Human Resource With 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 40 and above Beds B 251040 Beds C Up to 250 Beds THQ Hospital A Above 60 Beds B 41060 Beds C Up to 40 Beds DHQ Hospital Sr. No. Nomenclature of Post Standard as per MSDS C Category Filled Vacancy Gap in relation to sanctioned posts Vacancy Gap in relation to filled posts Gynaecologist 3 3 3 0 0 Paediatrician 3 1 1 2 2 Anesthetist 4 1 0 3 4 Medical Officer including APMO, EMO 21 17 5 4 16
WMO, APWMO 6 5 0 5 6 Nurse 36 17 19 21 THQ Hospitals There are five THQ hospitals in the district. The following table shows the consolidated position of all the THQ hospitals in the district. Sr. No. of Post Standard as per MSDS C Category Sanctioned Filled Vacancy Gap in relation to posts Vacancy Gap in relation to filled posts Gynecologist 4 2 2 0 2 Pediatrician 4 2 2 0 2 Anesthetist 6 2 1 5 3 Medical Officers including SMO,APMO & PMOs 34 17 4 17 30
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light) 1 1 1 0 1 23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo0tracheal tube, BP Apparatus, Chargeable light) 1 1 1 1 0 24 Cardiac Monitor 1 1 1 0 1 25 Pump Breast Electronic 1 1 1 0 1 26 Vaginal Hysterectomy Set 2 2 2 2 0 26.1 Toothed Tissue Forceps (8”) 2 2 2 2 0 26.2 Non-Tooted Tissue Forceps (8”) 2 2 2 2 0
26.16 Sponge holding forceps 8 8 8 8 0 26.17 Volselum forceps 4 4 4 4 0 26.18 Uterine Sound 2 2 2 2 0 26.19 Bladder Sound 2 2 2 2 0 27 Delivery Sets 6 6 10 6 0 27.1 Episiotomy Scissors 6 6 10 6 0 27.2 Straight Scissors 6 6 10 6 0 27.3 Needle holder 6 6 10 6 0 27.4 Non-toothed tissue forceps 8 inches 6 6 10 6 0 27.5 Toothed tissue forceps 8 inches 6 6 10 6 0 27.6 Sims Speculum single blade 12 12 20 12 0 27.7 Sims Speculum double blade 12 12 20 12 0 27.8 Sponge holding forceps 40 40 40 40 0 27.9 Artery forceps 40 40 40 40 0 27.10 Straight clamps (cord) 20 20 30 20 0
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. Health Problems Problem Causes Intervention Activity Unit Plan Activities Targets Target for 2010-11 Target for 2011-12 Target for 2012-13 Remarks 1. Anemia in pregnancy · Poverty & malntrition · Awareness raising for behaviour change · Messages on local cable network Monthly Messages telecat packages 36 12 12 12 -
Lack of awareness about balanced diet Improving ante-natal coverage Printing and distribution of IPC material Brochure 300,000 100,000 100,000 100,000 - Multiple pregnancies Improving ante-natal coverage Printing and distribution of IPC material Poster 30,000 10,000 10,000 10,000 - Inadequate and poor MCH services Deworming campaign Short refresher trainings of LHWs about balanced diet and provision of Batch of 50 LHWs For 1 Days 20 10 5 5 -
Gender discrimination Provision/ Distribution of supplements Procurement of de-worming tablets No. of courses 150,000 50,000 50,000 50,000 - Worm infestation Diagnosis and treatment of infections Purchase of medicine ( Folic Acid) Pack of 100 Tablets 150,000 50,000 50,000 50,000 - Purchase of medicine (Ferrous Sulphate) Pack of 100 Tablets 150,000 50,000 50,000 50,000 -
2. ARI Malnutrition Health promotion campaign Messages on local cable networks Monthly Telecast 36 12 12 12 Activity Air contamination Capacity building of health staff in Integrated Management of Childhood Illnesses (IMCI) Messages through FM radio channels Monthly Telecast 36 12 12 12 - housing Provision of medicines for ARI Printing and distribution of IPC material Poster 30,000 10,000 10,000 10,000 -
practices Procurement of nebulizing drugs Drug 6,000 3,000 1,500 1,500 - 3. Diarrhea Poor Hygiene & sanitation with TMA for of water supply and sanitation Quarterly meetings with TMA and other agencies Meetings 12 4 4 4 -
Lack of safe drinking water Awareness raising campaign Messages on local cable network Monthly Telecast 36 12 12 12 Activity Unhygienic practices Proper treatment of Diarrhea including ORT Printing and distribution of IPC material Poster 30,000 10,000 10,000 10,000 - Lack of awareness among mothers about feeding and weaning practices Health awareness in the community Conduction of HES in Schools Sessions 1,000 500 300 200 -
Capacity building of health staff in Integrated Management of Childhood Illnesses (IMCI) Training of medics and paramedics in IMCI Batch 6 3 2 1 Integrated Activity - Procurement and distribution of ORS and Zinc Sulphate ORS packets 1,200,000 400,000 400,000 400,000 -
Procurement and distribution of Zinc Sulphate Syrup 600,000 200,000 200,000 200,000 - 4. TB Low status Health Messages on local cable networks Monthly telecast 36 12 12 12 activity housing facilities TB DOTS program through involvement of private sector Messages through FM radio channels Monthly telecast 36 12 12 12 activity
services for safe transfusions IPC and hepatitis awareness material Transfusion of blood and blood products Campaign against drug addiction Procurement and supply of screening kits Kits 400,000 150,000 150,000 100,000 - Unsafe sexual practices Regulatory mechanism to ensure use of safe instruments by dentists, Procurement of safety boxes Syringe cutter 400 200 100 100 -
barbers etc. Ear piercing and tattooing Procurement of drugs for treatment of Hepatitis patients Injection 1,500 500 500 500 - Use of unsterilized equipment by dentists and barbers Develop and implement SOPs for sterilization of equipment - - - - - SOPs
6. Scabies Overcrowding in schools and homes Awareness raising campaign Community health education sessions HES 100 50 25 25 No Cost Low conditions Provision of medicines Printing & Distribution of IPC Material Brochure 15,000 5,000 5,000 5,000 - Poor Health Education - Supply of anti scabies drugs drug 250,000 100,000 75,000 75,000 -
Management Problems Human Resource Plan to bridge gap between MSDS and Existing sanctioned posts Sr. No. Name of Post Basic Scale Basic Pay Allowances Requirement as per Gap Physical Targets Year I Year II Year III 1 Gynaecologist 18 12,910 18,099 2 1 1 0 2 Paediatricians 18 12,910 18,099 4 2 1 1 3 Anesthetists 18 12,910 18,099 6 3 2 1 4 MO / WMO 17 9,850 15,345 67 33 17 17 5 Nurses 16 6,060 8,934 72 36 18 18 6 Lady Health Visitors 9 3,820 4,750 23 10 7 6
- Lack of permanent postings Incentivized pay package at all levels Demand generation and request to the Department of Health by the districts for recruitment through PSC against vacant posts - - - - - Plan - Lack of incentivized and differential Well defined career structure including Orientation trainings of the recruited staffs Batch 7 3 2 2 -
2. Inadequate budget for POL Generator provision for backup of electricity supply Rational increase in POL budget Assessment of additional requirement - - - - - NO COST ACTIVITY Less budget allocation - Costing and submission of additional demand - - - - - - · Frequent increase in prices - Provision of POL budget for District Level supervisor litre 86,400 28,800 28,800 28,800 -
Provision of POL budget for EPI litre 27,000 9,000 9,000 9,000 - Provision of POL budget for generator litre 87,600 29,200 29,200 29,200 - 3. Deficient infra structure Debilitated condition of existing Make up the deficiencies against standards specified in MSDS Identify the gaps in infrastructure of THQ and DHQ hospitals individually - - - - - Need Assessment - Lack of repair and maintenance Devise appropriate mechanisms Costing of the gaps - - - - - Plan
for repair and maintenance - Inadequate infrastructure for Emergency, Operation Theatre, OPD and Inpatients, residences for staff at THQ and DHQ hospitals Provision of infrastructure at THQ and DHQ according to the MSDS Phasing - - - - - Demand submission
EmONC at primary and secondary level of care with the notified equipment list based on the gaps between MSDS and existing available Old and equipment Provision of adequate budget for maintenance and repair Allocation of enhanced amount for M&R of equipments - - - - - Submission of demand Shortage of regular budget for M&R Capacity building of staff regarding maintenance Orientation of staffs in maintenance of logos for equipments - - - - - Plan
packages Printing and distribution of IPC material 5 300,000 550,000 605,000 1,655,000 - Printing and distribution of IPC material Poster 30 30,000 330,000 363,000 993,000 - Short refresher trainings of LHWs about balanced diet and provision Batch of 50 LHWs For 1 Days 79,000 20 434,500 477,950 1,702,450 -
of · Procurement of de-worming tablets No. of coursers 20 150,000 1,210,000 3,310,000 - Purchase of medicine ( Folic Acid) Pack of 100 Tablets 30 150,000 1,815,000 4,965,000 - Purchase of medicine (Ferrous Sulphat) Pack of 100 Tablets 50 150,000 3,025,000 8,275,000 -
2 ARI Messages on local cable networks Monthly Telecast - 36 _ _ _ - Integrated Activity Messages through FM radio channels Monthly Telecast 35,000 36 462,000 508,200 1,390,200 - Printing and distribution of IPC material Poster 30 30,000 330,000 363,000 993,000 - Training of medics and Para-medics in IMCI Batch 240,000 6 528,000 290,400 1,538,400 -
agencies Messages on local cable network Monthly Telecast - 36 - - - - Integrated Activity Printing and distribution of IPC material Poster 30 30,000 330,000 363,000 993,000 - Conduction of HES in Schools Sessions 2,000 1,000 660,000 484,000 2,144,000 -
Training of medics and paramedics in IMCI Batch - 6 - - - - Integrated Activity Procurement and distribution of ORS and Zinc Sulphate ORS packets 5 2,420,000 6,620,000 - Procurement and distribution of Zinc Sulphate Syrup 60 600,000 -
4 TB Messages on local cable networks Monthly telecast - 36 - - - - Integrated activity Messages through FM radio channels Monthly telecast - 36 - - - - Integrated activity Printing and distribution of IPC and TB awareness material Poster 30 30,000 330,000 363,000 993,000 - Procurement of drugs to address day 4,800 6,000 11,616,000 -
Messages on local cable network Monthly Package - 36 - - - - Integrated Activity Printing and distribution of IPC and hepatitis awareness material Poster 30 20,000 165,000 181,500 646,500 - Procurement and supply of screening kits Kits 50 400,000 6,050,000 -
Procurement of safety boxes Syringe cutter 500 400 55,000 60,500 215,500 - Procurement of drugs for treatment of Hepatitis patients Injection 15,000 1,500 9,075,000 - Develop and implement SOPs for sterilization of equipment - - - - - - - SOPs
6 Scabies Community health education sessions HES - 100 - - - - No Cost Printing & Distribution of IPC Material Brochure 30 15,000 165,000 181,500 496,500 - Supply of anti scabies drugs drug 50 250,000 4,537,500 - - - - - - - - - -
Request to the Provincial Government for approval and implementation of agreed pay packages - - - - - - - Plan Review and revise the career structure of medics and paramedics - - - - - - - Technical assistance Filling of Human Resource gaps as per MSDS Posts - 18,167,279 38,140,007 Detail HR plan is attached
Posts - 2,591,335 458,400 857,208 1,275,727 2,591,335 Detail HR plan is attached HR - 29,008,071 60,768,130 Detail HR plan is attached 2 Inadequate budget for POL Assessment of additional requirement - - - - - - - NO COST ACTIVITY Costing and submission of additional demand - - - - - - - -
5 Ineffective supervision / monitoring Training of district managers in supervision and monitoring batch 35,000 231,700 70,000 77,000 84,700 231,700 - Procurement of transport for supervision Vehicles 3,800,000 3,800,000 - - 3,800,000 - - Vehicles 900,000 3,780,000 - 3,780,000 - Development and printing of monitoring tools checklist visit form 10,000 3,310,000 1,100,000 1,210,000 3,310,000 -
A01270 - 11,809,236 11,809,236 - 19,950,823 - 29,008,071 A09501 1,150 5,600,000 5,601,150 1,323 1,980,000 1,981,323 1,521 - 1,521 A03820 - - - - - - - - - A03807 9,223,000 5,095,000 14,318,000 10,606,450 16,210,950 12,197,418 6,164,950 18,362,368 A03902 645,150 1,000,000 1,645,150 741,923 1,100,000 1,841,923 853,211 1,210,000 2,063,211 A01102 - 458,400 458,400 - 857,208 857,208 - 1,275,727 1,275,727
Acid) Purchase of medicine (Ferrous Sulphat) 2,500,000 2,750,000 3,025,000 8,275,000 2 ARI Messages on local cable networks _ _ _ - Messages through FM radio channels 420,000 462,000 508,200 1,390,200 Printing and distribution of IPC material 300,000 330,000 363,000 993,000 Training of medics and in IMCI 720,000 528,000 290,400 1,538,400 Procurement of drugs 9,100,000 10,010,000 11,011,000 30,121,000 - 20,800,000 22,880,000 25,168,000 68,848,000 Procurement of nebbulizing 90,000 49,500 54,450 193,950
4 TB Messages on local cable networks - - - - Messages through FM radio channels - - - - Printing and distribution of IPC and TB awareness material 300,000 330,000 363,000 993,000 Procurement of drugs to address deficiency according to regimen 9,600,000 10,560,000 11,616,000 31,776,000 Procurement of reagents and slides for notified diagnostic facilities under DOTS program - - - - 5 Hepatitis Quarterly co-ordination meetings with TMA and other agencies - - - - Messages on local cable - - - -
network Printing and distribution of IPC and hepatitis awareness material 300,000 165,000 181,500 646,500 Procurement and supply of screening kits 7,500,000 8,250,000 6,050,000 21,800,000 Procurement of safety boxes 100,000 55,000 60,500 215,500 Procurement of drugs for treatment of Hepatitis patients 7,500,000 8,250,000 9,075,000 24,825,000 Develop and implement SOPs for sterilization of equipment - - - - 6 Scabies Community health education sessions - - - - Printing & Distribution of IPC Material 150,000 165,000 181,500 496,500
Review and revise the career structure of medics and paramedics - - - - Filling of Human Resource gaps as per MSDS 7,448,040 12,524,688 18,167,279 38,140,007 - 458,400 857,208 1,275,727 2,591,335 - 11,809,236 19,950,823 29,008,071 60,768,130 2 Inadequate budget for POL Assessment of additional requirement - - - - Costing and submission of additional demand - - - - Provision of POL budget for District Level supervisor 2,160,000 2,376,000 2,613,600 7,149,600
Provision of POL budget for EPI 675,000 742,500 816,750 2,234,250 Provision of POL budget for generator 2,190,000 2,409,000 2,649,900 7,248,900 3 Deficient infra structure Identify the gaps in infrastructure of THQ and DHQ hospitals individually - - - - Costing of the gaps - - - - Phasing - - - - Construction of residences at DHQ hospital 1,925,000 - - 1,925,000 Construction of residences at THQ hospitals (2*1) 1,925,000 2,117,500 - 4,042,500 4 Lack of MNCH related Procurement of equipments for THQ and DHQ hospitals 7,189,500 9,438,545 - 16,628,045
equipments based on the gaps between MSDS and existing available Allocation of enhanced amount for M&R of equipments - - - - Orientation of staffs in maintenance of logos for equipments - - - - 5 Ineffective supervision / monitoring Training of district managers in supervision and monitoring 70,000 77,000 84,700 231,700 Procurement of transport for supervision 3,800,000 - - 3,800,000 - 1,800,000 1,980,000 - 3,780,000 Development and printing 1,000,000 1,100,000 1,210,000 3,310,000
% of health facilities with of essential MNCH related equipment (level specific) 10% During 1st year Stock Register EDOH/ DOH/ MSs 6 monthly Availability of relevant (MNCH) laboratory equipment at appropriate level of care 10% During 1st year Stock Register EDOH/ DOH/MSs, Store keeper Quarterly % facilities with availability of essential medicines 10% During 1st year Stock Register EDOH/ DOH/ MSs, Store keeper Monthly % of functional ambulances in the district 10% (DHQH/ THQH/ RHCs) Log Book EDOH/DOH/ Transport officer Quarterly
23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo0tracheal tube, BP Apparatus, Chargeable light) 1 1 2 1 0 1100 0 24 Cardiac Monitor 1 1 2 5 0 5000 0 25 Pump Breast Electronic 1 1 1 1 0 2500 0 26 Vagi0l Hysterectomy Set 2 2 4 2 0 300 0 26.1 Toothed Tissue Forceps (8”) 2 2 4 2 0 55 0 26.2 Non0Tooted Tissue Forceps (8”) 2 2 4 2 0 55 0 26.3 Dissection Scissors (Curved 7”) 2 2 4 2 0 150 0 26.4 Dissection Scissors (Straight 7”) 2 2 4 2 0 150 0 26.5 Hysterectomy Clamps (Straight) 8 8 16 8 0 150 0 26.6 Hysterectomy Clamps (Curved) 8 8 16 8 0 175 0 26.7 Uterine Sound 2 2 4 2 0 90 0
29.7 X0RT Film Processing Tank 1 1 1 1 0 500 0 29.8 Chest Stand 1 1 1 1 0 450 0 29.9 X0Ray film Illumi0tor 2 2 2 2 0 400 0 29.1 X0Ray Film Hangers All sizes 4 4 4 4 0 400 0 30 MNCH Related Paediatrics Equipments 0 30.1 Paediatric Ventilator 1 2 2 0 1 12000 12000 30.2 Incubator 1 1 2 0 1 15000 15000 30.3 Photo Therapy Unit 1 1 1 1 0 2200 0 30.4 Over0head Radiant Warmer 1 1 1 1 0 9100 0 30.5 Infant Length Measuring Scale 2 2 2 2 0 500 0 30.6 Infant Weighing Machine 2 2 2 2 0 310 0 30.7 Nebulizer 1 1 2 1 0 2200 0 30.8 Billirubino0meter 1 1 2 1 0 3600 0 30.9 Exchange Blood Transfusion Set 1 1 2 0 1 200 200 30.1 0sal Probe Paed size 2 2 4 2 0 700 0
22 Infant Resuscitation Trolley (with life saving medicines, baby laryngoscope, Endo-tracheal tube, Infant BP Apparatus, Chargeable Light) 1 1 1 0 1 9500 9500 23 Mother Resuscitation Trolley (with life saving medicines, Laryngoscope, Endo-tracheal tube, BP Apparatus, Chargeable light) 1 1 1 1 0 1100 0 24 Cardiac Monitor 1 1 1 0 1 5000 5000 25 Pump Breast Electronic 1 1 1 0 1 2500 2500
29.1 Ultrasound Machine 1 1 2 1 1 57500 57500 29.2 X-Ray Unit 50 kw 1 1 1 0 1 6000 6000 29.3 Color Doppler 0 0 0 0 0 57500 0 29.4 Lead Screen for X-Ray Unit 1 1 1 1 0 300 0 29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Go0dal Sheets 1 1 1 1 0 1000 0 29.6 Safe Light 1 1 1 1 0 500 0 29.7 X-RT Film Processing Tank 1 1 1 1 0 500 0 29.8 Chest Stand 1 1 1 1 0 450 0 29.9 X-Ray film Illumi0tor 2 2 2 2 0 400 0 29.1 X-Ray Film Hangers All sizes 4 4 4 4 0 400 0 30 MNCH Related Paediatrics Equipments 0 0
31.2 Ventilators 1 1 1 1 0 52500 0 31.3 Nebulizer 1 1 1 1 0 16500 0 31.4 Pulse Oximetry 1 1 1 1 0 2100 0 31.5 Defibrillator 1 1 1 1 0 5000 0 31.6 Airway Oral and 0sal 1 2 2 1 0 50 0 31.7 Tracheostomy tube (adult and paeds) 1 2 2 1 0 100 0 31.8 Face mask of all sizes 1 2 2 1 0 100 0 31.9 Double Cuff Tourniquet (for regio0l block) 1 1 1 1 0 320 0 31.1 AMBO bag adult 1 2 2 0 1 2450 2450 31.11 AMBO Bag paeds 2 2 2 0 2 300 600 31.12 Red Rubber 0sal tubes all sizes without cuff 4 4 4 4 0 100 0 32 Blood Bank 0 0