   to   SC/ST   category.   An   analysis   of   critical   indicators  related  to  health  and  reproductive  health  are  as  follows.     2.1:  Dependence  on  Public  Medical  Health  Care  System:   More   than   three   quarters   of   households   in   Odisha,   depend   on   Public   sector   medical   set   up   for   availing   health   care   services.     62%   urban   households   and   79%   rural   households   use   public   medical   facilities   for   health   care.   The   National   average   for   households   seeking   services   of   public  health  facilities  is  35%.  In  India,  seven  states,  Himachal  Pradesh,  Odisha  and  five  North-­‐ Eastern  states  have  high  dependence  for  medical  care  on  public  health  system  as  per  NFHS-­‐III.   2.2:  Fertility:   2.2.1:  Age  at  first  Marriage:     The   median   age   at   first   marriage   is   17.9   years   among   women   aged   between   25-­‐49   years   (2011   Census),  which  is  about  one  year  less  in  comparison  to  the  national  counterpart.   2.2.2:  Fertility  Levels   The   Total   Fertility   Rate   (TFR)   of   the   state   as   per   NFHS-­‐III   is   2.37   against   National   average   of   2.7.   Fertility   in   Odisha   is   approaching   the   replacement   level,   however   fertility   decline   between   NFHS-­‐II   &   III   is   slower   than   the   rate   recorded   between  NFHS-­‐I  &  NFHS-­‐II.   As   per   the   NFHS-­‐III,   fertility   in   rural   areas   is   2.5   children   per   women.   Fertility   rates   are   higher   for   Scheduled   Tribe   women   (TFR-­‐3.1)   than   that   for   women   from   schedule   caste,   other   backward   classes   and   from   general   category   (2.0   to   2.3   TFR).  

9

2.2.3:  Teenage  Pregnancy:   14   percent   women   in   Orissa,   in   the   age   group   of   15-­‐19   years,   begin   child   bearing,   which   is   lower   than   the   national   average   of   16   percent.   The   ASFR   (Age   Specific   Fertility   Rate)   for   the   same   group   (15-­‐19   years)   is   35   per   1000   currently   married   women.   This   rate   is   again   much   lesser  than  the  national  average  of  41  per  1000  women  as  per  SRS  2007  estimates.   But  at  the  same  time,  a  large  segment  of  population  is  expected  to  enter  the  reproductive  age.   About   32%   (one   third)   of   Odisha’s   population   is   under   15   years.   They   need   to   be   given   information   and   services   for   contraception   to   attain   their   reproductive   intention   in   the   next   five  to  ten  years  period  through  promotion  of  informed  choices.   2.2.4:  Birth  Intervals:   The   median   interval   between   births   in   Odisha   is   34   months   against   national   average   of   31   months.  As  per  NFHS-­‐III,  9  percent  of  births  take  place  within  18  months  of  the  last  birth  and   23  percent  take  place  within  24  months.   2.2.5:  Fertility  Preferences  (NFHS-­‐III):   About   70   percent   of   currently   married   women   and   men   aged   15-­‐49   years   want   no   more   children,   are   already   themselves   sterilized,   or   have   a   spouse   who   is   sterilized.   Among   those   who   want   another   child,   44   percent   of   women   and   40   percent   of   men   would   like   to   wait   at   least   two   years   before   having   another   child.   The   ideal   family   size   for   ever-­‐married   women   and   men   is   2.3   children.   The   table   2.1   indicates   difference   in   the   total   wanted   fertility   and   total   fertility  rate   Table-­‐2.1:    Wanted  Fertility  Rates  by  States  (NFHS-­‐III)   Total  wanted  fertility  rates  and  total  fertility  rates  for  the  three  years  preceding  the  survey  by   States,  India  –  2005-­‐06   State   Total  wanted  fertility   TFR   Differential   India   1.9   2.7   0.8   Rajasthan   2.2   3.2   1.0   Madhya  Pradesh   2.1   3.1   1.0   UP   2.3   3.8   1.5   Bihar   2.4   4.0   1.6   Odisha   1.8   2.4   0.6   Andhra  Pradesh   1.5   1.8   0.3   Kerala   1.8   1.9   0.1   Source  –  Strategy  note    UNFPA     The   differential   of   0.6   for   Odisha   indicates   that   unplanned   pregnancies   are   relatively   less   common  than  the  other  States  compared  in  the  Table  mentioned  above.  If  all  women  were  to   have   only   the   number   of   children   they   want   the   TFR   would   be   1.8   children   instead   of   2.4   children  for  Orissa.   2.2.6:  CPR:  The  CPR  (Contraceptive  Prevalence  Rate)  amongst  currently  married  women  aged   between  15  –  49  years  is  50.4%  as  against  the  national  average  of  56.3%.  

10

2.3:  Family  Planning:   India  launched  the  National  Family  Planning  Program  in  1951  with  the  objective  of  reducing  the   birth   rate   to   the   level   of   population   stabilization.   In   1997,   the   services   and   interventions   under   Family  Welfare  program  and  CSSM  program  have  been  integrated  with  Reproductive  and  Child   Health  Programs.  The  11th  five  year  plan  has  three  major  goals  for  RCH  program.     These   are   reducing   TFR   to   the   replacement   level,   reducing   IMR   and   MMR   to   30   and   100   respectively  by  2012.  The  National  Family  Health  Survey–III,  2005-­‐06  came  out  with  the  status   of  various  indicators  related  to  Family  Planning.   2.3.1:  Knowledge  of  Family  Planning  Methods:   Knowledge   of   Contraception   is   almost   universal   among   currently   married   women   in   Orissa.   Female  sterilization  is  the  most  widely  known  method,  known  by  virtually  all  married  women   and  men.  The  government  family  planning  program  promotes  three  temporary  methods:  the   Oral   pill,   the   IUCD   and   condoms.   Out   of   all   these   contraceptive   methods,   currently   married   women  know  about  the  pills   (89%)  and  currently  married  men  are  aware  about  both  the  pill   (87%)  and  condoms  (84%).  The  least  known  method  is  IUCD  (56%).   Knowledge   of   sterilization   has   been   high   since   NFHS-­‐I,   but   knowledge   of   temporary   contraceptive  methods  has  increased  substantially  since  NFHS-­‐II.  For  example,  among  currently   married  women,  89  percent  now  know  about  pill,  compared  to  only  52  percent  in  NFHS-­‐I  and   75  percent  in  NFHS-­‐2.   The   DLHS-­‐3   (2007-­‐2008)   indicates   that   awareness   of   contraceptive   methods   among   unmarried   women   is   also   high.   As   per   DLHS-­‐3   in   Odisha,   67   percent   of   unmarried   women   know   about   condom,   81   percent   unmarried   women   know   about   pills   and   about   one   fourth   of   unmarried   women  discuss  about  contraception  with  others.   Table  2.2:    Family  Planning  (Currently  married  women  age  15-­‐49  years)   Current  Use   NFHS-­‐III   Any  Method   50.7   Any  modern  method  (%)   44.6   Female  Sterilization  (%)   33.1   Male  Sterilization  (%)   1.0   IUD  (%)   0.6   Pill  (%)   7.0   Condom  (%)   3.2   Unmet  need  for  Family  Planning   Total  Unmet  Need   15.0   For  Spacing  (%)   6.9   For  limiting  (%)   8.1  

Urban     59.4   49.9   30.3   1.1   1.5   10.2   6.9  

Rural   49.0   43.6   33.7   1.0   0.4   6.4   2.4  

NFHS-­‐II   46.8   40.3   33.9   1.7   0.8   3.0   0.9  

NFHS-­‐I   36.3   34.7   28.3   3.4   1.5   0.9   0.6  

12.5   5.6   6.9  

15.5   7.1   8.4  

15.5   8.7   6.8  

22.4   12.7   9.7  

Source  –  Strategy  note    UNFPA       11

The  female  sterilization  accounts  for  around  65%  of  all  contraceptive  use  as  per  NFHS-­‐III.  The   service  statistics  of  Odisha  indicates  that  minilap  is  the  most  popular  method  with  70  percent   of  acceptors  of  limiting  method  prefers  to  avail  it.   The  spacing  methods  most  commonly  used  by  currently  married  women  are  the  oral  pill  (7%),   followed  by  the  withdrawal  method  and  condoms  (3%  each).  In  general,  better-­‐educated  and   wealthier  women  are  more  likely  to  use  spacing  methods  than  other  women.   Ninety-­‐seven  percent  of  sterilized  women  had  the  operation  in  a  government  facility,  usually  in   a   sterilization   camp   (45%),   Community   Health   centre/rural   Hospital/Primary   Health   Centre   (32%),  or  a  government/municipal  hospital  (18%).     Odisha  is  one  of  the  states  of  India  having  highest  dependency  of  households  for  health  care  on   public   health   facilities.   The   Table   2.3   indicates   comparison   of   different   states   with   dependency   on  public  health  sector  as  source  of  modern  contraceptives  services.   Table2.3:    Public  Sector  as  source  of  modern  contraceptives  by  state  (NFHS-­‐III)   Percentage  of  current  users  of  modern  contraceptive  methods  for  whom  the  most  recent  source   of  contraceptives  was  the  public  sector,  by  specific  method  and  residence,  according  to  state,   India,  2005-­‐06   Female   Male   Pill   Sterilization   Sterilization   83.5   85.3   15.3  

State   India  

IUD   45.6  

Condom/   All  modern  methods   Nirodh   Urban   Rural   Total   13.4   56.8   78.2   70.6  

Rajasthan  

93.8  

96.7  

27.0  

77.0  

23.2  

62.8  

91.9  

81.1  

Madhya  Pradesh  

95.9  

96.8  

25.5  

43.9  

19.2  

66.1  

94.2  

86.3  

Bihar  

62.1  

-­‐  

0.0  

-­‐  

6.3  

40.6  

57.3  

53.9  

Orissa  

96.5  

94.9  

14.4  

-­‐  

19.3  

60.9  

82.9  

78.8  

Maharashtra  

79.3  

90.5  

15.3  

31.8  

12.5  

53.2  

83.5  

69.1  

Andhra  Pradesh  

78.3  

76.1  

1.6  

14.7  

16.2  

68.1  

81.4  

77.1  

Kerala  

66.9  

89.9  

-­‐  

51.8  

17.3  

58.8  

63.7  

62.0  

Tamil  Nadu    

77.1  

-­‐  

-­‐  

32.7  

12.0  

67.0  

78.3  

73.1  

2.3.2:  Informed  Choice:   Table  2.4:    Comparison  of  states  on  informed  choice  as  per  NFHS-­‐III   State  

India   Rajasthan   Madhya  Pradesh   Bihar   Orissa  

%  who  were   informed  about  side   effects  or  problems   of  method  use  

%  who  were   informed  about  what   to  do  if  experienced   side  effects  

%  who  were  informed  by  a   health  or  family  planning   worker  about  other   methods  that  could  be  used  

32.2   29.9   44.7   10.8   21.6  

26.0   23.3   34.6   8.5   15.7  

27.9   24.0   41.1   27.0   14.4  

Source  –  Strategy  note    UNFPA     12

Women  who  know  about  all  available  contraception  methods  and  their  side  effects  can  make   better   &   informed   choices   about   methods   to   be   used   and   has   high   possibilities   of   making   sustainable   decisions.   However,   most   of   the   time   they   receive   information   from   the   mass   media   channels   &   only   twenty-­‐two   percent   of   current   users   were   told   by   a   health   worker   about  side  effects  of  the  method.  This  is  much  lesser  than  the  National  average  in  Odisha.   DLHS-­‐III  (2007-­‐08)  also  reported  similar  findings.  Only  18  percent  currently  married  non-­‐users   ever   received   counseling   by   health   personnel   to   adopt   family   planning   in   the   state   whereas   only   13   per   cent   current   users   of   contraceptives   ever   had   been   told   about   side-­‐effects.   The   follow  up  services  for  IUCD/sterilization  acceptors  within  48  hours  of  intervention  is  88  percent   of  the  users.   2.3.3:  Men’s  attitudes  for  Contraception:   Almost   all   men   in   Orissa   reject   the   idea   that   contraception   is   women’s   business   and   a   man   should  not  have  to  worry  about  it  (97%)  and  reject  the  idea  that  women  using  contraception   may   become   promiscuous   (92%).   However,   52   percent   of   men   incorrectly   believe   that   a   woman  who  is  breastfeeding  cannot  become  pregnant.  Large  proportions  (72%)  of  men  know   that  a  condom,  if  used  correctly,  protects  against  pregnancy  most  of  the  time.   2.3.4:  Unmet  Need:   Unmet   need   for   family   planning   is   defined   as   the   percentage   of   currently   married   women   who   either  want  to  space  their  next  birth  or  stop  childbearing  entirely  but  are  not  using  any  method   of  contraception.24%  of  the  currently  married  women  have  an  unmet  need  for  family  planning   (8.2%  for  spacing  and  15.8%  for  limiting)  as  per  DLHS  III.  However,  unmet  needs  in  12  districts   are  much  below  the  state  average.      

   

13

2.3.5:  Methods  of  Contraception:     Analysis  of   various   methods   of   Family   Planning   and   contraception   used   by   couples   reveals   that   about  80%  of  them  accept  limiting  methods.  Use  of  spacing  methods  is  less  than  20%  among   the  eligible  couples  effectively  using  protection.  Female  sterilization  accounts  for  about  75%  of   all   contraceptive   use   and   mini   lap   is   most   popular   method.   As   per   (NFHS   III)   In   Odisha,   discontinuation  rates  for  spacing  methods  are  quite  high.  Half  of  condom  users  and  42  percent   of  pill  users  discontinue  use  within  the  first  year  after  they  adopt  the  method  as  per  NFHS-­‐III.   Condom, 3.20%

Natural & Others, 5.80%

Oral Pill, 7%

IUD, 0.60%

Not using any method, 49.30% Male sterilisation, 1%

Female sterilisation, 33.10%

  2.4:    Key  Issues  in  Family  Planning:   a. Availability  of  information  and  services  is  a  perennial  concern   b. Poor  logistics  and  supply  chain  management     c. Need  based    communication  activities  for  family  welfare  activities     d. Slow  progress  in  capacity  building  of  human  resources   e. Weak    procurement  systems  for  family  planning  equipments     f. Techno-­‐  managerial  capacity  for  family  welfare  activities  at  district  and  block  levels       g. Male  sterilization  is  virtually  non-­‐existent.   2.5:  Analysis  and  Interpretations:   The  analysis  and  interpretation  of  secondary  data  is  done  with  an  objective  to  draw  linkages  for   programmatic  interventions:     i. In  Odisha  public  health  system  is  a  major  source  of  availing  health  care  services  including   Family  Planning  services.  The  majority  of  population  resides  in  rural  area.  This  implies  that   14

efficiency   and   effectiveness   of   Primary   health   care   system   has   a   bearing   on   the   performance  of  Family  Planning  Program  in  the  state.   ii.

The   TFR   of   the   state   is   reaching   replacement   levels.   But,   the   fertility   rates   of   scheduled   tribes   and   rural   population   are   higher   than   state   average.   There   is   a   need   to   ensure   access   to  quality  information  and  services  for  contraception  to  the  above  population  segments.  

iii.

Among   limiting   method,   female   sterilization   is   the   most   popular   method.   Within   this   segment,  minilap  is  70  percent  of  all  acceptors.  The  quality  of  services  offered  by  facilities   at  the  peripheral  level  is  crucial  to  improve  acceptance.  NSV  is  to  be  promoted  in  order  to   balance  method  choices  among  men  and  women  for  contraception.  

iv.

The  unmet  need  for  family  planning  although  reduced  from  NFHS-­‐I  to  NFHS-­‐III,  it  is  still  very   high.  An  analysis  of  service  provision  for  limiting  and  spacing  methods  for  each  district  will   throw  light  into  gray  areas  and  inter-­‐district  variations.  

v.

Among   spacing   method   users,   the   acceptance   of   IUCD   is   least   and   knowledge   among   currently   married   women   in   reproductive   age   is   also   low   for   IUCD.   One   of   the   reasons   assigned  by  the  service  providers  is  that  more  than  60  percent  of  women  in  reproductive   age  group  are  anemic  and  IUCD  increases  blood  loss  during  menstruation.  Hence,  IUCD  is   least   preferred   as   it   causes   inconvenience   to   the   users.   It   is   necessary   to   carry   out   a   systematic  study  on  the  clinical  and  socio-­‐cultural  determinants  resulting  to  low  acceptance   of  IUCD  for  developing  programmatic  interventions  in  the  State.  

vi.

Odisha   is   having   relatively   comfortable   levels   of   age   at   marriage,   as   well   as   sufficient   spacing   between   pregnancies.   The   state   witnesses   high   in   and   out   migration   of   male   population.  There  is  a  need  to  promote  condom  as  a  means  of  dual  protection  to  prevent   HIV/AIDS.  

vii.

Counseling  offered  to  present  and  potential  users  for  contraception  is  poor.  There  is  a  need   to   promote   “Community   Based   Distribution   (CBD)   of   contraception”   through   ASHAs.   This   will   help   in   overcome   barriers   and   reach   the   unreached   for   spacing   methods   particularly   counseling  for  IUCD  and  clubbing  information  and  services  for  oral  pills  and  condom.     Source  –  Strategy  note    UNFPA    

2.6:  Assessment  of  Service  Utilization  and  Trends  in  family  planning:   2.6.1:  Trends  in  Sterilization  performance:   Table  2.5:  The  comparison  of  sterilization  performance  among  states  with  high  TFR  (2008-­‐09)   Sl.   Parameters   No.   1.   Eligible  couples  (in  000’s)  

Odisha   Bihar  

UP  

MP  

Rajasthan   Kerala  

6507  

16376  

31405  

12022  

11286  

5414  

Tamil   Nadu   11302  

2. 3.

  TFR     No.  of  sterilizations  per  1000   population  2007-­‐08  

2.5   3.3  

4.2   3.5  

4.2   2.8  

3.5   7.46  

3.5   5.8  

1.7   6.7  

1.7   5.65  

4.

  Sterilization  per  10000  unsterilized   couples  exposed  to  higher  order   births  of  3  &  3+     Ratio  of  Minilap  to  Laparoscopy     Proportion  of  NSV  to  total   sterilization  (2007-­‐08)     Present  Performance  (2007-­‐08)  in   lakhs  

664  

320  

319  

1331  

867  

2212  

3039  

71:29   2.2%  

99:.05   2.9%  

14:86   1.3%  

19:81   6.8%  

20:80   3.8%  

86:14   0.9%  

87:13   0.4%  

1.2  

3.01  

4.7  

4.5  

3.3  

3.5  

3.5  

5. 6. 7.

15

8.

  ELA  for  2008-­‐09  In  lakhs  

1.6  

4.7  

8.1  

4.8  

4.7  

-­‐  

-­‐  

9.

  Expected  TFR  in  2012  as  per  ELA   set  

2.18  

3.42  

3.47  

2.4  

2.4  

-­‐  

-­‐  

*Source-­‐  Operational  guidelines  of  FDS,  MOHFW,  GoI   The  sterilization  performance  of  Odisha  has  been  showing  increasing  trends  during  the  past  six   years  with  NRHM  playing  a  supportive  role.   Table  2.6:  Sterilization  Performance  of  the  State   Year   2005-­‐06   2006-­‐07   2007-­‐08   2008-­‐09   2009-­‐10   2010-­‐11  

Sterilization  acceptors  Orissa   84,267   94,309   120,983   119,889   122,171   138174   (*  Demography  wing,  DFW,  GoO,)  

2.7:  Spacing  Methods:   The  trend  analysis  of  contraceptive  use  as  per  NFHS-­‐III  indicates  that     a) The   current   use   of   condom   by   eligible   couples   is   3.2   percent   out   of   44.6   per   cent   CPR.   There   is   a   steady   increase   in   condom   use   from   0.6   per   cent   point   (NFHS-­‐I)   to   0.9   per   cent   point  (NFHS-­‐II).  Still  condom  use  as  a  part  of  CPR  is  lesser  than  the  National  average  of  5.2   per  cent  point.     b) The  oral  pills  are  popular  spacing  method  in  the  State.  This  contributes  to  7  per  cent  of   the   contraceptive   prevalence   rate   of   Orissa   as   per   NFHS-­‐III.   The   use   of   oral   pills   and   contribution  in  CPR  of  Orissa  is  double  the  national  average.   c) The  IUCD  is  least  preferred  spacing  method  in  Orissa  with  0.6  per  cent  contribution  in  the   CPR  by  modern  contraceptive  method  in  the  state.    The  trend  in  contraceptive  use  and   comparison  with  National  level  pattern  is  given  in  Table  2.7.   Table  2.7  –  Emerging  Trends  in  family  Planning  Orissa   Emerging  Trends  in  Family  Planning  –  Orissa   Sl.   Method   NFHS-­‐I   NFHS-­‐II   NFHS-­‐III   NFHS-­‐III   No   (1992-­‐93   (1998-­‐99   (2005-­‐06   (2005-­‐06)   Orissa)   Orissa)   Orissa)   (India)   1.   Any  Method   36.3   46.8   50.4   64.0   2.   Any  modern  method   34.7   40.3   44.7   55.8   3.   Female  Sterilization   28.3   33.9   33.1   37.8   4.   Male  Sterilization   3.4   1.7   1.0   1.1   5.   Pill   0.9   3.0   7.0   3.1   6.   IUD   1.5   0.8   0.6   1.7   7.   Condom/Nirodh   0.6   0.9   3.2   5.2     At  present  distribution  channels  for  spacing  methods  exist  through  public  health  care  delivery   facilities  like  DHH/SDH/CHC/PHC  &  Sub  Centre.  For  every  1,000  population  there  is  one  ASHA.   Each  ASHA  receives  supplies  of  OP  &  CC  through  ASHA  kit.   16

2.8:  Performance  during  2010-­‐11:   During   last   year   (2010-­‐11)   state   had   recorded   highest   number   of   acceptors   in   sterilization   i.e.87%   of   the   expected   level   of   achievement.   The   graphs   and   tables   on   the   performances   2009-­‐10 2010-­‐11 shows   an   encouraging   trend   in   257083 family   planning   achievements   in   Odisha.  It   is   also   observed   that   in   214597 last   five   years   there   is   constant   174922 173335 148727 rise   in   number   of   acceptors   of   138174 133658 122171 various   family   planning   methods   per   1000   population.   The   86% 60% 82% 83% average  acceptors  per  method  in   76% 77% 89% 80% last   five   years   as   per   service   statistic   Sterilisation IUCD CC Oral  P ills Sterilization  (2.8)   IUCD  (3.65)     CC  (7.25)     OP  (4.52).   However   in   last   five   years   there   is   substantial   improvement   in   performance   for   all   methods   other  than  CC.  The  reason  for  the  same  can  be  attributed  to  the  erratic  supply.     The   achievement   during   the   year   2010-­‐11   reflects   that   16   districts   have  achieved  better  performances   in   family   planning   than   the   state   average   with   Boudh   (45%)   was   being   the   poorest   &   Malkanagiri   (152%)   being   the   highest   among   all   districts   in   sterilization.   Similarly,   IUCD   insertion,   17   districts   are   above   the   state   average,   Nuapada   has   performed   lowest   (27%)   and   5  YRS  T REND  IN  STERILIZATION  IN  ORISSA   Jharasuguda   performing   highest   (128%).   In   case   of   other   spacing   methods   17   districts   are   above   state   average   in   CC   and   19   in   use   of   oral   contraceptives   pills.     Ganjam   is   at   the   bottom   in   CC   performances   with   26%   achievement   and   Malkanagiri   leading   the   list   at   140.In   the   case   of   OCP   performances   Nuapada   at   the   bottom   (30%)   with   Bhadrak   leading  the  table  (125%).  With  concentrated  efforts  the  state  is  moving  gradually  towards  the   replacement  level.     ELA

Achievement

127714

160008

134423

120983

160706

138174

134423

119889

122170

89%

76%

94309

74%

2006 -­‐0 7

90%

2007 -­‐0 8

2008 -­‐09

2009-­‐10

86%

2010-­‐11

17

The   approach   and   provisions   to   ensure   the   family   planning   service   of   limiting   and   spacing   is   categorized   in   this   section.   It   is   observed   that   there   is   seasonality   in   terms   of   acceptance   of   various  family  planning  methods.  The  table  below  reflects  the  same.   Table  2.8:  FP  performance  of  last  three  years  

    2008-­‐09   2009-­‐10   2010-­‐11  

Quarter  wise  Progress  on  Family  planning  method  mix  in  %   Sterilization   IUCD   1st   2nd   3rd   4th   1st   2nd   3rd   13.4   17.6   18   27   4   8   31.4   14   19   23   24.4   3   8   34   12   27   20.3   23.7   2.5   18.5   31  

4th   44.6   31   34  

 

   

Quarter  wise  Progress  on  Family  planning  method  mix  in  %   CC   OP   1st   2nd   3rd   4th   1st   2nd   2008-­‐09   16   18   21   25   15   19   2009-­‐10   20   25   23   21   17.5   21.5   2010-­‐11   13   21   22   25   13   17  

3rd   21   20   14  

4th   24   18   16  

  The  general  trend  indicates  maximum  performance  in  the  3rd  and  4th  quarter  aimed  to  reach   ELA.   But   the   change   was   conceived   by   all   stake   holders   (Service   Providers,   beneficiaries   and   others)  after  the  phenomenal  success  during  the  last  population  week  of  July  2010.  State  had   recorded  more  than  13,000  sterilization  cases  during  usually  reported  low  acceptance  season   for  family  planning.     This   brought   back   believe  and   restored   the   conviction   that   systematic   and   routine   service   delivery   on   family   planning   yield   results.   Further   a   coordinated   and   planned   effort   can   bring   better   result   by   ensuring   quality   of   care.   This   policy   level   conviction   led   to   undertake   various   initiatives   spearheaded   by   the   SFW   Cell   established   with   UNFPA   support   during  last  year.     1. Developing   District   Family   Planning   Plans:   As   part   of   the   effort   to   promote   differential   planning   and   evidence-­‐based   strategy   in   line   with   mandate   of   National   Rural   Health   Mission,  district  family  planning  plan  documents’  for  all  the  30  Districts  were  developed   through  a  consultative  process.   2. Orientation  on  Family  Planning  Program  Guidelines:    As   part   of   the   effort   to   promote   prudent   clinical   practices,   district   level   program   officers   and   operating   surgeons   were   sensitized   on   various   standards   and   guidelines   published   by   MoHFW,   Government   of   India.   A   total   of   122   program   Officers   from   state   and   districts   were   oriented.   Also   practitioners,   i.e.   surgeons   from   the   accredited   and   private   intuitions   providing   sterilization  and  other  family  planning  services  were  oriented.     3. Contraceptive   Update   Training:   Service   providers,   particularly   medical   officers   were   oriented   on   various   technical   aspects   of   contraception   through   contraceptive   updates   which   is   expected   to   improve   the   contraceptive   services   at   the   district   level   and   would   help  address  the  unmet  need.  

18

4. Promoting   Emergency   Contraceptive   Pills   and   Need-­‐based   Communication   Activities:   Various   communication   activities   utilizing   the   channels   of   mass   media,   mid   media   &   community   mobilization   interventions   along   with   developing   and   distribution   of   information   and   resource   material   on   different   aspects   (MTP,   Cu   T   380   A,   FP   methods,   myths   &   misconception   regarding   FP   services,   contraceptives,   etc)   of   family   planning   were  taken  up  during  the  year.     5. Promoting   Post-­‐Partum   &   Post-­‐Abortion   Contraception   Services:   Orissa   has   witnessed   a   steep  rise  (39%  in  2005-­‐06  to  78%  in  2010-­‐11)  in  the  numbers  of  institutional  deliveries   after   implementation   of   ‘Janani   Surakshya   Yojana’   (JSY),   which   has   created   ample   opportunities   for   promoting   both   limiting   &   spacing   services   among   the   clients   visiting   the  health  facilities  for  institutional  delivery.   5.1:   Post-­‐Partum   Contraception   through   ‘Yashoda’:   Realizing   the   importance   of   the   facility-­‐based   volunteer   (Yashoda)   working   to   promote   post-­‐partum   &   newborn   care   among   the   clients   visiting   the   health   facility   for   delivery,   an   attempt   was   made   to   improve  her  knowledge  &  build  her  capacity  on  counseling  skills  on  family  planning  and     enabling  her  to  promote  post-­‐partum  contraception.     5.2:   Post-­‐Partum   Contraception   through   ‘Family   Planning   Counselors’:   As   part   of   the   state’s   innovation,   steps   have   been   taken   to   re-­‐designate   Yashoda   coordinators   placed   under   NIPI   intervention   as   ‘FP   counselors’   in   16   Districts.   They   have   been   sensitized   through   a   one-­‐day   orientation   workshop   to   promote   post-­‐partum   family   planning   services  among  the  clients  visiting  the  health  facilities  through  counseling  &  motivation.     5.3:  Orientation  of  Staff  Nurses  of  Labour  Rooms  &  Post  Partum  Centers:          In   order   to   promote  counseling  and  provider  client  interface  more  than  78  staff  nurses  were  trained   through  one  day  orientation  workshop  on  “post  partum  &  post  abortion  family  planning   counseling”  at  regional  levels  in  an  attempt  to  promote  informed  choices  among  clients.     In  order  to  move  away  from  camp  mode  to  fixed  day  services,  the  state  has  made  conscious   efforts   to   provide   fixed   day   services   throughout   the   year.   Monday   has   been   designated   as   “Parivar   Kalyan   Diwas”.   This   was   announced   by   the   Hon’ble   Chief   Minister   on   the   occasion   of   “World   Population  Day”  2010.  All  functional  L3  and  L2  centers  are  providing  fixed  day  family   planning   services   on   the   designated   days.   Presently,   it   is   reported   that   291   fixed   day   static   centers  are  in  operation.    

 

19

Table  2.9:  FDS  Centers  in  the  State   District   Angul   Balasore   Baragarh   Bhadrak   Bolangir   Boudh   Cuttack   Deogarh   Dhenkanal   Gajapati   Ganjam   Jagatsinghpur   Jajpur   Jahrsuguda   Kalahandi   Kondhamal   Keonjhar   Kendrapara   Khurda   Koraput   Malkangir   Mayurbhnaj   Nawarangpur   Nayagarh   Nuapada   Puri   Rayagada   Sambalpur   Sonepur   Sundargarh  

No.  of  FDS  Centers   (Target)   12   17   14   7   20   4   21   04   13   09   35   10   12   06   18   14   17   10   14   17   8   34   11   10   06   13   14   15   07   23  

No.  of  FDS  Centers   (Functional)   12   09   10   7   19   2   19   04   13   08   35   10   10   06   18   09   5   10   14   14   7   22   07   09   05   10   04   15   05   13  

No  of  Empanelled  Surgeons   as  on  30.04.2011     33   31   -­‐-­‐   -­‐-­‐   -­‐-­‐   30   6   23   -­‐-­‐   52   -­‐-­‐   -­‐-­‐   -­‐-­‐   27   20   -­‐-­‐   -­‐-­‐   -­‐-­‐   -­‐-­‐   -­‐-­‐   40   6   31   -­‐-­‐   -­‐-­‐   -­‐-­‐   44   6   -­‐-­‐  

 

20

Chapter  -­‐  3   PLAN  FOR  2011-­‐12   Based  on  the  above  facts  and  analysis  of  secondary  data  sources,  the  following      priorities  have   been  assigned  to  the  family  planning  program  by  the  state.    The  priorities  are     3.1:  State  Priorities  during  the  Year:   a. Continuous   effort   to   strengthen   State   Family   Welfare   Bureau   for   better   program   management   b. Strengthening  Quality  Assurance  Mechanism  -­‐  Improved  monitoring  and  feedback  system   for  prudent  clinical  practices  and  quality  of  care     c. Promoting  facility-­‐based  monitoring  of  Family  Welfare    Programs     d. Operationalising  Fixed  Day  Centers  in  all  L1,  L2,  L3  institutions   with  appropriate  for  each   level   e. Promoting  IUCD  as  a  spacing  method   f. Increasing  Focus  on  Promotion  of  NSV  –  10  backward  districts  prioritized       g. Promoting   Post   Partum   &   Post   Abortion   Family   Planning   Services   –   L3   institutions   with   high  delivery  load  and  post  partum  centers     h. Robust    Logistics  &  Supply  Management  System  for  ensuring  Contraceptive  Security     i. Promoting   Informed   Choices   for   FP   Services   by   promoting   ASHA   and   staff   nurses   as   family   planning   counselors.   Mamata   Divas   platform   will   be   used   to   provide   information   and   supplies  for  family  planning   j. Community  Based  non-­‐  Clinical  Contraceptive  Distribution  through  involvement  of  ASHA   3.2:  Service  provisions  in  institutions  at  respective  levels:   Table  3.1:  Service  Provision  –  State  mandate   Services  

L3  Institutions  

L2  Institutions  

L1  Institutions   -­‐-­‐-­‐-­‐-­‐    

Laparoscopic    

L3    Institutions    with  PPC  -­‐79  

-­‐-­‐-­‐-­‐-­‐    

Mini  Lap    

All  Institutions    

All  Institutions     -­‐-­‐-­‐-­‐-­‐-­‐    

NSV/  Conventional    

All  Institutions    

All  Institutions     -­‐-­‐-­‐-­‐-­‐-­‐    

IUD    

All  Institutions    

All  Institutions     All  Institutions    

Distribution  of  OP,  CC     All  Institutions    

All  Institutions     All  Institutions    

Family  Planning   Counseling    

-­‐-­‐-­‐-­‐-­‐-­‐    

All  Institutions  –  YASODHA  in   L3  DHH,  Staff  Nurse/ANM  in   other  institutions      

-­‐-­‐-­‐-­‐-­‐    

  3.3:    Service  Environment:     State   mandate   on   levels   of   institutions   defined   the   minimum     service   provisions   for   family   planning   .It   emphasizes   the   necessary   equipments   and   instruments   at   respective   levels-­‐for   example   in   all   the   L3   institutions   “Laparoscope”   and   IUCD   insertion   kit   in   L1   institutions.   In   order  to  strengthen  and  streamline  the  fixed  day  static  centres  and  to  ensure  quality  services,   these  instruments  and  equipments  are  essential.  Lack  of  the  adequate  &  requisite  facilities  also   21

affects   the       service   delivery   and   poses   a   threat   on   quality   of   care,   compromising   infection   prevention  practices.   Table  3.2:  Presently  the  institutional  readiness  for  limiting  procedure  s  as  follows   Category   Targeted   Functional  Facilities  with    following   of   Institutions   services   Institutions   By  2012   Laparoscopy   Minilap   NSV  

Functional  Fixed  day  Centers   (Any  one  of  the  limiting   Procedures  available  

1   2   1   1   1   0   0   0   0   1   2   1   0   1   0   0   0   3   14   1   1   0   1   0   1   0   1   1   0   1   0   7   21  

0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0   0  

1   2   1   1   1   0   0   0   0   1   2   1   0   0   0   0   0   3   13   1   1   0   1   0   1   0   1   1   0   1   0   7   20  

1   3   1   4   2   2   2   3   3   2   2   1   8   2   2   3   2   5   48   3   3   8   3   5   2   2   2   15   2   3   2   50   98  

1   2   1   2   2   2   2   2   1   2   1   1   5   2   2   2   2   4   36   1   1   5   3   3   2   2   2   8   1   1   2   31   67  

Functional   Institution  

Functional   Institution  

3   3   2   1   1   0   0   0   2   1   2   1   0   0   0   0   3   4   23   2   1   1   1   0   1   0   2   1   0   2   0   11   34  

No.  of  Doctor  

13   9   9   5   3   7   5   11   13   14   13   7   3   9   4   4   14   12   155   11   8   17   5   26   8   11   10   11   29   9   5   150   305  

Functional   Institution  

11   9   9   5   3   4   5   11   13   7   1   3   3   9   4   4   14   9   124   14   8   17   5   26   7   11   10   7   28   9   5   147   271  

NSV  

Non  Functional  

11   13   18   6   4   5   7   19   15   7   1   4   5   22   5   7   16   9   174   15   17   41   6   55   11   15   18   10   35   22   6   251   425  

Laparoscopic  Machine   Functional  

Angul   Baragarh   Bolangir   Boudh   Deogarh   Gajapati   Jharsuguda   Kalahandi   Kandhmal   Keonjhar   Koraput   Malkangiri   Nawarangpur   Nayagarh   Nuapada   Rayagada   Sambalpur   Sundargarh   High  Focus   Balasore   Bhadrak   Cuttack   Dhenkanal   Ganjam   Jagatsinghpur   Jajpur   Kendrapara   Khurda   Mayurbhanj   Puri   Sonepur   Other   Total  

No.  Functional   facility   (observing  in   every  Monday)   No.  Functional   facility   (observing   weekly   sessions)  

  District  

No.  of  Doctors   available  

Minilap  

Laparoscopic   Surgeon  (Yes/  No)  

L3   145   20   119   43   127   L2   438   -­‐-­‐-­‐   152   32   164   L1   899   -­‐-­‐-­‐-­‐   -­‐-­‐-­‐-­‐   -­‐-­‐-­‐-­‐-­‐   -­‐-­‐-­‐-­‐-­‐   Total   20   271   67   291           Table  3.3:  District  wise  Institutional  Readiness  status  for  providing  limiting  Procedures  

12   10   9   5   4   5   5   11   13   7   3   4   6   10   4   5   14   11   138   14   8   17   7   26   7   11   10   11   28   9   5   153   291  

 

22

In  order  to  provide  services  in  L1,  L2,  L3  level  institutions  as  per  mandate,  the  state  has  made   provisions  for  procurement  of  instruments  and  equipments  as  detailed  below.     Table  3.4:  District  wise  procurement  plan   Q1  

Q1  

Q1  

Laparoscope   machine   Q1  

1  

ANUGUL  

9  

17  

31  

 

2  

BALASORE  

12  

27  

24  

 

3  

BARAGARH  

9  

19  

47  

 

4  

BHADRAK  

12  

20  

33  

 

5  

BOLANGIR  

9  

24  

39  

 

6  

BOUDH  

2  

7  

14  

 

7  

CUTTACK  

12  

28  

16  

1  

8  

DEOGARH  

2  

5  

14  

 

9  

DHENKANAL  

7  

17  

25  

 

10  

GAJAPATI  

3  

9  

26  

1  

11  

GANJAM  

19  

35  

63  

1  

12  

JAGATSINGHPUR  

7  

13  

27  

 

13  

JAJPUR  

10  

24  

38  

1  

14  

JHARSUGUDA  

3  

8  

11  

1  

15  

KALAHANDI  

9  

22  

32  

1  

16  

KANDHAMAL  

9  

17  

47  

1  

17  

KENDRAPADA  

12  

20  

17  

 

18  

KEONJHAR  

7  

20  

21  

1  

19  

KHURDA  

10  

14  

19  

 

20  

KORAPUT  

9  

21  

44  

 

21  

MALKANGIRI  

5  

11  

36  

 

22  

MAYURBHANJ  

16  

34  

51  

1  

23  

NABARANGPUR  

7  

20  

28  

1  

24  

NAYAGARH  

7  

16  

26  

 

25  

NUAPADA  

3  

9  

26  

1  

26  

PURI  

9  

19  

29  

 

27  

RAYAGADA  

5  

14  

18  

1  

28  

SAMBALPUR  

5  

17  

21  

1  

29  

SONEPUR  

5  

10  

19  

1  

30  

SUNDERGARH  

17  

24  

57  

 

251  

541  

899  

14  

Sl.   No.  

District  

Total  

NSV  kit  

Minilap-­‐kit  

IUCD  kit  

In  order  to  promote  infection  prevention  practices,  an  amount  of  Rs  20/-­‐  is  allocated  per  each   IUCD  inserted.         3.4:  Human  Resource  Development  Plan  (Training  Plan):   Lack   of   adequate   human   resource,   especially   trained   professionals   to   conduct   sterilization   operation   is   one   of   the   bottlenecks   in   making   the   targeted   institutions   to   ensure   family   planning  services  as  per  the  state  mandate.  The  focus  is  to  make  all  the  L3  intuitions  and  70%   of  L2  institutions  to  provide  at  least  one  of  the  family  planning  services.  This  year  emphasis  is   23

being   given   on   training.   Each   district   has   developed   a   training   plan   identifying   specific   personnel  to  provide  services  at  each  identified  institution.     3.5:   The   training   load   for   the   state   on   Family   Planning   and   special   skill   development   trainings:    

Q1  

Q2  

Q3  

Q4  

Total  target   (batches)  

Remark  

IUCD    

 

 

 

 

 

Medical  officer  &  Staff  Nurses  

 

10  

10  

10  

30  

Dist.  

ANM  &  LHV  

 

20  

20  

20  

60  

Dist.  

O&G  specialists    

3  

 

 

 

3  

State  

Minilap  

 

10  

10  

10  

30  

Dist.  

NSV(ToT)  

 

1  

2  

1  

4  

State  

NSV  

 

10  

10  

 

20  

Dist.  

Contraceptive  update(doctors)  

5  

5  

5  

3  

18  

Dist.  

Contraceptive  update(paramedics)  

5  

5  

10  

10  

30  

Dist.  

Laparoscopy  

 

10  

10  

10  

30  

State  

 

Logistics  &  Supply  chain   management  

 

 

 

 

 

 

Any  other  

 

 

 

 

 

 

  State  Family  Welfare  Cell  will  support  and  supplement  the  efforts  of  State  Institute  of  Health  &   Family   Welfare   in   expediting   and   monitoring   of   the   sessions   by   providing   techno   managerial   support.  The  trainees  will  be  selected  with  preference  to  levels  of  MCH  centers.       (District  wise  training  load)    

 

24

 

 Family  Planning  Training   Sl.   No  

District  

Laparoscopic   Sterilization  Training  

Minilap  Training  

NSV  Training  

Q2   Q3   Q4   Total   Q2   Q3   Q4   Total   Q2   Q3   Q4   Total  

Q2   Q3   Q4   Total  

1  

ANUGUL  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

2  

BALASORE  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

3  

BARAGARH  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

0  

0  

4  

BHADRAK  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

5  

BOLANGIR  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

0  

0  

6  

BOUDH  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

0  

0  

7  

CUTTACK  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

8  

DEOGARH  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

0  

0  

9  

DHENKANAL  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

10   GAJAPATI  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

11   GANJAM  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

12   JAGATSINGHPUR  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

0  

0  

13   JAJPUR  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

0  

0  

14   JHARSUGUDA  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

15   KALAHANDI  

0  

0  

1  

1  

0  

0  

1  

1  

0  

0  

0  

0  

0  

0  

1  

1  

16   KANDHAMAL  

0  

1  

0  

1  

0  

1  

0  

1  

0  

0  

0  

0  

0  

1  

0  

1  

17   KENDRAPADA  

0  

1  

0  

1  

0  

1  

0  

1  

0  

0  

0  

0  

0  

0  

0  

0  

18   KEONJHAR  

0  

1  

0  

1  

0  

1  

0  

1  

0  

0  

0  

0  

0  

1  

0  

1  

19   KHURDA  

0  

1  

0  

1  

0  

1  

0  

1  

0  

0  

0  

0  

0  

0  

0  

0  

20   KORAPUT  

0  

1  

0  

1  

0  

1  

0  

1  

0  

0  

0  

0  

0  

1  

0  

1  

21   MALKANGIRI  

0  

1  

0  

1  

0  

1  

0  

1  

0  

0  

0  

0  

0  

1  

0  

1  

22   MAYURBHANJ  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

1  

0  

0  

1  

23   NABARANGPUR  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

1  

0  

0  

1  

24   NAYAGARH  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

1  

0  

0  

1  

25   NUAPADA  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

1  

0  

0  

1  

26   PURI  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

0  

0  

0  

0  

27   RAYAGADA  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

1  

0  

0  

1  

28   SAMBALPUR  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

1  

0  

0  

1  

29   SONEPUR  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

0  

0  

0  

0  

30   SUNDERGARH  

1  

0  

0  

1  

1  

0  

0  

1  

0  

0  

0  

0  

1  

0  

0  

1  

31   State  

0  

0  

0  

0  

0  

0  

0  

0  

1  

2  

1  

4  

0  

0  

0  

0  

9  

6  

15  

30  

9  

6  

15  

30  

1  

2  

1  

4  

7  

4  

9  

20  

Total  

    25

Sl.   No.  

District  

Training  of  MO  &  SN  

Training  of  ANM  &  LHV  

Q2   Q3   Q4   Total   Q1   Q2   Q3   Q4   Total  

Trng.  of   OG  Spl.   (State)  

IUD  Insertion  Training   Training  of  OG  SPl.  &  SN       (3  days)  

Q1  

Q1   Q2   Q3   Q4   Total  

1  

ANUGUL  

1  

0  

0  

1  

0  

1  

0  

1  

2  

0  

1  

0  

0  

0  

1  

2  

BALASORE  

1  

0  

0  

1  

0  

1  

0  

1  

2  

0  

1  

0  

0  

0  

1  

3  

BARAGARH  

1  

0  

0  

1  

0  

1  

0  

1  

2  

0  

1  

0  

0  

0  

1  

4  

BHADRAK  

1  

0  

0  

1  

0  

1  

0  

1  

2  

0  

1  

0  

0  

0  

1  

5  

BOLANGIR  

1  

0  

0  

1  

0  

1  

0  

1  

2  

0  

1  

0  

0  

0  

1  

6  

BOUDH  

1  

0  

0  

1  

0  

0  

0  

1  

1  

0  

0  

1  

0  

0  

1  

7  

CUTTACK  

1  

0  

0  

1  

0  

1  

0  

1  

2  

0  

0  

1  

0  

0  

1  

8  

DEOGARH  

1  

0  

0  

1  

0  

0  

0  

1  

1  

0  

0  

1  

0  

0  

1  

9  

DHENKANAL  

1  

0  

0  

1  

0  

1  

0  

1  

2  

0  

0  

1  

0  

0  

1  

10  

GAJAPATI  

1  

0  

0  

1  

0  

0  

0  

1  

1  

0  

0  

1  

0  

0  

1  

11  

GANJAM  

0  

0  

1  

1  

1  

1  

1  

2  

5  

0  

0  

1  

0  

0  

1  

12  

JAGATSINGHPUR  

0  

0  

1  

1  

0  

0  

1  

0  

1  

0  

0  

1  

0  

0  

1  

13  

JAJPUR  

0  

0  

1  

1  

0  

1  

1  

0  

2  

0  

0  

1  

0  

0  

1  

14  

JHARSUGUDA  

0  

0  

1  

1  

0  

0  

1  

0  

1  

0  

0  

1  

0  

0  

1  

15  

KALAHANDI  

0  

0  

1  

1  

0  

1  

1  

0  

2  

0  

0  

1  

0  

0  

1  

16  

KANDHAMAL  

0  

0  

1  

1  

0  

1  

1  

0  

2  

0  

0  

0  

1  

0  

1  

17  

KENDRAPADA  

0  

0  

1  

1  

0  

1  

1  

0  

2  

0  

0  

0  

1  

0  

1  

18  

KEONJHAR  

0  

0  

1  

1  

0  

1  

1  

0  

2  

0  

0  

0  

1  

0  

1  

19  

KHURDA  

0  

0  

1  

1  

0  

1  

1  

1  

3  

0  

0  

0  

1  

0  

1  

20  

KORAPUT  

0  

0  

1  

1  

0  

1  

1  

0  

2  

0  

0  

0  

1  

0  

1  

21  

MALKANGIRI  

0  

1  

0  

1  

0  

0  

1  

0  

1  

0  

0  

0  

1  

0  

1  

22  

MAYURBHANJ  

0  

1  

0  

1  

0  

0  

3  

2  

5  

0  

0  

0  

1  

0  

1  

23  

NABARANGPUR  

0  

1  

0  

1  

0  

0  

1  

1  

2  

0  

0  

0  

1  

0  

1  

24  

NAYAGARH  

0  

1  

0  

1  

0  

0  

1  

0  

1  

0  

0  

0  

1  

0  

1  

25  

NUAPADA  

0  

1  

0  

1  

0  

0  

1  

0  

1  

0  

0  

0  

1  

0  

1  

26  

PURI  

0  

1  

0  

1  

0  

0  

1  

1  

2  

0  

0  

0  

0  

1  

1  

27  

RAYAGADA  

0  

1  

0  

1  

0  

0  

1  

1  

2  

0  

0  

0  

0  

1  

1  

28  

SAMBALPUR  

0  

1  

0  

1  

0  

0  

1  

1  

2  

0  

0  

0  

0  

1  

1  

29  

SONEPUR  

0  

1  

0  

1  

0  

0  

1  

0  

1  

0  

0  

0  

0  

1  

1  

30  

SUNDERGARH  

1  

0  

0  

1  

0  

0  

2  

2  

4  

0  

0  

0  

0  

1  

1  

31  

State  

0  

0  

0  

0  

0  

0  

0  

0  

0  

3  

0  

0  

0  

0  

0  

11  

9  

10  

30  

1  

15  

23  

21  

60  

3  

5  

10  

10  

5  

30  

Total  

  26

Contraceptive  Update  Training   Sl.   No.  

District  

Training  of  MOs  (  1  day)  dist.  

Training  of  paramedics  

Q1  

Q2  

Q3  

Q4  

Total  

Q1  

Q2  

Q3  

Q4  

Total  

1  

ANUGUL  

0  

0  

0  

0  

0  

1  

0  

0  

0  

1  

2  

BALASORE  

0  

0  

0  

0  

0  

1  

0  

0  

0  

1  

3  

BARAGARH  

0  

0  

0  

0  

0  

1  

0  

0  

1  

2  

4  

BHADRAK  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

5  

BOLANGIR  

0  

0  

0  

0  

0  

1  

0  

0  

0  

1  

6  

BOUDH  

0  

0  

0  

0  

0  

0  

1  

0  

0  

1  

7  

CUTTACK  

0  

0  

0  

0  

0  

0  

1  

0  

0  

1  

8  

DEOGARH  

0  

0  

0  

0  

0  

0  

1  

0  

0  

1  

9  

DHENKANAL  

0  

0  

0  

0  

0  

0  

1  

0  

0  

1  

10  

GAJAPATI  

0  

0  

0  

0  

0  

0  

1  

0  

0  

1  

11  

GANJAM  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

12  

JAGATSINGHPUR  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

13  

JAJPUR  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

14  

JHARSUGUDA  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

15  

KALAHANDI  

0  

0  

 

0  

0  

0  

0  

0  

0  

0  

16  

KANDHAMAL  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

17  

KENDRAPADA  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

18  

KEONJHAR  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

19  

KHURDA  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

20  

KORAPUT  

0  

0  

0  

0  

0  

0  

0  

1  

0  

1  

21  

MALKANGIRI  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

22  

MAYURBHANJ  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

23  

NABARANGPUR  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

24  

NAYAGARH  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

25  

NUAPADA  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

26  

PURI  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

27  

RAYAGADA  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

28  

SAMBALPUR  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

29  

SONEPUR  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

30  

SUNDERGARH  

0  

0  

0  

0  

0  

0  

0  

0  

1  

1  

31  

State  

5  

5  

5  

3  

18  

0  

0  

0  

0  

0  

5  

5  

5  

3  

18  

4  

5  

9  

12  

30  

Total  

      27

3.6:    Logistics  and  Supply  System:   To  address  the  existing  bottlenecks  in  supply  chain  management  and  to  strengthen  the  logistics   and  supply  chain  of  the  family  planning  supplies,  major  initiatives  planned  for  the  year  are  as   follows.   • Establishment   of   Mobile   SMS   based   CLMIS   (Contraceptive   Logistics   Management   Information  Systems)  is  one  of  the  major  activities  planned.  This  innovative  system  has   been   developed   with   an   intention   to   track   the   entire   supply   chain   accurately   and   in   time   up   to   sub   center   level.   This   will   control   the   supply   chain   operation   to   reduce   supply   imbalance   and   regulate   the   flow   of   supplies   up   to   sub   center   level   through   mobile  SMS.   • Capacity   building   program   for   district   and   block   level   store   officials   on   demand   forecasting,  inventory  management  and  warehouse  management  will  be  carried  out.       3.7:  Quality  assurance  Plan:     All   districts   have   constituted   quality   assurance   Committees.   The   committee   meets   every   quarter  and  discusses  issues  pertaining  to  sterilization  complication,  failure,  insurance,  quality   standards   and   empanelment   of   doctors   for   sterilization   operations.   This   year   the   thrust   is   to   sensitize  the  members  of  district  Quality  Assurance  Committee  and  ensuring  their  involvement   and   active   participation   in   performing   the   six   activities   of   QACs   i.e.   Facility   audit,   client   exist   interview,   review   of   records,   empanelment   of   doctors,   quality   and   technical   aspects   of   the   family  planning  interventions.       3.8:  Plan  for  promoting  Public  Private  Partnership  for  Family  Planning:     Partnership   with   the   Private   health   institutions   expands   the   horizon   of   service   reach   &   accessibility.   This   year   it   is   planned   to   accredit   more   private   institutions   for   family   planning   services.  Efforts  are  being  made  to  initiate  new  interventions  with  the  support  and  partnership   of  NGOs.  Presently  the  Community  Based  Distribution  of  non  clinical  contraceptives  is  piloted   in  Ganjam  with  UNFPA  support,  where  ASHA  and  spouse  are  engaged  at  the  community  level   for  promoting  non  clinical  contraceptives  and  information  on  family  planning.     3.9  IEC/BCC  Plan:   Given  the  uniqueness  of  initiative  of  the  district  administration  to  promote  &  revive  traditional   local  folk  theatre  in  Ganjam  district,  steps  have  been  taken  to  organize  community  mobilization   activities  for  promoting  family  planning  and  improve  maternal  and  child  health  outcomes.       Measures  have  been  taken  for  devising  effective  communication  strategy.  SFW  cell  is  making   concentrated   efforts   to   promote   need   based   communication   initiatives   in   family   planning   program.   Several   pathways   are   being   adopted   to   reach   every   section   of   the   society   and   to   promote  informed  choices.     3.9.1 Promoting  communication  through  traditional  folk  arts  has  been  piloted  in  Ganjam  with   extensive   engagement   of   community   based   theatres   to   promote   family   planning   messages.   Trainings   were   organized   to   develop   standardized   scripts   and   sensitizing   the   troupes   for   disseminating   family   planning   messages.   Efforts   are   underway   to   promote   this   initiative   in   other  districts.   28

3.9.2 Engagement  of  mass  media-­‐  Several  programs  like  live  panel  discussions  and  phone  in   and  scrolls  through  popular  TV  channels  are  also  planned  in  this  year.     3.9.3 In  addition  to  this,  regular  IEC  activities  will  also  continue.     3.10:  Eligible  Couple  Survey:   The   last   eligible   Couple   survey   conducted  in   2005-­‐06.   This   year   it   is   planned   to   re-­‐   conduct   the   survey  and  update  the  Eligible  Couple  register.  The  survey  will  be  conducted  in  each  village  of   the   6688   sub   centers   around   Feb-­‐March   2012.   In   order   to   ensure   complete   coverage,   ASHAs   are  being  engaged  in  conducting  eligible  couple  survey.  

29

Chapter  -­‐  4   DETAILED  FAMILY  PLANNING  BUDGET:    2011-­‐  12   Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter   Q-­‐II  

Q-­‐III  

Q-­‐IV  

 Financial  target  for  the  quarter     Total   Target  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

Remarks    

 Amount   (Rs.  Lakhs)    

   

A3.            FAMILY  PLANNING   A3.1  

Terminal/Limiting  Methods  

   

   

A3.1.1  

Dissemination  of  manuals  on   sterilization  standards  &  quality   assurance  of  sterilization  services     Orientation  of  Programme  Officers   (ADMOs-­‐FW,  DPMs  &  RCH   Coordinators)  at  State  level   Orientation  workshop  at  District   level  for  Block  MO  I/C,  empanelled   operating  surgeons  including  that   of  accredited  institutions   Quarterly  Female  Sterilization   Camps  to  address  backlogs  -­‐  one   camp  per  qtr  per  district  in  the  low   performing  zone   NSV  camp  -­‐  one  camp  per  qtr  per   district  in  10  districts  (  Koraput,   Rayagada,  Malkangiri,   Nabarangpur,  Kalahandi,  Nuapada,   Bolangir,  Sonepur,  Mayurbhanj   and  Kandhamal)   Compensation  for  Female   sterilization     Compensation  for  Male   sterilization     Total  of  Sterilization   Budget  for  Sterilization  (85%  of   Total  Sterilization  Budget)  

   

   

Per  Work   Shop    

   

Per  Work   Shop    per   district  

   

Per  camp   per   quarter  

A3.1.1.1  

A3.1.1.2  

A3.1.2  

A3.1.3  

A3.1.4   A3.1.5          

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

              1   100,000    

   

   

   

1  

                      1.00    

                            -­‐        

                                                                                        -­‐         -­‐         1.00    

                  30   15,000    

   

   

   

30  

                      4.50    

                            -­‐        

                                                                                        -­‐         -­‐         4.50    

   

                  30   15,000    

30  

30  

30  

120  

                      4.50    

                      4.50    

                                                  4.50     4.50    

                      18.00    

Per  camp   per   quarter  

   

                  10   35,000    

10  

10  

10  

40  

                      3.50    

                      3.50    

                                                  3.50     3.50    

                          14.00    

Per   Beneficiary   Per   Beneficiary          

   

           1,000     38900  

38900  

38900  

38926  

155626  

   389.00    

1,556.26    

   

   

           1,500    

5300  

5300  

5300  

5320  

21220  

   

       

       

       

       

       

       

       

                                                                                                  79.50     79.50     79.50     79.80     318.30     468.50     468.50     468.50     469.06     1,874.56                                                                                   398.23     398.23     398.23     398.70     1,593.38    

   

389.00    

389.00    

389.26    

       

   

    Based  on  the   previous  year  trend   (last  year  coverage   was  85%)  

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

   

   

   

   

Per  block  

   

   

               

               

               

Per   beneficiary  

   

Per  case  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter  

 Financial  target  for  the  quarter    

Remarks    

Q-­‐III  

Q-­‐IV  

Total   Target  

   

   

   

   

94  

   

   

   

94  

               

               

               

               

               

     20    

39790  

39790  

39790  

39790  

159160  

7.96    

7.96    

7.96    

7.96    

31.83    

Budgeted  for  80%   beneficiaries  

   

     100    

1990  

1990  

1990  

1990  

7960  

1.99    

1.99    

1.99    

         1.99    

7.96    

Per  case  

   

     75    

   

3315  

3315  

3315  

9945  

-­‐        

2.49    

2.49    

2.49    

7.46    

Budgeted  for  5%  of   159160   beneficiaries   Budgeted  for  5%   beneficiaries  

   

   

   

   

   

   

   

   

   

   

   

   

   

Q-­‐II  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

   

   

   

   

 Amount   (Rs.  Lakhs)    

    A3.1.6  

Accreditation  of  private  providers   for  sterilization  services   A3.1.6.1   Accreditation  of  private   institutions  for  Inst.  Del.  &  FP   services  -­‐  Mobility  support  to  the   appraisal  team     Sub-­‐total  A3.1  (excluding  Sterilization  &  NSV)   A3.2   Spacing  Methods   A3.2.1   IUD  Camps   A3.2.2   IUD  services  at  health  facilities/   compensation   A3.2.2.1   For  Beneficiary  (to  be  utilized  to   meet  essential  requirements  on   IUD  services  at  institution  level)   A3.2.2.2   Incentive  to  ASHA  for  ensuring   retention  of  IUD  by  plants  for  1yr     A3.2.3  

A3.2.4   A3.2.4.1  

A3.2.4.2  

A3.3   A3.3.1   A3.3.2   A3.3.3  

Incentive  to  private  accredited   institutions  for  IUD  insertion   services   Social  Marketing  of   contraceptives   One  Day  Contraceptive  update  &   family  planning  guideline  trg.  for   MOs  (District)     Contraceptive  update  Trg.  To   Paramedics  (SN,  LHV,  HWF,  HWM,   HSM)  per  Dist.  One  batch  at   District  level   Sub-­‐total  A3.2   POL  for  FP/Others  -­‐  Trasportation   of  FW  materials   State  to  district   District  to  Block   Block  to  Sector    

                                                          -­‐         -­‐        

9.00                

4.50                

   

                                                                                             -­‐         -­‐         -­‐        

4.50                

4.50                

23.50                

30/batch  

440  

41,025    

5  

5  

5  

3  

18  

   

   

   

   

                               -­‐        

30/batch  

NIL  

 36,525    

5  

5  

10  

10  

30  

   

   

   

   

                               -­‐        

       

       

       

       

       

       

       

       

9.95        

           

           

           

           

           

           

           

           

           

12.43                    

12.43                    

12.43                    

47.25                    

    30%  blocks  having   private  institutions.   Budget  under  Inst.   Strgh.  

               

     Budget  under   training    

        Budget  under  Reg.   Drug  WH  (NRHM   Int.)   State-­‐B21.1.2,  Dist-­‐ B21.2.4  &  Block-­‐

31

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

Physical  Target  for  the  quarter  

 Rate   (Rs./unit)       Q-­‐I  

Q-­‐II  

Q-­‐III  

 Financial  target  for  the  quarter     Total   Target  

Q-­‐IV  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

   

B21.3.4  

A3.4  

Repair  of  laprascopes  

   

   

   

   

   

   

   

   

   

A3.5  

Sub-­‐total  A3.3  &  A3.4   Other  strategies/activities      

       

       

       

       

       

       

       

       

       -­‐            

Strengthening  of  Family  Welfare   Bureau  for  quality   implementation  of  family   planning  program     At  State  level   Manpower     Mobility  cost  for  supportive   supervision   Operational  cost   At  District  level   Manpower    

   

   

   

   

   

   

   

   

   

        Per  month  

           

   

Per  month          

           

                          20,000     10,000            

   

   

   

Per  district   per  month  

   

2,500    

   

   

   

   

A3.5.1  

A3.5.1.1   A3.5.1.1.1   A3.5.1.1.2   A3.5.1.1.3  

A3.5.1.2   A3.5.1.2.1  

A3.5.1.2.2   A3.5.1.2.3  

A3.5.2   A3.5.2.1  

A3.5.2.2  

Mobility  cost  for  supportive   supervision   Operational  cost  for  Dist.  FW   Bureau  for  meeting  exp.,   reporting,  internet,  telephone,   postage  etc.   Operationalization  of  fixed  day   static  services-­‐Family  welfare  day   Mapping  of  availability  of  skilled   human  resources,  regularly   updating  empanel  of  doctors  and   orientation  at  district  level   Minilap  training  for  MO  (Asst   Surgeon  of  L3  &  L2):  twelve   working  days  at  District  level  

3/batch  

154  

   

Remarks    

 Amount   (Rs.  Lakhs)    

   

   

    -­‐        

   

    -­‐        

    -­‐        

   

   

   

   

   

   

   

   

   

   

State  Eqp.  Maint.   Unit  to  look  into    

                               -­‐                    

   

   

       

       

       

       

           

       

       

       

       

        Funded  by  UNFPA                                      -­‐         Budget  under  Prog.  

           

           

           

           

           

           

           

           

           

                               -­‐                

   

   

   

   

   

   

   

   

   

Mgt.  

   

    RCH  Coordinator   will  be  given   additional   responsibility   Budget  under  Prog.   Mgt.  

30  

30  

30  

30  

30  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

To  be  updated  in   regular  monthly   meeting  

   

10  

10  

10  

30  

   

   

   

   

32,580    

                               -­‐        

                               -­‐          Budget  under   training    

32

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter   Q-­‐II  

 Financial  target  for  the  quarter    

Q-­‐III  

Q-­‐IV  

Total   Target  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

 Amount   (Rs.  Lakhs)    

Remarks    

    A3.5.2.3   A3.5.2.4   A3.5.2.5  

A3.5.3  

A3.5.3.1  

A3.5.3.2  

A3.5.4   A3.5.4.1  

A3.5.5   A3.5.5.1   A3.5.5.1.1  

A3.5.5.2   A3.5.5.2.1  

NSV  training  for  MOs  five  working   days.  State    level  TOT   NSV  training  for  MOs  five  working   days.  District    level  

5/batch  

0  

94,188    

   

1  

2  

1  

4  

   

   

   

   

                               -­‐        

5/batch  

62  

27,375    

   

10  

10  

   

20  

   

   

   

   

                               -­‐        

Organisation  of  Fixed  day  -­‐  weekly   Per  fixed   (Contigency  cost  to  L3:145  (100%)   day  weekly   +  L2:  219  (50%))     per  inst.   Promote  postpartum  and  post       abortion  family  planning  services   including  sterilization  in  facilities     having  high  institutional  deliveries       Orientation  cum  review  of  FP   Per   counselors/  Yashodas  supervisor  &   training   SN  (bi-­‐annually)  to  access  &  review   FP  performance  &  providing   handholding  for  improving   performance     Biannual  review  of  PPC  I/c  on  FP       activities  at  divisional  level  for   strengthening  FP  service  in  PP   centers   Promote  Community  Based  family       planning  services    

   

                 200    

300  

350  

364  

364  

1378  

   

   

   

   

                               -­‐        

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

Supported  by   UNFPA  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

Community  based  distribution  of   non-­‐clinical  contraceptives  (piloted   in  Ganjam)  through  ASHAs   Trainings   Laparoscopic  sterilization  training   Laparoscopic  sterilization  training   for  teams  (three  members  :  MO,   SN,  Attendant)  :twelve  working   days  at  Zonal  Level   IUD  insertion  training   Six  days  Dist  level  IUCD  training  for   MO  and  SN    

   

   

   

   

   

   

   

   

   

   

   

 Supported  by   UNFPA    

           

        10  

        10  

        10  

        30  

           

           

           

           

                                       -­‐        

       

    10  

    10  

    10  

    30  

       

       

       

       

                                   -­‐        

   

        3/batch  

        55  

    12/batch  

    378  

   

                          29,360    

    63,755    

Cost  to  be  met   from  RKS  

Budget  under   Training  

33

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter   Q-­‐II  

 Financial  target  for  the  quarter    

Q-­‐III  

Q-­‐IV  

Total   Target  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

 Amount   (Rs.  Lakhs)    

Remarks    

    A3.5.5.2.2   A3.5.5.2.3  

A3.5.5.2.4  

A3.5.6   A3.5.6.1   A3.5.6.2   A3.5.6.3  

A3.5.6.4   A3.5.6.5  

A3.5.6.6  

Six  days  Block  level  IUCD  training   for  ANM,  LHV   Three  Days  Postpartum  IUCD   Training  for  O&G  Spl.,  Staff  Nurses   of  Dist.,  Prof.  &  Asso.  Proff.  (O&G)   of  MCH,  Faculty  of  SIHFW  at  State   Level   Three  days  Postpartum  IUCD   Training  for  O&G  Spl    and  Staff   Nurses  of  Respective  Districts   (5MOs+5SNs)   Printing   Printing  of  sterilization  case  cards     Printing  of    village  wise  EC  register   Printing  of  resource  materials  on   contraceptive  choices  in  local   languages  for  Service  provider   Printing  of  checklist  for  FP   Counselor   Display  boards  depicting  all   benefits,  side  effects  &  contra   indications  of  Contraceptives  to  be   displayed  in  PP  centers   Printing  of    green  cards  

10/batch  

0  

49,950    

   

20  

20  

20  

60  

   

   

   

   

                               -­‐        

25/batch  

0  

114,920    

3  

0  

0  

0  

3  

   

   

   

   

                               -­‐        

10/batch  

0  

   32,225    

4  

10  

10  

6  

30  

   

   

   

   

                               -­‐        

    Per  card   Per   register   Per   material  

           

               10                40    

    180000   60000  

           

           

           

    180000   60000  

           

           

           

           

           

   

   

   

500000  

   

   

   

500000  

   

   

   

   

   

UNFPA  support  

Per   checklist      

   

   

100000  

   

   

   

100000  

   

   

   

   

   

   

   

   

   

   

   

0  

   

   

   

   

   

Per  card  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

Met  from  State   budget      

Budget  under   procurement   (NRHM  Int.)  

A3.5.7  

Procurement  of  equipment  &   instrument  for  operationalisation   of  FP  services  

A3.5.7.1   A3.5.7.2  

NSV  kit   Minilap  kit  

Per  kit   Per  kit  

       

2,500            6,000    

251   541  

       

       

       

251   541  

       

       

       

       

       

A3.5.7.3  

IUCD  kit  

Per  kit  

   

2,000    

899  

   

   

   

899  

   

   

   

   

   

Budget  under   Advocacy  for   NRHM    

34

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter   Q-­‐II  

 Financial  target  for  the  quarter    

Q-­‐III  

Q-­‐IV  

Total   Target  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

Remarks    

 Amount   (Rs.  Lakhs)    

    A3.5.7.4  

A3.5.7.5   A3.5.7.6  

Laparoscope  machine  (Total   requirement  is  42  to   operationalise  all  L3  institutions   having  PPC,  but  fund  request  for   50%  of  it)   Racking  system  at  State  FW  store   Pregnancy  kit  to  be  used  before   sterilization  during  camp  

Per   machine  

   

630,000    

14  

   

   

   

14  

   

   

   

   

   

       

       

2,000,000        

1      

       

       

       

1      

       

       

       

       

       

GoI  supply  

   

A3.5.7.7   A3.5.8  

FW  material   Performance  Based  Awards    

       

       

       

       

       

       

       

       

       

       

       

       

       

A3.5.8.1  

Performance  based  incentives  (3   districts)  to  best  performing   districts   Performance  based  incentives  (3   awards)  to  best  performing   surgeons       Performance  based  incentives   (awards)  to  best  Fixed  Day  Static   Unit  at  district  level     Monitoring   Bi-­‐annual  state  level  QAC  review   meeting  (Integrated  with  general   QAC  meeting)   State  level  quarterly  review   meeting  of  low  performing   districts     Divisional  Bi-­‐annual  Review   meeting  of  ADMO  and  DPM   Bi-­‐annual  review  of  DHIO  &  SA/SI   for  improved  monitoring  at  state   level   District  level  QAC  meeting   (Integrated  with  general  QAC   meeting)  

   

   

              100,000    

   

   

   

   

   

   

   

   

   

   

   

   

              100,000    

   

   

   

   

   

   

   

   

   

   

Per   district  

   

                  20,000    

   

   

   

30  

30  

   

   

   

   

   

    per   meeting  

       

                          5,000    

    1  

       

    1  

       

    2  

       

       

       

       

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

                      1,000    

30  

30  

30  

30  

120  

   

   

   

   

A3.5.8.2  

A3.5.8.3  

A3.5.9   A3.5.9.1  

A3.5.9.2  

A3.5.9.3   A3.5.9.4  

A3.5.9.5  

Per  district   per  quarter  

                                   -­‐        

                               -­‐        

Budget  under  Infr.   &  HR  

    Budget  under  M&E  

UNFPA  support  

Budget  under  M&E  

35

Point   No.  

Budget  head  

Unit  of   measure  

Base-­‐line   (current   status)  

   

   

   

   

Lump  sum  

   

   

       

       

   

 Rate   (Rs./unit)       Q-­‐I  

Physical  Target  for  the  quarter  

 Financial  target  for  the  quarter    

Remarks    

Q-­‐III  

Q-­‐IV  

Total   Target  

   

   

   

   

   

   

   

   

   

   

                                                          -­‐         -­‐        

                                                                                             -­‐         -­‐         -­‐        

       

       

       

       

       

       

       

       

       

       

       

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

       

       

       

       

       

       

       

       

       

       

       

       

       

0  

1  

0  

0  

1  

   

   

   

   

                               -­‐        

 Budget  under   Training    

       

       

       

       

       

-­‐         4.50    

-­‐         4.50    

-­‐         4.50    

                               -­‐         23.50    

   

Q-­‐II  

 Q-­‐I    

 Q-­‐II    

 Q-­‐III    

 Q-­‐IV    

   

   

   

 Amount   (Rs.  Lakhs)    

    A3.5.9.6  

Quarterly  family  planning  review   by  District  Authorities  

A3.5.9.7  

Rapid  assessment  cum  validation   of  FP  services  at  all  Fixed  Day   Static  Centres   IEC/BCC   State  Media  Workshop    with  focus   on  FDSA   Mass  media  activities  –  production   &  telecasting/  dissemination  

A3.5.10   A3.5.10.1   A3.5.10.2   A3.5.10.3  

Observation  of  World  Population   Week     A3.5.10.4   PRI  sensitization  on  FP  issues   A3.5.10.5   Create  ‘Enabling  Environment’  in   PPC     A3.5.11   Training  on  effective  Management   of  Pro-­‐Mis  to  Block  level  staff  of   Puri  Dist.  On  Pilot  basis  at  District   level   Sub-­‐total  A3.5   Total  (excluding  Sterilization,  NSV  &  IUD)  

33/batch  

       

NIL  

       

                  34,225    

       

         -­‐            9.00    

   

Met  out  of  Dist.   Level  monthly   meeting  (Inst.   Strg.)   Budget  under     OHSP       Budget  under   IEC/BCC  (NRHM   Int.)  

   

   

             

36

Annexure  –  1    

District  Wise  Expected  Level  of  Achievement  for  the  Year  2011-­‐12   Sl.   No.  

District  

Expected  Level  of  Achievement  (ELA)  (2011-­‐12)   Condom   Oral  Pills   CuT380A   Sterilization   14,266   8,406   7,118   5,898  

01  

Bargarh  

02  

Jharsuguda  

5,401  

3,183  

2,695  

2,231  

03  

Sambalpur  

9,914  

5,842  

4,947  

4,071  

04  

Debagarh  

2,905  

1,712  

1,449  

1,201  

05  

Sundargarh  

19,399  

11,431  

9,679  

8,018  

06  

Kendhujhar  

16,552  

9,753  

8,258  

6,844  

07  

Mayurbhanj  

23,561  

13,883  

11,755  

9,738  

08  

Baleswar  

21,453  

12,641  

10,703  

8,867  

09  

Bhadrak  

14,133  

8,328  

7,051  

5,839  

10  

Kendrapara  

13,797  

8,130  

6,884  

5,706  

11  

Jagatsinghpur  

11,207  

6,604  

5,592  

4,631  

12  

Cuttack  

24,807  

14,618  

12,377  

10,259  

13  

Jajpur  

17,212  

10,142  

8,588  

7,113  

14  

Dhenkanal  

11,305  

6,662  

5,641  

4,672  

15  

Angul  

12,080  

7,118  

6,027  

4,994  

16  

Nayagarh  

9,161  

5,398  

4,571  

3,787  

17  

Khorda  

19,894  

11,722  

9,926  

8,216  

18  

Puri  

15,923  

9,383  

7,945  

6,568  

19  

Ganjam  

33,492  

19,735  

16,710  

13,749  

20  

Gajapati  

5,498  

3,240  

2,743  

2,272  

21  

Kandhamal  

6,869  

4,047  

3,427  

2,840  

22  

Boudh  

3,956  

2,331  

1,974  

1,635  

23  

Sonepur  

5,742  

3,383  

2,865  

2,370  

24  

Balangir  

14,170  

8,349  

7,070  

5,855  

25  

Nuapada  

5,623  

3,314  

2,806  

2,325  

26  

Kalahandi  

14,152  

8,339  

7,061  

5,849  

27  

Rayagada  

8,807  

5,189  

4,394  

3,607  

28  

Nabaranghpur  

10,870  

6,405  

5,423  

4,463  

29  

Koraput  

12,511  

7,372  

6,242  

5,163  

30  

Malkangiri  

5,343  

3,148  

2,666  

2,105  

   

Total  

390,003  

229,808  

194,587  

160,886    

   

Annexure  -­‐  II  

Monitorable  Indicators  Family  Planning  2011-­‐12,  Orissa   2010-­‐11  

2011-­‐12  

Baseline   SN.  

INDICATOR  

Q1  Target  

(Apr-­‐Nov  2010)  

Q2  Target  

Q3  Target  

Q4  Target  

Annual  Target  

HF  

State  

HF  

State  

HF  

State  

HF  

State  

HF  

State  

HF  

State  

Districts  

total  

Dist  

Total  

Dist  

Total  

Dist  

Total  

Dist  

Total  

Dist  

Total  

C  

Family  Planning  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

C.1  

Service  Delivery   %  of  total  sterilization  against   ELA     %  post  partum  sterilization  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

35%  

   

33%  

20  

20  

43  

45  

70  

70  

90  

90  

90  

90  

   

4%  

   

5%  

4  

5  

6  

8  

6  

8  

8  

10  

10  

10  

   

5%  

   

4%  

5  

6  

7  

9  

8  

10  

12  

12  

12  

12  

   

46%  

   

49%  

20  

20  

45  

50  

65  

70  

90  

90  

90  

90  

C.1.5  

%  male  sterilizations   %  of  IUD  insertions  against   planned   %  IUD  retained  for  6  months  

   

39%  

   

42%  

   

   

   

   

   

   

   

   

   

   

C.2  

Quality    

   

   

   

   

   

   

   

   

   

   

   

   

   

   

C.2.1  

%  of  complications  following   sterilization  

   

2.90%  

   

2.71%  

   

   

   

   

   

   

   

   

   

   

C.3  

Outputs  

Cur.Yr  

Cum  

Cur.Yr  

Cum  

   

   

   

   

   

   

   

   

   

   

C.3.1  

%  doctors  trained  as  minilap  

20   (48%)  

69     (51%)  

45   (50%)  

136    (15%)  

-­‐-­‐-­‐-­‐  

-­‐-­‐-­‐-­‐  

18   (60%)  

30   (33%)  

18   (60%)  

30   (33%)  

18    (60%)  

18   (60%)  

54     (60%)  

90   (100%)  

C.3.2  

%  doctors  trained  as  NSV  

14    (14%)   30   (50%)  

59   (8%)   49   (21%)  

-­‐-­‐-­‐-­‐  

%  doctors  trained  as   laparoscopic  sterilization    

32   (55%)   15   (30%)  

-­‐-­‐-­‐-­‐  

C.3.3  

9   (68%)   14   (45%)  

-­‐-­‐-­‐-­‐  

-­‐-­‐-­‐-­‐  

32   (65%)   18   (60%)  

50    (33%)   30   (33%)  

32   (65%)   18   (60%)  

50     (33%)   30   (33%)  

32   (65%)   18   (60%)  

50    (33%)   30   (33%)  

96   (65%)   18   (60%)  

150   (100%)   90   (100%)  

C.1.1   C.1.2   C.1.3   C.1.4  

2010-­‐11  

2011-­‐12  

Baseline   SN.  

INDICATOR  

C.3.4  

%  ANM/LHV/SN/MO  trained   in  IUD  insertion    

C.4  

HR  productivity    

C.4.1   C.4.2  

C.4.3  

C.4.4  

C.4.5   C.5   C.5.1   C.5.2  

Average  no.  of  NSVs   conducted  by  trained  doctors   Average  no.  of  minilap   sterilizations  conducted  by   minilap  trained  doctors    Average  no.  of  laparoscopic   sterilizations  conducted  by   lap  sterilization  trained   doctors   Average  no.  of  IUDs  inserted   by  MO  trained  in  IUD   insertion   Average  no.  of  IUDs  inserted   by  SN/  LHV/  ANM  trained  in   IUD  insertion   Facility  utilization     Average  no.  of  sterilizations   performed  in  FRUs   Average  no.  of  sterilizations   performed  in  24x7  PHCs  

Q1  Target  

(Apr-­‐Nov  2010)  

Q2  Target  

Q3  Target  

Q4  Target  

Annual  Target  

HF  

State  

HF  

State  

HF  

State  

HF  

State  

HF  

State  

HF  

State  

Districts  

total  

Dist  

Total  

Dist  

Total  

Dist  

Total  

Dist  

Total  

Dist  

Total  

111   (49%)  

117   (32%)  

228   (76%)  

366   (49%)  

-­‐-­‐-­‐-­‐  

-­‐-­‐-­‐-­‐  

528   (55%)  

320   (33%)  

528   (55%)  

320   (33%)  

528   (55%)  

320   (33%)  

528   (55%)  

960   (100%)  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

21  

20  

   

35  

40  

45  

50  

50  

55  

60  

67  

60  

21222   (67)  

   

115  

127  

   

120  

130  

140  

145  

145  

150  

150  

155  

150  

88423   (155)  

   

487  

270  

   

150  

185  

175  

200  

200  

240  

240  

288  

240  

49516   (288)  

   

79  

58  

   

30  

50  

50  

75  

60  

100  

100  

112  

100  

44764   (112)  

   

268  

196  

   

75  

86  

80  

90  

80  

90  

75  

114  

75  

134292   (114)  

   

   

   

   

   

   

   

   

   

   

   

   

   

   

   

311  

332  

   

75  

100  

100  

125  

120  

150  

150  

177  

150  

177  

   

108  

68  

   

150  

200  

210  

250  

255  

275  

275  

304  

275  

304  

      39

Annexure  -­‐  III  

STERILISATION  PERFORMANCE  2010-­‐11   Sl.No.   Name  of  the  District  

 

Expected  Level   Achievement  from   %  increase(+)  or   April    to  March   of  achievement   decrease(-­‐)   2010-­‐11   2010-­‐11   2009-­‐10  

%  of   achievement  to   ELA  

1  

MALKANGIRI  

2102  

3193  

1445  

120.97  

152  

2  

NAWARANGPUR  

4458  

5736  

5108  

12.29  

129  

3  

KORAPUT  

5157  

6080  

6938  

-­‐12.37  

118  

4  

DHENKANAL  

4667  

5013  

4402  

13.88  

107  

5  

BHADRAK  

5833  

6207  

5834  

6.39  

106  

6  

ANGUL  

4988  

5213  

4058  

28.46  

105  

7  

MAYURBHANJA  

9727  

9860  

8014  

23.03  

101  

8  

KEONJHAR  

6836  

6811  

5695  

19.60  

100  

9  

PURI  

6561  

6261  

5420  

15.52  

95  

10  

BARAGARH  

5891  

5609  

5421  

3.47  

95  

11  

BOLANGIR  

5848  

5326  

5829  

-­‐8.63  

91  

12  

GAJAPATI  

2270  

2065  

2053  

0.58  

91  

13  

BALASORE  

8857  

7781  

7027  

10.73  

88  

14  

JAJPUR  

7105  

6199  

5291  

17.16  

87  

15  

NUAPARA  

2323  

2019  

1917  

5.32  

87  

16  

NAYAGARH  

3782  

3276  

1970  

66.29  

87  

17  

KENDRAPARA  

5700  

4697  

2136  

119.90  

82  

18  

KALAHANDI  

5842  

4794  

5188  

-­‐7.59  

82  

19  

SAMBALPUR  

4067  

3324  

3332  

-­‐0.24  

82  

20  

SUNDARGARH  

8009  

6143  

6107  

0.59  

77  

21  

CUTTACK  

10248  

7762  

7381  

5.16  

76  

22  

JHARSUGUDA  

2229  

1606  

1624  

-­‐1.11  

72  

23  

SONEPUR  

2367  

1602  

1174  

36.46  

68  

24  

KHURDA  

8206  

5522  

3291  

67.79  

67  

25  

GANJAM  

13734  

8195  

7693  

6.53  

60  

26  

RAYAGADA  

3603  

2140  

2101  

1.86  

59  

27  

JAGATSINGHPUR  

4626  

2736  

2744  

-­‐0.29  

59  

28  

DEOGARH  

1200  

685  

614  

11.56  

57  

29  

KANDHAMAL  

2837  

1580  

1328  

18.98  

56  

30  

BOUDH  

1633  

739  

1036  

-­‐28.67  

45  

   

ORISSA  

160706  

138174  

122171  

13.10  

86  

   

Annexure  -­‐  III  

IUCD  PERFORMANCE  2010-­‐11   Sl.  No.  

REVIEW  OF  F.W.&MCH  PROGRAMME  DURING  AND  UP  TO  END  OF  MARCH,2011   Expected   Achievement  from   %  of   Name  of  the   %  increase(+)   Level  of   April    to  March   achievement   District   or  decrease(-­‐)   achievement   to  ELA(10-­‐11)   2010-­‐11   2009-­‐10   2010-­‐11  

%  of   achievement   to  ELA(9-­‐10)  

1  

JHARSUGUDA  

2491  

3177  

2673  

18.86  

128  

107.3  

2  

BHADRAK  

6517  

7949  

10409  

-­‐23.63  

122  

159.7  

3  

MALKANGIRI  

2464  

2957  

2293  

28.96  

120  

93.1  

4  

NAYAGARH  

4224  

4750  

4762  

-­‐0.25  

112  

112.7  

5  

KENDRAPARA  

6362  

6476  

5255  

23.24  

102  

82.6  

6  

PURI  

7343  

7449  

4102  

81.59  

101  

55.9  

7  

JAJPUR  

7937  

7958  

7827  

1.67  

100  

98.6  

8  

MAYURBHANJA  

10864  

10621  

8555  

24.15  

98  

78.7  

9  

ANGUL  

5570  

5375  

4930  

9.03  

96  

88.5  

10  

KORAPUT  

5769  

5468  

4286  

27.58  

95  

74.3  

11  

NAWARANGPUR  

5012  

4634  

3062  

51.34  

92  

61.1  

12  

KANDHAMAL  

3167  

2910  

3828  

-­‐23.98  

92  

120.9  

13  

DHENKANAL  

5213  

4663  

4740  

-­‐1.62  

89  

90.9  

14  

KEONJHAR  

7632  

6814  

4420  

54.16  

89  

57.9  

15  

SUNDARGARH  

8945  

7971  

6966  

14.43  

89  

77.9  

16  

BALASORE  

9892  

8674  

8170  

6.17  

88  

82.6  

17  

CUTTACK  

11439  

10019  

9127  

9.77  

88  

79.8  

18  

JAGATSINGHPUR  

5168  

4207  

5255  

-­‐19.94  

81  

101.7  

19  

SONEPUR  

2648  

2078  

2361  

-­‐11.99  

78  

89.2  

20  

BARAGARH  

6579  

5128  

4743  

8.12  

78  

72.1  

21  

BOLANGIR  

6534  

4861  

5490  

-­‐11.46  

74  

84.0  

22  

KHURDA  

9173  

6549  

5600  

16.95  

71  

61.0  

23  

BOUDH  

1824  

1241  

746  

66.35  

68  

40.9  

24  

DEOGARH  

1339  

885  

451  

96.23  

66  

33.7  

25  

GAJAPATI  

2535  

1532  

1572  

-­‐2.54  

60  

62.0  

26  

RAYAGADA  

4061  

2410  

1996  

20.74  

59  

49.2  

27  

KALAHANDI  

6526  

3318  

3216  

3.17  

51  

49.3  

28  

SAMBALPUR  

4572  

2112  

1761  

19.93  

46  

38.5  

29  

GANJAM  

15444  

5846  

3844  

52.08  

38  

24.9  

30  

NUAPARA  

2593  

695  

1218  

-­‐42.94  

27  

47.0  

179838  

148727  

133658  

11.27  

83  

74.3  

   

ORISSA  

41

Annexure  -­‐  III  

CC    PERFORMANCE  2010-­‐11   REVIEW  OF  F.W.&MCH  PROGRAMME  DURING  AND  UP  TO  END  OF  MARCH,2011   Sl.   No.  

Name  of  the  District  

Expected  Level   of  achievement   2010-­‐11  

Achievement  from   April    to  March   2010-­‐11  

2009-­‐10  

%  increase(+)   or  decrease(-­‐)  

%  of   achievement   to  ELA  (10-­‐ 11)  

%  of   achieveme nt  to   ELA(9-­‐10)  

1  

MALKANGIRI  

4938  

6916  

4102  

68.60  

140  

83.07  

2  

JAJPUR  

15908  

19344  

15449  

25.21  

122  

97.12  

3  

JHARSUGUDA  

4992  

5886  

5760  

2.19  

118  

115.38  

4  

SONEPUR  

5306  

5918  

4655  

27.14  

112  

87.72  

5  

KANDHAMAL  

6348  

6427  

10532  

-­‐38.98  

101  

165.91  

6  

ANGUL  

11165  

10980  

9732  

12.82  

98  

87.17  

7  

JAGATSINGHPUR  

10358  

10008  

13169  

-­‐24.00  

97  

127.14  

8  

KENDRAPARA  

12751  

10694  

8318  

28.57  

84  

65.23  

9  

DHENKANAL  

10448  

8750  

8820  

-­‐0.79  

84  

84.41  

10  

KEONJHAR  

15297  

10833  

11683  

-­‐7.28  

71  

76.37  

11  

BHADRAK  

13062  

9090  

21455  

-­‐57.63  

70  

164.25  

12  

NAYAGARH  

8467  

5828  

9570  

-­‐39.10  

69  

113.04  

13  

GAJAPATI  

5081  

3481  

4924  

-­‐29.32  

68  

96.91  

14  

NAWARANGPUR  

10046  

6644  

6900  

-­‐3.70  

66  

68.68  

15  

DEOGARH  

2684  

1771  

2864  

-­‐38.18  

66  

106.70  

16  

BARAGARH  

13185  

8566  

14242  

-­‐39.85  

65  

108.02  

17  

BOUDH  

3657  

2204  

4918  

-­‐55.19  

60  

134.49  

18  

KHURDA  

18386  

9544  

7767  

22.88  

52  

42.24  

19  

SAMBALPUR  

9163  

4567  

5972  

-­‐23.52  

50  

65.17  

20  

MAYURBHANJA  

21775  

10802  

14536  

-­‐25.69  

50  

66.75  

21  

CUTTACK  

22927  

11310  

14240  

-­‐20.57  

49  

62.11  

22  

KORAPUT  

11562  

5550  

6968  

-­‐20.36  

48  

60.27  

23  

SUNDARGARH  

17929  

7913  

7207  

9.80  

44  

40.20  

24  

RAYAGADA  

8139  

3388  

3563  

-­‐4.92  

42  

43.78  

25  

BALASORE  

19827  

6951  

7515  

-­‐7.51  

35  

37.90  

26  

KALAHANDI  

13079  

4024  

4430  

-­‐9.18  

31  

33.87  

27  

NUAPARA  

5197  

1533  

1356  

13.06  

29  

26.08  

28  

BOLANGIR  

13096  

3840  

10247  

-­‐62.53  

29  

78.24  

29  

PURI  

14716  

3937  

7369  

-­‐46.57  

27  

50.07  

30  

GANJAM  

30953  

7901  

8821  

-­‐10.43  

26  

28.50  

   

ORISSA  

360444  

214597  

257083  

-­‐16.53  

60  

71.32  

42

OCP    PERFORMANCE  2010-­‐11   REVIEW  OF  F.W.&MCH  PROGRAMME  DURING  AND  UP  TO  END  OF  MARCH,2011   Sl.   No.  

Name  of  the   District  

Expected   Level  of   achievement   2010-­‐11  

2010-­‐11  

2009-­‐10  

Achievement  from   April    to  March  

%  increase(+)   or  decrease(-­‐)  

%  of   achievement   to  ELA(10-­‐11)  

%  of   achievement   to  ELA(09-­‐10)  

1  

BHADRAK  

7697  

9612  

14814  

-­‐35.12  

125  

124.88  

2  

ANGUL  

6579  

8009  

8825  

-­‐9.24  

122  

121.75  

3  

KORAPUT  

6813  

8138  

7273  

11.90  

119  

119.44  

4  

JAJPUR  

9374  

10785  

9871  

9.25  

115  

115.05  

5  

MALKANGIRI  

2910  

3166  

3384  

-­‐6.43  

109  

108.82  

6  

BOUDH  

2155  

2249  

3146  

-­‐28.51  

104  

104.38  

7  

JAGATSINGHPUR  

6103  

6338  

7939  

-­‐20.16  

104  

103.85  

8  

NAYAGARH  

4989  

5139  

5801  

-­‐11.41  

103  

103.02  

9  

BALASORE  

11683  

11815  

9556  

23.64  

101  

101.13  

10  

DHENKANAL  

6157  

6169  

5938  

3.90  

100  

100.20  

11  

RAYAGADA  

4796  

4766  

5397  

-­‐11.68  

99  

99.38  

12  

KENDRAPARA  

7514  

7103  

7520  

-­‐5.54  

95  

94.53  

13  

KANDHAMAL  

3741  

3502  

6088  

-­‐42.48  

94  

93.61  

14  

NAWARANGPUR  

5919  

5178  

4919  

5.27  

87  

87.48  

15  

MAYURBHANJA  

12831  

11055  

6858  

61.19  

86  

86.16  

16  

JHARSUGUDA  

2941  

2501  

2201  

13.64  

85  

85.02  

17  

SONEPUR  

3127  

2648  

2129  

24.38  

85  

84.68  

18  

BARAGARH  

7769  

6489  

4526  

43.37  

84  

83.53  

19  

DEOGARH  

1582  

1312  

1075  

22.10  

83  

82.94  

20  

KEONJHAR  

9014  

6559  

7776  

-­‐15.66  

73  

72.76  

21  

GAJAPATI  

2994  

2090  

2427  

-­‐13.87  

70  

69.81  

22  

CUTTACK  

13510  

9426  

7527  

25.23  

70  

69.77  

23  

PURI  

8672  

5907  

5673  

4.13  

68  

68.11  

24  

KHURDA  

10834  

6923  

5996  

15.47  

64  

63.90  

25  

SAMBALPUR  

5399  

3441  

3370  

2.08  

64  

63.72  

26  

BOLANGIR  

7717  

4758  

6895  

-­‐30.99  

62  

61.66  

27  

SUNDARGARH  

10564  

6310  

6774  

-­‐6.85  

60  

59.73  

28  

KALAHANDI  

7707  

4163  

3844  

8.30  

54  

54.01  

29  

GANJAM  

18239  

6877  

6222  

10.54  

38  

37.71  

30  

NUAPARA  

3062  

907  

1161  

-­‐21.89  

30  

29.61  

212390  

173335  

174922  

-­‐0.91  

82  

81.61  

   

ORISSA  

43

Annexure  –  IV   GUIDELINES  FOR  QUARTERLY  FEMALE  STERILIZATION  CAMPS  TO  IMPROVE  DISTRICT  PERFORMANCES  

FAMILY  PLANNING  PIP-­‐11-­‐12  

(BUDGET HEAD: A3.1.2) Out  of  the  Expected  Level  of  Achievement  (ELA)  60%  to  be  achieved  in  the  Fixed  Day  Static   Centers  approach  and  40%  in  the  camp  mode.     Prerequisite  for  the  quarterly  sterilization  camps:     1. 2. 3.

District  must  have  analyzed  the  performance  of  the  quarter  and  identify  the  poor   performers  with  the  context  of  the  achievement  in  Fixed  Day  Static  Centers.   The  poorest  performing  blocks  to  be  identified  and  the  camp  to  be  held  in  the   identified  block.       A  minimum  of  50  cases  to  be  operated  in  a  camp.  

Client  Load:     From  the  quarterly  review  the  district  Nodal  Officer,  ADMO  (FW)  must  finalize  the  tentative   load  for  the  camp.  The  Quality  norms  led  down  by      GoI  to  be  strictly  adhered  to.     Empanelled  surgeon  to  operate  to  a  maximum  number  of  cases  per  day  as  per  the  GoI   guidelines.   • 30  laparoscopic  Tubectomy   • 30  minilap    Tubectomy         For   such   quarterly   camp,   the   organizing   officer   in   consultation   with   the   ADMO   (FW)   must   see  that  at  least  two  empanelled  doctor  and  their  team  to  conduct  the  sessions/operations   in  the  camp.     The   organizing   officer   i.e.   the   concern   MOI/c/MO   or   the   Medical   Officer   assigned   by   ADMO   (FW)  is  to  be  responsible  for  the  prerequisite  checkups,  screening  and  other  needful  as  per   the  GoI  directives.     ADMO   (FW)   will   be   the   overall   charge   of   the   camps   and   he/she   will   assign   the   concern   MOI/c/MO/SDMO  (as  per  the  case)  as  the  Camp  organizing  officer.   Camp  Site:     The  camp  to  be  organized  in  established  health  facilities  as  per  the  directives  laid  down  in   GoI   “SOP”.   Under   no   circumstances   it   should   be   held   in   other   facilities   other   than   health   institutions   having   all   the   requisites   laid   down   in   government   of   India   programme   guidelines.  The   district   Quality   Assurance   Committee   must   approve   the   venue   even   in   level-­‐ 1  institutions  considering  the  expected  case  load  (camp  mode).     Planning  &  Coordination  for  the  camp:   1. 2. 3.

After   the   quarterly   review   the   proceedings   to   be   shared   with   the   District   Quality   assurance  Committee.   The   date   and   venue   for   the   camp   along   with   the   list   of   empanelled   surgeons   to   be   finalized  by  the  QAC  in  consultation  with  the  Nodal  Officer,  ADMO  (FW).     The  camp  to  be  organized  within  2weeks  of  succeeding  quarter.  For  example  the  camp   to  be  held  within  14th  July  for  the  quarter  ending  in  June  2011.  

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CAMP  ARRANGEMENT:     1.

ADMO  (FW)  to  intimate  the  concern  MO  or  MOI/c  regarding  the  date  and  venue  of  the   camp  at  least  before  one  week.   Necessary  arrangement  for  the  camp  to  be  the  responsibility  of  the  concern  MOI/c.   BEE   will   be   exclusively   responsible   for   the   publicity   and   needful   IEC   activities   and   venue  arrangement  in  consultation  with  MOI/c.   MOI/c   in   consultation   with   the   ADMO   (FW)   arrange   the   availability   of   the   concern   /enlisted  surgeons  for  the  camps.     BEE,  SA  &  BPO  to  ensure  the  necessary  logistics  support  required  for  the  camps.  This   includes   necessary   screening,   waiting   place   for   the   beneficiaries   both   pre   and   post   operation  phase.  Drinking  water  facility,  parking  places,  medicine  distribution,  facility   for  screening  etc.  and  needful  emergency  services  to  be  arranged  properly.   The  concern  SA  /person  assigned  by  MOI/c  of  the  block  to  support  the  beneficiary  in   filling  the  consent  form  &  registration  or  other  formalities  thereof.   The  concern  MOI/c  will  be  the  overall  in  charge  of  the  camp  SA/BPO  to  support  for  the   needful.    

2. 3. 4. 5.

6. 7.

FUND  RELEASE:       1.

Once   the   QACs   approved   the   date   and   venue,   the   fund   as   earmarked   in   the   budget   to   be   placed   directly   to   the   concern   MOI/c   through   e-­‐transfer   or   as   soon   as   possible   including  that  of  loss  of  Wages  (  LOW  )    and  camp  cost  Rs.  15000/-­‐    

Financial  Breakup:     Sl.   No   1   2  

3   5   6     7   8  

Activity   Camp  /Venue  arrangement     IEC/Publicity  in  the  area  :(Intimation  to  ASHAs,  information  to  all  GKS  of   the   area,   intimation   to   the   SHG   Federation   members   of   the   Grampanchayat,  leaflet,  banner,  mike)  Focus  to  be  on  IPC  through  ASHA   &  AWWs)   Mobility  support  for  the  camps     Contingency  :  Stationery,  emergency  drugs  etc.     Perdiem   @Rs.150/-­‐     to   HW(M)/HW(F)/LHV/MPHS(M)/BEE/SA/BPO/BADA   to   a   maximum   of   10   persons    those  who  participated  and  supported  the  camp  .   Sub-­‐staff  and  any  community  volunteers  involved  @Rs.100/-­‐   Payment   to   loss   of   wages   to   be   done     on   posting   of   eligible   couple   Number(Case  card/Sterilization  Register)   The   outside   cases   accepted   sterilization   need   to   be   reported   to   the   concerned  medical  institution  to  which  they  belong  for  reference.     Total  

Budget   (Rs)   4000   4000  

3500   1500   1500   500       15000  

   

 

45

OPERATIONAL  COST  FOR  DISTRICT  FAMILY  WELFARE  BUREAU  [email protected]/-­‐  PER  MONTH     BUDGET  LINE  ITEM  NO:  A3.5.1.2.3   It  is  only  to  maintain  and  suffice  the  need  of  District  Family  Welfare  Bureau  (DFWB)  towards   better  planning,  coordination  and  communication  and  correspondence.     This  fund  to  be  utilized  for     a) b) c) d)

Support   the   expenditure   relating   to   correspondence,   internet   charges,   couriers   chargers,  fax,  postage  etc.    .     For  the  photocopy  circulars,  letters,  documents  etc.      .   Timely  submission  of    reports    i.e.  HMIS,  other  reports     Stationeries  for  office,  computer  maintenance  etc.    

46

GUIDELINES  FOR  QUARTERLY    NSV  CAMPS  TO  IMPROVE  DISTRICT  PERFORMANCES     FAMILY  PLANNIG  PIP-­‐11-­‐12   BUDGET  LINE  ITEM  NO  :  A3.1.3   Koraput,   Rayagada,   Malkangiri,   Nabarangpur,   Kalahandi,   Nuapada,   Bolangir,   Sonepur,   Mayurbhanj  and  Kandhamal   Quarterly  NSV  Camps  to  improve  district  performances        The   NSV   camps   will   be   organized   at   the   district   Headquarters/Sub   divisional   head   quarter/or  only  in  L3  institutions  once  in  a  quarter  @  Rs.35000/-­‐  per  camp.  The  camp  site   and   venue   is   to   be   decided   by   ADMO   (FW)   in   consultation   with   the   QAC   of   the   district.   Preference  to  be  given  in  areas  having  low  or  poor  performances  for    NSV.     Minimum  number  of      cases      to  be    planned  for  the  camp  35  to  60  for  operation.     At  least  two  empanelled  NSV      surgeons  to  attend  the  camp  along  with  their  team.   Rest  to  be  as  per  the  guideline  mentioned  below.   Sl.  No  

Activity  –cum-­‐  Budget  Head  

Amount   Earmarked  

1  

IEC/BCC  

  Rs.  10000  

2  

Banners,  posters  and  leaflets  printing  and  display  in   strategic  locations.   Mike  publicity,  Folk  shows     IPC    through  ASHA  &  AWWS   Intimation  and  information  to  the  GKS  of  the  area.     (Breakup  of  each  activity  and  fund  allocation  to  be   decided  by  the  concern  MOI/c,  SDMO,  MO  of  the   hospital.   Special  focus  to  cover  the  weekly  markets  (  hattas)   in  the  area.   Camp  Arrangement  :  

Responsibility   Concern  BEE  of   the  CHC/PHC  if   at  the  Dist.   Level   MIEO/DyMIEO   to  be   responsible.  

A  week  before   the    camp    

Rs.  15000  

MOI/C  and  BPO  

All  the   arrangements   and  the  needful   to  be   completed   before  the   camp  day.  

Rs.  10000  

MOI/c  of  the   Block    or  MO  as   per  the  case  

To  be  done   during  the   camp  day  after   completion  of   the  camp.  

 Arrangement    for  the  beneficiaries,  waiting  place,   drinking  water  ,  transportation  of  surgeons  ,   preparatory  meeting    and  contingency   Counter  for  the  screening  test,  filling  up  of  consent   forms  and  other  requisites  (  person  to  be  ear   marked  for  each    by  the  MOI/c)   3  

Performance  Incentives  to  the  GKS  having  more   than  5  persons  accepting  NSV,  Qualifying  is  5  (best   three),  will  get  Rs1000/-­‐  incentive  award.   The    GKS  can  utilizes  the  fund  in  organizing  meeting   to  sensitize  on  the    various  family  planning     methods,  recognizing    and  facilitating  the     Motivators  and  beneficiaries  .    

Timeline  

Rs.500/-­‐  to  the  ANMs/HW(M)  who  have  motivated   more  than  07  cases  for  NSV    on  their  own,(Best  two)   DA  to  the  (officers  &  paramedics)SA,  BPO,   Supervisors,  LHV  &  BEE)   10  %  as  an  institutional  overhead  to  the  RKS  of  the   institutions  where  the  camp  is  organized.    

47

GUIDELINES  FOR  INFECTION  PREVENTION  &  CONTROL  ON  IUCD  @  RS.20/-­‐  PER  CASE   BUDGET LINE ITEM NO : A3.2.2.1 The  Rs.20/  is  to  be  used  by  the  service  provider  towards  promotion  of  the  IUCD  community.   It’s   to   be   used   as   institutional   overhead   for   the   promotion   of   IUCDs.   This   can   be   used   specially  for  infection  prevention  and  management.  Due  emphasis  is  to  be  given  for  use  of   globes,  sterilization  of  instruments,  proper  follow  up  &  monitoring.   The  modalities  for  the  fund:     The   service   providers   have   to   submit   a   report   to   the   concern   supervisor   in   every   month   during   the   health   sector   meeting.   The       details   report   to   state   the   TC   No.   and   date   of   insertion  of  the  IUCD.    The  reporting  format  to  be  printed  and  supplied  to    all  the  reporting   units.   The   fund   for   the   printing   to   be   made   from   this     fund   and   printing   to   be   done   at   h   district  level.     Modalities  for  the  Payment:     The   respective   supervisor   submits   the   report   to   the   MOI/c   in   every   month   after   due   verification.   The  allocated  Rs.20/-­‐  to    be  used  for  the  infection  control  mechanism    relating  to    IUCD   insertion    i.e    sterilizing    of  the  instruments  and  equipments  for    insertion,   purchase  of     liquid   soap,   plastic   gloves,   medicines   for   minor   complications,   instruments   for   IUCD   insertion.       The  amount  to  be  directly  placed  to  the  concern  MOI/c  from  the  block  and  MOI/c  to   provide  the  requisite  materials  to  the  concern  service  provider  and  institutions.   The  records  maintain  by  the  service  providers  as  the  procedure  at  present.        

3.

Name  of   the   acceptor   Address  :   Village     SC  and   CHC/  PPC   etc.  

EC   No.  

Acceptor  

Spouse  

4.   S.   No  

Date  of   Insertion  

Age  

Living   Children  

1  

 

 

 

 

 

 

 

2  

 

 

 

 

 

 

 

M  

F  

Educational   Status  

Age  of   last  child   with  Sex  

Religion /  Caste   of  the   acceptor  

Signature   of   Acceptor  

Signature   of  the   Inserter  

Remarks  

 

 

 

 

 

 

 

 

 

 

 

 

Spouse  

2.

Acceptor  

1.

           

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INCENTIVES  TO  THE  PRIVATE  ACCREDITED  INSTITUTIONS  FOR  IUCD  INSERTION  SERVICES   BUDGET LINE ITEM NO : A3.2.3 Steps:     1.

The  beneficiary  may  directly  approach  the  accredited  institutions  and  avail  the  benefit.    

2.

The  amount  of  Rs.75.00  will  be  given  to  the  accredited  institutions  only  after  the   verification  of  the  TC  No.  by  the  concern  ADMO  (FW)  as  the  case  may  be.  

3.

Government  will  not  provide  any  IUCD  to  the  accredited  institutions.  

4.

The  accredited  institutions  will  be  given  the  amount  through  e-­‐transfer  only  after  the   institutions  submit  the  name  of  the  beneficiaries  along  with  their  respective  TC.   Numbers  authenticated  or  endorsed  by  the  concern  MOI/c.    

5.

The  institutions  will  receive  payment  bi-­‐monthly  against  the  authentication  with  TC   number  duly  verified  by  MOI/c  or  ADMO  (FW).    

6.

Unlike  sterilization  operation,  the  amount  to  be  paid  to  the  institutions  bi-­‐monthly   manner  as  per  the  number  of  cases  inserted  IUCD.  

7.

The  institutions  will  be  responsible  for  any  complication  therefore.  

8.

The  institutions  must  have  to  submit  a  report  every  month  with  details  of  the   beneficiaries  to  ADMO  (FW)  in  soft  and  hard  copies  as  per  the  format  below.  

9.

The  institutions  must  not  take  any  service  charges  from  the  beneficiaries.     EC   No  

Date  of   Insertion  

Age  

Living   Children  

M  

F  

Age  of   last   child   with   Sex  

Educational   Status  

Religion  /   Caste   Of  the   acceptor  

Signature   of   Acceptor  

Remarks  

1  

 

 

 

 

 

 

 

 

 

 

 

 

 

2  

 

 

 

 

 

 

 

 

 

 

 

 

 

Acceptor  

Spouse  

Name  of   the   acceptor   Address  :   Village     SC  and   CHC/PPC     etc.  

Acceptor  

Sl.   No.  

Spouse  

 

         

49