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1 NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME Annual Action Plan for Malaria Programme - 2011-12 State Annual Action Plan Year:_2011-2012__ A. Population:2872870 B. Status of Health facilities S. No Health facility No 1 District Hospital 6 2 PHC/ CHC 106/30 3 Dispensary 11 4 Sub centre 406 5 Villages 6508 6 Rapid response team 7 7. Any other - C. Human Resource S. No Health facility Sanctioned / Required In Place Trained as per new Malaria guidelines 1 DMO (Full Time) 7 7 4 2 DVBDC Consultant 7 1 - 3 AMO 7 4 - 4 Block PHC/ CHC-MO 5 PHC-MO 515 231 6 Other MO 7 Lab Technician (regular) 156 156 156 8 LabTechnician (contractual)* 10 10 9 Health Supervisors (M) 273 273 120 10 Health Supervisors (F) 188 188 Nil 11 MPW (M) 872 872 74 12 MPW (M) (contractual)# 100 100 Nil 13 MPW (F) 758 758 Nil 14 Malaria Technical Supervisor - MTS- (contractual)* 21 12 11
Transcript
Page 1: NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMMErrcnes.gov.in/pdf_ppt_zip/dc_spip_megh_11_12.pdf · NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME Annual Action Plan for Malaria Programme

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NATIONAL VECTOR BORNE DISEASE CONTROL PROGRAMME

Annual Action Plan for Malaria Programme - 2011-12

State Annual Action Plan

Year:_2011-2012__ A. Population:2872870 B. Status of Health facilities S. No Health facility No 1 District Hospital 6 2 PHC/ CHC 106/30 3 Dispensary 11 4 Sub centre 406 5 Villages 6508 6 Rapid response team 7 7. Any other - C. Human Resource

S. No Health facility Sanctioned /

Required In Place

Trained as per new Malaria

guidelines 1 DMO (Full Time) 7 7 4 2 DVBDC Consultant 7 1 - 3 AMO 7 4 - 4 Block PHC/ CHC-MO 5 PHC-MO 515 231 6 Other MO 7 Lab Technician (regular) 156 156 156 8 LabTechnician (contractual)* 10 10 9 Health Supervisors (M) 273 273 120 10 Health Supervisors (F) 188 188 Nil 11 MPW (M) 872 872 74 12 MPW (M) (contractual)# 100 100 Nil 13 MPW (F) 758 758 Nil 14 Malaria Technical Supervisor -

MTS- (contractual)* 21 12 11

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15 ASHA 6255 5307 * GFATM/World Bank GFATM / World Bank Project States Only

State PMU In Place Consultant M&E 1 Project Director/ Programme Officer Finance Consultant 1 IEC Consultant 1 Other Consultants 1 (DVBDC Consultant)* Data entry operator 1 (Selection under process) Secretarial Assistant 1 (Selection under process) Statistical Assistant 1

Other 6 DVBDC Consultants: Selection in process

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D. District wise Epidemiological Situation:

District Year Population BSC/BSE ABER Total Pf. API SPR SFR Deaths Name Malaria Case Due to

Cases malaria

East khasi Hills

2006 853789 65724 7.6 7552 6731 8.8 11.4 10.2 51 2007 660923 40618 6.1 2050 1411 3.1 5.04 3.4 58 2008 660923 16305 2.4 572 462 0.8 3.5 2.8 5

2009 756185 25668 3.4 1062 862 1.4 4.1 3.4 5 West Khasi Hills

2006 294115 13154 4.5 1451 1339 4.9 11 10.1 13 2007 296049 10243 3.4 988 737 3.3 9.6 7.1 14 2008 296049 15431 5.2 1075 712 3.6 6.9 4.6 14

2009 345739 28335 8.2 2911 2749 8.4 10.3 8.6 22

Jaintia Hills

2006 295692 56536 19.1 4543 1555 15.3 8 2.7 23 2007 299108 51597 17.4 3705 530 12.5 7.1 1.02 22 2008 299108 42750 14.2 1369 243 4.5 3.2 0.5 1

2009 367173 50108 13.6 1171 408 3.2 2.3 0.8 20

West Garo Hills

2006 614918 138374 22.5 15220 15156 24.7 10.9 10.9 44 2007 518390 132250 25.5 19154 18422 36.9 14.4 13.9 117 2008 518390 155529 30 24259 24159 46.7 15.5 15.5 30

2009 630068 231650 36.8 43890 43699 69.7 18.9 18.9 72

East Garo Hills

2006 247555 16323 6.5 1158 1126 4.6 7 6.8 6 2007 250582 18463 7.4 1710 1643 6.8 9.2 8.8 22 2008 250582 53184 21.2 6487 5660 25.8 12.1 10.6 10

2009 275000 70155 25.5 14379 14121 52.3 20.5 20.1 28

Ri Bhoi 2006 - - - - - - - - 2007 192890 31797 6.4 3175 2327 16.4 9.9 7.3 4 2008 192890 28917 14.9 1311 819 6.7 4.5 2.8 8

2009 235472 52805 22.4 3025 2393 12.8 5.7 4.5 19 South Garo Hills

2006 - - - - - - - - 2007 100980 30496 30.1 3197 3109 31.6 10.4 10.1 0

2008 100980 20319 20.1 2876 2875 28.4 14.1 14.1 5 2009 124137 42698 34.39 10321 10319 83.1 24.2 26 26 State Total 2006 2306069 290111 12.58 29924 25907 12.9 10.3 8.9

137

2007 2318922 315464 13.60 31794 28179 14.65 10.76 8.9 237 2008 2318922 332435 14.33 37949 34930 16.36 11.41 10.50 73 2009 2733774 501419 18.34 76759 74551 28.07 15.30 14.86 192

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District wise Epidemiological Situation upto November, 2009- 2010

District Year Population BSC/BSE ABER Total Pf. API SPR SFR Deaths Name Malaria Case Due to

Cases malaria

East Khasi Hills

2009 756185 24213 3.2 1014 821 1.3 4.1 3.3 4

2010 868209 28141 3.2 698 593 1.8 2.4 2.1 3

West Khasi Hills

2009 345739 26249 7.5 2652 2190 7.6 10 8.3 21 2010 369515 21569 5.8 1692 1240 4.5 8 5.7 12

Jaintia Hills 2009 367173 45751 12.4 1105 364 3 2.4 0.7 20 2010 433205 50520 11.6 908 463 2 1.7 0.9 9

West Garo Hills

2009 630068 221726 35.1 42338 42149 67 19 19 66 2010 645876 191191 29.6 21534 21389 33 11.2 11.1 31

East Garo Hills 2009 275000 67433 24.5 13963 13720 50 20 20 25 2010 237110 49849 21.03 8865 8240 37 18 16.5 10

Ri Bhoi 2009 235472 50147 21.2 2798 2286 12 5.5 4.5 19 2010 237110 47805 20.1 1857 1423 8 4 3 2

South Garo Hills

2009 124137 39552 31.8 9614 9612 77 24 24 21 2010 131602 37225 28.2 4619 4614 35 12 12 15

Total 2009 2733774 475071 17.3 73484 71142 27 15 15 176 2010 2922627 426300 14.5 40173 37962 14 9.4 9 82

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High Risk Areas:

Name of District

High Risk PHC (no)

High Risk Health Sub-Centres (No)

High Risk Village

(No)

High Risk Population

(No) EKH 14 27 410 208487 RI-BHOI 14 26 578 248199 WKH 12 39 637 1,36100 JH 10 21 91 145000 WGH 24 81 1735 600195 SGH 8 21 442 108346 EGH 18 82 413 111607

Total 100 297 4306 1557934

D3. Classify the areas as per following API ranges

Sl. No

API Dist No

PHCs No

Sub-Centre

No

Village No

Population @villages

No.

% Population @ villages

1 < 1 5 25 48 185 215582 18 2 1-2 5 12 14 177 182791 8 3 2-5 6 27 43 469 211957 18 4 5-10 7 34 120 1422 537478 47 5 > 10 5 39 119 2481 80976 7

API > 10

NAME OF DISTRICTS

NOS. OF PHCS

NOS. OF SUBCENTRES

NOS. OF VILLAGES

POPULATION

East Khasi Hills - - - - Ri-Bhoi 3 12 173 85094 West khasi hills 1 2 188 17734 Jaintia hills 4 8 28 24166 West Garo Hills 23 76 1680 594777 South Garo Hills 8 21 412 87996 East Garo Hills. - - - - TOTAL 39 119 2481 80976

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API 5-10

NAME OF DISTRICTS

NOS. OF PHCS

NOS. OF SUBCENTRES

NOS. OF VILLAGES

POPULATION

East Khasi Hills 1 3 58 26892 Ri-Bhoi 3 3 68 30770 West khasi hills 2 8 125 26950 Jaintia hills 1 6 26 48335 West Garo Hills 3 7 138 109181 South Garo Hills 8 17 52 20350 East Garo Hills. 16 73 955 275000 TOTAL 34 120 1422 537478

API 2-5

NAME OF DISTRICTS

NOS. OF PHCS

NOS. OF SUBCENTRES

NOS. OF VILLAGES POPULATION

East Khasi Hills 4 8 165 51436

Ri-Bhoi 4 1 53 29241

West khasi hills 3 10 157 33849

Jaintia hills 5 7 37 72499

West Garo Hills 6 7 20 17098

South Garo Hills 5 10 37 7834

East Garo Hills. - - TOTAL 27 43 469 211957

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API 1 – 2

NAME OF DISTRICTS

NOS. OF PHCS

NOS. OF SUBCENTRES

NOS. OF VILLAGES POPULATION

East Khasi Hills 4 3 77 34955 Ri-Bhoi 1 1 33 10384

West khasi hills 3 12 174 37515 Jaintia hills 6 9 34 96666

West Garo Hills 1 1 1 1006 South Garo Hills 5 6 12 2265 East Garo Hills. nil nil nil nil

TOTAL 20 32 331 182791

API < 1 NAME OF

DISTRICTS NOS. OF

PHCS NOS. OF

SUBCENTRES NOS. OF

VILLAGES POPULATION

East Khasi Hills 4 4 69 27935 Ri-Bhoi - - - -

West khasi hills 3 7 93 20052 Jaintia hills 9 70 428 144999

West Garo Hills 1 5 18 4311 South Garo Hills 6 20 117 13157 East Garo Hills. Nil - - -

TOTAL 25 48 185 215582

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E. GIS mapping (Based on epidemiological data for the years 2009 for identified

high endemic districts) List Attached

Status of Village wise data entry of the district for 2009 in GIS format for identified high endemic districts: yet to be received.

F. Outbreak: No if yes give details as

follows; No. of outbreaks: Area affected: Period of outbreak: No of Cases & deaths reported during outbreak: Reasons for outbreak: Containment measures taken: Outbreak Containment Report(s) submitted by State to Centre? Yes/ No

G. Specific activities:

a)RD Kits (selected Pf endemic districts only)

Sl. No

District Name

No. of PHCs Where RDTs are to be used in emergency Hours

No. of sub-centre

areas with SFR >2% &

no microscopy

Results within 24

hrs

No blood examinations

in those S/c/PHC areas last

year (A)

Expected RDT

requirement in remote

high Pf areas & PHCs

(A x1.25)(B)

RDTs for buffer

stock & distribution

to other areas

(B x0.20) (C)

Total annual RDT

supply(B+C)

No.s to be distributed

in prioritized

areas

1 EKH 14 18 9685 12106 2421 27527 5811

2 RI-BHOI

13 26 20058 25073 5014 40387 12034

3 WKH 12 39 10499 13123 2624 49147 6299

4 JH 19 50 18300 22875 4575 37172 10788

5 WGH 23 82 88690 110863 22172 194135 53214

6 SGH 8 21 15821 19776 3955 45231 9492

7 EGH 16 73 26973 33716 6743 81059 16183 Total 104 309 190026 237532 47504 474658 113821

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b) Areas for supply of ACT

Allocation of ACTs & Quinine for a year based on epidemiological & operational data.

Data latest complete year

Allocation for Plan year

District Total population

Pf cases reported in previous year

Adults (60% of Pf cases

Children (40% of Pf cases) Pregnant women

ACT Blister

9-14 yrs (38%)

5-8 yrs (30%)

1-4 yrs (22%)

Under 1 yr (10%)

Quinine tablets

A

A x 1.5.x.60

B x0.38 x1.5

B x 0.30x 1.5

B x 0.22 x1.5

B x0.10 x1.5

A x1.5 x.02 x21

WGH 642139 43699

39329 9963 7865 5767 2620 27530

SGH 128883 10319 9287 2353 1857 1362 618 6500 EGH 275000 14121 12708 3219 2541 1865 848 8896 RB 247965 2393 2154 545 430 317 144 1507 WKH 358331 2449 2204 558 441 324 147 1543 EKH 853379 886 775 197 155 114 51 542 JH 367173 609 367 93 74 54 24 257 Total 2872870 74476 66824 16928 13363 9803 4452 46775 Caritas 17109 4334 3421 2509 1140 11976

B. Requirement of Rapid Diagnostic Kits based on epidemiological data for next Plan Year

S. No. Details Sub

Centre Village (no) Total Population BSC

1 Areas with high Pf % 309

4267

1368937

190026

2 Of the above prioritized to be equipped with RDT during the year

154

2581

887502

113821

3 No of RDTs Required for Next Plan Year

500000

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Grand Total 83933 21262 16784 12312 5592 58751

B. Allocation of ACTs for Next Plan Year

Data latest complete year Allocation for Next plan year

S. No.

District/ PHC

Total Population

Pf cases reported in previous year

Adults (60% of Pf cases

Children ( 40% of Pf cases) =B= (A*0.40)

Adult ACT Blister

9-14 Yrs (38%)

5-8 Yrs (30%)

1-4 Yrs (22%)

Under 1 yr (10%)

A A x 0.60 x1.5

B x 0.38 x 1.5

B x 0.30 x 1.5

B x 0.22 x 1.5

B x 0.10 x 1.5

1 West Garo Hills 642139 43699 39329 9963 7865 5767 2620 2 South Garo

Hills 128883 10319 9287 2353 1857 1362 618

3 East garo Hills 275000 14121 12708 3219 2541 1865 848 4 Ri Bhoi 247965 2393 2154 545 430 317 144 5 West Khasi

Hills 358331 2449 2204 558 441 324 147

6 East Khasi Hills 853379 861 775 197 155 114 51 7 Jaintia Hills 367173 408 367 93 74 54 24 Total 2872870 74250 66824 16928 13363 9803 4452 Caritas 17109 4334 3421 2509 1140 Grand Total 83933 21262 16784 12312 5592

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c) Bednet

District Name

Eligible Sub Centre (Nos)

Eligible villages

(no)

Eligible Population

Total Bed nets required

Number of bed nets available in household survey(no)

2009-10

Required in the

current year (no) 2011-12

Total planned to be distributed in the

year (no) 2010-11

Total planned to be treated

ITNs LLINs ITNs LLINs

A B C D=A-C E F G=B+E

West Garo Hills 82 1735 642139 256856 282216 67500 89856 Nil 100000 282216

South Garo Hills 21 630 128883 51553 21761 32500 Nil nil 20000 21761

East Garo Hills 73 955 275000 110000 59000 50000 25000 nil 35000 59000

Ri-Bhoi 26 517 247965 99186 32916 Nil 99186 30000 Nil 62916 Jaintia Hills 27 122 70361 30000 35305 Nil 30000 13900 Nil 49205

West Khasi Hils 39 277 167122 66848 23853 Nil 66848 28600 Nil 55453

East Khasi Hills 27 410 208487 83395 22984 Nil 60411 15000 Nil 22984

Total 286 4605 1672688 670930 408748 150000 520930 87500 155000 553535

Total bed nets required = 670930 Already supplied = 305000 To be supplied = 108631 (already allotted) Net required = 257299 (2011-12)

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d)Planning for IRS:

Name of District

No. of CHC/

PHC/Dispensary selected for IRS

Health

Sub-Centr

es (Nos)

Village

selected

(Nos)

Total Popula

tion selected

(Nos)

Spray Squad

Required (Nos)

Training

Batch of

Spray. Squad (Nos)

Equip-ment

required (Nos)

Pumps

Name of Insecti-cide

Insecticide required (MTs)

DDT Malathion SP

EKH 12 16 308 138218 4 2 9 DDT 50% 18.00

RI-BHOI 14 26 517 247965 9 2 20 DDT 50% 30.0

WKH 12 39 637 136100 9 3 20 DDT 50% 20.0

JH 19 69 387 209806 10 5 22 DDT 50% 31.0

WGH 24 81 1674 580999 19 8 40 DDT 50% 70.0

SGH 8 21 630 128883 5 2 12 DDT 50% 19.0

EGH 18 73 955 275000 13 2 26 DDT 50% 41.0

Total 107 325 5108 1718727 69 24 149 DDT 50% 229.00

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e) Innovations

S. No. Innovations Describe details Fund Allocated (Rs)

1 Patient referral e.g. Like use of NRHM/ RKS flexi funds for transport of severe cases

Patient at village level with sign of severe malaria will be escorted by the ASHA using vehicles available at village level or other method of transportation Subcentre level- using flexi fund available for P.O.l PHC Level- for severe complicated malaria needed a specialized treatment

@ 200/ referred case from District to PHC @ 150/ case 500/case

2 Transportation of slides E g. Use of Public transport system

From village to PHC by special messenger every week Using public transport where ever available

Rs. 100 per week Rs. 100 per week

3 NGO/ CBO involvement Refer to PPP guidelines on www.nvbdcp.gov.in

As per PPP Plan

As per PPP Plan

4 Community mobilization eg. Mobilizing using street plays, puppet plays, self help groups

Involvement of students, guides and scouts, VHC, NGOs and FBOs

As per BCC Plan

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f) Commodity Requirement

Previous year's utilization (no) Jan-Dec,2009

Requirement for

current year

(no) 201 -12

Balance Net Requirement (2-3)

Available Item (no) Upto Oct,

2010. 1 2 3 4

Insecticide For IRS (Kg) 3,265 Lts. 22900 31200 19800

Insecticide For ITMN (Lts 3065 4962 3409

1553 lt

LLINs 150000 520930 ( LLINs) nil

Chloroquine (No.) 50,62,200 1880321 1,01,100 2000000 Primaquine 2.5 (No.) 2,97,000 70224 5,600 80000

Primaquine 7.5 (No.) 1,00,400 1110795 1,15,000 1200000

ACT (Artesunate+ 48,125 83529 226 Blister (No.) 84000

Quinine Injection (No.) 19,980 37125 9,200 40000

Quinine Sulphate (No.) 69,000 111386 59,890 120000

Arteether Inj (No.) 17,499 16707 153 16707

RDK (No.) 2,70,800 500000 1,075 500000 Micro Slides (No.) 3,20,000 500000 16,000 500000

---

Pumps (No.) 150 31 nil

Lancet 319400 500000 6000 500000

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g) Training: mention number of batches to be trained

S. No Trainings

Cost per Batch

Trained in Previous year (no)

To be Trained in Current year Q1 (no)

Q2 (no)

Q3 (no)

Q4 (no)

Total (no)

Total Cost (Rs)

1 Medical specialists at Dist. Hospital

1,00,000 Nil 1 1 100000

2 Medical Officers 1,00,000 56 1 1 1 3 300000 3 Lab. Technicians

(reorientation) 80000 19 1 1 2 160000

4 Health Supervisors (M)

50000 7 7 350000

5 Health Supervisors (F)

50000 7 7 350000

6 Others specify(Spray Squads)

20000 7 7 140000

7 Training for M.T.S. on LQAS

50000 12 1 1 50000

8 MTs - Refreshes 50000 1 1 50000 Total 1500000

DBS – Lab Technician - 1,60,000 (Re-orientation) Health Supervisor (M) - 3,50,000 Health Supervisor (F) - 3,50,000 Spray Workers - 1,40,000 Total - 10,00,000 GFATM – Medical Specialist - 1,00,000 Mo PHC - 3,00,000 MTS LQAS - 50,000 MTS Refresher Course - 50,000 Total - 5,00,000

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h) BCC/ IEC: mention number of each

S. No Activities

Unit Cost (Rs)

Previous year (no)

Current year

Q1 (no) Q2 (no) Q3 (no) Q4 (no) Total (no)

Total Cost (Rs)

A. Print Media 1 Posters 15 12000 20000 20000 300000 2 Hoardings 50000 5 7 7 350000 3 Newspaper

advertisement 21000 1 1 1 1 4 84000

B. Electronic Media

4 TV campaigns 6000 Nil 4 4 4 4 12 144000 5 Radio

campaigns 4000 960 960 960 400000

C. Community level

15000 100 95 195 292500

Total 15,70,500

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Larvivorous Fish

Proforma for Urban Malaria Scheme

Status of hatcheries/ up-scaling of Larvivorous fish in the States:-

S.No

Name of states/UTs. No. of hatcheries at District level

No.of hatcheries at Block/PHC/ Village level

No. of water bodies seeded

Meghalaya 2 1 (one) only at village level (Bolchugre village, West Garo Hills )

4157 (number of fishes ) 21 (water bodies)

S. No. District Hatcheries

Seasonal water bodies

Perennial water bodies

Water bodies released with fish previous year (no)

Planned in Current year (no)

Cost

1 West Garo Hills 2 (2 nos to be constructed)

Irrigation Channel, Rice Field

Drains, Ponds etc.

15,197 50,000 200000

2 East Garo Hills 1( 1 no. to be constructed)

Irrigation Channel, Rice Field

Drains, Ponds etc

Yet to be released

100000

3 RiBhoi To be constructed (2 nos)

100000

4 South Garo Hills

To be constructed (2 nos)

100000

5 West Khasi Hills

To be constructed (2 nos.)

100000

6 East Khasi Hills To be constructed

50000

7 Jaintia Hills To be constructed (2 Nos)

100000

Total 7,50,000

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MONTH-WISE EPIDEMIOLOGICAL REPORT FOR THE YEAR 2009

Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Total Population

No. of BSC/ BSE

22685 20693 27656 38715 61197 65937 63956 50380 39084 42613 42451 26348 501715

No. of Pv 82 99 119 170 340 304 396 338 177 148 142 166 2481

No. of Pf 1907 1745 2863 5741 14396 12730 10246 7218 4474 5228 4594 3109 74251

No. of total positives

1989 1844 2982 5911 14736 13034 10642 7556 4651 5376 4763 3275 76759

SPR 8.8 8.9 10.8 15.2 24.1 19.8 16.6 15 11.9 12.7 11.2 12.4 15.29 SFR 8.4 8.4 10.4 14.9 23.5 19.3 16.1 14.3 11.4 12.7 10.8 11.8 14.79 ABER 0.7 0.7 0.9 1.3 2.1 2.2 2.2 1.7 1.3 1.4 1.4 0.9 17.4 RT given 1989 1844 2982 5911 14736 13034 10642 7556 4651 5376 4763 3275 76759

Deaths 3 1 3 15 44 23 38 11 11 17 10 16 192

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SWOT Analysis

SWOT/STATUS Actions to be taken to match the requirements

STRENGTHS 1. Re-organised and revitalise of the NVBDCP

1. Involvement of the District Administration

DC’s at District Level & SDO (civil) , BDO at Block Level for monitoring and Supervision of programme Activities

1. Fund for training available from the

GFATM.

1. Malaria Activities to be fully integrated with the general Health Services

1. Dist. Level monthly meeting of the Deputy

Commissioner with the DM&HO’s, DMO’s and at Sub-Divisional level & Block Level monthly meeting of the SDO (Civil) & BDO’s with SDM& HO’s & MO CHC/PHC to review malaria situation & prompt action for controlling outbreak.

2. All Categories of Health Personnel could be trained.

WEAKNESS 1. Inadequate Health Infrastructure

2. Inadequate mobility for monitoring and

supervision 3. Storage of DDT and other commodities.

4. Recording and Reporting unsatisfactory 5. Inadequate surveillance

1. Procurement of vehicle for State & District through NRHM

2. Hiring of Vehicles through IMCP.

3. Separate ware house for each DMO.

4. Staff responsibilities are trained.

5. Training of all ASHA in English far flung areas. Contractual MPW, MTS at all Block.

OPPORTUNITIES

1. Formation of the Village Health & Sanitation Committee in each and every village.

1. Identification of the number of Villages having VHSC. 2. Organised a Sensitization Camp for the members of the VHSC.

2. Recruitment of ASHA by the VHSC to work as a Link Health workers in their respective villages.

1. Identification of the number of villages having an ASHA 2. Organised a training camp for them.

3. Presence of the NGO/ FBO/ CBO, in the locality. 4. Involvement of Caritas

1. Identification of the villages taken up by caritas. Adequate planning for RDK and Anti Malaria to meet the requirement

2. Planning for Awareness Camp and IEC activities adequate IEC Material.

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THREATS 1. Global warming 2. By Government Agency- Pollution Board-

intersectoral meeting. 2. High illiteracy rate and ignorant, in the Rural areas.

1. Intersecotral activity with the Education Department through the School Health Programme.

3. Poor/Poverty/ low socio-economic development in the Rural areas.

1. Intersectoral discussion to identify and to plan for uplift of the Rural areas.

4. Unplanned Industrialization in the Rural areas - mining.

1. Formation of the Industrial policy by the Government so as to be more environmental friendly

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District wise Epidemiological Situation:

District Name Year Population BSC/BSE

Total Malari

a Cases

Pf. Case SPR SFR

Deaths Due to

malaria

East khasi Hills 2009 756185 21877 971 786 4.4 3.5 3

2010 853379 25768 659 560 2.5 2.1 3

West Khasi Hills

2009 345739 23046 2363 1935 10.2 8.3 21

2010 358331 19730 1543 1114 7.8 5.6 11

Jaintia Hills 2009 367173 39083 969 306 2.4 0.7 19

2010 367173 44760 784 383 1.7 0.8 6

West Garo Hills 2009 630068 209751 39682 39500 18.9 18.8 63

2010 642139 179182 20478 20350 11.4 11.3 29

East Garo Hills 2009 275000 63127 13166 12938 20.8 20.4 25

2010 275000 46394 8318 7714 17.9 16.6 10

Ri Bhoi 2009 235472 44440 2571 2086 5.7 4.6 17

2010 247965 44958 1677 1295 3.7 2.8 0

South Garo Hills

2009 124137 36296 8999 8997 24.7 24.7 18

2010 128883 35070 4247 4242 12.1 12.0 13

State Total 2009 2733774 432620 68721 66548 15.8 15.3 166

2010 2872870 395862 37706 35658 9.5 9.0 72

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COMPARATIVE STATE MONTH-WISE EPIDEMIOLOGICAL DATA FOR 2009-2010 (up to November)

Total Year BSC/BSE Positive cases PF Death Pf %

JAN 2009 22685 1989 1907 3 2010 21440 1950 1899 4

FEB 2009 20693 1844 1745 1 2010 22692 1904 1872 1

MAR 2009 27656 2982 2863 3 2010 28261 2554 2481 1

APRIL 2009 38715 5911 5741 15 2010 31073 3137 3035 12

MAY 2009 61197 14736 14396 44 2010 42616 4743 4583 11

JUNE 2009 65937 13034 12730 23 2010 48979 5290 5118 12

JULY 2009 63956 10642 10246 33 2010 58079 5561 5295 9

Aug 2009 50380 7556 7218 11 2010 56501 5059 4500 11

Sep 2009 39084 4651 4474 11 2010 50315 4779 4445 5

Oct 2009 42317 5376 5228 17 2010 35546 2729 2430 6

Nov

2009 42451 4763 4594 10 2010 30438 2467 2304 10

Total

2009 475071 73484 71142 171 2010 425940 40173 37962 82

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Action Plan for JE for the year 2011-2012

REPORTS OF JAPANESE ENCEPHALITIS FOR THE YEAR 2009-10.

STATE: MEGHALAYA.

DISTRICT WISE DISTRIBUTION OF POSITIVE CASES OF J.E. FOR THE MONTH OF JAN UPTO AUG-2010.

Sl.No Name of District No. of Confirmed Cases

Deaths

1. West Khasi Hills 2 NIL

2. Ri Bhoi 1 NIL

3. East Khasi Hills 1 NIL

Total 4 NIL

DISTRICT WISE DISTRIBUTION OF SUSPECTED CASES OF J.E. FOR THE MONTH OF JAN UPTO AUG-2010.

Sl.No Name of District Name of PHC Total Suspected Cases

1. Ri Bhoi Mawlasnai PHC,

Umsning CHC and Bhoirymbong

4

2. East Khasi Hills Diengpasoh CHC , Laitryngew PHC KVEAC Upper Shillong Mawngap-Marbi

4

3. Jaintia Hills

Nongtalang PHC Sahsniang

2

4.

WKH

Mawkyrwat CHC

1

Total

11

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1.Early AES case detection and management.

a. Identification of Health Institute for AES treatment

Sl. No.

District Name of Health Institute

1. Jaintia Hills Civil Hospital, Jowai 2. East Khasi Hills Civil Hospital, Shillng

NEIGRIHMS, Shillong 3. West Khasi Hills Nongstoin District Hospital

Mairang Sub Division Hospital 4. Ri Bhoi Nongpoh District Hospital

b. Identification of Sentinel Surveillance site with laboratory (SSSL)

Name of Proposed SSSL for 2011-2012 1. Civil Hospital Shillong

2. Vector Control a. Outdoor Space Spray (with Malathion Technique) Fogging. b. Promotion of ITBN. c. Introduction of Larvivorous fish. d. Entomological study

3.Capacity Building

Sl No.

Purpose of training Category of training No. of batches

No. of Participants

1. Implementation of AES DM&HO and DMO Districts 1 25 2. Surveillance System M.O PHC/CHC/Private

Practitioners/Dispensary 2 25

3. Clinical JE Cases Management Medical Specialist /Paed 1 25 4. Lab. Diagnosis Microbiologist / Phathologist

/Lab.tech. 1 20

5. Early reporting of AES SMI/SI/SW/ANM/AWW/ASHA 7 25

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Logistics:

BCC/ IEC 2011-12

Sl.No. Patrticular OPening Balance Requirement

Laboratory Elisa Reader with washer Nil 3

Mac-Elisa Kit (JE)

Nil 6

Vector Control Malathion Technical Nil 150 Kg

Sl No. Activities

Unit Cost ( Rs) Previous

Year (No)

Current Year Total Cost (Rs) Q1 Q2 Q3 Q4 Tota

l

1 Posters 15000 per 1000 nos. 500 500 500 500 2000 30000

2 Hoardings 3 AIR Campaign

6879.20/ week (4 times a day)

4 week

s 27516.80 p

4 Others (a) Handbills (b) Pamphlets

8 2 5000

5000 5000 5000

40,000 10,000

5 Stickers Flipchart Billboard

6 (b) Intersectoral Workshop (District Level)

(c) State Level 7

(a) Advocacy Workshop at District

(b) State Level 8 Meetings at the

village Level 1000 35 35 35 35 140 140,000

2,47,516.8

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Budget:

Sl. NO.

Item Cost (Rs.in lac) Total (in lac)

1 Elisa Reader with washer 4.5 4.5

2 Malathion Technical 0.018/ Kg 2.7

3 Drugs and Hospital Logistics - 2.00

4 Training - 3.3

5 B.C.C. - 2.4

6 Monitoring and Supervision - 1.5

Total - 16.4

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i. District wise distribution of Positive cases of JE for the year 2009.

Sl No.

Name of District No. of Confirmed cases

Deaths

1. Jaintia Hills 5 Nil 2. West Khasi Hills 2 Nil 3. East Khasi Hills 1 Nil 4. Ri Bhoi 1 Nil Total 9 Nil ii. District wise distribution of Suspected cases of JE for 2009.

Sl No.

Name of District Name of PHC Total Suspected cases

1. Jaintia Hills 1. Mynso PHC 1 2. Ri Bhoi 1. Umsning

CHC 2. Nongpoh

CHC

1 1

Total 3 iii. Distribution of JE cases by sex and Age for 2009.

AGE Year 0-1 1-5 6-5 15 above total 2009 M F M F M F M F M F 0 0 0 0 3 3 2 1 5 4

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Basic Facts of the District

EKH RI-BHOI WKH JH WGH SGH EGH Total

Population 853379 247965 358331 367173 642139 128883 275000 2872870

Area(in sq km) 2748 2448 5427 3937 3640 1887 2342 22429 Sub division 1 1 3 3 3 2 13 Community Developed Block 8 3 6 5 8 4 5 39

No. of Villages 980 578 1128 555 1735 630 955 6508 Literacy 76.1 65.7 53 51.9 50.7 36.7 62.6 No. of Households 109115 39245 58736 55751 118678 20819 56827 459171 Status of Health Facilities Sl No

Health facility

EKH RI-BHOI

WKH JH WGH SGH EGH A. Total

1 District Hospital

3 1 Nil 1 1 - 1 6

2 CHC 6 3 06 5 6 1 2 29 3 PHC 23 8 23 17 18 7 16 105 4 Sub-centres 66 26 62 76 82 21 73 406 5 FTD 100 3 34 234 234 44 649 6 Rapid

Response Team

1 1 1 1 1 1 1 7

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Human Resource Sl No

Health facility EKH RI-BHOI WKH JH WGH SGH EGH Total

1 DMO (full time) 1 1 1 1 1 1 1 7 2 AMO 1 Nil Nil 1 1 - 1 4 3 MO 130 25 51 71 53 17 36 443 4 Lab-Technician 42 17 (24)27 24 26 8 19 151 5 Microscopist 6 1 4 2 9 2 3 27 6 Lab-Technician

(contractual) 0 1 (1)2 2 3 1 1 10

7 Health Supervisors (M) 22 8 48 51 57 10 70 273 8 Health Supervisors (F) 32 14 58 35 48 6 188 9 MPW (M) 41 147(M+F) 76 48 96 31 258 872 10 Surveillance worker 13 24 19 18 62 18 307 11 MPW(F) 107 104 124 180 47 570 12 Malaria Technical

Supervisor (contractual) * 0 1 4 1 3 1 2 12

13 ASHA 1033 536 1112 552 1629 554 952 6255 14 SFW (12 months) - Nil Nil 7 2 1 10 15 Spray squads 4 9 9 8 19 5 54 16 MPW (contractual)

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Areas for supply of ACT

A. Allocation of ACTS & Quinine for a plan years based on epidemiological & operational data

Allocation of ACTs & Quinine for a year based on epidemiological & operational data.

Data latest complete year

Allocation for Plan year

District Total population

Pf cases reported in previous year

Adults (60% of Pf cases

Children (40% of Pf cases) Pregnant women

ACT Blister

9-14 yrs (38%)

5-8 yrs (30%)

1-4 yrs (22%)

Under 1 yr (10%)

Quinine tablets

A

A x 1.5.x.60

B x0.38 x1.5

B x 0.30x 1.5

B x 0.22 x1.5

B x0.10 x1.5

A x1.5 x.02 x21

WGH 642139 43699

39329 9963 7865 5767 2620 27530

SGH 128883 10319 9287 2353 1857 1362 618 6500 EGH 275000 14121 12708 3219 2541 1865 848 8896 RB 247965 2393 2154 545 430 317 144 1507 WKH 358331 2449 2204 558 441 324 147 1543 EKH 853379 861 775 197 155 114 51 542 JH 367173 408 367 93 74 54 24 257 Total 2872870 74250 66824 15932 13363 8577 4452 46775 Caritas 17109 43342 3421 2509 1140 11976 Grand Total

83933 59274 16784 11086 5592 58751

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Allocation of ACTs for next Plan year

Data latest complete year

Allocation for next plan year

District Total population

Pf cases reported in previous year

Adults (60% of Pf cases

Children (40% of Pf cases) =B= (A*0.40)

ACT Blister

9-14 yrs (38%)

5-8 yrs (30%)

1-4 yrs (22%)

Under 1 yr (10%)

A

A x 1.5.x.60

B x0.38 x1.5

B x 0.30x 1.5

B x 0.22 x1.5

B x0.10 x1.5

WGH 642139 43699

39329 9963 7865 5767 2620

SGH 128883 10319 9287 2353 1857 1362 618 EGH 275000 14121 12708 3219 2541 1865 848 RB 247965 2393 2154 545 430 317 144 WKH 358331 2449 2204 558 441 324 147 EKH 853379 861 775 197 155 114 51 JH 367173 408 367 93 74 54 24 Total 2872870 74250 66824 15932 13363 8577 4452 Caritas 17109 43342 3421 2509 1140 Grand Total

83933 59274 16784 11086 5592

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RDK Kits

Sl. No

District Name

No. of PHCs Where RDTs are to be used in emergency Hours

No. of sub-centre areas

with SFR >2% & no

microscopy Results

within 24 hrs

No blood examinations

in those S/c/PHC areas

last year (A)

Expected RDT

requirement in remote

high Pf areas & PHCs

(A x1.25)(B)

RDTs for buffer stock

& distribution

to other areas

(B x0.20) (C)

Total annual RDT

supply(B+C)

No.s to be distributed in prioritize areas

1 EKH 14 18 9685 12106 2421 14527+ *13000 =27527

5811

2 RI-BHOI

13 26 20058 25073 5014 30087+*10300 =40387

12034

3 WKH 12 39 10499 13123 2624 15747+*33400 =49147

6299

4 JH 19 50 18300 22875 4575 26972+*10200 =37172

10788

5 WGH

23 82 88690 110863 22172 133035+*61100 =194135

53214

6 SGH 8 21 15821 19776 3955 23731+*21500 =45231

9492

7 EGH 16 73 26973 33716 6743 40459+*40600 =81059

16183

Total 104 309 190026 237532 47504 474658 113821 *RDKs for caritas = 190,100(Based on 100 test/ASHA or NGO /yr/no. of villages taken up by the caritas /district) * 10% of these test will be diagnosed as positive for Pf i.e = 190100 x 10% = 19,010

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a. RD Kits

Sl. No District Name

No. of PHCs Where RDTs are to be used in emergency Hours

No. of sub-centre areas

with SFR >2% & no

microscopy Results

within 24 hrs

No blood examinations

in those S/c/PHC areas

last year (A)

Expected RDT

requirement in

remote high Pf areas & PHCs

(A x1.25)(B)

RDTs for buffer

stock & distribut

ion to other areas

(B x0.20) (C)

Total annual RDT

supply(B+C)

No.s to be distributed in prioritize areas

1 EKH 14 18 9685 12106 2421 27527 5811

2 RI-BHOI

13 26 20058 25073 5014 40387 12034

3 WKH 12 39 10499 13123 2624 49147 6299

4 JH 19 50 18300 22875 4575 37172 10788

5 WGH 23 82 88690 110863 22172 194135 53214

6 SGH 8 21 15821 19776 3955 45231 9492

7 EGH 16 73 26973 33716 6743 81059 16183

Total 104 309 190026 237532 47504 474658 113821

B. Requirement of Rapid diagnostic Kits based on epidemiological data for

next plan year SL No.

Details Sub centre (No)

Village (No)

Total Population

Slide Collection

1 Areas with high Pf% 309

4267

1368937

190026

2 Of the above no. prioritized to be equipped

with RD Kits

154

2581

887502

113821

RDT reqd 500000

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BEDNETS

District Name

Eligible Sub

Centre (Nos)

Eligible

villages (no)

Eligible Population

Total Bed nets required

Number of bed nets available in household survey(no)

2009-10

Required in the current year (no) 2011-12

Total planned to be distributed in

the year (no) 2010-11

Total planned

to be treated

ITNs LLINs ITNs LLINs

A B C D=A-C E F G=B+E

West Garo Hills 82 1735 642139 256856 282216 67500 89856 Nil 100000 282216

South Garo Hills 21 630 128883 51553 21761 32500 Nil nil 20000 21761

East Garo Hills 73 955 275000 110000 59000 50000 25000 nil 35000 59000

Ri-Bhoi 26 517 247965 99186 32916 Nil 99186 30000 Nil 62916

Jaintia Hills 27 122 70361 30000 35305 Nil 30000 13900 Nil 49205

West Khasi Hils 39 277 167122 66848 23853 Nil 66848 28600 Nil 55453

East Khasi Hills 27 410 208487 83395 22984 Nil 60411 15000 Nil 22984

Total 286 4605 1672688 670930 408748 150000 520930 87500 155000 496248

Total bed nets required = 670930 Already supplied = 305000 To be supplied = 10863 (already allotted) Net required = 257299 (2011-12)

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Requirement of vehicle district wise:

Monitoring and supervision has been carried out using hired vehicle. The rate at Rs. 1000/day as per guideline is not acceptable by the transporter and as such hiring of vehicle at the state level has to be hired as per rate of the transporter which is at an average of Rs. 2500/day, which amount to a total of about Rs.3 lacs per year (minimum) (2500x10x12).

Vehicle Available

Requirements

State/District

Gypsy

Minitrucks

Gypsy/Bolero

Minitrucks

State hq1

1 (with heavy expenditure)

0 1 nil

West Garo Hills

1 1 nil nil

East Garo Hills

Nil

Nil

1

1

South Garo Hills

Nil

Nil

1

1

Ri-Bhoi

Nil

Nil

1

1

East Khasi Hills

1(with heavy

expenditure)

1

1

0

West Khasi Hills

0

0

1

1

Total

3 2 6 4

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Action Plan on Chikungunya and Dengue:

District wise Distribution of Chikungunya and Dengue cases & deaths Sl No.

Name of District

Suspected Cases

Positive Cases

Death Remarks

Chikungunya Dengue 1. WGH 90 30 2 1 Death

due Dengue

2. EGH Nil Nil Nil Nil Nil 3. SGH Nil Nil Nil Nil Nil 4. WKH Nil Nil Nil Nil Nil 5 EKH Nil Nil Nil Nil Nil 6 JH Nil Nil Nil Nil Nil 7 RB Nil Nil Nil Nil Nil Diagnosis I. Establishment of SSS Laboratory Sl

No. Name of

SSSL identified

Facility available

Strengthening required

Cost (Rs. In lakhs)

1. Tura Civil Hospital

Pathologist i) Elisa Reader

i) Computer ii) Internet iii) Contingen

cy

4.5 0.50

Total 5.00 II. Apex Laboratory/Referral Lab (strengthening)

Name of Referral

Lab. Function Fund requirement

(Rs. In lacs) RMRC, Dibrugarh

1. Training of Lab personal of SSSL

1.00 2. Quality control of SSSL 3. Viral isolation & identified of other

viral activities

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37

Requirement of Elisa Kits

Name of SSSL No of Kits Required

Tura Civil Hospital 1000 test

Vector Control

No. of district

No. of micro discharge fogging Machine required

Cost (Rs. In lacs)

7 i. 7 3.85 ii. Operation cost 20.00 Total 23.85

Capacity Building:

Sl No.

Category of staff No. to be

trained

Batches

Cost (Rs. In lacs)

Person responsible

1. Pathologist & Lab. Tech of SSSL

1 1.00 RMRC

2. MO Integrated with other vector borne disease

SPO 3. Para-medical DMO 4. ASHA I/C PHC Total 1 1.00

IEC/BCC:

Sl No.

Item Cost (Rs. In lacs)

1. Interpersonal communicative & group discussion 2.97 2. Production folder poster and distribution 1.50 3. Newspaper advertisement 0.30 4. Telecasting TV spot in local language 0.42 Total 5.78

Sample Total Dengue Total Chikungunya

90 88 2 77 30

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38

Monitoring and Supervision

No. of district

Cost (Rs. In lacs)

7 2.00 Budget:

Sl No.

Component Cost (Rs. In lacs)

1 Apex lab referral lab 1.00 2. Laboratory up gradation 5.00 3. Vector control 23.85 4. Capacity Building 1.00 5. IEC/BCC 5.78 6. Monitoring and Supervision 2.00 Total 38.63

396 Spray workers @ 5000/- per month = 396 x 5000 x 1 month = 19.8 lakhs Grand Total = 58.43

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Expenditure ( Financial Performance)- Budget Proposal for 2011-2012 (Rs. in lakhs)

2010-11 (Expenditure)

2011-12 (Proposed)*

Support to be met from NVBDCP/GoI or state resources or NRHM flexi fund

Malaria

DBS

MPW Nil 120.00

ASHA 2.00 15.1

Operational Cost including spray wages 49.00 102.5

NAMMIS Nil 5.0

IEC,BCC &PPP Nil 29.25

Training 23.8 10

LLIN (Transportation) 10.9

Additional support under World Bank (if applicable)

Human Resource -

Capacity building in project areas -

Mobility support -

Spray equipments 5.58

Additional support under GFATM (if applicable)

Capacity Building

Establishment State Society

Human Resource 20.09 105.19

Monitoring & Evaluation 20.00 30.92

BCC/PPP/Soc.Mkt. - 40.00

Drugs

Chloroquine phosphate tablets 10.4

Primaquine tablets 0.21/3.62

Quinine sulphate tablets 2.79 28.3

Quinine Injections 32.5

Sulphadoxine + Pyremethamine tablets

Microslides 1.25 3.12

Lancets .62 3.69

Slide box .63

Stain J.S.B.I 10.5 1.62

Stain J.S.B.II 1.62

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Diagnostics

IRS

Wages

Human resource

Monitoring & Evaluation

Bednet

Impregnated mosquito nets

LLIN (Transportation) 0.0001 10.9

Insecticides

DDT 50% wdp

Synthetic Pyrethroid

Malathion 25%/Technical

UMS – Larvicides

For polluted water

For non-polluted water

Pyrethrum extract 2% Total Malaria 331.128 Filaria

Drugs (by GoI)

Training

BCC Preparatory activity (may be shown activity-wise including hydrocelectomy)

Drug distributor’s including ASHA and supervisors honorarium

Total (Filaria)

Dengue/Chikungunya Grant in respect of Dengue and Chikungunya Strengthening surveillance (As per GOI approval)

Apex Referral Labs recurrent @ Rs/

1.00 lakh

Sentinel surveillance Hospital recurrent

@ Rs. 0.50 lakhs

Test kits (Nos.) to be supplied by GoI

Operational cost

1.00 5.00 20.00

Monitoring/Supervision and Rapid Response 2.00 Epidemic Preparedness Fogging machine 3.85 IEC/BCC/Social Mobilization

5.78

Training/Workshop 1.00

Total Dengue/Chikungunya 38.63

AES/JE Diagnostics and Management 6.5

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Elisa Kits IEC/BCC 2.4 Training 3.3 Monitoring and Supervision 1.5 Technical Malathion 2.7

Total AES/JE 16.4

Kala-azar (only for 4 states)

DDT 50%

Amphotericin-B

Miltefosine

RDK for Kala-azar

Case search

Spray Pumps

Operational cost for spray including spray wages

Mobility/POL

Training for spraying

BCC/IEC

Monitoring & Evaluation

Kala-azar Sub-Total (DBS)

Kala-azar World Bank Project assistance

Human resource

Capacity building

Mobility Kala-azar Sub-total (World Bank Project assistance)

Kala-azar Total

Grand Total

Any activity not listed and if required may be shown in separate row.

Outstanding balance………….. (as on previous month of submission of PIP). Committed expenditure ………….. (till March, 2011). Balance expected…………… (on 1.04.2011). This is most important as cash releases are based on the funds availability with state in totality and not head wise.

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EXECUTIVE SUMMARY

In the state Meghalaya vector borne diseases are major public health problem. Malaria is endemic in 7 districts viz; EKH, WKH, RB, WGH, SGH, JH & EGH. Filaria is endemic in Nil districts viz; --------------------------------------. Kala azar is endemic in Nil districts viz; --------------------------------------. AES including JE is endemic in --- districts viz; WKH, EKH, RB (in pockets only). Dengue is endemic in --- districts viz; WGH (imported). Chikungunya is endemic in --- districts viz; WGH (imported) The requirement for programme implementation has been indicated in detail and the summary

is indicated below :

Disease Cash assistance from GoI 2010-11

Balance from previous years 2009-10

Committed expenditure

Net requirement

State resources

Malaria

a. DBS

b. World Bank for project states

c. GFATM for project states

19.31 Nil 1,27.68

51.00 nil

-

331.128 - 289.18

Filaria Kala-azar Kala-azar World Bank Project assistance

AES including JE 8 16.40 Dengue & Chikungunya 38.63 Total 154.99 675.34

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BUDGET.

Total Requirement of fund for NVBDCP, Meghalaya for the year 2011-12 (in lacs of Rupees).

A. DBS. Requirement of fund.

(a) Salary for Contractual MPW. - Rs. 72.00

(b) ASHA Incentives - Rs. 15.1

(c) Spray wages - Rs.98.25

(d) DDT Dumping - Rs. 3.5

(e) Drugs. - Rs.30.95

(f) MIS (NAMMIS) - Rs. 5.00

(g) Spray - Rs. 5.58

(h) Construction of Hatcherys. - Rs. 6.00

(i) Maintenance of Hatchery. - Rs. 1.5

(j) Printing of Register and Formats. - Rs. 5.00

(k) IEC/BCC. - Rs. 8.00

(l) Training. - Rs. 21.7

(m) Impregnation of Bed nets. - Rs. 50.00

Total D.B.S. - Rs. 322.58

B. GFATM. Requirement of fund

1. Human Resource - 105.19

2. Training. - 11.00

3. Planning & Administrative. - 60.95

4. Monitoring and Evaluation. - 35.38

5. IEC. - 16.43

6. Operational expenses for treatment - 11.50

of Bednets.

Total GFATM - 240.45

Grand Total: - 563. 03

Proposed Action Plan:2011-2012

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State:Meghalaya Currency in Lakhs

Component

Unit Cost in lacs of Rs

No. of Units Requirement of funds as reflected in PIP

Proposed allocation by NVBDCP

A. DBS a) Salary for contractual MPW (unit cost for the year per MPW)

0.72 100 72.00

B)ASHA incentive (a) BS Collection (b) R.D.K.Positive (c) Bsc Positive.

Rs. 5/- Rs.20/- Rs. 50/-

150426 (30% of Bsc) 22275 (30% of PFPositive) 61.41 (7% of Positive)

15.1

Spray Wages 98,25,000 DDT Dumping spray 3,50,000

Operational Exp for Fogging Drug (PQ, ,Cloroquine Syrup , Quinine Tablet 30.95

MIS (NAMMIS) 1 Laptop and AMC for computer with internet connectivity, training for District Staff

5,00,000

Spray Equipment (Materials & Maintenance) 5,58,000 Construction of Hatcheries 2 7 6,00,000 Maintenance of Hatcheries 0.5 7 1,50,000 Printing of Registers and Formats based on the new operational expenses

5,00,000

Quality Assurance scheme of Lab Diagnosis IEC/BCC 8,00,000 Training Health Supervisor / MPW (Male and Female) - 0.50 14 3,60,000 3.60 Rapid Response Team 1 1 1,00,000 1.00 Total DBS 1,66,13,000 166.13

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Component

Unit Cost in lacs of Rs

No. of Units

Requirement of funds as reflected in PIP

Proposed allocation by NVBDCP

1.3 District

1.3.1 3.6 7 30000x7x12=25,20,000

1.3.2 Lab. Technician 1.2 10 10000x10x12=12,00,000

1.3.3 Block level MTS 1.8 21 15000x21x12=37,80,000

1.3.4 DEO 1.2 7 1000x7x12=8,40,000

Sub-Total

105.19

2. Training

a) Training of ASHA/ Community Volunteers in use of RDT, drug distribution and Bednet treatment detail Larvivorous fish (20 persons per course) (unit cost per training)

0.20 21 4,20,000 1,400.00 1,820.00

b) Training for Medical Officers (unit cost per training)

1 4 4,00,000

b) Training for Lab. Technicians (unit cost per training) (1)Induction (II)Re orientation

1.20 .80

1 2

1.20,000 1,60,000

Sub-Total 25,00,000

3. Planning and Administration

a) Office expenses for the state level per year (unit cost per year for state) 10.6 1 10.6

b) Office expenses for the district level per year (unit cost per year per district) 7 49.35

c) Accounting and Auditing Cost per year (unit cost per year for state) 1 1.00

Sub-Total 60.95

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4. Monitoring and Evaluation a) Hiring of vehicles for field visit and supervision at state level each yaer (@ 1000/ day ) (unit cost per year for state) 3.0 1 3.0

a) Hiring of vehicles for field visit and supervision at district level @ 1000/ day for 7 days in a month (unit cost per year per district) .28 7 2.0

b1) Travel related expenses for State & District Level Officers( D.A & field contingency) (Unit cost per month) 1 0.240 7 1.68 b2) TA DA expenses for Consultant M&E For 10 days in a month (Unit cost per month) 0.2 12 2.40 TA DA for State level consultants i.e PC, FC , IEC 0.2 12 2.40

b3) DA for MTS (Unit cost per month) 0.06 21 12.60

c) Review meeting of States / district ( Annual Unit cost) 0.30 10 5.00

e) POL (Rs 2500 per months) (unit cost per month/ MTS) 0.3 21 6.30 Sub-Total 35.38

5. IEC

b) IEC Awareness campaigns 50% through state health & 50% through NGOs / CBOs / Panchayat (Unit cost per annum per district)

1500 per camp.

954 camps. 14,31,000

PPP

211800

6. Operational expenses for treatment of bed net * 0.001 1,15,000 11,50,000

Sub-Total 27,92,800

Grand Total GFATM 413.38

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Component

Unit Cost in lacs of Rs

No. of Units

Requirement of funds as reflected in PIP

Proposed allocation by NVBDCP

B. GFATM

1. Human Resource

1.2 State

1.2.1 Financial Consultant @ one for each state

3 1 25000x12=3,00,000`

1.2.2 Project Director/ Coordinator @ one for each state

6 1 50000x12=6,00,000

1.2.3 IEC Consultant @ one for each state

3.6 1 30,000x12x360000

1.2.4 Statistical Assistant. 1.8 1 15000x12=180000

1.2.5 Secretarial Assistant (State) 1.2 1 10000x12=120000

1.2.6 DEO 1.2 1 10000x12=120000

b) Consultant M&E (Unit cost per month for state)

4.992 1 41600x12=499200

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Sl.No

Component Total requirement

Cost 4% Vat Total cost

1. Chloroquine Tab. 20,00,000 10,00,000 @ .50/tab

4000 10,40,000

2. Primaquine 2.5mg. 80,000 20,000 @.25/tab.

800 20,800

3. Primaquine 7.5mg. 12,00,000 3,48,000 @.29/tab

13,920 3,61,920

4. Quinine Injection 40,000 3,12,000 @ 7.80

12,480 3,24,480

5. Tab Quinine Sulphate 1,11,386 2,71,782 @ 2.44/tab

10,871 2,82,653

6. Microslides 5,00,000 3,00,000 @ .60/slide

12,000 3,12,000

7. Lancets 6,00,000 3,54,000 @ .59/lancets

14,160 36,8,160

8. Slide box 500 60,000 @ 120/box

2,400 62,400

9 Stain J.S.B.I 2500 (100ml) 1,55,000 @ 62/100ml

6,200 1,61,200

10. Stain J.S.B.II 2500 (100ml) 1,55,000 @ 62/100ml

6,200 1,61,200

Total: 30,94,813

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STOCK POSITION IN THE STATE HEAD – QUARTER AS ON 28-10-2010.

Sl.No. Items Balance Exp. Date

1. Chloroquine 65,100 09/14

2. Primaquine 7.5mg 1,15,000 06/11

3. Primaquine 2.5mg 5,600 07/11

4. Comblister Pack 1,15,975 5/2010

5. Arteerther Injection 9,643 282011

6. R.D.K. 1,075 4/2011

7. Artesunate 55,700 10/11

8. Comblister Pack (Act) 76 10/11

9. J.S.B. I 466 10/11

10 J.S.B. II 466 10/11

11. K. Othrine (2815 Exp. May, 2010 3,409 4/11

12. Blood Lancets 6,000 7/11

13. Microslides 11,000 8/11

14. Quinine Sulphate Tabs. 59,890 7/12

15. Sulpha pyre- methamine Tabs. 8,490 10/12

16. Quinine Injection. 7,900 04/13

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BUDGET

PROPOSED ACTION PLAN 2011-2012

Component Unit Cost

in lac No. of Units

Requirement of funds as reflected in PIP (in lacs)

allocation by NVBDCP 2010-11

A. DBS

(a) Salary for contractual MPW 0.1 100 120 30

ASHA incentive (Rs.55/- per RDT test & complete treatment ) b) Preparation of slides * a) B.S Collection, (b) RDK POS, (c) BSC POS

0.00005 .00020 .00050

150426 22275 6141

15.1 5

Spray Wages 0.05 396 99 included in

121.98

DDT Dumping spray 0.05 7 3.5

Operational Exp for Fogging

Anti Malarial Drug .50/tab 20.00,000 10.4

Primaquine 7.5 mg .29/tab 12,00,000 3.62

Primaquine 2.5 mg .25/tab 80,000 0.208

Quinine Sulphate tab 2.44/tab 1,11,386 2.83

Quinine Inj. 7.80/Amp 40,000 3.24

SP tab

MIS (NAMMIS) 5 2.24

Spray Equipment (Materials & Maintenance)

5.58

included in 121.98

Procurement of Microscopes

Construction of Hatcheries 2 3 6.00

Maintenance of Hatcheries 0.5 7 1.50 Printing of Registers and Formats based on the new operational expenses

5.00 5

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Quality Assurance scheme of Lab Diagnosis

IEC/BCC (awareness camp) 0.015 195 29.25 10

Training

Health Supervisor (M&F) 0.5 14 7 5

Lab Technician (Re-orientation) 0.8 2 1.6

Spray squads 0.2 7 1.4

LLIN (Transportation)

10.9

Total Malaria 331.128 179.22

* (a) - 30% of BSC include 4% Vat

(b) - 30% of PF Pos

(c) - 7% of Positive

Dengue/Chikungunya Grant in respect of Dengue and Chikungunya Strengthening surveillance (As per GOI approval) Ø Apex Referral Labs recurrent @ Rs/ 1.00 lakh Ø Sentinel surveillance Hospital recurrent @ Rs. 0.50 lakhs Ø Test kits (Nos.) to be supplied by GoI Operational cost

1.00

5.00

20.00

Monitoring/Supervision and Rapid Response

2.00

Epidemic Preparedness Fogging machine 3.85

IEC/BCC/Social Mobilization 5.78 Training/Workshop 1.00

Total Dengue/Chikungunya 38.63

AES/JE Diagnostics and Management 6.5 Elisa Kits IEC/BCC 2.4 Training 3.3 Monitoring and Supervision 1.5 Technical Malathion 2.7

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Total AES/JE 16.40

Component Unit Cost

in Rs No. of Units

Requirement of funds as reflected in PIP in lacs

allocation by NVBDCP 2010-11

GFATM

1. Human Resource

1.1 State

Financial Consultant 0.25 1 3 85

IEC Consultant 0.3 1 3.6

Assistant/Computer Operator 0.1 1 1.2 Secretarial Assistant 0.1 1 1.2 Statistical Assistant 0.15 1 1.18

Consultant M&E 0.416 1 4.992

PSMC 0.35 1 4.2 sub-total 19.992 85 1.2 Setting up of 2 Sentinel Sites at Tura and Shillong

1. DEO 0.1 2 2.4

2. Lab -Technician 0.1 2 2.4 Procurement 1. Binocular Microscope

2. Desktop Computer with computer table, Chair , UPS, Printer

0.4 2 0.8

3.Accessories/Equipments etc. 0.5 2 1

sub-total 6.6

Strengthening of Entomological Cell at State Headquarter

1. Mobility 0.02 10X12 2.4

2. Entomological Equipments 0.4

3. DA for entomological team 0.4

4. Office Expenses - Stationeries 0.2

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Sub-total 3.4

1.3District

1.3.1 Dist. VBD (Mal) Consultant 0.30x12 7 25.2

1.3.2 Salary to Accountant at District 0.10x12 7 8.4

1.3.3 Lab. Technician 0.10x12 10 8.4

1.3.4 MTS 0.15x12 21 37.8

1.3.5 SA cum DEO 0.10x12 7 8.4

Sub-Total 88.2 included in 85

Unit Cost

in Rs No. of Units

Requirement of funds as reflected in

PIP in lacs

allocation by NVBDCP 2010-11

2. Training

a) Training of ASHA/ Community Volunteers in use of RDT, drug distribution and Bednet treatment detail Larvivorous fish (20 persons per course) (unit cost per training)

b) Training for Medical Officers (unit cost per training) 25 nos

1 3 3.0

c) Training for Lab. Technicians (unit cost per training) 25 nos

d.Other MTS LQAS MTS for Refresher

0.50 0.50

1 1 0.50 0.50

Sub-Total 4.00

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3. Planning and Administration

State

Office infrastructure- Laptop with all necessory software & Data card 0.5 3 1.5 45

Office infrastructure and equipment- Desktop with all with all necessory software & Broad Bank connection (3)

0.3 3 0.9

Office infrastructure and equipment- Office automation units (1) - Printer (1) , Copier (1), Fax (1), Scanner (1), Telephone with intercom facility (5)

0.5 3 1.5

Office expenses- Documantation and Printing 10x12 1 1.20

Office infrastructure and equipment ( Furniture etc..) 4 1 4

Office expenses- Space, Water, Electricity, Consumables and Rent etc.

0.4 1 0.4

Rent (Storage State) 12x12 1 1.08

Logistic arrrangement state to distt. (two round trips in a year) 0.15 7 2.1

Office expenses for the state level per year (unit cost per year for state)

3 1 3.00

Office expenses for the district level per year (unit cost per year per district)

1 7 7.00

Accounting and Auditing Cost per year (unit cost per year for state)

1 1 1.00

Sub-Total 23.68

District

Office infrastructure- Laptop with all necessory software & Data card (86)

0.5 7 3.5

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Office infrastructure and equipment- Desktop with all with all necessory software & broad bank connection (86)

0.3 7 2.1

Office infrastruecture and equipment- Office automation units (1) - Printer (1) , Copier (1), Fax (1), Scanner (1), Telephone with intercom facility (1)

0.5 7 3.5

Office expenses- Documantation and Printing 0.05 7 0.35

Office infrastructure and equipment ( Furniture etc..) 1.2 7 8.4

Office expenses- Space, Water, Electricity, Consumables and Rent etc.

0.15 7 1.05

Rent (Storage Distt.) 0.04 7 3.36

Sub Total 22.26 45

Monitoring and Evaluation

Travel (State) Review Meeting (State with District) 0.3 12 3.6

Quaterly Meeting (At Distt Level) 0.1 12x7 8.4 Travel (Distt)

a) Hiring of vehicles for field visit and supervision at state level each year (@ 1000/ day )

0.02 3x10x12 7.2

a) Hiring of vehicles for field visit and supervision at district level @ 1000/ day for 7 days in a month

0.02 14x10x12 33.6

b. 1) Travel related expenses for District Level Officers( D.A & field contingency)

0.0015 17x5x10x12 15.6

Unit Cost No. of Units

Requirement of funds as reflected in PIP in lacs

allocation by NVBDCP 2009-10

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b 2) TA DA expenses for Consultant M&E For 10 days in a month

0.2 12 2.4

TA DA for State level consultants i.e PC, FC , IEC

0.2 12 2.4

b. 3) DA for MTS (Unit cost per month)

0.06 21 12.6

c. Review meeting of States / district (Annual Unit cost)

d. POL (Rs 2500 per months) (unit cost per month/ MTS)

0.025 12x21 6.3

d. Provision of Motorcycles for MTS (Discovery 350cc)

Sub-Total 91.8 5. IEC

a. IEC Awareness campaigns 50% through state health & 50% through NGOs / CBOs / Panchayat (Unit cost per annum per district)

0.15 195 29.25

PPP Sub-Total 29.25 50 6. a. Operational expenses for treatment of bed net

b. Procurement of bednets (LLINs)

Sub-Total Total GFATM 289.18 220.00

GRAND TOTAL 675.34 399.22

Outstanding Balance Rs.( as on previous month of submission of PIP) 85,25,344 (12.2010)

Committed expenditure Rs. ( till march,2011)

Balance expected Rs.( on 1.04.2011)

NRHM

1. Operational expenses for Treatment of bednets

0.0001 5,00,000 55.3

b) Re-impregnation of bednets 0.0005 5.00,000 27.6 2. Synthetic pyrethorid 0.00154 5000 7.7 3. Salary of Mpw 0.1 100x12 120

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4. Procurement of Vehicle (a) Gypsy In kind (b) Pickup Truck Total 210.60 Total cash assistance under NVBDCP 675.34 Total cash assistance required under NRHM flexi fund 210.60

Grand Total 885.94

Expenditure (Financial Performance) Budget Proposal

2010-2011

(Expenditure) 2011-2012 (Proposed)

(A) DBS (a) Salary of MPW 120 (b) ASHA 2.00 15.1 (c) Spray Wages & op.Cool 49.00 102.5 (d) IEC/BCC (Awareness Camps) 29.25 (e) Construction and maintenance of Hatcheris 7.5 (f) Printing of Registrets and formats 5 (g) Training 23.8 10 (h) Drugs & equipments 15.16 20.298 (i) Spray equipments 5.58 (j) MIS(NAMMIS) 5 LLIN (Transportation) 10.9 Total DBS 331.128 (B) Dengue/Chikungunya (a) Apex Referral Labs 1.00 (b) Estt. Of SSS Labs 5.00 © Operational Cost 20.00 (d) Monitoring & Supervision 2.00 (e) Procurement of Fogging Machine 3.85 (f) IEC/BCC 5.78 (g) Training 1.00 Total Dengue/Chikungunya 38.63

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(C) AEC/JE (a) Diagnostic & Management 6.50 (b) IEC/BCC 2.40 © Training 3.30 (d) Monitoring & Supervision 1.50 (e) Technical Malathion 2.70 Total AES/JE 16.40 (D) GFATM (a) Human Resource 20.09 (i) State 19.99 (ii) District 88.20 (b) Sentinel Sites 6.4 © Training 4 (d) Planning and Admininstration State 23.68 District 22.26 (E) Monitoring & Evaluation 20 91.8 Entomological Cell 3.4 (F) IEC 29.25 Total GFATM 289.18

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Revised National Tuberculosis Control Programme

Annual Plan for Programme Performance & Budget for the year 1st April 2011 to 31st March 2012 State: __Meghalaya_________________

Objectives: 1. To achieve and maintain a cure rate of at least 85% among newly detected infectious (new sputum

smear positive) cases, and 2. To achieve and maintain detection of at least 70% of such cases in the population

This action plan and budget have been approved by the STCS. Signature of the STO__________ _______ Name_______________ Dr(Ms)J.Nongrum Section-A – General Information about the State

1 State Population (in lakh) please give projected population for next year 2621000 2 Number of districts in the State 7 3 Urban population 439605 4 Tribal population 1863890 5 Hilly population 2621000 6 Any other known groups of special population for specific interventions (e.g.

nomadic, migrant, industrial workers, urban slums, etc.) 317505

(These population statistics may be obtained from Census data /State Statistical Dept/ District plans) No. of districts without DTC: __Nil____

No. of districts that submitted annual action plans, which have been consolidated in this state plan: ____7_

Organization of services in the state: S.

No. Name of the District Projected

Population (in Lakhs)

Please indicate number of TUs

of each type

Please indicate no. of DMCs of each type in the district

Govt NGO Public Sector* NGO Private Sector^

1 East Khasi Hills 744958 3 0 12 2 0 2 West Khasi Hills 331475 2 0 8 1 0 3 Ri-bhoi 217285 1 0 6 0 0 4 Jaintia Hills 333253 1 0 6 0 0 5 East Garo Hills 279001 2 0 5 0 0 6 West Garo Hills 581335 2 0 11 1 0 7 South Garo Hills 111694 1 0 3 0 0 Total 2599001 12 0 51 4 0 *Public Sector includes Medical Colleges, Govt. health department, other Govt. department and PSUs i.e. as defined in PMR report ^ Similarly, Private Sector includes Private Medical College, Private Practitioners, Private Clinics/Nursing Homes and Corporate sector

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RNTCP performance indicators: Important: Please give the performance for the last 4 quarters i.e. Oct’ 09 to September’10

Name of the District (also

indicate if it is notified hilly or

tribal district

Total number of patients put on treatment*

Annualised total case detection

rate (per lakh pop.)

No of new smear positive cases put on treatment *

Annualised New smear

positive case detection rate (per lakh pop)

Cure rate for cases

detected in the last 4

corresponding

quarters

Plan for the next year Proportion of TB

patients tested for

HIV

No. of MDR TB

suspects identifie

d and subjects

to C/DST

of sputum

No. of MDR TB

cases diagnosed & put

on treatment

Annualized NSP case detection

rate

Cure rate

East Khasi Hills 2135 285 556 74(99%) 71% 80% 85% 15(1%) 10 0 West Khasi Hills 736 223 176 53(71%) 86% 80% 85% 16(3%) 10 0 Jaintia Hills 559 169 181 55(73%) 82% 80% 85% 9(16%) 0 0 Ri-bhoi 439 209 153 75(97%) 77% 80% 85% 50(11%) 0 0

East Garo Hills 269 97 114 41(54%) 85% 80% 85% 12(4%) 0 0 West Garo Hills 757 131 459 79(106%) 93% 80% 85% 96(13%) 6 0 South Garo Hills 115 105 112 102(136%) 75% 80% 85% 13(11%) 0 0 Total 5010 1219 1751 67(89%) 82% 1400 85% 211 26 0

* Patients put on treatment under DOTS regimens only are to be included.

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Section B – List Priority areas at the State level for achieving the objectives planned:

S.No. Priority areas Activity planned under each priority area 1 Increase case holding

1 a)Initial and regular home visits 1 b)Counselling of patient and families of all cases with emphasis on NSP cases 1 c)Mobilize community support

2 To achieve and maintain cure rate >85%

2 a)Intensify supervision and monitoring in areas with low cure rate 2 b) Sensitisation of MO for correct categorisation. 2 c)Intensify monitoring of DOT providers performance.

3 To maintain >70% NSP case detection rate

3 a) To implement and monitor ACSM activities. 3 b) To maintain cases referral from PHIs to DMCs keeping in view the goals of universal access to TB care. 3 c)Capacity building of LTs and STLSs in maintaining quality of sputum collection and sputum microscopy is accurate.

4 Involvement of NGOs and PPs 4 a) Identify NGOs and PPs in district for involvement in RNTCP and sensitize them. 4 b)Monitoring of those NGOs those who are already involved in RNTCP.

5 Sputum conversion rate >90% 5 a) Ensuring that all Health care providers understand the importance of follow up sputum examination. 5 b) Intensify supervision monitoring of low performing areas. 5 c) To counsel patients regarding the treatment compliance.

6 Human Resources 6 a) Fresh training of new staff. Filling up of vacant post of DTO & MOTC.

6 b) Refresher and retraining as per need. Training of untrained key staff.

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6 c) TBHIV refresher training.

6 d) CME to be conducted as per Action Plan.

7 Scaling up of Intensified TBHIV intensified package

1. Release of fund. 2. Training. 3. Printing and distribution of materials. 4. Regular SCC and DCC meeting. 5. Improve T.B.- HIV cross referral

8 Initiate MDR – Treatment activities

1. Formation of State DOT Plus Committee 2. Develop Action Plan 3. Identify DOTS Plus Site

Priority Districts for Supervision and Monitoring by State during the next year

S No

District Reason for inclusion in priority list

1 East Khasi Hills Low case holding 2 West Khasi Hills Routine monitoring 3 Jaintia Hills High default 4 Ri-bhoi Low case detection & low case holding 5 East Garo Hills Low case detection 6 West Garo Hills Routine monitoring 7 South Garo Hills Routine monitoring

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Section C – Consolidated Plan for Performance and Expenditure under each head, including estimates submitted by all districts, and the requirements at the State Level

1. Civil Works

Activity No. required as per the

norms in the state

No. already upgraded/

present in the state

No. planned to be upgraded during

next financial year

Pl provide justification if an increase is planned in excess of

norms (use separate sheet if required)

Estimated Expenditure on

the activity

Quarter in which the planned activity expected to be

completed (a) (b) (c) (d) (e) (f)

STC/STDC/ IRL

1 1 0 0

SDS 1 1 0 DTCs 7 7 0 Repair and maintenance of

the existing 40950

TUs 12 12 1 -do- 20280 DMCs 52 51 2 -do- and upgradation of 2

general labs into RNTCP lab under Khliehriat TU

153770 2q11 & or need basis

DOT Plus site

2 0 2 2000000 3q11

TOTAL 22,15,000

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2. Laboratory Materials

Activity Amount permissible as

per the norms in the state

Amount actually

spent in the last 4

quarters

Procurement planned during the

current financial year (in Rupees)

Estimated Expenditure for the next financial year for

which plan is being submitted

(Rs.)

Justification/ Remarks for (d)

(a) (b) (c) (d) (e) Purchase of Lab

Materials by Districts 511095 1149855 1500000 2000000 Amount proposed base on

expenditure during the last quarters.

Lab materials for EQA activity at STDC (eg. Lab consumables for

trainings, preparation of Panel slides etc)

Lab materials & consumables for

Culture/DST activity at IRL and other Accredited

Culture & DST labs in Govt. sector including

Medical Colleges

Total:- 20,00,000/-

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3. Honorarium

Activity Amount permissible as

per the norms in the state

Amount actually spent in the last 4

quarters

Expenditure (in Rs) planned for current financial

year

Estimated Expenditure for the next financial year for which plan is being submitted

(Rs.)

Justification/ Remarks for (d)

(a) (b) (c) (d) (e) Honorarium for DOT

providers (both tribal and non tribal districts)

911860 1100000 1300000 90% of the patients are tribal 40% of the patients lived in difficult and inaccessible areas required DOT

providers. Sputum transportation is required from some PHCs to DMCs.

Budgeted amount includes estimate as per the norms for tribal patients, DOT

provider and transportation of sputum.

Honorarium for DOT providers of Cat IV

patients

Total:- 13,00,000

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No. presently involved in RNTCP Additional enrolment proposed for the next fin. year

Community volunteers in all the districts* 1830 300

* These community volunteers are other than salaried employees of Central/State government and are involved in provision of DOT e.g. Anganwadi workers, trained dais, village health guides, ASHA, other volunteers, etc. Approved Budget for the last IEC activities of whole State 2010-11 : Rs.10,90,000 Total Estimated Budget for ACSM activities in the District for 2010-11: Rs.8,18,895 Total Estimated Budget for ACSM activities for State TB Cell for 2010-11: Rs.3,79,920 Amount spent by the State and Districts: 4,38,909 (from Oct 09 – Sept 10) TOTAL ESTIMATED BUDGET FOR ACSM ACTIVITIES IN MEGHALAYA for 2011-12: Rs.11,98,815

Budget for ACSM Activities as per respective challenges

Quarter wise No. of activities planned

State Own(S

tate TB

Cell) budget

Districts budget Total Budget South

Garo hills

West Garo Hills

West Khasi Hills

East Khasi Hills

Jaintia Hills

Ri Bhoi

East Garo Hills

1st Qrt

2nd Qrt

3rd Qrt

4th qrt

Sensitization meetings

32 42 45 38 157 9500 18000 12380 6000 24000 16280 17200 7000 110360

World TB Day

8 X X X 8 20000 15000 7500 20000 56000 12000 20000 12000 162500

Community meetings

32 34 34 32 132 6000 5000 11000 24000 36000 4000 4000 18000 108000

School activity

17 18 16 15 66 4000 25000 12700 10000 24000 3200 4200 5600 887000

Street plays 4 6 4 5 19 16000 6000 2700 0 0 0 0 0 24700

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Patient provider interaction

178 178 178 178 712 0 9600 29000 24000 57600 28800 20000 10000 179000

Print publicity

2 2 1 1 6 6000 0 1015 0 0 0 0 0 61015

Wall writings 32 29 35 42 138 0 18000 6000 40000 18000 25700 16000 12000 135700 Media activity

6 5 7 6 24 100000 0 0 0 0 0 0 0 100000

CME/seminars

2 4 3 3 12 3000 0 0 0 0 4000 3200 0 10200

Other meetings/programmes/roadshow

18 22 20 17 77 10000 0 0 0 0 0 0 6000 16000

Banners 6 5 1 3 15 3000 4000 0 6400 0 0 0 0 13400 Any Other activities

12 7 8 10 37 8420 1000 4000 10000 0 2400 0 0 25820

Total 349 352 352 350 1403 239920 101600 86295 120400 215000 140400 84600 70600 10,58,815

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4. IEC

Annual Action Plan Format Advocacy, Communication and Social Mobilization (ACSM) for RNTCP State own (State TB Cell)

1) Information on previous year’s Annual Action Plan a) Budget proposed in last Annual Action Plan: ……Rs.10,40,000…………. b) Amount released by the state: …4, 35, 000 (till September 2010)… c) Amount spent by the State: 1,87,236 (from October 09 – September 2010)

2) Permissible budget as per norm: 6, 50, 000…… 3) Budget for next financial year for the state own activity as per action plan detailed below: ………Rs.

3,79,920……………….

Program Challenges to be tackled by ACSM during the Year 2010-11

WHY

ACSM Objective

For WHOM Target Audience

WHAT

ACSM Activities

When

Time Frame

By

WHOM

Monitoring and Evaluation

Budget

Based on existing TB indicators and analysis of communication challenges (Maximum 3 Challenges )

Desired behavior or action (make SMART: specific, measurable, achievable, realistic & time bound objectives)

Activities Media/ Material Required

Q1 Q2 Q3 Q4 Key implementer and RNTCP officer responsible for supervision

Outputs; Evidence that the activities have been done

Outcomes: Evidence that it has been effective

Total expenditure for the activity during the financial year

Challenge 1. Low cure rate Advocacy Activities

Low cure rate

Increase involvement of eminent people in the community in RNTCP, explaining to

Headmen 1.Sensitization meetings 2. one on one interaction 3. World TB day events

Posters/banners

and pamphlets

on the impact of TB and

x x 1 x STO/DTO/IEC Officer

Attendance/Minutes/Photographs/feedback received

Increase in cure rate by 10% Study to document cure

3000x1=3000

MLAs/ other state authorities

1 1 1 1 2.No cost involved

NGOs/ Private

1

X

X

X

3.20000x1=20000

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them the activities they can carry out to increase the cure rate as well as providing suggestions focusing on low performing districts

Health care providers

4.Interaction meetings

non complianc

e with treatment

, to be prepared at State TB Cell /media agency-

RED FM,AIR,PC

N, Doordarsh

an and others

x 1 1 x rate within one yr

4.1000x2=2000

Community groups

2 1 1 1

X 1 1 1

X 1 1

X 1 1

Posters: 6x5000=

30000 Pamphlets=5x6000=30000 Banners:500x5=2

500

Radio: 10000x4=40000

Cable

channels/Doordars

han: 15000

X4=60000

Communication Activities

Low cure rate

Motivating and sensitizing health care providers/community volunteers to improve counseling and providing patient friendly services and strictly follow DOT(focusing on low performing districts)

DOT providers

1.Sensitization meetings

Power point presentation/banners

x

1 1

x 1 STO/IEC Officer/DTO/MOTC

Attendance sheet/Minutes/Photographs/feedback received

1000x2=2000

Banner:500x1=50

0

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Communicate with MOs to take accurate history of Patients, improve IPC skills

Medical officers

2.One on one interactions

Quarterly feedback on performance indicators

7 7 7 7 STO/ programme managers

Supervisory registers/feedback

No cost involved

Explain to patients and family about the importance of treatment compliance Renumeration for Communication Facilitators**

TB patients 3.Counseling/house visits

TB Patient booklet

1

1

1 1 STO/IEC Officer/CFs/STS

Attendance/minutes and feedback/photographs

No cost involved

1,40,000

Social Mobilization activities

Low cure rate

Sensitizing and involving the communities( church leaders, youth groups, etc) in supporting TB patient and providing information about Tuberculosis and the need for their support

1.General public 2. Schools 3. Colleges 4. World TB Day events

1. Community Meeting/ 2.awareness through advertisements

Pamphlets /banners/newspapers advertisement

1 1

1 1

1 1

1 1

STO/IEC Officer/CFs/NGOs

Attendance/minutes and feedback/photographs

1.1500x4=6000

Newspaper/articles ads: 2105X4=84

20

2.school programmes (lecture, quiz, drawing competitions)/role plays

Flip chart/presentations/chart paper/prizes

1 1 1 x IEC Officer/CFs/NGOs

Minutes/photographs/no. of participants

2.1000x3=3000

Materials:10x100=1000

3. street plays 4.road show

Pamphlets /Banners

2 1

x X

x X

x X

STO/IEC Officer/CFs

Minutes/photographs/no. of participants

3.8000x2=16000

4.8000x1=8000

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Challenge 2: High Default Rate Advocacy Activities

High Default Rate

Sensitizing state authorities about the importance of reducing default cases & for their support for necessary instructions to the programme staff

1.Health care providers Public & Private

1.Interaction Meetings 2.One to One Interaction Meetings 3. Use of quarterly performance

Audio Visual Aids -Posters-booklets/brochure -poster in local language -Factsheets -success stories

1 1 1 1 STO(with support from WHO Consultant)

Review of default case TU wise Minutes of meetings

Reduction in default rate by 2% - Data analysis Study to document default within one yr

No cost involved

Communication Activities High Default Rate

To motivate patients & their families for completion of treatment Increase in no. community based involvement

Patients, Their Family Members, DOT Providers

1. Sharing of experience of cured patients / Patients during Treatment.

Patient interaction meetings & involvement of cured persons Development of material for Community DOT Providers

X

X

X

X

MO, STS & Communication facilitators

Records of meeting Evidence of material development – pre testing

Reduction in default rate by 2%- Analysis of programme data Reduction in time for retrieval of defaults

1.No cost involved

NGOs

2.Sensitization meetings

x x 1 x STO/ IEC Officer

2. 1500x1=1500

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Social Mobilization

High Default Rate

To link poor patients to the welfare schemes

Departments Social welfare schemes

1.Sensitization meeting

Posters, programme fact sheet, Presentation Annual reports

x

X

1

X

STO/IEC officer

Documentation, Records , Photographs

Reduction in defaults Documentation of effectiveness of such linkages through a study after one year

1.1500x1=1500

Involvement of cured TB Patients for support

To link cured patients with defaulters

2.Sensitization meetings

x x 1 x STO/DTO/ IEC Officer/ CF/STS

Records of meetings, attendance

Documentation of effectiveness of such linkages through a study after one year

2.1000x1=1000

Challenge 3:- Re-treatment cases

Advocacy activities

Re-treatment cases

Sensitizing programme staff on the importance of supporting re-treatment cases

1.DTOs/MOTCs

One on one interaction

Quarterly feedback base on performance indicators cure rate and detection of re-treatment cases

7 7 7 7 STO/DTO/MOTC

Minutes/ supervisory registers

Documen- tation of effectiven- ess of such interactio-ns based on quarterly reports through a study after one year

No cost involved

Communication activities

Re-treatment cases

Capacity-building of the TU teams

RNTCP staff at TU level

1.Sensitization meeting

TB indicators at TU

1 1 x x STO/IEC officer

Minutes/ attendance

Documen-tation of improve

No cost involved

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for improving support for patients under re-treatment

levels ment /Feedback after one year

Private and public health care providers

1.Private practitioners 2.MOs

1.Seminars/CMEs in collaboration with STF

Audio and visual aids/ materials prepared at state level pertaining to re-treatment cases/ banners

x x 1 X 1

STF(with support from WHO Consultant)/DTO/IEC Officer

Records/ publication/feedback

Achievem-ent of performance indicators as per national target after a year

3000x1=3000

Social Mobilization Activities

Re-treatment cases

To mobilize support from communities

1.Headmen/youth groups/women’s groups

1. Community meetings

Pamphlets / other materials prepared/visual aids

Projected above STO/ IECO/CFs/NGOs

Minutes/photographs

Improvement an increase in cure rate and detection of retreatment cases

Budgeted above

TOTAL BUDGET Rs.379920

NOTE: - Printing of materials and media activity will be carried out at state level (exception: West Garo hills and Jaintia hills district). Comment: Amount spent by the State TB Cell does not include the expenditure for quarter ending December ’09 as there are certain committed expenditure/ liabilities. ** Budget for Communication Facilitators involvement included in ACSM Action Plan 2010 as per direction from CTD: Rs.1, 40,000 Total Estimated Budget for ACSM activities in the District: Rs.8,18,895 Total Estimated Budget for ACSM activities for State TB Cell: Rs.2,39,920+Rs.1,40,000(CF)=3,79,920 TOTAL ESTIMATED BUDGET FOR ACSM ACTIVITIES IN MEGHALAYA as per approved budget from CTD: Rs.11,98,815

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74

5. Equipment Maintenance:

Item No. actually

present in the state

Amount actually spent in the last 4

quarters

Amount Proposed for Maintenance during current financial yr.

Estimated Expenditure for the next financial year for

which plan is being submitted

(Rs.)

Justification/ Remarks for (d)

(a) (b) (c) (d) (e) Computer

(Maintenance includes AMC, software and hardware upgrades, Printer Cartridges and

Internet expenses)

26 314648 275000 480000 Equipment includes computers, photocopier and OHP each in DTCs and STCs and 1 Fax at

State and 1 LCD projector. Estimated amount also includes

purchased of Toners etc. Binocular Microscopes (RNTCP) 76 185000 185000 220000 AMC for Microscopes is

managed by State and the cost is high as the firms are from outside

North East. STDC/ IRL Equipment Any Other (pl. specify)

TOTAL : 4,99,648 4,60,000 7,00,000

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6. Training:

Activity No. in the state

No. already trained in RNTCP

No. planned to be trained in RNTCP during each quarter of next FY (c)

Expenditure (in Rs)

planned for current

financial year

Estimated Expenditure for the next financial year

(Rs.)

Justification/ remarks

(a) (b) Q1 Q2 Q3 Q4 (d) (e) (f) Training of DTOs (at National level) 7 3 2 2 0 0 As per scheduled at

the National level for new turn over and

expenditure budgeted from Miscellaneous

head Training of MO-TCs 12 12 2 12000 15000 New TU at

Khliehriat and if any turn over.

Training of MOs (Govt + Non-Govt) 592 497 25 25 25 20 166000 227000 Training of LTs of DMCs- Govt + Non

Govt 113 82 15 16 48000 52000

Training of MPWs 1198 924 30 30 91500 114500 Training of MPHS, pharmacists, nursing

staff, BEO etc 1247 919 50 50 131000 230000

Training of Community Volunteers 7400 1830 50 50 164000 365180 Training of Pvt Practitioners 79 29 10 10 10 22000 27000

Other trainings #

0 0 0 0 0 0 0

Other trainings Medical College STF Chairperson

0 0 0 0 0 0 25000

Other trainings Medical College TOTs

3 3 2 0 30000

Other trainings Medical College Others faculty members

0 0 0 0 0 0 26000

Re- training of MOs 592 497 50 50 50630 85000 Re- Training of LTs of DMCs 48 21 15 15 22000 30500

Re- Training of MPWs 741 489 50 50 38265 90330

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76

Vehicle Maintenance:

Re- Training of MPHS, pharmacists, nursing staff, BEO

793 270 25 25 38125 155675

Re- Training of CVs 2094 1079 50 50 50 23180 93050 Re-training of Pvt Practitioners 13 0 500 0

Activity No. in the state

No. already trained in RNTCP

No. planned to be trained in RNTCP during each quarter of next FY (c)

Expenditure (in Rs) planned for current financial

year

Estimated Expenditure for the next financial year

(Rs.)

Justification/ remarks

Q1 Q2 Q3 Q4 TB/HIV Training of MO-TCs and MOs 315 141 50 50 50 50 0 110360

TB/HIV Training of STLS, LTs , MPWs, MPHS, Nursing Staff, Community

Volunteers etc

6705 0 50 50 50 50 0 104360

TB/HIV Training of STS 6 3 7 0 76000 Training of MOs and Para medicals in

DOTS Plus for management of MDR TB 528 0 0

Provision for Update Training at Various

Levels # Review Meetings at State Level Review Meetings for STF

57

0

40

7

0

0

0

7

1 1

1 1

1 1

1 1

21500

70000 0

80000 60000

34045

Any Other Training Activity Retraining of part-time accountants Retraining of STS and STLS

7

7

# Please specify

TOTAL :- 19,50,000

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77

Type of Vehicle Number permissible as

per the norms in the state

Number actually present

Amount spent on POL and Maintenance in

the previous 4 quarters

Expenditure (in Rs) planned for current

financial year

Estimated Expenditure for the next financial year for which plan

is being submitted (Rs.)

Justification/ remarks

(a) (b) (c) (d) (e) (f) Four Wheelers 8 8 846216 1372500 1545000 POL of Vehicle of

Maintenance includes Vehicle insurances for all Vehicles in the

State. Two Wheelers 12 12 279935 416500 606000

TOTAL 11,26,151 17,89,000 21,51,000/-

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8. Vehicle Hiring*:

Hiring of Four Wheeler

Number permissible as per the norms in

the state

Number actually requiring hired

vehicles

Amount spent in the prev. 4

qtrs

Expenditure (in Rs) planned for current

financial year

Estimated Expenditure for the next financial year for

which plan is being submitted (Rs.)

Justification/ remarks

(a) (b) (c) (d) (e) (f) For STC/ STDC 2 Rs.3.6lakhs

3,60,000/-

(1) STO vehicle not road worthy.(2)Amount for STC officer within the State HQ

1500/- per day within district, outside district 2500/- per day. As the

approved budget of Rs.850/- per day for hiring vehicle is not feasible for

both state and district. This proposed budget NRHM

norms of Govt of Meghalaya.

For MOTC 12 221878 709200 Rs 12.09 lakhs 1209600

Rs 1500/-per day for district. As the approved

budget of Rs.850/- per day for hiring vehicle is not

feasible for both state and district. This proposed

budget as NRHM norms of Govt of Meghalaya.

Total 15, 69,600/-

* Vehicle Hiring permissible only where RNTCP vehicles have not been provided

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9. NGO/ PP Support: NGO/ PP Support: (New schemes w.e.f. 01-10-2008)

Activity No. of currently

involved in RNTCP

Additional enrolment

planned for this year

Amount spent in the

previous 4 quarters

Expenditure (in Rs) planned for current

financial year

Estimated Expenditure for the next financial year for which plan is

being submitted (Rs.)

Justification/ remarks

(a) (b) (c) (d) (e) (f) ACSM Scheme: TB advocacy,

communication, and social mobilization 8 0 121000 70000 292525

The amount planned is

increase due to the

involvement of CBCI.

SC Scheme: Sputum Collection Centre/s 3 3 22500 75250 360000

Transport Scheme: Sputum Pick-Up and Transport Service 2 4 26000 112250 144000

DMC Scheme: Designated Microscopy Cum Treatment

Centre (A & B) 3 0 150000 525000 560000

LT Scheme: Strengthening RNTCP diagnostic services 0 0

Culture and DST Scheme: Providing Quality Assured

Culture and Drug Susceptibility Testing Services

0

Adherence scheme: Promoting treatment adherence 5 3 63000 680000

Slum Scheme: Improving TB control in Urban Slums 1 1 82500 99500

Tuberculosis Unit Model 0 TB-HIV Scheme: Delivering TB-

HIV interventions to high HIV Risk groups (HRGs)

1 0 72000

Total : 10,00,000 21,36,025

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10. Miscellaneous:

Activity* e.g. TA/DA, Stationary, etc

Amount permissible as

per the norms in the state

Amount spent in the previous 4

quarters

Expenditure (in Rs) planned for current

financial year

Estimated Expenditure for the next financial year

(Rs.)

Justification/ remarks

(a) (b) (c) (d) (e) Payment of

Stationery, TA/DA of staff, Telephone Expenses, Sputum Collection Kit, etc,.

Transport arrangements of

Drugs Transportation to

Districts

1152309 1100000 1743000 TA&DA for the training of DTOs at National level.

TOTAL 17,43,000 * Please mention the main activities proposed to be met out through this head

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11. Contractual Services:

Category of Staff No. permissible as per the norms in the state

No. actually present in the state

No. planned to be additionally hired during this year

Amount spent in the previous 4

quarters

Expenditure (in Rs) planned for current fin. year

Estimated Expenditure for the next financial

year (Rs.)

Justification/ remarks

(a) (b) (c) (d) (e)

Asst. Programme Officer/Epidemiologist 1 0 1 80000 480000 496000 Increment 5%.

DOTS Plus site Sr.M.O 1 0 1 - - 360000

DOTS Plus site S.A 1 0 1 - - 180000

MO-STCS 1 0 1 60000 360000 372000 -do-

State Accountant 1 1 0 178530 226800 222300 -do-

State IEC Officer 1 1 0 237150 226800 220500 -do-

Pharmacist 1 0 1 - - 144000 -do- (Store keeper is an existing staff with the implementation of

DOTS Plus Pharmacist is needed.) Secretarial Asst 1 1 0 25200 25200 25200

MO-DTC

STS 12 12 1 2009100 1807300 2198480 5%

STLS 12 12 1 2040900 1807300 2198480 -do-

TBHV 7 6 6 600540 534200 616560 -do-

DEO 8 8 0 1017300 837800 910155 -do-

Accountant – part time 7 7 0 261200 239000 285890 -do-

Contractual LT 1 228300 95000 125055 -do-

Driver 1 2 91300 88200 260400 Driver deputed from the DM&HO were taken back due to workload

at DM&HO. Any other contractual post approved

under RNTCP- Store keeper 1 1 0 24000 24000 24000

Store Assistant ( State drug Store)

Any other contractual post approved under RNTCP- communication facilitator

TOTAL : 86,39,020

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12. Printing:

Activity Amount permissible as per the norms in

the state

Amount spent in the previous 4

quarters

Expenditure (in Rs) planned for current

financial year

Estimated Expenditure for the next financial year for which plan is being submitted

(Rs.)

Justification/ remarks

(a) (b) (c) (d) (e) Printing-State level:*

511095 574300 500000 600000/- Expenditure of last 4 qtrs upto

Sept-10. Printing- Distt. Level:*

Total:- 6,00,000/- * Please specify items to be printed in this column

13. Research and Studies (excluding OR in Medical Colleges):

Any Operational Research project planned (Yes): (Post Graduate grant for one research paper OR and studies included in the Medical College Action Plan from each Medical College) Estimated Budget (to be approved by STCS).

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14. Medical Colleges

Activity Number in Medical College

Amount permissible as per norms

Estimated Expenditure for the next

financial year(Rs.)

Justification/ remarks

(a) (b) (d) (e) Civil Works & Maintenance

DMC & DOTs Centre DOTs Plus Sites /IRLs

1

Nil

1000/-

1000/-

Routine

Contractual Staff: MO (In place: Yes/No) STLS (In place: Yes/No) LT (In place: Yes/No) TBHV (In place: Yes/No)

1 1 1

30800/-

10350/-

8800/- TA =750/-

369600/-

124200/-

105600/- TA = 9000/-

5% increment per year for all 3 staff

Research and Studies: Thesis of PG Student Operations Research*

1 3

20000/- 500000/-

20000/- 500000/-

Travel Expenses for attending STF/ZTF meetings

1 ZTF 1 NTF 1 OR

30000/- 25000/- 2x5000/-

30000/- 25000/- 10000/-

ZFT for 4 NTF one person OR for 2 persons

ACSM: Meetings and CME planned 2 CME 2x50000/- 100000/- 2 State level CME Training:

Faculty members, Residents, interns, nursing staff, paramedical staff etc.

2 Sensitization Programme

2x2500/- 50000/- 5 days MO training not feasible at present

Total 1299200/- 1299400/-

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15. Procurement of Vehicles:

Equipment No. actually present in the

state

No. planned for procurement this

year (only if permissible as per

norms)

Estimated Expenditure for the next financial year for

which plan is being submitted (Rs.)

Justification/ remarks

(a) (b) (c) (d) 4-wheeler ** 8 2 1118000 Replacement of the existing, as they are in a

very bad condition already seven years for West Khasi Hills and South Garo Hills 5 four

wheeler planned during the current year written approval awaited.

2-wheeler 12 5 325000 -do- Total:- 14,43,000

** Only if authorized in writing by the Central TB Division

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16. Procurement of Equipment:

Equipment No. actually present in the state

No. planned for this year (only as per

norms)

Estimated Expenditure for the next financial year for

which plan is being submitted (Rs.)

Justification/ remarks

(a) (b) (c) (d) Office Equipment

(Computer, modem, scanner, printer, UPS etc.) Laptop

26

0

1

1

280000

40000

The existing photocopier in the State needs to be replace as the present set is in used more than 7 years. With frequent breakdown and

the maintenance cost is too high. Procurement of equipment required during

training and meeting for presentation of information.

Computer , monitor , printer, UPS, CPU need to be replace as the present sets are in use for more than 6 years for Ribhoi and Photocopier for the East Khasi Hills as the presents set is irreparable.

Any Other UPS 8 9 0 Total:- 3,20,000/-

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Section D: Summary of proposed budget for the state –

Category of Expenditure Budget estimate for the coming FY 2011- 2012

(To be based on the planned activities and expenditure in Section C)

1. Civil works 22,15,000 2. Laboratory materials 20,00,000 3. Honorarium 13,00,000 4. IEC/ Publicity 11,98,815 5. Equipment maintenance 7,00,000 6. Training 19,50,000 7. Vehicle maintenance 21,51,000 8. Vehicle hiring 1569600 9. NGO/PP support 21,36,025 10. Miscellaneous 17,43,000 11. Contractual services 86,39,020 12. Printing 6,00,000 13. Research and studies 0 14. Medical Colleges 12,99,400 15. Procurement –vehicles 14,43,000 16. Procurement – equipment 3,20,000

Total:- 2,92,64,860/-

(Rupees Two Crores ninety two Lakhs sixty-four thousand eight hundred and sixty) only.

Additionality Funds from NRHM-Details of the activities with justification for which

Additionality Funds are proposed to be sought.

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National Programme for Control of Blindness

ACTION PLAN 2011 - 2012 Sl.No Name of Activity Physical Targets

1 Cataract Operations 2,000

1.1 I.O.L Implantation. 1,800 (90%)

1.2 Women Beneficiaries. 1,100 (55%)

1.3 Surgery on Bilaterally blind. 1,000 (50%)

1.4 SC/ST/BPL Beneficiaries. 1,000 (50%)

2 School Eye Screening

2.1 Children to be Screened. 1,00,000

2.2 Probability of Children detected with refractive errors. (10% of 2.1)

10,000

2.3 Free spectacles to be provided (30% of 2.2). 3,000

Physical Target For 2011-12 District Wise Distribution

Indicators East Khasi Hills

West Garo Hills

East Garo Hills

South Garo Hills

Ri-Bhoi District

Jaintia Hills

West Khasi Hills

Total

Catops 1000 400 100 100 100 200 100 2000

I.E.C. 30 20 10 5 10 10 20 105

S.E.S 45,000 20,000 7,500 5000 7,500 7,500 7,500 1,00,000

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TRAINING FOR THE YEAR 2011-12 Training of Eye Specialist Sub Speciality in: Medical Retina - 1

Occuloplasty - 1

IOL - 3

Phaco - 1

Training of M&H.O’s in diagnosing Operable Cataract - 100

Training of Nurses in ophthalmic techniques - 7

Training of Teachers for School Eye Screening - 500

Training of Selected Link Workers - 600

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FINANCIAL STATEMENT FOR 2010-11(Figures in lakhs) FUNDS

PROPOSAL APPROVED AMOUNT

RELEASED OPENING BALANCE

TOTAL EXPEN DITURE

TILL DEC, 2010

% OF UTILI SATION TILL

DEC 2010

CLOSING BALANCE TILL DEC,

2010

PROPOSED EXPENDITURE

TILL MARCH,2011

% OF UTILISA

TION TILL March 2011

CLOSING BALANCE AT THE END OF MARCH ,2011

PRO- POSED

BUDGET FOR

2011-12

247.80 174.80 126.64 90.36 217.00 43.75* 20.16% 173.25 166.81** 97.03% 06.44 318.20

* Recurring GIA - 29.28 Non-recurring GIA - NIL Contractual Man Power - 14.47 ** 30.00 - Jaintia O.T 40.00 - NEIGRIHMS 1.30 - Consolidation Auditor’s fees 1.00 - UPS 15.00 - Districts 1.00 - AMC 0.50 - I EC 0.65 - Furnishings of EYE OT 2.36 - Salary till March,2011 75.00 - Ri Bhoi Eye O.T & Eye Ward

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(*) = Recurring Grant in Aid for Free Cataract Operations and various other schemes which include: Other Eye Diseases @ Rs. 1000/-, School Eye Screening Programme @ Rs. 200/- per pair of spectacles, Private Practitioners @ as per NGO norms, Management of State Health Society and District Health Society @Rs.14 lakhs/ 7 lakhs, Recurring GIA to eye Donation centres @ Rs.1000/- pair of Eye Ball collection and Eye Banks @ Rs. 1500/- per pair of Eye Ball collection Rs.1500, Training , IEC, Procurement of Ophthalmic Equipment, Maintenance of Ophthalmic Equipments , Remuneration, Other Activities & Contingency. (**) As at Annexure I

NATIONAL PROGRAMME FOR CONTROL OF BLINDNESS GRANT-IN-AID TO STATES/UT’S FOR VARIOUS COMPONENT DURING 2011-12

PHYSICAL TARGET

FUNDS REQUIRED (in lakhs)

RECURRING GRANT-IN-AID(*) RECURRING GRANT-IN-AID(**)

For free cataract operations @ rs.750/- per case and other approved schemes as per financial norms(*) Proposal from Bansara Eye Care Centre

2000 189.80

42.6

NON RECURRING GRANT-IN-AID:

For Eye Wards & Eye OTs @ Rs. 75 LAKHS 1 75.00

CONTRACTUAL MANPOWER

Ophthalmic Surgeons Ophthalmic Assistants

2 5

6.00 4.80

TOTAL GRANT-IN -AID 318.2

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ACTIVITIES MBCS EAST KHASI HILL

WEST KHASI HILLS

JAINTIA HILL

DISTRICT

RI-BHOI DISTT

EAST GARO HILLS

WEST GARO HILLS

SOUTH GARO HILLS

TOTAL FINANCIAL TARGET

(IN LAKHS)

CATOPS - 1000 100 200 100 100 400 100 2000 15.000

*TRAINING

1).M&H.O’s 25 - 30 20 5 5 10 5 100 0.975

2). TEACHERS - 200 100 60 25 40 50 25 500 4.300 3). ASHA’S & HEALTH WORKERS

- 150 100 50 40 10 40 10 400 3.440

4). ANGANWADI’S - 50 50 20 20 20 30 10 200 1.720

SCHOOL EYE SCREENING

Children to be Screened - 45,000 7,500 7,500 7,500 7,500 20,000 5,000 1,00,000

Children Detected with Refractive Error

- 4,500 750 750 750 750 2,000 500 10,000

Children provided with Free Specs

- 2,250 375 375 375 375 1,000 250 5,000 12.500

EQUIPMENTS

PHACO - 1 - 1 - - - - 2 32.000

B.SCAN - 1 - - - - - - 1 15.000 APPLANATION TONOMETER

- 1 - - - - 1 - 2 1.200

A.M.C - - - - - - - - 8.000

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Programme Implementation Plan (P.I.P) of the Meghalaya Blindness Control Society 2011-12 *Training Details Medical &Health Officer’s - 20 per batch x 5 Batches = 100

Teachers - 20 per batch x 25 batches = 500

AHSA’S & Health Workers - 20 per batch x 20 batches = 400

Anganwadi’s - 20 per batch x10 batches = 200

EYE WARDS & O.T - - - - - - 1 - 1 75.000

SALARIES 13.62 - - - - 1.56 1.56 6.36 23.10 23.100

HONORARIUM 0.24 0.24 0.24 0.24 0.24 0.24 0.24 0.24 1.92 1.920

WAGES 0.50 0.30 0.24 0.25 0.25 0.25 0.25 0.25 2.29 2.290 OPERATIONAL COSTS

TA/DA 0.25 0.50 0.50 0.50 0.50 0.50 0.50 0.50 3.75 3.750

Fee to CA 0.15 0.15 0.05 0.05 0.05 0.05 0.05 0.05 0.60 0.600 POL & Hiring of Vehicles 3.50 2.00 1.60 1.00 1.50 1.50 1.50 1.50 14.10 14.100

I.E.C 1.50 1.00 0.60 0.80 0.50 0.50 1.00 0.50 6.40 6.400

O.T. Requirements 4.50 10.00 2.50 5.00 2.50 2.50 10.00 2.50 39.50 39.500 Other Contingencies 5.00 5.00 0.80 1.00 0.50 0.50 1.00 1.00 14.80 14.800

Total 275.595

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Expenditure

M & H.O’s Teachers ASHA’S & Health Workers

AWW’s Total

Honorarium to faculty

Rs.500 x 5 =Rs.2500

Rs.200 x 25 =Rs.5,000

Rs.200 x 20 =Rs.4,000

Rs.200 x 10 =Rs.2,000

Rs.13,500

Light Refreshment per participant @Rs.150.00

Rs.150 x 100 =Rs.15,000

Rs.150 x 500 =Rs.75,000

Rs.150 x 400 =Rs.60,000

Rs.150 x 200 =Rs.30,000

Rs.1,80,000

Training Materials per participant

Rs.200 x 100 =Rs.20,000

Rs.100 x 500 =Rs.50,000

Rs.100 x 400 =Rs.40,000

Rs.100 x 200 =Rs.20,000

Rs.1,30,000

Contingency per Programme @ Rs.12,000

Rs.12,000 x 5 =Rs.60,000

Rs.12,000 x 25 =Rs.3,00,000

Rs.12,000 x 20 =Rs.2,40,000

Rs.12,000 x10 =Rs.1,20,000

Rs.7,20,000

Total Rs.97,500 Rs.4,30,000 Rs.3,44,000 Rs.1,72,000 Rs.10,43,500

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NATIONAL LERPOSY ERADICATION PROGRAMME

Format for inclusion in the PIP FOR 2010 – 2011 1. STITUATION ANALYSIS: STRENGTH: i) Trained District Nucleus Staff ii) Trained and Motivated GHC Staff iii) Availability of Guidelines from Government of India from time to time. iv) Availability of adequate and effective MDT

v) Good coordination with DLOs, MOs, GH Staff with other department like Education, Social Welfare. vi) Ability in looping Missionaries of Charity (Shantivan, Nongpoh) into the system has enable the programme to be extended to the Person Affected by Leprosy (LAP) taking treatment there.

WEAKNESS: i) Lack of vehicles lead to poor Monitoring and Supervision

ii) Lack of Periphery Staff. Because of Multi purpose programmes under the umbrella of NRHM, the staff cannot concentrate on one single programme. iii) The State Leprosy Officer has other responsibilities eg. Is also functioning as State Surveillance Officer, IDSP and also entrusted with other official works in the Directorate and therefore cannot fully concentrate on the programme. OPPORTUNITY: Integration of General Health Care System under the umbrella of the NRHM, coordination with other Departments and involvement of NGOs, Members of the community will help in creating awareness of the programme and also to reduce the stigma and discrimination to the Leprosy affected person. THREATS: Leprosy being a communicable disease and the State having a porous borders and both national and international on all four sides, there is a threat that this disease may spread through these areas. New initiatives suggested to improve physical & financial performance. Physical improvement of the activities of the Society is dependant on timely and adequate release of funds. Presently funds are released in two installments, in November and January. The funds are received at the District level in the following months resulting timely implementation difficult. It is therefore suggested that arrangements are made for early release of funds.

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2. PERFORMANCE UNDER NLEP:

Indicators 2007-08 2008-09 2009-10 2010-11 upto Nov.

2010 No. of new cases detected (ANCDR/10,000)

14 0.50

17 0.60

20 0.68

57 2.00

No. of cases on record at year end (PR/10,000)

43 0.15

36 0.07

48 0.11

95 0.24

No. of Grade II disability among new cases (%)

Nil 5% 20% 84%

Treatment Completion Rate 30% 45% 63% N.A. Re-constructive Surgery conducted

0 0 0 12

(Cumulative number to be mentioned and rate/percentage to be given in brackets) 3. INFRASTRUCTURE: a) State Leprosy Cell - 1 (one) State Leprosy Officer – in position 1 1 (one) Zonal Leprosy Officer - vacant b) MLES - 1 (one) i.e.Budget & Finance Officer – in position 1 1 (one) Surveillance Medical Officer - vacant 1 (one) Administrative Assistant Appointment 1 (one) Data Entry Operator issued

1 (one) Driver – State level 6 Drivers in the District – in position 6 1 (one) additional Driver for remaining 1 (one) District is proposed 4. TRAINING PLAN: a) 4 days Training of Newly appointed MO (Rural & Urban)- 60 b) 3 days Training of Newly appointed Health Worker - 70

and Supervisor c) 5 days Training for Newly appointed Lab. Technicians - 30 d) ½ day Training for ASHA Workers - 6,000 e) 2 days refresher Training of MOs, Health Workers - 450

and Supervisors, Lab. Technicians and Pharmacists f) 2 days Training of DPMR and Leprosy Management - 245 at all levels

5. IEC: i) Hoardings - 25 ii) Bus Panel to be utilized for Advertisement - Nil

in print media iii) Posters/pamphlets - 80,000 iv) Wall Painting - 90

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v) Rallies & banner/out door publicity - 15 vi) School Quiz - 7 vii) Folk show/Puppet shows/street plays - 7 viii) IPC workshop for MO & HW/Advocacy meetings - 14

ix) Meeting with Zilla Paishad - 7 x) Orientation for NGOs,SSG & MM - Nil xi) Health Mela/Exhibitions/haats/Bazors - 16 xii) IPC meeting at Block level for Teachers,Govt. officials - 28

& ASHA/Patient provider interaction meetings xiii) Others (eg) Publicity by Mega phone - Nil 6. DPMR:

i) Procurement of MCR Footwear, aids & appliances- 140 including cases released from

treatment with loss of sensation etc.

ii) Name of Recognized Institutes conducting RCS - Under process iii) Expected No. of patients to be undergoing RCS - Nil iv) Coordination with other departments for - Will be made with

rehabilitation of Leprosy affected persons the Social Welfare Department

7. URBAN LEPROSY CONTROL: i) List of identified urban localities - Nil ii) Any new urban area to be included, justification - Nil

to be given for the same iii) Plan for Urban Leprosy Control - Coordination may be

made with the Medical Officers, Shillong Municipal Board to take up necessary steps

8. LEPROSY COLONIES: i) No. of Leprosy Colonies - 1 (one) ii) No. of persons living in colonies - 60 (sixty) all cases released

from treatment (RFT) iii) No. of persons with Grade II disability - Nil iv) No. of cases with Ulcers - 2 (two) under Self care v) Services to be provided during the year - Services given and will be

- Free health checkup, medicines, continue dressing Materials. MCR footwear and Civic amenities like electricity, water,

sanitation etc.

9. PROCUREMENT PLAN: As per Action Plan.

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10. NGO SERVICES: Missionaries of Charity (Shantivan, Nongpoh) has a number of Person Affected by Leprosy attending and staying there. Reconstructive Surgery conducted there during 2010-11 in collaboration with the State Government, NEIGRIHMS, Guwahati Medical College and GNRC, Guwahati. Most such Reconstructive Surgery expected to be conducted in 2011-12.

11. INCENTIVE FOR ASHA: To be given as per norms. 12. MONITORING: State level - Will be done as usual District level 13. VEHICLE OPERATION: State level - Vehicle hiring will have to be District level - continued in the absence of

adequate vehicles. 14. OFFICE EXPENDITURE & CONSUMABLES: State level - Expenditures will have to be incurred on office expenses in order to continue with the

activities of the Society. District level - As stated The Action Plan for 2011-2012 is attached herewith.

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NLEP – PROPOSED ANNUAL ACTION PLAN (2011-2012) STATE OF MEGHALAYA

Sl. No.

Activity Proposed Amount Proposed (in Rs.)

1 Contractual Services 11,25,000/- One SMO @ Rs. 20,000/- pm. One BFO Cum AO @ Rs. 15,000/- pm. One DEO @ Rs. 8,000/- pm. One AA @ Rs. 7,000/- pm. Eight Drivers @ Rs. 4,500/- pm. Honorarium for 7 district accountants @ Rs. 1,000/- pm. 2 Services through ASHA/USHA 35,000/- Honararium to ASHA, sensitization of ASHA 3 Office expenses & Consumables 3,50,000/- 4 Capacity building 6,00,000/- i) 4 days training of newly appointed MO (rural & urban) ii) 3 days training of newly appointed health worker &

health supervisor

iii) 2 days refresher training of MOs iv) 5 days training of newly appointed Lab. Technician v) 1 day Training for 6000 ASHAs vi) 1 day Training for Pharmacists vii) Training for Media Persons 5 Behavioral Change Communication 6,00,000/- Quiz, folk show, IPC workshop, Meeting of opinion

leaders, Health melas

Wall painting, Rallies, Hoardings etc. 6 POL/Vehicle operation & hiring 6,00,000/- 2 vehicles at state level & 1 vehicle at district level 7 DPMR 3,00,000/- MCR footwear, Aids and appliances, Welfare allowance

to BPL patients for RCS, Support to govt. institutions for RCS

8 Materials & Supplies 3,50,000/- Supportive drugs, lab. Reagents & equipments and

printing forms

9 Urban Leprosy Control 50,000/- 10 NGO – Set Scheme 50,000/- 11 Supervision, Monitoring & Review 2,00,000/- Review meetings and travel expenses

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12 Cash Assistance 2,40,000/- TOTAL 45,00,000/-

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INTEGRATED DISEASE SURVEILLANCE PROJECT (IDSP)

PIP-2011-12.

SITUATION ANALYSIS 1. CURRENT SCENARIO:

Manpower: The State Surveillance Unit is being manned by the State Surveillance Officer with all the supporting staff in position except Epidemiologist which is vacant as no candidate turned for interview.

Similarly the District Surveillance Units are being manned by the District Surveillance Officers with all the supporting staff except Epidemiologist which is vacant in all the Districts as no one turned up for the interview.

Effort will be made to recruit Epidemiologist in the near future. Reporting: Though Districts are reporting, the reporting from some of the Districts is still not up to the mark. Effort will be made to improve reporting in terms of regularity, timeliness and completeness of reporting.

Some Districts are still having problem in reporting through On-line Portal. With the completion of Training of Data Managers and DEOs on the 13th & 14th Jan. 2011 it is expected that the Portal Data Entry will be possible from all the Districts. Laboratory: Procurement of Lab Equipments for Priority Lab. Tura Civil Hospital under process (quotations received, procurement will follow soon). Microbiologist already appointed and in position. Strengthening of District Lab. in Civil Hospital, Shillong, is being proposed for 2011-12. Training: Training of Medical Officers and staff expected to be completed by March 2011.

Further training of remaining Medical Officers and staff is being plan for 2011-12. I.T. Component: Almost all Training Equipments not functioning due to one or the other problem. Minor problems that could be sorted out locally will be sorted out. Others need CSU support.

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Shifting of Disc Antenna of SSU and DSU, Nongstoin, West Khasi Hills,

pending due non-payment of estimated amount. In the Review meeting held in Delhi on the 6th-7th December 2010, it was mentioned that the cost of shifting should be borne by the State from State Fund but the same was not reflected in the minutes of the meeting.

Telephone-cum- Broad-band Bill still unresolved as a result many Districts got disconnected. 2. STRATEGIES:

Sensitization of MOs and Staff for regular, timely and completeness of reporting.

Involvement of more private institutions including private practitioners in reporting.

Usage of Portal entry for Data Reporting and analysis. Strengthening of laboratories.

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PROPOSED BUDGET : 2011-12

SUMMARY SURVEILLANCE PREPAREDNESS

1. TRAINING 14,70,650/-

2. STAFF REMUNERATION 51,04,500/-

3. OPERATIONAL COST 12,54,000/-

4. OUTBREAK INVESTIGATION &

RESPONSE (Priority Lab-Civil Hospital, Tura)

2,00,000/-

DEVELOPMENT OF DISTRICT LAB FOR DIAGNOSIS OF EPIDEMIC PRONE DISEASES

1. DISTRICT LAB- CIVIL HOSPITAL,

SHILLONG 28,23,500/-

TOTAL 108,52,650/-

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Activity Sub-activity

Unit cost Sub-activity

No of Units

Proposed Budget

Surveillance Preparedness Training

One day training of Hospital Doctors

20 per districts, 10 per batch. Per Head: Food & Tea Rs 250, D.A Rs 700, Training materials Rs 250, Resource Person (local) Rs 600, (Non Local) Rs 1000, Travel Rs 300 Venue hiring & other Misc Rs 8000

(2 Batches,

7 Districts)

14 361900

One day training of Hospital Pharmacist / Nurses

40 per districts, 20 per batch. Per Head: Food & Tea Rs 200, D.A Rs 400, Training materials Rs 200, Resource Person (local) Rs 500, (Non Local) Rs 800, Travel Rs 250 Venue hiring & other Misc Rs 8000

(2 Batches,

7 Districts)

14 438200

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One day training of Medical College Doctors

20 per districts, 10 per batch. Per Head: Food & Tea Rs 250, D.A Rs 700, Training materials Rs 250, Resource Person (local) Rs 600, (Non Local) Rs 1000, Travel Rs 300 Venue hiring & other Misc Rs 8000

(2 Batches,

7 Districts)

14 361900

One day training Data entry and analysis training for Block Health Team

20 per districts, 10 per batch. Per Head: Food & Tea Rs 200, D.A Rs 400, Training materials Rs 150, Resource Person (local) Rs 400, (Non Local) Rs 600, Travel Rs 250. Venue hiring & other Misc Rs 8000

(2 Batches,

7 Districts)

14 280000

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One day training of DM & DEO

17 DM & DEO Per Head: Food & Tea Rs 200, D.A Rs 400, Training materials Rs 150, Resource Person (local) Rs 400, (Non Local) Rs 600. Travel Rs 7000, Venue hiring & other Misc Rs 8000

1 Batch 28650

Sub total 1470650

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Surveillance Preparedness

Staff Remuneration*

State/district Epidemiologists (1 at

Rs 30,000 State-1 District-7

2880000

State HQs-SSUs and 1 each at district HQs - DSUs)

State/ district Microbiologists ( 1 at State

HQs- SSUs

Rs 17,500 & Rs 15,500

State- 1 District -1

396000

and 1 each at identified district priority labs )

Entomologist (1 at State HQs - SSUs)

Rs 20,000 State -1 240000

Consultants Finance (1 at State HQs - SSUs)

Rs 14,000 State-1 168000

Consultants Training (1 at State HQs - SSUs)

Rs 20,000 State -1 240000

Data Managers (1 at State HQs - SSUs and 1 each at

district HQs- DSUs)

Rs 14,000 & Rs 13,500

State -1 District -7

262500

Data Entry Operators (1 at State HQs - SSUs, 1 each at district Hos- DSUs and 1 identified Medical Colleges/ Others Institution viz ID Hospital) Identified under IDSP

Rs 8500

State-2

District-7

918000

* The State Health Societies may fix the remuneration as per IDSP guidelines or less as per State Policy

Sub Total 5104500

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Surveillance Preparedness

Operational Cost Transport (Rs 1500 per visit x 4 visits)/ per month

per district State- 1

District -7 576000

Office Expenses, Broadband Expenses, Collection and Transportation of samples and other misc. Expenses ( to be specified)

Broadband Rs 1000 per district+SSU+Medical Colleges per month, Office Expenses Rs 2000 per district and Rs 5000 at SSU per month. Transportation of Samples Rs 6000 per district per year. Other Misc Rs 3000 per district & Rs 5000 at SSU per month.

State-1 District-7 678000

Sub total 1254000

Surveillance Preparedness

Sub Total (Surv. Preparedness= Training + Remuneration + Operatnl. cost)

7829150

OB Investigation & response

Consumables for and kits for Rs 2,00,000/-per year per priority

district lab (Identified No. of labs in States are as follows: Andaman Nicobar-1, Bihar-1, Chandigarh-1, Chattisgarh-1, Delhi-1, Daman & Diu-1, Goa-2, Haryana-2,

District-1 200000

identified priority district labs Himachal Pradesh-2, Jammu Kashmir-1, Jharkhand-1, Kerala-2, Lakshadweep-1, Madhya Pradesh-1, Orissa-1, Puducherry-1, Uttar Pradesh-2, Arunachal Pradesh-1, Assam-1, Mizoram-2, Manipur-1, Meghalaya-1, Nagaland-2, Sikkim-1, Tripura-1,Dadar and Nager Haveli-1)

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Sub Total (OB Investigation & Resp.) Total 8029150

II. DEVELOPMENT OF DISTRICT LAB FOR DIAGNOSIS OF EPIDEMIC PRONE DISEASES No. of District Lab proposed for 2011-12: 1(one). Name of the District Lab proposed: Civil Hospital Lab, Shillong.

Item Approx. cost Basic Equipments (one time expenditure) 1560000 Staff Salary 816000 Other recurring expenditure (including consumables cost, cost of kits, media, reagents, and contingency amount)

447500

Sub Total (The requirement proposed is after taking into account the available manpower and equipments)

2823500

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DETAILED BUDGET-DEVELOPMENT OF DISTRICT LAB FOR DIAGNOSIS OF EPIDEMIC PRONE DISEASES Name of the District Lab. identified: Civil Hospital Lab., Shillong. 1. Basic Equipments:

Name of Equipment No. reqd. Total approx. cost (in lakh) Bio-safety Cabinet Class-I 1 3.0

Autoclave (Sterilization) 1 1.5 Autoclave(Decontamination)-Vertical 1 1.5

Hot Air Oven 1 1.0

Incubator 1 0.5 Binocular Microscope 1 0.4

ELISA Reader and Washer 1 5.0 Refrigerator 285ltrs 1 0.2

Deep Freezer (-20 degree C) 1 2.0

Micro pipette; 0.2-10ul,20-200ul,100-1000ul 3 0.3 Weighing Scale & Mixer 1 0.2

Sub Total 15.6

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2. Recurring Expenditure: a. Staff Salary

Position No. reqd. Unit approx. salary Total salary in lakh Microbiologist 1 40,000/- 4.80

Lab. Technician (Minimum qualification -DMLT)

1 12,000/- 1.44

Lab. Assistant 1 10,000/- 1.20

Cleaner 1 6,000/- 0.72

Sub Total 8.16

b. Consumables and general lab aware (approx):

Sub Total 1.00

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c. Cost of kits, media and reagents:

Name of the test Expected no. of tests/annum

Approx. unit cost

Approx. total (in lakh)

Gm Stain smears of clinical samples e.g. throat swab, sputum, CSF, etc

500 35/- 0.175

Smear examination of Malaria 1000 35/- 0.350 Culture blood, stool, CSF etc for bacterial pathogens and perform Antimicrobial susceptibility testing on the isolates

500 200/- 1.000

ELISA for Viral Hepatitis A & E 200 200/- 0.400 Diphtheria- smear examination & culture 200 200/- 0.400 Rapid Latex Agglutination Test for meningitis (during suspected outbreak)

- 40,000/- 0.400

Ig M ELISA for Measles 200 200/- 0.400 Sputum for AFB 500 50/- 0.250 Other tests relevant for locally prevalent epidemic prone diseases i.e. ELISA for leptospirosis etc.

50 200/- 0.100

Sub Total 3.475 TOTAL 28.235 lakhs

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NATIONAL PROGRAMME FOR PREVENTION AND CONTROL OF DEAFNESS

(carried forward to 2011-12)

CivilL Hospital, Shillong is the referral centre for the State of Meghalaya but Civil Hospital, Shillong caters mostly to four Districts, i. e East Khasi Hills, West Khasi Hills, Ri BHoi and Jaintia Hills District. Cases referred are the following:

1. Chronic –Suppurative Otitis Media. 2. Acute Suppurative Otitis Media. 3. Sensori-Neural hearing loss. 4. Congenital Atresia (Unilateral and Bilateral) 5. Noise Induced Hearing Loss. 6. Congenital Deaf Mute.

3, 4, 5 & 6 are irreversible diseases where only AIDS can be beneficial to them, where as 1 & 2 are temporary diseases where treatment can be given. As the case load of the above cases is increasing day by day therefore, Financial and Training Aid is warranted from the Centre (NRHM)

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PROGRAMME EXECUTION & EXPANSION Presently National Programme for Prevention and Control of Deafness has not been implemented in any Districts of the state. It is proposed to start with 3 Districts in year 2010-11 under the programme. The districts selected for the implementation of the programme are

1. 2. 3.

6 ACTIVITIES A Manpower Training & Development Objectives:

1. To orient all the Health Care personnel from the district to grassroot level about prevention, promotion, early identification and rehabilitation of all types of ear diseases leading to deafness.

2. To make these personnel aware of the existing facilities available for deafness in order to facilitate appropriate referral.

3. To sensitize the health care personnel regarding their specific roles in the programme. 4. To enable the health providers to provide a leadership role in creating awareness about

hearing impairment. 5. To facilitate development of suitable manpower, in order to be able to implement this

programme in the entire nation, in a phased manner. Training would be imparted to the following functionaries at all levels:

Sensitization of the State medical college experts District level ENT Doctors and Audiologists & Audiometricians Obstetricians and Pediatricians at the district and CHC level Medical Officers under CHC/PHC and School Health Scheme Multi Purpose Workers male and female Functionaries at grass root level such as

o Anganwadi workers o Accredited Social Health Activist (ASHA) o Trained Birth Attendants

Primary School teachers at village level B Service Provision including Rehabilitation

Service components will include: Early detection Ear Screening camps Treatment: medical and surgical

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Appropriate referral Rehabilitation of hearing and speech disorders and hearing aid provision. Awareness creation in the community.

Early Detection

By sensitized personnel at grass root level House to house surveys conducted by the AWWs & ASHAs, for detection of cases of

hearing impairment and deafness. Refferal of child born of a high risk pregnancy or delivery, and/or children who are

exposed to a high risk factor in infancy and who show features suggestive of hearing impairment by Pediatricians and Gynecologists

Screening at School by School teachers and proper referral to health care facility.

Ear Screening Camps For screening the general population in respect of ear problems, hearing impairment

and deafness. Detection and treatment of common ear problems. Spreading awareness regarding ear problems, early detection of deafness, available

treatment and health care facilities for referral of such cases. Education of community, especially the parents of young children regarding

importance of right feeding practices, various common ear problems, early detection of deafness in young children and available treatment for hearing impairment/deafness.

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Treatment

Treatment of all affected persons would be undertaken at the PHC, CHC and district Hospital level.

Rehabilitation and Hearing Aid provision: All patients who are identified as having an ear problem that either requires surgery,

hearing aid fitting or rehabilitative therapy will be referred to the ENT doctor and Audiologist at the district level.

Those who need surgery will be given the appropriate treatment at the district hospital. Complicated cases that cannot be adequately handled at the District hospital will be

further referred to the State Medical College for expert treatment. Patients who suffer with Sensorineural hearing loss that is not amenable to medical or

surgical correction and which requires hearing aid, will be fitted with the same at the district level.

The requirement for Speech therapy and Hearing therapy will be met with by the Audiologist / Audiometric Assistant and Instructor for Hearing Impaired Children at the District level.

C Capacity Building

1 PHC & CHC: for screening of ear morbidity and detection of hearing loss, the equipment required / would be:

PHC Kit a) Head Light b) Ear Specula c) Ear Syringe d) Otoscope e) Jobson Horne Probe f) Tuning fork g) Noise Maker

District hospital:

The District hospital is to be an important center for the management of ear problems and deafness cases, which are referred from the health care facilities at various levels.

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Equipment required: 1. Microscope 2. 2 sets of Microdrills with 2 handpeices and burrheads 3. 2 sets of micro-ear surgery instruments 4. Pure Tone Audiometer 5. Impedance Audiomter 6. OAE machine 7. Sound treated room

2 Provision of one Audiometric Assistant and one Instructor for Hearing Impaired Children at the District hospital on contractual basis under the programme to strengthen the diagnostic and rehabilitative services.

7 Time line Sno Activities 1st Quarter 2nd Quarter 3rd

Quarter 4th Quarter

1 Training (1-7 level) 2 Procurement of Equipments

1. PHC KIT 2. District Hospital 3. Sound treated room

3 Recruitment of 1. Audiometric Assistant 2. Instructor for Hearing

Impaired

4 Screening camps organized 5 Hearing aids fitted

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8 Proposed budget for NPPCD for the year 2010-11 S.No. Component Nature of

Expenses

1 Training Financial Guidelines appended

at Annex I

One time Expenditure

2. Capacity Building PHCs/CHCs & District Hospitals ( Rs 9.5 lakh per district hospital and Rs 10000/- per CHC and PHC of the selected/proposed district)

One time Expenditure

Rs 9.5 lakh X no of Dist. +

Rs 10000 X total No of CHC and PHC in

proposed dist.

3. Manpower at district level (Audiometric assistant & Instructor for hearing Impaired) (@ Rs 7500/- per person for 2 contractual person)

Recurring expenditure

Rs 180000 x no of Dist.

4. Screening Camps (Rs. 10,000/- per camp per month per district)

Recurring expenditure

Rs 120000 x no of Dist.

5. Hearing Aids 200 HI per district per year (Rs 4,86,600/- per district for 200 hearing aids)

Recurring expenditure

Rs 486600 X no of Dist.

6. Central Cell at state level Recurring expenditure

Rs 5.72 lakh

7. Misc. & Contingency Recurring expenditure

Rs 10000/-

TOTAL Note: The States are advised to add specific requirements as per there need.

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National Iodine Deficiency Disorders Control Programme

PROFORMA FOR MONITORING OF IODATED SALT THROUGH SALT TESTING KIT AT THE COMMUNICY LEVEL BY ASHA

Name of State: Meghalaya.

Sl.No. Name of the District

No. of salt samples tested

No. of salt samples with

NIL iodine

No. of salt samples with inadequate iodine (less than 15ppm)

No. of salt samples with

adequate iodine (above

15ppm)

1 East Khasi

Hills 24 0 0 24

2 West Khasi

Hills

From (2003

onwards) -

24911 0 5442 19468

3 Ri Bhoi Nil (Target for 2010-11: Testing of Iodized Salt in 3 blocks every

quarter).

4 Jaintia Hills 3920 Nil Nil 3920

5 East Garo

Hills Nil (Target for 2010-11 – 55,000 Household to be surveyed for

Iodine through salt testing).

6 West Garo

Hills Nil

7 South Garo

Hills Nil (Target for 2010-11 – 1000 samples to be tested.)

Meghalaya (Total) 28855 0 5442 23412

As the post of Public Analyst is lying vacant on super annuation of the last incumbent, test on samples collected under Prevention of Food Adulteration Act, 1954 has not been forth coming from the State Iodised Salt Testing Laboratory.

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National Iodine Deficiency Disorders Control Programme Name of the State: Meghalaya.

S.No. Activity Amount Proposed

(Rs. In Lakhs)

1. Establishment of IDD Control Cell 6.00

2. Establishment of IDD Monitoring Lab 4.00

3. Health Education & Publicity 24.50

4. IDD Survey of Districts @ Rs. 50,000 per district 3.50

5 Observing IDD Day (Once a year @ Rs. 20,000 per

district) 1.40

Total 39.40


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