DISTRICT HEALTH ACTION PLAN TIRUVANNAMALAI DISTRICT.PPT

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Preparation of District health Action Plan to the District comprise district requirements and its availability and needs

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DISTRICT HEALTH ACTION PLAN 2013 – 14 :

DISTRICT HEALTH ACTION PLAN 2013 – 14 District Health Society TIRUVANNAMALAI DISTRICT

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Plan: District Health Action Plan, Tiruvannamalai District under NRHM Prepared by: District Health Society, Tiruvannamalai District Programmed Framework: Integrated plan for district Project purpose: “The Goal of the Mission is to improve the availability of and access to quality health care by people, especially for those residing in rural areas, the poor, women and children in the state.”

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Duration: 2013-14 Locations: Tiruvannamalai District, Tamil Nadu Programme Management: Programme management is being done at three levels District Level- District Health Society and DPMU Block Level- Block Medical Officer and his teamPHC & Village level – Govt. & Community level

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Different Stakeholders GoI, GoTN,SHS, District Collector, DPH, DMS, DME, ISM, ICDS, DHS, Different Programme Officers at district level and NGOs, Trust Hospitals, Private Practitioners, Suppliers, BMO (& his team) and community itself Primary beneficiaries: Each person of the community

NRHM(2005-12):

NRHM(2005-12) The National Rural Health Mission (NRHM) aims to provide for an accessible, affordable, acceptable and accountable health care through a functional public health system.

THE EXPECTED OUTCOMES FROM THE STATE MISSION: :

THE EXPECTED OUTCOMES FROM THE STATE MISSION: IMR reduced to 15/1000 live births by 2013. Maternal Mortality reduced to 80/100,000 by 2013. TFR reduced to 1 by 2013. Upgrading Community Health centres to Indian Public Health standards. Increase utilization of First referral units from less than 20 % to 75%. Engaging ASHAs

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DISTRICT PROFILE Thiruvannamalai District came in to existence on 30 th September 1989 consequent on the bifurcation of North-Arcot District. It is bounded on the North and West by Vellore District, South West by Krishnagiri District, South by Villupuram District and East by Kanchipuram District. It is 190 Kms away from State Capital, Chennai. The Nearest airport is at Chennai.It is well connected with neighbouring Districts and NH 66 (Puducherry to Krishnagiri) passes through this District. Thiruvannamalai is situated on the Railway line between Villupuram and Katpadi Junction.

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One sixth of the area is covered by Reserve Forest and Hills of Eastern Ghats. The important Hills are Thiruvannamalai (2668 ft), Jawadhu Hills (2500 ft) and Kailasagiri (2743 ft). Lord Arunachala Temple, Sathanur Dam, Ramanashram are important tourist places. The important festival is Karthigai Deepam and the festival is celebrated for a period of 10 days in the month of Karthigai. As per Census 2011, the District has the population 24,68,965 with literacy rate of 74.72 (Female-65.71, Male-83.73). The district has the lowest female literacy (65.71%) and ranked in 7 th Place in the State. The District has the growth rate of 7.01% and population density of 399 per sq. Km.The District has highest number of ST population in the State next to Salem and it contributes 3.33 % of the District population.

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Description Tiruvannamalai HUD Cheyyar HUD Total No. of Revenue Divisions 1 1 2 No. of Taluks 5 3 8 No.of Blocks 10 8 18 No. of Municipalities 1 3 4 No. of Revenue Villages 434 426 1067 No. of Panchayat Unions 10 8 18 No. of Village Panchayats 434 426 860 No.of Villages 560 535 1095 No. of Town Panchayats 7 3 10 No. of Parlimentary Constituencies 1 1 2 No. of Assembly Constituencies 5 3 8 No.of ICDS Centres 790 591 1381 No. of PHCs 50 41 91 No. of HSCs 253 157 410 No. of 1 0 1 No. of Govt. Hospitals 3 4 7 ADMINISTRATIVE UNITS The administrative units in the district is given below

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GOVERNMENT HEALTH FACILITIES S.No Institution Tiruvannamalai HUD Cheyyar HUD DISTRICT 1 Govt. Dist.HQ Hospital 0 1 1 2 Govt. Taluk Hospital 2 2 4 3 Govt. Non Taluk Hospital 1 0 1 5 Govt. TB Hospitals 1 0 1 6 Govt. Leprosy Hospital 1 0 1 7 ESI Dispensaries 0 1 1 8 Railway Hospital 1 0 1 9 Municipal Maternal and Child Health Centres /UHP 3 1 4 10 Municipal ISM & H Clinic 2 0 2 11 CEmONC Centres 1 1 2

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12 Total PHCs in the District 50 41 91 13 CHC 10 8 18 14 PHC 40 33 73 15 TOTAL 50 41 91 16 PHCs with 24 x 7 Delivery Services 50 41 91 17 PHCs with OT 13 8 12 18 PHCs with AYUSH 14 9 23 19 Hospital on Wheels Programme 10 8 18 20 Health Sub Centres 253 157 410 21 Blood banks 1 0 1 22 Blood storage units (GH) 0 2 2 23 Blood storage units (PHCs) 7 6 13 24 PHCs with ICTCs 10 8 18 25 District/Sub district with ICTCs 3 3 6

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Recognized Private Institutions as on 31.12.2012 The table below profiles the strength of the Private Health Facilities. S.No . Institution Total 1 Trust Hospitals 8 2 Allopathy Clinics 10 3 Allopathy Hospitals 8 4 Nursing Institutions 10 Paramedical Institutions 1 Pharmacy 1 2 Lab Technician 1

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VITAL STATISTICS Indicators India Tamil Nadu Tirvannamalai District Source Birth Rate(per 1000 Population) 22.8 16 17.5 SRS for 2008 Death Rate (per 1000 Population) 7.4 7.4 6.4 SRS for 2008 Infant Mortality Rate ( per 1000 Live Births) 53 31 24.5 SRS for 2008 Still Birth Rate(per 1000 deliveries) 9 9 11.7 SRS for 2008 Maternal Mortality Ratio (per 1000 Live Births) 2.54 * 0.9 # 1.1# *SRS 2004-06 # State HMIS 2009-10 Couple Protection Rate(%) 56 58 61 DLHS -3(2007-08)

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DISTRICT SPECIPIC TARGETS FOR NEXT FIVE YEARS - OUTCOME INDICATORS OF THE DISTRICT TIRUVANNAMALAI Indicators Current status as on latest available data Cumulative Target for next five year 2013-14 2014-15 2015-16 2016-17 2017-18 Maternal Mortality Ratio (MMR) 0.79 0.44 0.77 0.71 0.65 0.58 0.53 Infant Mortality Rate (IMR) 14.8 6.8 14 13 12 11 9 Total Fertility Rate (TFR) 1.7 0.68 1.5 1.3 1 1 1

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OUTPUT INDICATORS Sl.No Activity / Measurable indicator Current status as on latest available data Cumulative Targets for the 2nd Phase of NRHM (2012-17) 2013-14 2014-15 2015-16 2016-17 2017-18 A Maternal Health 1 Institutional Deliveries (%) 99.2 99.3 99.5 99.7 99.9 100 2 24x7 Facilities (Sub-District) 5 5 5 5 5 5 3 Functional First ReferralUnits 6 20 24 32 45 55 B Child H ealth C Population Stabilization D Disease Control E Training F Community Processes G Improved Management H Infrastructure I MMU and Referral Transport J Operationalisation of MCTS K Operationalisation of HMIS

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Human Resources Sl.No . Category Number of Sanctioned post Number of vacant post against sanctioned Target for Filling up of vacant posts 2012-13 2013-14 1 Doctors 236 52 52 2 Staff Nurses 271 42 42 3 LHV 80 26 26 4 ANM 99 15 15 5 MPW 410 13 13 6 Laboratory Technicians 95 52 52 7 Pharmacists 92 19 0

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RCH MONITORABLE INDICATORS Sl.No . Activity /Measurable indicator Baseline 13-14 14-15 15-16 16-17 17-18 A MATERNAL HEALTH A.1 Service Delivery A.1.1 % Pregnant women registered for ANC in the quarter 99% 100 100 100 100 100 A.1.2 % PW registered for ANC in the first trimester, in the quarter 87% 95 100 100 100 100 A.1.3 Institutional deliveries (%) in the quarter 99.2% 100 100 100 100 100 A.2 Quality A.2.1 % high risk pregnancies identified 11% 9.5 9 8.5 8 7.5 A.2.2 C-sections performed (%) Govt 65% 70 80 85 90 100 Private 35% 30 20 15 10 0

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S.No . Indicators Baseline 13-14 14-15 15-16 16-17 17-18 A.3 Outputs A.3.1 % of 24x7 PHCs operationalised as per the GoI guidelines 100% 100 100 100 100 100 A.3.2 % of FRUs operationalised as per the GoI guidelines 100% 100 100 100 100 100 A.3.3 % of FRUs (except DH) conducting 20 deliveries per month 100% 100 100 100 100 100 A.3.4 % ANMs/ LHVs/ SNs trained as SBA 100% 100 100 100 100 100 A.3.5 % doctors trained as EmOC 2% 2.5 5 7.5 9 10 A.3.6 % doctors trained as LSAS 3% 3.5 4 4.5 5 5 A.4 HR productivity A.4.1 Average no. of deliveries performed by SBA trained SN/LHV/ANM 258 260 268 270 275 275 A.4.2 % of SBA trained ANMs conducting deliveries 100% 100 100 100 100 100 A.5 Facility utilization A.5.1 % of FRUs conducting C- section 100 100 100 100 100 100 A.5.2 Average no. of c-sections per FRU 5 5 5 6 6 7

PHC OPERATION THEATRE PERFORMANCE :

PHC OPERATION THEATRE PERFORMANCE Sterilisation 2006-07 2007-08 2008-09 2009-10 2010-11 2011-12 Tiruvannamalai 750 1440 2221 2851 2170 2182 Cheyyar 474 517 2171 2929 2571 3071 TOTAL 1224 1957 4392 5780 4741 5253

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YEAR 2005 2006 2007 2008 2009 2010 2011 MMR 1.3 1.3 1.1 1.0 1.0 0.8 0.79 MMR TREND ANALYSIS

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IMR TREND ANALYSIS

SITUATIONAL ANALYSIS:

SITUATIONAL ANALYSIS In Tiruvannamalai District there has been a decreasing trend in indicators like IMR,MMR & Higher Order Birth. Though the indicators are of decreasing trend, when a Blockwise analysis of the above indicators IMR,MMR & HOB were done some blocks are found to be higher than District Average. So based on that Six Blocks are taken as High Risk Blocks and analysed for improving Mother & New born care in that Blocks.

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In comparing all the Blocks with the district and State Average the following 6 Blocks are selected as High Risk Blocks requiring reforming and improving the maternal and new born care thereby decreasing the IMR, MMR and HOB. Chengam Block Kalasapakkam Block in Tiruvannamalai HUD Pudupalayam Block Jamunamarathur Block West Arani Block Cheyyar Block in Cheyyar HUD Vembakkam Block Trend of IMR,MMR & HOB are discussed and the interventions planned for decreasing IMR,MMR & HOB.

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CHENGAM BLOCK ANALYSIS

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JAMUNAMARATHUR BLOCK ANALYSIS

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WEST ARANI BLOCK ANALYSIS

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CHEYYAR BLOCK ANALYSIS

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VEMBAKKAM BLOCK ANALYSIS

IMR TRENDS IN HIGH RISK BLOCKS (2006 TO 2011) CHENGAM BLOCK - IMR:

IMR TRENDS IN HIGH RISK BLOCKS (2006 TO 2011) CHENGAM BLOCK - IMR

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KALASAPAKKAM BLOCK - IMR

PUDUPALAYAM BLOCK – IMR :

PUDUPALAYAM BLOCK – IMR

WEST ARANI BLOCK – IMR :

WEST ARANI BLOCK – IMR

CHEYYAR BLOCK – IMR:

CHEYYAR BLOCK – IMR

VEMBAKKAM BLOCK - IMR :

VEMBAKKAM BLOCK - IMR

MMR TRENDS IN HIGH RISK BLOCKS (2006 TO 2011) CHENGAM BLOCK - MMR:

MMR TRENDS IN HIGH RISK BLOCKS (2006 TO 2011) CHENGAM BLOCK - MMR

KALASAPAKKAM BLOCK - MMR :

KALASAPAKKAM BLOCK - MMR

PUDUPALAYAM BLOCK - MMR:

PUDUPALAYAM BLOCK - MMR

WEST ARANI BLOCK :

WEST ARANI BLOCK

CHEYYAR BLOCK – MMR :

CHEYYAR BLOCK – MMR

VEMBAKKAM BLOCK - MMR :

VEMBAKKAM BLOCK - MMR

HOB TRENDS IN HIGH RISK BLOCKS (2006 TO 2011) JAMUNAMARATHUR BLOCK - HOB :

HOB TRENDS IN HIGH RISK BLOCKS (2006 TO 2011) JAMUNAMARATHUR BLOCK - HOB

CHENGAM BLOCK – HOB :

CHENGAM BLOCK – HOB

WEST ARANI BLOCK – HOB:

WEST ARANI BLOCK – HOB

OBJECTIVE :

OBJECTIVE To reduce MMR to 0.5 To reduce IMR to < 10 in upcoming years i.e. within 2017 in these To reduce HOB to 10 selected 6 High Risk Blocks

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INTERVENTION FOR REDUCTION OF IMR,MMR & HOB: To improve maternal nutrition status and reduce incidence of maternal anemia and its complications Implement plans to prevent early marriage, early pregnancy and early detection and referral services of high risk ANCs and New Borns Improve care of antenatal and postnatal mothers and infants at community level. Improve baby weighing methods and treatment of neonatal jaundice. Improve well baby performance clinic. To improve acceptance of family welfare practices among mothers with higher order birth. Improve NSV performance. Providing Reorientation Training for all Medical Officers & Paramedical Staffs. IEC activities and Counselling by appointing a Counsellors at Block level on Hiring basis.

WORK PLAN FOR REDUCTION OF MMR, IMR & HOB: :

WORK PLAN FOR REDUCTION OF MMR, IMR & HOB: Identify low weighing mothers below 45 kg and poor weight gain of less than 8 Kg in AN visits and provide extra nutritional support by improving their visits to ICDS centres thereby improving their nutritional status. During AN visits providing adequate awareness of services provided in HSCs,PHCs & in ICDS centres through Interpersonal Counselling .

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To provide adequate Iron sucrose supply based on Antenatal prevalence of anemia in that PHC. Providing additional USG Machines in required PHCs along with Software for regular monitoring and early detection of High Risk AN mothers Providing Anti Shock Garment & Blood Collection Drape for all PHCs in those Blocks in cases of Post Partum Haemorrhage . Providing Foetal Doppler for all HSCs and PHCS for efficient monitoring of Foetal well being as proposed in Innovative Projects.

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To supply calibrated digital baby weighing machine to PHC with annual maintenance contract in place To supply standard calibrated Phototherapy unit for all PHC for initial treatment of Jaundice before referring the New Born. Establishing and Maintenance of Neonatal Units in PHCs if any sick newborn comes to PHC.

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Refresher training for all Medical Officers, Staff Nurses and ANM in those blocks about Job skills for both AN Mother including Active Management of Third Stage of Labor and improvising the usage of NASG & Blood Collection Drape for early identification of PPH and New born resuscitation care including Phototherapy unit with regard to identifying level of jaundice and hours of phototherapy needed in Neonatal Units and also Protocols for identifying high Risk patients and early referral. USG with Software Compulsory Training for One Medical Officer /PHC for regular monitoring and early detection of High Risk AN mothers

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Providing Compulsory Training for One Medical Officer / Block in NSV, TAT and Puerperal Sterilisation,so as to improvise the sterilization procedures. Refresher training for Staff Nurses/ANMs on Partograph To provide incentive to mothers with higher order birth accepting any family welfare method/ sterilization. Providing IEC charts/ posters explaining Maternal Nutrition, Breast Feeding practices, with pictures explaining the position and attachment in local language to display in Antenatal , Postnatal and Immunisation units

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Strengthening of Referral system of these blocks can be improved by providing 24*7 Ambulance services with 2 Drivers as proposed in Innovative Projects. In addition to these 6 High Risk Blocks Jamunamarathur Block of Tiruvannamalai HUD can also be included as High Risk as there is poor reporting and requiring all these interventions for better performance.

TRIBAL HEALTH:

TRIBAL HEALTH According to 2001 census, the total population of the Scheduled Tribes is 60,159 Male 30,467 Female 29,692 constituting 1.20 per cent of total population. The main problem is that they are scattered throughout the HSC/PHC area and in certain villages with an exclusive tribal population.

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But there are 21 HSCs which are having concentrated clusters of tribal population which are distributed among the general population. Hence the provision of exclusive scheme for them is not possible and one has to strengthen the available services which would be specifically made accessible to the tribal population.

No.of Primary Health Centre covered in Tribal Areas :

No.of Primary Health Centre covered in Tribal Areas Sl.No Name of the Block Name of the PHC VHV Selected Total Tribal Hilly No. of HSC No. of VHV 1 Jawadhu Hills Jamunamarathur 7 63 63 2 Jawadhu Hills Nammiyampattu 6 50 50 3 Thandarampattu Reddiyarpalayam 1 6 6 4 Thandarampattu Perungulathur 3 8 8 5 Melpallipattu Paramanandal 2 9 9 6 Polur Kelur 1 3 3 Total 20 139 139

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Sl. No Dist. HUD Block P.H.C Difficult PHC /Tribal PHC No. of the HSC No. of VHV 1 Thiruvannamalai Cheyyar Arani(East) Mullandiram Difficult PHC 3 16 2 Peranamallur Madam Difficult PHC 4 14 3 Thellar Kunnagampoondi Difficult PHC 4 15 4 Thiruvanna malai Chengam Arattavadi Difficult PHC 3 4 5 Chennasamudram Difficult PHC 3 4 6 Elangunni Difficult PHC 3 4 7 Kalasapakkam A.M.Pudur Difficult PHC 5 10 8 Padagam Difficult PHC 4 6 9 Polur Vazhiyur Difficult PHC 5 7 No.of Primary Health Centre covered in Inaccessible/Difficult areas

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Activity Thiruvannamalai HUD AN/ PN care 444800 Family Welfare services 236300 Child Care 809675 Attending PHC monthly meeting (Rs 200/ month) for 6 months 250200 VHN day participation (Rs 100/ month) 125100 Adolescent Health 27800 RNTCP 13900 Care of Leprosy cases 97300 IDSP 125100 Total amount Rs. in Lakhs required for 9 months 2130175 Total amount Rs. in Lakhs required for 2013-14 28.40 Budget for ASHAs working in Tribal areas

Innovative and Area Specific Plan Tiruvannamalai District:

Innovative and Area Specific Plan Tiruvannamalai District

STRENGTHENING OF MANPOWER IN LAB SERVICES :

STRENGTHENING OF MANPOWER IN LAB SERVICES Total No PHCs = 91 Total No of LTs sanctioned= 89 / vacant = 54 Total No of contractual LT sanctioned through TANSACS = 18 Components Proposed:- Manpower – Lab Technicians

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S.No No. of PHCs requiring Lab Technicians Budgetary provision for Hiring LT in Vacant places at Rs 300 /day / LT 1 36 3,24,000 Budget: Provision of Manpower to PHCs such as Laboratory Assistants or Lab technicians to the Additional Primary Health Centres

SUPPLEMENTING THE AN CARE BY PROVIDING FOETAL DOPPLER IN HSCS AND PHCS:

SUPPLEMENTING THE AN CARE BY PROVIDING FOETAL DOPPLER IN HSCS AND PHCS Components Proposed: Foetal Doppler (for 91 PHCs+410 HSCs)=501 Budget: No. of Foetal Doppler Required =501 X 10000 Budgetary Requirement for Purchasing Foetal Doppler =50,10,000

STRENGTHENING OF PHARMACY SERVICES & STORES:

STRENGTHENING OF PHARMACY SERVICES & STORES Components Proposed: Expansion of the existing infrastructure of Pharmacy (20’ X 15’) Budget: Budgetary Requirement for expanding the existing infrastructure: Sl.No Total No of Main PHCs Amount Required Budget Required 1 18 500000 9000000

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STRENGTHENING OF NRHM ACCOUNTS & ONLINE ENTRY SERVICES BLOCK LEVEL Sl.No Requirement No.Required Per unit Cost Budget 1 Accountant cum Data Entry Operator 18 6,000/ month 12,96,000 2 Desktop, Table, Chair + Contigencies 18 50,000 9,00,000 TOTAL 21,96,000 Components Proposed: NRHM Accounts cum Data Entry Operator required = 18 No. of Desktops required = 18 Budget:

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STRENGTHENING OF OPERATION THEATRE PERFORMANCES BLOCK LEVEL Sl.No Total No of Theatres Assistants to be Hired Budget per Theatre Assistant Total Budget Required In lakhs 1 21 21 3000/month 7.56 Components Proposed:- Theatre Assistants required = 21 Budget: 21 PHC Operation Theatres

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STRENGTHENING OF AN CARE BY PROVIDING USG MACHINES TO PHCS No. of USG Required Per unit Cost Total Budget 44 2,50,000 1,10,00,000 Components Proposed:- USG Machines with Software = 44 Budget:-

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EARLY DETECTION OF HEARING IMPAIRMENT BY PROVIDING AUDIOMETRY Requirement Per unit Cost No Required Total Budget Audiometry 50,000 18 9,00,000 Sound Proof Room 5,00,000 18 90,00,000 Training 10,000/Block 1,80,000 1,00,80,000 Components Proposed:- Audiometry = 18 Sound Proof Room construction(12 ’ X 10 ’ )=18 Training of MO/Paramedical Staff – 5 days Budget:-

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ESTABLISHMENT OF BIO-MEDICAL WASTE MANAGEMENT IN PRIMARY HEALTH CENTRES Sl.No Color of the Bin No of Bins Required PHC * 5 Budget Required 1 Yellow 455 1,36,500 2 Red 455 1,36,500 3 Blue 455 1,36,500 4 White 455 1,36,500 5 Hub Cutter 273 ( 3/PHC) 17,06,250 Temporary Worker for Maintaining & Cleaning 91 PHCs x Rs.3000/per month 2,73,000 Total 25.25 lakhs Components Proposed: Yellow Bin with Lid Red Bin with Lid Blue Bin with Lid White Bin with Lid Hub Cutter – 3/PHC Budget :

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S.No . Description Amount (Rs. in Lakhs) 1 Village Health and Water Sanitation & Nutrition Committee (VHSNC) 90.4 2 Untied funds to PHCs/CHCs, Sub District hospitals 102.0 3 Annual Maintenance Grants for PHCs/CHCs and Sub District Hospitals 193.60 4 Patient Welfare Society 115.0 5 Hospital on Wheels Programme 156.24 6 District Programme Management Unit 30.6 7 Block Project Management Unit 56.7 8 Strengthening of Manpower in Lab Services 3.24 9 Strengthening of Laboratory Services 551.0 10 Supplementing the AN care by providing Foetal Doppler in HSCs 50.10 DHAP 2013-14 : NRHM FLEXIPOOL BUDGET

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11 Strengthening of Pharmacy services & stores 90.0 12 Strengthening of NRHM accounts & Online entry services Block level 21.96 13 Strengthening of Operation Theatre performances Block level 7.56 14 Tackling emergencies by proving extra ambulance for PHC 3877.20 15 Strengthening of AN Care By Providing USG Machines To PHCs 1.10 16 Early Detection Of Hearing Impairment By Providing Audiometry 100.8 17 Provision of DDHS office building for Thiruvannamalai HUD 280.50 18 Provision of Meeting Hall at DDHS Office 51.0 16 Provision of Computer and Online Training Centre 37.00 17 Provision of Generator at DDHS Office 8.00 18 Provision of Vehicles Shed at DDHS Office 40.00 19 Provision of Manpower to Urban PHCs 8.64 20 Provision of Store room at DDHS Office 40.00 15 Impact assesment of NRHM components 42.2 16 Additional funds for Communicable Diseases 9.0 17 Procurements (Theatre Instruments & Drugs) 31.5 18 District Plan (Bio-Medical Waste Management in PHCs) 25.25 19 Health Mela 16.0 20 IEC/BCC 24.6 TOTAL Rs. (in Lakhs) 6061.19

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S.No Routine Immunisation Sessions 2011-12 2012-13 upto Sep. 2013-14 (Planned) 1. Total Sessions Planned 21684 9840 21684 2. Total Sessions Held 21034 9545 21034 3. No. of Outreach Sessions 936 432 936 4. No. of Fixed site Sessions 936 432 936 5. No. of Sessions in Urban Areas 364 168 364 6. No. of Sessions in Rural Areas 21684 9840 21684 7. No. of Sessions in hard to reach areas 600 301 600 8. No. of Sessions with hired vaccinators* 0 0 0 9. No. of hired vaccinators* 0 0 0 10. No. of villages where sessions are held monthly 410 410 410 11. No. of villages (smaller) where sessions are held on alternate months 0 0 0 12. No. of Villages where sessions are held quarterly 0 0 0 . IMMUNISATION The current level Immunization achievements are as follows: Details of Routine Immunisation Sessions

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S .No B e n e fi c ia r i e s T a r g e t 2011-12 2012-13 2013-14 1. P r eg n a nt women 45116 45128 45128 2. 0 to 1 y r in f a nts 40471 40522 40522 3. 1 - 2 y r 40471 40522 40522 4. 2 - 5 y r 40471 40522 40522 5. 5 y r 39283 39340 39340 6. 10 y r 41809 41888 41888 7. 16 y r 40466 40546 40546

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VACCINE 2011-12 2012-13 ( upto Sep) Target Act % Target Act % BCG 26060 26227 100.6 13153 12364 94.0 DPT – III 26060 23875 91.6 13153 12736 96.8 Polio – III 26060 23875 91.6 13153 12736 96.8 Measles 26060 26089 100.1 13153 13056 99.3 DPT Booster 26060 24513 94.1 13153 10906 82.9 Polio Booster 26060 24513 94.1 13153 10906 82.9 Hepatitis B 26060 24513 94.1 13153 0.0 IMMUNISATION COVERAGE: TIRUVANNAMALAI HUD

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VACCINE 2011-12 2012-13 ( upto Sep) Target Act Target Act Target Act BCG 14411 14440 100.2 7108 7086 99.7 DPT – III 14411 14282 99.1 7108 7223 101.6 Polio – III 14411 14282 99.1 7108 7223 101.6 Measles 14411 14692 101.9 7108 7420 104.4 DPT Booster 14411 13556 94.1 7108 7119 100.2 Polio Booster 14411 13556 94.1 7108 7119 100.2 Hepatitis B 14411 13071 90.7 8293 0.0 CHEYYAR HUD

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S l No I tem S tock ( f un c t i on a l) a s on 31st Nov’12 R e quir e ment R e ma r ks 2012-13 2013-14 2014-15 1 Cold C h a in Equipments - a) W I C 0 0 0 0 b) W I F 0 0 0 0 c) I L R 91 91 91 91 d) DF 91 91 91 91 e) Cold B o x e s 91 91 91 91 f) V acc i n e C a r r i e r 800 800 800 800 g) I c e P ac k 6000 6000 6000 6000 h) V acc i n e V a n 2 2 2 2 V acc i n e stock a nd r e qui r e ment ( including 2 5 % w a stage a nd 2 5 % buf f e r) a) TT 42194 122151 122151 122151 b) B CG 18392 61076 61076 61076 c) OPV 38701 305378 305378 305378 d) DPT 10817 122151 122151 122151 e) Me a sles 23131 122151 122151 122151 f) H e p B 3772 61076 61076 61076 g) J E ( Rout i n e ) 13321 61076 61076 61076 h) Pentavalent 39190 183227 183227 183227 3 S y ri n g e s includi n g w a st a g e o f 10% a nd 25 % buf f e r a) 0.1 ml 901 54968 54968 54968 b) 0.5 ml 245896 274840 274840 274840 Existing Support:

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S. No Name of District Yearly Target (2012-13) BCG Coverage (in Numbers) OPV - 1st Dose Coverage (in Numbers) OPV - 3rd Dose Coverage (in Numbers) Pentavalent- 1 st Dose Coverage ( in Numbers) Pentava- 3rd Dose Coverage (in Numbers) Infants Pregnant Women 1 TVMALAI 26306 28937 12364 12840 12736 12799 12736 2 CHEYYAR 14411 16191 7086 7155 7223 7328 7223 TOTAL 40717 45128 19450 19995 19959 20127 19959 To sustain the high coverage in immunization the following budget is proposed. COVERAGE REPORTS (IN NUMBERS) (UPTO SEPTEMBER 2012)

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S. No Name of District Measles Coverage Measles 2nddose Coverage TT2 Booster Coverage JE-routine (Wherever applicable) Infants 1-2 year 1 T.V.MALAI 13055 12040 14017 12035 2 CHEYYAR 7420 7119 7746 7173 TOTAL 20475 19159 21763 19208

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S.l Name Period No 2011-12 2012-13 1 T.V.MALAI -NIL- -NIL- 2 CHEYYAR Total District –wise VPD reports in 2011-12 & 2012-13 (in numbers) * till Sep‟12

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TVMALAI CHEYYAR Dise a se Cas e s D e a t h s Cas e s D e a t h s D i ph t h e r i a -- -- -- -- Whoo p i ng C ou g h -- -- -- -- N eona t al Te t a nus -- -- -- -- T e t an u s ( O t h e r ) -- -- -- -- M e a s l e s -- -- -- -- Pol i o -- -- -- -- A ES -- -- -- --

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Sl.No Activities Actual No of Units Total Amount Required (In Lakhs) Remarks i Sensitisation Meeting (once in a Quarter) Per Quarter 5000 x 2 HUD x 4 2 0.400 ii Mobility Support for Dist.level officers 50000 2 1.0 iii Mobility Support (200 x 12 x 410) 200 410 9.84 iv Cold Chain Maintenance 10000/HUD 500/CHC&PHC 2+91 0.655 v POL for vaccine delivery from WIC To District & District to PHC&CHCs 1,20,000 2 2.40 vi Consumables for computer including provision for internet access for RIMS @ 1000/ -month/district 2 0.24 vii Injection Safety 0 Red/Black Plastic bags etc @Rs.2/bags/session 0.853 Bleach/Hypochlorite solution @ Rs.500 /PHC&CHC per year 0.455 Twin bucket @ Rs.400/- @Rs.400/PHC&CHC/year 0.364 Operational Cost 0 BUDGET FOR IMMUNISATION

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viii Alternate Vaccinators (200 x 10 x 52) Rs.200 10 1.04 At a point of Time in Each HUD 3 to 5 VHNs will be on Leave, Maximum of 10 VHNs in the District will be on the Leave ix Alternate Vaccine delivery (50 x 10 x 52) Rs.50 10 0.26 ix Slum Vaccinators (Rs .350 x 4 x 25 x 12) 25 4.200 x Proposal for Computer Assistant (Rs.10,000 x 12 x 2) 2 2.400 TOTAL 24.107

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Similar assessment and estimation have been done for all other Programes like INTEGRATED DISEASE SURVEILLANCE PROJECT (IDSP) NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAM (NVBDCP) NATIONAL LEPROSY ERADICATION PROGRAMMED NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS RNTCP Miscellaneous Medical Colleges Additionality Funds from NRHM- Details of the activities for which additionality funds are proposed to be sought. MONITORING & EVALUATION- HMIS.PICME

BUDGET ABSTRACT:

BUDGET ABSTRACT

THANK YOU:

THANK YOU

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