three years rolling plan 2010-2013 district...
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THREE YEARS ROLLING PLAN 2010-2013 DISTRICT SHEIKHUPURA
Table of ContentsAcronyms...........................................................................................................................................................4
EXECUTIVE SUMMARY........................................................................................................................................5
SECTION 1: DISTRICT HEALTH PROFILE........................................................................................................7
Vision of the District.........................................................................................................................................7
Background of the District...............................................................................................................................7
Three Years Rolling Plan 2010-2013 District Sheikhupura
Map of the District............................................................................................................................................8
Demography......................................................................................................................................................8
Area-wise population.......................................................................................................................................8
Socio-Economic Indicators.............................................................................................................................10
Health Indicators............................................................................................................................................10
Organizational Structure of District Health Administration........................................................................11
Health Resources............................................................................................................................................12
1. Health Facilities...................................................................................................................................12
a) Public...............................................................................................................................................12
b) Private..............................................................................................................................................12
2. Human Resource.................................................................................................................................13
a) Administrative.................................................................................................................................13
b) Facility Based...................................................................................................................................14
Post..............................................................................................................................................................18
c) Outreach...........................................................................................................................................21
d) Training Institutions........................................................................................................................21
Health Financing.............................................................................................................................................24
Disease Pattern...............................................................................................................................................25
Status of Vertical Programs............................................................................................................................27
1. National Program for FP and PHC.........................................................................................................27
2. EPI.........................................................................................................................................................27
3. MNCH Program.....................................................................................................................................28
4. TB Control Program..............................................................................................................................28
5. Malaria Control Program......................................................................................................................28
6. Hepatitis Control Program....................................................................................................................28
7. School Health Services Program...........................................................................................................29
8. Any other District Specific Program......................................................................................................29
SECTION 2: PROBLEM ANALYSIS..................................................................................................................30
Objectives........................................................................................................................................................30
Plan Development Process.............................................................................................................................30
Problem Identification....................................................................................................................................31
Health Problems.............................................................................................................................................31
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Problem Prioritization................................................................................................................................32
Underlying causes of prioritized problems...............................................................................................33
Service delivery/Management problems......................................................................................................35
MDGs and MSDS..............................................................................................................................................36
a) Human Resource.................................................................................................................................37
i. DHQ Hospital Sheikhupura..............................................................................................................37
ii. THQ Hospital....................................................................................................................................38
b) Equipment...........................................................................................................................................38
i. DHQ Hospital Sheikhupura..............................................................................................................39
ii. THQ Hospital....................................................................................................................................46
SECTION 3: INTERVENTIONS AND TARGETS...............................................................................................55
Health Problems.............................................................................................................................................56
Management Problems...................................................................................................................................66
Human Resource Plan to bridge the Gaps between MSDS Proposed and Sanctioned Posts............................66
SECTION 4: COSTING AND FINANCING PLAN..............................................................................................71
Activity based costing.....................................................................................................................................71
Problem wise cost summary of Health Problems.............................................................................................71
a) Health Problems..................................................................................................................................72
Problem wise cost summary of Management Problems..................................................................................87
b) Management Problems.......................................................................................................................88
Financial Outlay..............................................................................................................................................93
Budget Summary..........................................................................................................................................93
SECTION 5: MONITORING & EVALUATION..................................................................................................94
M&E of Plan.....................................................................................................................................................94
Annex-I............................................................................................................................................................97
Annex- II.........................................................................................................................................................103
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Three Years Rolling Plan 2010-2013 District Sheikhupura
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Acronyms
3YRP Three Years Rolling planADB Asian Development BankAPMO Additional Principal Medical OfficerARI Acute Respiratory InfectionsBHU Basic Health CenterBoD Burden of DiesesCDC Communicable Disease ControlCDR Case Detection RateCPR Contraceptive Prevalence Rate DHIS District Health Information SystemDHQH District Head Quarter HospitalDoH Department of HealthDR Default RateEDO(H) Executive District Officer HealthEPI Expended Program on Immunization HSRP Health Sector Reforms ProgramIMR Infant Mortality RateIPC Interpersonal CommunicationM & E Monitoring and EvaluationM & E Maintenance and RepairMCH Maternal Child HealthMMR Maternal Mortality RatioMNCH Maternal Newborn and Child HealthMO Medical OfficerMoV Means of VerificationMSDS Minimum Service Delivery StandardsPDSSP Punjab Devolved Social Services ProgramPHC Primary Health CarePMO Principal Medial OfficerPOL Petrol, Oil and LubricantRHC Rural Health CenterSCR Sputum Conversion RateSHC Secondary Health CareSMO Senior Medical OfficerTAMA Technical Assistance Management AgencyTB TuberculosisTHQH Tehsil Head Quarter HospitalTNA Training Need AssessmentWHO World Health OrganizationWMO Women Medical Officer
Three Years Rolling Plan 2010-2013 District Sheikhupura
EXECUTIVE SUMMARY
Prior to devolution, planning process was carried out at provincial level. Districts were supposed to
implement plans and programs developed/designed at provincial and federal levels. Devolution
brought a paradigm shift where planning became a district responsibility. This change provided an
opportunity to the district at one hand and challenge on other due to their limited capacity in planning
and budgeting. Planning focus also changed from short term to medium term planning recognizing the
flexibility /adaptability it provided. Government envisions that medium term plan .i.e. 3YRP will be
instrumental in using health resources effectively and efficiently through adapting Minimum Service
Delivery Standards (MSDS) as the strategy to achieve objectives of MDGs.
Districts have been preparing 3YRP (medium term plan) for last few years under the
auspices/patronage of Department of Health (DoH) Government of Punjab through technical assistance
of Punjab Devolved Program Social Services Programme (PDSSP). This year government of the Punjab
through Health Sector Reforms Program (HSRP) with the technical assistance from a team of
consultants (SP09) and wide consultations/inputs from all key stake holders has established a bench
mark in standardization of the format of 3YRP. Capacity building of the districts has been done on the
standardized format.
Current 3 Years Rolling Plan (3YRP) plan is first attempt by the district on that agreed format . First
section of the format (District Health Profile) contains all relevant information on Geography,
Demographic, Socioeconomic and Health indicators of the district. It also takes stock of health resources
in terms of human resource, infrastructure and others. District diseases pattern compiled from DHIS
Primary and Secondary Health Care reports and current status of vertical /national programs is part of
the profile. In fact district profile is a health related fact sheet of the district and depicts the true picture
of health status and health resources/services of the district. An accurate district health profile provides
a sound basis for evidence-based planning.
3YRP plan has been developed by following the standard planning cycle approach. 3YRP details the
current year activities, physical targets and fiscal targets. Projections of second and third year physical
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Three Years Rolling Plan 2010-2013 District Sheikhupura
and financial targets are given. Section Two includes problems identification from various
perspectives, and their prioritization by applying WHO prioritization criteria. This section also contains
underlying causes of the prioritized problems. Section Three of the plan relates to developing best
possible interventions/activities and setting physical targets for each year. Section Four consists of
costing based on additional requirements taking account of implementation of current status of
activities. Best available estimates have been used to accurately cost the activities. The detailed activity
based costing of the Health and Service Delivery problems has been developed on automated Excel
sheets, and annexed for details as ready reference. Last section of the 3YRP consists of Monitoring and
Evaluation of plan to gauge the progress of different activities and targets of the plan using reliable
district data sources. This permits timely remedial action for smooth implementation of planned
activities.
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Three Years Rolling Plan 2010-2013 District Sheikhupura
SHEIKHUPURA
SECTION 1: DISTRICT HEALTH PROFILE
Vision of the DistrictDistrict Health Government has evolved strategies to address all the components of the Primary Health Care in a befitting manner for enhanced utilization of the services by the community.
Mission of the District
Health for all, to provide quality health care services to the community through an efficient and effective service delivery system i.e. accessible, equitable, culturally acceptable, affordable and sustainable.
Background of the DistrictSheikhupura is one of the oldest districts in the Punjab province, established in 19thcentury in the
name of a Mughal emperor Jahangir, who was called Sheikhu.
This District is sandwiched by eight districts of the province and one district of India (Amritsar). River
Ravi traverses from north to west boundary of the district. The district is expanded by 103km in length
and 74km by width.
Sheikhupura district has 4 tehsils (Sheikhupura, Muridke, Ferozewala, Sharaqpur Sharif) in its revenue
limits.
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Map of the District
Demographyo Total Population 2820139
o Total Area 4160 square kilometers
o Annual growth rate 2.41%
o Population density 678 persons per sq. km
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Area-wise populationArea Population Percentage
Rural 18,89,493 67
Urban 9,30,646 33
Source: Standard Demographic population groups based on DHIS
Gender-wise population
Gender Population Percentage
Male 2307720 49
Female 2401912 51
Source: Standard Demographic population groups based on DHIS
Population groups
Population GroupsStandard Demographic
(%)Estimated Population
Under 1 year of age 2.7 76144
Under 5 years 13.4 377899
Under 15 years 44 1240861
Women in child bearing age (15-49 years) 22 620430
Married Child Bearing age Women 16 451222
Expected pregnancies 3.4 95885
Standard Demographic population groups based on DHIS
Tehsil wise distribution
Tehsil Number of UC Population
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sheikhupura 51 14,30,762
Ferozewala 21 6,14,246
Muridke 21 5,76,979
Sharaq pur 8 1,98,152
Languages
Punjabi is the main language spoken in the district.
Socio-Economic Indicators
Education and Literacy
Literacy rate Male Female
Urban 75.6% 71.1%
Rural 61.9% 54.7%
Overall District 66% 66%
Source: EDO Literacy and Formal Education Sheikhupura
Health Indicators Infant Mortality Rate 79/1000
Under 5 mortality Rate 116/1000 Live births
Maternal mortality Ratio 227/1,000 Live births(Provincial
Figure*)
Malnutrition (women and children)
o Over all (Moderate & Severe) 29%o Over all (Severe) 10%o Stunting Prevalence (Moderate & Severe) 38%o Stunting Prevalence (Severe) 21%o Wasting Prevalence (Moderate & Severe) 11%o Wasting Prevalence (Severe) 4.3%
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Life expectancy 63 years
Proportion of children 0-23 months immunized 92%
Source: MICS 2007-08
*Source: EDO (Health) Office Sheikhupura
Organizational Structure of District Health Administration
There exists a three-tier system in the health sector in the country. At federal level, Federal Secretary of
Health is responsible to administer and supervise the health related activities and programs. Major
function of federal tier is to provide policy guidelines and ensure quality of health care standards
through federal legislation. After the 18th amendment in the constitution, and announcement of National
Finance Award, most of the existing federal level programs will be transferred to the provincial level. At
provincial level, provincial Secretary of Health along with Director General Health Services is
responsible for managing and supervising health care services. The district is still an administrative
entity in the system and EDO (Health) acts as head of the district health department, under overall
supervision of DCO. The organizational structure at district level is as under:
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M S D H Q H osp . P D D H D C
D D O H S K P D D O H F .w a la D S V D S I A s s is t . E n tom olog is t A IH S C D C I
D O H D C N P M S TH Q H os p .M u rid k e
D ru g In sp ec to r
E D O (H )
D C O
Z ila N az im
Three Years Rolling Plan 2010-2013 District Sheikhupura
Health Resources
1. Health Facilitiesa) Public
Details of physical infrastructure of public health facilities in the district is given in the table below
Facility Type Name/Number of FacilityBed
Strength
No. of Functional
BedsRemarks
DHQ Hospital DHQ Hospital Sheikhupura 368 368 -------
THQ Hospital THQ Hospital Muridke 68 68 -------
RHCs 07 20 each RHC 20 each RHC -------
BHUs 65 02 each BHU 02 each BHU -------
Govt. Rural Dispensaries
04 Nil Nil -------
MCH Centers 04 1 each MCH Center
1 each MCH Center
-------
Sub Health Centers 15 Nil Nil Closed in 2008
TB Hospital 1 TB Clinics (PATA) is functioning in the District.
-------
Health houses 859 Nil Nil -------12
Three Years Rolling Plan 2010-2013 District Sheikhupura
Facility Type Name/Number of FacilityBed
Strength
No. of Functional
BedsRemarks
Data source: DHIS/EDOH office
b) PrivateThe district has provided a list of private service providers including hospitals, clinics, laboratories and maternity homes. These private providers are used for providing support in preventive programs like Polio and other EPI activities. With the passage of time, role of private providers will expand, and there is a need to develop an effective coordination between public and private sector. Detailed list of private sector health facilities is attached as Annex-I.
2. Human Resource The Human resource of district health department has been placed in following categories:
a) Administrativeb) Facility basedc) Outreachd) Training institutions
a) Administrative
Sr. # NAME OF POST SANCTION FILLED
1 Executive District Officer Health
01 01
2 District Officer Health 1 1
3 DDOH 2 2
4 Program Director 1 1
5 MREO 1 1
6 CDCO 1 1
7 D.S.I 1 1
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Three Years Rolling Plan 2010-2013 District Sheikhupura
8 DSV 1 1
9 ASV 2 2
10 AIHC 1 1
11 DSC 1 1
12 DFO (TB DOTS) 1 1
13 Senior Microscopes 1 1
14 Assistant Entomologist 1 1
b) Facility Based
i. Basic Health Units (65)Sr. No. Name of Post/Designation Sanctioned Filled Vacant
1 Medical Officer 65 53 12
2School Health & Nutrition Supervisor 65 62
3
3 Medical Assistant 65 20 45
4 Computer Operator 65 32 33
5 Medical Technician 65 59 6
6 LHV 65 65 0
7 Dispenser 130 111 19
8 Midwife 65 63 3
9 N/Qasid 65 61 4
10 Chowkidar 65 48 17
11 Sanitary Worker 65 53 12
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Three Years Rolling Plan 2010-2013 District Sheikhupura
ii. Rural Health Centres (7)
Sr. No.
Name of Post/Designation Sanctioned Filled Vacant
1 Senior Medical Officers 7 5 2
2 Women Medical Officers 7 1 6
3 Dental Surgeons 7 3 4
4 Medical Officers 7 7 0
5 Charge Nurses 44 34 10
8 Computer Operators 7 2 5
9 Medical /Health Technician 6 3 3
10 LHV 12 12 0
11 Lab. Technician 7 0 7
12 Dental Technician 11 9 2
13 R.H.I 14 14 0
14 Junior Clerk 10 6 4
15 Vaccinator 13 13 0
17 Dawasaz 1 1 0
18 Radiographer/X-Ray Asstt. 7 3 4
19 Dresser 7 7 0
20 Anesthesia Assistant 7 2 5
21 O.T.A 2 1 1
22 Dispenser 25 24 1
23 Dental Assistant 1 0 1
24 Laboratory Assistant 7 5 2
25 Midwife 26 24 2
26 Driver 11 11 0
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Name of Post/Designation Sanctioned Filled Vacant
27 T.O 8 7 1
30 Ward Servant 20 19 1
31 Sweepers 2 1 1
32 Sanitary Worker 28 16 12
33 Sanitary Patrol 30 30 0
34 Naib Qasid 13 13 0
35 Mali 7 7 0
36 Cook 8 6 2
37 Chowkidar 13 11 2
38 Water Career 6 6 0
iii. THQ Hospital Muridke
Sr.No. Post Sanctioned Filled
01 Medical Superintendent 1 1
02 APMO 2 2
03 Senior Medical Officer 1 1
04 Surgeon 1 1
05 Pediatrician 1 1
06 Anesthetist 1 0
07 Eye Specialist 1 0
08 Gynecologist 2 1
09 Dental Surgeon 1 1
10 Medical Officer 5 4
11 WMO 2 2
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr.No. Post Sanctioned Filled
12 Pharmacist 1 1
13 Head Nurse 1 1
14 Charge Nurses 11 10
15 Homeopathic Doctor 1 1
16 Hakim 1 1
17 Lady Health Visitor 1 1
18 Dental Technician 1 1
19 Junior Clerk 1 1
20 Radiographer 2 0
21 Homeopathic Dispenser 1 1
22 Dispenser 8 7
23 Store Keeper 1 1
24 Operation Theatre Assistant 1 0
25 Dawasaz 1 1
26 Laboratory Assistant 2 1
27 Driver 2 2
28 Midwife 2 2
29 Tube-well operator 1 1
30 Water Carrier 1 1
31 Ward Servant 10 9
32 Ward Bearer 1 1
33 Sanitary Worker 11 7
34 Naib Qasid 2 2
35 Masalchi 1 117
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr.No. Post Sanctioned Filled
36 Mali 1 1
37 Gate Keeper 1 1
38 Dhobi 1 0
39 Dawacob 1 0
40 Dai 1 0
41 Cook 2 0
42 Chowkidar 3 2
43 Baildar 3 3
iv. DHQ Hospital Sheikhupura
Sr.No. Post Sanctioned Filled
1. Medical Superintendent 1 1
2. Chief Consultant Surgeon 3 3
3. PMO 1 1
4. PWMO 1 0
5. APMO 5 4
6. APWMO 3 1
7. Principal Dental Surgeon 2 2
8. Surgeon 1 1
9. Senior Consultant 4 3
10. Trauma Surgeon 1 1
11. T.B & Chest Specialist 1 1
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr.No. Post Sanctioned Filled
12. Senior Medical Officer 3 1
13. Physician 2 0
14. Pathologist 1 0
15. Pediatrician 1 0
16. Ophthalmologist 1
17. Orthopedic Surgeon 1 1
18. Nursing Superintendent 1 1
19. Gynecologist 3 1
20. ENT Specialist 1
21. DMS 4 3
22. Anesthetist 1 1
23. AMS 2 1
24. Cardiologist 1 2
25. CMO 1
26. WMO 20 7
27. Radiologist 1 0
28. Pharmacist 2 2
29. Medical Officer 64 19
30. Physiotherapist 1 0
31. Dental Surgeon 1 1
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr.No. Post Sanctioned Filled
32 Nursing Sister/Head Nurse 13 12
33 Charge Nurses 74 71
34 Internee /House Officers 8 4
35 Hakim 1 1
36 Homeo Doctor 1 1
37 AMO 1 1
38 House Keeper 1 1
39 Medical Technician 2 2
40 Dental Technician 2 1
41 ECG Technician 2 1
42 Blood Technician 1 1
43 Senior Clerk 1 1
44 Junior Clerk 5 4
45 O.T. Assistant 5 5
46 Radiographer/X-Ray Assistant 6 3
47 Homeo Dispenser 1 1
48 Dawasaz 1 1
49 Store Keeper 1 1
50 Dispenser/ Dresser 13 13
51 Record Keeper 1 1
52 Lab: Assistant 5 4
53 Nursing Orderlies 3 3
54 Driver 3 3
55 Midwife 2 2
56 Tailor 1 1
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr.No. Post Sanctioned Filled
57 O.T. Attendant 3 3
58 Daftri 1
59 Lab: Attendant 1 1
60 X-Ray Attendant 1 1
61 Naib Qasid 7 7
62 Attendant 3 2
63 Dhobi 2 2
64 Gate Keeper 6 6
65 Ward Servant 39 39
66 Chowkidar 5 5
67 Cook 3 3
68 Mali 3 3
69 Bearer 13 12
70 Bahishti 3 3
71 Dawakob 1 1
72 Sanitary Worker 36 30
73 Baildar 2 2
c) OutreachThis information is about outreach program workers such as Vaccinators, CDC Supervisors and Sanitary Inspectors which are not part of above mentioned health facilities.
Post Sanctioned Filled
Vaccinators 92 92
CDC Supervisors 60 52
Sanitary Inspectors 66 42
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Three Years Rolling Plan 2010-2013 District Sheikhupura
d) Training Institutions A number of training institutions are working in the district, which include the following:
Type of institute Number
DHDC 01
General Nursing school 01
Midwifery school 01
i. DHDC
Post Sanctioned Filled
Program Director 1 1
Multipurpose Paramedical staff 1 0
Monitoring Re-& Evaluation Officer 1 1
Health Nutrition Education Officer 1 0
LHV Trainers 1 0
Assistants 1 1
Driver 1 1
Naib Qasid 1 1
Sweeper 1 1
Chowkidar 2 2
ii. General Nursing School
Post Sanctioned Filled
Principal 1 1
Nursing Instructor 3 3
Head Nurse 4 4
Charge Nurse 2 2
Stenographer 1 1
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Post Sanctioned Filled
Head Clerk 1 1
Accountant 1 0
House Keeper 1 1
Senior Clerk 1 1
Junior Clerk 1 1
Ayya 1 1
Sweeper 3 1
Naib Qasid 3 1
Masalchi 1 1
Cook 1 1
Chowkidar 2 2
iii. Midwifery School
Posts are same in Midwifery School as mentioned in Nursing School.
iv. Community Midwifery SchoolMNCH Program is providing community midwifery training at General Nursing School DHQ Hospital Sheikhupura. Following staff has been provided by National MNCH Program.
Post Sanctioned Filled
Principal 1(Principal GNS dual charge)
1
CMW Tutor 3 3Computer Operator 1 1Security Guard 2 2
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Three Years Rolling Plan 2010-2013 District Sheikhupura
v. Paramedics (UTD) TrainingNo specific post have been designated for training of paramedics in DHQ Hospital Sheikhupura, however one medical officer and one pharmacist from the DHQ hospital has been detailed to impart training to the dispenser class.
Health FinancingThe provision of financial resources at district level is prime responsibility of district government. However, keeping in view the budget constraints at the district level, federal and provincial governments also augment financial resources in form of kind and cash, through different programs. Financial resources of the district during the last three years out of different sources are given as under:
Rs. Million
Source of Funding Year
2007-08 2008-09 2009-10
Allocation Exp Allocation Exp Allocation Exp
District Health Budget
Non-developmental
-407.9
-298.5
-559.3
-412.7
-915.7
-407.7
PHSRP - - 12,.0 11.5 10.8 8.2
PMDGP - - 76.7 13.5 63.1 11.5
PDSSP 8.5 8.2 14.5 5.5 23.8 5.7
Provincial development budget for district
- - - - - -
Other sources (Specify source)
- - - - - -
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Grand Total 416.4 306.7 662.5 443.2 1013.4 433.1
Disease PatternThe disease pattern is determined through regular and periodic reporting through surveys and studies. Punjab health department has adopted DHIS as regular reporting mechanism to collect information on diseases and other variables. Currently, DHIS is in transitional stage, and is establishing itself as a tool to be used for evidence based planning and management. The following trend of the diseases has been taken from the consolidated DHIS reports that include reports from PHC and SHC facilities.
Disease Group Percentage Of Total
Respiratory Diseases
1 Acute (upper) respiratory infections 14.52796855
2 Pneumonia < 5 yrs. 0.341548439
3 Pneumonia >5 yrs. 0.360846237
4 TB Suspects 1.147993227
5 Chronic Obstructive Pulmonary diseases 0.31373027
6 Asthma 1.096701713
Gastro Intestinal Diseases
7 Diarrhea / Dysentery < 5 yrs. 2.603735534
8 Diarrhea / Dysentery < 5 yrs. 2.579415796
9 Eneric / Typhoid Fever 0.204714644
10 Worm infestations 0.7206768
11 Peptic Ulcer Diseases 1.4370652
12 Cirrhosis of Liver 0.045705309
Urinary Tract Diseases
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Three Years Rolling Plan 2010-2013 District Sheikhupura
13 Urinary Tract Infections 1.006532474
14 Nephritis / Nephrosis 0.013655166
15 Sexually Transmitted Infections 0.056313455
16 Benign Enlargement of Prostrate 0.034758605
Other Communication Diseases
17 Suspected Malaria 0.806275508
18 Suspected Meningitis 0.035774279
19 Fever due to other causes 2.74852544
Vaccine Preventable Diseases
20 Suspected Measles 0.001467084
21 Suspected viral Hepatitis 0.162225634
22 Suspected Neonatal Tetanus 0.004401252
Cardiovascular diseases
23 Ischemic heart disease 0.118382393
24 Hypertension 1.232971246
Skin Diseases
25 Scabies 6.088229303
26 Dermatitis 1.343566808
27 Cutaneous Leishmaniasis -
Endocrine Diseases
28 Diabetes Mellitus 0.658720714
Neuro-Psychiatric Diseases
29 Depression 0.214081411
30 Drug Dependence 0.008520372
31 Epilepsy 0.026971775
Eye & ENT
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Three Years Rolling Plan 2010-2013 District Sheikhupura
32 Cataract 0.140840064
33 Trachoma 0.075046989
34 Glaucoma 0.029567385
35 Otitis Media 0.582545199
Oral Diseases
36 Dental Caries 2.106337634
Injuries / Poisoning
37 Road traffic accidents 1.136595112
38 Fractures 0.123517187
39 Burns0.130119065
40 Dog bite 0.075329121
41 Snake bite (with signs/ symptoms of poisoning) 0.003724136
Miscellaneous Diseases
42 Acute Flaccid Paralysis 0.00000056
43 Suspected HIV/AIDS 0.006827583
44 Any Other Unusual Diseases (Specify) -
Total 100%
Source: Compiled from PHC and SHC reports of DHIS
Status of Vertical ProgramsThe following paragraphs depict the current status of the program being implemented in the district. The indicators and their values have been taken from the program reports.
1. National Program for FP and PHC No. of seats allocated for LHWs 899 No. of LHWs working 859 Percentage of population covered by the program 30% Important Program indicators
o IMR 42 per 1000 live birthso MMR 55 per 100000 live births
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Three Years Rolling Plan 2010-2013 District Sheikhupura
o CPR 38.7%o No. of antenatal visits 99%o TT Coverage of Pregnant women 98%
2. EPI EPI coverage rate of the district
o Based on program information 92%o Based on Third Party Validation 89%
Fully immunized children 0-23 months 91%
Pregnant women received TT vaccine 56% Availability of cold chain equipment 80%
3. MNCH Program
Status of Recruitment of WMOs, Nurses, LHVs & MIDWIFEs
4. TB Control Program CDR all types 74% CDR NSS Positive 79% SCR 78% TSR 99% DR 1%
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S.# Name Of Post Sanctioned Filled Vacant
1 WMO (MNCH) 07 02 05
WMO (Health) 34 13 21
2 Nurses 155 120 35
3 LHVs (MNCH) 07 07 0
LHVs (Health) 80 76 04
4 Midwifes (Health)
130 95 35
Three Years Rolling Plan 2010-2013 District Sheikhupura
5. Malaria Control Program No. of slides examined 38937 No. of positive slides 9 Slides positively ratio 0.02 Percentage of plasmodium Falciparum 0.0006
6. Hepatitis Control Program No. of hepatitis tests conducted 1552 No. of positive cases detected 235 No. of persons vaccinated against Hepatitis B 1402 No. of cases treated for Hepatitis B 0 No. of cases treated for Hepatitis C 37
7. School Health Services Program Total visits to the schools 4269 No. of students examined 122543 No. of students referred to BHUs 35963 No. of students treated in BHUs 26567 No. of students referred from BHUs to higher facilities 3650 No. of schools in catchment areas 941 No. of students 123730 No. of SH & NS 62 No. of teachers trained 1807
8. Any other District Specific Program
Universal Salt Iodization Program is functional in the district.
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Three Years Rolling Plan 2010-2013 District Sheikhupura
SECTION 2: PROBLEM ANALYSIS
The Health sector in Punjab is facing enormous health and service delivery problems. Common health problems are communicable, non communicable, MNCH related diseases and accident/ trauma. The society is passing through demographic and epidemiological transition. This is due to changing life style, urbanization, ecological and other factors. Disease pattern is changing where non communicable diseases are gradually increasing and the communicable diseases are still posing serious threat. Punjab is practically facing Double Burden of Disease (BOD). Besides, health problems service delivery/ managerial issues are also hindering the access and quality of health services to the population. The service delivery/management problems are diverse in nature, and include shortage of technical human resource, capacity issues, lack of infrastructure and equipment.
Devolution was introduced during 2001 affecting the administrative and financial set up of the districts. The devolution also brought political culture in the decision making of the districts in the shape of Nazims, Naib-Nazims and Councilors. This system is now in the phase of reshaping and it is not clear what will be future structure and managerial shape when new local bodies system is put in place. The District Manager and functionaries are in the state of uncertainty and confusion in this scenario. However, one thing is clear that the district shall remain a hub of all primary and secondary health services delivery. Despite the source of funding in the future, either from provincial or district government, health planning at district level shall continue to play a pivotal role in provision of quality health services.
In view of the above situation the district considers following objectives for developing three year rolling plan.
Objectives Improve health status of the population Meeting the requirements of national and provincial health policies Achievement of MDGs through MSDS Introducing evidence-based planning culture by addressing district specific problems/issues Addressing emerging health needs or re-emergence of health problems (e.g. H1N1, HIV-AIDS,
Polio, T.B) Ensuring effective inter-sectoral coordination with a view to improving health indicators
The objectives would guide in problem analysis, designing interventions, setting /phasing the targets, costing and monitoring the plan activities.
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Plan Development ProcessPlan development has been a systematic and consultative process. A core planning team consisting of EDO (H), DOH, MS DHQ and THQs, Statistical officer, and Budget and Accounts Officer, was designated by Director General Health Services Punjab. This team received three days customized training from SP-09 team at divisional headquarters. The main components of the trainings were: (i) developing a three-year rolling health sector plan using the standard three year rolling plan format; (ii) costing of the plan; (iii) preparing related budget projections; (iv) accounting procedures; (v) preparing adequate financial reports on the use of funds.
The district planning team adopted the following steps for the preparation of three years rolling plan:
Problem identification Prioritization of identified problems Identifying underlying causes of prioritized problems Developing interventions and activities Setting targets Determining resource requirements, costing and budgeting Preparing action plans Preparing monitoring plan
Problem IdentificationThis step involved assessment of the current situation from various perspectives to establish the actual health situation in terms of health and service delivery/management problems. Problem identification is based on the district health profile, review of previous plans, MIS (DHIS, Program reports and periodic reports etc.); District specific surveys (MICS), MSDS, and national and provincial policy guidelines.
The district planning team held meetings and started with identification of problem using the training received from SP-09 team and consulting the above mentioned documents. The problems identified were broadly divided into two categories i.e.
a) Health Problemsb) Health Service Delivery or Management Problems
Health ProblemsThe district specific health problems identification process started during the three years rolling plans workshop. The planning team in the initial stage prepared a long list of the health problems. The identification of health problems was based on various information sources including DHIS, and district specific reports. The enlisted health problems of the district are given in the following table.
1. Diarrheal Diseases 2. Acute respiratory tract infections (ARI)
3. Hepatitis 4. Suspected Tuberculoses
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Three Years Rolling Plan 2010-2013 District Sheikhupura
5. Road Side Accident/Injuries 6. Suspected Malaria
7. Anemia 8. High maternal mortality
9. High under five mortality 10. Scabies
11. Dental Caries 12. Hypertension
13. Peptic Ulcer Diseases 14. Asthma
Problem PrioritizationWHO has developed standard criteria for prioritization of health problems; which is based on the following five elements:
Magnitude Severity/danger Vulnerability to intervention (feasibility) Cost-effectiveness of the intervention Political expediency
Each element has been assigned a score from 1 to 4 depending upon grade/scale of that element i.e.
Very High=4, High=3, Medium=2 and Low=1.
Elements of the prioritization criteria were applied to each of the enlisted health problems. The
aggregate of individual scores assigned to the elements of the prioritization criteria gave the total score
for a health problem. This total score was then used to prioritize the health problems. A cut-off point of
was decided, to establish the priority health problems of the district. These problems will be addressed
in the three years rolling plan.
Problem Magnitude Severity Vulnerability to
intervention
Cost Effectiveness
Political Expediency
Total Score
Priority Number
Diarrheal Diseases
3 4 4 4 1 16 1
ARI (under 5) 3 3 4 3 1 14 3
Hepatitis 3 3 3 2 3 14 4
Tuberculosis 2 3 3 3 2 13 7
Accidents & Injuries
2 3 2 2 2 11 8
Suspected 1 2 3 3 2 11 9
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Problem Magnitude Severity Vulnerability to
intervention
Cost Effectiveness
Political Expediency
Total Score
Priority Number
Malaria
Anemia 3 3 3 4 2 15 2
High maternal mortality
3 3 3 3 2 14 5
High under five mortality
3 2 3 3 3 14 6
High infant mortality
2 2 2 2 1 9 10
Pneumonia 1 1 3 2 1 8 11
Ischemic Heart Diseases
1 2 2 1 2 8 12
Underlying causes of prioritized problemsHealth problems have their underlying causes. It is important to know the underlying causes of the
health problems so that appropriate interventions are developed. There may be a long list of these
causes but only few of them are vital ones; and rectifying these causes can resolve the problem to a
large extent. Following table gives common causes of the prioritized health problems pertaining to the
district.
Sr. No. Health Problem Causes
1 Diarrheal Diseases Poor sanitation
Lack of safe drinking water
Unhygienic practices
Lack of awareness in general population
Lack of awareness among mothers about feeding and weaning practices
Low Socio Economic status
Malnutrition
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Health Problem Causes
2 Anemia ( including pregnancy)
Lack of awareness about balanced diet
Gender discrimination
Social taboos and norms
Worm infestation
Infections
Poor quality of MNCH services
Poverty/ Low socio economic status
3 Acute (upper) respiratory infections
Malnutrition
Air contamination
Over-crowding/Poor housing facilities
Lack of proper sanitation
Seasonal variation
Lack of awareness and hygienic practices
4 Hepatitis Poor sanitation
Unsafe drinking water
Sharing of used syringes
Transfusion of unsafe blood and blood products
Unsafe sexual practices
Ear & Nose piercing and tattooing
Use of unsterilized equipment by dentists and barbers
5 High MMR Poor access to healthcare delivery services
Lack of awareness about danger signs of pregnancy
Low ante-natal coverage
Low skilled birth attendance
Three delays (seeking health care, transportation, and lack of referral back-up services)
Complications of pregnancy
Capacity Issues related to maternal care
Maternal Anemia
Pregnancy following chronic severe diseases
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Health Problem Causes
6 High under 5 Mortality Poor antenatal natal and post natal coverage
Neo-natal Infections
Birth Trauma & Asphyxia
Prematurity
Poor feeding and weaning practices
Diarrhea
ARI
Lack of capacity of staff for provision of proper child health care (diagnostic and timely referrals)
Low socio economic status
Malnutrition
Lack of birth spacing
Low EPI Coverage
7 TB Suspects Low socio-economic status Seasonal variation
Lack of proper sanitation
Lack of awareness and hygienic practices
8 Road traffic accidents
Lack of traffic sense
Poor maintenance of vehicles
Poor road conditions
Lack of safety measures at work place
Fire-arm injuries
Domestic accidents
Burns
Bomb blasts/terrorist activities
Lack of tolerance in the society
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Service delivery/Management problemsThis segment entails the district specific management problems. Management problems are result of deficiency/lack of resources; these problems range from administrative to financial issues, and cause hindrance in the smooth delivery of health services in the district. It was observed that solution of some of these problems lies with the provincial government; whereas remaining can be addressed at the district level. While proposing the interventions, their action at provincial or district level has been specifically mentioned. The planning team discussed these problems in detail and enlisted the main problems as under:
Sr.No
Service Delivery / Management Problems
1 Shortage of skilled staff due to: Ban on permanent postings Non availability of incentivized pay package and career structure Medico-legal work for WMOs Non sanctioning of posts according to MSDS
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Three Years Rolling Plan 2010-2013 District Sheikhupura
2 Deficient MNCH related equipment (with reference to standard notified list) at: DHQH THQHs
3 Capacity issues related to: Financial Management Supportive Supervision and Use of information
4 Inadequate budget for POL due to: Price hikes Installation and use of generators
MDGs and MSDSThe government is committed to achieve the MDGs targets. For this purpose, the government of Punjab has decided to adopt Minimum Service Delivery Standards (MSDS) as strategy to achieve the MDGs within the province. Health Department of Punjab is especially focusing on MNCH related component of MSDS for which substantial resources are coming from Asian Development Program funded Punjab Millennium Development Goal Program (PMDGP). MSDS entails a level-specific service delivery package
37
Three Years Rolling Plan 2010-2013 District Sheikhupura
(for primary and secondary health care) along with their standards and system specifications including human, infrastructure, equipment, medical supplies, medicine and other consumables.
In order to achieve the MDGs, the government of Punjab has adopted MSDS as strategic framework. During the development of three years rolling plans, gaps under MSDS focusing on MNCH interventions have been identified. Most essential areas for which gaps have been identified are human resource and equipment of DHQ and THQ hospitals, as per lists notified by the government in accordance with MSDS standards.
a) Human ResourceWith regard to MSDS gap analysis for human resource, the difference between the standards proposed in MSDS and filled posts has been calculated as the vacancy gap. The hospitals have been categorized based on their bed strength as follows:
Hospital Category Bed Strength
DHQ Hospital
A 400 and above Beds
B 251-400 Beds
C Up to 250 Beds
THQ Hospital
A Above 60 Beds
B 41-60 Beds
C Up to 40 Beds
i. DHQ Hospital Sheikhupura(Category A)
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Post Standard as per MSDS
Sanctioned Filled Vacancy Gap in
relation to sanctioned positions
Vacancy Gap in
relation to filled
positions
1 Gynecologist 4 3 1 1 3
2 Pediatricians 3 3 1 0 2
3 Anesthetists 5 1 3 4 4
4 Medical Officers including SMO,APMO & PMOs
125 73 25 52 100
5 Women Medical Officers including SWMO, APWMO &PMOs
48 24 8 24 40
6 Lady Health Visitors 11 0 0 11
7 Nurses 189 87 73 102 116
ii. THQ Hospital (Category B)
Sr. No. Post Standard as per MSDS
Sanctioned Filled Vacancy Gap in
relation to sanctioned positions
Vacancy Gap in
relation to filled
positions
1 Gynecologist 2 2 0 0 2
2 Pediatricians 2 1 1 1 1
3 Anesthetists 3 1 0 2 3
4 Medical Officers including SMO,APMO & PMOs
19 8 6 11 13
5 Women Medical Officers including SWMO, APWMO &PMOs
10 11 2 2 9
6 Lady Health Visitors 8 1 1 7 7
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Post Standard as per MSDS
Sanctioned Filled Vacancy Gap in
relation to sanctioned positions
Vacancy Gap in
relation to filled
positions
7 Nurses 24 12 11 12 13
b) EquipmentGovernment of Punjab has notified a standard list as yard-stick of MNCH related equipment to provide comprehensive EmONC services in the DHQ and THQ hospitals. Provision of comprehensive EmONC services is essentially required to decrease the high MMR and IMR prevailing in the province.
Gaps in relation to the MNCH related equipment have been identified taking into account the equipment purchased or under process of purchase from all funds including PMDGP funds allocated/sanctioned to the district. The cost of equipment gap has been included in the equipment portion of the Management/Service delivery problems.
i. DHQ Hospital Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
1 CTG (Cardiac Topography)
1 1 2 2 -
2 Foetal Doppler 3 5 5 2 3
3 Diagnostic Laparoscope 1 1 2 1 1
4 Bulb Sucker 10 20 20 1 20
5 Baby Warmer 3 3 6 2 4
6 Mechanical Sucker 3 3 6 4 2
7 Fetal Stethoscope 4 4 4 0 4
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
8 Delivery Table 2 2 3 2 1
9 D&C Set 2 3 4 1 3
10 Outlet forceps 4 4 4 1 3
11 Myoma Screw 2 2 2 2 0
12 Kochers forceps 4 4 8 1 7
13 Volselum forceps 6 8 10 8 2
14 Lanes Tissue holding forceps
2 2 4 12 -
15 Vaginal Retractors 10 10 10 2 8
16 Polypectomy forceps 2 2 2 - 2
17 Sponge holder 10 15 20 20 -
18 Uterine elevator 1 1 1 - 1
19 CosCo Speculum
Small, Medium, Large (for each category)
6 10 10 1 9
20 Examination light 3 3 6 2 4
21 Suction Curette 1 2 2 0 2
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 2 0 2
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 2 0 2
24 Cardiac Monitor 1 1 2 1 1
25 Pump Breast Electronic 1 1 1 - 1
26 Vaginal Hysterectomy Set
2 2 4 0 4
26.1 Toothed Tissue Forceps (8”)
2 2 4 0 4
26.2 Non-Tooted Tissue Forceps (8”)
2 2 4 0 4
26.3 Dissection Scissors (Curved 7”)
2 2 4 5 -
26.4 Dissection Scissors (Straight 7”)
2 2 4 0 4
26.5 Hysterectomy Clamps (Straight)
8 8 16 6 10
26.6 Hysterectomy Clamps (Curved)
8 8 16 3 13
26.7 Uterine Sound 2 2 4 6 -
26.8 Needle Holder (7”) 2 2 4 21 -
26.9 Needle Holder (10”) 2 2 4 24 -
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
26.10 Artery Forceps (Straight 6”)
16 16 32 - -
26.11 Artery Forceps (Curved 6”)
16 16 32 47 -
26.12 Allis Forceps 8 8 16 109 -
26.13 Towel Clamps 8 8 16 1 15
26.14 Single blade Sims speculum
4 4 8 2 6
26.15 Double blade Sims speculum
4 4 8 4 3
26.16 Sponge holding forceps 8 8 16 - 16
26.17 Volselum forceps 4 4 8 - 8
26.18 Uterine Sound 2 2 4 0 4
26.19 Bladder Sound 2 2 4 4 0
27 Delivery Sets 10 10 15 1 14
27.1 Episiotomy Scissors 10 10 15 1 14
27.2 Straight Scissors 10 10 15 1 12
27.3 Needle holder 10 10 15 1 14
27.4 Non-toothed tissue forceps 8 inches
10 10 15 1 14
27.5 Toothed tissue forceps 8 inches
10 10 15 0 15
27.6 Sims Speculum single blade
20 20 30 1 29
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
27.7 Sims Speculum double blade
20 20 30 1 29
27.8 Sponge holding forceps 40 40 60 2 58
27.9 Artery forceps 40 40 60 0 60
27.10 Straight clamps (cord) 20 20 30 2 28
27.11 Vacuum Extractor pump 1 1 1 1 0
27.12 Towel clip 40 40 60 0 60
28 Caesarian Section 6 8 10 - 10
28.1 Scalpel 6 8 10 42 -
28.2 Artery Forceps Straight 6 inches
24 32 40 - 40
28.3 Artery Forceps Curved 6 inches
24 32 40 - 40
28.4 Artery forceps 8 inches 24 32 40 - 40
28.5 Myoma Scissors straight 7 inches
6 8 10 - 10
28.6 Dissecting scissors (curved) 7 inches
6 8 10 - 10
28.7 Green Armtage forceps 8 inches
24 32 40 4 36
28.8 Obstetric outlet forceps (pair)
6 8 10 1 9
28.9 Doyene’s Retractor 6 8 10 1 9
28.10 Small Retractors 12 16 20 2 18
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
28.11 Towel Clippers 24 32 40 - 40
28.12 Suction Nozzle 6 8 10 2 8
29 MNCH Related Radiology Equipments
29.1 Ultrasound Machine 1 2 3 1 2
29.2 X-Ray Unit 500 kw 1 1 1 1 0
29.3 Color Doppler 0 1 1 1 0
29.4 Lead Screen for X-Ray Unit
1 1 1 1 0
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets
1 1 1 1 0
29.6 Safe Light 1 1 1 1 0
29.7 X-RT Film Processing Tank
1 1 1 1 0
29.8 Chest Stand 1 1 1 - 1
29.9 X-Ray film Illuminator 2 2 2 2 0
29.10 X-Ray Film Hangers All sizes
4 4 4 4 0
30 MNCH Related Pediatrics Equipments
30.1 Pediatric Ventilator 1 2 2 - 2
30.2 Incubator 1 1 2 2 0
30.3 Photo Therapy Unit 1 1 1 1 0
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
30.4 Over-head Radiant Warmer
1 1 1 1 0
30.5 Infant Length Measuring Scale
2 2 2 2 0
30.6 Infant Weighing Machine
2 2 2 1 1
30.7 Nebulizer 1 1 2 1 1
30.8 Billiubino-meter 1 1 2 - 2
30.9 Exchange Blood Transfusion Set
1 1 2 1 1
30.10 Nasal Probe Paed size 2 2 4 1 3
31 Anesthesia/ICU
31.1 Anesthesia Machine 1 1 2 3 -
31.2 Ventilators 1 1 1 1 0
31.3 Nebulizer 1 1 1 1 0
31.4 Pulse Oximetry 1 1 1 7 -
31.5 Defibrillator 1 1 1 6 -
31.6 Airway Oral and Nasal 2 3 4 1 3
31.7 Tracheostomy tube (adult and paeds)
2 2 4 4 0
31.8 Face mask of all sizes 2 2 4 100 -
31.9 Double Cuff Tourniquet (for regional block)
1 2 2 2 0
31.10 AMBO bag adult 2 2 4 20 -
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
31.11 AMBO Bag paeds 2 2 4 - 4
31.12 Red Rubber Nasal tubes all sizes without cuff
4 4 8 - 8
32 Blood Bank
32.1 Blood storage cabinet (100 bag capacity)
1 1 2 1 1
32.2 Packed cell machine 1 1 1 - 1
32.3 Cell Separator 1 1 1 - 1
32.4 Freezer for Fresh Frozen Plasma
1 1 1 - 1
32.5 Blood bag shaker 1 1 2 1 1
32.6 RH view box 2 2 4 1 3
32.7 Water bath 2 2 2 1 1
32.8 Micro-pipette 4 6 8 1 7
32.9 Blood grouping tiles 3 3 6 - 6
32.10 Plasma Extractor 1 1 1 - 1
32.11 Platelets agitator 1 1 1 - 1
32.12 Blood thawing bath 1 1 1 - 1
32.13 Microscopes 1 1 2 1 1
33 Gynae & Labor Room Related Laboratory Equipment
33.1 Hematology Analyzer 1 1 1 - 1
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
33.2 Electrolyte Analyzer 1 1 1 - 1
33.3 Analyzer Bio-chemistry Semi-automatic
1 1 1 - 1
33.4 Glucometer 2 2 2 - 2
33.5 Haemoglobino-meter 2 2 4 - 4
33.6 Centrifuge 1 1 2 - 2
ii. THQ Hospital
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
1 CTG (Cardiac Topography)
1 1 1 - 1
2 Foetal Doppler 2 2 3 - 2
3 Diagnostic Laparoscope
1 1 1 - 1
48
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
4 Bulb Sucker 5 10 20 1 9
5 Baby Warmer 2 2 3 1 1
6 Mechanical Sucker 3 3 3 1 2
7 Fetal Stethoscope 2 3 4 - 3
8 Delivery Table 2 2 2 - 2
9 D&C Set 2 2 2 - 2
10 Outlet forceps 4 4 4 1 3
11 Myoma Screw 2 2 2 1 1
12 Kochers forceps 4 4 4 - 4
13 Volselum forceps 4 4 6 1 3
14 Lanes Tissue holding forceps
2 2 2 1 1
15 Vaginal Retractors 4 4 6 1 3
16 Polypectomy forceps 2 2 2 - 2
17 Sponge holder 10 10 15 3 7
18 Uterine elevator 1 1 1 - 1
19 CosCo Speculum
Small, Medium, Large (for each category)
4 6 6 1 5
20 Examination light 3 3 3 1 2
21 Suction Curette 1 1 2 - 1
49
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
1 1 1 1 0
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
1 1 1 1 0
24 Cardiac Monitor 1 1 1 - 1
25 Pump Breast Electronic
1 1 1 - 1
26 Vaginal Hysterectomy Set
2 2 2 - 2
26.1 Toothed Tissue Forceps (8”)
2 2 2 6 -
26.2 Non-Tooted Tissue Forceps (8”)
2 2 2 6 -
26.3 Dissection Scissors (Curved 7”)
2 2 2 1 1
26.4 Dissection Scissors (Straight 7”)
2 2 2 1 1
26.5 Hysterectomy Clamps (Straight)
8 8 8 - 8
50
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
26.6 Hysterectomy Clamps (Curved)
8 8 8 - 8
26.7 Uterine Sound 2 2 2 1 1
26.8 Needle Holder (7”) 2 2 4 4 -
26.9 Needle Holder (10”) 2 2 2 4 -
26.10 Artery Forceps (Straight 6”)
16 16 16 12 4
26.11 Artery Forceps (Curved 6”)
16 16 16 12 4
26.12 Allis Forceps 8 8 8 10 -
26.13 Towel Clamps 8 8 8 8 0
26.14 Single blade Sims speculum
4 4 4 1 3
26.15 Double blade Sims speculum
4 4 4 1 3
26.16 Sponge holding forceps 8 8 8 8 0
26.17 Volselum forceps 4 4 4 1 3
26.18 Uterine Sound 2 2 2 1 1
26.19 Bladder Sound 2 2 2 - 2
27 Delivery Sets 6 6 10 2 4
27.1 Episiotomy Scissors 6 6 10 3 3
27.2 Straight Scissors 6 6 10 6 0
27.3 Needle holder 6 6 10 6 0
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
27.4 Non-toothed tissue forceps 8 inches
6 6 10 6 0
27.5 Toothed tissue forceps 8 inches
6 6 10 4 2
27.6 Sims Speculum single blade
12 12 20 1 11
27.7 Sims Speculum double blade
12 12 20 1 11
27.8 Sponge holding forceps 40 40 40 8 32
27.9 Artery forceps 40 40 40 12 28
27.10 Straight clamps (cord) 20 20 30 2 18
27.11 Vacuum Extractor pump
1 1 1 - 1
27.12 Towel clip 40 40 40 8 32
28 Caesarian Section 4 4 6 2 2
28.1 Scalpel 4 4 6 4 0
28.2 Artery Forceps Straight 6 inches
16 16 24 6 10
28.3 Artery Forceps Curved 6 inches
16 16 24 12 4
28.4 Artery forceps 8 inches 16 16 24 - 16
28.5 Myoma Scissors straight 7 inches
4 4 6 - 4
28.6 Dissecting scissors (curved) 7 inches
4 4 6 2 2
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
28.7 Green Armtage forceps 8 inches
16 16 24 - 16
28.8 Obstetric outlet forceps (pair)
4 4 6 2 2
28.9 Doyene’s Retractor 4 4 6 2 2
28.10 Small Retractors 8 8 12 6 2
28.11 Towel Clippers 16 16 24 8 8
28.12 Suction Nozzle 4 4 6 1 3
29 MNCH Related Radiology Equipments
29.1 Ultrasound Machine 1 1 2 1 0
29.2 X-Ray Unit 500 kw 1 1 1 - 1
29.3 Color Doppler 0 0 0 - 0
29.4 Lead Screen for X-Ray Unit
1 1 1 - 1
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets
1 1 1 - 1
29.6 Safe Light 1 1 1 - 1
29.7 X-RT Film Processing Tank
1 1 1
29.8 Chest Stand 1 1 1 1
29.9 X-Ray film Illuminator 2 2 2 2
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
29.10 X-Ray Film Hangers All sizes
4 4 4 4
30 MNCH Related Pediatrics Equipments
30.1 Pediatric Ventilator 1 1 2 - 1
30.2 Incubator 1 1 1 - 1
30.3 Photo Therapy Unit 1 1 1 - 1
30.4 Over-head Radiant Warmer
1 1 1 - 1
30.5 Infant Length Measuring Scale
2 2 2 - 2
30.6 Infant Weighing Machine
2 2 2 - 2
30.7 Nebulizer 1 1 1 1 0
30.8 Billiubino-meter 1 1 1 - 1
30.9 Exchange Blood Transfusion Set
1 1 1 - 1
30.10 Nasal Probe Paed size 1 2 2 1 1
31 Anesthesia/ICU
31.1 Anesthesia Machine 1 1 1 1 0
31.2 Ventilators 1 1 1 - 1
31.3 Nebulizer 1 1 1 1 0
31.4 Pulse Oximetry 1 1 1 1 0
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
31.5 Defibrillator 1 1 1 1 0
31.6 Airway Oral and Nasal 1 2 2 2 0
31.7 Tracheostomy tube (adult and paeds)
1 2 2 - 2
31.8 Face mask of all sizes 1 2 2 - -
31.9 Double Cuff Tourniquet (for regional block)
1 1 1 - 1
31.10 AMBO bag adult 1 2 2 1 1
31.11 AMBO Bag paeds 2 2 2 1 1
31.12 Red Rubber Nasal tubes all sizes without cuff
4 4 4 - 4
32 Blood Bank
32.1 Blood storage cabinet (100 bag capacity)
1 1 1 - 1
32.2 Packed cell machine 1 1 1 - 1
32.3 Cell Separator 1 1 1 - 1
32.4 Freezer for Fresh Frozen Plasma
1 1 1 - 1
32.5 Blood bag shaker 1 1 1 - 1
32.6 RH view box 1 2 2 - 2
32.7 Water bath 2 2 2 - 2
32.8 Micro-pipette 4 4 6 - 4
55
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Equipment Standard as per MSDS
(Qty.)
Available Gap Remarks
C B A
32.9 Blood grouping tiles 3 3 3 - 3
32.10 Plasma Extractor 1 1 1 - 1
32.11 Platelets agitator 1 1 1 - 1
32.12 Blood thawing bath 1 1 1 - 1
32.13 Microscopes 1 1 1 1 0
33 Gynae & Labor Room Related Laboratory Equipment
33.1 Hematology Analyzer 1 1 1 - 1
33.2 Electrolyte Analyzer 1 1 1 - 1
33.3 Analyzer Bio-chemistry Semi-automatic
1 1 1 - 1
33.4 Glucometer 2 2 2 1 1
33.5 Haemoglobino-meter 1 1 1 1 0
33.6 Centrifuge 1 1 1 1 0
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Three Years Rolling Plan 2010-2013 District Sheikhupura
SECTION 3: INTERVENTIONS AND TARGETS
After enlisting the vital causes of prioritized health problems, team proposed appropriate interventions
to tackle the problems. Once interventions and activities had been identified, next task the planning
team performed was to set the number and quality of specific activities (targets) that have to be carried
out. It is pertinent to mention over here that the plan envisages additional activities along with routine
activities under regular budget.
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Health Problems
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
1 Diarrhea Poor sanitation Coordination with TMA for improvement of water supply and sanitation
Quarterly co-ordination Meeting with TMA and other agencies
Meeting 12 4 4 4
Lack of safe drinking water
Health Education campaign
Messages on local cable network
Message 36 12 12 12
Unhygienic practices
Improving literacy through coordination with education department
Printing and distribution of IPC material
Brochure 100,000 40,000 30,000 30,000
Lack of awareness in general population
Proper treatment of Diarrhea including ORT
Address in school assemblies
Session 2,000 2,000 2,000 2,000
Lack of awareness among mothers about feeding and weaning practices
Capacity building of health staff in Integrated Management of Childhood Illnesses (IMCI)
Training of medics and paramedics in IMCI
No. of trainings
15 15 - -
Low Socio Economic status
Procurement and distribution of ORS
ORS packets 100,000 40,000 35,000 25,000
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Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Malnutrition Procurement and distribution of Syp. Zink Sulphate
Syrup 200,000 100,000 50,000 50,000
Procurement and Distribution of Syrup Metronidazole
Syrup 150,000 50,000 50,000 50,000
Procurement and Distribution of Inj. Metronidazole
Injection 30,000 10,000 10,000 10,000
Procurement & Distribution of IV Fluids
Injection 20,000 10,000 5,000 5,000
2 Anemia ( including pregnancy)
Lack of awareness about balanced diet
Awareness raising for behavior change
Messages on local cable network
Message 36 12 12 12
Gender discrimination
Awareness raising for behavior change
Printing and distribution of IPC material
Brochure 100,000 40,000 30,000 30,000
Social taboos and norms
Awareness raising for behavior change
Counseling of pregnant mothers
Session - - -
Worm infestation Deworming campaign
Procurement of de-worming tablets
No. of doses 100,000 35,000 35,000 30,000
Infections Diagnosis and treatment of infections
Distribution through LHWs and health facilities
- - - -
59
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Poor quality of MNCH services
Strengthening MNCH Services
Refresher Trainings of LHWs on BCC, balanced diet and provision of micro-nutrients
No. of trainings
65 35 30 -
Poverty/ Low socio economic status
Equity of services Provision of Sehat Suhlat Card/health voucher
- - - -
3 Acute (upper) respiratory infections
Malnutrition Capacity building of health staff in ARI case management
Messages on local cable networks
Message 36 12 12 12
Air Contamination
Capacity building of health staff in Integrated Management of Childhood Illnesses (IMCI)
Messages through FM radio channels
Message 36 12 12 12
Over-crowding/Poor housing facilities
Provision of medicines for ARI
Printing and distribution of IPC material
Brochure 400,000 200,000 100,000 100,000
Lack of proper sanitation
Timely referral of complicated cases
Training of medics and para-medics in IMCI
No. of trainings
- - - -
Seasonal variation
Procurement and distribution of Antibiotic Syrup Amoxicillin
Antibiotic (Syrup)
60,000 20,000 20,000 20,000
60
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Lack of awareness and hygienic practices
Procurement and distribution of Inj. Cefotaxime Sodium 1mg
Injection 25,000 10,000 8,000 7,000
Procurement and distribution of Inj. Cefotaxime Sodium 500mg
Injection 25,000 10,000 8,000 7,000
Procurement and distribution of Inj. Cefotaxime Sodium 250mg
Injection 25,000 10,000 8,000 7,000
4 Hepatitis Poor sanitation Health Education/Promotion
Quarterly co-ordination meetings with TMA and other agencies
Meetings - - - -
Unsafe drinking water
Improving water & sanitation
Messages on local cable network
Message 36 12 12 12
Sharing of used syringes
Campaign against quackery
Printing and distribution of IPC material
Brochure 500000 200000 200000 100000
Transfusion of unsafe blood and blood products
Strengthening blood transfusion services for safe transfusions
Printing and pasting of stickers at clinics and Barber shop highlighting use of new syringes & Razors
Stickers 1500 1500 - -
61
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Unsafe sexual practices
Regulatory mechanism to ensure use of safe instruments by dentists, barbers etc.
Hepatitis awareness week ( walk/display banners/seminars)
3 1 1 1
Ear & Nose piercing and tattooing
Procurement & Distribution of HCV Device
Kits 30000 10000 10000 10000
Use of unsterilized equipment by dentists and barbers
Procurement & Distribution of BSAG Device
Kits 30000 10000 10000 10000
Procurement & Distribution of HIV Device
Kits 30000 10000 10000 10000
Procurement and supply of HCV Eliza kits
Kits 18 6 6 6
Procurement and supply of HBV Eliza kits
Kits 9 3 3 3
Procurement of syringe cutters
Syringe cutter
1800 600 600 600
Procurement and distribution of Interforan Injection
Courses 1200 400 400 400
62
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Documentation of expense of disposable syringes
- - - -
Procurement & Distribution of SGPT
Kits 36 12 12 12
Procurement & Distribution of SGOT
Kits 36 12 12 12
5 High MMR Poor access to healthcare delivery services
Health education/promotion
Messages on local cable network
Message 36 12 12 12
Lack of awareness about danger signs of pregnancy
Behaviour change communication for Mothers of child bearing age
Printing and distribution of IPC material
Brochure 300,000 100,000 100,000 100,000
Low ante-natal coverage
Provision of Quality basic EmONC services at BHU & RHC
Training of LHWs on BCC
No. of trainings
65 65 - -
Low skilled birth attendance
Provision of Quality Comprehensive EmONC services at THQs hospital
Procurement of vehicles for transportation through CCBs
- - - -
63
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Three delays (seeking health care, transportation, and lack of referral back-up services)
Improving transportation of the patients
Operation and management of vehicles through CCBs
- - - -
Complications of pregnancy
Repair of non functional ambulances for timely transportation of pregnant mothers
- - - -
Capacity Issues related to maternal care
Replacement of the non functional ambulances for timely transportation of pregnant mother
- - - -
Maternal Anemia Procurement of the MNCH related equipment and Instruments
- - - -
Pregnancy following chronic severe diseases
Implementation of the referrals protocols
- - - -
Procurement of Micro-nutrients
Packs 60,000 30,000 15,000 15,000
Procurement and distribution of Calci-D
No. of tablets 60,000 30,000 15,000 15,000
64
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Procurement and distribution of Anti-D
Injection 30 10 10 10
6 High under 5 Mortality
Poor antenatal natal and post natal coverage
Health awareness/education
Message on local cable
Message 36 12 12 12
Neo-natal Infections
Provision of the quality basic EMONC services at BHU & RHC
BCC of mothers 0n promotion of breast feeding and weaning practices through LHWs
Number of Trainings
- - - -
Birth Trauma & Asphyxia
Provision of the quality Comprehensive EMONC services at THQH & DHQH
Provision of the deficient infrastructure at THQ
Assessment - - - -
No cost activity
Prematurity Improvement of feeding and weaning practices
Trainings on IMNCI No. of trainings
- - - -
Poor feeding and weaning practices
Capacity building of Human Resource dealing child health care
Need assessment of food supplements
Assessment - - - -
Diarrhea Enhancing EPI coverage
procurement from DGHs office
Assessment - - - -
65
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
ARI Poverty elevation Distribution of food supplements to mothers & children through LHWs & community mid wives
Assessment - - - -
Lack of capacity of staff for provision of proper child health care (diagnostic and timely referrals)
Provision of food supplements
Raising income of the poor families through Baitul Mall and Zakat
Assessment - - - -
Low socio economic status
Revising the micro plans of Vaccinators
- - - -
Malnutrition - - - -
Lack of birth spacing
- - - -
Low EPI Coverage
- - - -
7 TB Suspects Low socio-economic status
Health education/promotion
Messages on local cable networks
Message 36 12 12 12
66
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Seasonal variation
Strengthening TB DOTS program through involvement of private sector
Printing and distribution of IPC material
Brochure 400,000 200,000 100,000 100,000
Lack of proper sanitation
Involvement of private providers through public private partnership
Procurement of drugs to ensure deficiency according to regimen
ATT course 600 200 200 200
Lack of awareness and hygienic practices
Procurement of reagents for notified diagnostic facilities under DOTS programme
Packs 80 30 30 20
Trainings on DOTS protocols
No. of trainings
20 10 10 -
8 Accident & Injuries
Lack of traffic sense
Coordination with police department to improve traffic sense and ensuring observance of traffic rules
Quarterly co-ordination meetings with Traffic Police department
Meeting 12 4 4 4
Poor maintenance of vehicles
Advocacy for improving the condition of roads
Quarterly co-ordination meetings with Highway department
Meeting 12 4 4 4
67
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Problem Causes Intervention Activities UnitPlan Activities
Targets
Target for 2010-
11
Target for 2011-
12
Target for 2012-
13Remarks
Poor road conditions
Health education/promotion to prevent domestic accidents
Preparation of Disaster Management Plan including the Patient Management protocols
1 1 - -
Lack of safety measures at work place
Ensure enforcement of safety laws at work places
Training of the medics and the paramedics
- - - -
Fire-arm injuries Provision of emergency kits for blast victims
Kits 1,100 800 300 -
Domestic accidents
Procurement of equipments / instruments / various splints and Plaster casts
- - - -
Burns - - - -
Bomb blasts/terrorist activities
- - - -
Lack of tolerance in the society
- - - -
68
Three Years Rolling Plan 2010-2013 District Sheikhupura
Management Problems
Human Resource Plan to bridge the Gaps between MSDS Proposed and Sanctioned Posts
Sr.No. Name of PostBasic Scale Basic Pay Allowances
Requirement as per Gap
Physical Targets
Year I Year II Year III
1 Gynecologist 18 12,910 18,099 1 1 - -
2 Pediatricians 18 12,910 18,099 4 2 1 1
3 Anesthetists 18 12,910 18,099 7 3 2 2
69
Three Years Rolling Plan 2010-2013 District Sheikhupura
4 MO / WMO 17 9,850 15,345 68 24 22 22
5 Nurses 16 6,060 8,934 45 15 15 15
6 Lady Health Visitors 9 3,820 4,750 18 6 6 6
Sr. No
Problem Causes Intervention Activities UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
1 Shortage of skilled staff
Vacant positions Filling of the vacant posts
Temporary Filling of the vacant posts of medics and the paramedics through existing recruitment committees
Recruitment - - - - -
Non-sanctioning of staff according to MSDS
Sanctioning of positions according to MSDS
Demand generation and request to the Department of Health by the districts for recruitment through PSC against vacant posts
Plan - - - - -
Lack of permanent postings
Recruitment through Public Service Commission on regular basis
Districts to prepare the incentivized pay package with consultation of all stockholders
Pay Package - - - - -
Lack of incentivies and differential pay packages
Incentivized pay package at all levels
Consensus building between the districts for uniform incentivized pay package for all categories and levels staff
Meeting - - - - -
70
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No
Problem Causes Intervention Activities UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
Frequent transfer postings
Well defined career structure including opportunities for higher education
Request to the Provincial Government for approval and implementation of agreed pay packages
Plan - - - - -
Job insecurity Conducive working environment
Review and revise the career structure of medics, paramedics and technical staff like Sos, Health Education officers etc
T A - - - - -
Lack of basic amenities at workplace
Provision of staff Residences
Availability of recreation, education and other facilities for children of staff working in rural areas
Plan EDOH - - - - -
Lack of conducive environment including insecurity and transport of children for education
High level political commitment for providing protection to staff working in health facilities
Construction of the residences for the staff
Requirement Plan
- - - - -
Political & Media Interference
provision of recreation facilities (Parks/Play area/common rooms)
Plan EDOH - - - - -
Deficient transparent accountability
Provision of the transport of staff children for the education purposes
Plan EDOH - - - - -
Shortage of the residences
Capacity and need assessment of the medics and the paramedics
TNA - - - - -
71
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No
Problem Causes Intervention Activities UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
Medico-legal work specially for Females
Prepare training programs for providing higher professional education based on TNA
Plan - - - - -
2 Inadequate budget for POL
Installation of the Generator for back up electricity supply
Rational increase in POL Budget
Assessing additional need for POL
- - - - -
Frequent increase in prices of POL
Costing & Submit ion the additional Demand for POL
P O L 60,143
Liters
60143
Less allocation for POL budget
- - - - -
Increase in Vehicles
- - - - -
72
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No
Problem Causes Intervention Activities UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
3 Capacity Issues of
Staff
Delayed release and use of funds due to procedural in- familiarity and clarity
Lack of culture of Supportive Supervision
Limited capacity in transforming data in to information
Lack of evidence based decision making in planning and management
Capacity building of DDOs and other related staff in financial management
Capacity building in Supportive Supervision
Capacity building in use of information
Financial Management workshops
No. of trainings
1 1 - - -
Training on Use of Information No. of trainings
1 1 - - -
Training on Supportive supervision
No. of trainings
1 1 - - -
73
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No
Problem Causes Intervention Activities UnitPlan Activities
TargetsTarget for 2010-11
Target for 2011-12
Target for 2012-13
Remarks
4 Deficient equipment (with reference to notified list) at DHQH,THQHs
Deficient equipment to cater basic and comprehensive EmONC at primary and secondary level of care
Make up the deficiencies against gaps identified
Purchase of MNCH related equipment at DHQ Hospital Sheikhupura
Equipment 1 1 - - -
Purchase of MNCH related equipment at THQ Hospital Muridke
Equipment 1 1 - - -
74
Three Years Rolling Plan 2010-2013 District Sheikhupura
SECTION 4: COSTING AND FINANCING PLANActivity based costingThe planning team has used the best available data sources, for calculation of estimates for the
intervention/activities. It is pertinent to mention that the costing of the plan is based on additional
needs and activities. The detailed activity based costing of the Health and Service Delivery
problems has been performed on automated Excel sheets, which are hyperlinked as H & M sheets .
A moderate estimate of equipment cost has been taken, as there is wide variation between the
minimum and maximum cost. The detailed cost of MNCH related equipment has been annexed as
Annex II
The summary of problem and activity wise costing is given below.
Problem wise cost summary of Health Problems
Sr. No
.Problem
F Y I FY II FY IIITotal Cost Rs.
Amount (Rs.) Amount (Rs.) Amount (Rs.)
1 Diarrheal Diseases 7,819,000 4,339,500 4,712,950 16,871,450
2Anemia ( including in pregnancy)
1,519,000
1,524,600
929,280
3,972,880
3 ARI (under 5) 2,584,000 2,235,200 2,366,760 7,185,960
4 Hepatitis 8,555,000 9,313,000 9,745,300 27,613,300
5 High maternal mortality 3,597,000 1,719,300 1,891,230 7,207,530
6 High under five mortality 288,000 316,800 348,480 953,280
7 Tuberculosis 1,272,000 959,200 832,480 3,063,680
8Road side accident & Injuries
4,496,800 1,871,430 29,040 6,397,270
Total 30,130,800 22,279,030 20,855,520 73,265,350
75
Three Years Rolling Plan 2010-2013 District Sheikhupura
a) Health Problems
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
1 Diarrhea Quarterly co-ordination Meeting with TMA and other agencies
Meeting 3,000 12 12,000 13,200 14,520 39,720
Messages on local cable network
Message 24,000 36 288,000 316,800 348,480 953,280
Printing and distribution of IPC material
Boucher 4 100,000 160,000 132,000 145,200 437,200
Address in school assemblies
Session 2,000 - - - -
Training of medics and paramedics in IMCI
No. of trainings
120,600 15 1,809,000 - - 1,809,000
76
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Procurement and distribution of ORS
ORS packets 5 100,000 200,000 192,500 151,250 543,750
Procurement and distribution of Syp. Zink Sulphate
Syrup 35 200,000 3,500,000 1,925,000 2,117,500 7,542,500
Procurement and Distribution of Syrup Metronidazole
Syrup 15 150,000 750,000 825,000 907,500 2,482,500
Procurement and Distribution of Inj. Metronidazole
Injection 60 30,000 600,000 660,000 726,000 1,986,000
Procurement & Distribution of IV Fluids
Injection 50 20,000 500,000 275,000 302,500 1,077,500
- - 7,819,000 4,339,500 4,712,950 16,871,450
77
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
2 Anemia ( including pregnancy)
Messages on local cable network
Message 24,000 36 288,000 316,800 348,480 953,280
Printing and distribution of IPC material
Boucher 4 100,000 160,000 132,000 145,200 437,200
Counseling of pregnant mothers
Session LHWs are expected to conduct counseling session on behavior change during their visit to pregnant ladies
- - - -
Procurement of de-worming tablets
No. of doses 12 100,000 420,000 462,000 435,600 1,317,600
Distribution through LHWs and health facilities
- - - - - -
78
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
·Refresher Trainings of LHWs on BCC, balanced diet and provision of micro-nutrients
No. of trainings
18,600 65 651,000 613,800 - 1,264,800
- - 1,519,000 1,524,600 929,280 3,972,880
3 Acute (upper) respiratory infections
Messages on local cable networks
Message 24,000 36 288,000 316,800 348,480 953,280
Messages through FM radio channels
Message 28,000 36 336,000 369,600 406,560 1,112,160
Printing and distribution of IPC material
Boucher 4 400,000 800,000 440,000 484,000 1,724,000
79
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Training of medics and para-medics in IMCI
No. of trainings
IMCI Training package costed in Diarrhea also includes management of ARI
- - - - -
Procurement and distribution of Antibiotic Syrup Amoxicillin
Antibiotic (Syrup)
20 60,000 400,000 440,000 484,000 1,324,000
Procurement and distribution of Inj. Cefotaxime Sodium 1mg
Injection 25 25,000 250,000 220,000 211,750 681,750
Procurement and distribution of Inj. Cefotaxime Sodium 500mg
Injection 26 25,000 260,000 228,800 220,220 709,020
Procurement and distribution of Inj. Cefotaxime Sodium 250mg
Injection 25 25,000 250,000 220,000 211,750 681,750
- - 2,584,000 2,235,200 2,366,760 7,185,960
80
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
4 Hepatitis Quarterly co-ordination meetings with TMA and other agencies
Meetings Costed in diarrhoeal disease
- - - - -
Messages on local cable network
Message 24000 36 288,000 316,800 348,480 953,280
Printing and distribution of IPC material
Boucher 4 500000 800,000 880,000 484,000 2,164,000
Printing and pasting of stickers at clinics and Barber shop highlighting use of new syringes & Razors
Stickers 50 1500 75,000 - - 75,000
Hepatitis awareness week ( walk/display banners/seminars)
Lump sum 3 150,000 150,000 150,000 450,000
Procurement & Distribution of HCV Device
Kits 30 30000 300000 330,000 363,000 993,000
81
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Procurement & Distribution of BSAG Device
Kits 30 30000 300000 330,000 363,000 993,000
Procurement & Distribution of HIV screening Devices
Kits 30 30000 300000 330,000 363,000 993,000
Procurement and supply of HCV Eliza kits
Kits 10000 18 60,000 66,000 72,600 198,600
Procurement and supply of HBV Eliza kits
Kits 8000 9 24000 26,400 29,040 79,440
Procurement of syringe cutters
Syringe cutter 150 1800 90,000 99,000 108,900 297,900
Procurement and distribution of Interferon Injection
Courses 15000 1200 6,000,000 6,600,000 7,260,000 19,860,000
Documentation of expense of disposable syringes
- - - - - -
82
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Procurement & Distribution of SGPT
Kits 7000 36 84,000 92,400 101,640 278,040
Procurement & Distribution of SGOT
Kits 7000 36 84000 92,400 101,640 278,040
- - 8,555,000 9,313,000 9,745,300 27,613,300
5 High MMR Messages on local cable network
Message 24,000 36 288,000 316,800 348,480 953,280
Printing and distribution of IPC material
Boucher 4 300,000 400,000 440,000 484,000 1,324,000
Training of LHWs on BCC
No. of trainings
18,600 65 1,209,000 - - 1,209,000
Procurement of vehicles for transportation through CCBs
Costed in service delivery problems
- - -
83
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Operation and management of vehicles through CCBs
Costed in service delivery problems
- - - -
Repair of non functional ambulances for timely transportation of pregnant mothers
Costed in service delivery problems
- - - -
Replacement of the non functional ambulances for timely transportation of pregnant mother
Costed in service delivery problems
- - - -
Procurement of the MNCH related equipment and Instruments
Costed in service delivery problems
- - - -
Implementation of the referrals protocols
Costed in MSDS Gaps
- - - - -
84
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Procurement of Micro-nutrients
Packs 35 60,000 1,050,000 577,500 635,250 2,262,750
Procurement and distribution of Calci-D
No. of tablets 20 60,000 600,000 330,000 363,000 1,293,000
Procurement and distribution of Anti-D
Injection 5,000 30 50,000 55,000 60,500 165,500
- - 3,597,000 1,719,300 1,891,230 7,207,530
6 High under 5 Mortality
Message on local cable
Message 24,000 36 288,000 316,800 348,480 953,280
BCC of mothers 0n promotion of breast feeding and weaning practices through LHWs
Number of Trainings
LHWs training on BCC of mothers on promotion of breast feedings
- - - - -
85
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Provision of the deficient infrastructure at THQ
Assessment As proposed in MSDS Gaps
- - - - -
Trainings on IMNCI No. of trainings
IMNCI Training package costed in Problem Diarrhea also includes management of ARI
- - - - -
Need assessment of food supplements
Assessment Assessing below poverty pregnant mother through LHWs and providing them food supplement through DGHS & Financial support from Baitul Mall & Zakat
- - - - -
86
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
procurement from DGHs office
Assessment Assessing below poverty pregnant mother through LHWs and providing them food supplement through DGHS & Financial support from Baitul Mal & Zakat
- - - - -
Distribution of food supplements to mothers & children through LHWs & community mid wives
Assessment Assessing below poverty pregnant mother through LHWs and providing them food supplement through DGHS & Financial support from Baitul Mall & Zakat
- - - - -
Raising income of the poor families through Baitul Mall and Zakat
Assessment Assessing below poverty pregnant mother through LHWs and providing them food supplement through DGHS & Financial support from Baitul Mal & Zakat
- - - - -
87
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Revising the micro plans of Vaccinators
- - - - -
288,000 316,800 348,480 953,280
7 TB Suspects Messages on local cable networks
Message 24,000 36 288,000 316,800 348,480 953,280
Printing and distribution of IPC material
Boucher 4 400,000 800,000 440,000 484,000 1,724,000
Procurement of drugs to ensure deficiency according to regimen
ATT course To be procured from the PTP
600 - - - -
Procurement of reagents for notified diagnostic facilities under DOTS programme
Packs To be procured from the PTP
80 - - - -
Trainings on DOTS protocols
No. of trainings
18,400 20 184,000 202,400 - 386,400
88
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
1,272,000 959,200 832,480 3,063,680
8 Accident & Injuries
Quarterly co-ordination meetings with Traffic Police department
Meeting 3,000 12 12,000 13,200 14,520 39,720
Quarterly co-ordination meetings with Highway department
Meeting 3,000 12 12,000 13,200 14,520 39,720
Preparation of Disaster Management Plan including the Patient Management protocols
EDOH prepared the plan
1 - - - -
Training of the medics and the paramedics
- - - - -
Provision of emergency kits for blast victims
Kits 5,591 1,100 4,472,800 1,845,030 - 6,317,830
89
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotal
CostUnit Rate Quantity Year IYear II
(10 %)
Year III
(10 %)
Procurement of equipments / instruments / various splints and Plaster casts
- - - - - -
- - 4,496,800 1,871,430 29,040 6,397,270
90
Three Years Rolling Plan 2010-2013 District Sheikhupura
Problem wise cost summary of Management Problems
91
Sr. No. Problem
F Y I FY II FY III Total Cost Rs.
Amount (Rs.) Amount (Rs.) Amount (Rs.)
1 HR Plan 12,80
4,768 26,27
7,385 42,31
6,478 81,
398,631
2 POL 4,51
0,725 -
-
4,510,725
3 Capacity Issues 10
2,600 -
-
102,600
4Lack of MNCH Equipment
47,133,060
-
-
47,133,060
TOTAL 64,55
1,153 26,27
7,385 42,31
6,478 133,
145,016
Three Years Rolling Plan 2010-2013 District Sheikhupura
b) Management Problems
Human Resource Plan to bridge the Gaps between MSDS Proposed and Sanctioned Posts
Sr.No. Name of PostBasic Scale
Basic Pay
AllowancesRequirement
as per Gap
Financial Targets
Year I Year II Year III
Pay of Officers
Pay of other staff
AllowancesPay of
Officers
Pay of other staff
AllowancesPay of
OfficersPay of
other staffAllowances
1 Gynecologist 18 12,910 18,099 1 154,920 - 217,188 170,412 238,907 187,453 262,797
2 Pediatricians 18 12,910 18,099 4 309,840 - 434,376 511,236 716,720 749,813 1,051,190
3 Anesthetists 18 12,910 18,099 7 464,760 - 651,564 852,060 1,194,534 1,312,172 1,839,582
4 MO / WMO 17 9,850 15,345 68 2,836,800 - 4,419,360 5,980,920 9,317,484 9,725,496 15,151,039
5 Nurses 16 6,060 8,934 45 1,090,800 - 1,608,120 2,399,760 3,537,864 3,959,604 5,837,476
6 Lady Health Visitors
9 3,820 4,750 18 275,040 342,000 605,088 752,400 998,395 1,241,460
4,857,120 275,040
7,672,608 9,914,388 605,088 15,757,909 15,934,538 998,395 25,383,545
92
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotalCost
Unit Rate Quantity Year I Year II (10 %) Year III (10 %)
1 Shortage of skilled staff
Temporary Filling of the vacant posts of medics and the paramedics through existing recruitment committees
Recruitment - - - - - -
Demand generation and request to the Department of Health by the districts for recruitment through PSC against vacant posts
Plan - - - - - -
Districts to prepare the incentivized pay package with consultation of all stockholders
Pay Package - - - - - -
Consensus building between the districts for uniform incentivized pay package for all categories and levels staff
Meeting - - - - - -
Request to the Provincial Government for approval and implementation of agreed pay packages
Plan - - - - - -
93
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotalCost
Unit Rate Quantity Year I Year II (10 %) Year III (10 %)
Review and revise the career structure of medics, paramedics and technical staff like Sos, Health Education officers etc
T A - - - - - -
Availability of recreation, education and other facilities for children of staff working in rural areas
Plan EDOH - - - - - -
Construction of the residences for the staff
Requirement Plan
- - - - - -
provision of recreation facilities (Parks/Play area/common rooms)
Plan EDOH - - - - - -
Provision of the transport of staff children for the education purposes
Plan EDOH - - - - - -
Capacity and need assessment of the medics and the paramedics
TNA - - - - - -
94
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotalCost
Unit Rate Quantity Year I Year II (10 %) Year III (10 %)
Prepare training programs for providing higher professional education based on TNA
Plan - - - - - -
2 Inadequate budget for POL
Assessing additional need for POL
- - - - - -
Costing & Submit ion the additional Demand for POL
P O L 75 60,143 4,510,725 4,510,725
4,510,725 4,510,725
3 Capacity issues of Management and Technical staff
Pursuance of EDO ( F&P) for timely release of funds
- - - - - -
Financial Management workshops
No. of trainings 39000
1 39,000 - - 39,000
Training on Use of Information
No. of trainings 31800
1 31,800 - - 31,800
95
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. Problem Activity
Define Financial TargetsTotalCost
Unit Rate Quantity Year I Year II (10 %) Year III (10 %)
Training on Supportive supervision
No. of trainings 31800
1 31,800 - - 31,800
- - - 102,600 - - 102,600
4 Deficient equipment (with reference to notified list) at THQHs and DHQH
Purchase of MNCH related equipment at DHQ Hospital Sheikhupura
Equipment Detail Annexed
21,813,280 - - 21,813,280
Purchase of MNCH related equipment at THQ Hospital Muridke
Equipment Detail Annexed
25,319,780 - - 25,319,780
- - - 47,133,060 - - 47,133,060
96
Three Years Rolling Plan 2010-2013 District Sheikhupura
Financial Outlay The costing of the plan includes routine recurring budget with 15% price escalation for subsequent years and additional cost involved on the basis of health and management problems; which is essentially required to bring visible improvement in the health system. Other financial resources expected from provincial level through ADP and PMDGP are also part of this plan. Details of the financial estimates for three years rolling plan are attached as Annex-III . Overall financial outlay of the plan is as under:
Budget Summary
2010-2011 2011-2012 2012-2013
Regular district budget 1,054,880,135 1,128,482,592 1,297,754,980
Additional budget based on problem identification
94,681,953 48,556,415 63,171,998
Total 1,149,562,088 1,177,039,007 1,360,926,978
97
Three Years Rolling Plan 2010-2013 District Sheikhupura
SECTION 5: MONITORING & EVALUATION
The monitoring and evaluation targets and indicators mentioned below will be used to gauge the progress of implementation of the plan. Monitoring and evaluation of the three years rolling plan would be carried out through the proposed indicators, targets and means of verifications, by the district health authorities.
M&E of Plan
Indicators Target % Achievement
MoV Responsibility Frequency of
monitoring
Remarks
% of planned supervisory visits conducted
50 visits /year
Inspection Book/Attendance
register
EDOH/DOH/ DDOH/Dist. Monitoring officer
Quarterly
% of RHCs with availability of services (on rotational basis) of essential specialties (Physician, Surgeon, Pediatrician and Gynecologist)
100%
During 1st
year
Movement register/visit book/Attendance register
EDOH / DOH Quarterly
% of health facilities with availability of essential MNCH related equipment (level specific)
100%
During 1st
year
Stock Register EDOH/ DOH/ MSs
6 monthly
Availability of relevant (MNCH) laboratory equipment at appropriate level of care
100%
During 1st
year
Stock Register EDOH/ DOH/MSs, Store keeper
Quarterly
% facilities with availability of essential medicines
100%
During 1st
year
Stock Register EDOH/ DOH/ MSs, Store keeper
Monthly
98
Three Years Rolling Plan 2010-2013 District Sheikhupura
Indicators Target % Achievement
MoV Responsibility Frequency of
monitoring
Remarks
% of functional ambulances in the district
100%
(DHQH/ THQH/ RHCs)
Log Book EDOH/DOH/ Transport officer
Quarterly
% utilization of sanctioned budget
100% of yearly budget
Quarterly Reports EDOH/ DOH/ MSs/ Accounts officer
Quarterly
% of facilities with availability of basic EmONC
100%
(50% during 1st
year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
% of DHQ/THQ hospitals with Comprehensive EmONC services
100% in 3 years
(50% during 1st
year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
% of facilities with availability of separate or partitioned room reserved exclusively for delivery
100% in 3 years (50% during 1st
year)
Supervisory visit report
EDOH/DoH/ DDOH
Quarterly
% of targeted pregnant women newly registered by LHW
Target according to population
DHIS Report EDOH/ Statistical Officer
Quarterly
% of targeted pregnant women received TT-2 vaccine
Target according to population
DHIS Report EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
Delivery conducted by or under supervision of skilled persons reported
60 % During 1st
year
DHIS Report EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
99
Three Years Rolling Plan 2010-2013 District Sheikhupura
Indicators Target % Achievement
MoV Responsibility Frequency of
monitoring
Remarks
%of target children between 18 - 23 months of age fully immunized
Target according to population
DHIS Report EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
% of referred cases attended
100% DHIS Report/ LHWs monthly report
EDOH/ DHIS Coordinator/ Statistical Officer
Quarterly
% of targeted eligible couples provided knowledge and information on Family Planning methods
Target according to population
LHW’s monthly/ quarterly report
EDOH/ Statistical Officer /Coordinator NP-FP&PHC
Quarterly
No. of meetings with participation from other sectors
12 meetings per year
Minutes of meetings
EDOH/ Focal person/s
Quarterly
100
Three Years Rolling Plan 2010-2013 District Sheikhupura
Annex-I
Private Health Facilities in District Sheikhupura
No. of Private Medical Practitioners in District Sheikhupura
Private Practitioners
Male Female Total
2013 78 2091
Private Hospitals
Sr. No.
Name of Location of Hospital
Name of Tehsil
Urban / Rural
Beds
Male Female Total
1. Haider Hospital G.T. Road Muridke
Muridke Urban 10 10 20
2. Raza-e-Habib Hospital G.T. Road Murdke
Muridke Urban 4 4 8
3. Husssain Hospital G.T. Road Muridke
Muridke Urban 3 3 6
4. Tippu Hospital G.T. Road Muridke
Muridke Urban 4 4 8
5. Tariq Hospital G.T. Road Muridke
Muridke Urban 3 3 6
6. Ijaz Hospital G.T. Road Muridke
Muridke Urban 2 2 4
7. Zaneb Hospital G.T. Road Muridke
Muridke Urban 4 4 8
8. Chatha Hospital G.T. Road Muridke
Muridke Urban 5 5 10
9. Mash-al-Clinic G.T. Road Muridke
Muridke Urban 3 3 6
10. Faisal Clinic, Tailway Station Narang Mandi.
Muridke Urban 4 4 8
11. Shahi Hospital G.T. Road Rachna Town F/Wala
Feroze Wala Urban 3 3 6
101
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Name of Location of Hospital
Name of Tehsil
Urban / Rural
Beds
Male Female Total
12. Malik Hospital G.T. Road Rachna Town F/Wala
Feroze Wala Urban 1 1 2
13. Bajwa Hospital G.T. Road Rachna Town F/Wala
Feroze Wala Urban 1 1 2
14. Bismillah Hospital Mian Road Kot Abdul Malik.
Feroze Wala Urban 4 4 8
15. Sarwer General Hospital, Sharif Park Kot Abdul Malik
Feroze Wala Urban
16. Mudassar Hospital Circular Road Sharaq Pur Sharif.
Sharaqpur Sharif
Urban 3 3 6
17. Alfarooq Hospital Circular Road Sharaq Pur Sharif.
Sharaqpur Sharif
Urban 5 5 10
18. Malik Hospital Circular Road Sharaq Pur Sharif.
Sharaqpur Sharif
Urban 4 4 8
19. Umair Hospital Bairoon Gare Sharq Pur.
Sharaqpur Sharif
Urban 5 5 10
20. Yousaf Qureshi Hospital Sargodha Road City Sheikhupura
Sheikhupura Urban 10 10 20
21. Jinnah General Hospital Sargodha Road City Sheikhupura
Sheikhupura Urban 10 10 20
22. Tariq Hospital Gujran Wala Road Sheikhupura.
Sheikhupura Urban 5 5 10
23. Sadiqe Children Hospital Lahore Toad City Sheikhupura.
Sheikhupura Urban 3 3 6
24. Punjab Hospital Sheikhupura Urban 5 5 10
102
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Name of Location of Hospital
Name of Tehsil
Urban / Rural
Beds
Male Female Total
Civil Lines Lahore Road City Sheikhupura
25. Shafa Hospital Civil Lines Lahore Road City Sheikhupura
Sheikhupura Urban 5 5 10
26. Ahmad Hospital Khalid Road City Sheikhupura.
Sheikhupura Urban 3 3 6
27. Centrel City Hospital Lahore Toad City Sheikhupura.
Sheikhupura Urban 10 10 20
28. Zaheer Hospital Lahore Toad City Sheikhupura.
Sheikhupura Urban 5 5 10
29. Pakistan Medical Complex Jadarta Road City Sheikhupura
Sheikhupura Urban 5 5 10
30. Akhter Memorial Hospital Lahor Road Housing Colon City Sheikhupura
Sheikhupura Urban 3 2 5
31. Muhammad Yousaf Saddiquee Hospital Gujeranwala Road City Sheikhupura.
Sheikhupura Urban 3 3 6
32. Saddiqre Hart & General Hospital
Sheikhupura Urban 1 1 2
33. Fatma Memorial Hospital Lahore Road City Sheikhuupura.
Sheikhupura Urban 5 5 10
34. National Hospital, Road Tasvir Mehal Cinema Ciity Sheikhupura.
Sheikhupura Urban 5 5 10
35. Medical Center, Jinnah Park City Sheikhupura.
Sheikhupura Urban 1 1 2
103
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Name of Location of Hospital
Name of Tehsil
Urban / Rural
Beds
Male Female Total
36. Shafi Clinic, Salahudin Road Moh. Jahangirabad City Sheikhupura.
Sheikhupura Urban 5 5 10
37. Nimra Gaini Hospital Near Taxi Stand City Sheikhupura.
Sheikhupura Urban 10 10 20
38. Khan Hospital Sergodha Road City Sheikhupura.
Sheikhupura Urban 5 5 10
39. Dar-ul- Berkat Medi Care Civil lines City Sheikhupura.
Sheikhupura Urban 3 3 6
40. Alsabah Hospital Khalid rod City Sheikhupura.
Sheikhupura Urban 3 3 6
41. Kangna Hospital Civil Lines City Sheikhupura.
Sheikhupura Urban 1 1 2
42. Ghazala Hospital Civil Lines City "Sheikhupura.
Sheikhupura Urban 4 4 8
43. Chlidren Clinic Lahore Road City Sheikhupura.
Sheikhupura Urban 3 3 6
44. Khawer Sergical Hospital Lahore Road City Sheikhupura.
Sheikhupura Urban 5 5 10
45. Zubada Memorial Clinic Railway Road SKP
Sheikhupura Urban 3 3 6
46. Yasib Hospital Civil Lines SKP
Sheikhupura Urban 3 3 6
47. Sheikhupura. Medical Complex
Sheikhupura Urban 5 5 10
48. Malik Hospital opposite Aftab Aslam Plaza City SKP
Sheikhupura Urban 1 1 2
104
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Name of Location of Hospital
Name of Tehsil
Urban / Rural
Beds
Male Female Total
49. Ramzan Memorial Sheikhupura 2 2 450. Virk Hospital
Railway Road Ghala Mandi SKP
Sheikhupura Urban 2 2 4
51. Zahid Eye Hospital Near Taxi Stand City Sheikhupura
Sheikhupura Urban 2 2 4
52. Jabir General & Gaini Hospital Bhakhi
Sheikhupura Rural 2 2 4
53. Mukhtar Memoreal Hospital Khan Colony
Sheikhupura Urban 1 1 2
54. Mohsan Clinic Khalid Road
Sheikhupura Urban 1 1 2
55. Family Hospital Shah Jamal Road SKP
Sheikhupura Urban 5 5 10
56. Shafa Hosopital Gujeranwala Road City Sheikhupurawala
Sheikhupura Urban 1 1 2
57. Nazir Surgical and Gaini Hospital Gujeranwala Road City Sheikhupura.
Sheikhupura Urban 1 1 2
58. Akbar Hosputal Gujeranwala road City Sheikhupura.
Sheikhupura Urban 5 5 10
59. Haji Muhammad Sadiq Memorial Hospital
Sheikhupura Urban 13 12 25
60. Islam Hospital Nankana Road Mana Wala
Sheikhupura Rural 3 3 6
61. Manzoor Hospital Nankana Road Mananwala
Sheikhupura Rural 4 4 8
62. Soikarno Hospital Nankana Road Mananwala
Sheikhupura Rural 3 3 6
105
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No.
Name of Location of Hospital
Name of Tehsil
Urban / Rural
Beds
Male Female Total
63. Abdul Hayee Memorial Hospital Lahore Road Farooq Abad
Sheikhupura Urban 7 7 14
64. Syed Hospital City Farooq Abad
Sheikhupura Urban 10 10 20
65. Virk Hospital Chock Dabay Shah Farooq Abad
Sheikhupura Urban 3 3 6
66. Children and General Hospital Farooqabad
Sheikhupura Urban 2 2 4
67. Jamshed Hospital Chock Dabay Shah Farooq Abad
Sheikhupura Urban 10 10 20
68. Anjum Hospital Chock Dabay Shah Farooq Abad
Sheikhupura Urban 10 10 20
69. Quraishi Hospital Gurunanak Pura Lahore Road Farooqabad
Sheikhupura Urban 2 2 4
106
Three Years Rolling Plan 2010-2013 District Sheikhupura
Annex- II
Costing of MNCH related equipment gaps for DHQ and THQ Hospitals
DHQ Hospital
Sr. No. Equipment GapUnit cost
Total cost(Rs.)
2 Foetal Doppler 3 10000 30,000
3 Diagnostic Laparoscope 1 1200000
1,200,000.00
4 Bulb Sucker 20 45 900.00
5 Baby Warmer 4 850000 3,400,000.00
6 Mechanical Sucker 2 28000 56,000.00
7 Fetal Stethoscope 4 1500 6,000.00
8 Delivery Table 1 17500 17,500.00
9 D&C Set 3 2100 6,300.00
10 Outlet forceps 3 900 2,700.00
12 Kochers forceps 7 235 1,645.00
13 Volselum forceps 2 235 470.00
15 Vaginal Retractors 8 350 2,800.00
16 Polypectomy forceps 2 750 1,500.00
18 Uterine elevator 1 150 150.00
19 CosCo Speculum 9 550 4,950.00
Small, Medium, Large (for each category) -
20 Examination light 4 18000 72,000.0
107
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Equipment GapUnit cost
Total cost(Rs.)
0 21 Suction Curette 2 95 190.0
0 22 Infant Resuscitation Trolley (with life saving
medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light)
2 95000 190,000.00
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light)
2 110000 220,000.00
24 Cardiac Monitor 1 500000 500,000.00
25 Pump Breast Electronic 1 250000 250,000.00
26.1 Toothed Tissue Forceps (8”) 4 55 220.00
26.2 Non-Tooted Tissue Forceps (8”) 4 55 220.00
26.4 Dissection Scissors (Straight 7”) 4 150 600.00
26.5 Hysterectomy Clamps (Straight) 10 150 1,500.00
26.6 Hysterectomy Clamps (Curved) 13 175 2,275.00
26.13 Towel Clamps 15 125 1,875.00
26.14 Single blade Sims speculum 6 275 1,650.00
26.15 Double blade Sims speculum 3 250 750.00
26.16 Sponge holding forceps 16 200 3,200.00
26.17 Volselum forceps 8 250 2,000.00
26.18 Uterine Sound 4 1500 6,000.00
27.1 Episiotomy Scissors 14 125 1,750.00
27.2 Straight Scissors 12 360 4,320.00
27.3 Needle holder 14 135 1,890.00
27.4 Non-toothed tissue forceps 8 inches 14 100 1,400.00 108
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Equipment GapUnit cost
Total cost(Rs.)
27.5 Toothed tissue forceps 8 inches 15 100 1,500.00
27.6 Sims Speculum single blade 29 275 7,975.00
27.7 Sims Speculum double blade 29 250 7,250.00
27.8 Sponge holding forceps 58 250 14,500.00
27.9 Artery forceps 60 275 16,500.00
27.1 Straight clamps (cord) 28 175 4,900.00
27.12 Towel clip 60 125 7,500.00
28.2 Artery Forceps Straight 6 inches 40 125 5,000.00
28.3 Artery Forceps Curved 6 inches 40 125 5,000.00
28.4 Artery forceps 8 inches 40 175 7,000.00
28.5 Myoma Scissors straight 7 inches 10 150 1,500.00
28.6 Dissecting scissors (curved) 7 inches 10 270 2,700.00
28.7 Green Armtage forceps 8 inches 36 300 10,800.00
28.8 Obstetric outlet forceps (pair) 9 900 8,100.00
28.9 Doyene’s Retractor 9 200 1,800.00
28.1 Small Retractors 18 300 5,400.00
28.11 Towel Clippers 40 125 5,000.00
28.12 Suction Nozzle 8 250 2,000.00
29.1 Ultrasound Machine 2 575000 1,150,000.00
29.8 Chest Stand 1 4500 4,500.00
30.1 Paediatric Ventilator 2 1200000
2,400,000.00
30.6 Infant Weighing Machine 1 3100 3,100.0109
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Equipment GapUnit cost
Total cost(Rs.)
0 30.7 Nebulizer 1 22000 22,000.0
0 30.8 Billiubino-meter 2 36000 72,000.0
0 30.9 Exchange Blood Transfusion Set 1 2000 2,000.0
0 30.1 Nasal Probe Paed size 3 7000 21,000.0
0 31.6 Airway Oral and Nasal 3 500 1,500.0
0 31.11 AMBO Bag paeds 4 3000 12,000.0
0 31.12 Red Rubber Nasal tubes all sizes without cuff 8 1000 8,000.0
0 32.1 Blood storage cabinet (100 bag capacity) 1 812000 812,000.0
0 32.2 Packed cell machine 1 600000 600,000.0
0 32.3 Cell Separator 1 522500
0 5,225,000.0
0 32.4 Freezer for Fresh Frozen Plasma 1 115000
0 1,150,000.0
0 32.5 Blood bag shaker 1 10000 10,000.0
0 32.6 RH view box 3 1000 3,000.0
0 32.7 Water bath 1 3000 3,000.0
0 32.8 Micro-pipette 7 8000 56,000.0
0 32.9 Blood grouping tiles 6 3000 18,000.0
0 32.1 Plasma Extractor 1 100000
0 1,000,000.0
0 32.11 Platelets agitator 1 100000
0 1,000,000.0
0 32.12 Blood thawing bath 1 3000 3,000.0
0 32.13 Microscopes 1 115000 115,000.0
0 33.1 Hematology Analyzer 1 425000 425,000.0
0 110
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Equipment GapUnit cost
Total cost(Rs.)
33.2 Electrolyte Analyzer 1 625000 625,000.00
33.3 Analyzer Bio-chemistry Semi-automatic 1 690000 690,000.00
33.4 Glucometer 2 2500 5,000.00
33.5 Haemoglobino-meter 4 1000 4,000.00
33.6 Centrifuge 2 133000 266,000.00
Total cost of equipment 21,813,280
THQH Muridke
Sr. No. Equipment Gap Unit cost Total cost(Rs.)
1 CTG (Cardiac Tocography) 1 285000 285,000
2 Foetal Doppler 2 10000 20,000
3 Diagnostic Laparoscope 1 1200000 1,200,000
4 Bulb Sucker 9 45 405
5 Baby Warmer 1 850000 850,000
6 Mechanical Sucker 2 28000 56,000
7 Fetal Stethoscope 3 1500 4,500
8 Delivery Table 2 17500 35,000
9 D&C Set 2 2100 4,200
10 Outlet forceps 3 900 2,700
11 Myoma Screw 1 320 320
12 Kochers forceps 4 235 94
111
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Equipment Gap Unit cost Total cost(Rs.)
0 13 Volselum forceps 3 235 70
5 14 Lanes Tissue holding forceps 1 400 40
0 15 Vaginal Retractors 3 350 1,05
0 16 Polypectomy forceps 2 750 1,50
0 17 Sponge holder 7 300 2,10
0 18 Uterine elevator 1 150 15
0 19 CosCo Speculum 5 550 2,75
0 Small, Medium, Large (for each category) -
20 Examination light 2 18000 36,000
21 Suction Curette 1 95 95
24 Cardiac Monitor 1 500000 500,000
25 Pump Breast Electronic 1 250000 250,000
26.3 Dissection Scissors (Curved 7”) 1 150 150
26.4 Dissection Scissors (Straight 7”) 1 150 150
26.5 Hysterectomy Clamps (Straight) 8 150 1,200
26.6 Hysterectomy Clamps (Curved) 8 175 1,400
26.7 Uterine Sound 1 90 90
26.1 Artery Forceps (Straight 6”) 4 110 440
26.11 Artery Forceps (Curved 6”) 4 125 500
26.14 Single blade Sims speculum 3 275 825
26.15 Double blade Sims speculum 3 250 750
26.17 Volselum forceps 3 250 750
26.18 Uterine Sound 1 1500 1,50
112
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Equipment Gap Unit cost Total cost(Rs.)
0 26.19 Bladder Sound 2 1500 3,00
0 27.1 Episiotomy Scissors 3 125 37
5 27.5 Toothed tissue forceps 8 inches 2 100 20
0 27.6 Sims Speculum single blade 11 275 3,02
5 27.7 Sims Speculum double blade 11 250 2,75
0 27.8 Sponge holding forceps 32 250 8,00
0 27.9 Artery forceps 28 275 7,70
0 27.1 Straight clamps (cord) 18 175 3,15
0 27.11 Vacuum Extractor pump 1 19000 19,00
0 27.12 Towel clip 32 125 4,00
0 28.2 Artery Forceps Straight 6 inches 10 125 1,25
0 28.3 Artery Forceps Curved 6 inches 4 125 50
0 28.4 Artery forceps 8 inches 16 175 2,80
0 28.5 Myoma Scissors straight 7 inches 4 150 60
0 28.6 Dissecting scissors (curved) 7 inches 2 270 54
0 28.7 Green Armtage forceps 8 inches 16 300 4,80
0 28.8 Obstetric outlet forceps (pair) 2 900 1,80
0 28.9 Doyene’s Retractor 2 200 40
0 28.1 Small Retractors 2 300 60
0 28.11 Towel Clippers 8 125 1,00
0 28.12 Suction Nozzle 3 250 75
0 29.2 X-Ray Unit 500 kw 1 6000000 6,000,000
113
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Equipment Gap Unit cost Total cost(Rs.)
29.4 Lead Screen for X-Ray Unit 1 30000 30,000
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets
1 100000 100,000
29.6 Safe Light 1 5000 5,000
29.7 X-RT Film Processing Tank 1 5000 5,000
29.8 Chest Stand 1 4500 4,500
29.9 X-Ray film Illuminator 2 4000 8,000
29.1 X-Ray Film Hangers All sizes 4 4000 16,000
30.1 Paediatric Ventilator 1 1200000 1,200,000
30.2 Incubator 1 1500000 1,500,000
30.3 Photo Therapy Unit 1 22000 22,000
30.4 Over-head Radiant Warmer 1 910000 910,000
30.5 Infant Length Measuring Scale 2 5000 10,000
30.6 Infant Weighing Machine 2 3100 6,200
30.8 Billiubino-meter 1 36000 36,000
30.9 Exchange Blood Transfusion Set 1 2000 2,000
30.1 Nasal Probe Paed size 1 7000 7,000
31.2 Ventilators 1 525000 525,000
31.7 Tracheostomy tube (adult and paeds) 2 1000 2,000
31.8 Face mask of all sizes 2 1000 2,000
31.9 Double Cuff Tourniquet (for regional block) 1 320 320
31.1 AMBO bag adult 1 2450 2,450
31.11 AMBO Bag paeds 1 3000 3,000
31.12 Red Rubber Nasal tubes all sizes without cuff 4 1000 4,000
114
Three Years Rolling Plan 2010-2013 District Sheikhupura
Sr. No. Equipment Gap Unit cost Total cost(Rs.)
32.1 Blood storage cabinet (100 bag capacity) 1 812000 812,000
32.2 Packed cell machine 1 600000 600,000
32.3 Cell Separator 1 5225000 5,225,000
32.4 Freezer for Fresh Frozen Plasma 1 1150000 1,150,000
32.5 Blood bag shaker 1 10000 10,000
32.6 RH view box 2 1000 2,000
32.7 Water bath 2 3000 6,000
32.8 Micro-pipette 4 8000 32,000
32.9 Blood grouping tiles 3 3000 9,000
32.1 Plasma Extractor 1 1000000 1,000,000
32.11 Platelets agitator 1 1000000 1,000,000
32.12 Blood thawing bath 1 3000 3,000
33.1 Hematology Analyzer 1 425000 425,000
33.2 Electrolyte Analyzer 1 625000 625,000
33.3 Analyzer Bio-chemistry Semi-automatic 1 690000 690,000
33.4 Glucometer 1 2500 2,500
Total cost of equipment 25,319,780
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