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9th Common Review Mission Presentation of Anantapur District, Andhra Pradesh

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Slide 1:

Welcome

Slide 2:

Presented to The 9 th Common Review Mission team Anantapuramu District Review

Glimpses:

Glimpses Situated in Rayalaseema region Largest district in Andhra Pradesh_ 19,130,000 sq.Kms 52 nd largest district in India Fifth largest populated district in AP Hub of educational activity Ranked 10 th in GDDP among 13 districts

Historical Background:

Historical Background Got its name from ' Anantasagaram ', a big tank, which means "Endless Ocean“ Formed in the year 1882  having been separated from Bellary District In the  year 1956, the present district was carved out Presently with 5 revenue divisions, 63 mandals, 7 Municipalities , 5 Nagara Panchayathis

Slide 5:

. It is  bounded by Bellary, Kurnool District on the North,   Cuddapah and Kolar  Districts  of Karnataka  on South  East  and  North respectively.  The  District  is roughly oblong  in shape,  the longer  side running North to South with a portion of   Chitradurg District of Karnataka State intruding into it from west between Kundurpi and Amarapuram Mandals .

Geopolitical Picture:

Geopolitical Picture 2 Parliamentary Constituencies 14 Assembly Constituencies 2 Legislative Council Constituencies

Administrative Divisions:

Administrative Divisions

Others:

Others

Slide 11:

Prasanthi nilayam,Puttaparthy Gugudu

Slide 12:

Lephakshi Iskcon Temple

Slide 13:

Yogi Vemana Samadhi Jambu Dweepa

Slide 14:

Dharmavaram Sarees Kasapuram Anajaneya Swamy

Slide 15:

Thimamma Marri Maanu , Guttibavala , Kadiri

Other places to visit:

Other places to visit Sri Kadiri Laxmi Narasimha Swamy Temple Chintala Venkataramana Temple , Tadipatri     Doddeswara Swamy temple built during the Pallava Reign, Hemavathi Sri Ranganatha Swamy Temple,Alurkona " Degurla Narasimha Swamy “ temple, Pennaahobilam Rayadurg fort Gooty fort

Slide 17:

ORGANOGRAM

DMHO with Hon’ble CM:

DMHO with Hon’ble CM

Demographic Profile:

Demographic Profile Description Total Rural Urban Population 4,081,148 2,935,437 1,145,711 71.93% 28.07% Male 2,064,495 1,489,157 575,338 Female 2,016,653 1,446,280 570,373 Population growth 12.10% Density/km2 213 Proportion to AP Population 4.83% Sex Ratio 977 971 991 Child sex Ratio 927 928 926 Census 2011

Demographic Profile:

Demographic Profile Description Total Rural Urban Average literacy 63.57 59.21 74.69 Male 73.02 69.41 82.32 Female 53.97 48.77 67.06% Total Child Population 445,956 323,884 122,072 Male 231,369 167,977 63,392 Female 214,587 155,907 58,680 Child proportion 10.93% 11.03% 10.65% Boys 11.21% 11.28% 11.02% Girls 10.64% 10.76% 10.29% CBR 18.7 CDR 7.3 Census 2011

Urban Demographics:

Urban Demographics Urban Agglomerations inside Anantapur Population Male Female Anantapur (Urban Agglomerate) 341,895 172,414 169,481 Cities inside Anantapur District Population Male Female Anantapur 262,340 131,506 130,834 Hindupur 151,835 76,625 75,210 Guntakal 126,479 62,695 63,784 Dharmavaram 121,992 62,186 59,806 Tadipatri 108,249 54,027 34,222 Census 2011

Urban Profile:

Urban Profile Name of area Population No.. of HH Notified slums Non Notified slums Slum Population Slum HH Total HH Anantapuramu 2,68,503 68,245 51 09 1,01530 22,563 90,817 Guntakal 1,26,479 28,106 48 02 56,652 12,589 40,695 Dhamavaram 1,21,992 27,109 35 05 70152 15,589 42,698 Tadipatri 54,041 12,509 33 01 33538 7,452 19,961 Hindupur 1,51,835 33,741 40 13 72075 16,016 49,751 722850 169710 207 30 333947 74209 243922 Census 2011

Slide 24:

Infrastructure

18:

18 CHNCs

Rural:

Rural Public Health Facilities SC 586 PHC 80 CHC 15(5-DH, 10 APVVP) AH 2 DH 1

Map Showing Health Facilities:

Map Showing Health Facilities PHCs CHCs AH DH

Urban:

Urban Public Health Facilities PPU 4 UFWC 8 MCH _Municipality 4 UHCs 19 GGH 1 CD hospital 1 CEmNOC 8 FRUs 5

AYUSH:

AYUSH Public Health Facilities Type Number NRHM 43 State Owned 53 Co-located _NRHM 43 Co-located State Owned 33 Rented buildings 0 State owned Not co-located-Rent free 20

AYUSH_type:

AYUSH_type Type State Owned NHM Total Ayurvedic 28 22 50 Unani 13 06 19 Homeo 12 13 25 Naturopathy 0 2 02 Sidda 0 0 00 Grand Total 53 43 96

Private:

Private Type of facility Number Nursing Homes 182 Dental hospitals 29 Clinics 48 Polyclinics 07 Diagnostic centres_Basic 89 Diagnostics_ Advanced O6 Physiotherapy 02 RDT Hospitals(Reputed Intl.NGO) 02 RDT-Super Specialty Hospital 01 Satya Sai Hospitals 01 Satya Sai Super Specialty Hospital 01 Health Facilities

Facilities in district_Current scenario:

Facilities in district_Current scenario Type of facility Number As per population norms Number functional Number deficit % of deficiency SC 587 586 1 0.17 AWC 4224 5126 +902 # PHC 98 80 18 18.36 UHC 23 19 4 17 CHC 25 15 10 40 AH(FRU) 9 2 7 78 DH 01 01 0 0

Sub centres:

Sub centres

Service delivery:

Service delivery

Service delivery in SCs:

Service delivery in SCs

Bed strength * Doctors for population:

Bed strength * Doctors for population Total number of beds available in Public health facilities 1914 Beds per 1000 population 0.46 Doctors per 1000 population (In public Health facilities) 0.4

Health Admn & Deliverance :

Health Admn & Deliverance PHCs per CHNC As per norms 4-6 Existing 2-8 Average 4 PHCs per CHC As per norms 4-6 Existing 2-8 Average 5 As per norms 6 Existing 3-18 Average 7 SC s per PHC Average habitations covered Per SC 6 Per PHC 42 Per CHC 227

Average Rural population covered by SC/PHC/CHC:

Average Rural population covered by SC/PHC/CHC Type of facility Population covered SC 5009 PHC 36693 CHC 195696 Facility wise population Number % SCs more than 5000 294 50% PHCs more than 30,000 53 66% CHC > 1,20000 11 73%

Average rural area covered in Sqkms:

Average rural area covered in Sqkms Type of facility Area in Sq kms SC 23.51 PHC 172.26 CHC 918.73

Time to care from village to PHC:

Time to care from village to PHC Time to care Number % Within 30 mins 91 9.51 more than 30 mins Less than 1 hour 360 37.65 More than I hour 505 52.82 0 – 5 kms 6 – 10 kms More than 10 kms 91 360 505 Average radial distance between PHCs and Villages in kms

Vulnerability Score _ NHSRC:

Vulnerability Score _ NHSRC Vulnerability Rank Score SCs PHCs CHC,AH,DH Number % Number % Number % V0 0-10 112 19.11 04 5 12 66.66 V1 11-20 465 79.35 76 9 6 33.33 V2 21-30 8 1.36 0 0 0 0 V3 31-40 1 0.17 0 0 0 0 V4 .>40 0 0 0 0 0 0

Building Status:

Building Status Type of facility Total Govt % Private Rented % Govt. rent free Sub Centres 586 294 50.1 292 49.9 0 PHCs 80 79 98.75 1

CEmNOCs:

CEmNOCs 1 Tadipatri 2 Gooty 3 Uravakonda 4 Kalyanadurg 5 CK Palli 6 Penugonda 7 Kadiri 8 Madakasira

Blood Banks & Storage Centres:

Blood Banks & Storage Centres 1 Anantapur 2 Ananthapur 3 Bathalapalli 4 Kadiri 5 Puttaparthy 6 Hindupur Blood Bank Blood Storage centers 1 Gooty 2 Guntakal 3 Tadipatri 4 Dharmavaram 5 Kalyandurg 6 Madakasira Pvt Govt 2 4

FUNCTIOLFRUs:

FUNCTIOLFRUs 1 GGH 2 Hindupur 3 Penukonda 4 Guntakal 5 Kadiri

FBNC :

FBNC SNCU _ Anantapur , GGH NBSU = 11 1 T adipatri 2 Gooty 3 Guntakal 4 Uravakonda 5 Rayadurg 6 Kalyanadurg 7 Madakasira 8 Hindupur 9 Penugonda 10 Dharmavaram 11 Kadiri NBCC = 73

Ultra Sounds:

Ultra Sounds 1 Tadipatri 2 Gooty 3 Guntakal 4 Anantapur 5 Dharmavaram 6 Kadiri 7 Penugonda 8 Hindupur 9 Madakasira USG Machines

RNTCP Infrastructure:

RNTCP Infrastructure Type Number DMCs 47 Govt 45 NGO 2 PHIs 110 TUs 19_Govt Medical college 01 District TB control centre is located in Government General hospital,Campus

RNTCP infrastructure:

RNTCP infrastructure Sl.no Equipment Number Status 1. X-Ray plant 01 Working 2 Microscopes 59 47 working 12 non functional 3 LED Microscopes 4 Working 4 Xerox 01 Working 5 Computer System 02 Working 6 Air Conditioners 02 Working

Infrastructure:

Infrastructure Infrastructure Type of facility Number Government 07 Private _ NGO based hospitals 01 Number of Ophthalmic Surgeons available 10 Number of PMOAs 19

Program Response (Facilities):

Program Response (Facilities) HIV Counseling & Testing Centers Stand alone ICTCs 18 FI-ICTCs (PHC) 80 FI-ICTCs (PPP) 09 Mobile ICTC 01 Care , Support and Treatment ART Centers 03 Link ART Plus 03 Link ART Centers 05 (4 Newly Sanctioned) CSC Vihaan 03 District Level Network 01 Targeted Interventions Core composite 10 FSW 01 Pehchan 01 Link worker Scheme 01 Blood Safety Blood Banks 06 Blood Storage Centers 6 STI clinics DSRCs 04 TI-STI Clinics/PHCs 6 +24 IEC Permanent Hoardings 17

Slide 52:

FICTCs -82 Mandal wise distribution of Existing ICTCs Stand alone ICTCs - 18 Mobile ICTC - 1 FI-ICTC (PPP) - 09

Mandal wise distribution of Existing Facilities:

ART Centre -3 Link ART Plus Centre - 3 Link ART Centre - 5 Newly Link ARTs - 4 CSC Vihaan - 03 Blood Banks Blood Storage Centres DSRCs Mandal wise distribution of Existing Facilities

Infra:

Infra Type of facility Number District Office 01 Urban leprosy centers 6

Immunization:

Immunization Cold Chain System EQUIPMENT Number Number of WIC 0 Number of WIF 0 Number of ILRs at District CCMU 6 Number of DFs at District CCMU 5 Number of functional Peripheral CCPs in the district 119 Gap in CCPs in periphery 04

IDSP _ Infrastructure:

IDSP _ Infrastructure Equipments Located Equipment existing Functioning (Y / N) Data Centre Equipments DSU Yes Yes MC Yes No Training Centre Equipments DSU Yes Yes MC Yes No Broadband Connectivity Yes Yes Inter wise Yes Yes 1075 Connectivity Yes Yes

SRL – STATE REFERENCE LABORATORY-AMC-IDSP Department of Microbiology:

SRL – STATE REFERENCE LABORATORY-AMC-IDSP Department of Microbiology Under SRL ICTC Centers - 28 PPTCT Centers - 04 Blood bank Centers - 08 CD4 Counts - 01

Virology:

Virology Viral Research Diagnostic Laboratory (VRDL) is under process. ICMR team has visited the department of Micro biology for starting VRDL. ICMR team satisfied with space, location and staff pattern Memorandum of Agreement (MOA) has approved Awaiting for process from ICMR.

Serology Services offered :

Serology Services offered 1. Dengue ELISA test 2. Chikungunya ELISA test 3. HBsAg 4. RPR Flocculation test 5. ASO 6. CRP 7. WIDAL 8. RA 9. ICTC, PPTCT, CD4 counts

Infra structure _ Urban:

Infra structure _ Urban Number of UHCs In Government Buildings In Private buildings 19 13 06

Constructions under NHM:

Constructions under NHM Type of facility 2009 - 10 2010-11 2011-12 2012-13 SC 11/11 17/23 4/9 10/25 CHNCs 0/5 SNCUs 1/1 NBSUs 11/11 NRC 1/1 PHCs 12/12 1/2 FRUs 5/5 Training building DEIC 1/1 DWH 1/1 Trauma Centre(2) 2/2

Constructions _ NHM:

Constructions _ NHM Facility Amount in Rs. Central Ware House _ Phase 1 Rs.1,76,00000 Central Ware House _ Phase 2 Rs.1,44,60000 Year Type of facility Number 2007-08 CEmNOC 7/7

NHM- Total expenditure-Constructions:

NHM- Total expenditure-Constructions Year Amount in Rs 2007-08 91,00000 2008-09 1,36,00000 2009-10 1,28,39,500 2010-11 65,41000 2011-12 2,039,3000 2012-13 2,997,6000 2013-14 2,828,4794 2014-15 1,911,9617 2015-16 48,00438 Total 14,46,54,349

Baby Friendly Hospital Services:

Baby Friendly Hospital Services At DH, Hindupur National accreditation for breastfeeding counseling

Slide 65:

Human Resources

HR _ DoPHFW(Static)-PHCs:

HR _ DoPHFW (Static)-PHCs Cadre Desired Sanctioned In position Vacancy% on desired % Vacancy on Sanctioned Regular Regular Contract Total MO 160 144 87 22 109 32 24.3 SN 164 101 90 67 157 4.26 LT 80 109 31 28 59 26.25 46 Pharmcist 80 89 53 12 65 18.75 27

HR in 24x7 PHCs – 42:

HR in 24x7 PHCs – 42 Cadre As per norms Sanctioned In position Vacancy% on set norms % Vacancy on Sanctioned Regular Contract Regular Contract MO 84 82 NA 46 11 32% 30% SN 126 54 84 50 67 7% 5% LT 42 28 0 12 12 43% 14% Pharmacist 42 42 0 23 6 31% 31% Watchmen 42 NA 42 0 41 2% 2% Contingent Worker 42 NA 42 0 42 0 0 Sr. Asst 42 42 NA 35 0 17% 17%

HR In CEmNOC:

HR In CEmNOC Name &Type of Facility Specialist( GynObs ) Staff Nurses Theatre Assistants Sanctioned In Position Sanctioned In Position Sanctioned In Position CHC Tadipatri 01 00 03 02 02 00 CHC Uravakonda 01 00 03 01 02 00 CHC Madakasira 01 00 03 01 02 00 CHC Gooty 01 00 03 03 02 00 CHC Dharmavarm 01 00 03 03 02 00 CHC Kalyandurg 01 00 03 02 02 00 PHC Gorantla 01 00 03 03 02 00 AH Kadiri 01 00 04 02 02 00 Total(8) 08 00 25 17 16 00

HR under NHM:

HR under NHM Cadre Number Place of positioning Medical officers 4 2 in NRC 2 in SNCU( in place of specialists in SNCU) Specialists( Paediatricians ) 1/4 1 in SNCU MPHA(F) s_ANM 472/586 SCs ASHAs 3003/3057 Villages AYUSH_MOs_NHM 14 AYUSH dispensaries at Mandals AYUSH_Compunders 31 AYUSH dispensaries at Mandals AYUSH_SNO 37 AYUSH dispensaries at Mandals Contingent workers 83/84 24x7 PHCs

HR under NHM:

HR under NHM Cadre Number Place of working Staff nurses 134 67/84 in 24x7 17/25 in CEmNOC 14/14 in SNCU 3/3 in NRC 31/33 in NBSU DPMU DPM 1 HQS DAO 1 HQS MISO 1 HQS Jr Asst 1 HQS DEO_RCH 1 HQS

On Foreign Service deputation to NHM:

On Foreign Service deputation to NHM Cadre Positioned as From Dy.CS DPMO_NHM APMHS Dy.CS DC_RBSK APMHS

HR trainings:

HR trainings All in position

HR in RNTCP:

HR in RNTCP Designation Sanction Positioned Vacancy DTCO 01 00 01 MO 01 01 00 DPC 01 00 01 DTBSA 01 00 01 TBHIV Supervisor 01 01 00 DPPM Coordinator 01 00 01 DTB counsellor 01 00 01 DOTS + Supervisor 01 01 00 DEO 01 01 00

HR in RNTCP:

HR in RNTCP Designation Sanction Position Vacancy STS at clusters 19 07 12 STLS 09 09 00 LT at DMCs 11 09 02 TBHV 9 7 2 Radiographer at dist 01 01 00 LT at dist 02 01 01 Lab Attendant(dist) 01 00 01 Sr.Asst (dist) 01 01 01 Jr.Asst (dist) 01 00 01

HR –MCH team-in Medical College:

HR –MCH team-in Medical College Cadre Sanction Position Vacant % of vacancy Gynecologist 11 08 3 27% Pediatrician 8 7 1 13% Anesthetist 9 7 2 22% General Medicine 11 10 1 9% General Surgery 11 7 4 36%

Specialty-AMC:

Specialty-AMC Cadre Sanction Position Vacant % of vacancy Orthopaedician 6 6 0 0 Chest diseases 4 2 2 50% ENT 5 4 1 20% Ophthalmology 6 4 2 33% Radiotherapy 3 2 1 33% Dermatology 5 4 1 20% Psychitrty 4 2 2 50%

Teaching HR:

Teaching HR Cadre Sanction Position Vacant % of vacancy Anatomy 8 3 5 62% Physiology 8 6 2 25% Biochemistry 6 5 1 17% Pharmacology 6 5 1 17% Pathology 9 8 1 11% Microbiology 7 7 0 0 Forensic Medcine 7 4 3 43% SPM 7 7 0 0

HR RBSK:

HR RBSK Cadre Number in position Dist Coordinator _ RBSK 1 DEO 1

HR in NLEP:

HR in NLEP District HQS Cadre Sanctioned In position Vacancy AddlDMHO 1 0 1 Nucleus MO 1 1 0 PMO 1 1 0 Physiotherapist 1 1 0 HEO 1 1 0 DPMO 1 1 0 DyHEOs 2 2 0 LT 1 1 0

HR in NLEP:

HR in NLEP Peripheral Designation Positioned at Sanctioned In position Vacancy DPMO ULCs 5 5 0 APMO ULC 1 1 0 DSO ULC 1 1 0 DPMO CHNC 18 18 0

HR NVBDCP:

HR NVBDCP Cadre Sanctioned Positioned Vacant DMO 1 1 0 AMO 2 2 0 MPHEO 1 1 0 MPHS(M) 7 7 0 MPHA(M) 21 4 17 MPHA(M)/LT 7 2 5 Lab Attendant 1 1 0 Field worker 4 2 2

HR in HIV/AIDS:

HR in HIV/AIDS Designation Sanctioned Positioned Vacant Addl DMHO 01 00 01 DPM 01 01 00 Dist ICTC Supervisor 01 01 00 Dist Asst Acounts 01 01 00 Dist Asst M& E 01 01 00 Dist Asst Program 01 01 00

HR in IDSP:

HR in IDSP DSO Addl.DMHO DEO 01 DM 01 Dist Epidemiologist 01

HR in Cold Chain Unit:

HR in Cold Chain Unit Designation Position Status DIO 01 Regular SO(UIP) 01 Regular Supply chain managers 02 On deputation No sanctioned posts Refrigerator Mechanic 01 On Contract DEO 01 On Contract

AYUSH HR:

AYUSH HR Medical Officers Compounders SNOs Sanctioned Positioned Vacant Sanctioned Positioned Vacant Sanctioned Positioned Vacant 96 49 47 96 75 21 67 42 25 Type Medical Officers Compounders SNOs Sanctioned Positioned Vacant Sanctioned Positioned Vacant Sanctioned Positioned Vacant State 53 35 18 53 44 09 24 5 19 NHM 43 14 29 43 31 12 43 37 6

HR in Blood Bank - GGH:

HR in Blood Bank - GGH Cadre Sanctioned Inposition APSACS Supported(Yes/No) MO 2 2 No SN 3 3 NO LT 6 6 4_Yes 2_No Counselor 1 1 Yes LA 1 1 No MRA 1 1 No Attender 1 1 Yes

HR:

HR 69 Employees Cadre Number Pharmacists 23 LTs 23 Drivers 23

SNCU NBSU-HR:

SNCU NBSU-HR SNCU Cadre Sanction Position Vacant MO* 4 3 1 SN 14 14 0 LT 1 1 0 DEO 1 1 0 Security 3 3 0 Supporting staff 4 3 1 NBSUs SN 33 29 02 4 MOs should be Specialist Paediatricians One is specialist Other 2 MBBS

NRC _ HR:

NRC _ HR Cadre Sanction Position Vacant MO 2 2 0 SN 3 3 0 Nutrition Counsellor 2 2 0 MSW 1 1 0 Cook cum caretaker 2 2 0 Attender & Cleaner 2 1 1

NRC-Akshaya:

NRC- Akshaya

HR GGH:

HR GGH Cadre Sanction Position Vacant Medical Superintendent 01 00 01 Civil Surgeon Specialist 08 01 07 DCS 4 0 4 Asst RMO 01 01 0 CAS 17 15 02 Chief radiographer 2 2 0 Radiographer 3 3 3

HR GGH:

HR GGH Cadre Sanction Position Vacnt Head Nurses 38 37 1 Staff Nurses 78 71 7 LT 5 5 0 OT Asst 3 2 1

HR NPCB:

HR NPCB Cadre Sanction Position Vacancy Civil Surgeon 01 01 00 Opthal Asst 1 1 0 Staff nurse 1 1 0 MNO 1 1 0 OT Assit 1 0 1 Driver 1 0 1

HR PP Unit:

HR PP Unit Cadre Sanction In position Vacant CAS 2 2 0 MPHA(F) 2 2 0 SN 1 1 0 FNO 2 1 1

HR _ MPHW(F) Training college:

HR _ MPHW(F) Training college Cadre Sanction position Vacant Principal 1 0 1 Sister tutor 2 2 0 PHN 4 2 2 MPHEO 1 1 0 Warden 1 0 1 Sweepers 2 1 1 Cook 2 0 2

HR in APVVP facilities-Specialists:

HR in APVVP facilities-Specialists Cadre Essential Position %Vacancy on Essential Regular Contract Gynecologist 16 08 00 50% Paeditrician 16 09 00 43.75% Anaesthetist 16 04 00 75%

HR in APVVP facilities:

HR in APVVP facilities Cadre Essential Sanction Position %Vacancy on Essential %Vacancy of Sanctioned Regular Contract SN 183 155 109 00 40.43 29.67 LT 34 16 06 07 61.76 18.75 Radiographer 14 12 07 04 21.42 8.33 Pharmacist 21 26 20 03 -9.52 11.53 GDMO 45 78 38 31 -53 11.53

SC with ANM, without both:

SC with ANM, without both

PHCs without MO, LT, Pharmacist, SN:

PHCs without MO, LT, Pharmacist, SN

HR in UHCs:

HR in UHCs Cadre Sanctioned Position Vacant MO 19 16 03 ANMs 38 38 00 MO Asst 19 19 00 CO 19 19 00 Watchmen 19 17 02 Sweeper 19 19 00 NUHM not yet launched

Slide 101:

Equipment status

Availability of equipment in delivery points:

Availability of equipment in delivery points Item Percentage of availability Labour table 98% OT Table 97% Electrical Suction Machine 98% Boyle apparatus 32% Pulse Oxymeter 57% Autoclave 97% Waste shredder 13%

Availability of equipment in delivery points:

Availability of equipment in delivery points Item % of availability Waste autoclave 20% Minilap Kit 93% IUCD kit 97% C-Sec Delivery kit FRUs 100% Semi Auto analyzer 10% Centrifuge 70% Microscope Binocular 97%

Equipment _ SNCU:

Equipment _ SNCU Name of equiupment Available Working Ventilator 0 0 Portable X Ray 1 1 Blod Gas Analyser 0 O Infantometer 1 1 Single Surface Phototherapy 6 6 Double sided light Phototherapy 2 2 Double outlet Oxygen concentrator 0 0 Pulse Oxymeter 11 10 Controlled Slow Suction 0 0 Servo controlled radiant warmer 21 21 Generator 0 0 Infusion pump 8 8

Specialty Diagnostics:

Specialty Diagnostics Available at GGH, and DH,Hindupur Radiologist not available at Hindupur X-Ray available at 11/13 APVVP facilities ECG facility available at all APVVP facilities

Equipment status_Blood bank:

Equipment status_Blood bank Name Equipment Quantity Status Donor coach 3 2 not working Incubators 4 2 not working Blood collection monitor 2 Working Digital calorimeter 1 Working Coagulameter 1 Working ELISA reader 2 1 not working ELISA washer 2 1 not working VDRL Rotator 1 Working

Equipment status _ Blood bank:

Equipment status _ Blood bank Name Equipment Quantity Status Refrigerator water bath 1 Working Cell counter 1 Working Platelet agitator 1 Working -40 Refrigerator 1 Working -80 Refrigerator 1 Working Plasma thawing bath 1 Working Blood bank refrigerators 2 Working Micro channel Pipette 6 Working

Equipment NVBDCP:

Equipment NVBDCP Item name Total Quantity in field Quantity at District Stirrup pumps 47 43 7 Knapsac Sprayers 40 39 1 Power sprayers 08 08 00 Fogging machines 11 10 1 Fit Pumps 31 30 01

Slide 109:

Health Indicators

Slide 110:

INFANT MORTALITY RATE S.no Description Status 1 Anantapur 45 2 Srikakulam 47 3 Vizianagaram 45 4 Visakapatnam 39 5 Prakasam 37 6 Nellore 35 7 East Godavari 34 8 West godavari 28 9 Chittor 35 10 Kurnool 43 11 YSR Kadapa 38 12 Krishna 25 13 Guntur 31 Source : SRS 2013/CHFW Office

Progress:

Progress Reduction in IMR 2005 2006-07 2012 2013 SRS SRS SRS RCH -2 Baseline NRHM SNCU

Slide 112:

MATERNAL MORTALITY RATIO Source : SRS 2010-12 S.no Description Status 1 Anantapur 98 2 Srikakulam 98 3 Vizianagaram 107 4 Visakapatnam 115 5 Prakasam 87 6 Nellore 77 7 East Godavari 74 8 West godavari 80 9 Chittor 86 10 Kurnool 108 11 YSR Kadapa 85 12 Krishna 79 13 Guntur 83

Progress:

Progress Reduction in MMR 2004-06 2007-09 2010-12 2011-13 SRS SRS SRS SRS NRHM MDR

Measles Vaccine -1 Coverage :

Below 20% Between 20% - 40% Between 40% - 60% Between 60% - 80% Above 80% Measles Vaccine -1 Coverage DLHS-4

Immunization %(Children 12-23mnths):

Immunization %(Children 12-23mnths)

Full immunization(2013-14):

Full immunization(2013-14) Source: CHFW

TFR:

TFR

RMNCH+A ranking-(13-14)[14-15]:

RMNCH+A ranking-(13-14)[14-15] Indicators Composite Index Overall Index Pregnancy care Child Birth Postnatal maternal & new born care Reproductive age group 2014-15 2013-14 2014-15 2013-14 2014-15 2013-14 2014-15 2013-14 2014-15 2013-14 1 Anantapur 0.3134 0.4679 0.28 0.4012 0.2356 0.2618 0.4838 0.7431 0.163 0.3267 2 Chittoor 0.3912 0.4726 0.3681 0.4863 0.0976 0.3444 0.6694 0.6627 0.2594 0.2613 3 Cuddapah 0.3968 0.5401 0.5291 0.5683 0.4598 0.5605 0.4212 0.5277 0.0726 0.4934 4 East Godavari 0.5167 0.5826 0.5051 0.7311 0.5597 0.7904 0.476 0.422 0.5612 0.3948 5 Guntur 0.4123 0.4486 0.1453 0.2076 0.2385 0.6052 0.5997 0.527 0.7189 0.5627 6 Krishna 0.5889 0.5496 0.5345 0.5663 0.9334 0.6667 0.5484 0.5396 0.4026 0.4213 7 Kurnool 0.2639 0.2849 0.3172 0.3515 0.2075 0.3752 0.2981 0.1614 0.1743 0.2896 8 Nellore 0.3211 0.3761 0.2962 0.3437 0.3247 0.3916 0.2771 0.4086 0.4325 0.3606 9 Prakasam 0.2417 0.2835 0.043 0.0088 0.1891 0.3782 0.4599 0.5091 0.262 0.2704 10 Srikakulam 0.3352 0.4889 0.3224 0.414 0.3466 0.5967 0.3576 0.4694 0.3076 0.5387 11 Vishakapatnam 0.3161 0.5954 0.2399 0.5987 0.2872 0.6783 0.3545 0.5002 0.4079 0.6657 12 Vizianagaram 0.6782 0.5546 0.8837 0.5868 0.5631 0.5246 0.5565 0.5598 0.6535 0.5221 13 West Godavari 0.4416 0.5312 0.4368 0.552 0.489 0.6306 0.4533 0.5173 0.3827 0.4202

Slide 120:

MCTS Progress From : 1/4/2015 Upto the Month Of : September, 2015 S.No Name of the District Mother Services Child Services Ante-Natal Care Intra-Natal Care Post-Natal Care ANC Registrations against ELA1 High Risk identified against ANC registration Received MO Checkup (2nd & 4th ANC)against ANC registration Pregnant women transported through 108 vs ELA 3 Total Live Births / Child Registration against ELA 2 Delivery outcome reported against ANC registration Deliveries in Public Institutions against Live births Home Deliveries against Live births C-Sections out of Institutional Deliveries Breast feeding within 1 hr against Live births 48 hours Stay in Hospital against institutional deliveries Postnatal care against Live births Total Live Births / Child Registration against ELA Zero Dose against Live births 3rd Dose against Live births Full Immunization against Live Births 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 1 Anantapur 92 18 47 0 88 75 47 1 27 61 58 80 88 93 39 0.11929 2 Chittoor 87 13 34 0 85 78 62 0 28 60 66 79 85 83 39 0.11997 3 East Godavari 88 10 32 0 86 85 41 0 48 46 67 77 86 75 39 0.10288 4 Guntur 80 17 47 0 88 95 29 0 47 47 80 85 88 89 40 0.11194 5 Kadapa 90 11 44 0 87 78 31 2 37 53 42 82 87 88 41 0.1673 6 Krishna 90 15 44 0 95 89 34 0 54 40 64 86 95 90 41 0.12109 7 Kurnool 92 8 34 0 83 73 47 9 29 62 46 71 83 65 39 0.11441 8 Prakasam 83 15 43 0 87 85 27 0 42 50 64 82 87 87 42 0.15754 9 Sri Potti Sriramulu Nellore 86 15 41 0 87 79 33 1 42 48 68 75 87 79 42 0.18708 10 Srikakulam 95 14 43 0 93 82 49 0 48 44 60 77 93 85 41 0.18763 11 Visakhapatnam 88 13 43 0 83 75 63 7 30 61 65 72 83 78 40 0.13139 12 Vizianagaram 99 16 37 0 92 81 61 0 38 58 57 81 92 89 40 0.20701 13 West Godavari 90 12 32 0 95 92 42 0 59 37 67 83 95 81 41 0.13177 SHISD report Sept’2015 District

Slide 121:

MCTS Progress From : 1/4/2015 Upto the Month Of : September, 2015 Ante-Natal Care S.No Name of the Health Block Mother Services Child Services Intra-Natal Care Post-Natal Care       ANC Registrations against ELA1 High Risk identified against ANC registration Received MO Checkup (2nd & 4th ANC)against ANC registration Total Live Births / Child Registration against ELA 2 Delivery outcome reported against ANC registration Deliveries in Public Institutions against Live births Home Deliveries against Live births C-Sections out of Institutional Deliveries Breast feeding within 1 hr against Live births 48 hours Stay in Hospital against institutional deliveries Postnatal care against Live births Total Live Births / Child Registration against ELA Zero Dose against Live births 3rd Dose against Live births Full Immunization against Live Births 1 2 3 4 5 7 8 9 10 11 12 13 14 15 16 17 18 1 Gooty 89 17 44 89 85 64 3 31 65 36 91 89 97 40 5.77181 2 Pamidi 98 27 47 88 75 58 2 32 61 46 86 88 90 40 4.1456 3 Konakondla 188 28 44 170 62 48 4 33 51 75 71 170 95 38 2.14067 4 Tadipathri 88 32 49 89 80 44 1 30 60 57 80 89 98 40 2.27503 5 Singanamala 116 20 44 117 80 52 0 31 58 46 77 117 93 40 2.88397 6 Anantapur 79 38 41 82 84 51 0 33 59 51 83 82 85 40 2.16272 7 Uravakonda 99 32 54 89 75 53 0 24 67 57 85 89 96 39 5.81395 8 Dharmavaram 92 49 45 102 82 37 1 26 59 48 76 102 93 38 2.50458 9 C.K.Palli 87 27 40 94 78 55 0 25 59 60 74 94 95 40 5.84329 10 Kalyandurg 100 27 60 102 86 36 0 10 82 79 91 102 97 40 1.86461 11 Kanekal 126 19 40 109 66 30 2 15 69 49 75 109 81 40 2.75908 12 Rayadurg 113 31 52 104 62 36 3 10 63 25 70 104 93 37 3.14327 13 Penukonda 93 45 40 93 74 60 0 26 58 55 75 93 94 40 1.8617 14 Nallamada 94 38 52 88 69 35 0 31 55 58 79 88 98 39 2.56257 15 Tanakallu 93 41 59 81 71 58 0 23 68 69 85 81 98 40 5.22134 16 Kadiri 89 21 48 85 74 50 0 22 65 65 81 85 96 39 2.48411 17 Hindupur 92 55 39 82 77 67 3 28 66 61 87 82 92 39 2.14435 18 Madakasira 88 23 49 81 71 61 1 25 54 65 69 81 96 38 1.85029 19 Urban Health Facilities 73 29 48 72 77 37 2 34 57 57 82 72 91 39 0.58988 SHISD report Sept’2015 Clusters

Comparative analysis based on RMNCH +A indicators SHISD report:

Comparative analysis based on RMNCH +A indicators SHISD report Month Rank in AP Sept 2013 6 th Sept 2014 6 th Sept 2015 3 rd

ELAs/Demographic denominators:

ELAs/Demographic denominators Year Projected population Estimated ECs Birth rate IMR Deliveries Expected/Live births Expected Infants TT(PW) 2years Children Estimated Source Projected 17% of total population SRS SRS Derived Derived Derived Derived 2013-14 4,130,592 702,201 18.6 47 73,767 74,569 86,307 71,164 2014-15 4,175,000 709,750 18.8 47 78,462 74774 86308 72075 2015-16 4,224,000 718,080 18.7 45 78,925 75374 86818 72730

RMNCH+A Indicators Progress & Performance:

RMNCH+A Indicators Progress & Performance

RMNCH+A Indicators _ ANC:

RMNCH+A Indicators _ ANC Year ANC registrations against ELA High Risk identified against ANC registered Received MO check up(2 nd & 4 th ) against ANC registrations 2013-14 91 10 45 2014-15 96 13 64 2015-16 92 18 47

RMNCH+A Indicators _ Intra natal:

RMNCH+A Indicators _ Intra natal Year Total live births/Child registrations against ELA Delivery outcome reported against ANC registrations Deliveries in Public Institutions against live births Home deliveries against live births C-Sections against Institutional deliveries 2013-14 79 44 40 3 24 2014-15 100 72 45 2 25 2015-16 88 75 47 1 27

RMNCH+A _ Postnatal:

RMNCH+A _ Postnatal Year Breastfeeding within 1 hour against live births 48 hours stay against institutional deliveries Postnatal care against live births 2013-14 41 37 47 2014-15 55 58 68 2015-16 61 58 80

RMNCH+A _ Child Services:

RMNCH+A _ Child Services Year Total live births/Child registrations ELA Zero dose against live births 3 rd dose against live births Full Immunizations against live births 2013-14 102% 87% 95% 88% 2014-15 110% 87% 95% 86% 2015-16 87% 93% 2% 72%

Sources:

Sources

Reproductive Health:

Reproductive Health Anemia in Women 15-49 years DLHS 4

Awareness on RTI/STI-HIV/AIDS:

Awareness on RTI/STI-HIV/AIDS

RTI/STI _ HMIS:

RTI/STI _ HMIS Year Total OPD Total RTI/STI cases - Male Total RTI/STI cases - Female Total RTI/STI cases RTI/STI cases as % ge of Total OPD Number of wet mount tests conducted 2012-13 4,246,460 704 581 1,285 0.030% 16 2013-14 3,946,344 280 170 450 0.011% 46 2014-15 5,591,196 4971 11365 16336 0.29% 481 2015-16 3,502,623 4176 4803 13979 0.39% 369

Performance and Progress:

Performance and Progress MATERNAL and CHILD HEALTH

ANC:

ANC Antenatal Care

Focused ANC with Dedication Patient amenities:

Focused ANC with Dedication Patient amenities

Recording Height & Weight:

Recording Height & Weight

ANC Package & Infant Weighing:

ANC Package & Infant Weighing

Waiting Place & Transportation:

Waiting Place & Transportation

Counseling & Health Education:

Counseling & Health Education

AN Care _dlhs:

AN Care _ dlhs

ANC HMIS_NRHM:

ANC HMIS_NRHM

ANC HMIS_NHM:

ANC HMIS_NHM

ANC_MCTS:

ANC_MCTS Indicator 2011-12 2012-13 2013-14 2014-15 2015-16 Total ANC registration 96 99 99 100 91 PW registered in 1t trimester 31 61 56 46 24 ANC 3 68 68 73 83 44 TT 2 91 89 91 99 75 IFA tablets 100 53 62 73 84 58 Full ANC 39 47 60 72 20

Anemia in PW:

Anemia in PW Anemia Status by Haemoglobin Levels in % _ DLHS 4

Anemia _ HMIS-NHM:

Anemia _ HMIS-NHM % of PW with Anemia Severe Anemia-treated in facility-number Severe Anemia-treated in facility- in %

Delivery care:

Delivery care

Delivery care:

Delivery care

Deliveries on Estimated _ HMIS NHM:

Deliveries on Estimated _ HMIS NHM YEAR Home SBA Home NSBA IDs Total reported deliveries Unreported deliveries on estimated 2012 -13 2% 1% 50% 53% 47% 2013-14 1% 1% 20% 22% 78% 2014-15 2.7% 0.5% 20% 27.4% 72.8% 2015-16 0.4% 0.4% 32% 32.6% 67.4%

Deliveries on Reported _ HMIS NHM:

Deliveries on Reported _ HMIS NHM Year ID(Pub) ID( Pvt ) Home SBA Home NSBA 2012-13 45.9 49.2% 3.9% 1% 2013-14 93.3% Not reported 4.3% 2.4% 2014-15 96% Not reported 2.4% 1.9% 2015-16 97% Not reported 1.4% 1.4%

Intranatal:

Intranatal Delivery Services And Care

Delivery points:

Delivery points Type of facility Number 24x7 42 CHC 15 AH 2 DH 1 GGH 1 PHCs 28 99

Delivery Care_HMIS-NHM:

Delivery Care_HMIS -NHM

Deliveries' benchmarks:

Deliveries' benchmarks Type of hospital Benchmark Director of Public Health & Family Welfare PHC 25 -30 CHC 50 APVVP CHC(30 beds) 50 CHC(50 beds) 75 AH(100) 150 DH(300) 500 CHFW

Delivery performance of 24x7 PHCs:

Delivery performance of 24x7 PHCs Parameter 2013-14 2014-15 2015-16 Total deliveries 5689 5899 2522 Average Deliveries per month all facility 479 491 420 Average deliveries per month per facility 11 12 10 RDHMIS

Mean deliveries in 24x7:

Mean deliveries in 24x7 Number 2013-14 2014-15 2015-16 1 to 5 7 6 9 6 to 10 15 10 15 11 to 15 10 14 10 16 to 20 6 6 4 21 to 25 4 6 4 > 25 0 0 0 RDHMIS

Deliveries _ MCTS-in%:

Deliveries _ MCTS-in% Indicator 2011-12 2012-13 2013-14 2014-15 2015-16 Total deliveries 66 68 76 81 75 IDs 94 95 96 97 98 Public 34 38 43 47 40 Private 60 57 53 50 52 Home 4 3 3 2 1 C-Sec 15 18 20 25 27

C-Sec against Reported Institutional deliveries :

C-Sec against Reported Institutional deliveries Complicated Pregnancies against Reported Institutional deliveries HMIS-NHM

Normal against Reported Institutional deliveries :

Normal against Reported Institutional deliveries HMIS-NHM

PNC:

PNC

PNC:

PNC

Discharge after minimum stay of 48 hours:

Discharge after minimum stay of 48 hours

PNC _ MCTS:

PNC _ MCTS Indicator 2011-12 2012-13 2013-14 2014-15 2015-16 PNC within 48 hours 41.83% 40% 49% 49% 37% PNC after 7 days 9.43% 9% 9% 12% 9% No postnatal visit 18.98% 27% 19% 14% 31%

PNC Complications in % Vs reported deliveries:

PNC Complications in % Vs reported deliveries HMIS-NHM

Quality of ANC_ Anemia in PW:

Quality of ANC_ Anemia in PW Indicator 2012-13 2013-14 2014-15 2015-16 ANC having Hb less than 11 19.2% 18.9% 31.3% 50% ANC having Hb less than 7 treated at Institutions 1% 0.9% 0.8% 0.6% HMIS_NHM

JSY :

JSY Year Public Deliveries JSY paid % JSY Paid 1000 % 1000 paid 600 % 600 paid SC % SC availed ST % ST availed benfit 2012-13 17789 14887 83.6% 12,538 84.2% 2349 15.8 2388 16 982 6.7 2013-14 18,181 17,423 95.8% 15,137 86.8% 2276 13.2 2913 16.7 1008 5.7 2014-15 20,418 22,324 109.3 19,377 86.8% 2944 13.2 3959 17.7 1339 5.9 2015-16 12,375 10,693 86.4% 9915 92.7% 1578 7.3 1603 15 662 6.2

JSSK:

JSSK Component Number of beneficiaries' 2013-14 2014-15 2015-16 Given diet one day 1707 2735 712 Given diet two days 5806 7001 2888 Given diet five days 2613 3349 1604 Given free Home to facility 22063 14105 Given Facility to Home Reverse Transportation 532 1137

USG MoUs under JSSK:

USG MoUs under JSSK Number of Health facilities MoU with Scanning centres Number of Scan centers under MoU Number of beneficiaries' 83 33 4957 Free scan under JSSK Initiated from July 2015 JSSK @ Rs.1000 for Private Specialist Doctors” Number of beneficiaries' 668

MDRs:

MDRs Indicator Number expected Number conducted % of performance 13-14 14-15 15-16 13-14 14-15 15-16 13-14 14-15 15-16 Number of DC_MDR meetings conducted 12 12 12 12 07 00 100 58 00 Number of Sub committee meetings held 12 12 6 12 12 6 100 100 100 Number of CBMDRs 58 85 30 58 85 30 100 100 100 Number of FBMDR 51 79 26 15 20 03 29 25 20

MDR Analysis{14-15},(15-16/Sept):

MDR Analysis{14-15 },( 15-16/Sept ) Description 2013-14 2014-15 2015-16 No % No % No % Apprehended 87 85 77 Notified 73 95 33 Maternal deaths 58 85 30 CBMDR 58 100 85 100 30 100 FBMDR 15 34.9 20 32.3 3 14.3 Home 07 12 06 7.5 04 13.3 Transit 08 13.8 17 20 5 16.6 Facility 43 74.1 62 72.9 21 70

Slide 172:

Births Newborn Care

Births and New Born :

Births and New Born

Slide 174:

SEX RATIO AT BIRTH HMIS-NHM

Birth weight & LBW:

Birth weight & LBW

Child Health:

Child Health

Anemia {6 -9 years}_ dlhs 4:

Anemia {6 -9 years}_ dlhs 4 Males Females

Anemia (6-14 years)_ dlhs 4:

Anemia (6-14 years)_ dlhs 4 Males Females

Anemia 10 – 19years _ dlhs 4:

Anemia 10 – 19years _ dlhs 4 Males Females

Immunization performance, Progress:

Immunization performance, Progress Year Full Immunization Complete Immunization DLHS 3 DLHS 4 HMIS MCTS HMIS MCTS 2007 -08 55% 2012-13 66.2% 108% 85% 102% 79% 2013-14 96% 87% 88% 80% 2014-15 102% 89% 39% 74% 2015-16 100% 66% 76.7% 15%

DPT 5_ NHM HMIS:

DPT 5_ NHM HMIS DPT 2 nd booster

Drop 0ut Rates:

Drop 0ut Rates Year Dropout from BCG to DPT3 Dropout from BCG to Measles Dropout from DPT3 to Measles 2012-13 -2% 0% 3% 2013-14 0 11 11 2014-15 0 0 0 2015-16 3% 1% 0.7%

Sessions :

Sessions Year Sessions Planned Sessions held % of sessions held Vs planned Sessions ASHA present % Sessions ASHA absent 2012-13 34,807 33,859 97.2% 28,403 83.8% 2013-14 34,311 33,310 97% 25,903 77.7% 2014-15 43,834 42,989 98% 36,436 84.7% 2015 -16 26,673 26,519 99.4% 23,283 87.7%

ORS + Zinc promotion:

ORS + Zinc promotion IYCF practices promotion

Awareness in Mothers on Diarrhea & ARI danger signs:

Awareness in Mothers on Diarrhea & ARI danger signs

Childhood diseases:

Childhood diseases % Children Under 5

IYCF:

IYCF

IDCF report 2015_IYCF week:

IDCF report 2015_IYCF week Conducted in August 3/2015 – August 15/2015 Indicator Number Number of villages covered 3411 No.of viallages IYCF counselling is conducted by ASHA 3411 Households visited by ASHA for conduction of IYCF counselling 723484 No. Of U 5 screened 353455 No. Of children detected by ASH as undernourished 754 No. Of villages VHSNC was conducted on sanitation 1003

IDCF report 2015_ORS+Zincweek:

IDCF report 2015_ORS+Zincweek Conducted in August 3/2015 – August 15/2015 Indicator Number No.children given ORS 1628 No.Children reportedw with diarhoea during the week 1628 No of children given Zinc 1628 No of ORS+Zinc corners established 2025 No of schools hand washing demonstrated 2986 No of slums/H2R areas covered 86

Mission Indradhanush _ Phase 2:

Mission Indradhanush _ Phase 2 Indicator Number Number of sessions planned 732 Number of sessions conducted 732(100%) No. Of children vaccinated 2134(99.9) No. Of children vaccinated for first time in life 238(11%) No. Of PW vaccinated 368 No of children fully vaccinated 507(24%) No of children completly vaccinated 430(20%) No of ORS distributed 3232 No, of Zinc tablets distributed 3060

VITAMIN A CAMPAIGN:

VITAMIN A CAMPAIGN Conducted in the year 2014 Two rounds 1 st round = 14/7/2014 to 19.07.2014 2 nd round = 15/12/2014 to 30/12/2014

Vitamin A performance:

Vitamin A performance Dates ELA Covered % Rural % Urban % 1 st round 357000 189189 53% 169028 89.34 20161 10.66 2 nd round 357000 262308 73% 225617 86.01 36691 13.99%

Slide 193:

Family Planning

FP:

FP 2013-14 2014-15 2015-16 Number of FP camps organized 378 381 74 Number of IUCD camps organized 0 0 0 FP Accredited private centres 49 51 51 FP trainings_MOs 15 06 00 RMNCH+A Counsellors 0 0 0 FDS for FP 14 14 11 FDS for IUCD 5 5 5 Status of PPIUCD service provision 00 01 01 FP Service centres for Camps 18 18 18

Permanent Sterilizations _ HMIS-NHM:

Permanent Sterilizations _ HMIS-NHM Indicator 2014-15 2015-16 Public Pvt Total Public Pvt Total NSV 05 00 05 01 00 01 Laproscopic 5798 00 5798 552 00 552 Minilap 3697 00 3697 1888 00 1888 Post partum 3099 00 3099 1135 00 1135 Female 12594 00 12594 3575 00 3575

FP performance - RDHIMS:

FP performance - RDHIMS Sterilizations 32,000_ELA 30,000_ELA ELA-13,533(27,067) 2013-14 2014-15 2015-16 Number % Number % Number % 29,171 91.2 27,449 91.5 9531 70.4

FP performance - RDHIMS:

FP performance - RDHIMS Sterilizations -Male Year ELA Male ELA Male Public Private % 2013-14 32000 1280 41 11 0.16 2014-15 30000 1200 4 11 0.05 2015-16 27067 541 00 01 0.007 % based

Female sterilizations:

Female sterilizations Year ELA Achievement Female Public Private Total Total % Mini % DPL % Total% Mini % DPL % 2013-14 32000 29119 58.6 6234 36.6 10824 63.4 41.4 7570 62.7 4491 37.3 2014-15 30000 27434 64.1 6746 38.3 10829 61.7 35.9 5950 60.3 3909 39.7 2015-16 27067 9530 47.9 3822 83.7 742 16.3 52.1 3207 64.5 1759 35.5 RDHMIS

FP Performance :

FP Performance Spacing IUCD OP Users CC Users Year ELA Ach % ELA Ach % ELA Ach % 2013-14 22000 18961 86.1 25000 2851 11.4 37000 14136 38.2 2014-15 22000 19625 89.2 24000 3294 13.7 37000 14956 40.4` 2015-16 8745 17490 8799 100 27484 6127 22.2 39094 5616 14.3

ASHA initiative:

ASHA initiative Home delivery of Contraceptives by ASHA Initiated in the year 2013-14 Stocks supplied from State Trainings given to ASHAs No acceptance from the community _ as they are insisting on free supply rather than with payment

Quality Assurance _ FP :

Quality Assurance _ FP YEAR Number 2013-14 02 2014-15 02 2015-16 01 Number of FP deaths

Abortions:

Abortions Indicator 2014-15 2015-16 MTP up to 12 weeks 62 80 MTP more than 12 weeks 26 40 Abortions(Spontaneous/Induced) 648 592 Abortion rate against reported pregnancies 0.67% 1.32%

Abortions/Still births_MCTS:

Abortions/Still births_MCTS Indicator 2011-12 2012-13 2013-14 2014-15 2015-16 Abortions 0%(226) 1%(446) 1%(900) 2%(1177) 2%(136) Still births 2%(1602) 3%(2638) 4%(3273) 6%(47) 5%(2071)

Progress and Performance:

Progress and Performance HMIS indicators

Key Performance Indicators:

Key Performance Indicators

ANM related:

ANM related Indicator 2012-13 2013-14 2014-15 2015-16 HMIS MCTS HMIS MCTS HMIS MCTS HMIS MCTS % of ANC registered Vs Expected 106 99 110 99 110 100 102 91 % ANC in 1 st Trimester Vs Reported PW 54 61 56 56 62 46 70 24 % 3 ANCs Vs reported 87 68 89 73 99 83 107 44 % HTN in reported 2 1.7 1.5 1.3 % Severe anemia in reported ANC 1 0.07 0.9 0.1 0.87 0.5 0.6 0.4 % PNC visits within 48 and 14 days Vs total deliveries 96 40 114 49 126 49 157 37 NHM-HMIS

ANM related KPIs:

ANM related KPIs Parameter 2012-13 2013-14 2014-15 2015-16 HMIS MCTS HMIS MCTS HMIS MCTS HMIS MCTS % DPT3 immunisation against Estimated Live Births 104 107 94 95 99 95 115 80 % Measles Immunization against Estimated Live Births 101 90 83 89 96 87 103 73 % Full immunisation against Estimated Live Births 109 86 99 88 103 86 100 72 TT(PW)% against reported PW 106 89 85.4 91 110 94 102 75 NHM-HMIS

ASHA related:

ASHA related Parameter 2012-13 2013-14 2014-15 2015-16 % Newborns weighed at birth against Estimated live Births 70 41% 48 52 % of Newborns having weighed less than 2.5 kg against newborns weighed 3 4% 5% 7 % Newborns visited within 24 hrs of Home deliveries 60 131% 106 91 % ASHAs present during immunisation Sessions 84 78% 85 88 NHM-HMIS

Facility related:

Facility related NA NA

Facility related KPIs:

Facility related KPIs Measure 2012-13 2013-14 2014-15 2015-16 OPD per 1000 population 1028 955 1339 829 IPD per 1000 population 33 44 52 40 Major surgeries per lakh population. 44 52 251 503 Institutional deliveries against estimated deliveries. 50% 20% 20 32 Institutional deliveries against Reported deliveries. 45.9 93% 96 97 NHM-HMIS

Facility KPIs:

Facility KPIs Parameter 2012- 13 2013- 14 2014-15 2015-16 % C- Section against Institutional Deliveries 9.2% 1.7% 6 13 Abortion Rate against Reported pregnancies 0.9% 0.2% 1 2 Total sterilization done per 1000 eligible couples 24 13 4.97 17.75 Total IUD inserted per 1000 eligible couples 15 6.11 7.44 9.84 PW with Anemia 19.2% 31.3% 18 5 PW with Severe Anemia 1.1% 0.9% 10 7.4 NHM-HMIS

AEFI:

AEFI Indicator 2013-14 2014-15 2015-16 Abscess 0 0 157 Deaths 0 1 3 Others 3 24 44

AYUSH Services:

AYUSH Services Parameter 2012-13 2103-14 2014-15 2015-16 OPD 260,607 215,270 258726 181900 As % of OPD 6.1% 5.5% 4.6% 5.1% NHM-HMIS

Facility related-HMIS NHM:

Facility related-HMIS NHM ZERO DOSE IMMUNIZATION Vs Reported Live births 2013-14 2014-15 2015-16 BCG 91% 96% 88 OPV 86% 88% 75 Hep B 2% 37% 60

Lab Services:

Lab Services Total Population Total HB tested Total HIV tested Total VDRL Tested Total Widal Test Conducted Blood Smear Examined 2012-13 4,130,592 47,828 69856 5042 3853 240,023 2013-14 4,130,592 63,330 47,056 6,269 4,592 168,160 Total OPD HB test conducted as %age of OPD HB<7gm as %age of HB tested HIV test conducted as %age of OPD HIV positive as %age of HIV tested VDRL test conducted as %age of OPD Widal test conducted as %age of OPD Blood Smear Examined as % of Population 2012-13 4,246,460 1.1% 8.6% 1.6% 2.3% 0.1% 0.09% 5.81% 2013-14 3,946,344 1.6% 8.3% 1.2% 2.5% 0.2% 0.12% 4.07% NHM-HMIS

Lab Services:

Lab Services Total Population Total HB tested Total HIV tested Total VDRL Tested Total Widal Test Conducted Blood Smear Examined 2014-15 4175001 109475 62248 5225 16691 237987 2015- 16 4224011 138843 46554 10653 21172 187892 Total OPD HB test conducted as %age of OPD HB<7gm as %age of HB tested HIV test conducted as %age of OPD HIV positive as %age of HIV tested VDRL test conducted as %age of OPD Widal test conducted as %age of OPD Blood Smear Examined as % of Population 2014 - 15 5591196 2% 5.2% 1% 4% 0.09% 0.2% 5.7% 2015 - 16 3502623 4% 4% 1.3% 4% 0.3% 0.6% 4.4% NHM-HMIS

Slide 217:

Grievance Redressal Mechanism

Grievance Redressal Mechanism:

Grievance Redressal Mechanism Mee Kosam Website Weekly Praja Vani at District HQS_ attended by the DMHO Weekly Praja Vani at Mandal HQS _ attended by the Medical Officer Mobile numbers of DMHO,MO wall written on all the facilities and DMHO office

Suggestion/Complaint boxes:

Suggestion/Complaint boxes

IMEP practices:

IMEP practices At Patnam PHC

Teachings:

Teachings Trainings Coaching New Skills

Trainings/Capacity building(1)2014-15:

Trainings/Capacity building(1)2014-15 Sl.no Training programme Objective Category trained Number trained Duration days 1 IMNCI Reduce NMR,IMR MPHA(F) 72 08 2 BEmNOC Reduce MMR,IMR MOs, 4 10 3 SBA Reduce MMR,IMR MPHA(F) 44 21 4 SBA Reduce MMR,IMR SNs 12 21 5 NSSK Reduce NMR,IMR MPHA(F) 35 02

Trainings/Capacity building(2)2014-15:

Sl.no Training programme Objective Category trained Number trained Duration days 6 ARSH Adolescent Health MPHA(F) MPHS(F),HE 100 05 7 STI/RTI Reduce RTI/STI Mos,LTs 58 02 8 MAARPU ISC in IMR,MMR reduction ICDS_Supervisors,MPHA (F),CRP,APMs 472 06 9 MiniLap Quality FP services MOs,SNs OT Techs 06 12 10 CDAC POs,Pharmacists,DEOs 192 01 Trainings/Capacity building(2)2014-15

Trainings/Capacity building(3)2014-15:

Trainings/Capacity building(3)2014-15 Sl.no Training programme Objective Category trained Number trained Duration days 11 PPIUCD MMR reduction MOs SNs 16_MOs 20_SNs 05

Trainings/Capacity building(1)2015-16:

Trainings/Capacity building(1)2015-16 Sl.no Training programme Objective Category trained Number trained Duration days 1 IMNCI Reduce NMR,IMR MPHA(F) 24 8 2 Safe birth Checklist Reduce MMR,IMR MOs,SNs 41 3 3 SBA Reduce MMR,IMR MPHA(F) 12 21 4 SBA Reduce MMR,IMR SNs 7 21 5 NSSK Reduce NMR,IMR MPHA(F) 36 02

Trainings/Capacity building(2)2015-16:

Sl.no Training programme Objective Category trained Number trained Duration days 1 BEmNOC Reduce MMR,IMR MOs 4 10 2 MDR_Avni Reduce MMR,IMR Deputy DMHOs/ DEOs 33 01 3 ASHA ToT_HBNC Strengthen MCH services PHN MPHS(F) 128 02 4 Reorientation on MCTS_Use of Tablet PCs Strengthen MCH services Deputy DMHOs,MO,DEOs,MPHA 82 01 Trainings/Capacity building(2)2015-16

Total trained:

Total trained Sl.no Name of training Cadre trained Trained To be trained Training load % 1 NSSK MOs 131 50 181 72% SNs 300 10 315 95% MPHA(F) 179 782 961 19% 2 SBA SNs 302 03 315 96% MPHA(F) 93 868 961 10% 3 IMNCI MPHA(F) 336 625 961 35% 4 BEmNOC MOs 38 76 114 33% 5 Minilap MOs 36 78 114 32% 6 CDAC MOs 192 24 216 89% Pharmacists 155 61 216 72%

Total trained(2):

Total trained(2) Sl.no Name of training Cadre trained Trained Untrained Training load % 7 MAARPU_dist ICDS Supervisors MPHA(F)s CRPs, APMs 615 78 693 89% 8 RTI/STI MOs 50 64 114 44% SNs 22 115 137 16% LTs 30 30 60 50% 9 ASHA 6 & 7 ASHAs 2729 328 3057 89% 10 Safe Child Birth Checklist MOs 30 151 181 17% SNs 62 253 315 20%

Total trained(3):

Total trained(3) Sl.no Name of the training Cadre trained Number trained Number to be trained Training load % 11 ARSH MPHS(F) 33 47 80 41% MPHA(F) 107 854 961 11% HEs 10 09 19 53% 12 Re- Oreintation on MCTS_Distribution of Tablet PCs Ddmhos MOs DEOs 82 0 82 100% 13 MDR Avni Cluster staff 33 0 33 100% 14 ASHA ToT_HBNC PHN MPHS(F) 128 0 128 100%

Other trainings:

Other trainings LSAS training – 4 members trained RCH portal trainings HMIS trainings MCCD trainings

Slide 231:

Free Diagnostics

108:

108

Ambulance Services:

Ambulance Services Eight Ambulances in APVVP Sl.no Stationed at Type of facility 1 Hindupur DH 2 Penukonda CHC 3 Uravakonda CHC 4 Dharmavaram CHC 5 Gooty CHC 6 Kadiri AH 7 CK Palli CHC 8 Rayadurg CHC

104 PHC Mobile:

104 PHC Mobile 104 PHC Mobile

104 PHC Mobile _ Performance:

104 PHC Mobile _ Performance Year Number of patients treated OPD per 1000 population 2013-14 4,96,823 120.2 2014-15 4,42.826 106 2015-16 2,41,541 57 Year Number of Lab tests conducted Tests per 1000 population 2013-14 2,94,614 71.3 2014-15 2,31.437 55.4 2015-16 90,541 21.4 Each vehicle covers 2 villages per day Conducts to OPD clinics 23 Vehicles functional 1104 villages are covered 30% of villages are covered

Drug policy & Supply chain management:

Drug policy & Supply chain management

Medicines budget allocations:

Medicines budget allocations Year Annual budget allocated Expenditure % 2012-13 137788935.4 114806268 83.32038249 2013-14 181619920 141494556 77.90695866 2014-15 164702246 163927761 99.52976658 2015-16 185665960 23620549.2 12.72206774

Budget per facility 2013-14 :

Budget per facility 2013-14 Budget allocated per facility annually 2013-2014 Type of facility Drugs Surgicals CTS Total PHC 49112499.5 4920000   54032499.5 CHC 20708965 5735920 235430 26680315 AH 8390280 2323925 102360 10816565 DH 5644230 1563325 51180 7258735 GGH 48113630 184228605 785570 233127805

Budget per facility 2014-15:

Budget per facility 2014-15 Budget allocated per facility annually 2014-2015 Type of facility Drugs Surgicals CTS Total PHC 39449960 3891760   43341720 CHC 16567172 4589006 188344 21344522 AH 6712224 1859140 81888 8653252 DH 4515384 1250660 40944 5806988 GGH 52866372 15957392 800000 69623764

Budget per facility – 2015-16:

Budget per facility – 2015-16 Budget allocated per facility annually 2015-2016 Type of facility Drugs Surgicals CTS Total PHC 59666000 7417300   67083300 CHC 19000000 5736000 378000 25114000 AH 6300000 1900000 130000 8330000 DH 3150000 1015000 65000 4230000 GGH 40866370 19597390 1100000 61563760

CDS Medicines:

CDS Medicines

Deliveries in GGH:

Deliveries in GGH Year Normal Assisted C-Sec Total 2013-14 3713 0 2115 5828 2014-15 4375 432 2644 7451 2015-16 2405 175 1455 4035

EDL:

EDL

SNCU - Sishu Sanjeevani:

SNCU - Sishu Sanjeevani

SNCU – Sishu Sanjeevani:

SNCU – Sishu Sanjeevani

SNCU _ Sishu Sanjeevani:

SNCU _ Sishu Sanjeevani

SNCU performance:

SNCU performance Indicator 2013-14 2014-15 2015-16 Total admissions 1228 1253 1149 Admissions per 100 deliveries 21 16.8 28.4 Inborn cases per 100 admissions 51 58 51 % of LBW per 100 admissions 36 37 37 Proportion of very LBW per 100 admissions 14 06 08 Number of beds 20 20 20 Nurse:bed ratio 1:5 1:5 1:5 Specilaist Doctor:bed ratio 1:20 1:20 1:20 BOR 16.8% 17.1% 31.3%

Slide 248:

In % Morbidity data SNCU Morbidity data SNCU

Slide 249:

Morbidity data SNCU in %

NRC Performance:

NRC Performance Indicator 2014-15 2015-16 Admissions 122 148 Gender disaggregated Male Female Male Female 51 71 63 85 Referred HW/Self/ Paediatrician 11/4/45 4/4/67 Target weight gain during stay(%) 34% 51% Referral rate to higher centre 0.8% 0.7% BOR 1.6% 4%

Slide 251:

Year Total camps Total collections Issue to BSC Issued to GGH % Isseud to PHFs 2014-15 54 3644 1355 108 40.14% 2015-16 30 1908 646 74 37.73 Indian Red Cross Society Blood Bank Anantapuramu

Blood bank services:

Blood bank services Blood collections 2014-15 Voluntary blood donations Replacement blood donations Total 2724 4219 6943 2015-16 3299 4475 7774 Collected Utilized Discarded Blood components Sept and October 2015 Platelet concentrate 164 100 40 Fresh frozen plasma 162 40 1 Cryoprecipitate 0 Plasma 17 5 12 APSACS

Chinnari Doctors:

Chinnari Doctors

Slide 254:

RBSK Screening activities Sl. No. Activity 2014-15 2015-16 Number Achievement Referrals Number Achievement Referrals 01. Schools Screening 3930 3841 (98%) -- 3983 1,023 (26%) -- Children 3,88,732 3,68,854 (95%) 370 3,82,031 90,755 (23%) 17 02 Chinnari Arogyam (Birth – 06 yrs) -- 58,732 (Only 05yrs children) -- 306454 304147 7484 03 Vidhyarthi Arogyam -- -- -- 3983 3415 (85.73%) 23718 -- -- -- 3,82,031 281400 (73.65%)

Slide 255:

On every Thursday (School Health Day) 5-18 years Govt. & Govt. Aided Schools & Jr. Colleges. Out of School Children (10-18 yea rs ) at AWCS I & FA syrup (3-5 years children) Tab. I & FA small (5-9 years) Tab. I & FA large (10-18 years) WIFS

Slide 256:

Referral Campaign 01. Total No. children treated 2011 02. No. children identified under Arogya Sri 102 03. No. children treated in Arogya Sri 53 04. No. of Children identified Non Arogya Sri 220 05. No. of children treated under Non Arogya Sri 24 06. No. of MR (Mentally Retarded children) identified for special campaign. 1449 07. No. children identified for Defective Vision Children & recommended for spectacles 1086 08. Spectacles supplied for identified children 1086 09. No. of Nystagmus children identified under “ Chinnari Choopu” 39 10. No. of Nystagmus children identified for surgery 30 11. No. of Nystagmus children surgery completed 02 12. Dental cases treated 102

Slide 257:

No. of Arogya Clubs formed: 1,535 No. of Chinnari Doctors Identified: 7,384 Arogya clubs should be form in all Residential mode , UP & High schools Arogya Clubs & Chinnari Doctors YUVA Clinic

Slide 258:

AFHCs 18 AH Consultants' 0 AH counselors 16 Peer Educators 9987 AHDs Every Tuesday Total Clients-2015 8472 RKSK Campaign 2013-14 Group meetings in Schools 1474 Group meetings in AWC 1840 Adolescents attended in Schools 53,962 Adolescents attended in AWCs 22,055

Slide 259:

Referral Follow-ups Nystagmus Children Surgeries Cleft lip and palate 06 Children was identified for cleft lip and palate surgery for cooperation of GSR Institute of Hyderabad 36 Children was identified for Nystagmus surgery for cooperation of Gouthami Eye Institute , Rajamundry, and 02 children surgery completed.

DEIC:

DEIC Construction completed Infrastructure-incomplete HR-under process

Slide 261:

Year ELA No of children administered % 2013-14 490877 446446 92% 2014-15 491605 462108 94%

RNTCP Performance Progress:

RNTCP Performance Progress Indicator 2013 2014 2015 ACDR 113% 47% 63% Proportion of New sputum + ve out of total New pulmonary cases 113% 151 86 Smear conversion rate 78% 82% 83% Treatment success rate 82% 67% 90% Ratio of number of smear negative to smear positive 63% 47% 63%

MDR TB:

MDR TB Culture & DST samples are identified as criteria wise. Presently district has followed criteria C. For smear positive patients samples sending to IRL Vizag . For smear negative patients samples sending to CBNAAT Chittoor . For follow up patients samples sending to DFIT Nellore. For initiation of treatment to DR TB cases using RDT Battalapalli as a DOTS PLUS site. Presently 8 XDR Cases registered in the district. (4 Died and 4 under Treatment).

DRTB Drug resistant TB status :

DRTB Drug resistant TB status Indicator Number Number of samples sent to C&DST 3237 Confirmed as MDR 189 Treatment started 166 Not initiated on treatment 23 Referred to other district 10 Died 5 Migrated 2 Refused treatment 6

Malaria-Status:

Malaria-Status Sl.No Activity 2013 2014 2015 1 No of BS Collection 459370 492773 329959 2 ABER % 11.8 12.71 8.81 3 SPR 0.04 0.10 0.12 4 Total Positive cases 222 515 414 PV 155 410 335 PF 67 105 79 5 Total Deaths Due to Malaria 0 0 0 6 No of High Risk villages 97 126 132

Dengue Status:

Dengue Status Sl.No 2013 2014 2015 1 No of Suspected Dengue 51 3184 2264 2 No of Confirmed Dengue 9 330 328 3 No of Deaths 0 0 0 4 No of High Risk Villages 76 169 152 5 No of Villages covered under ALO operations 357 1097 1245 6 No of Villages covered with Pyrethrum spray 186 638 465 7 No of villages covered with fogging operations 75 503 73 8 No of Villages covered with Malathion WDP25% 102 62 45

Malaria-High Risk:

Malaria-High Risk

Slide 268:

Malaria-High Risk

Slide 269:

Malaria High Risk

Slide 270:

High Risk areas

Slide 271:

High Risk areas

Performance:

Performance Sno Year 2014-2015 Year 2015-2016 ( upto sep-2015 Programme Annual Target Achievement % Annual Target Prop. Target Achievement % 1 Cataract Blindness 24000 24713 102.97% 26836 13418 10291 76.69% 2 School Children Eye Screening A Screening 72348 152336 210.56% 72348 36174 35059 96.91% B Refractive Errors 4341 4633 106.72% 4341 2170 1227 56.54% C Spectacles Distribution 3350 4566 136.29% 3350 1675 1191 71.10% 3 Eye Ball Collection 90 28 31.11% 90 45 20 44.44% 4 Other Eye Diseases A Diabetic Retinopathy 400 117 29.25% 400 200 46 23% B Glaucoma 250 51 20.11% 250 125 46 36.8%

Comparative Month wise Analysis of Physical performance (Cataract Blindness):

Comparative Month wise Analysis of Physical performance (Cataract Blindness) Sno Month Year 2014-2015 Year 2015-2016( upto Sep-2015) Target Achievement Target Achievement 1 April 2000 2370 2236 2137 2 May 2000 2271 2236 1676 3 June 2000 1977 2236 1768 4 July 2000 1937 2236 1837 5 August 2000 1721 2236 1712 6 September 2000 1661 2236 1181

IDSP Performance Progress:

IDSP Performance Progress Reporting Status in % 2013 2014 2015 Indicator S form P form L form Timely Complete 97% 95% 98% Timely Incomplete 0 1 0 Not timely Complete 0 2 1 Incomplete Late 0 1 0 No reports 3 1 1

IDSP-Performance:

IDSP-Performance Outbreaks Year Type No Number Investigated 2013 ADD 2 All Food Poison 2 All 2014 ADD 1 All 2015 ADD 1 Food poison 2 H1N1 Year Suspected Confirmed Deaths 2013 0 0 0 2014 0 0 0 2015 26 16 5

Responding to Outbreak:

Responding to Outbreak

NLEP Performance Progress:

NLEP Performance Progress

Performance Indicators:

Performance Indicators Indicator Measure Prevalence 0.79 New case detection rate 11.11 Proportion of child cases in new cases 0.6 Proportion of disabled among new cases 11.4 Proportion of MB cases among New cases 63.2 Treatment completed rate_MB 99 Treatment completed rate_ PB 99 Proportion of new cases correctly diagnosed 99.5

NACP Performance Progress:

NACP Performance Progress Indicator 2014-15 2015-16(Sept) No % No % Tested for HIV 164093 96% 75718 88% Found positive 1554 729 ANC tested 76535 104 37282 101 Found positive 100 48 HIV+ mothers delivered 179 82 General cases tested 87558 89 38436 78.4 STI clinic visits 17044 8646` Episodes treated 9419 55 5751 68 Partners treated 5582 3806

Performance report:

Performance report Indicator 2014-25 2015-16 No % No % RPR tests 1015 4126 RPR tests_PW 7183 4618 Pre ART registrations 18993 Alive & On ART 9877 Deaths 2751 Lost to follow up 1412 Missed for follow up 543 HRG tested for HIV 24408 11017 HRG found + HIV 45 14

Slide 281:

Situation Analysis ( Pregnant)

Slide 282:

Situation Analysis ( General Cases)

Slide 283:

ASHA PBIs _ Mode of payment Online Paid up to Sept’2015

ASHA :

ASHA Description Number Number of ASHAs desired 4100 Number of ASHAs recruited/Sanctioned 3057 ASHAs dropped out 54 ASHA in position(Urban & Rural) 3003 ASHA trained –Induction training 3057 ASHA Module 6 & 7 2729 -1 st round 2723, 2 nd round- 2723 3 rd round-199 HBNC trainings 180 HBNC Kits 2983 ASHA Kits 3057

ASHA Grievance Redressal:

ASHA Grievance Redressal Grievance redressal committee constituted in 2013-14 7 meetings conducted so far 7 Grievances addressed ASHA day meetings conducted at PHC level every 1 st Tuesday

ASHA supportive Structure:

ASHA supportive Structure PHC level ASHA facilitators from within the system = 128-MPHS(F),Sr. ANMs At Cluster level 18 Block Community Mobilizers identified – PHNs/CHOs Conducted ASHA facilitators training & HBNC ASHAs oriented on HBNC by ASHA facilitators during ASHA day meeting Generating HBNC monthly reports

VHSNC:

VHSNC Number of GPs 1003 Number of VHSNC constituted 1003 Percentage of constitution 100 2014-15 2015-16 Number of meetings expected 12,036 6,018 Number of meetings conducted 9,989 5536 Periodicity of meetings Once monthly every GP, First Saturday % of conduction of meetings 82% 92%

VHSNCs:

VHSNCs

VHSNC & ISC:

VHSNC & ISC

PHC Convergence meetings:

PHC Convergence meetings Number of PHC convergence committees constituted 80 Expected 80 Periodicity Once monthly, 1oth Number expected 480 Number conducted 320 % of performance 66%

PHC HDS meetings:

PHC HDS meetings Number of HDS committees constituted 98 % Constituted 100% 2014-15 2015-16 Meetings conducted 278 70 Meetings expected 392 196 Periodicity Once in 3 months % Performance 71% 36%

DHS/DLVMC meetings:

DHS/DLVMC meetings Year 2012-13 2013-14 2014-15 2015-16 Number 00 02 00 00 No DLVMC meeting is conducted so far

Internet connectivity:

Internet connectivity % of PHCs having internet connectivity 91% (73/80) % of CHCs having internet connectivity 80% (12/15) % of CHNC having internet connectivity 100% (18/18) % of MOs having Tablet PCs with SIM on CUG 100% % of MPHA(F)s having Tablet PCs with 3G SIM on CUG 100% % of PHCs having Laptops 100% % of CHCs having desktops 100%

HMIS_NHM:

HMIS_NHM Data entry status-Sept’15 SC PHC CHC AH DH 99% 94% 67% 71% 50% Facility Progress over years 2012-13 2013-14 2014-15 2015-16 SC 99 100 100 100 PHC 68 68 85 96 CHC 92 92 92 91 AH 71 86 71 86 DH 100 100 100 100

MCTS:

MCTS MCTS analysis and feedback is done regularly and periodically Now the field staff are uploading immediately after the service delivery as they are provided with Tablet PCs

Tablet PCs distribution to field staff by our JD MHN:

Tablet PCs distribution to field staff by our JD MHN

Slide 298:

Video Conferencing by the District Collector SKYPE review

Using Tablet PCs:

Using Tablet PCs

Slide 300:

Implemented in all health facilities Online indenting Doorstep delivery

QAC:

QAC KayaKalp Guidelines AEFI Committee FPQAC

IEC/BCC/SBCC:

IEC/BCC/SBCC

IEC:

IEC

Our Hon’ble CM at our Exhibition stall at Guttlur Village:

Our Hon’ble CM at our Exhibition stall at Guttlur Village

Our Independence day Tableaux Vivant:

Our Independence day Tableaux Vivant

Independence day –Tableaux vivant:

Independence day –Tableaux vivant

Slide 307:

IT Minister IPPI Civil Supplies minister in IPPI

Slide 308:

MDR with JC - II Promoting Male participation -DC

Slide 309:

World Population Day 2015 with JC-II World Malaria Day 2015

Slide 310:

Anti leprosy day with JC RCH portal trainings- Ddmho

Slide 311:

HMIS Reorientation Workshop IEC activity book

Citizen Charter:

Citizen Charter

IEC/BCC Activities:

IEC/BCC Activities Sl.no Type of activity Topic Number 1 Kalajathas NVBDCP Water borne 150 2 Kalajathas Pentavalent 100 3 Meetings Age at Marriagr 586 4 Exhibitions

Financial management NHM:

Financial management NHM 2013-14 Component Allocated Expenditure % RCH Flexi 181018261 147958058 81.74 Additionalities 187687370 82220720 43 Immunization 7005214 2517270 35.93 IPPI 10580686 10365352 97.96 2014-15 Component Allocated Expenditure % RCH Flexi 173277362 144256756 83.25 Additionalities 149269907 93437048 62.60 Immunization 14401989 3267729 22.69 IPPI 101677781 10164160 95.19

Slide 320:

2015-16 Component Allocated Expenditure % RCH Flexi 99093334 58731280 59.27 Additionalities 100074779 45011599 44.98 Immunization 15501956 5771159 37.23

JSY/JSSK-Financial performance:

JSY/JSSK-Financial performance JSK Year Allocated Expenditure % 2013-14 30744150 16513500 53.71% 2014-15 39757229 21134500 53.16% 2015-16 35684417 10061800 28.20% JSSK Year Allocated Expenditure % 2013-14 3577155 513275 14.35% 2014-15 6576372 2292409 34.86% 2015-16 4283962 2496895 58.28%

FP -Financial performance:

FP -Financial performance Family Planning Year Allocated Expenditure % 2013-14 41516577 25780112 62.09% 2014-15 37341269 20662485 55.33% 2015-16 29331784 4464455 15.22%

HDS -Financial performance:

HDS -Financial performance HDS Year Allocated Expenditure % 2013-14 35921362 10479407 29.17% 2014-15 55392997 17963733 32.43% 2015-16 37429264 9967816 23.61

JSY/JSSK-Financial performance:

JSY/JSSK-Financial performance SC Untied Year Allocated Expenditure % 2013-14 5081466 3428525 67.47% 2014-15 1675893 806910 48.15% 2015-16 868983 58621 6.75% VHSNC Year Allocated Expenditure % 2013-14 16896136 9967553 58.99% 2014-15 22242174 13058585 58.71% 2015-16 9183589 1073044 11.58%

NRHM funds utilization:

NRHM funds utilization 2013-14 2014-15

Financial management report:

Financial management report RNTCP as on 30.09..2015 Budget received Expenditure Balance % performance 10154293 5092793 5061500 50%

Financial HIV/AIDS 2014-15:

Financial HIV/AIDS 2014-15 01.04.2015 to 31.03.2015 DBS & GFATM-II funds item Releases APSACS Expenditure % Total 685,500 554,153 81%

Financial report _ HIV/AIDS:

Financial report _ HIV/AIDS 01.04.2014 to 31.03.2015 DBS(Domestic budgetary Source) Item Releases from APSACS Expenditure % DSRC contingency 20000 20000 100 Candle light memorial day 10000 10000 100 Operational Expenses 342000 352052 100% IEC 120000 120000 100 World AIDS day 40000 39998 100 VBD camps 113500 00 0

Financial report HIV/AIDS :

Financial report HIV/AIDS 01.04.2014 to 31.03.2015 GFATM-funds item Releases APSACS Expenditure % World blood donation day 20000 6531 0.3% VBD camps 20000 5572 0.27%

Financial report HIV/AIDS :

Financial report HIV/AIDS 01.04.2015 to 23.10.2015 DBS funds item Releases APSACS Expenditure % Candle light memorial day 5000 4960 99% Blood transportation van 35000 0 0% DSRC counsellors Outreach activity 30000 16460 55%

Financial performance:

Financial performance Sno Year Budget Released Budget utilised Balance available Pending dues to NGOs 1 2013-2014 Rs.47,04,000 Rs.22,33,250 Rs.24,70,750 Rs.31,11,500/- Submitted to District Collector for approval 2 2014-2015 By ROP JBMV-I Total Rs.32,13,500 Rs.38,44,900 Rs.70,58,400 Rs.22,54,065 Rs.48,04,335 Grand Total Rs.1,17,62,400 Rs.44,87,315 Rs.72,75,085

Financial report_Trainings:

Financial report_Trainings OB Receipts Unspent surrendered Released to other depts Total Expenditure Balance % 1356369 2491283 38070 382490 3466952 1872249 1212213 54% Training Unspent amt Head Unspent amt SBA 142480 Interest 348657 NSSK 49118 IOH 421911 IMNCI 220262 BEmNOC 21310 Minilap 8610

Financial report _ IDSP:

Financial report _ IDSP Year Allocated funds Expenditures Balance % of Expenditure 2013-14 736423 723882 12531 98.29 2014-15 955417 769469 185948 80.53 2015-16 539201 305942 233259 56.73

Financial Report _ NVBDCP:

Financial Report _ NVBDCP 2015-16 Allocated Expenditure Balance % 26,59,090 4,33,518 22,25,572 16.30%

Financial report RBSK:

Financial report RBSK Year Allocated Expenditure % 2013-14 449902 415393 92.32% 2014-15 2133016 118189 5.54% 2015-16 46220 13006 28.13%

104 Mobile Financial report:

104 Mobile Financial report Year Allocated Expenditure % 2013-14 27346627 26405027 96.55% 2014-15 28325472 24065515 87.57% 2015-16 21964535 11576378 52.70%

Monitoring Supportive Supervision:

Monitoring Supportive Supervision GPS fixed to Deputy DMHOs vehicles Supportive supervision Checklists for SC / PHC / CHC /CHNO Session monitoring(UIP) House to House monitoring RMNCH+A Supportive Supervision checklist

Monitoring/Supervision:

Monitoring/Supervision PCPNDT Checklist SKYPE review with clusters MCTS analysis - feedback HMIS analysis - feedback Daily SMS alerts to Deputy DMHOs & Pos on MCTS status Daily OPD/IPD/Deliveries performance

Monitoring and Supervision:

Monitoring and Supervision Deputy DMHOs review once in 15 days ASHA nodal officers monthly meeting Mandatory monitoring of ANC day every Friday by all POs Quarterly ZP general body meetings DDRC meetings

Monitoring MCTS uploading :

Monitoring MCTS uploading

Review by our Principal Sec’ &CHFW & DoPH&FW:

Review by our Principal Sec’ &CHFW & DoPH&FW

Supportive Supervison:

Supportive Supervison

Evening meetings:

Evening meetings

CRM preparedness meetings:

CRM preparedness meetings

Supportive Supervison:

Supportive Supervison Supportive e Supervision Building Skills Teaching them- Supportive Supervision

MH Guidelines MagSulf & Calcuim Gluconate:

MH Guidelines MagSulf & Calcuim Gluconate

Teaching & Learning :

Teaching & Learning

Monitoring and Supervision:

Monitoring and Supervision Mobility support by NRHM Deputy DMHOs(18) DPMU_1 RBSK Coordinator_1 DIO mobility(POL)_1

PCPNDT:

PCPNDT Implementation Status

Performance:

Performance Sl.no Activity Number 1 Scan centers Registered 152 2 Scan centers _ Renewed 79 3 Scan centers closed 28 4 Functioning as on 26.10.15 128

APPAMCEA 2002:

APPAMCEA 2002 Activity Number Nursing Homes registered 182 Dental hospitals registered 29 Clinics registered 48 Polyclinics 07 Physiotherapy clinics 02 Diagnostics_basic 89 Diagnostic Centres_Hi End 06

Prevalence of Chronic Conditions:

Prevalence of Chronic Conditions 22.8 % of Hypertensive's(18 and above) 10% _Chronic Respiratory disease 6.5% _CVD 7.5% _ DM(18 and above) Reported prevalence of Chronic Diseases DLHS_4

HIGH PRIORITY AREAS:

HIGH PRIORITY AREAS Sl.no Name of the area/cluster 1 Madakasira 2 Penugonda 3 Nallamada 4 Dharmavaram 5 Tadipatri 6 Hindupur

Good practices:

Good practices Focused ANC care day –Every Friday Escort activity for HR pregnancies Strengthening ISC Social Media Usage-Twitter, Whatsapp , Telegram

Free food sponsored by staffs every Friday-PHC, N.S.Gate:

Free food sponsored by staffs every Friday-PHC, N.S.Gate

Escort activity-intensifying efforts to reduce MMR:

Escort activity-intensifying efforts to reduce MMR

CHALLENGES CONSTRAINTS:

CHALLENGES CONSTRAINTS Vehicles provided are more than 15 years old POL is inadequate Lack of adequate managerial ,logistics support for the Ddmhos Inadequate rental to SCs Old computer systems HR in DPMU

Challenges & Constraints:

Challenges & Constraints Dearth of ICT and mass internet connectivity compounded by a paucity of ICT related knowledge and skills limiting capacities of the HMIS and MCTS to generate, analyze and disseminate information for use in local decision making

Constraints:

Constraints Lack of operational research Lack of local surveys and evaluations

GAPS:

GAPS HR Equipment for ideal labour room Knee jerk activities

Way Forward:

Way Forward Incorporating primary care strategies having symbiotic relationship with secondary and tertiary level of clinical care and all stakeholders Integrated Comprehensive MCH approach

Thank You:

Thank You

Thank You very much:

Thank You very much

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