36
Page | 1 Basti City Program Implementation Plan National Urban Health Mission Prepared by District Health Officials with support from Urban Health Initiative
Page | 1
Basti City
Program Implementation Plan
National Urban Health Mission
Prepared by District Health Officials with support from Urban Health Initiative
Page | 2
District Health Society Jhansi
NATIONAL URBAN
HEALTH MISSION
Programme Implementation Plan
of
Jhansi 2013-14
Page | 3
PREAMBLE
National Urban Health Mission aims to improve the health status of urban population in general and the poor
and other disadvantaged sections in particular. This would be made possible by facilitating equitable access to
quality health care through a revamped primary public health care system, targeted outreach services and
involvement of the community and urban local bodies. Under the scheme, the government proposes to
strengthen and enhance the health care service delivery in urban areas with targeted focus on urban poor and
the disadvantaged.
In Jhansi, out of the total population for 2011 census, 41.7 percent lives in urban regions of district. In total
83384 people lives in urban areas of which males are 441807 and females are 391677. Sex Ratio in urban
region of Jhansi district is 886 as per 2011 census data. Similarly child sex ratio in Jhansi district was 864 in
2011 census. Child population (0-6) in urban region was 96742 of which males and females were 51896 and
44846. This child population figure of Jhansi district is 13.15 % of total urban population. Average literacy
rate in Jhansi district as per census 2011 is 65.27 % of which males and females are 74.11 % and 65.61 %
literates respectively. In actual number 601520 people are literate in urban region of which males and females
are 344504 and 257016 respectively.
The health indicators for Jhansi show that they are way behind in so many aspects and with the launch of
National Urban Health Mission, the efforts for improving the health parameters will complement towards
betterment of urban population and in particular to the urban poor & slum dwellers.
The NUHM planning for this financial year based on the data and available information at city level and
hoping that we will initiate the process very systematically so that we can make the difference in improvement
of quality life of urban people specially by reaching the unreached areas.
HUP – PFI deserves a very special mention for providing generous technical support in preparation of City
PIP.
DPM-NHM
Jhansi
Nodal NUHM
Jhansi
Chief Medical Officer
Jhansi
District Magistrate
Jhansi
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Acronyms
ANM Auxiliary Nurse Midwife
ASHA Accredited Social Health Activist
AWC Aanganwari Center
AWW Aanganwari Worker
BSGY Bal Swasthya Guarantee Yojna
BSUP Basic services for urban poor
BSA Basic Shiksha Adhikari
CDPO Child Development Project Officer
DH District Hospital
DHS District Health Society
DUDA District Urban Development Authority
ICDS Integrated Child Development Scheme
IDSMT
Integrated Development of Small & Medium Towns
IDSP Integrated Diseases Surveillance Program
IHL Individual House level
IMR Infant Mortality Rate
KFA Key Focus Area
LHV Lady Health Visitor
LT Lab Technician
MAS Mahila Arogya Samiti
MMR Maternal Mortality Ratio
NHM National Health Mission
NPP Nagar Palika Parishad
NPSP National Polio Surveillance Program
NRHM National Rural Health Mission
NUHM National Urban Health Mission
OD Open Drainage
RSAP Remote Sensing Application Center
UA Urban Agglomeration
UCHC Urban Community Health Center
UFWC Urban Family Welfare Center
UHI Urban Health Initiative
UHP Urban Health Post
UPHC Urban Primary Health Center
SAM Severely acute Malnourishment
Page | 5
National Urban Health Mission- Programme Implementation Plan
Jhansi 2013-14
1. Jhansi Profile
Jhansi is a historic city of northern India, located in the region of Bundelkhand on the banks of the
Pahuj or Pushpavati River, in the extreme south of Uttar Pradesh. Jhansi city is the administrative
headquarters of Jhansi District and Jhansi Division. istrict is located on the banks of the Betwa River.
It is about 415 kilometres from New Delhi and 292 kilometres from Lucknow, and is called the
Gateway to Bundelkhand. It is situated between North longitudes 24°11´ and 25°57´and East latitudes
78°10´and 79°25´ and has an average elevation of 284 metres (935 feet).
The history of Jhansi is full of patriotism, treason and valor. The place is widely known for “Jhansi ki
Rani” and the hindi poem by noted poetess Subhadra Kumari Chauhan which catapulted her to the
highest position of sacrifice in first independence struggle of the nation in 1857.
The area was a stronghold of Chandela kings till eleventh century. The magnificent fort was built by
Raja Bir singh deo in five years from 1613 to 1618 and the capital was shifted from Orchha to
Balwant Nagar, a city established by him around the fort. For two hundred years it was ruled by
Bundelas, Peshwas and local Chandela kings with support and defiance of Mughal and English
empires. From 1817 to 1854 Jhansi was the capital of the princely state of Jhansi which was ruled by
Maratha rajas. It bore the wraths of English army after the slaughtering of its officials in the hands of
mutineers in the fort precincts during the sepoy mutiny. During the English rule it was included in the
United Province which became Uttar Pradesh after the Independence.
The district is located at south - western border in the Bundelkhand region of the state. The district
consists of the level plain of Bundelkhand, distinguished for its deep black soil, known as mar, and
admirably adapted for the cultivation of cotton. The district is intersected or bounded by three
principal rivers, the Pahuj, Betwa and Dhasan. Jhansi city, being in the middle of mainland India, is
well connected to all major towns in state and nation by road and railway networks. The National
Highway Development Project has supported development of Jhansi. The north-south corridor
connecting Kashmir to Kanyakumari passes through Jhansi as does the East-West corridor;
Page | 6
consequently there has been a sudden rush to infrastructure and real estate development in the city. A
green field airport development has also been planned.
Jhansi district has the headquarters of the 31st Indian Armoured Division of the Indian Army,
stationed at Jhansi-Babina. It is an armoured division which has equipment like the T-72 and T-90
tanks, and the BMP-2 armoured personnel carrier.
Jhansi Junction is a major railway junction of Indian Railways: a major intercity hub and a technical
stoppage for many superfast trains in India. Jhansi has its own division in the North Central Railway
zone of Indian Railways. It lies on the main Delhi-Chennai and Delhi-Mumbai lines.
The district is bordered on the north by Jalaun District, to the east by
Hamirpur and Mahoba districts, to the south by Tikamgarh District of
Madhya Pradesh state, to the southwest by Lalitpur District, which is
joined to Jhansi District by a narrow corridor, and on the east by the
Datia and Bhind districts of Madhya Pradesh. Lalitpur District, which
extends into the hill country to the south, was added to Jhansi District
in 1891, and made a separate district again in 1974. South part of
Jhansi district is dominated by the hilly landscapes of Bundelkhand,
which slopes down from the Vindhya Range.
1.1. SOCIO CULTURAL PROFILE
Page | 7
The district has a one of the largest mining industry in the state. Other towns are Mauranipur,
Garautha, Moth, Babina, Chirgaon, Samthar Gursarai, etc Bundelkhand region is one of the richest
areas in terms of natural resources, but the area is grossly undeveloped. Major problems associated
with this region are those of drought, development disparities due to industrialization, lack of potable
water and declining economic and social status of indigenous population. It is one of the backward
areas because of low productivity, lack of awareness and social evils like cartelism, inequality, child
abuse, etc. Lots of male are engaged in stone crushing. Women of the district are engaged in Bidi
Making. As a result, they develop respiratory problems and ultimately end up in permanent disability.
The rural economy of the district is based on wheat and pulse cultivation, which calls for a lot of
migrating population. In view of large proportion of marginalized and sahariya population, the
district will be take steps towards improving health, through school health programme, routine
immunization, swasthya mela’s, Integrated Reproductive and child health camps etc. The same has
been proposed in the action plan for every mother and child tracking and insure ANC registration,
PNC and child immunization.
1.2. DISTRICT HEALTH INFRASTRUCTURE
Having the only medical college of the Bundelkhand region, Jhansi is a hub for medical care in the
region. The District Hospital has many new facilities to serve patients. There are plenty of private
Page | 8
ospitals, especially in the Medical College area.
1.3. Demographic details
The area of District Jhansi is 5024 sq.km. In 2011, Jhansi had population of 1998603 of which male
and female were 1957436 and 941167 respectively. Density of Jhansi district is 251 people per sq.
Km in 2011.
Description Rural Urban
Population (%) (Census 2011) 58.30% 41.70
Total Population (Census 2011) 1,165,119 833,484
Male Population 615629 441807
Female Population 549490 391677
Sex Ratio 892.57 886.53
Child Population (0-6) 163631 96742
Male Child(0-6) 87663 51896
Female Child(0-6) 75968 44846
Child Sex Ratio (0-6) 866.59 864.15
Child Percentage (0-6) 14% 12%
Male Child Percentage 6.98% 6.23%
Female Child Percentage 6.04% 5.38%
Literates 1304513 601520
Male Literates 783705 344504
Female Literates 520808 257016
Average Literacy 65.27% 72.17%
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Male Literacy 74.11% 77.98%
Female Literacy 55.34% 65.62%
Average literacy rate of Jhansi in 2011 was 65.27%. If things are looked at gender wise, male and
female literacy were 74.11% and 55.34% respectively. Total literate in Jhansi District were 1304513
of which male and female were 783705 and 520808 respectively.
1.4. Jhansi City
Out of the total Jhansi population for 2011 census, 41.7 percent lives in urban regions of district. Out of these,
as per provisional reports of Census 2011, population of Jhansi city in 2011 is 505693. This is 25.30% of total
population of the district.
Decadal Growth
Year 1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 2011
Populatio
n
55,72
4
70,20
8
66,43
2
64,59
1
88,09
9
106,33
3
140,21
7
173,29
2
246,17
2
313,49
1
426,19
8
505,69
3
Jhansi City Total Male Female
Population 505693 265449 240244
Literates 373500 209391 164109
Children (0-6) 55824 29919 25905
Average Literacy (%) 73.86% 78.88% 68.31%
Sex ratio 905 ----------- -------------
Child Sex ratio 866 --------- -------------
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Demographic Profile Jhansi City & Mauranipur City
Jhansi City Mauranipur
City
Total Poulation 505693 61449
Slum Population 211550 32000
Slum Population as percentage of urban population 41.83 % 52 %
Number of Slums notified by Nagar Nigam (DUDA) 3 NA
Number of Non- notified Slums 54 NA
No. of Slum Households 42310 NA
No. of slums covered under slum improvement programme (BSUP,
IDSMT, etc.)
NA NA
Number of slums where households have individual water
connections*
3 NA
Number of slums connected to sewerage network* Nil NA
Number of slums having a Primary school
NA NA
No. of slums having AWC 116 (Urban) NA
No. of slums having primary health care facility 3 NA
1.5. Mauranipur City
Mauranipur is a city in Jhansi district in the Indian state of Uttar Pradesh, India. It is largest Tehsil in
Uttar Pradesh and its headquarters is in Jhansi District . It is a textile production centre. Mauranipur
was known as Madhupuri in ancient time by its rulers.
Geography
Mauranipur is located at {25°14'23"N 79°7'47"E}.[1] It has an average elevation of 192 metres
(630 ft). Sukhnai river flow around the town. Mauranipur is 60.43 km from the city Jhansi. It is
252 km from Uttar Pradesh's capital city Lucknow.
Dam and lakes
Saprar Dam at about 3 km from Mauranipur on sukhnai river which looks beautiful specially in rainy
season.
Siaori Lake Situated at about 8 km north-west of Mauranipur at village Siaori on Lakheri river, this
lake was improved in 1906 and opened for irrigation. This also receives water from Kamlasagar,
which has increased its irrigation capacity.
Pahari dam Situated about 18 km east of Mauranipur in Jhanshi district on Dhasan river this weir
was built in the years 1909-12. This serves the purpose of irrigation through the Lachura dam mainly
in Hamirpur district. 16.46 m Pahari Weir provides irrigation to Jhanshi dist.
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Gross capacity of reservoir is 47,800,000 cubic metres and live storage capacity is 46,000,000 cubic
metres.
Lakheri Dam Lakheri Dam is situated a little upstream of the junction of Chiraya & Tola Nallas near
Village Mahewa about 16 km from Mauranipur in Dist Jhansi on Lakheri river. Max. flood discharge
of the dam is 1744.07 m³/s. The construction of the dam started in 1981. Lakheri Dam will provide
irrigation to 1980 ha of land in doab of Lakheri and Pathari river spread in 13
villages of Tehsil Garautha, through main canal of 9.20 km and distribution system 21 km. The
length and the height of the dam are 4 880 m and 10.6 m respectively. Dead dead Storage Capacity
of the dam will be 1,700,000 cubic metres and Live Storage Capacity will be 13,900,000 cubic
metres.
Lahchura Dam was located on Dhasan river, a tributary of river Betwa in Mauranipur Tehsil. The
present dam, constructed in 1910.[3]
Kamla Sagar
Demographics
As of 2011 India census Mauranipur had a population of 61,449. Males constitute 52.4% of the
population and females 47.2%. Mauranipur has an average literacy rate of 66%, male literacy is
73%, and female literacy is 60%. In Mauranipur, 12.81% of the population is under 6 years of age.
Year 1901 1911 1921 1931 1941 1951 1961 1971 1981 1991 2001 2011
Population 17,231 12,927 12,554 12,797 13,105 15,981 20,224 25,651 33,754 43,714 50,882 61,449
Description Mauranipur NPP Population 61,449
Male Population 32,221
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Female Population 29,228 Sex Ratio 90.711 Child Population (0-6) 7,875
Male Child(0-6) 4,174 Female Child(0-6) 3,701 Child Sex Ratio (0-6) 886.68
Child Percentage (0-6) 12.82 Male Child Percentage 6.79
Female Child Percentage 6.02 Literates 41,103
Male Literates 23,550 Female Literates 17,553 Average Literacy 66.89
Male Literacy 73.09
Female Literacy 60.06
Culture
Faag songs and its rhythmic music could be heard in the whole Bundelkhand region during spring
season when the crops are ready for harvesting. The spring season of March–April express the
vibrant emotions which are hidden in the tender hearts of the youth, invites each other and to
express the mystical attachment between male and female. Finally emotions are transformed into
devotion to make devotee divine . Faag was enriched in the early twentieth century by a folk poet
Isuri (born 1881, in Mauranipur) who is credited to have composed over a thousand Faags.
This festival is celebrated by moving the statue of Hindu God (Ram, Krishna, Ganesh, etc.) on a
special type of cart which is carried by the peoples on their shoulders. And in this way they move in
the whole town where every home welcomes this Movement. this is done only once in a year.
Before moving to the city this cart is carried to the river Sukhnai , where God take a bath for a while
and after that they move to city. In this celebration a fair is arranged called Jal Vihar, in which
different types of Programs are celebrated for one month.
1.6. Work Participation & Occupation Structure1
The work participation rates as per census 2011 for Jhansi City are:
Total Workers Population 167,897
Total Workers Male 133,853
Total Workers Female 34,044
Main Workers Population 123,281
Main Workers Male 103,912
Main Workers Female 19,369
Main Cultivaters Population 3302
Main Cultivaters Male 2572
Main Cultivaters Female 730
Main Agricultural Labourers Population 6546
Main Agricultural Labourers Male 5550
1 Census 2011
Page | 13
Main Agricultural Labourers Female 996
Main Household industries Population 8368
Main Household industries Male 6331
Main Household industries Female 2037
Main Other workers Population 105,065
Main Other workers Male 89,459
Main Other workers Female 15,606
1.3. Urban Poor & Slums2
The UP Slum Areas (Improvement and Clearance) Act, 1962, considers an area a slum if the majority of
buildings in the area are dilapidated, are over-crowded, have faulty arrangement of buildings or streets, narrow
streets, lack ventilation, light or sanitation facilities, and are detrimental to safety, health or morals of the
inhabitants in that area, or otherwise in any respect unfit for human habitation. It mentions factors such as
repairs, stability, extent of dampness, availability of natural light and air, water supply; arrangement of
drainage and sanitation facilities as considerations.
Sl. Name of Slums Notified (Yes/ No) Population
1 Puliya No. 9 Yes 10650
2 Tal Pura Yes 10650
3 Nai Basti Yes 12000
4 Mahrajpura NO 750
5 TolaBadluram NO 900
6 puviatola NO 900
7 Biharipura NO 900
8 Schoolpura NO 2400
9 Villashverpura NO 1050
10 Silvatganj NO 450
11 Hirapura NO 750
12 Nainagarh NO 2550
13 Prathappura NO 750
14 Kasaipura NO 2250
15 Mahaveerpura NO 1800
16 Esaitola NO 1350
17 Khodan NO 600
18 Piriya NO 750
19 Summer Nagar NO 750
20 MasihaGanj NO 6600
21 Sangalpura NO 750
22 Gwaltoli NO 1350
23 Gondu Compound NO 1500
24 Bahar Khanderao Gate NO 600
25 Toria Narsinhrao NO 3900 2 State of Urban Health in Uttar Pradesh, 2006
Page | 14
26 Ander Datia Gate NO 948
27 Bahar Datia Gate NO 1500
28 Sarai NO 1350
29 Aligol Khidaki NO 2124
30 Bhera Khidaki NO 1350
31 Etwariganj NO 6150
32 Mewati Pura NO 6000
33 Ander Unnav Gate NO 3150
34 Bahar Bhandari Gate NO 1350
35 Ander Unnav Gate NO 1416
36 Bahar Bhandari Gate NO 2700
37 Darigaran NO 2850
38 Rai Ka Tajiya NO 1050
39 Mukaryana NO 3900
40 Bisati Khana NO 1500
41 Purai Najhaye NO 3000
42 Panna Lal NO 900
43 Bahar Saiyer Gate NO 5850
44 Mohani Baba NO 2550
45 Madak Khana NO 2100
46 Suje Kha Khidaki NO 1735
47 Gudari NO 2286
48 Bahar Bhandari Gate NO 3300
49 Darigaran NO 4758
50 Khusi Pura NO 9600
51 Chaniapura NO 810
52 Bahar Orcha Gate NO 600
53 Kushthyana NO 2400
54 Sagar Gate NO 3000
55 Lashmi Gate NO 600
56 Bangalagh NO 6000
57 Ander Orcha Gate NO 5400
159127
The rapidly growing urban population poses great challenge to the efforts of the state government towards
improving the health of the urban poor.
Sr. No.
Ward
No. Name of Slams
Population
Quality Of Housing (Kacha/
Pakka/Mixed)
Quality of Sanitation
(IHL/CommunityTotail& OD)
Status of Water
Supply (Piped, Hand
Pump,we
Location &
Distance From AWC
Location &
Distance From
Primaery School
Location & Distance From
PHC/UHP/UFWC
No Of Urban Asha Praposed
Page | 15
lls &other)
Loc.
Dis.
Loc.
Dis. Loc. Dis.
1 Puliya No.
9 10650 Mixed Community Toilet Piped,
HP NA NA NA NA
UHP Puliya No. 9 0 Km.
2 Tal Pura 10650 Mixed Community Toilet Piped,
HP NA NA NA NA UHP
Tahseel 0.5 Km
3 Nai Basti 12000 Mixed Community Toilet Piped,
HP NA NA NA NA UHP
Tahseel 0.5 Km
4 Mahrajpura 750 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
0.5 Km
5 TolaBadlur
am 900 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
0.5 Km
6 puv iatola 900 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
0.5 Km
7 Biharipura 900 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
0.5 Km
8 Schoolpura 2400 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
0.5 Km
9 Villashverp
ura 1050 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
1.5 Km
10 Silvatganj 450 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
1.0 Km
11 Hirapura 750 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
1.0 Km
12 Nainagarh 2550 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
3.0 Km
13 Prathappur
a 750 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
2.0 Km
14 Kasaipura 2250 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
1.0 Km
15 Mahaveerp
ura 1800 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
1.5 Km
16 Esaitola 1350 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
1.5 Km
17 Khodan 600 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra
1.0 Km
18 Piriya 750 Mixed IHL & OD HP,wells NA NA NA NA UHP Nagra NA
19 Summer Nagar 750 Mixed IHL & OD HP,wells NA NA NA NA
UHP Nagra NA
20 MasihaGan
j 6600 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel
1.2Km
21 Sangalpura 750 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
22 Gwaltoli 1350 Mixed IHL & OD HP,wells NA NA NA NA
UHP Sipri Bazar
2.0 km
23 Gondu
Compound 1500 Mixed IHL & OD HP,wells NA NA NA NA
UHP Sipri Bazar
2.0 km
24
Bahar Khanderao
Gate 600 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
2.0 km
25 Toria
Narsinhrao 3900 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
1.0 km
26 Ander
Datia Gate 948 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
2.5 km
27 Bahar
Datia Gate 1500 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
0.5 km
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28 Sarai 1350 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
1.5 km
29 Aligol
Khidaki 2124 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
0.7 km
30 Bhera
Khidaki 1350 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
0.6 km
31 Etwariganj 6150 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
0.7 km
32 Mewati Pura 6000 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
0.1 km
33
Ander Unnav Gate 3150 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
0.5 km
34
Bahar Bhandari
Gate 1350 Mixed IHL & OD HP,wells NA NA NA NA
UHP Etwariganj
0.5 km
35
Ander Unnav Gate 1416 Mixed IHL & OD HP,wells NA NA NA NA
UHP Tahseel
1.2 km
36
Bahar Bhandari
Gate 2700 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel
1.5 km
37 Darigaran 2850 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
38 Rai Ka Tajiya 1050 Mixed IHL & OD HP,wells NA NA NA NA
UHP Tahseel
0.2 km
39 Mukaryana 3900 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel
0.5 km
40 Bisati Khana 1500 Mixed IHL & OD HP,wells NA NA NA NA
UHP Tahseel NA
41 Purai
Najhaye 3000 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
42 Panna Lal 900 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
43
Bahar Saiyer Gate 5850 Mixed IHL & OD HP,wells NA NA NA NA
UHP Tahseel
1.5 km
44 Mohani Baba 2550 Mixed IHL & OD HP,wells NA NA NA NA
UHP Tahseel NA
45 Madak Khana 2100 Mixed IHL & OD HP,wells NA NA NA NA
UHP Tahseel NA
46 Suje Kha Khidaki 1735 Mixed IHL & OD HP,wells NA NA NA NA
UHP Tahseel NA
47 Gudari 2286 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
48
Bahar Bhandari
Gate 3300 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel
1.0km
49 Darigaran 4758 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
50 Khusi Pura 9600 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel
0.8 km
51 Chaniapura 810 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
52 Bahar
Orcha Gate 600 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel
1.2km
53 Kushthyan
a 2400 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
54 Sagar Gate 3000 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
Page | 17
55 Lashmi Gate 600 Mixed IHL & OD HP,wells NA NA NA NA
UHP Tahseel
0.5 km
56 Bangalagh 6000 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel NA
57 Ander
Orcha Gate 5400 Mixed IHL & OD HP,wells NA NA NA NA UHP Tahseel
1.0 km
159127
1.4. Urban Governance
There are multiple agencies responsible for urban governance and provision and management of infrastructure
and services. While, the Jhansi NPP, Jhansi Jal Sansthan, Jhansi Development Authority and UP Jal Nigam
(UPJN) are the key urban service providers, other agencies include the Housing Board, Central and State
Public Works Departments (CPWD and PWD), Transport Department, Industries Department and the
Department of Environment. There is significant overlap of roles and responsibilities and fragmentation in
service provision and management of infrastructure, which makes it difficult to hold institutions accountable
and to coordinate.
Urban Governance and Service delivery institutions
City Level
Jhansi NPP Local level governance; Primary Collection of Solid Waste; Maintenance of Storm
Water Drains; Maintenance of municipal roads; Allotment of Trade Licenses under the
Prevention of Food Adulteration Act; O&M of internal sewers and community toilets;
Street lighting; O&M of water supply and sewerage assets; Collection of water tariff
Jhansi Development Authority Preparation of Master Plans for land use; Development of new areas as well as
provision of housing and necessary infrastructure
District Urban Development
Authority (DUDA)
Implementing agency for plans prepared by SUDA.
Responsible for the field work relating to community development – focusing on the
development of slum communities, construction of community toilets, assistance in
construction of individual household latrines, awareness generation etc.
State Level
UP Jal Nigam (UPJN)
Water supply and sewerage including design of water supply and sewerage networks.
In the last two decades ‘pollution control of rivers’ has become one of their primary
focus areas
State Urban Development
Authority (SUDA)
Apex policy-making and monitoring agency for the urban areas of the state.
Responsible for providing overall guidance to the District Urban Development
Authority (DUDA) for implementation of community development programmes
UP Awas Vikas Parishad
(UPAVP)
Nodal agency for housing in the state. Involved in planning, designing, construction
and development of almost all types of urban development projects in the state.
Autonomous body generating its own resources through loans from financial
institutions
Page | 18
UP State Transport Corporation
(UPSTC)
Provides intra-city and state wide public transport; maintenance of buses, bus stands
Public Works Department
(PWD)
Construction of main roads and transport infrastructure including construction and
maintenance of Government houses and Institutions
State Tourism Department
(STC)
Promotion of tourism
Archaeological Survey of India
(ASI)
Maintenance of heritage areas and monuments
UP Pollution Control Board
(UPPCB)
Pollution control and monitoring especially river water quality and regulating
industries
Town and Country Planning
Department (TCPD)
Preparation of Town Plans including infrastructure for the state (rural and urban)
Office of Commissioner Jhansi
Division
Coordination of activities of various institutions
1.5. Access to Public Facilities
Infrastructure development has not been commensurate with the growth of the city and there are problems
confronting the city in terms of access and coverage in key infrastructure sectors – water supply, sewerage,
housing, drainage, and transport. Overall service levels are inadequate and the situation is worse for the urban
poor.
1.6. Housing
Jhansi has witnessed a radical growth. The position of the city as the only large urban centre amidst a number
of small towns in the surrounding districts makes it an attractive destination for job seekers and people in need
of education and health facilities. One of the features of the city’s growth has been an increase in the number
of slums but disagreements about the definition of slums and about data hamper efforts to address service
delivery challenges in these areas.
HOUSING CHARACTERISTICS
1 Households living in a Pucca House (%) 83.8
2 Households living in a Owned House (%) 82.1
3 Households having improved source of Drinking Water (%) 97.6
4 Households treating water to make it safer for drinking (%) 11.3
5 Households having access to toilet facility (%) 78.3
6 Households sharing toilet facility (%) 23.7
7 Households having access to electricity (%) 94.9
8 Households using Electricity (%) 90.5
9 Households using Firewood/Crop Residues/Cow Dung Cake (%) 34.8
10 Households using LPG/PNG (%) 61.6
11 Households having a separate Kitchen (%) 63.3
12 Households having Computer/laptop with or without Internet Connectivity (%) 11
Page | 19
13 Households having Telephone/M obile (%) 86.5
HOUSEHOLD CHARACTERISTICS
14 Average Household Size 4.5
EFFECTIVE LITERACY RATE
15 Person 86.2
16 Male 92.1
17 Female 79.5
2. Health Infrastructure and scenario
Unlike in the rural areas, where the health department has a wide network of primary health care facilities
providing reproductive and child health services, the urban slums lack basic health infrastructure and outreach
services. Thus, they are often bypassed even by national programmes providing immunization, safe
motherhood and family planning services. The sparse health coverage provided by health facilities like urban
family welfare centers, health posts, and maternity homes in cities is used more for emergencies and curative
services. Often these facilities are far from their service area, poorly staffed, with inadequate space and supply
of medicines and equipment. Urban local bodies like municipal corporations and nagar panchayats are also
expected to provide health care, but resource scarcity restricts them to only providing sanitation services.
NGOs and private trusts are also few and far between.
2.1. First and Second Tier Health Services
The Government has committed itself to make provisions for health care services to the people. Though the
efforts have been rural centric some efforts have also been made to improve the delivery of primary health care
services to the population living in urban areas. It has established D Type health centers and dispensaries for
providing family welfare services and OPD facilities. The Urban Local bodies and Department of Health and
Family Welfare are the two main stakeholders for managing these services. In urban areas of UP, first tier
health services are available through D-type health centers, the family welfare centre, health post and PP
centers3. Second tier health services are provided in urban areas through District Male and Female or
Combined Hospitals.
Sl. Name & Type of health
Facility
Managing Authority
Location Population covered
Services provided
Human resources No. and type of
equipments available
Sanctioned In position
1 UHP Jhokanbag
State Health Deptt
Jhokanbag locality in
sadar
23580 Immunization, FP, OPD
MO-1, SN-3, & Other
-5
MO-1, SN-0,
& Other -5
No
2 UHP State Tahseel 25950 Immunization, MO-1, SN- MO-1, No
3 Ministry of Health and Family Welf are. 2005 Annual Report 2003-04. New Delhi : MoHFW.
Page | 20
Tahseel Health Deptt
locality in sadar
FP, OPD 3, & Other -6
SN-0, & Other
-6 3 UHP
Etwariganj State
Health Deptt
Etwariganj locality in
sadar
63262 Immunization, FP, OPD
MO-1, SN-3, & Other
-6
MO-1, SN-0,
& Other -6
No
4 UHP Sipri Bazar
State Health Deptt
Sipri Bazar locality in
sadar
55600 Immunization, FP, OPD
MO-1, SN-3, & Other
-6
MO-1, SN-0,
& Other -6
No
5 UHP Rajghat
State Health Deptt
Rajghat locality in
sadar
55388 Immunization, FP, OPD
MO-1, SN-3, & Other
-6
MO-1, SN-0,
& Other -6
No
6 UHP Puliya No-9
State Health Deptt
Puliya No-9 locality in
sadar
18583 Immunization, FP, OPD
MO-1, SN-3, & Other
-5
MO-1, SN-0,
& Other -5
No
7 UHP Nagra State Health Deptt
Nagra locality in
sadar
50984 Immunization, FP, OPD
MO-1, SN-3, & Other
-6
MO-1, SN-0,
& Other -6
No
8 UHP Etwariganj
NRHM Etwariganj locality in
sadar
63262 Immunization, FP, OPD
MO-1, SN-1, ANM-1 & Other -1
MO-0, SN-1,
ANM-1 & Other
-1
No
9 UHP Puliya No-9
NRHM Puliya No-9 locality in
sadar
18583 Immunization, FP, OPD
1 MO-1, SN-1,
ANM-1 & Other -1
MO-1, SN-1,
ANM-1 & Other
-1
No
10 UHP Rajgath
NRHM Nagra locality in
sadar
55388 Immunization, FP, OPD
MO-1, SN-1, ANM-1 & Other -1
MO-1, SN-1,
ANM-1 & Other
-1
No
11 PP Center District Women Hospital
State Health Deptt
District Women Hospital,
City
63548 MCH, Immunization,
FP, Pathology,
OPD, IPD & All Other Sevises
MO-1, SN-2, ANM-2 & Other -4
MO-1, SN-2,
ANM-2 & Other
-4
Yes
12 PP Center Maharani Laxmi Bai Medical College
State Health Deptt
MLB Medical college
2042569 MCH, Immunization,
FP, Pathology, OPD, IPD,
Other
MO-3, SN-2, ANM-2 & Other -9
MO-3, SN-2,
ANM-2 & Other
-5
Yes
13 Cantonment Hospital
Armed Forces
CATT. 17070 MCH, Immunization,
NA NA Yes
Page | 21
FP, Pathology, OPD, IPD,
Other 14 Railway
Hospital Railway Railway 20619 MCH,
Immunization, FP,
Pathology, OPD, IPD,
Other
NA NA Yes
15 KochaBawar State Health Deptt
KochaBawar 62750 Immunization, FP, OPD
MO-1, SN-1, & Other
-1
MO-1, SN-0,
& Other -0
No
16 School Health
Dispensary
State Health Deptt
Tahseel locality in
sadar
25950 Immunization, FP, OPD
MO-1, & Other -2
MO-1, & Other
-2
No
17 Government Homeopathy
Hospital
State Health Deptt
Near CMO office in sadar
63548 OPD MO-2, SN-1 & Other -2
MO-2, SN-1 & Other -
2
No
The data given in the table above reveals inadequacy of primary health care services. The situation gets
compounded due to lack of adequate infrastructure, equipments and medicines. The staff mainly Doctors and
ANM is also inadequate. The high population- staff ratio results in poor service coverage with some areas
being underserved. From the above assessment it becomes evident to consider the poor health indicators for
deciding the norms of staff population ratio
2.2 Health Scenario
Health/Morbidity Profile of the City:
Sl. No.
Name of Disease/ cause of morbidity (e.g. COPD, trauma, cardiovascular disease etc.)
Number of cases admitted in 2012
1. Injuries and Trauma 108494
2. Self inflicted injuries/suicide 0
3. Cardiovascular Disease 31089
4. Cancer (Breast cancer) 0
5. Cancer (cervical cancer) 0
6. Cancer (other types) 91
7. Mental health and depression 918504
8. Chronic Obstructive Pulmonary Disease (COPD) 0
9. Malaria 40029,PV-1010,PF-11
10. Dengue 1
11. Infectious fever (like H1N1, avian influenza, etc.) 0
12. TB 1330
13. MDR TB
14. Diarrhea and gastroenteritis 49962
15. Jaundice/Hepatitis 1130
Page | 22
16. Skin diseases
17. Severely Acute Malnourishment (SAM) 0
18. Iron deficiency disorder 0
19. Others 0
(Source: )-District male and Female Hospital and other dispensaries
The above table reflects the health/ morbidity profile of the Jhansi city. As there are three sources of data, the
city planning team has approached all three sources for getting most authenticated as well as updated data. So,
data from IDSP, TB clinic and District hospital were taken and mentioned in the above table.
Based on the results of AHS the health scenario of Jhansi city (proxy by the urban part of the district) is
presented as below.
Health Indicators4
Marrige below legal age (%)
1 Among females (below 18 Years) 2.2
2 Among males (below 21 Years) 3.6
3 CMW age ( 20-24 Years) married before age 18 years 27.7
4 CMM age ( 20-24 Years) married before age 21 years 23.5
Mean Age at Marriage
5 Male 25.8
6 Female 22.5
Children Currently Attending School (Age 6-17 years)
7 Person 89.3
8 Male 88.7
9 Female 89.9
Children attended before (Drop out %)
10 Person 7.7
11 Male 8.2
12 Female 7.1
Morbidity and Health issues
Number of disable persons (1000,000 population)
13 Person 689
14 Male 719
15 Female 654
Number of Injured Persons by type of Treatment received (Per 100,000 Population)
Severe
16 Person 47
17 Male 69
18 Female 22
Major
19 Person 47
4 AHS 2010-11
Page | 23
20 Male 57
21 Female 36
Minor
22 Person 84
23 Male 120
24 Female 44
Persons Suffering from any kind of Acute Illness (Per 100,000 Population)
Diarrhea/Dysentery
25 Person 324
26 Male 303
27 Female 349
Acute Respiratory Infection (ARI)
28 Person 61
29 Male 69
30 Female 51
Fever (All Types)
31 Person 1526
32 Male 1324
33 Female 1758
Any type of Acute Illness
34 Person 2096
35 Male 1898
36 Female 2324
Taking treatment from Any Source (%)
37 Person 86.5
38 Male 86.4
39 Female 86.6
Taking treatment from Government Source (%)
40 Person 16.9
41 Male 15.8
42 Female 18.1
Having Any kind of Symptoms of Chronic Illness (Per 100,000 Population)
43 Person 3841
44 Male 3708
45 Female 3995
sought Medical Care (%)
46 Person 95.3
47 Male 95.2
48 Female 95.5
Diagnosed for (Per 100,000 Population)
Any kind of Chronic Illness
49 Person 419
50 Male 221
Page | 24
51 Female 646
Diabetes
52 Person 3709
53 Male 3575
54 Female 3864
Hypertension
55 Person 574
56 Male 662
57 Female 472
Tuberculosis (TB)
58 Person 1040
59 Male 914
60 Female 1184
Asthma/Chronic Respiratory Disease
61 Person 101
62 Male 139
63 Female 58
Arthritis
64 Person 219
65 Male 265
66 Female 167
Getting Regular Treatment (%)
67 Person 72.5
68 Male 76.7
69 Female 68
Getting Regular Treatment from Government Source (%)
70 Person 32
71 Male 35.3
72 Female 28.5
FERTILITY
73 Total Fertility Rate (TFR) -
74 Women aged 20-24 reporting birth of order 2 & above (%) 40.9
75 birth of order 3 & above (%) 27.7
76 Women with two children wanting no more children (%) 61.1
77 Median age at first live birth of Women aged 15-49 years 23.5
78 Median age at first live birth of Women aged 25-49 years 22.7
79 Women age 15-19 who were already mothers or pregnant at the time of the survey (%) 34
80 Mean number of children ever born to aged 15-49 2.5
81 Mean number of children surviving to Women aged 15-49 2.4
82 Mean number of children ever born to Women aged 45-49 3.6
83 Live Births taking place after an interval of 36 months (%) 51.3
ABORTION to EMW 15-49 Years (%)
84 Pregnancy resulting in abortion 2.7
Page | 25
85 Women who received any ANC before abortion 59.5
86 Married Women who went for Ultrasound before abortion 27
87 Average Month of pregnancy at the time of abortion 3.4
88 Abortion performed by skilled health personnel (%) 73
89 Abortion taking place in Institution (%) 64.9
90 Currently Married Pregnant Women aged 15-49 registered for ANC (%) 78.3
FAMILY PLANNING PRACTICES (CMW AGED 15-49 YEARS)
Current Usage
91 Any method (%) 76.4
92 Any modern method (%) 66.8
93 Female sterilization (%) 40
94 Male sterilization (%) 0.4
95 Copper-T /IUD (%) 0.8
96 Pills (%) 2.6
97 Condom/Nirodh (%) 22.8
98 Emergency Contraceptive Pills (%) 0
99 Any traditional method (%) 9.6
100 Periodic abstinence (%) 8.7
101 Withdrawal (%) 0.7
102 LAM (%) 0.1
UNMET NEED
103 Unmet need for Spacing (%) 10.1
104 Unmet need for Limiting (%) 3.7
105 Total Unmet need (%) 13.8
Maternal Health Care
ANTE NATAL CARE
106 Mothers who received any antenatal check-up (%) 95.7
107 Mothers who had antenatal check-up in first trimester (%) 70.5
108 Mothers who received 3 or more antenatal care (%) 60
109 Mothers who received at least one tetanus toxoid (TT) injection (%) 95.4
110 Mothers who consumed IFA for 100 days or more (%) 17.1
111 Mothers who had Full Antenatal Check-up (%) 12.4
112 Mothers who received ANC from Govt. Source (%) 61.4
113 Mothers whose Blood Pressure (BP) taken (%) 73.6
114 Mothers whose Blood taken for Hb (%) 63.9
115 Mothers who underwent Ultrasound (%) 46.9
DELIVERY CARE
116 Institutional Delivery (%) 80.3
117 Delivery at Government Institution (%) 45.4
118 Delivery at Private Institution (%) 34.8
119 Delivery at Home(%) 19.6
120 Delivery at home conducted by skilled health personnel (%) 68.8
121 Safe delivery *(%) 93.8
122 Caesarean out of total delivery taken place in Government Institutions (%) 9.6
Page | 26
123 Caesarean out of total delivery taken place in Private Institutions (%) 38.4
124 Less than 24 hrs. stay in institution after delivery (%) 70
125 Mothers who received Post-natal Check-up within 48 hrs. of delivery (%) 79.5
126 Mothers who received Post-natal Check-up within 1 week of delivery (%) 82.8
127 Mothers who did not receive any post-natal Check-up (%) 15.1
128 New borns who were checked up within 24 hrs. of birth (%) 80.1
JANANI SURAKSHA YOJANA (JSY)
129 Mothers who availed financial assistance for delivery under JSY (%) 40.1
130 Mothers who availed financial assistance for institutional delivery under JSY (%) 49.5
131 Mothers who availed financial assistance for government institutional delivery under JSY(%) 84.6
IMMUNIZATION (%)
132 No of Children age 12-23 months 96.2
133 Children aged 12-23 months who have received BCG 97.3
134 Children aged 12-23 months who have received 3 doses of Polio vaccine 88.5
135 Children aged 12-23 months who have received 3 doses of DPT vaccine 87.2
136 Children aged 12-23 months who have received Measles vaccine 85
137 Children aged 12-23 months Fully Immunized 80.6
138 Children who have received Polio dose at birth 93.7
139 Children who did not receive any vaccination 2.2
140 Children Vitamin A dose during last six months 63.4
141 Children (aged 6 months) who received IFA tablets/syrup during last 3 months (%) 6
142 Children whose birth weight was taken (%) 65.6
143 Children with birth weight less than 2.5 Kg. (%) 14.3
CHILDHOOD DISEASES
144 Children suffering from Diarrhoea (%) 3.8
145 Children suffering from Diarrhoea
77.6 146 who received HAF/ORS/ORT (%)
147 Children suffering from Acute Respiratory Infection (%) 2.5
148 Children suffering from Acute Respiratory Infection who sought treatment (%) 100
149 Children suffering from Fever (%) 3.5
150 Children suffering from Fever who sought treatment (%) 95.6
Child Feeding practices and nutritional staus of children (%)
151 Children under 3 years breastfed within one hour of birth 77.3
152 Children (aged 6-35 months) exclusively breastfed for at least six months (%) 34
153 Water 57.1
154 Animal/Formula Milk 52.2
155 Semi-Solid mashed food 7.8
156 Solid (Adult) Food 3.7
157 Vegetables/Fruits 2.9
Average month of receiving foods other than other than breast milk for children under 3 years
158 Water 3.6
159 Animal/Formula Milk 4
Page | 27
160 Semi-Solid mashed food 6.9
161 Solid (Adult) Food 8.3
162 Vegetables/Fruits 9.5
BIRTH REGISTRATION
163 Birth registered (%) 28
164 Children whose birth was registered and received birth certificate (%) 23.9
AWARENESS ON HIV/AIDS
165 Women who are aware of HIV/AIDS (%) 74.8
166 Women who are aware of RTI/STI (%) 88
167 Women who are aware of HAF/ORS/ORT (%) 88.2
168 Women who are aware of danger signs of ARI/Pneumonia (%) 72.2
3. Key Issues
The Eleventh Plan had suggested Governance reforms in public health system, such as Performance linked
incentives and Devolution of powers and functions to local health care institutions and making them
responsible for the health of the people living in a defined geographical area. NRHM’s strategy of
decentralization, PRI involvement, integration of vertical programmes, inter-sectoral convergence and Health
Systems Strengthening has been partially achieved. Despite efforts, lack of capacity and inadequate flexibility
in programmes forestall effective local level Planning and execution based on local disease priorities.
In order to ensure that plans and pronouncements do not remain on paper, NUHM UP would strive for system
of accountability that shall be built at all levels, reporting on service delivery and system, district health
societies reporting to state, facility managers reporting on health outcomes of those seeking care, and territorial
health managers reporting on health outcomes in their area. Accountability shall be matched with authority and
delegation; the NUHM shall frame model accountability guidelines, which will suggest a framework for
accountability to the local community, requirement for documentation of unit cost of care, transparency in
operations and sharing of information with all stakeholders. The state will incorporate the core principles of
The National Health Mission of Universal Coverage, Achieving Quality Standards, Continuum of Care and
Decentralized Planning.
Following would be the issues for the cities to address: City Health Planning, Public Private Partnership,
Convergence, Capacity Building, Migration, Communitization, Strengthen Data, Monitoring and Supervision,
Health Insurance, Information Dissemination and Focus on NCDs/ Life-Style Diseases.
After considering the available data, city scenario and analysis, the City planning team has identified issues at both
service delivery & demand generation level. Following are the details of issues which would be addressed through
NUHM at the city level:
1) Need of community volunteers (ASHAs) for taking up the community mobilization activities
2) Need of Mahila Arogya Samiti (MAS- a group of 10-12 women) for wider spread of information/ rights and
entitlements
3) Strengthening of ANC, PNC & identification of high risk pregnancies at community level
4) Home based care of neonates at community level
5) Promotion of institutional deliveries
6) Health education for all, especially for adolescent group
7) Complete immunization of pregnant women & children
8) Needs to strengthen the existing health care facilities by recruiting human resources
Page | 28
9) Need assessment of community in health scenario
10) Need a better convergence with other programs and wider determinants
11) Need of training & capacity building of human resources
12) Need of Strengthened program management structure at district level
13) Need of intensive baseline survey to start the community processes and identifying local needs
14) Involvement of local bodies in decision making and managing the program locally
15) Gap analysis of HR & recruitment
16) Promotion of family planning methods through basket of choice approach & counselling because unmet need for
family planning is high in Jhansi
17) Management of communicable & non- communicable diseases
18) Strengthening AYUSH
19) Constitution of BSGY team for urban areas.
20) Identification & management of SAM children
4. Strategies, Activities and Work plan
The key overarching strategies under NUHM for 2013-14 include data based planning, strengthening of
management and monitoring systems at the state and district level, improving the primary health care delivery
system and community outreach through ASHAs, MAS and Urban Health and Nutrition Days(UHNDs).
The key activities at the district level will include convergence with key urban stakeholders, sensitization of
ULBs on their role in urban health, strengthening UPHCs for provision of primary health care to urban poor,
community outreach through selection, training and support to ASHAs and MAS, conducting UHNDs and
outreach camps to get services closer to the community and reach complete coverage of slum and vulnerable
populations.
With the aim to improve the health parameters of urban population in the city, structures and strategies as
recommended for the NUHM in its framework will be adopted and operationalised rapidly over the years.
4.1. Listing and Mapping of Households in slums and Key Focus Areas
Listing and mapping of households will provide accurate numbers for population their family size and
composition residing in slums. Currently, estimates of population residing in slums are available from District
Urban Development Agency (DUDA) and National Polio Surveillance Project as the immunization micro
plans (under NPSP) provide updated estimates of slum and vulnerable populations and are expected to be
fairly complete. The current plan for covering slums is based on the currently available data of urban
population of each city.
Once the ASHA are deployed they will list all households and fill the Slum Health Index Registers (SHIR)
including the number and details of family members in each household. This data will be compiled for city and
will provide the population composition of slums and key focus areas. This will also help the urban ASHA
know her community better and build a rapport with the families that will go a long way in helping her
advocate for better health behaviors and link communities to health facilities under the NUHM. It is expected
that once the household mapping is completed in cities, the number of ASHAs will be reviewed and adjusted
upwards or downwards and the geographical boundaries of the coverage area for each ASHA would be
realigned. This is due to the reason that the actual population may be higher or lower than the original estimate
used for planning.
Page | 29
4.2. Facility Survey for gaps in infrastructure, HR, equipment, drugs and consumables
Facility survey will be carried out in the public facilities to assess the gaps in infrastructure, human resource,
equipment, drugs and consumables availability as against expected patient load. Further planning, particularly
for UCHCs, will be based on these gaps. This work will be outsourced to a research agency. Development
Partners like Health of the Urban Poor project will technically support this effort.
4.3. Baseline Survey
The state envisions monitoring progress in health indicators in urban areas and among urban poor over the
period of implementation of NUHM. This proposed Baseline survey will generate data on the health and
related indicators which will be reviewed during the course of implementation of the program to assess the
impact of implementation and necessary course corrections can accordingly be made and use of resources can
be optimized.
4.4. Training and Capacity Building
ULB, Medical and Paramedical staff, Urban ASHAs and MAS will be trained. The trainings will have to be
followed by periodic refresher trainings to keep these frontline health workers motivated. NUHM will engage
with development organizations to develop the training modules and facilitate the trainings.
4.5. Monitoring & Evaluation
The M&E systems would also capture qualitative data to understand the complexities in health interventions,
undertake periodic process documentation and self evaluation cross learning among the Planning Units to be
made more systematic.
The Monitoring and Evaluation framework would be based on triangulation of information. The three
components would be Community Based Monitoring, HMIS for reporting and feedback and external
evaluations.
4.6. Strengthening of health facilities
Urban - Primary Health Centre (U-PHC) –
During the first year of implementation of the program, the existing urban health posts will be attempted to be
strengthened. Towards this, the UHPs existing in rented accommodations will be shifted to adequately larger
premises which would help in rendering the mandated services. A provision of Rs. 10,000/- per month per
UPHC is being proposed for immediate service provision capacity enhancement, but over the period of time
the said rented accommodations will be shifted to owned premises for sustained services. Accommodations
belonging to other stakeholder government line departments will be explored and then adopted after entering
into necessary agreements/ arrangements with the said department.
4.7. Targeted intervention for urban poor –
The process of listing of households in the KFAs, mapping of KFAs and health facilities and baseline survey
of the KFA households will help determine the scope and extent of services required for targeting of the urban
poor. A deliberate effort will be made to identify the vulnerable poor on the basis of their residence status,
occupational status and social status, besides other micro-level indicators, which will further help focusing the
health care services to the most deserving.
4.8. Mahila Arogya Samiti (MAS)-
Page | 30
MAS will act as community based peer education group in slums, involved in community mobilization,
monitoring and referral with focus on preventive and promotive care, facilitating access to identified facilities
and management of grants received. Existing community based institutions could be utilized for this purpose.
City planning team is proposing formation of only one MAS under each ASHA in the first year and the
identification of the remaining planned MAS will be undertaken in the subsequent years.
4.9. ASHA-
For reaching out to the households ASHAs (frontline community worker) would serve as an effective and
demand–generating link between the health facility and the urban slum population. Each link worker/ASHA
would have a well-defined service area of about 1000-2,500 beneficiaries/ between 200-500 households based
on spatial consideration.
4.10. Outreach services –
Outreach services will be provided to the slum areas and KFAs through ANMs who would be responsible for
providing preventive and promotive healthcare services at the household level through regular visits and
outreach sessions. Each ANM will organize a minimum of one routine outreach session in her area every
month.
Special outreach sessions (for slum and vulnerable population) will be organized once in a week in partnership
with other health professionals (doctors/ pharmacist/ technicians/ nurses – government or private). It will
include screening and follow-up, basic lab investigations (using portable /disposable kits), drug dispensing,
and counseling. The outreach sessions (both routine and special outreach) could be organized at designated
locations mentioned in the aforesaid paras in coordination with ASHA and MAS members
4.11. Innovations –
4.11.1. PPP & CSR –
For Jhansi city a few innovative interventions would be planned. Interventions performed under Public Private
Partnership (PPP) arrangements and Corporate Social Responsibiltoy (CSR) will be undertaken with the intent
to evolve successful models for health care delivery to the urban poor with the technical support of Health of
the Urban Poor program of PFI.
4.11.2. An urban specific IEC strategy covering urban contexts would be developed, field tested and then applied to
cover RCH. The IEC plans should especially focus on interpersonal or group communication which would include a
description of expected behaviour change in different community segments. For effective tracking of its implementation,
benchmarks and milestones would be developed.
4.11.3. School Health Services
School health program under NUHM has been an important component to provide not only the preventive and
curative services to children but also to ensure their contribution in overall health development of the urban
communities. It is envisaged that the active involvement of children in the program will enable them to be a
change agent for themselves as well as communities by taking home good knowledge and practices in terms of
preventive health care activities. It is planned that children will be engaged through innovative and creative
actions to make the learning entertaining and educational.
4.12. Convergence –
Intra-sectoral convergence is envisaged to be established through integrated planning for implementation of
various health programmes like RCH, RNTCP, NVBDCP, NPCB, National Mental Health Programme,
National Programme for Health Care of the Elderly, etc. at the city level. Inter-sectoral convergence with
Departments of Urban Development, Housing and Urban Poverty Alleviation, Women & Child Development,
Page | 31
School Education, Minority Affairs, Labour will be established through DHS headed by the District
Magistrate.
5. Activity Plan under NUHM
Act.
No. Activity
Months : October'13 - March'14 Remarks
City
level
Oct.
No
v.
Dec
Ja
n
Feb
Ma
r
1
Establishment of Platform for
Convergence at state level
Circular to be
isued from state
level to all their
district level nodal
officers
2
Preparation & Finalization of
Guidelines for City Coord.
Committee/ City Program
Management Committee
These will be one
time activities and
will apply across
the state
3 Preparation & Finalization of
Guidelines for Urban ASHAs
4
Preparation & Finalization of
Guidelines for Mahila Arogya
Samiti
5 Preparation & Finalization of
Guidelines for UHND
6
Preparation & Finalization of
Guidelines for Outreach sessions/
School Health Programs
7
Preparation & Finalization of Job
Descriptions for all district level
NUHM positions
8 Preparation & Finalization of
Guidelines for PPP
9 Induction of state level staff for
Urban Health Cell
10 Induction of city level staff for
Urban Health program
11
Meeting of DHS for establishment
of City Program Management
Committee (UH)
12 Sensitization of new probable
members on NUHM
13 Identification of NGOs for their
role under NUHM
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14
Establishment & orientation of
City Program Management
Committee (UH)
15
Identification of groups, collectives
formed under various govt.
programs (like NHG under
SJSRY, self help groups etc.) for
MAS
16
Organize meetings with women in
slums where no groups could be
identified
17 Formation and restructuring of
groups as per MAS guidelines
18 Orientation of MAS members
18 Selection of ASHAs
18a - Selection of local NGOs for ASHA
selection facilitation
18b - Listing of local community
members as facilitators by NGOs
18c - Listing of probable ASHA
candidates and finalize selection
19 Convergence meeting with govt.
Stakeholders
20 Mapping & listing exercise (for
health facilities and slums)
20a - Mapping of all urban health
facilities (public & pvt.) for services
To continue in
2014-15
20b - Mapping of slums (listed and
unlisted)
To continue in
2014-15
20c - House listing of slums/ poor
settlements
To continue in
2014-15
21 Planning for strengthening of
health facilities/ services
- Health Facility Assessment (of
public facilities including listing of
public facility wise infra & HR
requirement)
To continue in
2014-15
22 Baseline survey of urban poor/
slums (KFAs)
(to determine vulnerability, morbidity
pattern & health status)
23 Meetings of RKS for all the public
health facilities under NUHM
24
Identification of alternate/ suitable
locations for UPHCs under various
urban devp. Programs
To continue in
2014-15
Page | 33
25 Strengthening of public health
facilities
- Selection, training and deployment
of HR in pub. health facilities
To continue in
2014-15
26 IEC activities
27 Outreach camps & UHNDs (from
existing UHPs)
28
Empanelment of Private Health
Facilities for health care
provisioning
To continue in
2014-15
29 Involvement of CSR activities
6. Programme Management Arrangements
Districts Heath Society will be the implementing authority for NUHM under the leadership of the District
Magistrate. District Program Management Units have been further strengthened to provide appropriate
managerial and operational support for the implementation of the NUHM program at the district level.
After extensive deliberations the state plans to designate the District Health Society under the chairmanship of the
District Magistrate as the implementing authority for NUHM
Fund flow mechanisms have been set up and separate accounts will be opened at in the district for receiving the
NUHM funds.
Urban Health will be included as a key agenda item for review by the District Health Society with participation of
city level urban stakeholders.
An Additional / Deputy CMO has been designated as the nodal officer for NUHM at the district level. The District
Program Management Unit will co-opt implementation of NUHM program in the district and the District Program
Manager will be overall responsible for the implementation of NUHM. To support this the following additional staff
and funds are proposed for strengthening the District Program Management Units for implementing NUHM:
a. Urban Health Coordinator, Accountant and Data Entry Operators according to the following norms:
Jhansi Urban population Additional Staff Proposed
1 lakh to 10 lakh 1 Urban Health Coordinator,1 Accountant and 1 Data Entry Operator
b. District Programme Manager will be nodal for all NUHM activities so extra incentive and budget for 1
laptop to each DPM has been proposed for DPM for undertaking NUHM activities.
c. A onetime expense for computers, printer and furniture for the above staff has been budgeted along with the
recurring operations expenses.
d. Onetime expenses have been budgeted for up-gradation of the office of Additional/ Deputy CMO and
District Programme management Unit.
The City Program Management Committee will function as an Apex Body for management of the City
Health Plan, which will lead to delivery of Maternal, Newborn, Child Health and Nutrition (MNCHN) and
water, sanitation and hygiene (WASH) services to the urban poor and will work towards the following
objectives:
1. Establish a forum for convergence of city level stakeholders for the delivery of MNCHN and WASH
services to the urban poor.
2. Serve as the nodal body for the planning and monitoring of MNCHN and WASH service delivery to
the urban poor.
Page | 34
3. Provide a forum for exploring, reviewing and approving PPP initiatives and innovations to address
the gaps in MNCHN and WASH service delivery to the urban poor.
The structure proposed for the City Coordination Committee :
Chairperson - DM
Convener - CMO
Members – Health - ACMO-Urban
Member – ICDS - CDPO
Member – Nagar Nigam- Sum Improvement Officer
Member – Water & Sanitation- Sup. En. / Ex.En. JalKal Vibhag, Nagar Nigam
Member DUDA & UD - Project Officer
Members – School Education - BSA & DIOS
Members – Dev. Partners - Partners working in urban NGO's
Review Meetings at UPHC and City Level
Nature of Meeting Periodicity Meeting
Venue
Participants
Mahila Aarogya Samiti
Meeting
Once a month for
each MAS
Slum ANM, HV, Community Organizer, Social
Mobilization officer
Review meeting with
Link workers and MAS
representatives
Once a month UPHC All ANMs, PHN, LMO, Community
Organizer, Social Mobilization officer
Meeting of UPHC
Coordination
Committee
Once a month UPHC LMO, PHN/Community Organizer, Social
Mobilization officer, representative from
2nd
tier facility, and reps. From other
departments
Meeting with CMO &
UH Program
Coordinator
Once a month CMO Office CMO, Program Coord., Asst. Program
Coordinator, LMO/ PHN/ Community
Organizer, Social Mobilization officer
City Task Force
Meeting
Once in two
months
DM’s office CMO, Program Coord. UH, Various
departments’ reps. , private partners, NGOs
7. City Level Indicators & Targets
Page | 35
7.1. Jhansi City
Processes & Inputs
Indicators Baseline (as
applicable)
Number Proposed
(2013-14)
Number
Achieved
(2013-14)
Community Processes
1. Number of Mahila Arogya Samiti (MAS) to be
formed *
0 210
0
2. Number of MAS members to be trained * 0 2100
0
3. Number of Accredited Social Health Activists
(ASHAs) to be selected and trained *
0 105
0
Health Systems
0
4. Number of ANMs to be recruited * 0 32
0
5. No. of Special Outreach health camps to be
organized in the slum/HFAs *
0 51
0
6. No. of UHNDs to be organized in the slums and
vulnerable areas *
0 212
0
7. Number of UPHCs to be made operational * 0 12
0
8. Number of UCHCs to be made operational * 0 0
0
9. No. of RKS to be created at UPHC and UCHC * 0 12
0
7.2. Mauranipur City
Processes & Inputs
Indicators Baseline (as
applicable)
Number Proposed
(2013-14)
Number
Achieved
(2013-14)
Community Processes
10. Number of Mahila Arogya Samiti (MAS) to be
formed *
0 22
0
11. Number of MAS members to be trained * 0 220
0
Page | 36
12. Number of Accredited Social Health Activists
(ASHAs) to be selected and trained *
0 11
0
Health Systems
0
13. Number of ANMs to be recruited * 0 5
0
14. No. of Special Outreach health camps to be
organized in the slum/HFAs *
0 6
0
15. No. of UHNDs to be organized in the slums and
vulnerable areas *
0 32
0
16. Number of UPHCs to be made operational * 0 1
0
17. Number of UCHCs to be made operational * 0 0
0
18. No. of RKS to be created at UPHC and UCHC * 0 1
0
Chief Medical Officer
Jhansi
