Rajanpur 16 580553 Rojhan 8 298206 Jampur 20 745953 Source: Bureau of Statistics (Projected from Census 1998) Socio-Economic Indicators Education and Literacy Overall district: 10+ years 33% 15+ years 30% 15-24 43% Source: MICS 2007 Housing House Occupancy Rate 7.3 person / House Household characteristics: - Finished floor (pacca) 27 - Finished roof (pacca) 47 - Finished wall (pacca) 32 Water and Sanitation Access to drinking (within dwelling) 82% Use of improved drinking water sources 89% Use of properly treated water 1.3% Safe drinking without bacteria 50% Use of sanitary means of excreta disposal 44% Use of improved water sources and improved sanitation 43% Proper disposal of: -Waste water 26 %
THQ Hospital Jampur (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 Gynaecologist 2 1 1 1 1 Paediatricians 2 1 1 1 1 Anesthetists 3 1 1 2 3 Medical Officers including SMO,APMO & PMOs 16 15 13 1 3 Women Medical Officers including SWMO APWMO & PMOs 9 6 6 3 3 Lady Health Visitors 8 2 2 6 6 Charge Nurses 15 16 16 0 0 THQ Hospital Rojhan (Category C) Sr. No. Post Standard as per MSDS Sanctioned Filled Vacancy Gap in relation to Sanctioned Positions Vacancy Gap in relation to Filled Positions 1 Gynaecologist 2 1 0 1 2 2 Paediatrician 2 1 0 1 2 3 Anesthetists 3 1 0 2 3 4 Medical Officers including SMO,APMO & PMOs 16 8 8 8 8 5 Women Medical Officers including SWMO APWMO & PMOs 9 3 1 6 8 6 Lady Health Visitors 8 1 1 7 7 7 Charge Nurses 15 10 4 5 11
28.7 Green Armtage forceps 8 inches 24 32 40 24 0 28.8 Obstetric outlet forceps (pair) 6 8 10 6 0 28.9 Doyene’s Retractor 6 8 10 6 0 28.10 Small Retractors 12 16 20 12 0 28.11 Clippers 24 32 40 24 0 28.12 Suction Nozzle 6 8 10 6 0 29 MNCH Related Radiology Equipments 29.1 Ultrasound Machine 1 2 3 1 0 29.2 X-Ray Unit 500 kw 1 1 1 1 0 29.3 Color Doppler 0 1 1 0 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 0 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 Paediatrics Equipments 30.1 Paediatric Ventilator 1 2 2 0 1 30.2 Incubator 1 1 2 1 0 30.3 Photo Therapy Unit 1 1 1 1 0 30.4 Over-head Radiant Warmer 1 1 1 0 1 30.5 Infant Length Measuring Scale 2 2 2 2 0 30.6 Infant Weighing Machine 2 2 2 2 0 30.7 Nebulizer 1 1 2 2 0 30.8 Billiubino-meter 1 1 2 1 0
26.11 Artery Forceps (Curved 6”) 16 16 16 16 0 26.12 Allis Forceps 8 8 8 8 0 26.13 Towel Clamps 8 8 8 8 0 26.14 Single blade Sims speculum 4 4 4 4 0 26.15 Double blade Sims speculum 4 4 4 4 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 27.1 Episiotomy Scissors 6 6 10 10 0 27.2 Straight Scissors 6 6 10 10 0 27.3 Needle holder 6 6 10 10 0 27.4 Non-toothed tissue forceps 8 inches 6 6 10 10 0 27.5 Toothed tissue forceps 8 inches 6 6 10 10 0 27.6 Sims Speculum single blade 12 12 20 20 0 27.7 Sims Speculum double blade 12 12 20 20 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 30 0 27.11 Vacuum Extractor pump 1 1 1 0 1 27.12 Towel clip 40 40 40 40 0 28 Caesarian Section 28.1 Scalpel 4 4 6 6 0 28.2 Artery Forceps Straight 6 inches 16 16 24 24 0 28.3 Artery Forceps Curved 6 inches 16 16 24 24 0 28.4 Artery forceps 8 inches 16 16 24 24 0
28.4 Artery forceps 8 inches 16 16 24 16 0 28.5 Scissors straight 7 inches 4 4 6 4 0 28.6 Dissecting scissors (curved) 7 inches 4 4 6 4 0 28.7 Armtage forceps 8 inches 16 16 24 16 0 28.8 Obstetric outlet forceps (pair) 4 4 6 4 0 28.9 Doyene’s Retractor 4 4 6 4 0 28.10 Retractors 8 8 12 8 0 28.11 Towel Clippers 16 16 24 16 0 28.12 Suction Nozzle 4 4 6 4 0 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 0 29.3 Color Doppler 0 0 0 0 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-Ray Film Processing Tank 1 1 1 1 0 29.8 Chest Stand 1 1 1 1 0 29.9 X-Ray film Illuminator 2 2 2 2 0 29.10 X-Ray Film Hangers All 4 4 4 4 0 30 MNCH Related Paediatrics Equipments 30.1 Paediatric Ventilator 1 1 2 0 1 30.2 Incubator 1 1 1 1 0 30.3 Photo Therapy Unit 1 1 1 1 0
2. Diarrhoeal diseases Poor Hygiene & sanitation with TMA for improvement of supply and sanitation Quarterly co-ordination meetings with TMA and other agencies Meetings 12 4 4 4 - Lack of safe drinking Awareness raising campaign Messages on local cable network Monthly Telecast 36 12 12 12 Integrated Activity Unhygienic practices Proper treatment of Diarrhoea including ORT Printing and distribution of IPC material Poster 30,000 10,000 10,000 10,000 - Lack of awareness mothers about feeding and weaning practices Health awareness in the community Conduction of HES in Schools Sessions 600 200 200 200 -
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 - 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. Worm Infestation low literacy Awareness raising for behaviour change Messages on local cable network Message 36 12 12 12 Integrated Activity
poor hygiene Improving sanitation through coordination with TNA Printing and distribution of IPC material Meeting 15,000 5,000 5,000 5,000 - Poverty health education in school Procurement of de-worming tablets Drug 110,000 10,000 50,000 50,000 - 5. TB Low status Health Messages on local cable networks Monthly telecast 36 12 12 12 Integrated activity - housing facilities TB DOTS program through involvement of private sector Messages through FM radio channels Monthly telecast 36 12 12 12 Integrated activity
Malnutrition - Printing and distribution of IPC and TB awareness material Poster 30,000 10,000 10,000 10,000 - Seasonal variation - of drugs to address deficiency according to regimen treatment day 6,000 2,000 2,000 2,000 - Lack of proper sanitation - of reagents and slides for notified diagnostic facilities under DOTS programme Diagnostics - - - - Need Assesment
6. HMM · Poor access to healthcare delivery services · Health · Messages on cable network Message 36 12 12 12 Integrated Activity · Lack of awareness danger signs of pregnancy Behaviour change for Mothers of bearing age · Printing and distribution of IPC material Poster 15,000 5,000 5,000 5,000 - · Low coverage Provision of Quality basic EmONC services at BHU & RHC Training of LHWs on BCC No. of trainings 12 12 - - - · Low skilled attendance Provision of Quality services at THQs hospital Procurement of vehicles for transportation through CCBs Vehicles 6 2 2 2 -
Problem Causes Intervention Activity Unit Plan Activities Targets Target for 2010-11 Target for 2011-12 Target for 2012-13 Remarks 1. Shortage of skilled staffs MNCH related · of trained staff · Filling of the vacant posts · Filling of the vacant posts of medics and the paramedics through existing recruitment committees - - - - - · of staff according to MSDS · of trained staffs according to MSDS Temporary filling of vacant positions on contract - - - - - · Lack of permanent postings · pay package at all levels · Demand generation and request to the Department of Health by the districts for recruitment through PSC - - - - - Plan availability
against vacant posts · Lack of incentivized and differential pay package · Well defined career structure including opportunities for higher education · Orientation trainings of the recruited staffs Batch 9 4 3 2 - · Frequent transfer postings · High level political commitment for providing protection to staff working in health facilities · Consensus building between the districts for uniform incentivized pay package for all categories and levels staff - - - - - Meeting · Job insecurity - · Request to the Provincial Government for approval and implementation - - - - - Plan
of agreed pay packages · Lack of amenities at workplace - · Review and revise the career structure of medics and paramedics - - - - - Technical assistance · Lack of conducive environment including insecurity and transport of children for education - · Filling of Human Resource gaps as per MSDS Posts 183 97 44 42 Detail HR plan is attached - - 23 10 7 6 Detail HR plan is attached
- · Old and un-serviceable equipment · of adequate budget for maintenance and repair Allocation of enhanced amount for M&R of equipments - - - - - of demand - · Shortage of regular budget for M&R · Capacity building of staff regarding maintenance of log books of each equipment Orientation of staffs in maintenance of logos for equipments - - - - - Plan
Messages through FM radio channels Monthly Telecast 35,000 12 140,000 154,000 169,400 463,400 - Printing and distribution of IPC material Poster 30 30,000 300,000 330,000 363,000 993,000 - Training of medics and in IMCI Batch 240,000 8 960,000 1,056,000 - 2,016,000 - Procurement of drugs Oral Medicine Package 70 390,000 11,011,000 30,121,000 - - Injectable 800 78,000 25,168,000 68,848,000 -
Procurement of nebulizing drugs Drug 30 6,000 90,000 99,000 54,450 243,450 - 2 Diarrhoeal diseases Quarterly meetings with TMA and other agencies Meetings 3,000 12 12,000 13,200 14,520 39,720 - Messages on local cable network Monthly Telecast - 36 - - - - Integrated Activity Printing and distribution of IPC material Poster 30 30,000 300,000 330,000 363,000 993,000 - Conduction of HES in Schools Sessions 2,000 600 400,000 440,000 484,000 1,324,000 -
Procurement of de-worming tablets Drug 40 110,000 400,000 2,200,000 2,420,000 5,020,000 - 4 TB Messages on local cable networks Monthly telecast - 36 - - - - Integrated activity Messages through FM channels Monthly telecast - 36 - - - - Integrated activity Printing and distribution of IPC and TB awareness material Poster 30 30,000 300,000 330,000 363,000 993,000 - Procurement of drugs to address deficiency treatment day 4,800 6,000 11,616,000 31,776,000 -
according to regimen Procurement of reagents and slides for notified diagnostic facilities under DOTS programme - - - - - - Need Assesment 5 HMM · Messages on local cable network Message - 36 - - - - Integrated Activity · Printing and distribution of IPC material Poster 30 15,000 150,000 165,000 181,500 496,500 -
Training of LHWs on BCC No. of trainings 79,000 12 948,000 - - 948,000 - Procurement of vehicles for transportation through CCBs Vehicles 3,800,000 6 8,360,000 9,196,000 25,156,000 - · Repair of non functional ambulances for timely transportation of pregnant mothers - 10,000 12 40,000 44,000 48,400 132,400 - · Replacement of the non functional ambulances for timely transportation of pregnant mother - Costed in Procurement of vehicles for through CCBS - - - - - -
Procurement of the MNCH related equipment and Instruments - Costed in service delivery problems - - - - - - Implementation of the referrals protocols - Costed in Management Problems - - - - - - Procurement of 70 150,000 3,850,000 4,235,000 11,585,000 - Procurement and distribution of Anti-D Injection 5,000 45 75,000 82,500 90,750 248,250 - Total 4,216,025 83,422,240 -
Management Problems Sr. No. Problem FY I FY II FY III Total Cost Rs. Amount (Rs.) Amount (Rs.) Amount (Rs.) Amount (Rs.) 1 Shortage of skilled staffs MNCH related 24,857,936 40,288,525 57,764,253 122,910,714 2 Inadequate budget for POL 2,887,500 3,176,250 3,493,875 9,557,625 3 Lack of MNCH related equipments 4,898,270 5,416,450 11,922,225 22,236,945 Total 32,643,706 48,881,225 73,180,353 154,705,284
Activity-wise Costing Health Problems Sr. No. Problem Activity FY-I FY-II FY-III Total 1 ARI Messages on local cable networks 432,000 475,200 522,720 1,429,920 Messages through FM radio channels 140,000 154,000 169,400 463,400 Printing and distribution of IPC material 300,000 330,000 363,000 993,000 Training of medics and in IMCI 960,000 1,056,000 - 2,016,000 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 nebulizing drugs 90,000 99,000 54,450 243,450 2 Diarrhoeal diseases Quarterly co-ordination meetings with TMA and agencies 12,000 13,200 14,520 39,720 Messages on local cable network - - - -
Printing and distribution of IPC material 300,000 330,000 363,000 993,000 Conduction of HES in Schools 400,000 440,000 484,000 1,324,000 Training of medics and paramedics in IMCI - - - - Procurement and distribution of ORS and Zinc Sulphate 2,000,000 2,200,000 2,420,000 6,620,000 Procurement and distribution of Zinc Sulphate 12,000,000 13,200,000 14,520,000 39,720,000 3 Worm Infestation Messages on cable network - - - - Printing and distribution of IPC material 150,000 165,000 181,500 496,500 Procurement of de-worming tablets 400,000 2,200,000 2,420,000 5,020,000 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 programme - - - - 5 HMM · Messages on local cable network - - - - · Printing and distribution of IPC material 150,000 165,000 181,500 496,500 Training of LHWs on BCC 948,000 - - 948,000 Procurement of vehicles for transportation through CCBs 7,600,000 8,360,000 9,196,000 25,156,000 · Repair of non functional ambulances for timely transportation of pregnant mothers 40,000 44,000 48,400 132,400 · Replacement of the non functional ambulances for timely - - - -
transportation of pregnant mother Procurement of the MNCH related equipment and Instruments - - - - Implementation of the referral protocols - - - - Procurement of Micro-nutrients 3,500,000 3,850,000 4,235,000 11,585,000 Procurement and distribution of Anti-D 75,000 82,500 90,750 248,250 - 69,297,000 76,943,900 83,422,240 229,663,140
implementation of agreed pay packages · Review and revise the career structure of medics and paramedics - - - - · Filling of Human Resource gaps as per MSDS 8,948,640 14,825,448 21,512,687 45,286,775 - 458,400 857,208 1,275,727 2,591,335 - 14,128,896 23,515,219 34,176,029 71,820,144 · Capacity and need assessment of the medics and the paramedics - - - - · Prepare training programs for providing higher professional education based on TNA - - - - 2 Inadequate budget for POL Assessment of additional requirement - - - -
Availability of relevant (MNCH) laboratory equipment at appropriate level of care 100% During 1st year Stock Register EDOH/ DOH/MSs, Store keeper % facilities with availability of essential medicines 100% During 1st year Stock Register EDOH/ DOH/ MSs, Store keeper % of functional ambulances in the district 100% (DHQH/ THQH/ RHCs) Log Book EDOH/DOH/ Transport officer % utilization of sanctioned budget 100% of yearly budget Quarterly Reports EDOH/ DOH/ MSs/ Accounts officer % of facilities with availability of basic EmONC services 100% in 3 years (50% during 1st year) Supervisory visit report EDOH/DoH/ DDOH % of DHQ/THQ hospitals with Comprehensive EmONC services 100% in 3 years (50% during 1st year) Supervisory visit report EDOH/DoH/ DDOH % 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
tube, BP Apparatus, Chargeable 24 Cardiac Monitor 1 1 2 1 0 500000 0 25 Pump Breast Electronic 1 1 1 1 0 250000 0 26 Vaginal Hysterectomy Set 2 2 4 30000 0 26.1 Toothed Tissue Forceps (8”) 2 2 4 2 0 55 0 26.2 Non-Tooted 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 26.8 Needle Holder (7”) 2 2 4 2 0 150 0 26.9 Needle Holder (10”) 2 2 4 2 0 300 0 26.1 Artery Forceps (Straight 6”) 16 16 32 16 0 110 0 26.11 Artery Forceps (Curved 6”) 16 16 32 16 0 125 0 26.12 Allis Forceps 8 8 16 8 0 230 0
29.4 Lead Screen for X-Ray Unit 1 1 1 1 0 0 29.5 0.5 MN Lead Lead Gloves, Goggles and Thyroid and Gonadal Sheets 1 1 1 1 0 100000 0 29.6 Safe Light 1 1 1 1 0 5000 0 29.7 X-RT Film Processing Tank 1 1 1 1 0 5000 0 29.8 Stand 1 1 1 1 0 4500 0 29.9 X-Ray film Illuminator 2 2 2 2 0 4000 0 29.1 X-Ray Film Hangers All sizes 4 4 4 4 0 4000 0 30 MNCH Related Paediatrics Equipments 0 30.1 Paediatric Ventilator 1 2 2 0 1 1200000 1200000 30.2 Incubator 1 1 2 1 0 1500000 0 30.3 Photo Therapy Unit 1 1 1 1 0 22000 0 30.4 Over-head Radiant Warmer 1 1 1 0 1 910000 910000 30.5 Infant Length Measuring Scale 2 2 2 2 0 5000 0 30.6 Infant Weighing Machine 2 2 2 2 0 3100 0 30.7 Nebulizer 1 1 2 2 0 22000 0 30.8 Billiubino-meter 1 1 2 1 0 0 30.9 Exchange Transfusion Set 1 1 2 1 0 2000 0
29.5 0.5 MN Lead Apron. Lead Gloves, Goggles and Thyroid and Gonadal Sheets 1 1 1 1 0 100000 0 29.6 Safe Light 1 1 1 1 0 5000 0 29.7 X-RT Film Processing Tank 1 1 1 1 0 5000 0 29.8 Chest Stand 1 1 1 1 0 4500 0 29.9 X-Ray film Illuminator 2 2 2 2 0 4000 0 29.1 X-Ray Film Hangers All sizes 4 4 4 4 0 4000 0 30 MNCH Related Paediatrics Equipments 0 30.1 Paediatric Ventilator 1 1 2 0 1 1200000 1200000 30.2 Incubator 1 1 1 1 0 1500000 0 30.3 Photo Therapy Unit 1 1 1 1 0 22000 0 30.4 Over-head Radiant Warmer 1 1 1 0 1 910000 910000 30.5 Infant Length Measuring Scale 2 2 2 2 0 5000 0 30.6 Infant Weighing Machine 2 2 2 2 0 3100 0 30.7 Nebulizer 1 1 1 1 0 0 30.8 Billiubino-meter 1 1 1 1 0 0 30.9 Exchange Blood Transfusion Set 1 1 1 1 0 2000 0 30.1 Nasal Probe Paed size 1 2 2 1 0 7000 0 31 Anaesthesia/ICU 0 31.1 Anaesthesia Machine 1 1 1 1 0 321000 0 31.2 Ventilators 1 1 1 1 0 525000 0 31.3 Nebulizer 1 1 1 1 0 165000 0 31.4 Oximetry 1 1 1 1 0 0 31.5 Defibrillator 1 1 1 0 1 500000 500000 31.6 Airway Oral and 1 2 2 1 0 500 0 31.7 Tracheostomy tube (adult and paeds) 1 2 2 1 0 1000 0 31.8 Face mask of all sizes 1 2 2 1 0 1000 0 31.9 Double Cuff Tourniquet (for regional block) 1 1 1 1 0 320 0