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NPCC Meeting

NPCC Meeting. New Delhi. TOTAL BUDGET NRHM. B) ADDDITIONALITIES UNDER NRHM. 1. United grants to village health and sanitation committees

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NPCC Meeting

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  1. NPCC Meeting New Delhi

  2. TOTAL BUDGET NRHM

  3. B) ADDDITIONALITIES UNDER NRHM 1. United grants to village health and sanitation committees Constitution of village health and sanitation committees is proposed to the State Government for considering all 369 inhabited villages. In the year 2008-2009, 92 village committees will be made functional. Such committees are essential for broad approach to health improvement that involves a wide range of activities and individuals. A committee can coordinate and support the different activities, provide leadership for community and can serve as the community contact point with local and district functionaries under the NRHM Program. The untied grant of Rs.10, 000/- per year will be used for development of the village health plans and the necessary approved activities. 2. Construction and Maintenance of Physical Infrastructure of SHCs The State of Goa has 172 Sub Health Centers. A sum of Rs.10, 000/-per year is allocated per Sub Health Center as Maintenance grant. All SHCs are functional from rented premises. In addition, as per 2001 population there is a shortfall of 28 SHCs. Thus 28 SHCs buildings are to be constructed during NRHM programme period. The State proposes construction of 10 SHCs in this year, for which there is provision of Recurring cost of Rs.3,50,000 per SHC.

  4. Construction and Maintenance of physical Infrastructure of PHCs Each PHC will receive annual maintenance grant of Rs.50,000/- per year as provided under NRHM guidelines of the GOI. (13 PHCs with inpatient facility, 6 PHCs with only outpatient facility and 4 Urban health centers) Three PHCs will be constructed during NHRM programme period.PHC Mayem, Calangute and Chimbel are considered for construction in the year 2008-2009. For the construction of PHC at Mayem, Calangute and Chimbel, a provision of Rs. 40, 00,000/- has been made. For the renovation of OT block maternity ward and the NICU of South Goa district hospital an allotment of Rs. 50 Lakh has been made in this budget.

  5. 4. Construction and Maintenance of physical infrastructure of CHCs Each CHC will receive annual manual grant of Rs.100, 000/- per year as provided under NRHM guidelines of the GOI. There is a shortfall of 2 CHCs as per 2001 population. These CHCs will be constructed during the programme period. It is proposed that construction of 1 CHC each will be undertaken in the year 2008-2009. The CHCs were designed to function as institutions so as to provide secondary level of health care to the rural population. The state has to ensure that the CHCs are able to provide good quality specialists health care to the rural population. These standards describe specialists services that should be available at CHC. It includes routine and emergency care in surgery, medicine, obstetric and gynecology and pediatric and all the National Health Programmes. These standards also prescribe the standards for support services at CHC level. The minimum requirement in terms of staff, skills, equipment, drugs, and investigated facilities, physical infrastructure, including electricity, telephone, water and sanitation have been prescribed. At present 3 CHCs are housed in government owned premises. CHC Canacona is housed in the newly constructed hospital complex since May 2006. CHC Ponda is under construction, whose foundation stone was been laid on 16th January, 2007.Work will be completed in the year 2009. PHC Sanquelim will be upgraded to CHC. Cottage Hospital Chicalim will be given the status of CHC after recognition. Hence the number of CHCs will be 7 in the year 2008-2009.

  6. 5. Untied grants to SHCs. PHCs and CHCs: At present 172 SHCs, 23 PHCs and 5+ 1CHCs For the untied funds a provision of Rs. 17,20,000/- for the sub health centers and 5,75,000/- and fifty thousand per CHC is required 6.Support to mobile Medical units/ health camps Procurement of staff vehicles one for each district @ Rs. 7 lakhs per staff vehicle will be purchased by the society. Recurring expenditure @ Rs. 10,00,000 per year district hospitals for drugs and rupees ten thousand per year district hospital for manpower. Provision for maintenance, repairs and servicing @ Rs. 5 lakhs per year is made.

  7. Support for school health programmes / adolescent health programmes The school health programme will be further strengthened to provide regular health check-up and health care services for all school going children. Sick children suffering from common illness are treated by the local institution while sick children requiring higher level of care are referred to secondary and tertiary care health institutions. Health education and personal hygiene are important components of the programme. To support the school health services and Adolescent health programme, provision is made for contingency expenses and trainings. 8. Support for IEC activities Health melas will be organized 1 per block per year in both the districts. This way 11 block level health melas will be covered. For block level melas Rs.2, 00,000/- per mela will be sanctioned. These melas will be organized every year from year 2 onwards.

  8. State level resource center The NRHM provides an allocation of Rs.50 lakhs for this. The State proposes to establish the State Health Resource Center to enable innovations and channelise coordinated technical assistance in the areas of strategic planning, technical assistance and operational support. Similar resource centers would be created at the district and block levels subsequently and the State Health Systems Resource Center will function as an apex resource center in the State. 10. Research Studies. Role of operation research needs to be optimized for improving programme performance as well as for improving the quality of programme implementation and monitoring. The State would establish an Operations Research Cell, which will coordinate all operational researches and maintain a catalogued documentation. This cell would be appropriately manned with requisite professionals having expertise in public and related disciplines including research methodology. The State would also seek to strengthen monitoring and evaluation system so that effective also proposes to develop and document best practices so that the program implementers can bench-mark their performances. The State Government would include e-governance and tele-medicine in its operations research agenda. The detailed work plan would be developed to address these initiatives. Two mobile medical units with Mammography facility @ 35 lakhs per unit. A study on breast cancer is going to initiated at the cost of rupees 12 Lakhs per year. It is proposed to provide facilities for DNB studies to the MO,s in the 2 district hospitals. Books, the necessary journals & stipend are required for the above. Hence a provision of Rs. 50 lakhs is made.

  9. 11. Improving physical infrastructure of SHC / PHC / CHC / District Hospital As provided under NRHM guidelines, services of second ANM would be made available at each SHC by appointing additional ANM on contractual basis (Rs 7000/- per month). . In this regard proposal has been sent to Govt. for approval. This would ensure that the SHC will always be open for serving the clients. An amount of Rs. 20 lakhs is required for making the necessary changes in the DHS head quarters. 12. Ambulances for all PHCs / CHCs / District Hospitals It has been decided that 2 ambulances per district will be procured and provided to two district hospitals. Also, one ambulance per CHC is proposed.

  10. Telephones for all SHCs/PHCs/CHCs/ District hospitals. Telephones at SHCs, with installation charges of Rs. 2000/- for 200 per unit and running costs @ Rs. 500/- per month. Telephone at PHCs, with installation charges installation of Rs. 2000/- for 23 PHCs and running cost Rs. 500/- per month. Telephone at CHCs, with installation charges installation of Rs. 2000/- for 6 CHCs and running costs @ Rs. 500/- per month. Telephone at District hospitals, with installation charges installation of Rs. 2000/- for 2 DHs and running costs @ Rs. 500/- per month. 14. Rogi Kalyan Samitis/ Hospital Management Committee The National Rural Health Mission guidelines provide a corpus grant for hospital management societies. It is proposed that a sum of Rs.5 lakhs per district hospital, Rs 1 lakh each per CHC and PHC will be provided as an incentive formation and operationalization of hospital management societies will promote social audit for provision of quality health services and will contribute to creation of fund at the facility level through levy of user charges on the services available at the institution.

  11. Double fortified Salt. Supplying DFS packs to all the pregnant women and lactating mothers in Goa wod be beneficial in reducing the incidence of diseases caused due to iodine deficiency. The ideal strategy would be to supply 1 kg DFS per family per month for 6 months to Pregnant Women (2nd & 3rd Trimesters of Pregnancy). It would be easy to monitor the supply through the Ante-natal Clinics at various centers of the Directorate of Health Services where women have to register for check-ups during pregnancy. The cost would work out to approximately Rs. 30 lakhs per year. • Strengthening Nursing Schools The State has 1 ANM Training Center. Considering the requirements of ANMs in the State, the State needs to augment its training capacity. For strengthening the ANM Training Center adequate infrastructure such as equipments, furniture, furnishings, training equipments, civil works, renovation and repairs and other basis amenities etc. must be in place. Budget provision is made of Rs 10 lakhs for the civil work and Rs 2 lakhs for the equipment & furniture. It is seen that the incidence of kidney ailments, specially kidney stones is on the rise in Goa. With due consideration it is decided to acquire Lithotriptors, one each for the 2 District Hospitals at the cost of 1 crore 20 lakhs per unit.

  12. B) BUDGET FOR THE YEAR 2008-09 (In lakhs) ADDITIONALITIES UNDER NRHM

  13. C) UNIVERSAL IMMUNISATION PROGRAMME 1.Alternate Vaccine Delivery – At sub center level immunisation sessions are held at monthly interval. However 16 sub centers are conducting immunization sessions twice a month. Hence, Rs. 50/- per session for 187 sessions will require Rs. 1,12,200/- (One lakh twelve thousand two hundred only ) for the year. 2.Mobilization of Childen through Anganwadi workers(AWW) No. of AWWs is 1012. Rs. 25/- per month per AWW in 172 sub centers for one session per month, the budget provision required is Rs. 3,03,600 /-

  14. 3.Slums & Underserved areas(Slum Like areas) in Urban - There are four urban areas in Goa which if allocated Rs. 1400/- per month for holding immunization session in slums areas the budget provision required is Rs. 67,200/-.(Hiring an ANM@ Rs.300/-per session for 4 sessions/month and Rs.200/-per month as contingency per slum. 4.Strengthening monitoring and supervision and surveillance – Presently no district level decentralization of health services is existing. It is proposed to have two DIOs in two districts of Goa. The budget provision @ of Rs. 50,000/- for mobility support would be Rs. 1,00,000/-. It is also planned to purchase a laptop & LCD projector for DIO designate South Goa so as to decentralize the training programme under UIP. Also plastic bags for waste disposal for immunization at sub centers need to be purchased • 5.Computer Assistant in State Family Welfare Bureau • As per the letter No.T.13011/01/2001-CC&V dated 3rd August 2005 services of Computer Assistant engaged at state level are allowed to be continued on contract basis if reflected in state PIP of UIP. Rs. 7000/- per month is the expenditure for the same. An amount of Rs. 84,000/- is required in the financial year.

  15. Computer Assistant to DIO Presently no district level decentralization of Health Services is existing. It is proposed to have two DIOs in two districts of Goa. Pending appointments of DIOs senior pediatricians from the district hospitals have been designated as DIOs for the respective districts. A provision of Computer Assistant with both the district immunization officers would require @ Rs. 7350/- per month (5% increment ) the budget provision of Rs. 1,76,400/- (One lakh seven six thousand four hundred only). The total amount for engaging one computer assistant at state level and two, one each at both districts is Rs. 2, 60,400/- Introduction of RIMS Software for monitoring UIP – As per the instructions received from vide letter No. T-13020/26/2004-CH dated 30th March 2006, from Dr. P. Haldar, Asstt. Commissioner (UIP), Department of Family Welfare, New Delhi to Secretary (Health), Government of Goa, the budgetary provisions for TA/DA is deleted since the training programme is conducted within the same district. RIMS software is already installed in both the districts and efforts are on to streamline the reporting. 6..Review Meetings-A provision of funds @ Rs. 1250/- per meeting per participant for 2 meetings in a year with three participants per district would require expenditure of Rs. 15,000/- per annum.

  16. Cold chain maintenance Maintenance funds - Most of the peripheral units have both ILR and DF. The budgetary provision @ Rs. 750/- per unit would be Rs. 22,500/- • Provision for Additional Support Pits need to be constructed for waste disposal at each health unit. Estimated cost of construction per pit = Rs. 10,000/- Total amount required = Rs. 10,000 X 30 = Rs. 3,00,000/- 9. Reorientation Training Reorientation of vaccinators including ANMS, LHV, PHN - 370 District level orientation training for two days . ANM, LHV, Health Assistant (Male/Female), BEEs & other specialist (per diem Rs.125/- per day for 250 participants = Rs.62,500/-, Rs. 100/- institutional costs per day for 250 participants = Rs.50,000/- & Honorarium to the faculty Rs. 200 X 4 lectures X 2 days X 12 batches =19200/-) Total Rs. Rs.1,31,700/- Orientation training for Medical Officers (per diem Rs.200/- per day for 150 participants for 2 days =Rs. 60,000/-, Rs.100/-institutional costs per day for 150 participants=Rs. 30,000/-,& honorarium to the faculty Rs.200 X 4 lectures x 2 days X 6 batches = Rs.9,600/-) Total = Rs.99,600/- Total budget for training = Rs.2,31,300 /- RIMS update for PHNS Rs. 10,000/-

  17. C) UNIVERSAL IMMUNISATION PROGRAMME BUDGET 2008-2009

  18. D) REVISED NATIONAL TUBERCULOSIS CONTROL PROGRAMME Summary of proposed budget for the state (Rupees fifty lakhs only) ** Only if authorized in writing by the Central TB Division

  19. E) STATE VECTOR BORNE DISEASE CONTROL PROGRAMME PLAN Total Budget Estimates 2008-09

  20. 1)Malaria Budget Estimates 2008-2009

  21. 2)Filaria Budget Estimates 2008-2009

  22. 3)JE Budget Estimates 2008-2009

  23. F(1) NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS BUDGET FOR THE YEAR 2008-09

  24. F(2) NATIONAL LEPROSY ERADICATION PROGRAMME (NLEP) Table Showing Budget plans for 2008-09

  25. F(3) INTEGRATED DISEASE SURVEILLANCE PROJECT Budget Estimates -2008-09

  26. Grand Total 49.17 Lakhs

  27. THANK YOU

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