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DEPARTMENT OF HEALTH,
MEDICAL EDUCATION &
FAMILY WELFARE
GOVT. OF JHARKHAND
Review by Chief Secretary11.07.2013
Health Indicator - Jharkhand
Indicator Jharkhand India Goal
Year 2001 2006 2009 2010-11 2012-13 2010-11 2015
IMR
(Infant Mortality Rate)
62
(SRS-2001)
49
(SRS-2006)
46
(SRS-2008)
39
(SRS 2011)
38
(AHS2011-12)
44
(SRS -2011)
< 30
Full Immunization (%)
8.8*
(1998-99)
34.5*
(2005-06)
54.1 #
(2007-08)
63.7
(AHS-2010-11)
77
(HMIS)61 (CES) 100
MMR
(Maternal Mortality
Rate)
400
(SRS-2001)
371
(SRS-2003)
312
(SRS-2006)
261
(SRS-2009)
-212
(SRS-2009)
< 100
TFR
(Total Fertiity Rate)N.A.
3.4
(2006)
3.2
(2008)
2.9
(SRS 2011)-
2.4
(SRS 2011)
< 2.1
Institutional
Delivery (%)
13.9*
(1998-99)
19.2*
(2005-06)
31.2340.1
(CES-2009)
46
(HMIS)
72.9
(CES)
(Source : SRS, *NFHS-2 & 3,, #DLHS-III SRS Special Bulletin, Coverage Evaluation Survey (CES-2009)
2
Indicator Jharkhand National
Birth Rate (Per 1000)
23.3 (AHS – 2011-12)
21.8(SRS 2011)
Death Rate (Per 1000)
5.8(AHS – 2011-12)
7.1(SRS 2011)
Child Mortality Rate(Per 1000 live birth)
26.1(National Health Profile)
18.4(National Health Profile)
Sex Ratio 947(Census 2011)
940(Census 2011)
Child Sex Ratio(0-6 Age Group)
943(Census 2011)
914(Census 2011)
Anemia among women (15 -49 Yrs)
70.4(NFHS-3)
56.2(NFHS-3)
Health Indicators - Overview
3
National Disease Control Program (Disease Prevalence)
Disease Prevalence 2007 2011 2012-13
Malaria Mortality Rate
(per lakhs)0.10 0.05 0.02
Kala Azar Mortality Rate
(per lakhs)0.47 0.06 0.01
Kala-azar prevalence rate
(per 10,000 population)11.38 12.89 7.48
Filaria prevalence rate
(per 10,00,000 population)412.7 157.2 139.3
Japanese Encephalitis prevalence rate
(per 10,000 population)0 0.03 0.003
Dengue prevalence rate
(per 10,000 population)0 0.012 0.025
Chikunguniya prevalence rate
(per 10,000 population)0 0.12 0.001
Leprosy Prevalence Rate
(per 10000 population)1.1 0.59 0.66
Tuberculosis Cure Rate (%)
(In 100 TB Patients)83 86 86
4
Health Infrastructure IPHS
(Census 2001)Sanctioned Gap
Health Facilities
HSC 7088 3958 3130
PHC 1005 330 675
CHC 188 188 0
SDH NA 12 NA
100 Bedded DH 24 24 0
200 Bedded DH - 3 -
300 Bedded DH - 1 -
500 Bedded DH - 3 -
Institutions & Others Facilities
ANM Training School NA 10 NA
GNM School NA 3 NA
Trauma Centre - 2 -
Medical Colleges NA 3 NA
MCH Centre NA 26 NA
Ayurvedic, Homeopathic, Unani
Medical College sNA 1+1+1 NA
Ayurvedic Pharmacy Colleges NA 2 NA
Construction StatusNo. of Schemes 1120
Ongoing 654
Complete 466
Health Facilities - Jharkhand
5
Medical Officers & Paramedics Status (HSC - 3958, PHC - 330, CHC - 188, SDH - 10, DH -22)
Category
To
tal
Req
uir
ed a
s
per
IP
HS
2
01
0
Sa
nct
ion
ed
(Reg
ula
r)
Wo
rkin
g
Reg
ula
r)
Wo
rkin
g
Co
ntr
act
ua
l
NR
HM
Wo
rkin
g S
tate
Co
ntr
act
Wo
rkin
g T
ota
l
(Reg
ula
r+
Co
ntr
act
ua
l)
Sh
ort
fall
as
per
IPH
S n
orm
s
Medical Officers 44512048 (MO)
35 Dentist1510 50 322 1882 2569
ANM 7916 6020 4668 3269 1192 9129 0
Staff Nurse 3381 379 276 371 99 746 2635
Pharmacist 1332 385 122 94 158 374 958
Lab Technician 1338 443 144 223 140 507 831
Radiographer 169 50 32 80 0 112 57
Lady Health Visitor 1045 473 155 0 0 155 890
Dresser 488 471 88 0 0 88 400 6
Sectors Amount (Rs. in Crores)
%
Machineries &
equipments
31.76 4.8Supplies and
materials
Medicines
Construction /
renovation works 229.42 35.0
Establishment 54.08 8.3
Other Units 81.64 12.5
Grant in aid 238.00 36.3
State Share 20.10 3.1
Total 655.00 100.0
State Plan-Outlay : 2013-14
Rs. In Crore3.89 % of the State Plan Budget
7
Outlay for Infrastructure & Others
35 %
65 %Scheme Amount
Infrastructure 229.42
Others 425.58
Total 655.00
(Rs. in Crores)
8
ProgrammeProposed
13-14
Approved
13-14
RCH Flexi
Pool 482.49 277.15
Mission
Flexi Pool 404.57 203.14
Immunizatio
n 45.75 41.61
NIDDCP 3.28 0.24
IDSP 5.84 2.66
NVBDCP 60.30 14.89
NLEP 7.32 5.12
NPCB 13.25
RNTCP 14.94 19.20
Infrastructu
re
Maintenance
(TR)
152.8
Total 1016.24 716.71
NRHM-Proposed Budget : 2013-14
Rs. In Crore
9
Improvement in health indicators.
Making functional of Jharkhand Medical & Health Infrastructure
Development and Procurement Corporation Ltd.
Construction of 24 HSCs and 1 PHC by pre-fabricated materials.
Signing of MoU with private partner for operation and
maintenance of 500 Bedded Hospital in Ranchi on PPP.
Setting-up of Advanced Diagnostic Centres on PPP at Medical
Colleges and District Hospitals.
Setting up of new Medical Colleges & Hospitals in 5 Divisional
Headquarters On PPP mode.
108 Emergency Ambulance service.
104 Health Information Helpline.
Focus and Priority Area : 2013-14
10
Setting-up Yoga Centre.
Telemedicine Centres.
Cancer Hospital in Ranchi.
Construction of various health facilities.
Control of diseases.
Efforts are being made for increasing of seats from 50 to 100 in
PMCH, Dhanbad and MGMCH, Jamshedpur and from 150 to
200 in RIMS, Ranchi.
Increase/start PG Courses in medical colleges.
Focus and Priority Area : 2013-14
11
Proposed Projects under PPP
Setting up of Medical Colleges with 300 bedded Hospitals at Palamau,
Chaibasa, Dumka, Hazaribagh & Ranchi.
Operating 500 bedded Hospital at Ranchi.
Advanced Diagnostic centres in 3 Medical Colleges and 24 District
Hospitals.
Setting up of Medico City near Ranchi.
Received concept note from Planning Commission. Clarification sought
from Planning Commission.
12
Improving Human
Development Indicators
13
Reducing MMR
14
Progress & Target : MMR
Year Jharkhand India
1999-2001 400
2001-2003 371 301
2004-2006 312 254
2010* 261 212
2015(Goal set by
NRHM, Jharkhand)
200 100
* Annual Health Survey 2010 - (35% reduction in last decade)
Maternal Mortality Rate (1 lakh live births)
15
Strategy for Reducing MMR
Home/ Out Reach Based :
2.88 lakh VHND sessions planned in FY 2013-14 for Registration of PW and ensuring
4 ANCs through monitoring, supervision, MCTS Tracking.
Sahiya has been given the responsibility
• To mobilize all PW to the VHND site for Full ANC
• Birth Preparedness/ Counseling.
• Post Natal Home visit
Duty Roster of ANM has been rescheduled for afternoon home visit to ensure ANC
HBNC Training for Sahiyas in Mod 6A, 6B and 7A is on going.
10400 Bicycle distributed to Sahiya and 16000 more Cycles in process to be
distributed.
Types of Service-
Home/ Outreach base
Programmatic/ Facility based
FRU based
16
Strategy for Reducing MMR
JSY: Women are given Cash Incentive after Institutional Delivery
• Rural Area = 1400/-
• Urban Area = 1000/-
• Sahiyya Incentive = 350/-
JSSK: Provision for Cash Less Delivery as an entitlement for PW
• Free Drug, Diagnostic, Blood, Diet for pregnant women.
• Free Referral through PPP mode Mamta Vahan initiative for pregnant
women.
• Free C-Section facilities in FRUs through specialist / trained Mos.
Programmatic/ Facility based
17
Strategy for Reducing MMR
Anaemia Control Measure - Strategy through Life Cycle Approach
• Through Iron Supplement among Children age group (6 months to 60
months)
• Weekly Iron Folic Supplement among Adolescent (WIFS)
• Bi-annual de-worming
• Iron Folic Acid Supplement among Pregnant Women during ANC.
• Screening for moderate and severe anaemia and referral appropriate
health facility
• Kishori Swasth Pakhwara for health screening of Adolescent girls
• Continuum of Care through RMNCH+A (Reproductive Maternal
Newborn Child Health + Adolescent)
Programmatic/ Facility based
18
Strategy for Reducing MMR
Proposed to introduce “108“ Emergency Ambulance Services
IEC & BCC Bureau setup for awareness creation in the community
3652 ANM/ Grade A nurse trained in SBA. 606 proposed in 2013-14.
Programmatic/Facility based
46 FRUs functional and 14 (6 old + 8 new) FRUs proposed.
Rational deployment of Specialist/ Trained Man power
Strengthening of Blood Banks / Blood Storage units
EMOC and LSAS training to Medical Officers
FRU Based
19
Improving Institutional
Delivery
20
Progress : Institutional Delivery
Source - HMIS
21
Progress : Janani Suraksha YojnaTarget & Achievement of 1st ANC & Institutional Delivery
959000
727764 (76%)
432668(46%)
Target of Pregnant Women
Registration of Pregnant Women (1st ANC)
Institutional Delivery
Source: HMIS
149176*
128004(85%)
64159 (43%)
Target of Pregnant Women
Registration of Pregnant Women (1st ANC)
Institutional Delivery
FY 2012-13 FY 2013-14 (April-
May)
* Annual Target : 895055 22
4
13
9
15
615
2
37
Abortion Obstructed/ prolonged labour
Severe hypertesnion/ fits Bleeding
High fever Anemia
N= 467 N=507
211
17
17
7
121
34
2012-132011-12
Maternal Death Review
23
17
46
60
0
10
20
30
40
50
60
70
2011-12 2012-13 2013-14 (E)
889
1941
628
0
500
1000
1500
2000
2500
2011-12 2012-13 2013-14 (April-May)
Progress: First Referral Unit (FRU)
24
Entitlements under JSSKAchievement
12-13
Achievement
13-14
Institutional Delivery 432667 128004
Free Drug 163573 40203
Free Diet 144551 34608
Free Diagnostic 138311 28606
Free Blood 224 192
Home to Health 149245 23890
Transfer to higher level 4555 753
Drop back home 131170 17705
Progress : Janani Shishu Surksha Karyakarm
25
Janani Surksha Yojana (JSY) & Janani Shishu Surksha Karyakaram (JSSK) -
Strategy for Improving Institutional Delivery
Cash incentive for pregnant women under institutional delivery.
Free drug, Diagnostic, Blood, Diet for pregnant women.
Free Referral through PPP mode Mamta Vahan initiative for pregnant women.
Free C-Section facilities in FRUs through specialist / trained MOs.
Implementation of JSSK upto HSC Level.
Normal (uncomplicated) pregnancies,
Normal childbirth,
The immediate postnatal period, and
Identify, manage and refer complications among pregnant women and newborns.
Skill Birth Attendant (SBA) –
A Skilled Birth Attendant is an accredited health professional – such as midwife, doctor
or nurse – who has been educated and trained to proficiency in the skills needed to
manage
26
Strategy for Improving Institutional Delivery
Increase in Delivery Points -
In addition to 465 existing delivery points (HSCs) , 776 new delivery
points has been identified & made operational by the state.
Strengthening of PHCs for 24x7 delivery services.
Strengthening of FRUs
Hiring of Specialist doctors.
Delivery Points FY 12-13FY 13-14
(April-May)Strategy
Level 1 465 1230 Ensure SBA Trained
24X7 PHC 45 85
Level 2 150 150
Level 3 46 46
Ensure Deployment of Specialist &
Motivational Incentive for 5000 C- Sections to
the team
Total 706 1057
27
Reducing IMR
28
IMR (Per 1000 Live Birth)
Progress & Target : IMR
Year Jharkhand India
2001 62 67
2002 51 60
2003 51 60
2004 49 58
2005 50 58
2006 49 57
2007 48 55
2008 46 53
2009 44 50
2010 (AHS)
41 47
2011 (SRS)
39 44
2012(AHS
2011-12)
38 -
2015 (E) 30 30
Lower reduction of IMR to 30 per 1000 live births by 2015 –
(44 % deduction in last decade)
62
51 5149
5049
4846
44
4139
38
30
67
60 6058 58
5755
53
50
47
44 44
30
25
30
35
40
45
50
55
60
65
70
Jharkhand
India
29
Child MortalitySRS
2007
SRS
2008
SRS
2009
SRS
2010
AHS
2010-
11
AHS
2011-
12
MDG
Target
Neo Natal
Mortality
Rate(NMR)28 25 NA NA 26 19
Infant Mortality
Rate(IMR)48 46 44 41 41 38 < 30
Under 5 Mortality NA NA NA NA 59 49
Estimated live births per year8.2 lakh
Estimated number of children under 5 years43 lakh
Progress : NMR, IMR & Under 5 Mortality
30
Progress & Target : Full Immunization
Source - HMIS
31
Progress : Full ImmunizationTarget & Achievement of Full Immunization
Source: HMIS
FY 2012-13 FY 2013-14 (April-
May)
* Annual Target : 782245
837000
643702
(77%)
0
100000
200000
300000
400000
500000
600000
700000
800000
900000
Target of Infant Full Immunization
130375
98915
(76%)
0
20000
40000
60000
80000
100000
120000
140000
Target of Infant Full Immunization
32
As on 13.05.2013 Mothers Children
District Target MCTS % Entered Target MCTS % Entered
Bokaro 60,000 26,547 44 53,000 26,303 50
Chatra 30,000 12,749 42 26,000 16,639 64
Deoghar 43,000 13,455 31 38,000 14,382 38
Dhanbad 78,000 24,092 31 69,000 30,264 44
Dumka 38,000 16,676 44 33,000 13,571 41
Garhwa 39,000 19,006 49 34,000 23,637 70
Giridih 71,000 36,342 51 62,000 42,955 69
Godda 38,000 21,231 56 33,000 23,324 71
Gumla 30,000 16,334 54 26,000 13,947 54
Hazaribagh 51,000 31,253 61 44,000 27,983 64
Jamtara 23,000 11,778 51 20,000 12,451 62
Khunti 15,000 10,157 68 14,000 7,414 53
Kodarma 21,000 9,538 45 18,000 8,214 46
Latehar 21,000 8,735 42 18,000 12,760 71
Lohardaga 13,000 9,198 71 12,000 8,344 70
Pakaur 26,000 13,369 51 22,000 8,030 37
Palamu 56,000 35,458 63 49,000 38,033 78
Pashchimi Singhbhum 44,000 30,234 69 38,000 26,546 70
Purbi Singhbhum 67,000 28,269 42 59,000 21,059 36
Ramgarh 28,000 12,019 43 24,000 10,005 42
Ranchi 85,000 35,476 42 74,000 29,887 40
Sahibganj 34,000 24,299 71 29,000 20,906 72
Saraikela 31,000 21,736 70 27,000 16,989 63
Simdega 17,000 8,352 49 15,000 9,988 67
JHARKAHND 9,59,000 4,76,303 50 8,37,000 4,63,631 55
Progress : MCTS (12-13)
33
As on 13.05.2013 Mothers Children
District Target MCTS % Entered Target MCTS % Entered
Bokaro 9285 4041 44 8205 662 8
Chatra 4631 190 4 4016 86 2
Deoghar 6427 827 13 5644 453 8
Dhanbad 12496 342 3 11065 44 0
Dumka 6484 297 5 5636 101 2
Garhwa 6006 264 4 5263 5 0
Giridih 10438 3519 34 9186 1483 16
Godda 5929 1845 31 5077 246 5
Gumla 5097 934 18 4430 408 9
Hazaribagh 6796 2242 33 5986 1952 33
Jamtara 3878 455 12 3370 8 0
Khunti 2376 326 14 2091 86 4
Kodarma 3173 1161 37 2798 330 12
Latehar 3295 247 7 2863 642 22
Lohardaga 2465 1061 43 2120 539 25
Pakaur 5149 1417 28 4428 83 2
Palamu 8381 1336 16 7284 449 6
Pashchimi Singhbhum 7429 2576 35 6395 1345 21
Purbi Singhbhum 9070 2680 30 8039 1307 16
Ramgarh 3722 1008 27 3279 162 5
Ranchi 13052 2556 20 11486 815 7
Sahibganj 5355 1657 31 4595 207 5
Saraikela 5264 2359 45 4532 1163 26
Simdega 2980 763 26 2587 527 20
JHARKAHND 149176 34103 23 130375 13103 10
Progress : MCTS (13-14)
34
Strategy to reduce Child Mortality
1. Essential Newborn Care
• NSSK – Training to all facility level worker & at present 203 NBCC
functional and in FY 13-14 - 335 New NBCC is proposed at L1 level.
2. Care of the sick newborn
• NBSU – 40 NBSU will be made functional at FRU
• SCNU – 17 new SCNU is proposed in FY 2013-14
• JSSK - New born will be provided free diagnostics, free treatment,
free referral and if needed free blood transfusion.
• Up-Referral – Mamta Wahan will be used for referring sick children
to higher facility as well as take up sick child from home to facility
and facility to home.
3. Home Based New Born Care
• By Sahiyya (HBNC Protocol) – 6 Home visits by Sahiyya will be
made.
4. Promoting IYCN practices – Breast feeding practices will be improved
5. Routine Immunization - 80 % Full Immunization among infant is targeted
35
Strategy to reduce Child Mortality
6. Micronutrient Supplementation
• Vit „A‟ Supplementation will be done in biannual round.
7. Control of Childhood Anaemia
• De-worming will be done in biannual round.
• IFA Supplementation will be done in biannual round.
8. Diarrhoea Management-Zinc and ORS
9. Acute Respiratory Infection (ARI) Management
36
Tackling under-nutrition
37
Facility Base Care of Children with Severe Acute Malnutrition
No. of functional
NRCs /MTCs
Total bed
strength To
tal
ad
mis
sio
ns
Ch
ild
ren
Tre
ate
d
Dea
th
Up
ref
erra
l
Def
au
lter
/
LA
MA
Total no. of children under
follow up
F1 F2 F3
57 NRHM + 09
MESO Hospitals
(66)
515 + 45
(560)14914 13387 60 278 1191 6478 4962 4123
IN FY 12-13 up to March‟13 7529 6514 16 151 482 3269 2377 1915
38
Strategy for under-nourished Children & Women
Under nourished Children –
66 Malnutrition Treatment Centres are functional with 560 beds and 28
new MTCs will be made functional with additional beds 370 in FY 2013-
14.
Control of Childhood Anaemia
• De-worming will be done in biannual round.
• IFA Supplementation will be done in biannual round.
Under nourished Women -
Weekly Iron Folic Acid Supplementation (WIFS) with convergence of
ICDS and HRD.
Kishori Swasthya Pakhwara – Following services given to school going
and out of school adolescent girls (10-19years )
• Hb testing
• BMI analysis
• IFA distribution
• De worming
• Nutrition education session
• Referral
39
Reducing TFR
40
Source - SRS
Progress : Total Fertility Rate (TFR)
Year Jharkhand India
2005 3.5 2.9
2006 3.4 2.8
2007 3.2 2.7
2008 3.2 2.6
2009 3.2 2.6
2010 3.0 2.5
2011 2.9 2.4
TFR has declined 14 % since 2004 to 2011
3.53.4
3.2 3.2 3.2
32.9
2.92.8
2.72.6 2.6
2.52.4
1
1.5
2
2.5
3
3.5
4
1 2 3 4 5 6 7
Jharkhand India
41
Strategy to reduce TFR
1. Strengthening Spacing Methods
a. Increasing number of providers trained in IUCD 380 A.
b. Strengthening Fixed Day IUCD services at facilities.
c. Introduction of Cu IUCD 375
d. Delivering contraceptives at home of beneficiaries.
2. Emphasis on Post Partum family planning services.
a. Strengthening Post Partum family planning services
b. Promoting Post Partum IUCD (PPIUCD) services at DH and CHC
c. Appointing counselors at high delivery points
3. Strengthening Sterilization service delivery
a. Increasing pool of trained service providers (Minilap & NSV)
b. Operationalizing Post Partum Sterilization.
c. Holding female & male sterilization camps
42
Strategy to reduce TFR
4. Strengthening quality of service delivery
a. Strengthening Quality Assurance Committee for monitoring.
b. Disseminating/following existing protocols/guidelines/manuals
c. Monitoring of FP Indemnity Scheme.
5. Development of BCC/IEC tools highlighting benefits of FP specially on
spacing methods
6. Focus on using Private Sector capacity for service delivery (exploring
PPP mode)
7. Strengthening programme management structure
a. Establishing new structure for monitoring & supporting
b. Strengthening programme management support to state & district
level
43
Source - HMIS
Progress : Family Planning Services
Services ELA Progress so far % Achievement
2012-13
NSV 25000 8830 35
Tubectomy 150000 132083 82
IUCD 200000 101220 51
2013-14 (April-May)
NSV 3333 198 6
Tubectomy 25000 2039 8
IUCD 33333 9730 5
44
ARSH Programme
45
ARSH, School Health Programme, WIFS, Menstrual Hygiene Programme
Programme Target Progress so far Remarks
ARSH Clinics 194 192Reporting of 2
remaining clinics will
start by May 2013
School Health
Programme
41700 School;
67 Lakh Student
Schools covered
1st Round - 31000
2nd Round 26196
2nd round
Students covered -
2562935
WIFS 51 lakh316565 Adolescents
received IFA
Report till March „13.
.
Menstrual Hygiene
(Free days sanitary
napkin)
2037920
Adolescents1932669 (Sold )
Ranchi, Bokaro,
Dhanbad, Giridh &
Hazaribagh
Adolescent Health
April 2012 – April 2013
Progress : ARSH Programme
46
Tackling sex-ratio
47
Sex Ratio
Source - Census
979
965
943
945
927
914
880
900
920
940
960
980
1000
CSR 1991 CSR 2001 CSR 2011
Jharkhand India
Sex Ratio
Child Sex Ratio
930934
927
933
940
945
940
922
941947
905
910
915
920
925
930
935
940
945
950
19 71 19 81 19 91 20 01 20 11
India Jharkhand
48
Initiative taken by government of Jharkhand to improve the CSR (Child Sex
Ratio) under PC & PNDT
Sensitization of different stake holders-PRI members, NGO member &
Media representatives at District and block level
Involvement of community and stake holders during Save the girl Child
campaign against sex selection.
Massive IEC through Mass media, Print Media- Hoarding, Pamphlet,
Brochure, TV spot, Radio Spots, Nukkad Natak, News Paper Advertisement,
Wall Writing etc.
IEC through MMU as “Beti Bachao Rath”
Total Number of registered clinics-717.
Notification & sensitization of four State Committees done.
Strategy for improving Child Sex Ratio
49
Initiative taken by government of Jharkhand to improve the CSR (Child Sex
Ratio) under PC & PNDT
Committee formed ;
State Supervisory Board.
State Appropriate Authority.
State Advisory Committee.
State Inspection & Monitoring Committee.
During FY 2012-13 501clinics were inspected / visited and 45 clinics were sealed.
Orientation of judiciary personnel's /Legal experts done with JHALSA.
Sensitization and orientation meetings of all civil Surgeons and District Nodal
Officers and other stake holders.
Orientation of SIMC & DIMC done.
Sensitization of USG service providers and Owners of the clinic.
Strategy for improving Child Sex Ratio
50
Capacity Building
51
Training
Programme
Target for
2012-13
Achieveme
nt Till Apr-
Mar 2013
Achievement of
April 2013
Cumulative
Achievement Till April
2013
MATERNAL HEALTH
Skilled Birth
Attendant (SBA)
Health Worker
Training
(ANM,LHV)
825 (173
Batch)
763 66 3817
Emergency Obstetric
Care (EmOC)
Training (MO)
- - - 80
Re Orientation of
EmOC Trained MO
(MO)
48 (16 Batch) 44 - 44
Life Saving
Anaesthesia Skill
(LSAS) Training
(MO)
- 7 (backlog) - 91
Re Orientation of
LSAS Trained MO
(MO)
64 (16 Batch) 60 - 60
RTI/STI Training
(MO)
480 (24 Batch)
279 40 319
Training Progress: 2012-13 & April 2013
52
Training
Programme
Target for
2012-13
Achievem
ent Till
Apr-Mar
2013
Achievement of April
2013
Cumulative Achievement
Till April 2013
MATERNAL HEALTH
Bio Medical Waste
Management Training
(SN,ANM)
720 (24 Batch)
637 - 637
BEmOC 10 days
Training (MO)
20 (5 Batch) 26 (With
Backlog)
8 34
Medical Termination
of Pregnancy (MTP)
Training (MO)
62 (31 Batch) 53 - 570
ANC, MCP card &
labor room Register
Training (ANM)
7530 (251 Batch)
2751 667 3418
Training Progress: 2012-13 & April 2013
53
Training Programme Target for 2012-
13
Achievement Till
Apr-Mar 2013
Achievement of
April 2013
Cumulative
Achievement Till
April 2013
CHILD HEALTH
IMNCI Health Worker
Training (ANM)
2400 (100 Batch) 2576 (with backlog) 20 19901
MTC Training on new
module (MO,ANM)
245 (7 Batch) 227 - 227
NSSK District Level
Training (MO)
96 (6 Batch) 201 (with backlog) - 1205
NSSK District Level
Training (SN,ANM)
1056 (44 Batch) 1058 - 2457
FAMILY PLANNING
Minilap cum MTP
Training (MO)
24 (12 Batch) 27 (with backlog) - 93
CU IUCD 375 Training
(MO,SN)
144 (6 Batch) 111 - 111
Training Progress: 2012-13 & April 2013
54
Training
Programme
Target for
2012-13
Achievement Till
Apr-Mar 2013
Achievement of
April 2013
Cumulative
Achievement Till
April 2013
PPIUCD Training
(MO/SN)
84 (7 Batch) 157 (with backlog) - 340
Non ScalpelVasectomy (NSV)
Induction Training (MO)
32 (8 Batch) 39 (with backlog) - 214
Non ScalpelVasectomy (NSV)
Refresher Training(MO)
28 (7 Batch) 26 - 26
CTU District Level Training
182 (8 Batch) 92 25 540
Training Progress: 2012-13 & April 2013
55
Training Programme Target for
2012-13
Achievement Till
Apr-Mar 2013
Achievement of
April 2013
Cumulative
Achievement Till
April 2013
ARSH TRAINING
Roll out training on
ARSH at District Level
(ANM,LHV, Male
Supervisor, MPW)
600 (24 Batch) 713 (with backlog) 47 2094
State Level ToT for
WIFS (ACMO,DEO,
DSWO)
72 (2 Batch) 58 - 58
ARSH Dist. ToT for
WIFS
600 (24 Batch) 638 - 638
Other ARSH Training
(Mahila Samakhya,
Nehru Yuva Kendra,
Refresher MO)
184 147 - 147
Training Progress: 2012-13 & April 2013
56
Community Mobilization &
Mobile Medical Unit
57
Progress: Community Mobilization
ActivityTarget (2012-
13)
Progress 2012-
13
Progress 2013-
14 (April-May)
No. of Sahiya Selected 40964 40964 40964
No. of VHSNC formed 30012 30012 30012
6A Module Training (HBNC) 40964 33092 36717
6B Module Training (HBNC) 40964 23711 32801
7A Module Training (HBNC) 40964
45 (State TOT)
831 Dist. Res.
Pers.
8267
No. of PTG Sahiya 150 120 120
Drug Kit Distribution 40964 40310 40310
PRI Training 60000 37392 39247
Sas Bahu Pati Sammelan 2000 1500 2175
Sahiya Sammelan 24 24 6
Sahiya Help Desk 98 98 98
Community Base
Monitoring
At Block level 48 46 29
At District
level24 16 0
58
Community Mobilization
Sahiya Samwad on every Saturday.
Formation of Sahiya Sanskritik Manch
Monthly Community news bulletin – Sahiya Sandesh
Special Appeals for Sahiya.
Distribution of Bi-cycle to 10435 Sahiya in High Focus Districts in 2011-12
and 6500 Bi-cycle in FY 2012-13
HBNC Kit – procurement & distribution under progress ; 15000 kit
distributed so far
Representation of PRI members in Rogi Kalyan Samitee and VHSNC
Delegation of financial and administrative powers to PRI has been notified.
59
Sl. No DISTRICT No. of MMUsTotal no. of Patient
observed
Cumulative report
on x-ray
Cumulative report
on Patho. Test
Cumulative report
on no. of ECG
Conducted
Cumulative report
on Cases reffered
1 Bokaro 4 86147 979 14506 2616 7231
2 Chatra 4 78471 783 5616 1017 1534
3 Deoghar 5 87750 421 13243 326 7937
4 Dhanbad 5 96873 856 11083 826 4670
5 Dumka 3 49651 377 8155 170 1357
6 E. Singhbhum 5 97375 2316 14382 184 2843
7 Garhwa 3 68151 327 4638 18 934
8 Giridih 5 94438 461 7459 2515 3672
9 Godda 3 56957 770 9574 87 2386
10 Gumla 4 64171 519 8009 49 1898
11 Hazaribagh 4 62645 1259 5837 1542 2163
12 Jamtara 5 80579 2238 19046 213 2233
13 Khunti 5 94613 1287 11373 509 2825
14 Koderma 3 89292 2226 10251 729 1946
15 Latehar 3 51198 1470 8746 64 1363
16 Lohardaga 5 84488 611 9622 320 1455
17 Pakur 3 34951 428 7807 35 960
18 Palamu 5 141756 1867 32317 511 3037
19 Ramgarh 3 54793 1146 10948 621 1775
20 Ranchi 5 82924 2203 10655 9 2123
21 Sahebganj 5 84971 1552 19808 370 2747
22 Saraikela 5 82405 496 8501 232 1958
23 Simdega 3 24723 82 3271 18 725
24 W.Singhbhum 4 98092 770 14456 326 1787
Total 99 1847414 25444 269303 13307 61559
Note:- Total-103 MMUs in Jharkhand State.
Total-99 MMUs Operatioanal, 1MMU District Hazaribagh are Repaired in BEBCO (Jamshedpur),1 MMU District
W.Singhbhum Tranfer to District Latehar, 1 MMU District Koderma Financial Tender under process, 1MMU District Latehar
MoU under Process.
Mobile Medical Unit Progress: 2012-13
60
National Disease Control
Programmes
61
National Vector Borne
Disease Control Programme
62
Physical Targets/ achievement for Vector Borne Diseases
Activity National TargetAchievement
(2012)
Target of Jharkhand for
2013-2014
ABER (Annual Blood
Slide Examination)ABER > 10 10.87 % 13%
API (Annual Parasite
Incidence)
(malaria cases per
thousand population)
API 1.3 or less by 2012 3.90 Less than 3.32
Mortality due to
malaria
50% reduction by 2010 (NHP
2002) 67.74% reduction w.r.t. 2007 Reduction by 40%
Kala-azar Case Elimination of Kala-azar by
2015 26% decrease w.r.t. 2007
Reduction in morbidity by
30%
Mortality due to Kala-
azar
100% reduction by 2010 and
elimination by 201595% decrease w.r.t. 2007
Reduction in mortality by
75%
Mortality due to
Dengue
- Effective morbidity control
- Reduction in mortality by 50%
compared to 2002
100% decreaseReduction in mortality by
50%
Mortality due to
AES/JE
Reduction in mortality by 50%
by the year 2010100% Decrease
Reduction in mortality by
50%
FilariaTo bring down Micro filaria rate
less than 1 0.63 Less than 1 Micro filaria rate
235 HR were recruited in FY 2012-13 and 493 HR proposed for FY 2013-14
63
Strategy : Vector Borne Diseases Control Programme
Bring down malaria cases per 1000 population - 3.32
Indoor Residual Spray (Malaria) – Target for spray – 63 lakhs population
Indoor Residual Spray (Kala-azar) - Target for spray - 16.54 lakhs population
Bring down Kala-azar cases per 10000 population – 6.0
Fortnight case search for Kala-azar – 4 (per quarter)
Filaria – hydrocele operation – 1500
Active vector surveillance for Dengue & Chikunguniya during transmission season
Space spray for control of JE vector.
Special Strategy for Saranda
Door to door fever survey by bivalent RD Kits
Indoor Residual Spray – Target for spray – 38527 population of all 56 villages
Introduction of larvivorous fish in perennial water bodies
64
National Leprosy Eradication
Programme
65
Progress : National Leprosy Eradication Programme
Prevalence Rate (PR/10,000 Population)
2007-
08
2008-
09
2009-
10
2010-
11
2011-
12
2012-
13June'13
India 0.74 0.72 0.71 0.69 0.68
Jharkhand 1.11 0.98 0.98 0.65 0.59 0.66 0.75
0.74 0.72 0.71 0.69 0.68
1.11
0.98 0.98
0.65 0.59
0.75
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
1
1.1
1.2
India
Jharkhand
66
Progress : National Leprosy Eradication Programme
Annual Case Detection Rate (ANCDR)
2007-08 2008-09 2009-10 2010-11 2011-12 2012-13 June'13
India 12 11 11 10 10
Jharkhand 21.9 16.7 16.4 13.4 10.7 10.8 10.9
1211 11
10 10
21.9
16.7 16.4
13.4
10.7 10.8 10.9
0
3
6
9
12
15
18
21
24
India
Jharkhand
*ANCDR-10/100000 Population 67
Strategy : National Leprosy Eradication Programme
Decentralized integrated leprosy services through General Health Care
system.
Early detection & complete treatment of new leprosy cases.
Carrying out house-hold contact survey of the all contacts of Multi-bacillary
(MB) & child cases.
Early diagnosis & prompt MDT, through routine and special efforts.
Involvement of Accredited Social Health Activities (ASHAs) in the detection
to & completion of treatment of Leprosy cases.
Strengthening of Disability Prevention & Medical Rehabilitation (DMPR)
services.
Information, education & communication (IEC) activities in the community
to improve self reporting to Primary Health Centre (PHC) and reduction of
stigma.
Intensive monitoring and supervision at Primary Health Centre/ Community
Health Centre.
68
Revised National TB Control
Programme
69
70
66% 66% 70%72% 72% 72% 72% 68%
41%
61%
71%72%
75%77% 77%
71%
86%83%
86%87% 87% 87% 88%
87%89% 89%
87%90% 90% 91%
30%
40%
50%
60%
70%
80%
90%
100%
2005 2006 2007 2008 2009 2010 2011 2012
Case Detection India Case Detection Jharkhand
Success Rate India Success Rate Jharkhand
Performance of Jharkhand in comparison to National performance Annualized NSP CDR & NSP Success Rate
Annualized NSP CDR1Q12 – 68%1Q13 – 67%
1Q12 – 91%1Q13 – 90%
70
Financial
Year
Opening
Balance
Approval
in FY
Funds
received
during FY
Total
funds
available
during
FY
Total
Expenditure
in the FY
Balance
in the FY
% of
Expenditur
e on fund
available
2012-13 206,29,
213
1270,96,
000
7,56,54,
510
9,62,83
,723
8,17,88,
891
1,44,94,
832
86%
2013-14
Till May
13
1,44,94,
832
To be
approvedNil
1,49,41,
505
20,47,
658
1,28,93,
84714%
Revised National Tuberculosis Control Programme
Progressive Expenditure for the financial Year 2012-13 & 2013-14
71
Progress : Revised National TB Control Programme
Other Achievements 2012-13
Expansion of Programmatic Management of Drug Resistant TB
(PMDT) Services in 15 more districts giving complete geographical
coverage
Commencement of second Drug Resistant TB Centre at Dhanbad
(1st at TB Sanatorium, Itki)
Introduction of
• Mandatory TB notification by all clinical facilities to Govt.
• Ban on serological diagnostics of TB
• Web based case based recording & reporting of TB cases - a
dedicated portal www.nikshaya.gov.in
• Rapid diagnostics for diagnosis of Drug Resistant TB
72
Strategy : Revised National TB Control Programme
Strengthening of services by
Infrastructure Development -
• 1 DTC/Drug Store (Ranchi), 48 TB Units (TUs) and 74
Designated Microscopy Centres (DMCs)
• Establishment of BSL III Liquid culture lab at Intermediate
Reference Lab (IRL), Itki & Up-gradation of Microbiology lab
of RIMS for diagnostic support to Drug Resistant TB
• DR TB (Drug Resistant TB) Centre at Dumka & Jamshedpur to
be made functional
• Recruitment on new posts
• Training/update training of HR
Continued Supervision, Monitoring & Internal Evaluations
Focus on Tribal Action Plan and IEC
73
National Programme for
Control of Blindness
74
1. Free Cataract operation & IOL implantation
2. School Eye Screening programme with free spectacles
distribution.
3. Management of other Eye decease
• Glaucoma
• Diabetic Retinopathy
• Squint Correction
• Keratoplasty
• Retinopathy of Prematurity
• Retinoblastoma
• Childhood Cataract & Glaucoma
4. Eye banking.
5. Examination of students of blind School
ACTIVITIES AT A GLANCE National BLINDNESS Control Programme
75
6. Strengthening of:
• Vision centre at CHC level
• District Eye Deptt.
• Eye Deptt at Medical College.
• Regional Institute of Ophthalmology
• NGO Eye Hospital
• Eye Bank at Medical College
7. IEC:-
• Eye Donation fortnight
• World Sight day
• Glaucoma Day
ACTIVITIES AT A GLANCE National BLINDNESS Control Programme
76
Year Target Achievement
2001-02 59000 24000
2002-03 70000 27092
2003-04 70000 28000
2004-05 70000 37553
2005-06 70000 47914
2006-07 70000 61559
2007-08 75000 71516
2008-09 75000 73370
2009-10 75000 78924
2010-11 75000 78734
2011-12 114000 84746
2012-13 114000 83619
2013-14 114000 4927
Cataract Achievement up to 2013-14 May
77
Year Target Achievement
2001-02 60000 10529
2002-03 25000 62300
2003-04 643500 42900
2004-05 70000 37553
2005-06 816667 398093
2006-07 816667 814962
2007-08 816667 885952
2008-09 476190 1120511
2009-10 476190 1045858
2010-11 476190 964450
2011-12 476190 958755
2012-13 476190 786925
2013-14 476190 80975
School Screening Achievement up to 2013-14 May
78
Strategy : National Programme for Control of Blindness
Strategy to reduce Blindness -
Village Blind Register preparation by PMOA with help of sahiya/ AWW/
ANM.
Stress on Eye surgeon of District hospital and Medical college.
Free cataract operation with IOL Implantation through out the year.
Seek help of NGO Eye hospital and private Eye practitioners for active
participation.
Timely MIS Entry of all NPCB Activities and timely payment to NGO.
Rapid blindness survey to assess prevalence of blindness.
Early Detection and prompt treatment of sight threatening Eye diseases at
district hospital.
Establish low vision centre at each district
Increase Eye donation and Eye utilization by appointing Eye counselors at
Medical colleges.
Blindness Prevalence -
Blindness prevalence in Jharkhand was 1.4% .(2003-04)
National Blindness prevalence was 0.7% (2003-04)
79
National Programme for Prevention and
Control of Cancer, Diabetes, Cardio-
vascular Disease & Stroke (NPCDCS)
And
National Programme for the Health Care
of the Elderly (NPHCE)
80
National Programme for Prevention and Control of Cancer, Diabetes,
Cardio-vascular Disease & Stroke (NPCDCS)
National Programme for the Health Care of the Elderly (NPHCE)
Strategy :NPCDCS :
Programme started in Ranchi, Bokaro and Dhanbad districts.
Prevention through behaviour change
Early Diagnosis
Treatment
Capacity building of human resource
Surveillance, Monitoring & Evaluation
NPHCE :
Preventive and promotive care.
Management of illness.
Health Manpower Development for geriatric services.
Medical rehabilitation & therapeutic intervention.
Developing appropriate training courses for medical and paramedical health
professional in geriatric care.
Promotion and encouraging basic, clinical, epidemiological and applied research in
ageing and the health care of the elderly.
81
Services Ranchi Bokaro Dhanbad
District
Hospital
Regular OPD Service
(NPHCE)
Integrated Integrated Attached
with Medical
College
IntegratedGeriatric Ward
(NPHCE)
Started with
4 Bed
Started
with 6 Bed
NCD Clinic Integrated Integrated
Community
Health
Centre
Bi-Weekly Geriatric Clinic Integrated Integrated Integrated
NCD Clinic Integrated Integrated Integrated
Sub Centre Opportunistic Screening of
Diabetes & Hypertension
Started Started Started
Status of Services Status of Service - NCD
82
Districts
No. of
persons
screened
Suspected
for Diabetes
( >140 )
Hypertensi
on ( >90 )
% of Diabetes
suspected
% of
Hypertension
Bokaro 243348 15543 28667 6.39 11.78
Dhanbad 188002 1535714730
8.17 7.84
Ranchi 457859 20109 15046 4.39 3.29
Total 889209 51009 584435.74 6.57
Screening of Diabetes and Hypertension till 29/06/2013
83
Financial Progress
84
Financial Progress (As on 31-03-2013) Figure in crore
Heads Approved Budget
2012-13
Opening
Balance as
on
01.04.2012
Amount
released by
GOI 2012-
13
Amount
to be
released
by GOI
Amount
to be
released
by State
State
Share
Total Amount
Available
Total
Exp(01.0
4.2012 to
31-03-
2013
% of
Expenditure
against total
Fund
Available
(9/8*100) (3+4+7)
1 2 3 4 5 6 7 8 9 10
RCH Flexible
Pool(Part A of PIP) 326.93 77.73 113.57 100 35 47 238.3 166.32 70
Additionalities under
NRHM(Part B of PIP) 207.16 78.12 140.83 70 21 37 255.95 136.62 53
Immunization &
Pulse Polio 42.83 8.88 0.88 20 15 30 39.76 21.41 54
Other National
Programme 77.42 11.73 27.59 17 0 1 40.32 32.29 78
Direction and Admin 114.6 0 80.26 0 0 0 80.26 69.66 87
Gross Total 768.94 176.46 354.9 207 71 115 654.59 426.30 65
Expenditure April & May17.72 Cr.
Financial Progress: NRHM 2013-14
85
Monitoring of Flagship
Programme / CSS
86
State Review Mission Team has been formed with eight teams, each team
consist of eight to ten members. Each team is assigned three districts with
monthly visit.
HMIS : Health Management Information System is being used as a strong tool
to monitor the progress of activities. It captures data at all levels right from
Health sub centers.
MCTS : Mother Child Tracking System is name based tracking system of
mother and child which is being implemented in all the districts. On pilot basis
four districts have been chosen for direct cash transfer.
Routine Immunization Monitoring: To strengthen routine immunization
regular monitoring is done along with development partners like WHO and
Unicef.
VHND monitoring: Village Health and Nutrition Day monitoring is done by the
district personals during the session site day.
Community based monitoring : Community based monitoring done in all the
districts and in 48 blokcs.
Monitoring of Sahiya by Sahiya Sathi (ASHA) : Each Sahiya Sathi has been
assigned few villages/ Hamlets where Sahiya Sathi regularly visits and monitor
the performance of Sahiya(ASHA).
ASHA performance monitoring system
Monitoring of Flagship Programme - NRHM
87
Schemes Year Outlay Ratio
Central State
Remarks Central
Share
Fund
Released
Rest
Fund
State
Share
Fund
Released
Rest
Fund
Rs. in Crore
9-GNM schools 90.00 85:15 76.50 17.00 59.50 13.50 0.00 13.50
4 GNM Schools –
sanctioned and work
allotted
5 GNM Schools –
sanctioned and in process
of tender
5-ANM schools2010-
11 25.00 85:15 21.25 10.63 10.63 3.75 0.00 3.75
5 ANM Schools - in
process of sanction
For PG course at
PMCH, Dhanbad
2011-
12 18.15 75:25 13.61 6.80 6.81 4.54 4.54 0.00
In process of sanction of
schemes and
procurement of
equipments.
For PG course at
MGMCH,
Jamshedpur
25.86 75:25 19.40 9.69 9.71 6.47 5.00 1.47
in process of sanction of
schemes and
procurement of
equipments.
Trauma Centre at DH,
Hazaribag
2006-
074.80 100:00 4.80 1.50 3.30 Complete
Trauma Centre at
PHMCH, Dhanbad
2012-
139.65 9.65 0.80 8.85 In process of sanction.
Up gradation of
Nursing School in
Nursing College at
PMCH, MGMCH
and RIMS
2009-
10520.50 100:00 520.50 102.50 418.00
Request sent to GoI for
release of balance funds.
2009-
10520.50 100:00 520.50 102.50 418.00 Work is in progress
2009-520.50 100:00 520.50 102.50 418.00
Work is in progress/ fund
Centrally Sponsored Schemes
88
Schemes Year Outlay Ratio
Central State
Remarks Central
Share
Fund
Released
Rest
Fund
State
Share
Fund
Released
Rest
Fund
Rs. in Crore
Ayurvedic Medical
College, Chaibasa
2011-
12 20.00 50:50 10.00 5.26 4.74 10.00 10.00 0.00 Sanction is in process
Supply of Home
Remedies Kits
2002-
030.06 100:00 0.06 0.06 0.00 Do
Drug Testing
laboratory & Drug
Enforcement
Mechanism, Ranchi
2005-
061.09 100:00 Do
Pharmacy State
Ayurvedic College,
Chaibasa
2005-
061.50 100:00 1.50 1.50 0.00 Do
ROT Programme 2005-
060.03 100:00 0.03 0.03 0.00 Do
1- Setting of 12
AYUSH Wing in
District Hospital @ 35
lakh per Hospital
2006-
074.20 100:00 4.20 4.20 0.00 Do
2- Establishment of
12 Panchkarma
Therapy Centers in 12
District @ 22 lakh per
centers AYUSH
Wings
2006-
072.64 100:00 2.64 2.64 0.00 Do
Centrally Sponsored Schemes
89
Schemes Year Outlay Ratio
Central State
Remarks Central
Share
Fund
Released
Rest
Fund
State
Share
Fund
Released
Rest
Fund
Rs. in Crore
Drug Enforcement
Mechanism
2007-
080.15 100:00 0.15 0.15 0 Do
Drug Enforcement
Mechanism - Drug
Testing Fee
2007-
080.02 100:00 0.02 0.02 0 Do
Drug Enforcement
Mechanism
2008-
090.14 100:00 0.14 0.14 0 Do
Seminar Role of
AYUSH in NRHM
2009-
100.03 100:00 0.03 0.03 0 Done
Collocation of 48
CHC & 97 PHC
2009-
1020.26 100:00 20.26 20.26 0 Sanction is in process
(i) State level
Orientation Workshop
(ii) State level TOT
2009-
100.10 100:00 0.10 0.1 0
State level workshop
done and TOT is in
process
Total 226.75 184.33 80.81 103.53 38.25 19.54 18.71
Centrally Sponsored Schemes
90
THANKS
91
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