1
NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME
Annual Action Plan for Malaria Programme - 2011-12
State Annual Action Plan
Year:_2011-2012__ A. Population:2872870 B. Status of Health facilities S. No Health facility No 1 District Hospital 6 2 PHC/ CHC 106/30 3 Dispensary 11 4 Sub centre 406 5 Villages 6508 6 Rapid response team 7 7. Any other - C. Human Resource
S. No Health facility Sanctioned /
Required In Place
Trained as per new Malaria
guidelines 1 DMO (Full Time) 7 7 4 2 DVBDC Consultant 7 1 - 3 AMO 7 4 - 4 Block PHC/ CHC-MO 5 PHC-MO 515 231 6 Other MO 7 Lab Technician (regular) 156 156 156 8 LabTechnician (contractual)* 10 10 9 Health Supervisors (M) 273 273 120 10 Health Supervisors (F) 188 188 Nil 11 MPW (M) 872 872 74 12 MPW (M) (contractual)# 100 100 Nil 13 MPW (F) 758 758 Nil 14 Malaria Technical Supervisor -
MTS- (contractual)* 21 12 11
2
15 ASHA 6255 5307 * GFATM/World Bank GFATM / World Bank Project States Only
State PMU In Place Consultant M&E 1 Project Director/ Programme Officer Finance Consultant 1 IEC Consultant 1 Other Consultants 1 (DVBDC Consultant)* Data entry operator 1 (Selection under process) Secretarial Assistant 1 (Selection under process) Statistical Assistant 1
Other 6 DVBDC Consultants: Selection in process
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D. District wise Epidemiological Situation:
District Year Population BSC/BSE ABER Total Pf. API SPR SFR Deaths Name Malaria Case Due to
Cases malaria
East khasi Hills
2006 853789 65724 7.6 7552 6731 8.8 11.4 10.2 51 2007 660923 40618 6.1 2050 1411 3.1 5.04 3.4 58 2008 660923 16305 2.4 572 462 0.8 3.5 2.8 5
2009 756185 25668 3.4 1062 862 1.4 4.1 3.4 5 West Khasi Hills
2006 294115 13154 4.5 1451 1339 4.9 11 10.1 13 2007 296049 10243 3.4 988 737 3.3 9.6 7.1 14 2008 296049 15431 5.2 1075 712 3.6 6.9 4.6 14
2009 345739 28335 8.2 2911 2749 8.4 10.3 8.6 22
Jaintia Hills
2006 295692 56536 19.1 4543 1555 15.3 8 2.7 23 2007 299108 51597 17.4 3705 530 12.5 7.1 1.02 22 2008 299108 42750 14.2 1369 243 4.5 3.2 0.5 1
2009 367173 50108 13.6 1171 408 3.2 2.3 0.8 20
West Garo Hills
2006 614918 138374 22.5 15220 15156 24.7 10.9 10.9 44 2007 518390 132250 25.5 19154 18422 36.9 14.4 13.9 117 2008 518390 155529 30 24259 24159 46.7 15.5 15.5 30
2009 630068 231650 36.8 43890 43699 69.7 18.9 18.9 72
East Garo Hills
2006 247555 16323 6.5 1158 1126 4.6 7 6.8 6 2007 250582 18463 7.4 1710 1643 6.8 9.2 8.8 22 2008 250582 53184 21.2 6487 5660 25.8 12.1 10.6 10
2009 275000 70155 25.5 14379 14121 52.3 20.5 20.1 28
Ri Bhoi 2006 - - - - - - - - 2007 192890 31797 6.4 3175 2327 16.4 9.9 7.3 4 2008 192890 28917 14.9 1311 819 6.7 4.5 2.8 8
2009 235472 52805 22.4 3025 2393 12.8 5.7 4.5 19 South Garo Hills
2006 - - - - - - - - 2007 100980 30496 30.1 3197 3109 31.6 10.4 10.1 0
2008 100980 20319 20.1 2876 2875 28.4 14.1 14.1 5 2009 124137 42698 34.39 10321 10319 83.1 24.2 26 26 State Total 2006 2306069 290111 12.58 29924 25907 12.9 10.3 8.9
137
2007 2318922 315464 13.60 31794 28179 14.65 10.76 8.9 237 2008 2318922 332435 14.33 37949 34930 16.36 11.41 10.50 73 2009 2733774 501419 18.34 76759 74551 28.07 15.30 14.86 192
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District wise Epidemiological Situation upto November, 2009- 2010
District Year Population BSC/BSE ABER Total Pf. API SPR SFR Deaths Name Malaria Case Due to
Cases malaria
East Khasi Hills
2009 756185 24213 3.2 1014 821 1.3 4.1 3.3 4
2010 868209 28141 3.2 698 593 1.8 2.4 2.1 3
West Khasi Hills
2009 345739 26249 7.5 2652 2190 7.6 10 8.3 21 2010 369515 21569 5.8 1692 1240 4.5 8 5.7 12
Jaintia Hills 2009 367173 45751 12.4 1105 364 3 2.4 0.7 20 2010 433205 50520 11.6 908 463 2 1.7 0.9 9
West Garo Hills
2009 630068 221726 35.1 42338 42149 67 19 19 66 2010 645876 191191 29.6 21534 21389 33 11.2 11.1 31
East Garo Hills 2009 275000 67433 24.5 13963 13720 50 20 20 25 2010 237110 49849 21.03 8865 8240 37 18 16.5 10
Ri Bhoi 2009 235472 50147 21.2 2798 2286 12 5.5 4.5 19 2010 237110 47805 20.1 1857 1423 8 4 3 2
South Garo Hills
2009 124137 39552 31.8 9614 9612 77 24 24 21 2010 131602 37225 28.2 4619 4614 35 12 12 15
Total 2009 2733774 475071 17.3 73484 71142 27 15 15 176 2010 2922627 426300 14.5 40173 37962 14 9.4 9 82
5
High Risk Areas:
Name of District
High Risk PHC (no)
High Risk Health Sub-Centres (No)
High Risk Village
(No)
High Risk Population
(No) EKH 14 27 410 208487 RI-BHOI 14 26 578 248199 WKH 12 39 637 1,36100 JH 10 21 91 145000 WGH 24 81 1735 600195 SGH 8 21 442 108346 EGH 18 82 413 111607
Total 100 297 4306 1557934
D3. Classify the areas as per following API ranges
Sl. No
API Dist No
PHCs No
Sub-Centre
No
Village No
Population @villages
No.
% Population @ villages
1 < 1 5 25 48 185 215582 18 2 1-2 5 12 14 177 182791 8 3 2-5 6 27 43 469 211957 18 4 5-10 7 34 120 1422 537478 47 5 > 10 5 39 119 2481 80976 7
API > 10
NAME OF DISTRICTS
NOS. OF PHCS
NOS. OF SUBCENTRES
NOS. OF VILLAGES
POPULATION
East Khasi Hills - - - - Ri-Bhoi 3 12 173 85094 West khasi hills 1 2 188 17734 Jaintia hills 4 8 28 24166 West Garo Hills 23 76 1680 594777 South Garo Hills 8 21 412 87996 East Garo Hills. - - - - TOTAL 39 119 2481 80976
6
API 5-10
NAME OF DISTRICTS
NOS. OF PHCS
NOS. OF SUBCENTRES
NOS. OF VILLAGES
POPULATION
East Khasi Hills 1 3 58 26892 Ri-Bhoi 3 3 68 30770 West khasi hills 2 8 125 26950 Jaintia hills 1 6 26 48335 West Garo Hills 3 7 138 109181 South Garo Hills 8 17 52 20350 East Garo Hills. 16 73 955 275000 TOTAL 34 120 1422 537478
API 2-5
NAME OF DISTRICTS
NOS. OF PHCS
NOS. OF SUBCENTRES
NOS. OF VILLAGES POPULATION
East Khasi Hills 4 8 165 51436
Ri-Bhoi 4 1 53 29241
West khasi hills 3 10 157 33849
Jaintia hills 5 7 37 72499
West Garo Hills 6 7 20 17098
South Garo Hills 5 10 37 7834
East Garo Hills. - - TOTAL 27 43 469 211957
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API 1 – 2
NAME OF DISTRICTS
NOS. OF PHCS
NOS. OF SUBCENTRES
NOS. OF VILLAGES POPULATION
East Khasi Hills 4 3 77 34955 Ri-Bhoi 1 1 33 10384
West khasi hills 3 12 174 37515 Jaintia hills 6 9 34 96666
West Garo Hills 1 1 1 1006 South Garo Hills 5 6 12 2265 East Garo Hills. nil nil nil nil
TOTAL 20 32 331 182791
API < 1 NAME OF
DISTRICTS NOS. OF
PHCS NOS. OF
SUBCENTRES NOS. OF
VILLAGES POPULATION
East Khasi Hills 4 4 69 27935 Ri-Bhoi - - - -
West khasi hills 3 7 93 20052 Jaintia hills 9 70 428 144999
West Garo Hills 1 5 18 4311 South Garo Hills 6 20 117 13157 East Garo Hills. Nil - - -
TOTAL 25 48 185 215582
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E. GIS mapping (Based on epidemiological data for the years 2009 for identified
high endemic districts) List Attached
Status of Village wise data entry of the district for 2009 in GIS format for identified high endemic districts: yet to be received.
F. Outbreak: No if yes give details as
follows; No. of outbreaks: Area affected: Period of outbreak: No of Cases & deaths reported during outbreak: Reasons for outbreak: Containment measures taken: Outbreak Containment Report(s) submitted by State to Centre? Yes/ No
G. Specific activities:
a)RD Kits (selected Pf endemic districts only)
Sl. No
District Name
No. of PHCs Where RDTs are to be used in emergency Hours
No. of sub-centre
areas with SFR >2% &
no microscopy
Results within 24
hrs
No blood examinations
in those S/c/PHC areas last
year (A)
Expected RDT
requirement in remote
high Pf areas & PHCs
(A x1.25)(B)
RDTs for buffer
stock & distribution
to other areas
(B x0.20) (C)
Total annual RDT
supply(B+C)
No.s to be distributed
in prioritized
areas
1 EKH 14 18 9685 12106 2421 27527 5811
2 RI-BHOI
13 26 20058 25073 5014 40387 12034
3 WKH 12 39 10499 13123 2624 49147 6299
4 JH 19 50 18300 22875 4575 37172 10788
5 WGH 23 82 88690 110863 22172 194135 53214
6 SGH 8 21 15821 19776 3955 45231 9492
7 EGH 16 73 26973 33716 6743 81059 16183 Total 104 309 190026 237532 47504 474658 113821
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b) Areas for supply of ACT
Allocation of ACTs & Quinine for a year based on epidemiological & operational data.
Data latest complete year
Allocation for Plan year
District Total population
Pf cases reported in previous year
Adults (60% of Pf cases
Children (40% of Pf cases) Pregnant women
ACT Blister
9-14 yrs (38%)
5-8 yrs (30%)
1-4 yrs (22%)
Under 1 yr (10%)
Quinine tablets
A
A x 1.5.x.60
B x0.38 x1.5
B x 0.30x 1.5
B x 0.22 x1.5
B x0.10 x1.5
A x1.5 x.02 x21
WGH 642139 43699
39329 9963 7865 5767 2620 27530
SGH 128883 10319 9287 2353 1857 1362 618 6500 EGH 275000 14121 12708 3219 2541 1865 848 8896 RB 247965 2393 2154 545 430 317 144 1507 WKH 358331 2449 2204 558 441 324 147 1543 EKH 853379 886 775 197 155 114 51 542 JH 367173 609 367 93 74 54 24 257 Total 2872870 74476 66824 16928 13363 9803 4452 46775 Caritas 17109 4334 3421 2509 1140 11976
B. Requirement of Rapid Diagnostic Kits based on epidemiological data for next Plan Year
S. No. Details Sub
Centre Village (no) Total Population BSC
1 Areas with high Pf % 309
4267
1368937
190026
2 Of the above prioritized to be equipped with RDT during the year
154
2581
887502
113821
3 No of RDTs Required for Next Plan Year
500000
10
Grand Total 83933 21262 16784 12312 5592 58751
B. Allocation of ACTs for Next Plan Year
Data latest complete year Allocation for Next plan year
S. No.
District/ PHC
Total Population
Pf cases reported in previous year
Adults (60% of Pf cases
Children ( 40% of Pf cases) =B= (A*0.40)
Adult ACT Blister
9-14 Yrs (38%)
5-8 Yrs (30%)
1-4 Yrs (22%)
Under 1 yr (10%)
A A x 0.60 x1.5
B x 0.38 x 1.5
B x 0.30 x 1.5
B x 0.22 x 1.5
B x 0.10 x 1.5
1 West Garo Hills 642139 43699 39329 9963 7865 5767 2620 2 South Garo
Hills 128883 10319 9287 2353 1857 1362 618
3 East garo Hills 275000 14121 12708 3219 2541 1865 848 4 Ri Bhoi 247965 2393 2154 545 430 317 144 5 West Khasi
Hills 358331 2449 2204 558 441 324 147
6 East Khasi Hills 853379 861 775 197 155 114 51 7 Jaintia Hills 367173 408 367 93 74 54 24 Total 2872870 74250 66824 16928 13363 9803 4452 Caritas 17109 4334 3421 2509 1140 Grand Total 83933 21262 16784 12312 5592
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c) Bednet
District Name
Eligible Sub Centre (Nos)
Eligible villages
(no)
Eligible Population
Total Bed nets required
Number of bed nets available in household survey(no)
2009-10
Required in the
current year (no) 2011-12
Total planned to be distributed in the
year (no) 2010-11
Total planned to be treated
ITNs LLINs ITNs LLINs
A B C D=A-C E F G=B+E
West Garo Hills 82 1735 642139 256856 282216 67500 89856 Nil 100000 282216
South Garo Hills 21 630 128883 51553 21761 32500 Nil nil 20000 21761
East Garo Hills 73 955 275000 110000 59000 50000 25000 nil 35000 59000
Ri-Bhoi 26 517 247965 99186 32916 Nil 99186 30000 Nil 62916 Jaintia Hills 27 122 70361 30000 35305 Nil 30000 13900 Nil 49205
West Khasi Hils 39 277 167122 66848 23853 Nil 66848 28600 Nil 55453
East Khasi Hills 27 410 208487 83395 22984 Nil 60411 15000 Nil 22984
Total 286 4605 1672688 670930 408748 150000 520930 87500 155000 553535
Total bed nets required = 670930 Already supplied = 305000 To be supplied = 108631 (already allotted) Net required = 257299 (2011-12)
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d)Planning for IRS:
Name of District
No. of CHC/
PHC/Dispensary selected for IRS
Health
Sub-Centr
es (Nos)
Village
selected
(Nos)
Total Popula
tion selected
(Nos)
Spray Squad
Required (Nos)
Training
Batch of
Spray. Squad (Nos)
Equip-ment
required (Nos)
Pumps
Name of Insecti-cide
Insecticide required (MTs)
DDT Malathion SP
EKH 12 16 308 138218 4 2 9 DDT 50% 18.00
RI-BHOI 14 26 517 247965 9 2 20 DDT 50% 30.0
WKH 12 39 637 136100 9 3 20 DDT 50% 20.0
JH 19 69 387 209806 10 5 22 DDT 50% 31.0
WGH 24 81 1674 580999 19 8 40 DDT 50% 70.0
SGH 8 21 630 128883 5 2 12 DDT 50% 19.0
EGH 18 73 955 275000 13 2 26 DDT 50% 41.0
Total 107 325 5108 1718727 69 24 149 DDT 50% 229.00
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e) Innovations
S. No. Innovations Describe details Fund Allocated (Rs)
1 Patient referral e.g. Like use of NRHM/ RKS flexi funds for transport of severe cases
Patient at village level with sign of severe malaria will be escorted by the ASHA using vehicles available at village level or other method of transportation Subcentre level- using flexi fund available for P.O.l PHC Level- for severe complicated malaria needed a specialized treatment
@ 200/ referred case from District to PHC @ 150/ case 500/case
2 Transportation of slides E g. Use of Public transport system
From village to PHC by special messenger every week Using public transport where ever available
Rs. 100 per week Rs. 100 per week
3 NGO/ CBO involvement Refer to PPP guidelines on www.nvbdcp.gov.in
As per PPP Plan
As per PPP Plan
4 Community mobilization eg. Mobilizing using street plays, puppet plays, self help groups
Involvement of students, guides and scouts, VHC, NGOs and FBOs
As per BCC Plan
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f) Commodity Requirement
Previous year's utilization (no) Jan-Dec,2009
Requirement for
current year
(no) 201 -12
Balance Net Requirement (2-3)
Available Item (no) Upto Oct,
2010. 1 2 3 4
Insecticide For IRS (Kg) 3,265 Lts. 22900 31200 19800
Insecticide For ITMN (Lts 3065 4962 3409
1553 lt
LLINs 150000 520930 ( LLINs) nil
Chloroquine (No.) 50,62,200 1880321 1,01,100 2000000 Primaquine 2.5 (No.) 2,97,000 70224 5,600 80000
Primaquine 7.5 (No.) 1,00,400 1110795 1,15,000 1200000
ACT (Artesunate+ 48,125 83529 226 Blister (No.) 84000
Quinine Injection (No.) 19,980 37125 9,200 40000
Quinine Sulphate (No.) 69,000 111386 59,890 120000
Arteether Inj (No.) 17,499 16707 153 16707
RDK (No.) 2,70,800 500000 1,075 500000 Micro Slides (No.) 3,20,000 500000 16,000 500000
---
Pumps (No.) 150 31 nil
Lancet 319400 500000 6000 500000
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g) Training: mention number of batches to be trained
S. No Trainings
Cost per Batch
Trained in Previous year (no)
To be Trained in Current year Q1 (no)
Q2 (no)
Q3 (no)
Q4 (no)
Total (no)
Total Cost (Rs)
1 Medical specialists at Dist. Hospital
1,00,000 Nil 1 1 100000
2 Medical Officers 1,00,000 56 1 1 1 3 300000 3 Lab. Technicians
(reorientation) 80000 19 1 1 2 160000
4 Health Supervisors (M)
50000 7 7 350000
5 Health Supervisors (F)
50000 7 7 350000
6 Others specify(Spray Squads)
20000 7 7 140000
7 Training for M.T.S. on LQAS
50000 12 1 1 50000
8 MTs - Refreshes 50000 1 1 50000 Total 1500000
DBS – Lab Technician - 1,60,000 (Re-orientation) Health Supervisor (M) - 3,50,000 Health Supervisor (F) - 3,50,000 Spray Workers - 1,40,000 Total - 10,00,000 GFATM – Medical Specialist - 1,00,000 Mo PHC - 3,00,000 MTS LQAS - 50,000 MTS Refresher Course - 50,000 Total - 5,00,000
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h) BCC/ IEC: mention number of each
S. No Activities
Unit Cost (Rs)
Previous year (no)
Current year
Q1 (no) Q2 (no) Q3 (no) Q4 (no) Total (no)
Total Cost (Rs)
A. Print Media 1 Posters 15 12000 20000 20000 300000 2 Hoardings 50000 5 7 7 350000 3 Newspaper
advertisement 21000 1 1 1 1 4 84000
B. Electronic Media
4 TV campaigns 6000 Nil 4 4 4 4 12 144000 5 Radio
campaigns 4000 960 960 960 400000
C. Community level
15000 100 95 195 292500
Total 15,70,500
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Larvivorous Fish
Proforma for Urban Malaria Scheme
Status of hatcheries/ up-scaling of Larvivorous fish in the States:-
S.No
Name of states/UTs. No. of hatcheries at District level
No.of hatcheries at Block/PHC/ Village level
No. of water bodies seeded
Meghalaya 2 1 (one) only at village level (Bolchugre village, West Garo Hills )
4157 (number of fishes ) 21 (water bodies)
S. No. District Hatcheries
Seasonal water bodies
Perennial water bodies
Water bodies released with fish previous year (no)
Planned in Current year (no)
Cost
1 West Garo Hills 2 (2 nos to be constructed)
Irrigation Channel, Rice Field
Drains, Ponds etc.
15,197 50,000 200000
2 East Garo Hills 1( 1 no. to be constructed)
Irrigation Channel, Rice Field
Drains, Ponds etc
Yet to be released
100000
3 RiBhoi To be constructed (2 nos)
100000
4 South Garo Hills
To be constructed (2 nos)
100000
5 West Khasi Hills
To be constructed (2 nos.)
100000
6 East Khasi Hills To be constructed
50000
7 Jaintia Hills To be constructed (2 Nos)
100000
Total 7,50,000
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MONTH-WISE EPIDEMIOLOGICAL REPORT FOR THE YEAR 2009
Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Total Population
No. of BSC/ BSE
22685 20693 27656 38715 61197 65937 63956 50380 39084 42613 42451 26348 501715
No. of Pv 82 99 119 170 340 304 396 338 177 148 142 166 2481
No. of Pf 1907 1745 2863 5741 14396 12730 10246 7218 4474 5228 4594 3109 74251
No. of total positives
1989 1844 2982 5911 14736 13034 10642 7556 4651 5376 4763 3275 76759
SPR 8.8 8.9 10.8 15.2 24.1 19.8 16.6 15 11.9 12.7 11.2 12.4 15.29 SFR 8.4 8.4 10.4 14.9 23.5 19.3 16.1 14.3 11.4 12.7 10.8 11.8 14.79 ABER 0.7 0.7 0.9 1.3 2.1 2.2 2.2 1.7 1.3 1.4 1.4 0.9 17.4 RT given 1989 1844 2982 5911 14736 13034 10642 7556 4651 5376 4763 3275 76759
Deaths 3 1 3 15 44 23 38 11 11 17 10 16 192
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SWOT Analysis
SWOT/STATUS Actions to be taken to match the requirements
STRENGTHS 1. Re-organised and revitalise of the NVBDCP
1. Involvement of the District Administration
DC’s at District Level & SDO (civil) , BDO at Block Level for monitoring and Supervision of programme Activities
1. Fund for training available from the
GFATM.
1. Malaria Activities to be fully integrated with the general Health Services
1. Dist. Level monthly meeting of the Deputy
Commissioner with the DM&HO’s, DMO’s and at Sub-Divisional level & Block Level monthly meeting of the SDO (Civil) & BDO’s with SDM& HO’s & MO CHC/PHC to review malaria situation & prompt action for controlling outbreak.
2. All Categories of Health Personnel could be trained.
WEAKNESS 1. Inadequate Health Infrastructure
2. Inadequate mobility for monitoring and
supervision 3. Storage of DDT and other commodities.
4. Recording and Reporting unsatisfactory 5. Inadequate surveillance
1. Procurement of vehicle for State & District through NRHM
2. Hiring of Vehicles through IMCP.
3. Separate ware house for each DMO.
4. Staff responsibilities are trained.
5. Training of all ASHA in English far flung areas. Contractual MPW, MTS at all Block.
OPPORTUNITIES
1. Formation of the Village Health & Sanitation Committee in each and every village.
1. Identification of the number of Villages having VHSC. 2. Organised a Sensitization Camp for the members of the VHSC.
2. Recruitment of ASHA by the VHSC to work as a Link Health workers in their respective villages.
1. Identification of the number of villages having an ASHA 2. Organised a training camp for them.
3. Presence of the NGO/ FBO/ CBO, in the locality. 4. Involvement of Caritas
1. Identification of the villages taken up by caritas. Adequate planning for RDK and Anti Malaria to meet the requirement
2. Planning for Awareness Camp and IEC activities adequate IEC Material.
20
THREATS 1. Global warming 2. By Government Agency- Pollution Board-
intersectoral meeting. 2. High illiteracy rate and ignorant, in the Rural areas.
1. Intersecotral activity with the Education Department through the School Health Programme.
3. Poor/Poverty/ low socio-economic development in the Rural areas.
1. Intersectoral discussion to identify and to plan for uplift of the Rural areas.
4. Unplanned Industrialization in the Rural areas - mining.
1. Formation of the Industrial policy by the Government so as to be more environmental friendly
21
District wise Epidemiological Situation:
District Name Year Population BSC/BSE
Total Malari
a Cases
Pf. Case SPR SFR
Deaths Due to
malaria
East khasi Hills 2009 756185 21877 971 786 4.4 3.5 3
2010 853379 25768 659 560 2.5 2.1 3
West Khasi Hills
2009 345739 23046 2363 1935 10.2 8.3 21
2010 358331 19730 1543 1114 7.8 5.6 11
Jaintia Hills 2009 367173 39083 969 306 2.4 0.7 19
2010 367173 44760 784 383 1.7 0.8 6
West Garo Hills 2009 630068 209751 39682 39500 18.9 18.8 63
2010 642139 179182 20478 20350 11.4 11.3 29
East Garo Hills 2009 275000 63127 13166 12938 20.8 20.4 25
2010 275000 46394 8318 7714 17.9 16.6 10
Ri Bhoi 2009 235472 44440 2571 2086 5.7 4.6 17
2010 247965 44958 1677 1295 3.7 2.8 0
South Garo Hills
2009 124137 36296 8999 8997 24.7 24.7 18
2010 128883 35070 4247 4242 12.1 12.0 13
State Total 2009 2733774 432620 68721 66548 15.8 15.3 166
2010 2872870 395862 37706 35658 9.5 9.0 72
22
COMPARATIVE STATE MONTH-WISE EPIDEMIOLOGICAL DATA FOR 2009-2010 (up to November)
Total Year BSC/BSE Positive cases PF Death Pf %
JAN 2009 22685 1989 1907 3 2010 21440 1950 1899 4
FEB 2009 20693 1844 1745 1 2010 22692 1904 1872 1
MAR 2009 27656 2982 2863 3 2010 28261 2554 2481 1
APRIL 2009 38715 5911 5741 15 2010 31073 3137 3035 12
MAY 2009 61197 14736 14396 44 2010 42616 4743 4583 11
JUNE 2009 65937 13034 12730 23 2010 48979 5290 5118 12
JULY 2009 63956 10642 10246 33 2010 58079 5561 5295 9
Aug 2009 50380 7556 7218 11 2010 56501 5059 4500 11
Sep 2009 39084 4651 4474 11 2010 50315 4779 4445 5
Oct 2009 42317 5376 5228 17 2010 35546 2729 2430 6
Nov
2009 42451 4763 4594 10 2010 30438 2467 2304 10
Total
2009 475071 73484 71142 171 2010 425940 40173 37962 82
23
Action Plan for JE for the year 2011-2012
REPORTS OF JAPANESE ENCEPHALITIS FOR THE YEAR 2009-10.
STATE: MEGHALAYA.
DISTRICT WISE DISTRIBUTION OF POSITIVE CASES OF J.E. FOR THE MONTH OF JAN UPTO AUG-2010.
Sl.No Name of District No. of Confirmed Cases
Deaths
1. West Khasi Hills 2 NIL
2. Ri Bhoi 1 NIL
3. East Khasi Hills 1 NIL
Total 4 NIL
DISTRICT WISE DISTRIBUTION OF SUSPECTED CASES OF J.E. FOR THE MONTH OF JAN UPTO AUG-2010.
Sl.No Name of District Name of PHC Total Suspected Cases
1. Ri Bhoi Mawlasnai PHC,
Umsning CHC and Bhoirymbong
4
2. East Khasi Hills Diengpasoh CHC , Laitryngew PHC KVEAC Upper Shillong Mawngap-Marbi
4
3. Jaintia Hills
Nongtalang PHC Sahsniang
2
4.
WKH
Mawkyrwat CHC
1
Total
11
24
1.Early AES case detection and management.
a. Identification of Health Institute for AES treatment
Sl. No.
District Name of Health Institute
1. Jaintia Hills Civil Hospital, Jowai 2. East Khasi Hills Civil Hospital, Shillng
NEIGRIHMS, Shillong 3. West Khasi Hills Nongstoin District Hospital
Mairang Sub Division Hospital 4. Ri Bhoi Nongpoh District Hospital
b. Identification of Sentinel Surveillance site with laboratory (SSSL)
Name of Proposed SSSL for 2011-2012 1. Civil Hospital Shillong
2. Vector Control a. Outdoor Space Spray (with Malathion Technique) Fogging. b. Promotion of ITBN. c. Introduction of Larvivorous fish. d. Entomological study
3.Capacity Building
Sl No.
Purpose of training Category of training No. of batches
No. of Participants
1. Implementation of AES DM&HO and DMO Districts 1 25 2. Surveillance System M.O PHC/CHC/Private
Practitioners/Dispensary 2 25
3. Clinical JE Cases Management Medical Specialist /Paed 1 25 4. Lab. Diagnosis Microbiologist / Phathologist
/Lab.tech. 1 20
5. Early reporting of AES SMI/SI/SW/ANM/AWW/ASHA 7 25
25
Logistics:
BCC/ IEC 2011-12
Sl.No. Patrticular OPening Balance Requirement
Laboratory Elisa Reader with washer Nil 3
Mac-Elisa Kit (JE)
Nil 6
Vector Control Malathion Technical Nil 150 Kg
Sl No. Activities
Unit Cost ( Rs) Previous
Year (No)
Current Year Total Cost (Rs) Q1 Q2 Q3 Q4 Tota
l
1 Posters 15000 per 1000 nos. 500 500 500 500 2000 30000
2 Hoardings 3 AIR Campaign
6879.20/ week (4 times a day)
4 week
s 27516.80 p
4 Others (a) Handbills (b) Pamphlets
8 2 5000
5000 5000 5000
40,000 10,000
5 Stickers Flipchart Billboard
6 (b) Intersectoral Workshop (District Level)
(c) State Level 7
(a) Advocacy Workshop at District
(b) State Level 8 Meetings at the
village Level 1000 35 35 35 35 140 140,000
2,47,516.8
26
Budget:
Sl. NO.
Item Cost (Rs.in lac) Total (in lac)
1 Elisa Reader with washer 4.5 4.5
2 Malathion Technical 0.018/ Kg 2.7
3 Drugs and Hospital Logistics - 2.00
4 Training - 3.3
5 B.C.C. - 2.4
6 Monitoring and Supervision - 1.5
Total - 16.4
27
i. District wise distribution of Positive cases of JE for the year 2009.
Sl No.
Name of District No. of Confirmed cases
Deaths
1. Jaintia Hills 5 Nil 2. West Khasi Hills 2 Nil 3. East Khasi Hills 1 Nil 4. Ri Bhoi 1 Nil Total 9 Nil ii. District wise distribution of Suspected cases of JE for 2009.
Sl No.
Name of District Name of PHC Total Suspected cases
1. Jaintia Hills 1. Mynso PHC 1 2. Ri Bhoi 1. Umsning
CHC 2. Nongpoh
CHC
1 1
Total 3 iii. Distribution of JE cases by sex and Age for 2009.
AGE Year 0-1 1-5 6-5 15 above total 2009 M F M F M F M F M F 0 0 0 0 3 3 2 1 5 4
28
Basic Facts of the District
EKH RI-BHOI WKH JH WGH SGH EGH Total
Population 853379 247965 358331 367173 642139 128883 275000 2872870
Area(in sq km) 2748 2448 5427 3937 3640 1887 2342 22429 Sub division 1 1 3 3 3 2 13 Community Developed Block 8 3 6 5 8 4 5 39
No. of Villages 980 578 1128 555 1735 630 955 6508 Literacy 76.1 65.7 53 51.9 50.7 36.7 62.6 No. of Households 109115 39245 58736 55751 118678 20819 56827 459171 Status of Health Facilities Sl No
Health facility
EKH RI-BHOI
WKH JH WGH SGH EGH A. Total
1 District Hospital
3 1 Nil 1 1 - 1 6
2 CHC 6 3 06 5 6 1 2 29 3 PHC 23 8 23 17 18 7 16 105 4 Sub-centres 66 26 62 76 82 21 73 406 5 FTD 100 3 34 234 234 44 649 6 Rapid
Response Team
1 1 1 1 1 1 1 7
29
Human Resource Sl No
Health facility EKH RI-BHOI WKH JH WGH SGH EGH Total
1 DMO (full time) 1 1 1 1 1 1 1 7 2 AMO 1 Nil Nil 1 1 - 1 4 3 MO 130 25 51 71 53 17 36 443 4 Lab-Technician 42 17 (24)27 24 26 8 19 151 5 Microscopist 6 1 4 2 9 2 3 27 6 Lab-Technician
(contractual) 0 1 (1)2 2 3 1 1 10
7 Health Supervisors (M) 22 8 48 51 57 10 70 273 8 Health Supervisors (F) 32 14 58 35 48 6 188 9 MPW (M) 41 147(M+F) 76 48 96 31 258 872 10 Surveillance worker 13 24 19 18 62 18 307 11 MPW(F) 107 104 124 180 47 570 12 Malaria Technical
Supervisor (contractual) * 0 1 4 1 3 1 2 12
13 ASHA 1033 536 1112 552 1629 554 952 6255 14 SFW (12 months) - Nil Nil 7 2 1 10 15 Spray squads 4 9 9 8 19 5 54 16 MPW (contractual)
30
Areas for supply of ACT
A. Allocation of ACTS & Quinine for a plan years based on epidemiological & operational data
Allocation of ACTs & Quinine for a year based on epidemiological & operational data.
Data latest complete year
Allocation for Plan year
District Total population
Pf cases reported in previous year
Adults (60% of Pf cases
Children (40% of Pf cases) Pregnant women
ACT Blister
9-14 yrs (38%)
5-8 yrs (30%)
1-4 yrs (22%)
Under 1 yr (10%)
Quinine tablets
A
A x 1.5.x.60
B x0.38 x1.5
B x 0.30x 1.5
B x 0.22 x1.5
B x0.10 x1.5
A x1.5 x.02 x21
WGH 642139 43699
39329 9963 7865 5767 2620 27530
SGH 128883 10319 9287 2353 1857 1362 618 6500 EGH 275000 14121 12708 3219 2541 1865 848 8896 RB 247965 2393 2154 545 430 317 144 1507 WKH 358331 2449 2204 558 441 324 147 1543 EKH 853379 861 775 197 155 114 51 542 JH 367173 408 367 93 74 54 24 257 Total 2872870 74250 66824 15932 13363 8577 4452 46775 Caritas 17109 43342 3421 2509 1140 11976 Grand Total
83933 59274 16784 11086 5592 58751
31
Allocation of ACTs for next Plan year
Data latest complete year
Allocation for next plan year
District Total population
Pf cases reported in previous year
Adults (60% of Pf cases
Children (40% of Pf cases) =B= (A*0.40)
ACT Blister
9-14 yrs (38%)
5-8 yrs (30%)
1-4 yrs (22%)
Under 1 yr (10%)
A
A x 1.5.x.60
B x0.38 x1.5
B x 0.30x 1.5
B x 0.22 x1.5
B x0.10 x1.5
WGH 642139 43699
39329 9963 7865 5767 2620
SGH 128883 10319 9287 2353 1857 1362 618 EGH 275000 14121 12708 3219 2541 1865 848 RB 247965 2393 2154 545 430 317 144 WKH 358331 2449 2204 558 441 324 147 EKH 853379 861 775 197 155 114 51 JH 367173 408 367 93 74 54 24 Total 2872870 74250 66824 15932 13363 8577 4452 Caritas 17109 43342 3421 2509 1140 Grand Total
83933 59274 16784 11086 5592
32
RDK Kits
Sl. No
District Name
No. of PHCs Where RDTs are to be used in emergency Hours
No. of sub-centre areas
with SFR >2% & no
microscopy Results
within 24 hrs
No blood examinations
in those S/c/PHC areas
last year (A)
Expected RDT
requirement in remote
high Pf areas & PHCs
(A x1.25)(B)
RDTs for buffer stock
& distribution
to other areas
(B x0.20) (C)
Total annual RDT
supply(B+C)
No.s to be distributed in prioritize areas
1 EKH 14 18 9685 12106 2421 14527+ *13000 =27527
5811
2 RI-BHOI
13 26 20058 25073 5014 30087+*10300 =40387
12034
3 WKH 12 39 10499 13123 2624 15747+*33400 =49147
6299
4 JH 19 50 18300 22875 4575 26972+*10200 =37172
10788
5 WGH
23 82 88690 110863 22172 133035+*61100 =194135
53214
6 SGH 8 21 15821 19776 3955 23731+*21500 =45231
9492
7 EGH 16 73 26973 33716 6743 40459+*40600 =81059
16183
Total 104 309 190026 237532 47504 474658 113821 *RDKs for caritas = 190,100(Based on 100 test/ASHA or NGO /yr/no. of villages taken up by the caritas /district) * 10% of these test will be diagnosed as positive for Pf i.e = 190100 x 10% = 19,010
33
a. RD Kits
Sl. No District Name
No. of PHCs Where RDTs are to be used in emergency Hours
No. of sub-centre areas
with SFR >2% & no
microscopy Results
within 24 hrs
No blood examinations
in those S/c/PHC areas
last year (A)
Expected RDT
requirement in
remote high Pf areas & PHCs
(A x1.25)(B)
RDTs for buffer
stock & distribut
ion to other areas
(B x0.20) (C)
Total annual RDT
supply(B+C)
No.s to be distributed in prioritize areas
1 EKH 14 18 9685 12106 2421 27527 5811
2 RI-BHOI
13 26 20058 25073 5014 40387 12034
3 WKH 12 39 10499 13123 2624 49147 6299
4 JH 19 50 18300 22875 4575 37172 10788
5 WGH 23 82 88690 110863 22172 194135 53214
6 SGH 8 21 15821 19776 3955 45231 9492
7 EGH 16 73 26973 33716 6743 81059 16183
Total 104 309 190026 237532 47504 474658 113821
B. Requirement of Rapid diagnostic Kits based on epidemiological data for
next plan year SL No.
Details Sub centre (No)
Village (No)
Total Population
Slide Collection
1 Areas with high Pf% 309
4267
1368937
190026
2 Of the above no. prioritized to be equipped
with RD Kits
154
2581
887502
113821
RDT reqd 500000
34
BEDNETS
District Name
Eligible Sub
Centre (Nos)
Eligible
villages (no)
Eligible Population
Total Bed nets required
Number of bed nets available in household survey(no)
2009-10
Required in the current year (no) 2011-12
Total planned to be distributed in
the year (no) 2010-11
Total planned
to be treated
ITNs LLINs ITNs LLINs
A B C D=A-C E F G=B+E
West Garo Hills 82 1735 642139 256856 282216 67500 89856 Nil 100000 282216
South Garo Hills 21 630 128883 51553 21761 32500 Nil nil 20000 21761
East Garo Hills 73 955 275000 110000 59000 50000 25000 nil 35000 59000
Ri-Bhoi 26 517 247965 99186 32916 Nil 99186 30000 Nil 62916
Jaintia Hills 27 122 70361 30000 35305 Nil 30000 13900 Nil 49205
West Khasi Hils 39 277 167122 66848 23853 Nil 66848 28600 Nil 55453
East Khasi Hills 27 410 208487 83395 22984 Nil 60411 15000 Nil 22984
Total 286 4605 1672688 670930 408748 150000 520930 87500 155000 496248
Total bed nets required = 670930 Already supplied = 305000 To be supplied = 10863 (already allotted) Net required = 257299 (2011-12)
35
Requirement of vehicle district wise:
Monitoring and supervision has been carried out using hired vehicle. The rate at Rs. 1000/day as per guideline is not acceptable by the transporter and as such hiring of vehicle at the state level has to be hired as per rate of the transporter which is at an average of Rs. 2500/day, which amount to a total of about Rs.3 lacs per year (minimum) (2500x10x12).
Vehicle Available
Requirements
State/District
Gypsy
Minitrucks
Gypsy/Bolero
Minitrucks
State hq1
1 (with heavy expenditure)
0 1 nil
West Garo Hills
1 1 nil nil
East Garo Hills
Nil
Nil
1
1
South Garo Hills
Nil
Nil
1
1
Ri-Bhoi
Nil
Nil
1
1
East Khasi Hills
1(with heavy
expenditure)
1
1
0
West Khasi Hills
0
0
1
1
Total
3 2 6 4
36
Action Plan on Chikungunya and Dengue:
District wise Distribution of Chikungunya and Dengue cases & deaths Sl No.
Name of District
Suspected Cases
Positive Cases
Death Remarks
Chikungunya Dengue 1. WGH 90 30 2 1 Death
due Dengue
2. EGH Nil Nil Nil Nil Nil 3. SGH Nil Nil Nil Nil Nil 4. WKH Nil Nil Nil Nil Nil 5 EKH Nil Nil Nil Nil Nil 6 JH Nil Nil Nil Nil Nil 7 RB Nil Nil Nil Nil Nil Diagnosis I. Establishment of SSS Laboratory Sl
No. Name of
SSSL identified
Facility available
Strengthening required
Cost (Rs. In lakhs)
1. Tura Civil Hospital
Pathologist i) Elisa Reader
i) Computer ii) Internet iii) Contingen
cy
4.5 0.50
Total 5.00 II. Apex Laboratory/Referral Lab (strengthening)
Name of Referral
Lab. Function Fund requirement
(Rs. In lacs) RMRC, Dibrugarh
1. Training of Lab personal of SSSL
1.00 2. Quality control of SSSL 3. Viral isolation & identified of other
viral activities
37
Requirement of Elisa Kits
Name of SSSL No of Kits Required
Tura Civil Hospital 1000 test
Vector Control
No. of district
No. of micro discharge fogging Machine required
Cost (Rs. In lacs)
7 i. 7 3.85 ii. Operation cost 20.00 Total 23.85
Capacity Building:
Sl No.
Category of staff No. to be
trained
Batches
Cost (Rs. In lacs)
Person responsible
1. Pathologist & Lab. Tech of SSSL
1 1.00 RMRC
2. MO Integrated with other vector borne disease
SPO 3. Para-medical DMO 4. ASHA I/C PHC Total 1 1.00
IEC/BCC:
Sl No.
Item Cost (Rs. In lacs)
1. Interpersonal communicative & group discussion 2.97 2. Production folder poster and distribution 1.50 3. Newspaper advertisement 0.30 4. Telecasting TV spot in local language 0.42 Total 5.78
Sample Total Dengue Total Chikungunya
90 88 2 77 30
38
Monitoring and Supervision
No. of district
Cost (Rs. In lacs)
7 2.00 Budget:
Sl No.
Component Cost (Rs. In lacs)
1 Apex lab referral lab 1.00 2. Laboratory up gradation 5.00 3. Vector control 23.85 4. Capacity Building 1.00 5. IEC/BCC 5.78 6. Monitoring and Supervision 2.00 Total 38.63
396 Spray workers @ 5000/- per month = 396 x 5000 x 1 month = 19.8 lakhs Grand Total = 58.43
39
Expenditure ( Financial Performance)- Budget Proposal for 2011-2012 (Rs. in lakhs)
2010-11 (Expenditure)
2011-12 (Proposed)*
Support to be met from NVBDCP/GoI or state resources or NRHM flexi fund
Malaria
DBS
MPW Nil 120.00
ASHA 2.00 15.1
Operational Cost including spray wages 49.00 102.5
NAMMIS Nil 5.0
IEC,BCC &PPP Nil 29.25
Training 23.8 10
LLIN (Transportation) 10.9
Additional support under World Bank (if applicable)
Human Resource -
Capacity building in project areas -
Mobility support -
Spray equipments 5.58
Additional support under GFATM (if applicable)
Capacity Building
Establishment State Society
Human Resource 20.09 105.19
Monitoring & Evaluation 20.00 30.92
BCC/PPP/Soc.Mkt. - 40.00
Drugs
Chloroquine phosphate tablets 10.4
Primaquine tablets 0.21/3.62
Quinine sulphate tablets 2.79 28.3
Quinine Injections 32.5
Sulphadoxine + Pyremethamine tablets
Microslides 1.25 3.12
Lancets .62 3.69
Slide box .63
Stain J.S.B.I 10.5 1.62
Stain J.S.B.II 1.62
40
Diagnostics
IRS
Wages
Human resource
Monitoring & Evaluation
Bednet
Impregnated mosquito nets
LLIN (Transportation) 0.0001 10.9
Insecticides
DDT 50% wdp
Synthetic Pyrethroid
Malathion 25%/Technical
UMS – Larvicides
For polluted water
For non-polluted water
Pyrethrum extract 2% Total Malaria 331.128 Filaria
Drugs (by GoI)
Training
BCC Preparatory activity (may be shown activity-wise including hydrocelectomy)
Drug distributor’s including ASHA and supervisors honorarium
Total (Filaria)
Dengue/Chikungunya Grant in respect of Dengue and Chikungunya Strengthening surveillance (As per GOI approval)
Apex Referral Labs recurrent @ Rs/
1.00 lakh
Sentinel surveillance Hospital recurrent
@ Rs. 0.50 lakhs
Test kits (Nos.) to be supplied by GoI
Operational cost
1.00 5.00 20.00
Monitoring/Supervision and Rapid Response 2.00 Epidemic Preparedness Fogging machine 3.85 IEC/BCC/Social Mobilization
5.78
Training/Workshop 1.00
Total Dengue/Chikungunya 38.63
AES/JE Diagnostics and Management 6.5
41
Elisa Kits IEC/BCC 2.4 Training 3.3 Monitoring and Supervision 1.5 Technical Malathion 2.7
Total AES/JE 16.4
Kala-azar (only for 4 states)
DDT 50%
Amphotericin-B
Miltefosine
RDK for Kala-azar
Case search
Spray Pumps
Operational cost for spray including spray wages
Mobility/POL
Training for spraying
BCC/IEC
Monitoring & Evaluation
Kala-azar Sub-Total (DBS)
Kala-azar World Bank Project assistance
Human resource
Capacity building
Mobility Kala-azar Sub-total (World Bank Project assistance)
Kala-azar Total
Grand Total
Any activity not listed and if required may be shown in separate row.
Outstanding balance………….. (as on previous month of submission of PIP). Committed expenditure ………….. (till March, 2011). Balance expected…………… (on 1.04.2011). This is most important as cash releases are based on the funds availability with state in totality and not head wise.
42
EXECUTIVE SUMMARY
In the state Meghalaya vector borne diseases are major public health problem. Malaria is endemic in 7 districts viz; EKH, WKH, RB, WGH, SGH, JH & EGH. Filaria is endemic in Nil districts viz; --------------------------------------. Kala azar is endemic in Nil districts viz; --------------------------------------. AES including JE is endemic in --- districts viz; WKH, EKH, RB (in pockets only). Dengue is endemic in --- districts viz; WGH (imported). Chikungunya is endemic in --- districts viz; WGH (imported) The requirement for programme implementation has been indicated in detail and the summary
is indicated below :
Disease Cash assistance from GoI 2010-11
Balance from previous years 2009-10
Committed expenditure
Net requirement
State resources
Malaria
a. DBS
b. World Bank for project states
c. GFATM for project states
19.31 Nil 1,27.68
51.00 nil
-
331.128 - 289.18
Filaria Kala-azar Kala-azar World Bank Project assistance
AES including JE 8 16.40 Dengue & Chikungunya 38.63 Total 154.99 675.34
43
BUDGET.
Total Requirement of fund for NVBDCP, Meghalaya for the year 2011-12 (in lacs of Rupees).
A. DBS. Requirement of fund.
(a) Salary for Contractual MPW. - Rs. 72.00
(b) ASHA Incentives - Rs. 15.1
(c) Spray wages - Rs.98.25
(d) DDT Dumping - Rs. 3.5
(e) Drugs. - Rs.30.95
(f) MIS (NAMMIS) - Rs. 5.00
(g) Spray - Rs. 5.58
(h) Construction of Hatcherys. - Rs. 6.00
(i) Maintenance of Hatchery. - Rs. 1.5
(j) Printing of Register and Formats. - Rs. 5.00
(k) IEC/BCC. - Rs. 8.00
(l) Training. - Rs. 21.7
(m) Impregnation of Bed nets. - Rs. 50.00
Total D.B.S. - Rs. 322.58
B. GFATM. Requirement of fund
1. Human Resource - 105.19
2. Training. - 11.00
3. Planning & Administrative. - 60.95
4. Monitoring and Evaluation. - 35.38
5. IEC. - 16.43
6. Operational expenses for treatment - 11.50
of Bednets.
Total GFATM - 240.45
Grand Total: - 563. 03
Proposed Action Plan:2011-2012
44
State:Meghalaya Currency in Lakhs
Component
Unit Cost in lacs of Rs
No. of Units Requirement of funds as reflected in PIP
Proposed allocation by NVBDCP
A. DBS a) Salary for contractual MPW (unit cost for the year per MPW)
0.72 100 72.00
B)ASHA incentive (a) BS Collection (b) R.D.K.Positive (c) Bsc Positive.
Rs. 5/- Rs.20/- Rs. 50/-
150426 (30% of Bsc) 22275 (30% of PFPositive) 61.41 (7% of Positive)
15.1
Spray Wages 98,25,000 DDT Dumping spray 3,50,000
Operational Exp for Fogging Drug (PQ, ,Cloroquine Syrup , Quinine Tablet 30.95
MIS (NAMMIS) 1 Laptop and AMC for computer with internet connectivity, training for District Staff
5,00,000
Spray Equipment (Materials & Maintenance) 5,58,000 Construction of Hatcheries 2 7 6,00,000 Maintenance of Hatcheries 0.5 7 1,50,000 Printing of Registers and Formats based on the new operational expenses
5,00,000
Quality Assurance scheme of Lab Diagnosis IEC/BCC 8,00,000 Training Health Supervisor / MPW (Male and Female) - 0.50 14 3,60,000 3.60 Rapid Response Team 1 1 1,00,000 1.00 Total DBS 1,66,13,000 166.13
45
Component
Unit Cost in lacs of Rs
No. of Units
Requirement of funds as reflected in PIP
Proposed allocation by NVBDCP
1.3 District
1.3.1 3.6 7 30000x7x12=25,20,000
1.3.2 Lab. Technician 1.2 10 10000x10x12=12,00,000
1.3.3 Block level MTS 1.8 21 15000x21x12=37,80,000
1.3.4 DEO 1.2 7 1000x7x12=8,40,000
Sub-Total
105.19
2. Training
a) Training of ASHA/ Community Volunteers in use of RDT, drug distribution and Bednet treatment detail Larvivorous fish (20 persons per course) (unit cost per training)
0.20 21 4,20,000 1,400.00 1,820.00
b) Training for Medical Officers (unit cost per training)
1 4 4,00,000
b) Training for Lab. Technicians (unit cost per training) (1)Induction (II)Re orientation
1.20 .80
1 2
1.20,000 1,60,000
Sub-Total 25,00,000
3. Planning and Administration
a) Office expenses for the state level per year (unit cost per year for state) 10.6 1 10.6
b) Office expenses for the district level per year (unit cost per year per district) 7 49.35
c) Accounting and Auditing Cost per year (unit cost per year for state) 1 1.00
Sub-Total 60.95
46
4. Monitoring and Evaluation a) Hiring of vehicles for field visit and supervision at state level each yaer (@ 1000/ day ) (unit cost per year for state) 3.0 1 3.0
a) Hiring of vehicles for field visit and supervision at district level @ 1000/ day for 7 days in a month (unit cost per year per district) .28 7 2.0
b1) Travel related expenses for State & District Level Officers( D.A & field contingency) (Unit cost per month) 1 0.240 7 1.68 b2) TA DA expenses for Consultant M&E For 10 days in a month (Unit cost per month) 0.2 12 2.40 TA DA for State level consultants i.e PC, FC , IEC 0.2 12 2.40
b3) DA for MTS (Unit cost per month) 0.06 21 12.60
c) Review meeting of States / district ( Annual Unit cost) 0.30 10 5.00
e) POL (Rs 2500 per months) (unit cost per month/ MTS) 0.3 21 6.30 Sub-Total 35.38
5. IEC
b) IEC Awareness campaigns 50% through state health & 50% through NGOs / CBOs / Panchayat (Unit cost per annum per district)
1500 per camp.
954 camps. 14,31,000
PPP
211800
6. Operational expenses for treatment of bed net * 0.001 1,15,000 11,50,000
Sub-Total 27,92,800
Grand Total GFATM 413.38
47
Component
Unit Cost in lacs of Rs
No. of Units
Requirement of funds as reflected in PIP
Proposed allocation by NVBDCP
B. GFATM
1. Human Resource
1.2 State
1.2.1 Financial Consultant @ one for each state
3 1 25000x12=3,00,000`
1.2.2 Project Director/ Coordinator @ one for each state
6 1 50000x12=6,00,000
1.2.3 IEC Consultant @ one for each state
3.6 1 30,000x12x360000
1.2.4 Statistical Assistant. 1.8 1 15000x12=180000
1.2.5 Secretarial Assistant (State) 1.2 1 10000x12=120000
1.2.6 DEO 1.2 1 10000x12=120000
b) Consultant M&E (Unit cost per month for state)
4.992 1 41600x12=499200
48
Sl.No
Component Total requirement
Cost 4% Vat Total cost
1. Chloroquine Tab. 20,00,000 10,00,000 @ .50/tab
4000 10,40,000
2. Primaquine 2.5mg. 80,000 20,000 @.25/tab.
800 20,800
3. Primaquine 7.5mg. 12,00,000 3,48,000 @.29/tab
13,920 3,61,920
4. Quinine Injection 40,000 3,12,000 @ 7.80
12,480 3,24,480
5. Tab Quinine Sulphate 1,11,386 2,71,782 @ 2.44/tab
10,871 2,82,653
6. Microslides 5,00,000 3,00,000 @ .60/slide
12,000 3,12,000
7. Lancets 6,00,000 3,54,000 @ .59/lancets
14,160 36,8,160
8. Slide box 500 60,000 @ 120/box
2,400 62,400
9 Stain J.S.B.I 2500 (100ml) 1,55,000 @ 62/100ml
6,200 1,61,200
10. Stain J.S.B.II 2500 (100ml) 1,55,000 @ 62/100ml
6,200 1,61,200
Total: 30,94,813
49
STOCK POSITION IN THE STATE HEAD – QUARTER AS ON 28-10-2010.
Sl.No. Items Balance Exp. Date
1. Chloroquine 65,100 09/14
2. Primaquine 7.5mg 1,15,000 06/11
3. Primaquine 2.5mg 5,600 07/11
4. Comblister Pack 1,15,975 5/2010
5. Arteerther Injection 9,643 282011
6. R.D.K. 1,075 4/2011
7. Artesunate 55,700 10/11
8. Comblister Pack (Act) 76 10/11
9. J.S.B. I 466 10/11
10 J.S.B. II 466 10/11
11. K. Othrine (2815 Exp. May, 2010 3,409 4/11
12. Blood Lancets 6,000 7/11
13. Microslides 11,000 8/11
14. Quinine Sulphate Tabs. 59,890 7/12
15. Sulpha pyre- methamine Tabs. 8,490 10/12
16. Quinine Injection. 7,900 04/13
50
BUDGET
PROPOSED ACTION PLAN 2011-2012
Component Unit Cost
in lac No. of Units
Requirement of funds as reflected in PIP (in lacs)
allocation by NVBDCP 2010-11
A. DBS
(a) Salary for contractual MPW 0.1 100 120 30
ASHA incentive (Rs.55/- per RDT test & complete treatment ) b) Preparation of slides * a) B.S Collection, (b) RDK POS, (c) BSC POS
0.00005 .00020 .00050
150426 22275 6141
15.1 5
Spray Wages 0.05 396 99 included in
121.98
DDT Dumping spray 0.05 7 3.5
Operational Exp for Fogging
Anti Malarial Drug .50/tab 20.00,000 10.4
Primaquine 7.5 mg .29/tab 12,00,000 3.62
Primaquine 2.5 mg .25/tab 80,000 0.208
Quinine Sulphate tab 2.44/tab 1,11,386 2.83
Quinine Inj. 7.80/Amp 40,000 3.24
SP tab
MIS (NAMMIS) 5 2.24
Spray Equipment (Materials & Maintenance)
5.58
included in 121.98
Procurement of Microscopes
Construction of Hatcheries 2 3 6.00
Maintenance of Hatcheries 0.5 7 1.50 Printing of Registers and Formats based on the new operational expenses
5.00 5
51
Quality Assurance scheme of Lab Diagnosis
IEC/BCC (awareness camp) 0.015 195 29.25 10
Training
Health Supervisor (M&F) 0.5 14 7 5
Lab Technician (Re-orientation) 0.8 2 1.6
Spray squads 0.2 7 1.4
LLIN (Transportation)
10.9
Total Malaria 331.128 179.22
* (a) - 30% of BSC include 4% Vat
(b) - 30% of PF Pos
(c) - 7% of Positive
Dengue/Chikungunya Grant in respect of Dengue and Chikungunya Strengthening surveillance (As per GOI approval) Ø Apex Referral Labs recurrent @ Rs/ 1.00 lakh Ø Sentinel surveillance Hospital recurrent @ Rs. 0.50 lakhs Ø Test kits (Nos.) to be supplied by GoI Operational cost
1.00
5.00
20.00
Monitoring/Supervision and Rapid Response
2.00
Epidemic Preparedness Fogging machine 3.85
IEC/BCC/Social Mobilization 5.78 Training/Workshop 1.00
Total Dengue/Chikungunya 38.63
AES/JE Diagnostics and Management 6.5 Elisa Kits IEC/BCC 2.4 Training 3.3 Monitoring and Supervision 1.5 Technical Malathion 2.7
52
Total AES/JE 16.40
Component Unit Cost
in Rs No. of Units
Requirement of funds as reflected in PIP in lacs
allocation by NVBDCP 2010-11
GFATM
1. Human Resource
1.1 State
Financial Consultant 0.25 1 3 85
IEC Consultant 0.3 1 3.6
Assistant/Computer Operator 0.1 1 1.2 Secretarial Assistant 0.1 1 1.2 Statistical Assistant 0.15 1 1.18
Consultant M&E 0.416 1 4.992
PSMC 0.35 1 4.2 sub-total 19.992 85 1.2 Setting up of 2 Sentinel Sites at Tura and Shillong
1. DEO 0.1 2 2.4
2. Lab -Technician 0.1 2 2.4 Procurement 1. Binocular Microscope
2. Desktop Computer with computer table, Chair , UPS, Printer
0.4 2 0.8
3.Accessories/Equipments etc. 0.5 2 1
sub-total 6.6
Strengthening of Entomological Cell at State Headquarter
1. Mobility 0.02 10X12 2.4
2. Entomological Equipments 0.4
3. DA for entomological team 0.4
4. Office Expenses - Stationeries 0.2
53
Sub-total 3.4
1.3District
1.3.1 Dist. VBD (Mal) Consultant 0.30x12 7 25.2
1.3.2 Salary to Accountant at District 0.10x12 7 8.4
1.3.3 Lab. Technician 0.10x12 10 8.4
1.3.4 MTS 0.15x12 21 37.8
1.3.5 SA cum DEO 0.10x12 7 8.4
Sub-Total 88.2 included in 85
Unit Cost
in Rs No. of Units
Requirement of funds as reflected in
PIP in lacs
allocation by NVBDCP 2010-11
2. Training
a) Training of ASHA/ Community Volunteers in use of RDT, drug distribution and Bednet treatment detail Larvivorous fish (20 persons per course) (unit cost per training)
b) Training for Medical Officers (unit cost per training) 25 nos
1 3 3.0
c) Training for Lab. Technicians (unit cost per training) 25 nos
d.Other MTS LQAS MTS for Refresher
0.50 0.50
1 1 0.50 0.50
Sub-Total 4.00
54
3. Planning and Administration
State
Office infrastructure- Laptop with all necessory software & Data card 0.5 3 1.5 45
Office infrastructure and equipment- Desktop with all with all necessory software & Broad Bank connection (3)
0.3 3 0.9
Office infrastructure and equipment- Office automation units (1) - Printer (1) , Copier (1), Fax (1), Scanner (1), Telephone with intercom facility (5)
0.5 3 1.5
Office expenses- Documantation and Printing 10x12 1 1.20
Office infrastructure and equipment ( Furniture etc..) 4 1 4
Office expenses- Space, Water, Electricity, Consumables and Rent etc.
0.4 1 0.4
Rent (Storage State) 12x12 1 1.08
Logistic arrrangement state to distt. (two round trips in a year) 0.15 7 2.1
Office expenses for the state level per year (unit cost per year for state)
3 1 3.00
Office expenses for the district level per year (unit cost per year per district)
1 7 7.00
Accounting and Auditing Cost per year (unit cost per year for state)
1 1 1.00
Sub-Total 23.68
District
Office infrastructure- Laptop with all necessory software & Data card (86)
0.5 7 3.5
55
Office infrastructure and equipment- Desktop with all with all necessory software & broad bank connection (86)
0.3 7 2.1
Office infrastruecture and equipment- Office automation units (1) - Printer (1) , Copier (1), Fax (1), Scanner (1), Telephone with intercom facility (1)
0.5 7 3.5
Office expenses- Documantation and Printing 0.05 7 0.35
Office infrastructure and equipment ( Furniture etc..) 1.2 7 8.4
Office expenses- Space, Water, Electricity, Consumables and Rent etc.
0.15 7 1.05
Rent (Storage Distt.) 0.04 7 3.36
Sub Total 22.26 45
Monitoring and Evaluation
Travel (State) Review Meeting (State with District) 0.3 12 3.6
Quaterly Meeting (At Distt Level) 0.1 12x7 8.4 Travel (Distt)
a) Hiring of vehicles for field visit and supervision at state level each year (@ 1000/ day )
0.02 3x10x12 7.2
a) Hiring of vehicles for field visit and supervision at district level @ 1000/ day for 7 days in a month
0.02 14x10x12 33.6
b. 1) Travel related expenses for District Level Officers( D.A & field contingency)
0.0015 17x5x10x12 15.6
Unit Cost No. of Units
Requirement of funds as reflected in PIP in lacs
allocation by NVBDCP 2009-10
56
b 2) TA DA expenses for Consultant M&E For 10 days in a month
0.2 12 2.4
TA DA for State level consultants i.e PC, FC , IEC
0.2 12 2.4
b. 3) DA for MTS (Unit cost per month)
0.06 21 12.6
c. Review meeting of States / district (Annual Unit cost)
d. POL (Rs 2500 per months) (unit cost per month/ MTS)
0.025 12x21 6.3
d. Provision of Motorcycles for MTS (Discovery 350cc)
Sub-Total 91.8 5. IEC
a. IEC Awareness campaigns 50% through state health & 50% through NGOs / CBOs / Panchayat (Unit cost per annum per district)
0.15 195 29.25
PPP Sub-Total 29.25 50 6. a. Operational expenses for treatment of bed net
b. Procurement of bednets (LLINs)
Sub-Total Total GFATM 289.18 220.00
GRAND TOTAL 675.34 399.22
Outstanding Balance Rs.( as on previous month of submission of PIP) 85,25,344 (12.2010)
Committed expenditure Rs. ( till march,2011)
Balance expected Rs.( on 1.04.2011)
NRHM
1. Operational expenses for Treatment of bednets
0.0001 5,00,000 55.3
b) Re-impregnation of bednets 0.0005 5.00,000 27.6 2. Synthetic pyrethorid 0.00154 5000 7.7 3. Salary of Mpw 0.1 100x12 120
57
4. Procurement of Vehicle (a) Gypsy In kind (b) Pickup Truck Total 210.60 Total cash assistance under NVBDCP 675.34 Total cash assistance required under NRHM flexi fund 210.60
Grand Total 885.94
Expenditure (Financial Performance) Budget Proposal
2010-2011
(Expenditure) 2011-2012 (Proposed)
(A) DBS (a) Salary of MPW 120 (b) ASHA 2.00 15.1 (c) Spray Wages & op.Cool 49.00 102.5 (d) IEC/BCC (Awareness Camps) 29.25 (e) Construction and maintenance of Hatcheris 7.5 (f) Printing of Registrets and formats 5 (g) Training 23.8 10 (h) Drugs & equipments 15.16 20.298 (i) Spray equipments 5.58 (j) MIS(NAMMIS) 5 LLIN (Transportation) 10.9 Total DBS 331.128 (B) Dengue/Chikungunya (a) Apex Referral Labs 1.00 (b) Estt. Of SSS Labs 5.00 © Operational Cost 20.00 (d) Monitoring & Supervision 2.00 (e) Procurement of Fogging Machine 3.85 (f) IEC/BCC 5.78 (g) Training 1.00 Total Dengue/Chikungunya 38.63
58
(C) AEC/JE (a) Diagnostic & Management 6.50 (b) IEC/BCC 2.40 © Training 3.30 (d) Monitoring & Supervision 1.50 (e) Technical Malathion 2.70 Total AES/JE 16.40 (D) GFATM (a) Human Resource 20.09 (i) State 19.99 (ii) District 88.20 (b) Sentinel Sites 6.4 © Training 4 (d) Planning and Admininstration State 23.68 District 22.26 (E) Monitoring & Evaluation 20 91.8 Entomological Cell 3.4 (F) IEC 29.25 Total GFATM 289.18
59
Revised National Tuberculosis Control Programme
Annual Plan for Programme Performance & Budget for the year 1st April 2011 to 31st March 2012 State: __Meghalaya_________________
Objectives: 1. To achieve and maintain a cure rate of at least 85% among newly detected infectious (new sputum
smear positive) cases, and 2. To achieve and maintain detection of at least 70% of such cases in the population
This action plan and budget have been approved by the STCS. Signature of the STO__________ _______ Name_______________ Dr(Ms)J.Nongrum Section-A – General Information about the State
1 State Population (in lakh) please give projected population for next year 2621000 2 Number of districts in the State 7 3 Urban population 439605 4 Tribal population 1863890 5 Hilly population 2621000 6 Any other known groups of special population for specific interventions (e.g.
nomadic, migrant, industrial workers, urban slums, etc.) 317505
(These population statistics may be obtained from Census data /State Statistical Dept/ District plans) No. of districts without DTC: __Nil____
No. of districts that submitted annual action plans, which have been consolidated in this state plan: ____7_
Organization of services in the state: S.
No. Name of the District Projected
Population (in Lakhs)
Please indicate number of TUs
of each type
Please indicate no. of DMCs of each type in the district
Govt NGO Public Sector* NGO Private Sector^
1 East Khasi Hills 744958 3 0 12 2 0 2 West Khasi Hills 331475 2 0 8 1 0 3 Ri-bhoi 217285 1 0 6 0 0 4 Jaintia Hills 333253 1 0 6 0 0 5 East Garo Hills 279001 2 0 5 0 0 6 West Garo Hills 581335 2 0 11 1 0 7 South Garo Hills 111694 1 0 3 0 0 Total 2599001 12 0 51 4 0 *Public Sector includes Medical Colleges, Govt. health department, other Govt. department and PSUs i.e. as defined in PMR report ^ Similarly, Private Sector includes Private Medical College, Private Practitioners, Private Clinics/Nursing Homes and Corporate sector
60
RNTCP performance indicators: Important: Please give the performance for the last 4 quarters i.e. Oct’ 09 to September’10
Name of the District (also
indicate if it is notified hilly or
tribal district
Total number of patients put on treatment*
Annualised total case detection
rate (per lakh pop.)
No of new smear positive cases put on treatment *
Annualised New smear
positive case detection rate (per lakh pop)
Cure rate for cases
detected in the last 4
corresponding
quarters
Plan for the next year Proportion of TB
patients tested for
HIV
No. of MDR TB
suspects identifie
d and subjects
to C/DST
of sputum
No. of MDR TB
cases diagnosed & put
on treatment
Annualized NSP case detection
rate
Cure rate
East Khasi Hills 2135 285 556 74(99%) 71% 80% 85% 15(1%) 10 0 West Khasi Hills 736 223 176 53(71%) 86% 80% 85% 16(3%) 10 0 Jaintia Hills 559 169 181 55(73%) 82% 80% 85% 9(16%) 0 0 Ri-bhoi 439 209 153 75(97%) 77% 80% 85% 50(11%) 0 0
East Garo Hills 269 97 114 41(54%) 85% 80% 85% 12(4%) 0 0 West Garo Hills 757 131 459 79(106%) 93% 80% 85% 96(13%) 6 0 South Garo Hills 115 105 112 102(136%) 75% 80% 85% 13(11%) 0 0 Total 5010 1219 1751 67(89%) 82% 1400 85% 211 26 0
* Patients put on treatment under DOTS regimens only are to be included.
61
Section B – List Priority areas at the State level for achieving the objectives planned:
S.No. Priority areas Activity planned under each priority area 1 Increase case holding
1 a)Initial and regular home visits 1 b)Counselling of patient and families of all cases with emphasis on NSP cases 1 c)Mobilize community support
2 To achieve and maintain cure rate >85%
2 a)Intensify supervision and monitoring in areas with low cure rate 2 b) Sensitisation of MO for correct categorisation. 2 c)Intensify monitoring of DOT providers performance.
3 To maintain >70% NSP case detection rate
3 a) To implement and monitor ACSM activities. 3 b) To maintain cases referral from PHIs to DMCs keeping in view the goals of universal access to TB care. 3 c)Capacity building of LTs and STLSs in maintaining quality of sputum collection and sputum microscopy is accurate.
4 Involvement of NGOs and PPs 4 a) Identify NGOs and PPs in district for involvement in RNTCP and sensitize them. 4 b)Monitoring of those NGOs those who are already involved in RNTCP.
5 Sputum conversion rate >90% 5 a) Ensuring that all Health care providers understand the importance of follow up sputum examination. 5 b) Intensify supervision monitoring of low performing areas. 5 c) To counsel patients regarding the treatment compliance.
6 Human Resources 6 a) Fresh training of new staff. Filling up of vacant post of DTO & MOTC.
6 b) Refresher and retraining as per need. Training of untrained key staff.
62
6 c) TBHIV refresher training.
6 d) CME to be conducted as per Action Plan.
7 Scaling up of Intensified TBHIV intensified package
1. Release of fund. 2. Training. 3. Printing and distribution of materials. 4. Regular SCC and DCC meeting. 5. Improve T.B.- HIV cross referral
8 Initiate MDR – Treatment activities
1. Formation of State DOT Plus Committee 2. Develop Action Plan 3. Identify DOTS Plus Site
Priority Districts for Supervision and Monitoring by State during the next year
S No
District Reason for inclusion in priority list
1 East Khasi Hills Low case holding 2 West Khasi Hills Routine monitoring 3 Jaintia Hills High default 4 Ri-bhoi Low case detection & low case holding 5 East Garo Hills Low case detection 6 West Garo Hills Routine monitoring 7 South Garo Hills Routine monitoring
63
Section C – Consolidated Plan for Performance and Expenditure under each head, including estimates submitted by all districts, and the requirements at the State Level
1. Civil Works
Activity No. required as per the
norms in the state
No. already upgraded/
present in the state
No. planned to be upgraded during
next financial year
Pl provide justification if an increase is planned in excess of
norms (use separate sheet if required)
Estimated Expenditure on
the activity
Quarter in which the planned activity expected to be
completed (a) (b) (c) (d) (e) (f)
STC/STDC/ IRL
1 1 0 0
SDS 1 1 0 DTCs 7 7 0 Repair and maintenance of
the existing 40950
TUs 12 12 1 -do- 20280 DMCs 52 51 2 -do- and upgradation of 2
general labs into RNTCP lab under Khliehriat TU
153770 2q11 & or need basis
DOT Plus site
2 0 2 2000000 3q11
TOTAL 22,15,000
64
2. Laboratory Materials
Activity Amount permissible as
per the norms in the state
Amount actually
spent in the last 4
quarters
Procurement planned during the
current financial year (in Rupees)
Estimated Expenditure for the next financial year for
which plan is being submitted
(Rs.)
Justification/ Remarks for (d)
(a) (b) (c) (d) (e) Purchase of Lab
Materials by Districts 511095 1149855 1500000 2000000 Amount proposed base on
expenditure during the last quarters.
Lab materials for EQA activity at STDC (eg. Lab consumables for
trainings, preparation of Panel slides etc)
Lab materials & consumables for
Culture/DST activity at IRL and other Accredited
Culture & DST labs in Govt. sector including
Medical Colleges
Total:- 20,00,000/-
65
3. Honorarium
Activity Amount permissible as
per the norms in the state
Amount actually spent in the last 4
quarters
Expenditure (in Rs) planned for current financial
year
Estimated Expenditure for the next financial year for which plan is being submitted
(Rs.)
Justification/ Remarks for (d)
(a) (b) (c) (d) (e) Honorarium for DOT
providers (both tribal and non tribal districts)
911860 1100000 1300000 90% of the patients are tribal 40% of the patients lived in difficult and inaccessible areas required DOT
providers. Sputum transportation is required from some PHCs to DMCs.
Budgeted amount includes estimate as per the norms for tribal patients, DOT
provider and transportation of sputum.
Honorarium for DOT providers of Cat IV
patients
Total:- 13,00,000
66
No. presently involved in RNTCP Additional enrolment proposed for the next fin. year
Community volunteers in all the districts* 1830 300
* These community volunteers are other than salaried employees of Central/State government and are involved in provision of DOT e.g. Anganwadi workers, trained dais, village health guides, ASHA, other volunteers, etc. Approved Budget for the last IEC activities of whole State 2010-11 : Rs.10,90,000 Total Estimated Budget for ACSM activities in the District for 2010-11: Rs.8,18,895 Total Estimated Budget for ACSM activities for State TB Cell for 2010-11: Rs.3,79,920 Amount spent by the State and Districts: 4,38,909 (from Oct 09 – Sept 10) TOTAL ESTIMATED BUDGET FOR ACSM ACTIVITIES IN MEGHALAYA for 2011-12: Rs.11,98,815
Budget for ACSM Activities as per respective challenges
Quarter wise No. of activities planned
State Own(S
tate TB
Cell) budget
Districts budget Total Budget South
Garo hills
West Garo Hills
West Khasi Hills
East Khasi Hills
Jaintia Hills
Ri Bhoi
East Garo Hills
1st Qrt
2nd Qrt
3rd Qrt
4th qrt
Sensitization meetings
32 42 45 38 157 9500 18000 12380 6000 24000 16280 17200 7000 110360
World TB Day
8 X X X 8 20000 15000 7500 20000 56000 12000 20000 12000 162500
Community meetings
32 34 34 32 132 6000 5000 11000 24000 36000 4000 4000 18000 108000
School activity
17 18 16 15 66 4000 25000 12700 10000 24000 3200 4200 5600 887000
Street plays 4 6 4 5 19 16000 6000 2700 0 0 0 0 0 24700
67
Patient provider interaction
178 178 178 178 712 0 9600 29000 24000 57600 28800 20000 10000 179000
Print publicity
2 2 1 1 6 6000 0 1015 0 0 0 0 0 61015
Wall writings 32 29 35 42 138 0 18000 6000 40000 18000 25700 16000 12000 135700 Media activity
6 5 7 6 24 100000 0 0 0 0 0 0 0 100000
CME/seminars
2 4 3 3 12 3000 0 0 0 0 4000 3200 0 10200
Other meetings/programmes/roadshow
18 22 20 17 77 10000 0 0 0 0 0 0 6000 16000
Banners 6 5 1 3 15 3000 4000 0 6400 0 0 0 0 13400 Any Other activities
12 7 8 10 37 8420 1000 4000 10000 0 2400 0 0 25820
Total 349 352 352 350 1403 239920 101600 86295 120400 215000 140400 84600 70600 10,58,815
68
4. IEC
Annual Action Plan Format Advocacy, Communication and Social Mobilization (ACSM) for RNTCP State own (State TB Cell)
1) Information on previous year’s Annual Action Plan a) Budget proposed in last Annual Action Plan: ……Rs.10,40,000…………. b) Amount released by the state: …4, 35, 000 (till September 2010)… c) Amount spent by the State: 1,87,236 (from October 09 – September 2010)
2) Permissible budget as per norm: 6, 50, 000…… 3) Budget for next financial year for the state own activity as per action plan detailed below: ………Rs.
3,79,920……………….
Program Challenges to be tackled by ACSM during the Year 2010-11
WHY
ACSM Objective
For WHOM Target Audience
WHAT
ACSM Activities
When
Time Frame
By
WHOM
Monitoring and Evaluation
Budget
Based on existing TB indicators and analysis of communication challenges (Maximum 3 Challenges )
Desired behavior or action (make SMART: specific, measurable, achievable, realistic & time bound objectives)
Activities Media/ Material Required
Q1 Q2 Q3 Q4 Key implementer and RNTCP officer responsible for supervision
Outputs; Evidence that the activities have been done
Outcomes: Evidence that it has been effective
Total expenditure for the activity during the financial year
Challenge 1. Low cure rate Advocacy Activities
Low cure rate
Increase involvement of eminent people in the community in RNTCP, explaining to
Headmen 1.Sensitization meetings 2. one on one interaction 3. World TB day events
Posters/banners
and pamphlets
on the impact of TB and
x x 1 x STO/DTO/IEC Officer
Attendance/Minutes/Photographs/feedback received
Increase in cure rate by 10% Study to document cure
3000x1=3000
MLAs/ other state authorities
1 1 1 1 2.No cost involved
NGOs/ Private
1
X
X
X
3.20000x1=20000
69
them the activities they can carry out to increase the cure rate as well as providing suggestions focusing on low performing districts
Health care providers
4.Interaction meetings
non complianc
e with treatment
, to be prepared at State TB Cell /media agency-
RED FM,AIR,PC
N, Doordarsh
an and others
x 1 1 x rate within one yr
4.1000x2=2000
Community groups
2 1 1 1
X 1 1 1
X 1 1
X 1 1
Posters: 6x5000=
30000 Pamphlets=5x6000=30000 Banners:500x5=2
500
Radio: 10000x4=40000
Cable
channels/Doordars
han: 15000
X4=60000
Communication Activities
Low cure rate
Motivating and sensitizing health care providers/community volunteers to improve counseling and providing patient friendly services and strictly follow DOT(focusing on low performing districts)
DOT providers
1.Sensitization meetings
Power point presentation/banners
x
1 1
x 1 STO/IEC Officer/DTO/MOTC
Attendance sheet/Minutes/Photographs/feedback received
1000x2=2000
Banner:500x1=50
0
70
Communicate with MOs to take accurate history of Patients, improve IPC skills
Medical officers
2.One on one interactions
Quarterly feedback on performance indicators
7 7 7 7 STO/ programme managers
Supervisory registers/feedback
No cost involved
Explain to patients and family about the importance of treatment compliance Renumeration for Communication Facilitators**
TB patients 3.Counseling/house visits
TB Patient booklet
1
1
1 1 STO/IEC Officer/CFs/STS
Attendance/minutes and feedback/photographs
No cost involved
1,40,000
Social Mobilization activities
Low cure rate
Sensitizing and involving the communities( church leaders, youth groups, etc) in supporting TB patient and providing information about Tuberculosis and the need for their support
1.General public 2. Schools 3. Colleges 4. World TB Day events
1. Community Meeting/ 2.awareness through advertisements
Pamphlets /banners/newspapers advertisement
1 1
1 1
1 1
1 1
STO/IEC Officer/CFs/NGOs
Attendance/minutes and feedback/photographs
1.1500x4=6000
Newspaper/articles ads: 2105X4=84
20
2.school programmes (lecture, quiz, drawing competitions)/role plays
Flip chart/presentations/chart paper/prizes
1 1 1 x IEC Officer/CFs/NGOs
Minutes/photographs/no. of participants
2.1000x3=3000
Materials:10x100=1000
3. street plays 4.road show
Pamphlets /Banners
2 1
x X
x X
x X
STO/IEC Officer/CFs
Minutes/photographs/no. of participants
3.8000x2=16000
4.8000x1=8000
71
Challenge 2: High Default Rate Advocacy Activities
High Default Rate
Sensitizing state authorities about the importance of reducing default cases & for their support for necessary instructions to the programme staff
1.Health care providers Public & Private
1.Interaction Meetings 2.One to One Interaction Meetings 3. Use of quarterly performance
Audio Visual Aids -Posters-booklets/brochure -poster in local language -Factsheets -success stories
1 1 1 1 STO(with support from WHO Consultant)
Review of default case TU wise Minutes of meetings
Reduction in default rate by 2% - Data analysis Study to document default within one yr
No cost involved
Communication Activities High Default Rate
To motivate patients & their families for completion of treatment Increase in no. community based involvement
Patients, Their Family Members, DOT Providers
1. Sharing of experience of cured patients / Patients during Treatment.
Patient interaction meetings & involvement of cured persons Development of material for Community DOT Providers
X
X
X
X
MO, STS & Communication facilitators
Records of meeting Evidence of material development – pre testing
Reduction in default rate by 2%- Analysis of programme data Reduction in time for retrieval of defaults
1.No cost involved
NGOs
2.Sensitization meetings
x x 1 x STO/ IEC Officer
2. 1500x1=1500
72
Social Mobilization
High Default Rate
To link poor patients to the welfare schemes
Departments Social welfare schemes
1.Sensitization meeting
Posters, programme fact sheet, Presentation Annual reports
x
X
1
X
STO/IEC officer
Documentation, Records , Photographs
Reduction in defaults Documentation of effectiveness of such linkages through a study after one year
1.1500x1=1500
Involvement of cured TB Patients for support
To link cured patients with defaulters
2.Sensitization meetings
x x 1 x STO/DTO/ IEC Officer/ CF/STS
Records of meetings, attendance
Documentation of effectiveness of such linkages through a study after one year
2.1000x1=1000
Challenge 3:- Re-treatment cases
Advocacy activities
Re-treatment cases
Sensitizing programme staff on the importance of supporting re-treatment cases
1.DTOs/MOTCs
One on one interaction
Quarterly feedback base on performance indicators cure rate and detection of re-treatment cases
7 7 7 7 STO/DTO/MOTC
Minutes/ supervisory registers
Documen- tation of effectiven- ess of such interactio-ns based on quarterly reports through a study after one year
No cost involved
Communication activities
Re-treatment cases
Capacity-building of the TU teams
RNTCP staff at TU level
1.Sensitization meeting
TB indicators at TU
1 1 x x STO/IEC officer
Minutes/ attendance
Documen-tation of improve
No cost involved
73
for improving support for patients under re-treatment
levels ment /Feedback after one year
Private and public health care providers
1.Private practitioners 2.MOs
1.Seminars/CMEs in collaboration with STF
Audio and visual aids/ materials prepared at state level pertaining to re-treatment cases/ banners
x x 1 X 1
STF(with support from WHO Consultant)/DTO/IEC Officer
Records/ publication/feedback
Achievem-ent of performance indicators as per national target after a year
3000x1=3000
Social Mobilization Activities
Re-treatment cases
To mobilize support from communities
1.Headmen/youth groups/women’s groups
1. Community meetings
Pamphlets / other materials prepared/visual aids
Projected above STO/ IECO/CFs/NGOs
Minutes/photographs
Improvement an increase in cure rate and detection of retreatment cases
Budgeted above
TOTAL BUDGET Rs.379920
NOTE: - Printing of materials and media activity will be carried out at state level (exception: West Garo hills and Jaintia hills district). Comment: Amount spent by the State TB Cell does not include the expenditure for quarter ending December ’09 as there are certain committed expenditure/ liabilities. ** Budget for Communication Facilitators involvement included in ACSM Action Plan 2010 as per direction from CTD: Rs.1, 40,000 Total Estimated Budget for ACSM activities in the District: Rs.8,18,895 Total Estimated Budget for ACSM activities for State TB Cell: Rs.2,39,920+Rs.1,40,000(CF)=3,79,920 TOTAL ESTIMATED BUDGET FOR ACSM ACTIVITIES IN MEGHALAYA as per approved budget from CTD: Rs.11,98,815
74
5. Equipment Maintenance:
Item No. actually
present in the state
Amount actually spent in the last 4
quarters
Amount Proposed for Maintenance during current financial yr.
Estimated Expenditure for the next financial year for
which plan is being submitted
(Rs.)
Justification/ Remarks for (d)
(a) (b) (c) (d) (e) Computer
(Maintenance includes AMC, software and hardware upgrades, Printer Cartridges and
Internet expenses)
26 314648 275000 480000 Equipment includes computers, photocopier and OHP each in DTCs and STCs and 1 Fax at
State and 1 LCD projector. Estimated amount also includes
purchased of Toners etc. Binocular Microscopes (RNTCP) 76 185000 185000 220000 AMC for Microscopes is
managed by State and the cost is high as the firms are from outside
North East. STDC/ IRL Equipment Any Other (pl. specify)
TOTAL : 4,99,648 4,60,000 7,00,000
75
6. Training:
Activity No. in the state
No. already trained in RNTCP
No. planned to be trained in RNTCP during each quarter of next FY (c)
Expenditure (in Rs)
planned for current
financial year
Estimated Expenditure for the next financial year
(Rs.)
Justification/ remarks
(a) (b) Q1 Q2 Q3 Q4 (d) (e) (f) Training of DTOs (at National level) 7 3 2 2 0 0 As per scheduled at
the National level for new turn over and
expenditure budgeted from Miscellaneous
head Training of MO-TCs 12 12 2 12000 15000 New TU at
Khliehriat and if any turn over.
Training of MOs (Govt + Non-Govt) 592 497 25 25 25 20 166000 227000 Training of LTs of DMCs- Govt + Non
Govt 113 82 15 16 48000 52000
Training of MPWs 1198 924 30 30 91500 114500 Training of MPHS, pharmacists, nursing
staff, BEO etc 1247 919 50 50 131000 230000
Training of Community Volunteers 7400 1830 50 50 164000 365180 Training of Pvt Practitioners 79 29 10 10 10 22000 27000
Other trainings #
0 0 0 0 0 0 0
Other trainings Medical College STF Chairperson
0 0 0 0 0 0 25000
Other trainings Medical College TOTs
3 3 2 0 30000
Other trainings Medical College Others faculty members
0 0 0 0 0 0 26000
Re- training of MOs 592 497 50 50 50630 85000 Re- Training of LTs of DMCs 48 21 15 15 22000 30500
Re- Training of MPWs 741 489 50 50 38265 90330
76
Vehicle Maintenance:
Re- Training of MPHS, pharmacists, nursing staff, BEO
793 270 25 25 38125 155675
Re- Training of CVs 2094 1079 50 50 50 23180 93050 Re-training of Pvt Practitioners 13 0 500 0
Activity No. in the state
No. already trained in RNTCP
No. planned to be trained in RNTCP during each quarter of next FY (c)
Expenditure (in Rs) planned for current financial
year
Estimated Expenditure for the next financial year
(Rs.)
Justification/ remarks
Q1 Q2 Q3 Q4 TB/HIV Training of MO-TCs and MOs 315 141 50 50 50 50 0 110360
TB/HIV Training of STLS, LTs , MPWs, MPHS, Nursing Staff, Community
Volunteers etc
6705 0 50 50 50 50 0 104360
TB/HIV Training of STS 6 3 7 0 76000 Training of MOs and Para medicals in
DOTS Plus for management of MDR TB 528 0 0
Provision for Update Training at Various
Levels # Review Meetings at State Level Review Meetings for STF
57
0
40
7
0
0
0
7
1 1
1 1
1 1
1 1
21500
70000 0
80000 60000
34045
Any Other Training Activity Retraining of part-time accountants Retraining of STS and STLS
7
7
# Please specify
TOTAL :- 19,50,000
77
Type of Vehicle Number permissible as
per the norms in the state
Number actually present
Amount spent on POL and Maintenance in
the previous 4 quarters
Expenditure (in Rs) planned for current
financial year
Estimated Expenditure for the next financial year for which plan
is being submitted (Rs.)
Justification/ remarks
(a) (b) (c) (d) (e) (f) Four Wheelers 8 8 846216 1372500 1545000 POL of Vehicle of
Maintenance includes Vehicle insurances for all Vehicles in the
State. Two Wheelers 12 12 279935 416500 606000
TOTAL 11,26,151 17,89,000 21,51,000/-
78
8. Vehicle Hiring*:
Hiring of Four Wheeler
Number permissible as per the norms in
the state
Number actually requiring hired
vehicles
Amount spent in the prev. 4
qtrs
Expenditure (in Rs) planned for current
financial year
Estimated Expenditure for the next financial year for
which plan is being submitted (Rs.)
Justification/ remarks
(a) (b) (c) (d) (e) (f) For STC/ STDC 2 Rs.3.6lakhs
3,60,000/-
(1) STO vehicle not road worthy.(2)Amount for STC officer within the State HQ
1500/- per day within district, outside district 2500/- per day. As the
approved budget of Rs.850/- per day for hiring vehicle is not feasible for
both state and district. This proposed budget NRHM
norms of Govt of Meghalaya.
For MOTC 12 221878 709200 Rs 12.09 lakhs 1209600
Rs 1500/-per day for district. As the approved
budget of Rs.850/- per day for hiring vehicle is not
feasible for both state and district. This proposed
budget as NRHM norms of Govt of Meghalaya.
Total 15, 69,600/-
* Vehicle Hiring permissible only where RNTCP vehicles have not been provided
79
9. NGO/ PP Support: NGO/ PP Support: (New schemes w.e.f. 01-10-2008)
Activity No. of currently
involved in RNTCP
Additional enrolment
planned for this year
Amount spent in the
previous 4 quarters
Expenditure (in Rs) planned for current
financial year
Estimated Expenditure for the next financial year for which plan is
being submitted (Rs.)
Justification/ remarks
(a) (b) (c) (d) (e) (f) ACSM Scheme: TB advocacy,
communication, and social mobilization 8 0 121000 70000 292525
The amount planned is
increase due to the
involvement of CBCI.
SC Scheme: Sputum Collection Centre/s 3 3 22500 75250 360000
Transport Scheme: Sputum Pick-Up and Transport Service 2 4 26000 112250 144000
DMC Scheme: Designated Microscopy Cum Treatment
Centre (A & B) 3 0 150000 525000 560000
LT Scheme: Strengthening RNTCP diagnostic services 0 0
Culture and DST Scheme: Providing Quality Assured
Culture and Drug Susceptibility Testing Services
0
Adherence scheme: Promoting treatment adherence 5 3 63000 680000
Slum Scheme: Improving TB control in Urban Slums 1 1 82500 99500
Tuberculosis Unit Model 0 TB-HIV Scheme: Delivering TB-
HIV interventions to high HIV Risk groups (HRGs)
1 0 72000
Total : 10,00,000 21,36,025
80
10. Miscellaneous:
Activity* e.g. TA/DA, Stationary, etc
Amount permissible as
per the norms in the state
Amount spent in the previous 4
quarters
Expenditure (in Rs) planned for current
financial year
Estimated Expenditure for the next financial year
(Rs.)
Justification/ remarks
(a) (b) (c) (d) (e) Payment of
Stationery, TA/DA of staff, Telephone Expenses, Sputum Collection Kit, etc,.
Transport arrangements of
Drugs Transportation to
Districts
1152309 1100000 1743000 TA&DA for the training of DTOs at National level.
TOTAL 17,43,000 * Please mention the main activities proposed to be met out through this head
81
11. Contractual Services:
Category of Staff No. permissible as per the norms in the state
No. actually present in the state
No. planned to be additionally hired during this year
Amount spent in the previous 4
quarters
Expenditure (in Rs) planned for current fin. year
Estimated Expenditure for the next financial
year (Rs.)
Justification/ remarks
(a) (b) (c) (d) (e)
Asst. Programme Officer/Epidemiologist 1 0 1 80000 480000 496000 Increment 5%.
DOTS Plus site Sr.M.O 1 0 1 - - 360000
DOTS Plus site S.A 1 0 1 - - 180000
MO-STCS 1 0 1 60000 360000 372000 -do-
State Accountant 1 1 0 178530 226800 222300 -do-
State IEC Officer 1 1 0 237150 226800 220500 -do-
Pharmacist 1 0 1 - - 144000 -do- (Store keeper is an existing staff with the implementation of
DOTS Plus Pharmacist is needed.) Secretarial Asst 1 1 0 25200 25200 25200
MO-DTC
STS 12 12 1 2009100 1807300 2198480 5%
STLS 12 12 1 2040900 1807300 2198480 -do-
TBHV 7 6 6 600540 534200 616560 -do-
DEO 8 8 0 1017300 837800 910155 -do-
Accountant – part time 7 7 0 261200 239000 285890 -do-
Contractual LT 1 228300 95000 125055 -do-
Driver 1 2 91300 88200 260400 Driver deputed from the DM&HO were taken back due to workload
at DM&HO. Any other contractual post approved
under RNTCP- Store keeper 1 1 0 24000 24000 24000
Store Assistant ( State drug Store)
Any other contractual post approved under RNTCP- communication facilitator
TOTAL : 86,39,020
82
12. Printing:
Activity Amount permissible as per the norms in
the state
Amount spent in the previous 4
quarters
Expenditure (in Rs) planned for current
financial year
Estimated Expenditure for the next financial year for which plan is being submitted
(Rs.)
Justification/ remarks
(a) (b) (c) (d) (e) Printing-State level:*
511095 574300 500000 600000/- Expenditure of last 4 qtrs upto
Sept-10. Printing- Distt. Level:*
Total:- 6,00,000/- * Please specify items to be printed in this column
13. Research and Studies (excluding OR in Medical Colleges):
Any Operational Research project planned (Yes): (Post Graduate grant for one research paper OR and studies included in the Medical College Action Plan from each Medical College) Estimated Budget (to be approved by STCS).
83
14. Medical Colleges
Activity Number in Medical College
Amount permissible as per norms
Estimated Expenditure for the next
financial year(Rs.)
Justification/ remarks
(a) (b) (d) (e) Civil Works & Maintenance
DMC & DOTs Centre DOTs Plus Sites /IRLs
1
Nil
1000/-
1000/-
Routine
Contractual Staff: MO (In place: Yes/No) STLS (In place: Yes/No) LT (In place: Yes/No) TBHV (In place: Yes/No)
1 1 1
30800/-
10350/-
8800/- TA =750/-
369600/-
124200/-
105600/- TA = 9000/-
5% increment per year for all 3 staff
Research and Studies: Thesis of PG Student Operations Research*
1 3
20000/- 500000/-
20000/- 500000/-
Travel Expenses for attending STF/ZTF meetings
1 ZTF 1 NTF 1 OR
30000/- 25000/- 2x5000/-
30000/- 25000/- 10000/-
ZFT for 4 NTF one person OR for 2 persons
ACSM: Meetings and CME planned 2 CME 2x50000/- 100000/- 2 State level CME Training:
Faculty members, Residents, interns, nursing staff, paramedical staff etc.
2 Sensitization Programme
2x2500/- 50000/- 5 days MO training not feasible at present
Total 1299200/- 1299400/-
84
15. Procurement of Vehicles:
Equipment No. actually present in the
state
No. planned for procurement this
year (only if permissible as per
norms)
Estimated Expenditure for the next financial year for
which plan is being submitted (Rs.)
Justification/ remarks
(a) (b) (c) (d) 4-wheeler ** 8 2 1118000 Replacement of the existing, as they are in a
very bad condition already seven years for West Khasi Hills and South Garo Hills 5 four
wheeler planned during the current year written approval awaited.
2-wheeler 12 5 325000 -do- Total:- 14,43,000
** Only if authorized in writing by the Central TB Division
85
16. Procurement of Equipment:
Equipment No. actually present in the state
No. planned for this year (only as per
norms)
Estimated Expenditure for the next financial year for
which plan is being submitted (Rs.)
Justification/ remarks
(a) (b) (c) (d) Office Equipment
(Computer, modem, scanner, printer, UPS etc.) Laptop
26
0
1
1
280000
40000
The existing photocopier in the State needs to be replace as the present set is in used more than 7 years. With frequent breakdown and
the maintenance cost is too high. Procurement of equipment required during
training and meeting for presentation of information.
Computer , monitor , printer, UPS, CPU need to be replace as the present sets are in use for more than 6 years for Ribhoi and Photocopier for the East Khasi Hills as the presents set is irreparable.
Any Other UPS 8 9 0 Total:- 3,20,000/-
86
Section D: Summary of proposed budget for the state –
Category of Expenditure Budget estimate for the coming FY 2011- 2012
(To be based on the planned activities and expenditure in Section C)
1. Civil works 22,15,000 2. Laboratory materials 20,00,000 3. Honorarium 13,00,000 4. IEC/ Publicity 11,98,815 5. Equipment maintenance 7,00,000 6. Training 19,50,000 7. Vehicle maintenance 21,51,000 8. Vehicle hiring 1569600 9. NGO/PP support 21,36,025 10. Miscellaneous 17,43,000 11. Contractual services 86,39,020 12. Printing 6,00,000 13. Research and studies 0 14. Medical Colleges 12,99,400 15. Procurement –vehicles 14,43,000 16. Procurement – equipment 3,20,000
Total:- 2,92,64,860/-
(Rupees Two Crores ninety two Lakhs sixty-four thousand eight hundred and sixty) only.
Additionality Funds from NRHM-Details of the activities with justification for which
Additionality Funds are proposed to be sought.
87
National Programme for Control of Blindness
ACTION PLAN 2011 - 2012 Sl.No Name of Activity Physical Targets
1 Cataract Operations 2,000
1.1 I.O.L Implantation. 1,800 (90%)
1.2 Women Beneficiaries. 1,100 (55%)
1.3 Surgery on Bilaterally blind. 1,000 (50%)
1.4 SC/ST/BPL Beneficiaries. 1,000 (50%)
2 School Eye Screening
2.1 Children to be Screened. 1,00,000
2.2 Probability of Children detected with refractive errors. (10% of 2.1)
10,000
2.3 Free spectacles to be provided (30% of 2.2). 3,000
Physical Target For 2011-12 District Wise Distribution
Indicators East Khasi Hills
West Garo Hills
East Garo Hills
South Garo Hills
Ri-Bhoi District
Jaintia Hills
West Khasi Hills
Total
Catops 1000 400 100 100 100 200 100 2000
I.E.C. 30 20 10 5 10 10 20 105
S.E.S 45,000 20,000 7,500 5000 7,500 7,500 7,500 1,00,000
88
TRAINING FOR THE YEAR 2011-12 Training of Eye Specialist Sub Speciality in: Medical Retina - 1
Occuloplasty - 1
IOL - 3
Phaco - 1
Training of M&H.O’s in diagnosing Operable Cataract - 100
Training of Nurses in ophthalmic techniques - 7
Training of Teachers for School Eye Screening - 500
Training of Selected Link Workers - 600
89
FINANCIAL STATEMENT FOR 2010-11(Figures in lakhs) FUNDS
PROPOSAL APPROVED AMOUNT
RELEASED OPENING BALANCE
TOTAL EXPEN DITURE
TILL DEC, 2010
% OF UTILI SATION TILL
DEC 2010
CLOSING BALANCE TILL DEC,
2010
PROPOSED EXPENDITURE
TILL MARCH,2011
% OF UTILISA
TION TILL March 2011
CLOSING BALANCE AT THE END OF MARCH ,2011
PRO- POSED
BUDGET FOR
2011-12
247.80 174.80 126.64 90.36 217.00 43.75* 20.16% 173.25 166.81** 97.03% 06.44 318.20
* Recurring GIA - 29.28 Non-recurring GIA - NIL Contractual Man Power - 14.47 ** 30.00 - Jaintia O.T 40.00 - NEIGRIHMS 1.30 - Consolidation Auditor’s fees 1.00 - UPS 15.00 - Districts 1.00 - AMC 0.50 - I EC 0.65 - Furnishings of EYE OT 2.36 - Salary till March,2011 75.00 - Ri Bhoi Eye O.T & Eye Ward
90
(*) = Recurring Grant in Aid for Free Cataract Operations and various other schemes which include: Other Eye Diseases @ Rs. 1000/-, School Eye Screening Programme @ Rs. 200/- per pair of spectacles, Private Practitioners @ as per NGO norms, Management of State Health Society and District Health Society @Rs.14 lakhs/ 7 lakhs, Recurring GIA to eye Donation centres @ Rs.1000/- pair of Eye Ball collection and Eye Banks @ Rs. 1500/- per pair of Eye Ball collection Rs.1500, Training , IEC, Procurement of Ophthalmic Equipment, Maintenance of Ophthalmic Equipments , Remuneration, Other Activities & Contingency. (**) As at Annexure I
NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS GRANT-IN-AID TO STATES/UT’S FOR VARIOUS COMPONENT DURING 2011-12
PHYSICAL TARGET
FUNDS REQUIRED (in lakhs)
RECURRING GRANT-IN-AID(*) RECURRING GRANT-IN-AID(**)
For free cataract operations @ rs.750/- per case and other approved schemes as per financial norms(*) Proposal from Bansara Eye Care Centre
2000 189.80
42.6
NON RECURRING GRANT-IN-AID:
For Eye Wards & Eye OTs @ Rs. 75 LAKHS 1 75.00
CONTRACTUAL MANPOWER
Ophthalmic Surgeons Ophthalmic Assistants
2 5
6.00 4.80
TOTAL GRANT-IN -AID 318.2
91
ACTIVITIES MBCS EAST KHASI HILL
WEST KHASI HILLS
JAINTIA HILL
DISTRICT
RI-BHOI DISTT
EAST GARO HILLS
WEST GARO HILLS
SOUTH GARO HILLS
TOTAL FINANCIAL TARGET
(IN LAKHS)
CATOPS - 1000 100 200 100 100 400 100 2000 15.000
*TRAINING
1).M&H.O’s 25 - 30 20 5 5 10 5 100 0.975
2). TEACHERS - 200 100 60 25 40 50 25 500 4.300 3). ASHA’S & HEALTH WORKERS
- 150 100 50 40 10 40 10 400 3.440
4). ANGANWADI’S - 50 50 20 20 20 30 10 200 1.720
SCHOOL EYE SCREENING
Children to be Screened - 45,000 7,500 7,500 7,500 7,500 20,000 5,000 1,00,000
Children Detected with Refractive Error
- 4,500 750 750 750 750 2,000 500 10,000
Children provided with Free Specs
- 2,250 375 375 375 375 1,000 250 5,000 12.500
EQUIPMENTS
PHACO - 1 - 1 - - - - 2 32.000
B.SCAN - 1 - - - - - - 1 15.000 APPLANATION TONOMETER
- 1 - - - - 1 - 2 1.200
A.M.C - - - - - - - - 8.000
92
Programme Implementation Plan (P.I.P) of the Meghalaya Blindness Control Society 2011-12 *Training Details Medical &Health Officer’s - 20 per batch x 5 Batches = 100
Teachers - 20 per batch x 25 batches = 500
AHSA’S & Health Workers - 20 per batch x 20 batches = 400
Anganwadi’s - 20 per batch x10 batches = 200
EYE WARDS & O.T - - - - - - 1 - 1 75.000
SALARIES 13.62 - - - - 1.56 1.56 6.36 23.10 23.100
HONORARIUM 0.24 0.24 0.24 0.24 0.24 0.24 0.24 0.24 1.92 1.920
WAGES 0.50 0.30 0.24 0.25 0.25 0.25 0.25 0.25 2.29 2.290 OPERATIONAL COSTS
TA/DA 0.25 0.50 0.50 0.50 0.50 0.50 0.50 0.50 3.75 3.750
Fee to CA 0.15 0.15 0.05 0.05 0.05 0.05 0.05 0.05 0.60 0.600 POL & Hiring of Vehicles 3.50 2.00 1.60 1.00 1.50 1.50 1.50 1.50 14.10 14.100
I.E.C 1.50 1.00 0.60 0.80 0.50 0.50 1.00 0.50 6.40 6.400
O.T. Requirements 4.50 10.00 2.50 5.00 2.50 2.50 10.00 2.50 39.50 39.500 Other Contingencies 5.00 5.00 0.80 1.00 0.50 0.50 1.00 1.00 14.80 14.800
Total 275.595
93
Expenditure
M & H.O’s Teachers ASHA’S & Health Workers
AWW’s Total
Honorarium to faculty
Rs.500 x 5 =Rs.2500
Rs.200 x 25 =Rs.5,000
Rs.200 x 20 =Rs.4,000
Rs.200 x 10 =Rs.2,000
Rs.13,500
Light Refreshment per participant @Rs.150.00
Rs.150 x 100 =Rs.15,000
Rs.150 x 500 =Rs.75,000
Rs.150 x 400 =Rs.60,000
Rs.150 x 200 =Rs.30,000
Rs.1,80,000
Training Materials per participant
Rs.200 x 100 =Rs.20,000
Rs.100 x 500 =Rs.50,000
Rs.100 x 400 =Rs.40,000
Rs.100 x 200 =Rs.20,000
Rs.1,30,000
Contingency per Programme @ Rs.12,000
Rs.12,000 x 5 =Rs.60,000
Rs.12,000 x 25 =Rs.3,00,000
Rs.12,000 x 20 =Rs.2,40,000
Rs.12,000 x10 =Rs.1,20,000
Rs.7,20,000
Total Rs.97,500 Rs.4,30,000 Rs.3,44,000 Rs.1,72,000 Rs.10,43,500
94
NATIONAL LERPOSY ERADICATION PROGRAMME
Format for inclusion in the PIP FOR 2010 – 2011 1. STITUATION ANALYSIS: STRENGTH: i) Trained District Nucleus Staff ii) Trained and Motivated GHC Staff iii) Availability of Guidelines from Government of India from time to time. iv) Availability of adequate and effective MDT
v) Good coordination with DLOs, MOs, GH Staff with other department like Education, Social Welfare. vi) Ability in looping Missionaries of Charity (Shantivan, Nongpoh) into the system has enable the programme to be extended to the Person Affected by Leprosy (LAP) taking treatment there.
WEAKNESS: i) Lack of vehicles lead to poor Monitoring and Supervision
ii) Lack of Periphery Staff. Because of Multi purpose programmes under the umbrella of NRHM, the staff cannot concentrate on one single programme. iii) The State Leprosy Officer has other responsibilities eg. Is also functioning as State Surveillance Officer, IDSP and also entrusted with other official works in the Directorate and therefore cannot fully concentrate on the programme. OPPORTUNITY: Integration of General Health Care System under the umbrella of the NRHM, coordination with other Departments and involvement of NGOs, Members of the community will help in creating awareness of the programme and also to reduce the stigma and discrimination to the Leprosy affected person. THREATS: Leprosy being a communicable disease and the State having a porous borders and both national and international on all four sides, there is a threat that this disease may spread through these areas. New initiatives suggested to improve physical & financial performance. Physical improvement of the activities of the Society is dependant on timely and adequate release of funds. Presently funds are released in two installments, in November and January. The funds are received at the District level in the following months resulting timely implementation difficult. It is therefore suggested that arrangements are made for early release of funds.
95
2. PERFORMANCE UNDER NLEP:
Indicators 2007-08 2008-09 2009-10 2010-11 upto Nov.
2010 No. of new cases detected (ANCDR/10,000)
14 0.50
17 0.60
20 0.68
57 2.00
No. of cases on record at year end (PR/10,000)
43 0.15
36 0.07
48 0.11
95 0.24
No. of Grade II disability among new cases (%)
Nil 5% 20% 84%
Treatment Completion Rate 30% 45% 63% N.A. Re-constructive Surgery conducted
0 0 0 12
(Cumulative number to be mentioned and rate/percentage to be given in brackets) 3. INFRASTRUCTURE: a) State Leprosy Cell - 1 (one) State Leprosy Officer – in position 1 1 (one) Zonal Leprosy Officer - vacant b) MLES - 1 (one) i.e.Budget & Finance Officer – in position 1 1 (one) Surveillance Medical Officer - vacant 1 (one) Administrative Assistant Appointment 1 (one) Data Entry Operator issued
1 (one) Driver – State level 6 Drivers in the District – in position 6 1 (one) additional Driver for remaining 1 (one) District is proposed 4. TRAINING PLAN: a) 4 days Training of Newly appointed MO (Rural & Urban)- 60 b) 3 days Training of Newly appointed Health Worker - 70
and Supervisor c) 5 days Training for Newly appointed Lab. Technicians - 30 d) ½ day Training for ASHA Workers - 6,000 e) 2 days refresher Training of MOs, Health Workers - 450
and Supervisors, Lab. Technicians and Pharmacists f) 2 days Training of DPMR and Leprosy Management - 245 at all levels
5. IEC: i) Hoardings - 25 ii) Bus Panel to be utilized for Advertisement - Nil
in print media iii) Posters/pamphlets - 80,000 iv) Wall Painting - 90
96
v) Rallies & banner/out door publicity - 15 vi) School Quiz - 7 vii) Folk show/Puppet shows/street plays - 7 viii) IPC workshop for MO & HW/Advocacy meetings - 14
ix) Meeting with Zilla Paishad - 7 x) Orientation for NGOs,SSG & MM - Nil xi) Health Mela/Exhibitions/haats/Bazors - 16 xii) IPC meeting at Block level for Teachers,Govt. officials - 28
& ASHA/Patient provider interaction meetings xiii) Others (eg) Publicity by Mega phone - Nil 6. DPMR:
i) Procurement of MCR Footwear, aids & appliances- 140 including cases released from
treatment with loss of sensation etc.
ii) Name of Recognized Institutes conducting RCS - Under process iii) Expected No. of patients to be undergoing RCS - Nil iv) Coordination with other departments for - Will be made with
rehabilitation of Leprosy affected persons the Social Welfare Department
7. URBAN LEPROSY CONTROL: i) List of identified urban localities - Nil ii) Any new urban area to be included, justification - Nil
to be given for the same iii) Plan for Urban Leprosy Control - Coordination may be
made with the Medical Officers, Shillong Municipal Board to take up necessary steps
8. LEPROSY COLONIES: i) No. of Leprosy Colonies - 1 (one) ii) No. of persons living in colonies - 60 (sixty) all cases released
from treatment (RFT) iii) No. of persons with Grade II disability - Nil iv) No. of cases with Ulcers - 2 (two) under Self care v) Services to be provided during the year - Services given and will be
- Free health checkup, medicines, continue dressing Materials. MCR footwear and Civic amenities like electricity, water,
sanitation etc.
9. PROCUREMENT PLAN: As per Action Plan.
97
10. NGO SERVICES: Missionaries of Charity (Shantivan, Nongpoh) has a number of Person Affected by Leprosy attending and staying there. Reconstructive Surgery conducted there during 2010-11 in collaboration with the State Government, NEIGRIHMS, Guwahati Medical College and GNRC, Guwahati. Most such Reconstructive Surgery expected to be conducted in 2011-12.
11. INCENTIVE FOR ASHA: To be given as per norms. 12. MONITORING: State level - Will be done as usual District level 13. VEHICLE OPERATION: State level - Vehicle hiring will have to be District level - continued in the absence of
adequate vehicles. 14. OFFICE EXPENDITURE & CONSUMABLES: State level - Expenditures will have to be incurred on office expenses in order to continue with the
activities of the Society. District level - As stated The Action Plan for 2011-2012 is attached herewith.
98
NLEP – PROPOSED ANNUAL ACTION PLAN (2011-2012) STATE OF MEGHALAYA
Sl. No.
Activity Proposed Amount Proposed (in Rs.)
1 Contractual Services 11,25,000/- One SMO @ Rs. 20,000/- pm. One BFO Cum AO @ Rs. 15,000/- pm. One DEO @ Rs. 8,000/- pm. One AA @ Rs. 7,000/- pm. Eight Drivers @ Rs. 4,500/- pm. Honorarium for 7 district accountants @ Rs. 1,000/- pm. 2 Services through ASHA/USHA 35,000/- Honararium to ASHA, sensitization of ASHA 3 Office expenses & Consumables 3,50,000/- 4 Capacity building 6,00,000/- i) 4 days training of newly appointed MO (rural & urban) ii) 3 days training of newly appointed health worker &
health supervisor
iii) 2 days refresher training of MOs iv) 5 days training of newly appointed Lab. Technician v) 1 day Training for 6000 ASHAs vi) 1 day Training for Pharmacists vii) Training for Media Persons 5 Behavioral Change Communication 6,00,000/- Quiz, folk show, IPC workshop, Meeting of opinion
leaders, Health melas
Wall painting, Rallies, Hoardings etc. 6 POL/Vehicle operation & hiring 6,00,000/- 2 vehicles at state level & 1 vehicle at district level 7 DPMR 3,00,000/- MCR footwear, Aids and appliances, Welfare allowance
to BPL patients for RCS, Support to govt. institutions for RCS
8 Materials & Supplies 3,50,000/- Supportive drugs, lab. Reagents & equipments and
printing forms
9 Urban Leprosy Control 50,000/- 10 NGO – Set Scheme 50,000/- 11 Supervision, Monitoring & Review 2,00,000/- Review meetings and travel expenses
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12 Cash Assistance 2,40,000/- TOTAL 45,00,000/-
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INTEGRATED DISEASE SURVEILLANCE PROJECT (IDSP)
PIP-2011-12.
SITUATION ANALYSIS 1. CURRENT SCENARIO:
Manpower: The State Surveillance Unit is being manned by the State Surveillance Officer with all the supporting staff in position except Epidemiologist which is vacant as no candidate turned for interview.
Similarly the District Surveillance Units are being manned by the District Surveillance Officers with all the supporting staff except Epidemiologist which is vacant in all the Districts as no one turned up for the interview.
Effort will be made to recruit Epidemiologist in the near future. Reporting: Though Districts are reporting, the reporting from some of the Districts is still not up to the mark. Effort will be made to improve reporting in terms of regularity, timeliness and completeness of reporting.
Some Districts are still having problem in reporting through On-line Portal. With the completion of Training of Data Managers and DEOs on the 13th & 14th Jan. 2011 it is expected that the Portal Data Entry will be possible from all the Districts. Laboratory: Procurement of Lab Equipments for Priority Lab. Tura Civil Hospital under process (quotations received, procurement will follow soon). Microbiologist already appointed and in position. Strengthening of District Lab. in Civil Hospital, Shillong, is being proposed for 2011-12. Training: Training of Medical Officers and staff expected to be completed by March 2011.
Further training of remaining Medical Officers and staff is being plan for 2011-12. I.T. Component: Almost all Training Equipments not functioning due to one or the other problem. Minor problems that could be sorted out locally will be sorted out. Others need CSU support.
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Shifting of Disc Antenna of SSU and DSU, Nongstoin, West Khasi Hills,
pending due non-payment of estimated amount. In the Review meeting held in Delhi on the 6th-7th December 2010, it was mentioned that the cost of shifting should be borne by the State from State Fund but the same was not reflected in the minutes of the meeting.
Telephone-cum- Broad-band Bill still unresolved as a result many Districts got disconnected. 2. STRATEGIES:
Sensitization of MOs and Staff for regular, timely and completeness of reporting.
Involvement of more private institutions including private practitioners in reporting.
Usage of Portal entry for Data Reporting and analysis. Strengthening of laboratories.
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PROPOSED BUDGET : 2011-12
SUMMARY SURVEILLANCE PREPAREDNESS
1. TRAINING 14,70,650/-
2. STAFF REMUNERATION 51,04,500/-
3. OPERATIONAL COST 12,54,000/-
4. OUTBREAK INVESTIGATION &
RESPONSE (Priority Lab-Civil Hospital, Tura)
2,00,000/-
DEVELOPMENT OF DISTRICT LAB FOR DIAGNOSIS OF EPIDEMIC PRONE DISEASES
1. DISTRICT LAB- CIVIL HOSPITAL,
SHILLONG 28,23,500/-
TOTAL 108,52,650/-
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Activity Sub-activity
Unit cost Sub-activity
No of Units
Proposed Budget
Surveillance Preparedness Training
One day training of Hospital Doctors
20 per districts, 10 per batch. Per Head: Food & Tea Rs 250, D.A Rs 700, Training materials Rs 250, Resource Person (local) Rs 600, (Non Local) Rs 1000, Travel Rs 300 Venue hiring & other Misc Rs 8000
(2 Batches,
7 Districts)
14 361900
One day training of Hospital Pharmacist / Nurses
40 per districts, 20 per batch. Per Head: Food & Tea Rs 200, D.A Rs 400, Training materials Rs 200, Resource Person (local) Rs 500, (Non Local) Rs 800, Travel Rs 250 Venue hiring & other Misc Rs 8000
(2 Batches,
7 Districts)
14 438200
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One day training of Medical College Doctors
20 per districts, 10 per batch. Per Head: Food & Tea Rs 250, D.A Rs 700, Training materials Rs 250, Resource Person (local) Rs 600, (Non Local) Rs 1000, Travel Rs 300 Venue hiring & other Misc Rs 8000
(2 Batches,
7 Districts)
14 361900
One day training Data entry and analysis training for Block Health Team
20 per districts, 10 per batch. Per Head: Food & Tea Rs 200, D.A Rs 400, Training materials Rs 150, Resource Person (local) Rs 400, (Non Local) Rs 600, Travel Rs 250. Venue hiring & other Misc Rs 8000
(2 Batches,
7 Districts)
14 280000
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One day training of DM & DEO
17 DM & DEO Per Head: Food & Tea Rs 200, D.A Rs 400, Training materials Rs 150, Resource Person (local) Rs 400, (Non Local) Rs 600. Travel Rs 7000, Venue hiring & other Misc Rs 8000
1 Batch 28650
Sub total 1470650
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Surveillance Preparedness
Staff Remuneration*
State/district Epidemiologists (1 at
Rs 30,000 State-1 District-7
2880000
State HQs-SSUs and 1 each at district HQs - DSUs)
State/ district Microbiologists ( 1 at State
HQs- SSUs
Rs 17,500 & Rs 15,500
State- 1 District -1
396000
and 1 each at identified district priority labs )
Entomologist (1 at State HQs - SSUs)
Rs 20,000 State -1 240000
Consultants Finance (1 at State HQs - SSUs)
Rs 14,000 State-1 168000
Consultants Training (1 at State HQs - SSUs)
Rs 20,000 State -1 240000
Data Managers (1 at State HQs - SSUs and 1 each at
district HQs- DSUs)
Rs 14,000 & Rs 13,500
State -1 District -7
262500
Data Entry Operators (1 at State HQs - SSUs, 1 each at district Hos- DSUs and 1 identified Medical Colleges/ Others Institution viz ID Hospital) Identified under IDSP
Rs 8500
State-2
District-7
918000
* The State Health Societies may fix the remuneration as per IDSP guidelines or less as per State Policy
Sub Total 5104500
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Surveillance Preparedness
Operational Cost Transport (Rs 1500 per visit x 4 visits)/ per month
per district State- 1
District -7 576000
Office Expenses, Broadband Expenses, Collection and Transportation of samples and other misc. Expenses ( to be specified)
Broadband Rs 1000 per district+SSU+Medical Colleges per month, Office Expenses Rs 2000 per district and Rs 5000 at SSU per month. Transportation of Samples Rs 6000 per district per year. Other Misc Rs 3000 per district & Rs 5000 at SSU per month.
State-1 District-7 678000
Sub total 1254000
Surveillance Preparedness
Sub Total (Surv. Preparedness= Training + Remuneration + Operatnl. cost)
7829150
OB Investigation & response
Consumables for and kits for Rs 2,00,000/-per year per priority
district lab (Identified No. of labs in States are as follows: Andaman Nicobar-1, Bihar-1, Chandigarh-1, Chattisgarh-1, Delhi-1, Daman & Diu-1, Goa-2, Haryana-2,
District-1 200000
identified priority district labs Himachal Pradesh-2, Jammu Kashmir-1, Jharkhand-1, Kerala-2, Lakshadweep-1, Madhya Pradesh-1, Orissa-1, Puducherry-1, Uttar Pradesh-2, Arunachal Pradesh-1, Assam-1, Mizoram-2, Manipur-1, Meghalaya-1, Nagaland-2, Sikkim-1, Tripura-1,Dadar and Nager Haveli-1)
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Sub Total (OB Investigation & Resp.) Total 8029150
II. DEVELOPMENT OF DISTRICT LAB FOR DIAGNOSIS OF EPIDEMIC PRONE DISEASES No. of District Lab proposed for 2011-12: 1(one). Name of the District Lab proposed: Civil Hospital Lab, Shillong.
Item Approx. cost Basic Equipments (one time expenditure) 1560000 Staff Salary 816000 Other recurring expenditure (including consumables cost, cost of kits, media, reagents, and contingency amount)
447500
Sub Total (The requirement proposed is after taking into account the available manpower and equipments)
2823500
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DETAILED BUDGET-DEVELOPMENT OF DISTRICT LAB FOR DIAGNOSIS OF EPIDEMIC PRONE DISEASES Name of the District Lab. identified: Civil Hospital Lab., Shillong. 1. Basic Equipments:
Name of Equipment No. reqd. Total approx. cost (in lakh) Bio-safety Cabinet Class-I 1 3.0
Autoclave (Sterilization) 1 1.5 Autoclave(Decontamination)-Vertical 1 1.5
Hot Air Oven 1 1.0
Incubator 1 0.5 Binocular Microscope 1 0.4
ELISA Reader and Washer 1 5.0 Refrigerator 285ltrs 1 0.2
Deep Freezer (-20 degree C) 1 2.0
Micro pipette; 0.2-10ul,20-200ul,100-1000ul 3 0.3 Weighing Scale & Mixer 1 0.2
Sub Total 15.6
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2. Recurring Expenditure: a. Staff Salary
Position No. reqd. Unit approx. salary Total salary in lakh Microbiologist 1 40,000/- 4.80
Lab. Technician (Minimum qualification -DMLT)
1 12,000/- 1.44
Lab. Assistant 1 10,000/- 1.20
Cleaner 1 6,000/- 0.72
Sub Total 8.16
b. Consumables and general lab aware (approx):
Sub Total 1.00
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c. Cost of kits, media and reagents:
Name of the test Expected no. of tests/annum
Approx. unit cost
Approx. total (in lakh)
Gm Stain smears of clinical samples e.g. throat swab, sputum, CSF, etc
500 35/- 0.175
Smear examination of Malaria 1000 35/- 0.350 Culture blood, stool, CSF etc for bacterial pathogens and perform Antimicrobial susceptibility testing on the isolates
500 200/- 1.000
ELISA for Viral Hepatitis A & E 200 200/- 0.400 Diphtheria- smear examination & culture 200 200/- 0.400 Rapid Latex Agglutination Test for meningitis (during suspected outbreak)
- 40,000/- 0.400
Ig M ELISA for Measles 200 200/- 0.400 Sputum for AFB 500 50/- 0.250 Other tests relevant for locally prevalent epidemic prone diseases i.e. ELISA for leptospirosis etc.
50 200/- 0.100
Sub Total 3.475 TOTAL 28.235 lakhs
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NATIONAL PROGRAMME FOR PREVENTION AND CONTROL OF DEAFNESS
(carried forward to 2011-12)
CivilL Hospital, Shillong is the referral centre for the State of Meghalaya but Civil Hospital, Shillong caters mostly to four Districts, i. e East Khasi Hills, West Khasi Hills, Ri BHoi and Jaintia Hills District. Cases referred are the following:
1. Chronic –Suppurative Otitis Media. 2. Acute Suppurative Otitis Media. 3. Sensori-Neural hearing loss. 4. Congenital Atresia (Unilateral and Bilateral) 5. Noise Induced Hearing Loss. 6. Congenital Deaf Mute.
3, 4, 5 & 6 are irreversible diseases where only AIDS can be beneficial to them, where as 1 & 2 are temporary diseases where treatment can be given. As the case load of the above cases is increasing day by day therefore, Financial and Training Aid is warranted from the Centre (NRHM)
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PROGRAMME EXECUTION & EXPANSION Presently National Programme for Prevention and Control of Deafness has not been implemented in any Districts of the state. It is proposed to start with 3 Districts in year 2010-11 under the programme. The districts selected for the implementation of the programme are
1. 2. 3.
6 ACTIVITIES A Manpower Training & Development Objectives:
1. To orient all the Health Care personnel from the district to grassroot level about prevention, promotion, early identification and rehabilitation of all types of ear diseases leading to deafness.
2. To make these personnel aware of the existing facilities available for deafness in order to facilitate appropriate referral.
3. To sensitize the health care personnel regarding their specific roles in the programme. 4. To enable the health providers to provide a leadership role in creating awareness about
hearing impairment. 5. To facilitate development of suitable manpower, in order to be able to implement this
programme in the entire nation, in a phased manner. Training would be imparted to the following functionaries at all levels:
Sensitization of the State medical college experts District level ENT Doctors and Audiologists & Audiometricians Obstetricians and Pediatricians at the district and CHC level Medical Officers under CHC/PHC and School Health Scheme Multi Purpose Workers male and female Functionaries at grass root level such as
o Anganwadi workers o Accredited Social Health Activist (ASHA) o Trained Birth Attendants
Primary School teachers at village level B Service Provision including Rehabilitation
Service components will include: Early detection Ear Screening camps Treatment: medical and surgical
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Appropriate referral Rehabilitation of hearing and speech disorders and hearing aid provision. Awareness creation in the community.
Early Detection
By sensitized personnel at grass root level House to house surveys conducted by the AWWs & ASHAs, for detection of cases of
hearing impairment and deafness. Refferal of child born of a high risk pregnancy or delivery, and/or children who are
exposed to a high risk factor in infancy and who show features suggestive of hearing impairment by Pediatricians and Gynecologists
Screening at School by School teachers and proper referral to health care facility.
Ear Screening Camps For screening the general population in respect of ear problems, hearing impairment
and deafness. Detection and treatment of common ear problems. Spreading awareness regarding ear problems, early detection of deafness, available
treatment and health care facilities for referral of such cases. Education of community, especially the parents of young children regarding
importance of right feeding practices, various common ear problems, early detection of deafness in young children and available treatment for hearing impairment/deafness.
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Treatment
Treatment of all affected persons would be undertaken at the PHC, CHC and district Hospital level.
Rehabilitation and Hearing Aid provision: All patients who are identified as having an ear problem that either requires surgery,
hearing aid fitting or rehabilitative therapy will be referred to the ENT doctor and Audiologist at the district level.
Those who need surgery will be given the appropriate treatment at the district hospital. Complicated cases that cannot be adequately handled at the District hospital will be
further referred to the State Medical College for expert treatment. Patients who suffer with Sensorineural hearing loss that is not amenable to medical or
surgical correction and which requires hearing aid, will be fitted with the same at the district level.
The requirement for Speech therapy and Hearing therapy will be met with by the Audiologist / Audiometric Assistant and Instructor for Hearing Impaired Children at the District level.
C Capacity Building
1 PHC & CHC: for screening of ear morbidity and detection of hearing loss, the equipment required / would be:
PHC Kit a) Head Light b) Ear Specula c) Ear Syringe d) Otoscope e) Jobson Horne Probe f) Tuning fork g) Noise Maker
District hospital:
The District hospital is to be an important center for the management of ear problems and deafness cases, which are referred from the health care facilities at various levels.
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Equipment required: 1. Microscope 2. 2 sets of Microdrills with 2 handpeices and burrheads 3. 2 sets of micro-ear surgery instruments 4. Pure Tone Audiometer 5. Impedance Audiomter 6. OAE machine 7. Sound treated room
2 Provision of one Audiometric Assistant and one Instructor for Hearing Impaired Children at the District hospital on contractual basis under the programme to strengthen the diagnostic and rehabilitative services.
7 Time line Sno Activities 1st Quarter 2nd Quarter 3rd
Quarter 4th Quarter
1 Training (1-7 level) 2 Procurement of Equipments
1. PHC KIT 2. District Hospital 3. Sound treated room
3 Recruitment of 1. Audiometric Assistant 2. Instructor for Hearing
Impaired
4 Screening camps organized 5 Hearing aids fitted
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8 Proposed budget for NPPCD for the year 2010-11 S.No. Component Nature of
Expenses
1 Training Financial Guidelines appended
at Annex I
One time Expenditure
2. Capacity Building PHCs/CHCs & District Hospitals ( Rs 9.5 lakh per district hospital and Rs 10000/- per CHC and PHC of the selected/proposed district)
One time Expenditure
Rs 9.5 lakh X no of Dist. +
Rs 10000 X total No of CHC and PHC in
proposed dist.
3. Manpower at district level (Audiometric assistant & Instructor for hearing Impaired) (@ Rs 7500/- per person for 2 contractual person)
Recurring expenditure
Rs 180000 x no of Dist.
4. Screening Camps (Rs. 10,000/- per camp per month per district)
Recurring expenditure
Rs 120000 x no of Dist.
5. Hearing Aids 200 HI per district per year (Rs 4,86,600/- per district for 200 hearing aids)
Recurring expenditure
Rs 486600 X no of Dist.
6. Central Cell at state level Recurring expenditure
Rs 5.72 lakh
7. Misc. & Contingency Recurring expenditure
Rs 10000/-
TOTAL Note: The States are advised to add specific requirements as per there need.
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National Iodine Deficiency Disorders Control Programme
PROFORMA FOR MONITORING OF IODATED SALT THROUGH SALT TESTING KIT AT THE COMMUNICY LEVEL BY ASHA
Name of State: Meghalaya.
Sl.No. Name of the District
No. of salt samples tested
No. of salt samples with
NIL iodine
No. of salt samples with inadequate iodine (less than 15ppm)
No. of salt samples with
adequate iodine (above
15ppm)
1 East Khasi
Hills 24 0 0 24
2 West Khasi
Hills
From (2003
onwards) -
24911 0 5442 19468
3 Ri Bhoi Nil (Target for 2010-11: Testing of Iodized Salt in 3 blocks every
quarter).
4 Jaintia Hills 3920 Nil Nil 3920
5 East Garo
Hills Nil (Target for 2010-11 – 55,000 Household to be surveyed for
Iodine through salt testing).
6 West Garo
Hills Nil
7 South Garo
Hills Nil (Target for 2010-11 – 1000 samples to be tested.)
Meghalaya (Total) 28855 0 5442 23412
As the post of Public Analyst is lying vacant on super annuation of the last incumbent, test on samples collected under Prevention of Food Adulteration Act, 1954 has not been forth coming from the State Iodised Salt Testing Laboratory.
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National Iodine Deficiency Disorders Control Programme Name of the State: Meghalaya.
S.No. Activity Amount Proposed
(Rs. In Lakhs)
1. Establishment of IDD Control Cell 6.00
2. Establishment of IDD Monitoring Lab 4.00
3. Health Education & Publicity 24.50
4. IDD Survey of Districts @ Rs. 50,000 per district 3.50
5 Observing IDD Day (Once a year @ Rs. 20,000 per
district) 1.40
Total 39.40