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Part B
National Rural Health Mission Additionalities 2011- 2012
B.1. Accredited Social Health Activist (ASHA)
B.2.1. Village Health & Sanitation Committee (VHSC)
B.2.2. Untied Funds for HSCs, PHCs & CHCs
B.3. Annual Maintenance Grant (AMG)
B.4. Rogi Kalyan Samiti (RKS)
B.5. Hospital Strengthening- (Health Care Infrastructure)
B.9. Mainstreaming of AYUSH
B.10. IEC-NRHM
B.12. Referral Transport
B.14. Manpower
B.15. Innovation/PPP/NGO/EMRI
B.16. Training & Capacity Buidling
B.17. Incentive schemes
B.18. Planning Implementation & Monitoring
B.19. Procurement
B.27. Programme Management
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ACCREDITED SOCIAL HEALTH ACTIVIST (ASHA)
Accredited Social Health Activist (ASHA) is an integral part of NRHM. With the
sixth year of implementation of NRHM in the state the strategies to strengthen the ASHA
programme year after year has always been a continuous effort. The state of Meghalaya at
present has 6258 ASHAs in place.
Sl.
No. Name of the District
No. of
Villages
No. of ASHA in
position
1 East Khasi Hills District 1033 1033
2 West Khasi Hills District 1126 1015
3 Jaintia Hills District 552 552
4 Ri bhoi District 570 537
5 East Garo Hills District 952 952
6 West Garo Hills District 1617 1617
7 South Garo Hills District 552 552
Total 6402 6258
I. TRAINING
ASHAs in the state have now completed five rounds of training. The training of ASHAs
on module 1-5 has been completed during 2008-10. Reorientation training for ASHAs on module
1-5 has also been completed and 6227 ASHAs have attended the same. Training of ASHA
Facilitators & ASHAs on module 6&7 commences from January 2011.
The training of ASHAs & ASHA Facilitator in module 6&7 will equip them with skills
related to;
Maternal Health
Home based newborn care
Child Health
Nutrition
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Module8: The focus of this manual is to promote healthy life and empowering ASHA with
knowledge and skills in preventing Non-Communicable Diseases. For the State of
Meghalaya Training of ASHA on module 8 will be covered in the 1st
& 2nd
phase of the
training in module 6 &7 for District trainer, ASHA Facilitators as well as ASHAs.
Sl.
No.
Activity Unit 2010-11 Unit 2011-12 Remarks
Training load Training
load
Planned Achieved Plan
1. ASHA Training
on module 6&7
5 days
6250 On going 10
days
6258
2. Training for
ASHA
Facilitators on
module 6&7
7 days
312 On going 7 days
(3+4)
312
3. Training of
DCPC
2 days
(Half yearly)
7 7
2days
7
4. Training of BAC 2 days (Half
yearly)
39 39 - - Will be trained
by DCPC if
need arises
5. Training of
District Trainers
on ASHA
Module 6&7
10 days 70 70 (8+7)
days
70
II. MEETINGS
For better support and assistance to the ASHA‟s in the field, orientation and meetings at
every level and on a regular basis have been conducted. Complimenting the best performing
ASHA on their performance every month has also been one of the initiatives taken up by some
districts and blocks in the state.
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Sl.
No.
Activity Unit 2010-11 Unit 2011-12 Remarks
Planned Achieved Plan
1. Meeting of
ASHAs at the
Sub centre
404
12 9 (April-
Jan 2011)
405
6 Discussions on current
health situations/
planning of VHND,
VHSC meeting
etc/evaluating
performances of
ASHA for the month/
making payments due
to ASHAs/ data on
Drug kit.
2. Meetings of AF
at the district
7 6 6 7 4 Evaluating the
performance of AF as
well as ASHAs/
evolving strategies &
plans for improving the
performance of AF
&ASHAs/ Submitting
& collecting Dues to
ASHAs
3. State level
meeting of
DCPC
1
4 2 1 2 Evaluating the
Performance of the
District/ evolving
strategies & plans for
improving the
performance of AF
&ASHAs etc
4. State level AMG
meeting
1 4 2 1 4
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The State ASHA Resource Centre (ARC) has been setup and is undertaking the task of
supporting & strengthening the ASHA programme in the state. To ensure better support and
supervision, 7nos District Community Process Coordinators (DCPCs) and 39 Block Programme
Managers cum Block ASHA Coordinators have been inducted into the programme.
Also in order to motivate and enable the ASHA to better their performance every trained
ASHA in the State have been provided with Drug Kit, Uniform, Bag, Diary and raincoats. Also
the Village Health and sanitation committee where the ASHA is a member have also been
provided with a Village Health Register.
III. SUPPORTIVE STRUCTURE
Sl.
No.
Activity Unit 2010-11 Unit 2011-12 Remarks
Planned Achieved Plan
1. Setting up of State ASHA
Resource Centre
1
1 1 1
1 SANO, SAPM &
SCPC in position
2. Setting up of State ASHA
Mentoring Group
1 1 1 1 1 5 mentors in place
Sl.
No.
Activity Unit
cost
2010-11 Unit
cost
2011-
12
Remarks
Planned Achieved Plan
1. Procurement of drug kit 937 6250 Distribution
ongoing
940
6500
2. Diaries & Module 6 &7
form register (new)
80 7000
7000 150 6800
3. Translation & printing of
Modules
80 7000 Distribution
ongoing
(Module 6)
100 6800 Module 7 & 8
to be proposed.
4. Drug kit Stock
Register(new)
- - 50 6800
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IV. HONORARIUM/INCENTIVE/SALARY
Sl.
No.
Activity Unit
(cost)
2010-11 Unit
(cost)
2011-12 Remarks
Planned Achieved Plan
1. State ASHA
Programme Manager
35,000
1 1 40,250 1
2. State Community
Process Coordinator
15,000 1 1 20,000 1
3. District Community
Process Coordinator
12,000
7 7 18,000 7
4. ASHA Facilitator 1000 312 312 1200 312
V.INCENTIVE
In order to increase the incentive earnings of an ASHA the State of Meghalaya wants to
propose incentives of Rs. 100 to the mother Rs. 50 per child to the ASHA for Accompanying &
Motivating Mothers for nutritional care of their malnourished / LBW child at the Health
institution. This would require the mother and the child to stay at the health institution for 2 days.
The mother will be taught and inform various things relating to malnutrition and how to take care
of their child who are either malnourished or LBW and how to prevent the same in future. A
separate room will also be arranged with various IEC material etc relating to Malnutrition &Low
Birth Weight Babies.
VI. SURVEY
With the 6th
year of implementation of NRHM, the state of Meghalaya would like to
conduct evaluation / survey on the effectiveness of the ASHA program in the state, benefits,
acceptance of ASHA in the community etc. The survey could be outsourced to an outside
agency. Preparations of Questionnaires for this purpose will be a joint effort of the State ASHA
Resource Center as well as the Agency to be involved for the same. This survey will be
conducted in 2-3 selected districts and will be conducted for a period of 15- 30 days.
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VII. ASHA DIVAS
The concept is designed in that manner so that all the ASHAs in the district may get
together on one stipulated place so that they can interact with one another share their
experiences, ideas and problems. On the stipulated date there will be an open meeting followed
by various programs including session on experience sharing by the ASHAs, competition for
ASHAs from various blocks, declaring and giving away prizes for best forming ASHAs from
each block, seminar on improving their performances and solving their problems, skits/ role
plays etc. dignitaries will be invited from the district (specially women/popular in that
area/district). The concept of ASHA Divas will not motivate ASHAs to better their performances
but it will also enable the State & district to draw in ideas from the ASHAs themselves on how to
further improve the Programme as a whole. Therefore, the state proposes to have at least one
ASHA Divas in each district in a year @ Rs.50000/- per ASHA Divas/ ASHA Day.
ASHA Grievance Cell
The state of Meghalaya also proposes to develop a mechanism to address all grievances
relating to payment, support mechanism etc to ASHA in the form of communication media. A
help line number will specially be assigned which will be equipped to address all quiries brought
up by the ASHAs. The ASHA from any part of the state can call up to this help line number free
of cost and answers to her question will be addressed accordingly. This activity will be
outsourced to an external agency @the cost of 20, 00,000 p.a.
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B1. Consolidated Budget for ASHA Programme
Sl.
No Activity Unit
Physical
Target
Required
Fund
under NRHM
Remarks
1 Training of ASHA in Module
6&7(5+5= 10 days) 29701640.00
2 Training of ASHA Facilitator in
Module 6&7 (3+4=7 days) 1096360.00
3 Training cum review meeting of DCPC
half yearly 40800.00
4 Training of District trainers on module
6&7 919000.00
5
Support to the ASHA MENTORING
GROUP 134400.00
6 Meeting of ASHA at sub center (bi
monthly) 487200.00
7 Quarterly district meeting of ASHA
Facilitator 138800.00
8 Procurement of Drug kit 12220000.00
9 Printing & Stationeries 2040000.00
10 Honorarium to AF 12916800.00
11 ASHA Evaluation Survey
2-3
district 300000.00
12 Salary 2235000.00
13 ASHA divas(50,000 per district) 350000.00
14 ASHA Grievance Cell
2000000.00
15
Incentive to ASHA for motivating
mothers for 2days nutritional care of
their malnourished / LBW child at the
Health institution.
Rs.50/-
per
child
Projected
under
CHILD
HEALTH
TOTAL 64580000.00
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Break up of ASHA Budget 2011-12 1.Training of ASHA on Module 6&7 (5+5) Remarks
1 TA Rs. 250 X 2 times X 6258 ASHA 3129000.00
trg of mod 8
included
2 DA Rs. 100 X 10 days X 6258 ASHA 6258000.00
3 Honorarium to RP Rs. 200 X 10 days X 2 trainers X 208
Batches 832000.00
4 Training material Rs. 80 X 6258 ASHA 500640.00
5 Food expenses Rs. 200 X 10 days X 6258 ASHA 12516000.00
6 Lodging expenses Rs. 100 X 10 days X 6258 ASHA 6258000.00
7 Misc exp Rs. 500 X 208 Batches X 2 208000.00
TOTAL 29701640.00
2.Training of AF for 7 days(3+4)
8 TA Rs. 250 X 2 times X 312 ASHA Facilitators 156000.00
trg of mod 8
included
9 DA Rs. 100 X 7 days X 312 ASHA Facilitators 218400.00
10 Honorarium to RP Rs. 200 X 7 days X 2trainers X 11Batches 30800.00
11 Training material Rs. 80 X 312 ASHA Facilitators 24960.00
12 Food expenses Rs. 200 X 7 days X 312 ASHA Facilitators 436800.00
13 Lodging expenses Rs. 100 X 7 days X 312ASHA Facilitators 218400.00
14 Misc exp Rs. 500 X 11 X Batches X 2 11000.00
TOTAL 1096360.00
3. Training of District trainers (8+7 days)
15 TA
Rs.1500 max. X 2 times X 70 District
trainers 210000.00
trg of mod 8
included
16 DA Rs. 150 X15days X 70 District trainers 157500.00
17 Honorarium to RP Rs. 250 X15 days X 3 trainers X 4 batches 45000.00
18 Training material Rs. 200 (100+100) X 70 District trainers 14000.00
19 Food expenses Rs. 250 X 15 daysX 70 District trainers 262500.00
20 Lodging expenses Rs. 200 X 15 daysX 70 District trainers 210000.00
21 Misc exp Rs. 5000 X 4 Batches 20000.00
TOTAL 919000.00
4. Meetings
22 Bi-Monthly meeting of
ASHA at the SubCentre Rs. 200 per meeting X 6 X 406 SC 487200.00
Total 487200.00
5. Printing & Stationery
23 Modules 7 & 8 100 X 6800 680000.00 ( 312+6402)
24
Diaries & Module 6 &7 Forms
(Register) 150 X 6800 1020000.00
25 Drug kit stock register 50 X 6800 340000.00
TOTAL 2040000.00
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6. Procurement of Drug kit
26
Drugkit (including eye ointment
&
GV Paint.) Rs.940 X 2 times X 6500 nos 12220000.00
7. Training cum Review Meeting of DCPC (2 days)Half Yearly
27 TA Rs. 1500 max. X 2 times X 7 21000.00
28 DA Rs. 100 X2days X 7 1400.00
29 Food expenses Rs. 200 X 2 days X 10 4000.00
30 Lodging expenses Rs. 500 X2 days X 10 10000.00
31 Misc exp Rs. 2200 X 2 times 4400.00
TOTAL 40800.00
8. Support to the ASHA Mentoring Group
32
TA for field visits by
AMG members 1 days x 6 time x 8 members X 1500 72000.00
33 Honorarium 1 days x 6 times x 8 members X 500 24000.00
34
State level quarterly meeting
( TA+ DA+ Misc) 4 times x 8 membersX1200 38400.00
TOTAL 134400.00
9. Honorarium & per day Allowances to AF
35 Honorarium Rs.1200X12X312 4492800.00
36 Per day allowances Rs. 150X12X15X312 8424000.00
TOTAL 12916800.00
10. Salary
37
State ASHA Programme
Manager 40250X 12 483000.00
38
State Community Process
Coordinator 20000 X 12 240000.00
39
District Community Process
coordinator 18000 X 12 X 7 1512000.00
TOTAL 2235000.00
11. Incentive to ASHA
40
Incentive to ASHA for
motivating mothers for 2 days
nutritional care of their
malnurished / LBW child at the
Health institution
Rs.50 per
child
To be
projected
from Child
Health
12. Survey
41 ASHA Evaluation(2-3 district) 300000.00
TOTAL 300,000.00
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13. Quarterly meeting of AF at District
42 TA/DA Rs. 100 X 4 times X 312 124800.00
43 Miscellaneous expenses Rs. 500 X 4 times X 7 districts 14000.00
44 TOTAL 138800.00
14. ASHA DIVAS
45 ASHA Divas/ ASHA Day Rs.50000 X7 districts 350000.00
TOTAL 350000.00
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B.2.1 Village Health & Sanitation Committee (VHSC)
VHSC in Meghalaya have been constituted in all the villages. In 2010-2011, only 6250 VHSCs
have been approved by GOI, based on 2001 Census. Currently, there are 6306 revenue villages. The
drawback on the other hand relating to VHSC is the problem of not receiving the UC from each
VHSC. This year it has been proposed that it is mandatory for every PHC accountant to get the UC
from each VHSC through its Treasurer.
Districts No of
villages
No of
VHSCs
East Khasi Hills 1033 1033
West Khasi Hills 1126 1126
Ri Bhoi 570 570
Jaintia Hills 422 422
East Garo Hills 952 952
West Garo Hills 1617 1617
South Garo Hills 586 586
Total 6306 6306
Budget required:
Item Unit Rate Amount
Untied Funds for VHSCs 6306 10000 63060000
Total 63060000
Training for VHSC members at District:
During the previous year, training of VHSC members has not really taken pace. Last year
district officials have undergone training in the State which was conducted in collaboration with
Public Health Foundation of India( PHFI). This District Team will conduct the training in their
respective districts for the VHSC members.
Every district will have 4 members each from each VHSC who will be trained. These members will
include:
1. President of VHSC/ Rangbah Shnong of Village
2. Secretary of VHSC/Secretary of Village
3. Anganwadi Worker (AWW)
4. Any other member of the VHSC ( school teacher/ women leaders/any influential member of the
village, etc)
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Districts No of
villages
No of VHSCs Total
members
East Khasi Hills 1033 1033 4132
West Khasi Hills 1126 1126 4504
Ri Bhoi 570 570 2280
Jaintia Hills 422 422 1688
East Garo Hills 952 952 3808
West Garo Hills 1617 1617 6468
South Garo Hills 586 586 2344
Total 6306 6306 25224
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B.2.2 Untied Funds for HSCs, PHCs, & CHCs
Untied funds have been one of the successful schemes under NRHM which has solved a lot
of problems arising at the PHCs and SC. Most of the urgent requirements of the Centres has been
able to procure and make the centre functional.
Activities Total No. Rate
(Rs.)
Total Budget
(Rs.)
Untied fund @ Rs.10,000/- per annum for all HSCs 407 10000 40700000
Untied fund @ Rs.25,000/- per annum for all PHCs 108 25000 27,00,000
Untied fund @ Rs.50,000/- per annum for all CHCs 30 50000 15,00,000
Untied fund @ Rs.25,000/- per annum for all State
Dispensaries
13 25000 3,25,000
Total 4,52,25, 000
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B.3 Annual Maintenance Grant (AMG): Annual Maintenance Grant for CHCs/PHCs
& HSCs has been of great help to the MOs and the staff working at the periphery since
there is equipments which needs urgent repair locally which needs no approval from the
state or districts. A number of equipments has been able to repair through this funds.
District wise break up of AMG
Districts RKS for DHs RKS for CHCs RKS for PHCs Total
East Khasi Hills 1 6 23 30
West Khasi Hills 1 5 17 23
Ri Bhoi 1 3 8 12
Jaintia Hills 1 5 17 23
East Garo Hills 1 2 16 19
West Garo Hills 1 7 18 26
South Garo Hills 0 1 7 8
Total 141
Budget:
Item Unit Rate Amount
AMG for CHCs 30 1,00,000 30,00,000
AMG for PHCs 108 50,000 54,00,000
AMG for HSCs 407 10,000 40,70,000
AMG for SDs 13 10,000 1,30,000
Total 1,26,00,000
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B. 4 Rogi Kalyan Samiti
Rogi Kalyan Samiti has been successfully formed in all the District Hospital, Community Health
Centres and Primary Health Centres. The RKS committee is looking for face lifting of the
facilities, procurement of emergency, medicine and equipments and to see that the hospitals set
up is for patient friendly environment. After the 6th
year of NRHM implementation, all RKS
committee are now active and aware of the role of the committee.
Districts RKS for DHs RKS for CHCs RKS for PHCs Total
East Khasi Hills 3 7 23 30
West Khasi Hills 2 5 17 23
Ri Bhoi 1 3 8 12
Jaintia Hills 1 5 18 23
East Garo Hills 1 2 16 19
West Garo Hills 2 7 18 26
South Garo Hills 0 1 8 8
Total 148
Item Unit Rate Amount
RKS for DHs 10 5,00,000 50,00,000
RKS for CHCs 30 1,00,000 30,00,000
RKS for PHCs 108 1,00,000 1,08,00,000
Total 1,88,00,000
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RKS Training:
During the previous year, training of RKS members has not really taken pace. Last year district
officials have undergone training in the State which was conducted in collaboration with Public
Health Foundation of India (PHFI). This District Team will conduct the training in their
respective districts for the RKS members.
Every district will have 4 members from each RKS who will be trained. These members will
include:
1. Members from the community
2. Member representative of the Health Facility
3. Any other member of the RKS ( school teacher/ women leader/any influential member of
the village, etc)
Districts RKS for DHs, CHCs,
PHCs
RKS Members
East Khasi Hills 30 120
West Khasi Hills 23 92
Ri Bhoi 12 48
Jaintia Hills 23 92
East Garo Hills 19 76
West Garo Hills 26 104
South Garo Hills 8 32
Total 141 564
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B.5. Hospital Strengthening-(Health Care Infrastructure)
1. Civil Construction
Civil works has been one of the activities under NRHM which has helped the State Government
for new construction of District Hospital, upgradation of CHCs into IPHS, MO Quarters in both
the CHCs and PHCs. It also under takes construction of new PHCs, Quarters for GNM and
creating new Sub Centres. Additional quarter for ANM in the Sub Centre has also been
constructed. The required civil work for the year 2011-12 has been projected in the table below:
A. Construction under SHCs.
Budget:
Sl.No Activity Unit Rate Total
Amount
1 Construction of New Health Sub Centre 20 15,00,000 3,00,00,000
2 Construction of Additional Quarters 102 3,50,000 3,57,00,000
3 Repair of Health Sub Centre 50 2,50,000 1,25,00,000
4. Upgradation of SC to MCH Level 1 maternity ward 69 2,00,000 1,38,00,000
Total 9,20,00,000
B. Construction under PHCs.
Sl.No Activity Un
it Rate
Total
Amount
1 Construction of New PHC at Byrnihat 1 1,00,00,000 1,00,00,000
2 Up gradation of Rynjah SD into PHC & and
extension of Pomlum PHC
2 50,00,000 1,00,00,000
3 Construction of MO‟s Quarters 20 10,00,000 2,00,00,000
4 Construction of GNM‟s Quarters 40 8,00,000 3,20,00,000
5 Major Repair of PHCs 8 20,00,000 1,60,00,000
6 Rain Water Harvesting 6 5,00,000 30,00,000
Total 9,10,00,000
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C. Construction under CHCs.
Sl.No Activity Unit Rate Total
Amount
1 Up gradation of CHC Building at Sohra and
Phulbari
2 1,00,00,000 2,00,00,000
2 Construction of Specialist Quarters 16 10,00,000 1,60,00,000
3 Construction of GNM‟s Quarters at CHCs 6 8,00,000 48,00,000
4 Upgradation of Mawkyrwat CHC into FRU 1 30,00,000 30,00,000
5 Improvement and Upgradation of Mawsynram
CHC
1 1,00,00,000 1,00,00,000
Total 5,38,00,000
D. Construction under DHs.
Sl.No Activity Unit Rate Total
Amount
1 Extension of Ganesh Das Hospital (MCH
Hospital) for 2nd
& 3rd
Floor
1 6,00,00,000 6,00,00,000
Total 6,00,00,000
E. Strengthening of District Hospitals
Sl.No Activity Unit Rate Total
Amount
1 Accountants – District Hospital 10 15000 15,00,000
2 Public Health Managers 10 20000 20,00,000
Total 35,00,000
F. Construction under SHS.
Sl.No Activity Unit Rate Total
Amount
1 Construction of Computer Laboratory at the
existing State Health & Family Welfare Training
Centre
1 24,000,000 24,00,000
Total 24,00,000
GRAND TOTAL Hospital Strengthening: (A+B+C+D+E+F) = Rs. 3,02,7,00,000 /-
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B.9. Mainstreaming of AYUSH
1. To appoint 14 AYUSH Doctors in PHCs/CHCs (7 Homoeo & 7 Ayur).
2. To appoint 14 AYUSH Multi-Purpose Health Workers in PHCs/CHCs.
3. To appoint 14 AYUSH Pharmacists (7 Homoeo & & Ayur) in PHCs/CHCs.
BUDGET FOR THE YEAR 2011-2012 FOR MANPOWER UNDER AYUSH NRHM.
Sl.
No
Activity Unit Rate (Rs.) Total Amount
1. Salary of Existing AYUSH MO‟s 65 x 12 30,000 2,34,00,000
2. Salary of New Proposed AYUSH MO‟s 14 x 12 25,000 42,00,000
3. Salary of AYUSH Multi-Purpose Health
Workers
79 x 12 8,000 75,84,000
4. Salary of Pharmacist 79 x 12 12,000 1,13,76,000
Total Budget 4,65,60,000
Rupees (Four Crore Sixty Five Lakhs Sixty Thousand) only.
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B.10. IEC-NRHM
1. HEALTH MELA
Health Melas is one of the activities which enable the Health Care system to reach the un-
reached and far flung areas. It aim at providing quality services, with converging and integrated
delivery of services for all segments of population. With the passage of time the involvement of
the community becomes more pro active. ASHAs are also engaged in the two days melas which
also build up the confidence of these grass root level workers. Thousands of people throng to the
Mela to avail specialized care.
Though the total no of Health Melas is 7 one for each districts, but the state has divided the
money into 2 health melas per districts with an amount of 2.5 lakhs. This year out of 14 health
melas 12 health melas has been completed and the rest will be completed by march 2011. This
year we have enhance the amount to 6 lakhs ( i.e 3 lakhs per health mela. The response of the
public in these health melas are very encouraging and the activity needs to be continued.
Synergy between Government, elected local bodies, NGOs and professional organizations has
already taken place .
Budget:
Activities Total No. Rate(Rs.) Total Budget(Rs.)
Health Mela 7 600000 42,00,000
Total for 2011-12 42,00,000
2. Mobile Medical Units:
MMU helps the system to strengthened and provide basic health and RCH services in remote and
difficult areas. It also operates Mobile Medical Units in the district for improved access to health
care services. To ensure health care services available in underserved areas.
State specific requirement of MMUs needs to be assessed realistically. However the efficacy of
the MMUs depend on the output being delivered by MMUs in terms of performance.
The State through the district heads will undertake the stringent monitoring and supervision to
ensure that the following parameters are being conducted regularly e.g a)Frequency of Visit
b)Following of Schedule c) Advance Intimation of Schedule d) Duration of Stay and Timing of
MMU e)Doctors accompanying f)Availability of Medicine g)Cured of illness in last visit
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h)People satisfaction about skill and behavior i)Location of MMU j)Average distance travelled
to MMU k)average time taken per patient l)Availability of diagnostics m)Follow up of Patients,
The Staff Position of MMU
Sl.NO Position Sanction Position
1 Medical Officer 7 7
2 STAFF NURSE 14 14
3 RADIOGRAPHER 7 7
4 LABTECHNICIAN 7 7
5 HELPER 7 7
6 DRIVER 21 21
BUDGET FOR MOBILE MEDICAL UNIT (2010-11)
Sl.
No Activity Unit Quantity
Rate
(Rs)
Total
Amount
Rs.
1 Salary to MOs 7 12 28750 2415000.00
2 Salary to Staff Nurse 14 12 13800 2318400.00
3 Salary to Technician 14 12 10350 1738800.00
4 Salary to Driver 21 12 8050 2028600.00
5 Salary to Helper 7 12 8050 676200.00
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6 Maintenance of vehicle 21 12 8000 20,16,000
7 Maintenance of equipment 7 12 5000 4,20,000
8 Incidental /Contingency 7 12 10000 8,40,000
9
Travel expenditure @ Rs. 20000 for
payment of daily allowances, staying and
food allowances
7 12 20000 16,80,000
10 POL 7 12 35000 29,40,000
11 Formats and Stationery 7 12 5000 4,20,000
Total 1,74,93,000
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B.12. Referral Transport
For referral services, ambulances have to be procured. The procurement will be done in a
phased manner. 15 ambulances were approved during 2010-11, and all these ambulances have
been procured and sent to district in September 2010 To strengthen functions of Primary Health
Centre working 24x7 another 15 Ambulances is required for 2011-12 as per the budget below:
Activities Total No. Rate (Rs.) Total Budget (Rs.)
Procurement of Ambulances four wheel drive.
6-seater
10 6,60,000 66,00,000
Procurement of Ambulances. 10-seater 8 6,90,000 55,20,000
Total for 2011-12 1,21,20,000
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B.14. Manpower
Under NRHM, Officers and staff has been recruited at different levels. Their presence
has been a great support for the state both at the programme management and as well as in the
technical point of views. The state are not increasing the HR this year under the Programme
Management but a number of Technical Staff needs to be inducted in the system.
Additional Contractual Staff - Mission Flexible Pool
FMR
Code Designation Unit
Current
Salary pm
Proposed
pm
Annual
Budget Remarks
B.1 ASHA
ASHA Resource
Centre
B.1.4 District Community
Process Coordinator 7 12000.00 18000.00
Budgeted in
ASHA (B.1.4)
B.1.4 ASHA Facilitator 312 1000 1200.00
Budgeted in
ASHA (B.1.4)
B.1.4 ASHA Programme
Manager 1 35000.00 40250.00
Budgeted in
ASHA (B.1.4)
B.1.4 State Community
Process Coordinator 1 15000.00 20000.00
Budgeted in
ASHA (B.1.4)
B.11
MOBILE
MEDICAL UNIT
B.11 Medical Officer 7 25000.00 28750.00
Budgeted in
Mobile Medical
Unit (B.11)
B.11 Staff Nurse 14 12000.00 13800.00
Budgeted in
Mobile Medical
Unit (B.11)
B.11 Technician 14 9000.00 10350.00
Budgeted in
Mobile Medical
Unit (B.11)
B.11 Driver 21 7000.00 8050.00
Budgeted in
Mobile Medical
Unit (B.11)
B.11 Helper 7 7000.00 8050.00
Budgeted in
Mobile Medical
Unit (B.11)
B.14
ADDITIONAL CONTRACTUAL STAFF (Selection,
Training, Remuneration)
B.14.1 GNM 53
12000.00 13800.00 8776800.00
B.14.1 PHN for 10 CHCs 10
10000.00 11500.00 1380000.00
B.14.1 Addl 3 SN/GNM for
25 CHCs 75
12000.00 13800.00 12420000.00
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26
B.14.2 ANMs 369
8000.00 9200.00 40737600.00
B.14.3 PHN for IPHS PHCs
@ Rs. 13000 pm 26
13000.00 14950.00 4664400.00
B.14.4
AYUSH Medical
Officers - Recruited
before 2010-11
50 22000.00 30000.00 18000000.00
B.14.4 AYUSH HEALTH
WORKER 50
8000.00 8000.00 4800000.00
B.14.4
AYUSH Medical
Officers - Recruited in
2010-11
15 20000.00 25000.00 4500000.00
B.14.4
AYUSH Medical
Officers – New
Proposal
14 20000.00
25000.00 4200000.00
B.14.4
AYUSH HEALTH
WORKER – New
Proposal
19 8000.00
8000.00 1824000.00
B.14.6 Obstretician &
Gyneacologist 5
50000.00 57500.00 3450000.00
B.14.6 Anaethetist 5
50000.00 57500.00 3450000.00
B.14.6 Paediatrician 5
50000.00 57500.00 3450000.00
B.14.7 Epidemiologist 1
40000.00 46000.00 552000.00
B.14.7 Microbiologist 1
40000.00 46000.00 552000.00
Grand Total
112756800.00
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27
B.15 Innovation/PPP/EMRI
PPP for Operationalization of „C‟ Category PHCs/CHCs
The shortage of doctors and qualified skilled manpower, particularly in certain remote PHCs and
CHCs, has adversely affect the overall “Health Care Delivery Service” of the people living in
these difficult and backward areas of the state. As a result, the public health indices have not
improved; despite the best efforts from the government. In order to ease the situation, the
Government of Meghalaya (GoM) has decided to involve experienced, resourceful and
committed Voluntary Agencies/ NGOs (Partnership Agencies); in the management and
functioning of these PHCs and CHCs on a Public Private Partnership model, as a pilot project
During the process, the respective District Medical and Health Officer were requested to identify
and submit a list of remote and difficult PHCs/CHCs along with the numbers and names of the
Sub-Centers, which were evaluated by the Directorate of Health Services and a final list of 29
PHCs, Sub Centres and CHCs; was prepared; based on many aspects of logistic difficulties and
operational limitations; with the objective of involving NGOs / Voluntary Organization in the
Management.
Terms of reference in the management of CHC/PHC including the respective sub centres by the
agency. The GoM will provide the requisite infrastructure, building, equipments, medicines; etc;
including maintenance thereof, the PPP partners will provide complete manpower of qualified
doctors, nurses and other skilled staff. The agency will ensure 24x7 services and other facilities
as per the optimum facilities as expected in a PHC and CHC. The overall functioning will be
supervised and monitored by DM&HO. All other GOI health schemes and other state health
programmes will be implemented as before.
Out of the 29 CHCs/PHCs & State Dispensary earmarked for handing over to NGOs only 2
CHCs,19 PHCs and 1 St. Dispensary has been handed over since February 2009. The building
and physical infrastructure of the PHC(s) and CHC(s) to the Agency along with the existing
equipment, furniture, etc and an inventory of the same would be made jointly by the State
Government and the Agency.
The agency shall provide all the Health/Medical/Family Welfare Services, curative, preventive
and promotive, as are normally expected from any Primary Health Centre/Community Health
Centre, to the local population residing in the geographical area under the jurisdiction of the said
PHC(s)/CHC(s).The agency will engage its own Medical/ Paramedical and other staff for
providing these services and will ensure that these personnel are always available at the pre-
decided timings.
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28
Financial implication and budgetary provisions
The financial implications quoted by the respective PPP partners ranges an average of Rs 2 lacs
for a PHC per month, every additional Sub Centre ranges from Rs 15000 to 20000; depending
upon the logistics, nature and spread of villages; and for the CHCs, it ranges from Rs 3.5 to 4.5
laks per months.
The Status of Implementation
The following list of NGOs, against which, the names and number of CHCs, PHCs and Sub
Centres are indicated:
North East Society for promotion of youth and masses (NESPYM), Guwahati, Assam
Sl. District Selected PHC/CHC Total Selected SC
1. West Khasi
Hills
Aradonga PHC @ 293500 x 12 35,22,000 1) Malangdona
2) Tyngor
3) Maweit
4) Khongjong
2.
Ri-Bhoi
Warmawsaw PHC @ 200500 x
12
24,06,000
Jirang State Dispensary@
118,500 x 12
14,22,000
Total Rs.73,50,000/-
Karuna Trust, Bangalore
Sl. District Selected PHC/CHC Total Selected SC
1.
East Khasi
Hills
1) Mawsahew PHC @228366 x 12 27,40,400 1) Wahkaliar
2) Mawphu
3) Rumnong
3) Mawlong PHC@200000x12 24,00,000
2. Ri-Bhoi 4) Umtrai PHC @201366x12 24,16,400 1) Umlaper
Total Rs. 75,56,800/-
Page 29
29
Citizens Foundation, 7, Betar Kendra, Niwaranpur, Ranchi-2, Jharkhand.
Sl.
No.
District Selected PHC/CHC Total Selected SC
1. West Khasi
Hills
Nongkhlaw CHC@418000x12 50,16,000 1) Mawkarah
2)Dongki-
ingding
3) Umpdem
Ichamati CHC @400000x12 48,00,000 1) Majai
Kynrud PHC @238000x12 28,56,000 Jakhong
Maweit PHC @218000x12 26,16,000 NIL
Myriaw PHC @218000x12 26,16,000 NIL
Khonjoy PHC@218000x12 26,16,000 All HSCs
Shallang @258000 x12 30,96,000 All HSCs
Nonglang@258000 x12 30,96,000 All HSCs
Total Rs. 2,67,12,000/-
Akhil Bhartiya Kishan Kalyan Samiti, New Delhi
Sl. District Selected PHC/CHC Total Selected Sub
Centre
1.
Jaintia Hills
Saipung PHC @240000x12 28,80,000 1) Shnongrim
2) Ryngkoh
3) Thuruk(NF)
4) Moul Sei
5) Saipung
Page 30
30
Umkiang PHC@225000x12 27,00,000 1) Rata Cherra
2) Huroi
3) Sunapur
4) Umkiang
Total Rs. 55,80,000/-
BAKDIL, Lower Chandmari, Tura, Meghalaya
Sl. District Selected PHC/CHC Total Selected Sub Centre
1. East Garo
Hills
Gabil PHC @234000x12 28,08,000 1) Lower Sambrak
Wageasi @252000x12 30,24,000 2) Lower Chima
Impel
3) Gambil A Pal
2. West Garo
Hills
Salmanpara PHC @247000x12 29,64,000 1) Salmanpara
2) Anagpara
Pedaldoba PHC @252000x12 30,24,000 1) Pedaldoba
2) Naguapara
3) Belguri
Babadam PHC @243000x12 29,16,000 1) Chedekgre
2) Boldakgre
3) Badadam
4) Dabakgre
3. South Garo
Hills
Siju PHC @236000x12 28,32,000 1) Rongsu Agal
Nangalbibra PHC
@247000x12
29,64,000 1) Rongsa Awe
Total Rs.2,05,32,000/-
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31
Voluntary Health Association of Meghalaya, Shillong
Sl. District Selected PHC/CHC Total Selected Sub Centre
1.
East Khasi
Hills
Jatah @205000x12 24,60,000 Nohrun
Balat @205000x12 24,60,000 Sonatola
Total Rs.49,20,000/-
Jaintia Hills Development Society, Jowai, Meghalaya
Sl. District Selected PHC/CHC Selected Sub
Centre
1.
.
Jaintia
Hills
Barato PHC @222833x12 26,74,000 Shyliang-Myntang
Thadbamon
Thangrain
Mukroh
Sahsniang PHC @189333x12 22,71,966 Nil
Total Rs. 49,45,966/-
Total amount requested is Rs. 7, 75, 96,766 /-
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32
PPP/NGOs- FMR Code- B.14
Code Activity Unit Cost Physical target Required fund from
NRHM
B14.5 Diet Facility for
PHC/CHC run by
NGO (PPP)
Rs. 60 per day
Breakfast= Rs.
10
Lunch= Rs. 25
Dinner= Rs. 25
21 PHCs/CHCs*
Rs.60 per day
Rs. 16,93,440 per
annum
15 day Evaluation
team to evaluate
the physical
achievements of
PHCs/CHCs
(PPP)(outsourced)
15days=
Rs. 1, 00,000
Evaluation on
performance of
health institutions
handed/taken over
by NGOs.
Rs. 1, 00, 000/-
Total Rs. 17, 93, 440/-
The Government of Meghalaya has entered into MoU with the PAs, during the month of
November – December 2008, on different dates, with the general agreement that; these PHCs
and CHCs will be jointly inspected before being handed over to them and pursued to make it
operational by the February 2009 onwards, under the agreed terms and conditions.
Since 3 years have passed since the inception of the PPP model it is required that a third party for
auditing and evaluation be done to see the achievement- physical and financial, of these NGOs
(PPP). While a third party has been carried out for financial auditing, a third party for evaluating
their physical performance is yet to be rolled out.
Budget:
Out of Rs. 7, 93, 90, 206/- which is total cost for the PHC/CHC running cost for the above
SHC/PHC/CHC in the state of Meghalaya, the state Government of Meghalaya will fund Rs. 5,
95, 42,655/- as part of regular operations of these PHC/CHC. The remaining part to be funded by
GOI which is 1, 37, 36,154/-.
Total amount requested is Rs.1, 98, 47,552/- for NGOs under PPP.
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33
Integrated Emergency Management Response Institution (EMRI)
The State of Meghalaya along with the rest of the states of North East has started the
operationalization of EMRI service w.e.f. February 2009. This service provides an integrated
emergency response service for medical, fire and police.
EMRI is a NON Profit Organization. This service has been implemented in the other
states, under the same terms and conditions of service and financial norms. Considering a
situation where emergency transport of critically ill, injured and other variety of emergency cases
are lacking mainly due to the absence of an integrated and efficient services, leading to a
substantial loss of valuables. The State Government has thereby felt the genuine need of
introducing this service in the state.
As a launch pad the State has attained 30 ambulances under the EMRI for quick and
efficient transfer and provider of medical services especially in the rural areas. But with the
growing popularity of EMRI ambulances in the state and within the public at large it has become
an essential need to increase the number of ambulances from the present 30 numbers to an
additional 24 number ambulances during the next financial year to facilitate areas that have not
attained such services. This proposal has also been included in the states supplementary plan
submitted by the State of Meghalaya through NRHM, Meghalaya addressed to Shri Amarjeet
Sinha (IAS), Joint Secretary, Government, Ministry of Health and Family Welfare dated 14th
October 2010. However the approval for the same is still pending.
The 24 new vehicles will include 6 Advance Life Support Vehicles and 18 Basic Life
Support Vehicles. This would incur Capital Expenditure for procurement, fabrication,
ventilation, defibrillators, medical equipments, insurance and registration, others. It has to be
taken into account that on procurement of the said new ambulances it would require larger and
additional infrastructural development including Call Centre Equipment, Call Centre
Infrastructure, AVLT for 54 vehicles, building of Ambulance Shelters, expansion of training
facilities, etc. In addition to the above it has also been proposed to provide for finance to
facilitate the expansion the EMRI Training Centre along with additional training equipment and
expansion of old work station.
Page 34
34
Projected Budget for the Year 2011 -12 (Inclusive of Supplementary Plan)
Particulars Quantity Unit Cost Total Budget/Remarks
Capital Expenditure:
Procurement of Ambulance:
Budget under the
Supplementary
Plan submitted on
the 14th October
2010. Awaiting
Approval.
Advanced Life Support Vehicle 6 19.67 118.02
Basic Life Support Vehicle 18 12.97 233.46
Ambulance Shelter for 54
Ambulances 54 2 108
AVLT 54 0.3 16.2
Call Centre Equipment 54.00
Call Centre Infrastructure 116.50
Expansion of Training Centre (New
Activity) 10 10.00
Training Centre Equipment (New
Activity) 5 5.00
Expansion of Old Work Station
(New Activity) 4 4.00
Total CAPEX
(A) 665.18 19.00
Operational Cost:
24 New
Ambulances
30 Existing
Ambulances Budget/Remarks
Salaries 198.38 247.97 446.35 446.35
Ambulance Running Cost 136.96 171.21 308.17 308.17
Other Cost Excluding Management
Cost 78.56 98.19 176.75 176.75
Total OPEX
(B) 413.90 517.37 931.27 931.27
Total Budget for EMRI (A+B) 1596.45 950.27
In the financial year 2010 – 11 the 30 existing ambulances operational under the
EMRI, the Government of Meghalaya had borne 60% of the operational cost and 40% was borne
by NRHM, GOI. Thus the contribution rate for the next financial year 2011 -12 will be 80%
borne by GOM and 20% by GOI. On the other hand considering the fact that approval for the
procurement of the 24 new ambulances proposed in the PIP & Supplementary Plan 2010-11 is
still pending, EMRI has stalled the procurement. However, this is proposed to be done by end of
Financial Year 2010-11. Thereby the operational cost for the new vehicles has not yet been
incurred. Keeping this in mind, it is proposed that the contribution ration of the present financial
year 2010 – 11 between the GOI:GOM at the rate of 60:40 will withhold in the next financial
year also i.e. 2011 - 12.
Page 35
35
Government of Meghalaya Contribution:
(Rs. In Lakhs)
Particulars Formula Amt.
40% Operational Expenditure for 24 New
Ambulance 413.90*40% 165.56
80% Operational Expenditure for 30 Existing
Ambulance 517.37*80% 413.90
Total 579.46
NRHM, Government of India Contribution:
(Rs. In Lakhs)
Particulars Formula/Remarks Amt.
60% Operational Expenditure for 24 New Ambulance 413.90*60% 248.34
20% Operational Expenditure for 30 existing
Ambulance 517.37*20%
103.47
100% CAPEX Contribution New Proposal 19.00
100% CAPEX Contribution Awaiting
Approval 646.18
Total 1016.99
Page 36
36
B.16 Training and Capacity Building
Besides the comprehensive Training plan budgeted under RCH, a number of trainings and orientation workshops needs to be
organized at the State and District Level as well and most of the time, Management staff has to go to the National Capital for such
trainings . These trainings are due to the frequent changes in the formats and guidelines.
Training Plan for 2011-2012
Training under NRHM : Besides the comprehensive Training Plan budgeted under RCH, a number of trainings and
orientation workshops needs to be organized at the State and District level as well and most of the management Staff has to go to the
National Capital for such trainings. These trainings are due to the frequent changes in the formats and guidelines.
Sl
No.
Type of
Training
activity
Category of Participants Duration Venue
Training
Load for
2011-12
No. of
Batches Budget Remarks
1.1
DTT for
Training of
ASHA
TOT for District Trainers on
module 6 & 7 8+7 days
State
headquarter 35 2
Budgeted
under ASHA
Programme
1.2
Training of
ASHA in
Module 6,7&
8
ASHA (5+5= 10
days)
1.3
Training of
ASHA
Facilitator in
Module 6&7
ASHA Facilitators (5+5=10
days)
1.4
Training cum
review
meeting of
DCPC half
yearly
DCPCs 1 day State
headquarter 10 2
2. Capacity Dy. CMOs, Sr MOs & MS, MOs
IIM, Shillong 200 9 4950000.00 Budgeted
Page 37
37
Building* Under
NRHM flexi
pool
3.
Community
Monitoring
State level
workshop
SAGCA, Nodal NGO
1day
State
headquarter 25 1
Budgeted
Under
Community
Monitoring
4. 1 Orientation District Mentoring Team 4 days State
headquarter 20 1
4.2 TOT for District Nodal NGO 4 days State Level 20 1
4.3 TOT for Block Facilitators 4 days District Level 20 1
4.4 Training for Block Nodal NGO 4 days District Level 15 1
5.
Orientation
Training on
VHSC
President of VHSC/ Rangbah
Shnong of Village, Secretary of
VHSC/Secretary of Village,
Anganwadi Worker (AWW), Any
other member of the VHSC (
school teacher/ women
leaders/any influential member of
the village, etc)
1 day Block level 25224 As per
district 8264400.00
Budgeted
Under
NRHM flexi
pool
6.
Orientation
Training on
RKS
3. RKS members, 2 Members from
the community, Member
representative of the Health
Facility, Any other member of the
RKS ( school teacher/ women
leader/any influential member of
the village, etc)
1 day Block level 564 As per
district 206400.00
Budgeted
Under
NRHM flexi
pool
7. Orientation of District Planning & Monitoring
Committee members 4days State Level 20
111150.00
Budgeted
Under
Page 38
38
8. Orientation
of
Block/ Village Planning &
monitoring Commmittee Members 4 Days District level 20
Community
Monitoring
9. Orientation of
CHC/PHC Planning & monitoring
Team Members 4 Days District Level 20
10.1 Capacity
Building SPMU staff
Management
Staff
State level
Budgeted
Under
NRHM flexi
pool
Finance Division
HMIS
IEC
ASHA
10.2 Capacity
Building DPMU Staff
Management
Staff
District level
Finance Division
HMIS
IEC
ASHA
10.3 Capacity
Building BPMU staff
Management
Staff
District level
Finance Division
HMIS
IEC
ASHA
11.1
PHFI
Training on
Using
management
tools for
improving
district health
services
Medical Officers, DPMUs 3 days Shillong/ Any
other place 25 2 282368.00 Budgeted
Under
NRHM flexi
pool
11.2 PHFI
Training on
Deputy CMOs, SMOs, Medical
Officers, DPMUs 5 days
Shillong/ Any
other place 25 1 194900.00
Page 39
39
Public Health
Management
11.3
PHFI
Training on
Public Health
Emergency
and Disaster
Management
SMOs / Deputy SMOs/
Administrators/ Medical
Superintendents and registrars
3 days Shillong/ Any
other place 25 2 282368.00
11.4
PHFI
Training on
Report
Writing
Consultants to Disease control
programmes, Medical Officers at
State and District Directorates
5 days Shillong/ Any
other place 25 2 389800.00
11.5
PHFI
Training on
Training of
ASHA
coordinators
ASHA coordinators (including
PHE) 5
Shillong/ Any
other place 25 4 779600.00
PHFI Training (all trainings total budget)( Annexure A+ Annexure C) 6717036.00
12.1
HMIS
Training :
Hands-on
training on
HMIS
application
DPMU & BPMU Staff 2 days State
Headquarter 110 4
Budgeted
Under HMIS
12.2 HMIS
DPMU & BPMU Staff 2 days State
Headquarter 110 4
Page 40
40
Training
(MCTS):
Hands-on
training on
MCTS
application
12.3
HMIS
Training
(MCTS) :On
MCTS
Formats
ASHA/Link Workers for
Household surveys 2 days Block level 6250
As per
block 3831000.00
12.4
HMIS
Training
(PROMIS):
3rd
Round
Training
Management
Development
Programme
on
Procurement
Management
Information
System
(ProMIS)
Nodal Officers, Logistics
Manager, Store Keepers
(UIP,RCH,RNTCP,Malaria,MCH)
and SPMU Officials/Staff
2 days Shillong 80 State
level 803000.00
Page 41
41
12.5
HMIS
Training
(PROMIS):
Orientation
Workshop on
State
Procurement
Information
System
(SProMIS)
Store Keeper, Assistant Store
Keeper, DEO, SPMU Staff 2 days
State
Headquarter
80
State
level
1039000.00
12.6
HMIS
Training
(PROMIS):
Workshop on
Warehouse
Information
System on
SProMIS
for 4 Districts
(EKH,WKH,JH,RB) 2 days Shillong
30
District
level
12.7
HMIS
Training
(PROMIS):
Workshop on
Warehouse
Information
System on
SProMIS
for remaining 3 Districts
(EGH,WGH,SGH) 2 days Tura 20
District
level
12.8
HMIS
Training on
GIS: Hands-DPMU & BPMU Staff 3 days
State
Headquarter 110 4 6759000.00
Page 42
42
on training
on GIS
application
13
Induction
Training cum
Workshop on
IEC/BCC
DPM, DCPC, DAM 4 days State
Headquarter 21 1 Budgeted
under
IEC/BCC
* It was felt that most Medical Officers and Doctors in charge of the PHCs, CHCs, and other health facilities lack management
skills and therefore needed training and orientation in Management , Finance and Administration. For this, it was felt that IIM,
Shillong would be best suited to impart the training. The training would be conducted in the IIM Campus itself for one month duration
and would include these three topics - Management , Finance and Administration. The participants would include all Additional DM
& HOs, Senior Medical Officers, Doctors and Medical Superintendents identified from the 7 district. A total of 200 doctors would be
trained within this year and this could be continued if need arises in the following years.
Total for Trainings Budgeted under NRHM Flexi Pool = Rs 2, 21, 16,872/-
Page 43
43
ANNEXURE A
TRAINING PLAN FOR THE PERIOD OF APRIL 2011 TO MARCH 2012 UNDER DEPARTMENT OF HEALTH AND
FAMILY WELFARE BY PHFI
S.No Type of Training Type of participants Venue
No.
of
days
No of Batches
(paricipant per
batch)
Cost of
training
per batch
(in Rs)
Total Cost
for all
batches (in
Rs)
1
Using management
tools for improving
district health
services
Medical Officers, DPMUs
Shillong/
Any other
place
3 2 (25) 141184 282368
2 Public Health
Management
Deputy CMOs, SMOs,
Medical Officers, DPMUs
Shillong/
Any other
place
5 1(25) 194900 194900
3
Public Health
Emergency and
Disaster
Management
SMOs / Deputy SMOs/
Administrators/ Medical
Superintendents and
registrars
Shillong/
Any other
place
3 2 (25) 141184 282368
4 Report Writing
Consultants to Disease
control programmes,
Medical Officers at State
and District Directorates
Shillong/
Any other
place 5 2(25) 194900 389800
5 Training of ASHA
coordinators
ASHA coordinators
(including PHE)
Shillong/
Any other
place
5 4 (25) 194900 779600
Total (Rs) 11 (275) 1929036
NOTE:
1. Types of Trainings tabulated are some of the suggested topics. In addition to the proposal mentioned above,
the Government may suggest topics of specific interest and relevance to the State of Meghalaya. In accordance
to the services sought, separate costing would be provided.
2. Tha above costs include the training fees, PHFI overhead expenses, training material, provision of working
lunch and tea during the training sessions.
3. This current proposal assumes that the training facilities will be provided by the State Governement of
Meghalaya and hence, does not include those costing heads.
4. Cost of accommodation, local travel, air travel and airport transfer, meals of faculty have been excluded in
this proposal as the necessary arrangements will be made by the State Government as undertaken for training
during financial year 2010-2011.
5. Any other personnel proposed by the Department of Health and Family Welfare and allied departments may
be also nominated.
6. Explanatory note giving cost breakdown for 3 & 5 days training is attached as Annexure B.
Page 44
44
The State Govt is requested to budget the following costs for the entire short term training
schedule for the year 2011-2012:
1. Air travel and airport transfers of the 5 faculties from their locations in Delhi to
Meghalaya.
2. Accommodation of 5 faculties in Shillong inclusive a night before and after training
session.
3. Local transport cost within Meghalaya
4. Per Diem, TA,DA, accommodation, breakfast and dinner for participant
ANNEXURE B
EXPLANATORY NOTE ON BREAKDOWN COST FOR 3 & 5 DAYS TRAINING
THREE DAY TRAINING (for a batch of 25 participants)
S.NO HEADS AMOUNT (INR)
1 Training cost per participant@ ` 4000 for 25
participants
100000
2 Per Diem of 4 Faculties@ `1400 per head for
5 days
28000
Subtotal 128000
3 Service Tax @10.3% 13184
Total Cost 141184
FIVE DAY TRAINING COST (for a batch of 25 participants)
S.NO HEADS AMOUNT (INR)
1 Training cost per participant @ `5500 for 25
participants
137500
2 Per Diem of 4 Faculties@ `1400 per head for
7 days
39200
Subtotal 176700
3 Service Tax @10.3% 18200
Total Cost 194900
Page 45
45
The PHFI responsibilities include:
1. Fully furnished training complex in the allotted building in financial year 2011-2012,
hence, the Government need not contract for furniture and furnishing. PHFI will bear the
cost of furnishing the training complex
2. With reference to discussions in financial year 2010-2011, the training complex allotted
to PHFI requires minor renovation. The details of these renovations will be forwarded to
Director, Health Services, Engineering Department, Govt of Meghalaya.
3. PHFI will provide working lunch, tea and training kit for all participants and faculties
during the short term training programmes.
ANNEXURE C
State Budget for PHFI Training:
PHFI Budget for the State Sl
No. Item Unit Amount Total
1
Air Tickets for 5 resource persons (5
trainings) 25 6000 150000.00
2
Taxi fare for (to and fro) from Airport
-locations in Delhi 25 1000 25000.00
3
Accomodation+food (breakfast&
dinner) for 25 resource persons (+ 2
days)@ Rs 1500/person/day 25x 31 days 1500 1162500.00
4
Travelling within Meghalaya @Rs
500/day 31 days 500 15500.00
5
Food for participants @ Rs
200/participant/day 275 participants x 21 days 200 1155000.00
6
Accomodation for participants @Rs
200/participant/day 275 participants x 21 days 200 1155000.00
7 TA for participants 11 batches 100000 1100000.00
8 Miscellaneous @ Rs 5000/training 5 trainings 5000 25000.00
Total 4788000.00
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46
3. Funding for Impact assessment of NRHM and assessment of various
components
Budget for One Day Orientation Training on VHSC for VHSC members
Districts No of
VHSCs
Total
members
(4 from
each
VHSC)
Number of
Trainings
at
40/batch
TA/DA
@ Rs
150/head
Fooding
@ Rs
100/head
Reading
Material
&
Stationery
@ Rs 100/
head
Honorarium
for 2
resource
person @
Rs 200/
head/
session
Total
East
Khasi
Hills
1033 4132 103
619800 413200 413200 41200 1487400
West
Khasi
Hills
1126 4504 112
675600 42800 42800 44800 806000
Ri Bhoi 570 2280 57 342000 228000 228000 22800 820800
Jaintia
Hills
422 1688 42
253200 168800 168800 16800 607600
East
Garo
Hills
952 3808 95
571200 380800 380800 38000 1370800
West
Garo
Hills
1617 6468 161
970200 646800 646800 64400 2328200
South
Garo
Hills
586 2344 58
351600 234400 234400 23200 843600
Total 8264400
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47
Budget fo One Day orientation Training on RKS for RKS members (DHs, CHCs, PHCs)
Districts RKS for
DHs,
CHCs,
PHCs
RKS
Members
Number of
Trainings
at
20/batch
TA/DA
@ Rs
150/head
Fooding
@ Rs
100/head
Reading
Material
&
Stationer
y @ Rs
100/
head
Honorariu
m for 2
resource
person @
Rs 200/
head/
session
Total
East
Khasi
Hills
30 120
6 18000 12000 12000 2400 44400
West
Khasi
Hills
23 92
4 13800 9200 9200 1600 33800
Ri Bhoi 12 48 2 7200 4800 4800 800 17600
Jaintia
Hills
23 92
4 13800 9200 9200 1600 33800
East Garo
Hills
19 76
3 11400 7600 7600 1200 27800
West
Garo
Hills
26 104
5 15600 10400 10400 1000 37400
South
Garo
Hills
8 32
1 4800 3200 3200 400 11600
Total 206400
Grand Total: Rs 30587672 /-
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48
An initiative of EAC, Indian Institute of Management (IIM), Shillong
IIM SHILLONG PROGRAM FOR THE STAKEHOLDERS OF GOVT.HOSPITAL IN
MEGHALAYA
SUSTAINABLE HOSPITAL CARE MANAGEMENT
(SHCM)
A PROPOSAL SUBMITTED TO GOVT.OF MEGALAYA
An initiative of EAC, Indian Institute of Management (IIM), Shillong
IIM SHILLONG PROGRAM FOR THE STAKEHOLDERS OF GOVT.HOSPITAL IN
MEGHALAYA
SUSTAINABLE HOSPITAL CARE MANAGEMENT (SHCM)
Indian Institute Management Shillong (IIMS) in association with Govt.of Meghalaya is
proposed to offer practice oriented Management development courses for the stakeholders of
healthcare sector in the state under the title SUSTAINABLE HOSPITAL CARE
MANAGEMENT (SHCM).
We ideally would like to seek the sponsorship for 500 participants for the proposed
programme in SHRM over a period of 2 years through a sponsored group of 20 to 25 participants
on a regular basis, from June 1, 2011 onwards for a period of 30 days.
Program-- SUSTAINABLE HOSPITAL CARE MANAGEMENT (SHCM)
First of Its kind in the country, EAC of IIM-S announced its seventh programme in
SHCM from June 01, 2011. The focus of this course is to provide detailed information on the
SHCM model with a view to take care of people/society, patients, para-medical staff, process,
procedures, administration for undertaking better care management in the healthcare sector in
Meghalaya.
Page 49
49
Brief content:
Integrated Hospital management- Better care management-motivation-leadership-team
building-planning- finance-cash flows-fund flow-accounts-IT management techniques- use of IT
tools in patient care and general administration- Case studies.
Module-1 Understanding the basic Concepts- - benefits- sustainable SHCM plans-
Leading SHCM best practices -Case studies.
Module-2 Rediscovering SHCM - Sustainable hospital administration- diagnostic cum
patient care activities-sustainability as business cum service model- Case studies.
Module-3 Building socially/environmentally centric SHCM teams and organization-
SHCM hardware and software-case studies- SHCM vision, mission, goal and strategies for ideal
PHCs and hospitals in the 21st century-Case studies.
Module-4 Passion for finance in SHCM - understanding the accounting transactions, trail
balance, balances sheet, fund flow and cash money flows and audit -case studies.
Module-5 Learning SHCM enterprises-rediscovering the passion for working in the
SHCM enterprise- importance of right attitude, motivation to work, importance of interpersonal
skills and styles of communication, steps to building positive and proactive SHCM leader-case
studies.
Module-6 Understanding services and relationship oriented SHCM enterprises- Key
performance indicators-Service quality requirements in SHCM -Target rating and User survey-
monthly status report- emerging CRM oriented SHCM strategies-case studies.
Module-7 Overview of information technology in SHCM organization-MS project based
applications- SAP based technologies- web based technologies- SRM technologies-
Contemporary Issues in SHCM.
One month (full time Condensed mode by following FINISHING SCHOOL
APPROACH) SHCM lecture/interactive sessions will be 5 days in a week from 10 am to 4.30
pm from Monday to Friday)
Program fee is Rs 5, 50,000 (For a batch of 20 to 25 sponsored candidates).
We can undertake 9 batches with a project cost of Rs 49.5 lakh in 2011-12.
Program can be conducted in IIM Shillong Nongthymmai campus at the barrack(MDP
hall) ; provided the cost of boarding and lodging of participants for a period of 30 days has to be
Page 50
50
sponsored by the Govt.of Meghalaya with local transport assistance. The cost of boarding and
lodging s estimated as Rs1, 500 per participant per day.
Proposal …
IIM SHILLONG PROGRAM FOR STAKEHOLDERS OF GOVT.HOSPITAL IN
MEGHALAYA
1.0 GENESIS
India spends around $60.9 billion in 2009 in healthcare, up from $ 40.4 billion in 2005.
While commending the increased patient outflow at primary health centres and ample
community health centres and improved institutional deliveries and immunization, as observed
by a Comptroller and Auditor General Report in 2010, the Survey took a serious note of the
loopholes there in. According to the Investment Commission of India the healthcare sector has
experienced phenomenal growth of 12 percent per annum in the last 4 years. Rising income
levels and a growing elderly population are all factors that are driving this growth. In addition,
changing demographics, disease profiles and the shift from chronic to lifestyle diseases in the
country has led to increased spending on healthcare delivery.
Enhanced services and overall improvement in healthcare has led to increase in life
expectancy and the population is expected to touch 1.27 billion by 2016. This would put a lot of
stress on the existing healthcare infrastructure in the country. In addition the changing
demography and socioeconomic mix are altering the population„s disease profile and increasing
the incidence of lifestyle diseases like diabetics and cardiac ailments. Although a large section of
the population is still poor, there has been a rapid increase in the middle class and rich segments.
The urban middle class segments accounts for a majority of healthcare expenditures in India. As
the numbers are on the rise, coupled with surge in income levels, the per capita expenditure on
healthcare is expected to increase. The demand for quality healthcare will also be driven by the
improvement in health awareness. From 52 percent in 1991 the literacy rate in the country has
increased to 65 percent in 2001 and this has resulted in better awareness and hence the need for
quality healthcare facilities.
Approximately one million people, mostly women and children, die in India each year
due to inadequate healthcare. 700 million people have no access to specialist care and 80% of
specialists live in urban areas. In addition to poor infrastructure India faces a shortage of trained
medical personal especially in rural areas where access to care is altogether limited. India„s
economic progress over the last few decades has brought with it some resultant improvement in
basic healthcare services. With focus on primary healthcare in the past in India, the life
expectancy and mortality ratios have improved over the years, though there is further scope for
improvement when compared with other countries of the world.
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51
It is important to be aware of changing needs, changes in what the people feel and even
changes in fashions. With the AIDS/Swine Flu scare, came the increasing insistence on
disposable needles. With women's fashions veering towards pencil thinness, came the popularity
of fitness clinics. We need to be sensitive, responsive, caring, and capable of changing. It is also
right to mention that amidst multi-dimensional constraints, some of the Indian hospitals have
been offering world-class services. Unfortunately due to poor information management system,
therural potential users fail in utilizing the services. The strengthening of advertising and
publicity measures would make available to them the information regarding the latest
developments in the field of medical sciences. Hence, it is appropriate to train the stakeholders of
Meghalaya health service sector in modern hospital care management practices by utilizing the
expertise of IIM Shillong through East Asia Centre (EAC) under the guidance of Prof.
S.Shajahan (Chair EAC & Dean, Planning& Research).
2.0 THE PROGRAM
Indian Institute Management Shillong (IIMS) in association with Govt.of Meghalaya
is proposed to offer practice oriented Management development courses for the stakeholders of
healthcare sector in the state under the title SUSTAINABLE HOSPITAL CARE
MANAGEMENT (SHCM).
We ideally would like to seek the sponsorship for 500 participants for the proposed
programme in SHRM over a period of 2 years through a sponsored group of 20 to 25 participants
on a regular basis, from June 1, 2011 onwards for a period of 30 days.
2.1 Program-- SUSTAINABLE HOSPITAL CARE MANAGEMENT (SHCM)
First of Its kind in the country, EAC of IIM-S announced its seventh programme in SHCM from
June 01, 2011. The focus of this course is to provide detailed information on the SHCM model
with a view to take care of people/society, patients, para-medical staff, process, procedures,
administration for undertaking better care management in the healthcare sector in Meghalaya.
Brief content:
Integrated Hospital management- Better care management-motivation-leadership-team
buildingplanning- finance-cash flows-fund flow-accounts-IT management techniques- use of IT
tools in patient care and general administration- Case studies.
Module-1 Understanding the basic Concepts- - benefits- sustainable SHCM plans-
Leading SHCM best practices -Case studies.
Page 52
52
Module-2 Rediscovering SHCM - Sustainable hospital administration- diagnostic cum
patient care activities-sustainability as business cum service model- Case studies.
Module-3 Building socially/environmentally centric SHCM teams and organization-
SHCM hardware and software-case studies- SHCM vision, mission, goal and strategies for ideal
PHCs and hospitals in the 21st century-Case studies.
Module-4 Passion for finance in SHCM - understanding the accounting transactions, trail
balance, balances sheet, fund flow and cash money flows and audit -case studies.
Module-5 Learning SHCM enterprises-rediscovering the passion for working in the
SHCM enterprise- importance of right attitude, motivation to work, importance of interpersonal
skills and styles of communication, steps to building positive and proactive SHCM leader-case
studies.
Module-6 Understanding services and relationship oriented SHCM enterprises- Key
performance indicators-Service quality requirements in SHCM -Target rating and User
surveymonthly status report- emerging CRM oriented SHCM strategies-case studies.
Module-7 Overview of information technology in SHCM organization-MS project based
applications- SAP based technologies- web based technologies- SRM technologies-
Contemporary Issues in SHCM.
2.2 Justification
India's recent economic performance has been commendable on many counts. The
economy grew at an average of annual rate of about 9 per cent before the global meltdown.
Despite the adverse circumstances, our economy grew by 6.7 per cent in 2008-09, and it has
accelerated to 7.2 per cent in 2009-10. India expects to achieve 8.5 per cent growth in 2010-11
and 9 per cent in 2011-12.A healthy population is a must for holding the prosperity of the nation
in the long run.
As patients are the best ambassadors of our PHCs and Hospitals, it is important to take
care of their needs and provide them with best possible care. Their apprehensions should be
addressed so that they have the courage to come back to the same facility. In this business, every
satisfied customer brings thousand new customers .Healthcare staff ready to make patient
experience a strategic social service initiative can soon make with operational accountability.
EAC is geared to supplying the trained human capital and professionals at all levels for
supporting the growth momentum of healthcare sector in the sustainable Hospital care
management platform.IIMS had already groomed 147 professionals with IIM Shillong
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53
certificates and presented to the government /corporates successfully through its launch
programmes in Retail management (CRM –level1), Sustainable Enterprise and Retail
Management (SERM level-3), Sustainable Global Enterprise and e_marketing SGEeM level-3),
SIBPM,IPRM since its inception in August 2008.
3.0 DURATION:
One month (full time Condensed mode by following FINISHING SCHOOL
APPROACH) SHCM lecture/interactive sessions will be 5 days in a week from 10 am to 4.30
pm from Monday to Friday).
4.0 PROGRAM FEE:
Rs 5, 50,000 (For a batch of 20 to 25 sponsored candidates).
We can undertake 9 batches with a project cost of Rs 49.5 lakh in 2011-12.
Program can be conducted in IIM Shillong Nongthymmai campus at the barrack (MDP
hall) ; provided the cost of boarding and lodging of participants for a period of 30 days has to be
sponsored by the Govt.of Meghalaya with local transport assistance. The cost of boarding and
lodging s estimated as Rs1, 500 per participant per day.
5.0 IIM ADVANTAGE
As you know, with the launch of Indian Institute of Management Shillong (IIMS) the
Govt.of India has provided new impetus to the quality of management education in North East.
In line with its commitment and mission to create an institution of excellence having a national
character while also considering the needs and aspirations of the people of the region; IIM has
set up accelerated learning centre ( now known as CEDNER) then for materializing the global
tie-ups/MoUs /Exchanges/Placements ; floated EAST ASIA Centre (EAC).
The serene ambiance of IIM Shillong surrounded by pine trees, lush green lawns and the
kaleidoscopic mountains in the backdrop creates an aura of stunned silence amidst nature. Within
the heart of Shillong city, the IIMS campus showcases a tranquil environment where the students
can concentrate in their regular activities. The institute aims to develop unbeatable leaders for an
economically and ecologically sustainable society, with the help of a unique curriculum that
comprises a mix of s short term ( certificate -6 month long) and main stream( PGDM- 2 year
long) courses, supplemented by specialised programmes( MDPs of 1 to 7 days) and workshops
on industry sectors. The institutes had its maiden convocation on April 03, 2010 and the chief
guest being the Hon‟ble Union Minister of Finance, Govt.of India Shri. Pranab Mukherjee.
IIM Shillong boasts of the latest sophisticated equipments with regards to keeping pace
with the trends in the modern Educational field: Enterprise Resource Planning, IIM Shillong
Network, Unified Threat Management (Firewall), Virtual Private Network (VPN of IIM
Shillong), IIM Shillong Servers, Microsoft Share Point Server 2007, PolyCom Video
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54
Conferencing System, Vennfer: Software based Video Conferencing System, Interactive
Whiteboards and Knowledge Centre Automation.
The Institute has implemented one of the world's leading campus ERP systems-Oracle
PeopleSoft.IIM Shillong has latest Cisco2800 series routers and Cisco 4500cores ,which
support12M bps of link. The network backbone is designed through single mode fiber optics
cable to provide the highest band width, there by the satisfaction to the user. IIM Shillong also
has Wi-Fi connectivity through the perimeter of the campus. A state-of-the art Wireless Mesh
Network (WMN) has been setup for seamless connectivity with necessary redundancy. The
Knowledge Centre (Library) of IIM Shillong has been totally automated. It is implemented with
RFID Library Management System. The users use the card and the Self Issue Kiosk for issue and
returns of books.
IIM Shillong focuses on building the skills and capabilities needed to formulate and
implement practical, operational solutions that have value in today's marketplace. We tap the
emerging opportunities in infrastructure building, project management and organized retailing
during the turbulent times. IIM-S maintains a global network engaged in corporate research and
field work focused on strategy formulation and implementation in two domains: sustainable
innovation and the enterprise management in the vertical of infrastructure building, project
management and organized retailing.
6.0 IIM Program Advantage
IIM programmes are focusing on bringing people together to learn how to build and lead
thriving sustainable global hospitals, PHCs that are in and for the world. It also attempting to
zero down the challenges that inhibit sustainable innovations in product, process, and services
and even in healthcare delivery Models from government mindsets to standard operating
procedures in the Meghalaya. Mentors are of the opinion that the participants of the programme
will see health and social problems as opportunities for them to serve the people of this state. A
unique aspect of this IIM program structure is the „free standing‟ modules which provide
participants an exposure to team building, leadership, equilibrium thinking and developmental
management basics along with financial statements. In short, IIM programmes are capped by a
number of capstone modules, activities and projects which help Program participants to
appreciate and develop a global SHCM orientation and IT initiatives while managing these
healthcare organizations.
7.0 Take away of the IIM programme on SHCM
Global exposure in SHCM with additional enhancement of employable managerial and
technical skills with latest art of technology and knowledge.IIM Certificate which will be valued
highly by the organisations in India and abroad.More IT skills and ability to shoot out/solve
managerial and operational problems in complex situations. Achieve an ability to understand the
forces at work and gain mental strength to operate within a dynamic, economic, technological,
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55
social, legal and political environment within the SHCM framework.To become aware of various
management teaching cum learning styles, and establish linkages between participants life‟s
goals and health education.Receive a balanced knowledge of both SHCM theory and practice, so
that course participant will be capable enough to conceptualize, synthesize and integrate both
qualitative and quantitative input.Become a true leader, giving importance to building human
networks and relationship across the stakeholders with enormous respect to human values and
social ethics.Look towards long term goals of the organization by integrating IT and customer
values in the operating SHCM model, rather than achieving short term quarterly targets.Acquire
a theoretically sound, yet operationally useful understanding of the various functions of the
hospital management from an integrated system perspective.Acquire competency for effective
„decision making‟ and problem solving skills through use of analytical tools and techniques
which will be duly endorsed by globally renowned brand of IIM through its advanced level-1
certification.
APPENDIX
FINANCIAL /PROGRAM COST ESTIMATES
1. Incidental expenses , TA , lodging & boarding, including lecture related
logistics expenses of resource people//program Associates
Rs.50,000
2. Multi colour Programme hand book, Multi colour ID card, attendance
sheet, Multi colour Program CD, Multi colour Executive leather Folder,
Pen, Multi colour Executive writing pad and program related expenses
Rs.1,00,000
3. Honorarium to resource persons for preparing Course materials and
corporate/hospital interface & co-ordinator fee
Rs.50,000
4. Honorarium to resource persons for lecture delivery 100 [email protected] per
hour
Rs.3,00,000
5. Honorarium to resource persons for paper setting- and evaluation Rs.10,000
6. Printing cost of certificates etc.
Administrative Assistance
Rs.20,000
Rs.10,000
7. Contingency Rs.10,000
8. T O T A L 5,50,000
Total: 9 batches @ Rs. 5,50,000 per batch. = Rs. 4950000/-
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Incentives Schemes
National Rural Health Mission- Difficult Areas:-
Objective:
To ensure the medical personnel posted in the difficult, most difficult and inaccessible areas
incentives are proposed.
The rural health care services in Meghalaya is well spread across the state specially in the High
Focus Districts namely – West Khasi Hills, Jaintia Hills, West Garo Hills, East Garo Hills and
South Garo Hills District and these districts has been identified as difficult, most difficult and
inaccessible districts and also named as High Focus Districts of Meghalaya.
Most of the health facilities in these districts are inaccessible during raining season, public
transport system is unavailable, very poor road condition, no telephone connectivity, no proper
water supply and electricity.
In order to encourage the doctors and health staffs working in the CHCs, PHCs, and SCs of these
high focus districts stay in the facility and also increase their motivation an incentives is
proposed. The rate for incentives is as follows:
Sl.
No
Type of staff Incentive propose
1 Medical Officers Rs. 3000/- pm
2 SN/Supervisors Rs. 2000/- pm
3 Pharmacist Rs. 2000/- pm
4 ANM/LT Rs. 1500/- pm
5 Chowkidar Rs. 1000/- pm
Salary for Contractual Appointment of Specialists (O&G, Paed. and Anesth.) for CHC/FRUs @
Rs. 60,000/- pm
Beside these since this areas are inaccessible and EMRI services cannot be available due to bad
road and connectivity it is proposed to provide Referral Transport money to the Obstetric
Emergency and Sick Child to a maximum of Rs. 700/- per cases.
Priority will be given to those Medical Officers who are serving in these areas for Post
Graduate studies.
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57
List of health institution under Difficult, Most Difficult and Inaccessible areas:
Districts CHC/PHC/SC Difficult Most Difficult Inaccessible
West Garo Hills CHC-1
PHC- 3
SC- 13
CHC- 1
PHC- 5
SC- 6
SC- 11 SC- 3
West Khasi Hills CHC- 2
PHC- 7
SC- 25
CJC- 2
SC- 11
PHC- 7 SC- 12
East Garo Hills CHC- 1
PHC- 3
SC- 19
CHC- 1
SC- 9
PHC- 3
SC- 7
SC- 3
South Garo Hills CHC- 1
PHC- 7
SC- 21
CHC- 1
PHC- 4
SC- 9
PHC- 3
SC- 7
PHC- 1
SC- 6
Jaintia Hills PHC- 1
SC- 18
PHC- 1
SC- 4
SC- 4 SC- 10
Proposed Incentives for Staffs:
Sl.
No
Types of staff Unit Cost Period Total Amount
(Rs.)
1 Medical Officer 60 3000 12 Rs. 2160000
2 Pharmacist 40 2000 12 Rs. 960000
3 Staff Nurse 200 2000 12 Rs. 4800000
4 ANM 320 1500 12 Rs. 5760000
5 LT 40 1500 12 Rs. 720000
6 Supervisor 35 2000 12 Rs. 840000
7 Chowkidar 30 1000 12 Rs. 360000
Total Rs, 1,56,00,000
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58
Salary for Contractual Appointment of Specialist for High Focus Districts
Sl.
No
Type of Staff Unit Cost Total Amount (Rs.)
1 Appointment of 5 Nos. of O&G 5 60000 3600000
2 Appointment of 5 Nos. of Paed. 5 60000 3600000
3 Appointment of 5 Nos. of Anesth. 5 60000 3600000
Total 15 Rs. 10800000
Referral Transport for High Focus Districts
Sl.
No
District Nos. of
Beneficiary
Rate Amount (Rs.)
1 West Garo Hills 4500 700 3150000
2 East Garo Hills 2000 700 1400000
3 South Garo Hills 500 700 350000
4 Jaintia Hills 2500 700 1750000
5 West Khsi Hills 2000 700 1400000
Total 11500 700 Rs. 80,50,000
Budget for Difficult Area
Sl. No Activity Amount (Rs.)
1 Incentive for staffs 15600000
2 Salary for contractual appointment (Specialist) 10800000
3 Referral transport for high focus districts 8050000
Total Rs. 3,44,50,000
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59
B.18. Planning, Implementation and Monitoring
Monitoring & Evaluation
Monitoring & Evaluation of the progress of NRHM has assumed importance for both the
physical and financial performance. The State is facilitating this process with various
interventions and has been actively cooperating in this exercise.
.
(i) For HMIS Portal:
An HMIS Portal was launched in October, 2008 by MoHFW and the State has been
regularly uploading data on the HMIS Portal from the health facility for the physical and
financial performance. The HMIS Portal is regularly updated with the periodic reports on
the progress of the State on various parameters. The HMIS Portal is ready for capturing
data at the facility level
The MIS for the National Disease Control Programmes has been integrated on the HMIS
Portal for which reporting will be initiated by 2011-12.
The FMRs, infrastructure details, facility survey reports are also integrated on the HMIS
portal.
The State/District have taken the advantage of the inbuilt features provided on the HMIS
portal to check the consistency and validity of data which may be used for improving the
quality of data.
(ii) For MCH Tracking system (MCTS)
NIC has developed the software for data capturing and reporting. Nodal Officers and NIC
Officers will be trained on the software once the mapping of facilities is complete..
(iii) Meghalaya needs to constitute a core team at the State and District level involving the State
Demographer and District Statistical Officer/Assistant and institutionalize a mechanism
for reviewing the HMIS data in regular review meetings and checking the validity and
reliability of data. It may also be ensured that the health interventions included in the State
and District PIPs are supported with HMIS and survey data.
Notification of Nodal M&E Officers for HMIS and MCH tracking
Level Nos. Required Nos. Present Remarks
State 1 0
Not yet Notified Districts 7 0
Blocks 39 0
(iv) Surveys and Studies
GIS Mapping of facilities and subsequent scaling up of application areas being initialized
in PIP 2011-12.
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The State specific strategy for Monitoring & Evaluation has evolved for strengthening
HMIS and other decision making systems likeMCTS, Hospital MIS, GIS, ProMIS, Supply Chain
Management etc.
Monitoring & Evaluation Budget Summary
Major Head Minor Head Budget in Rs Details
Strengthening of
M&E/HMIS and
new initiatives
Salaries of M&E, MIS &
Data Entry Consultants 1.1
Budgeted under the Manpower at the
SPMU, DPMUs & BPMUs and omitted
from the M&E Budget
Mobility for M & E Officers 1.2 5,00,000.00
1.25 lakhs for each
quarter. Budgeted
under HMIS.
Workshops/Training on M &
E / HMIS/MCTS / ProMIS &
GIS
1.3
Budgetary Details
enclosed in separate
sections.
1. HMIS
49,27,000.00
2. MCTS
62,23,000.00
3. ProMIS
18,42,000.00
4. GIS
67,59,000.00
Sub-Total 1,97,51,000.00
M&E Studies 1.4 10,00,000.00 Budgetary Details
enclosed under HMIS
Others
(HMIS/MCTS/ProMIS/GIS) 1.5 10,00,000.00 Contingency & POL
OTHERS (A-D)
A. Hospital MIS
Implementation
Nongstoin Civil Hospital 26,73,424.00
Detailed Project
Implementation
Proposal submitted by
NIC, Shillong
enclosed as Annexure
Nongpoh Civil Hospital 22,39,183.00
Shillong Civil Hospital 49,37,858.00
Tura Civil Hospital 32,19,390.00
Jowai Civil Hospital 26,57,554.00
Williamnagar Civil Hospital 22,75,089.00
Project Roll Out 1,92,192.00
Sub-Total 1,81,94,690.00
Procurement of
HW/SW, Other
equipments and
Hardware/Software
Procurement 2.1
Tables showing
deployment detail
included 1. HMIS
62,15,300.00
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61
Printing of
formats
2. ProMIS
96,79,700.00
3. MCTS
54,15,000.00
4. GIS
52,60,000.00
Sub-Total 2,65,70,000.00
Internet connectivity 2.2
1. HMIS
43,000.00
2. MCTS
23,66,400.00
3. ProMIS
3,36,000.00
Sub-Total 27,45,400.00
Annual Maintenance 2.3
1. HMIS
8,97,000.00
Sub-Total 8,97,000.00
Printing & Computer
Stationery
(HMIS/MCTS/ProMIS/GIS
2.4 31,00,000.00
Budgeted under HMIS Sub-Total 31,00,000.00
Operational cost (consumables etc) 5,00,000.00
Others (Contingency) 2.5
1. HMIS
5,00,000.00
2. GIS
5,00,000.00
3. ProMIS
2,54,64,000.00 Warehouse
Modernization
Sub Total
2,64,64,000.00
Operationalising
HMIS at Sub
District level
Review of Existing registers –
to make them compatible with
National HMIS 3.1
Printing of new
Registers/Forms 3.2
Budgeted under HMIS
Training of staff 3.3
Operationalising
MCH tracking
Printing and reproducing
Registers/ Forms 4.1 10,00,000.00
Capacity building of teams 4.2
Ongoing review of MCH
tracking activities 4.3
Monitoring data collection and
data quality 4.4
Others (Specify) 4.5 1,10,00,000.00
Household Survey &
Data Entry on Portal
Sub-Total
1,20,00,000.00
M&E PIP 2010-2011 Grand Total
11,27,22,090.00
(Rupees Eleven Crore Twenty Seven Lakhs Twenty Two Thousand and Ninety only)
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Health Management Information System (HMIS)
Status of Implementation:
Health Management Information System incorporates all the data needed by policy makers,
clinicians and health service users to improve and protect population health. In Meghalaya an
HMIS Portal was launched in October, 2008 by MoHFW and the State as well as all the 7
districts has been regularly uploading data on the HMIS Portal for the physical performance and
for the Financial Monitoring Reports. Major achievement made during the period 2010-11 is the
facility-level uploading of data in the HMIS Web-portal. The HMIS Portal is regularly updated
with the periodic reports on the progress of the State on various parameters.
1. 39 Block Data Managers has been appointed in the 39 blocks of the state for facility data
entry in the HMIS Web Portal.
2. Trainings has been conducted for the 39 Block Data Manager (BDMs) for Facility-wise
data entry in the HMIS Web-Portal in collaboration with RRC-NE, Khanapara and
Ministry of Health & Family Welfare (MoH&FW), New Delhi.
3. Facility-wise data entry in the HMIS Web-Portal by the Block Data Managers
(BDMs)has already started for the month of December 2010-11 .
4. The HMIS division of Meghalaya has developed the Health Statistical Handbook 2010-
11 for Meghalaya.
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63
Major Head
Minor Head
Budget
in Rs
Details
(including
cost per
unit)
Remarks
1.Strengthening
of
M&E/HMIS/
MCH
Tracking
Salaries of M&E, MIS
Consultants &
Data Entry
1.1 Budgeted under the Manpower at the SPMU,
DPMUs & BPMUs and omitted from the
M&E Budget
Mobility for M & E Officers 1.2 5,00,000.00
Workshops/Training on M
& E
1.3 49,27,000.00 Enclosed
M&E Studies 1.4 10,00,000.00
Others (specify) 1.5 10,00,000.00 Contingenc
y,
stationary,
POL
2. Procurement
of
HW/SW and
other
equipments
Hardware/Software
Procurement
2.1 62,15,300.00 Enclosed
Internet connectivity 2.2 43,000.00 Enclosed
Annual Maintenance 2.3 8,97,000.00 Enclosed
Operational Costs
(consumables etc)
2.4 5,00,000.00
Others (Specify) 2.5 5,00,000.00
3.Operationalisin
g
HMIS at Sub
District level
Review of existing registers
– to make them compatible
with National HMIS
3.1
Printing of new
registers/Forms
3.2 31,00,000.00 Enclosed
Training of staff 3.3 Budgetted
under
Workshop
on HMIS
Monitoring data collection
and data quality
3.4
Grand Total 1,86,82,300.00
(Rupees One Crore Eighty Six Lakhs Eighty Two Thousand & Three Hundred only)
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1.3 Workshops/Training on HMIS
Item
Cost per
Participant
s
Number of
Participants
No of
days
No. of
Training
s
Total in Rupees
2 days hands-on training on HMIS application to conducted by at the State Headquarter Office
DPMU & BPMU Staff
TA/DA 2,000 110 2 4 17,60,000.00
Honorarium for
Resource Person 1,500 2 - - 3,000.00
Food and refreshment 300 110 2 4 2,64,000.00
Hiring of Conference
Hall, (Martin Luther
Christian University,
Conference Hall,
Shillong).+ Sound
System Arrangement.
Cost = 10,000 2 4 80,000.00
Accommodation 2,000.00 110 3 4 26,40,000.00
Hiring of Generator 5,000 3 3 4 1,80,000.00
Total 49,27,000.00
2.1 Hardware & Software Procurement.
Item Units Approx.
Rate Budget(In Rupees)
Hardware & Software Procurement for Computer Lab. at RHFWTC
Server 1 2,50,000.00 2,50,000
Desktop Computer 50 45,000.00 22,50,000
UPS(Line Interactive 1.0 KVA) 51 8,000.00 4,08,000
Generator(20 KVA) 1 3,00,000.00 3,00,000
Smart Interactive White Board
(including Projector)
3(one for NRHM
Conference
Hall/one for
training center)
2,00,000.00 6,00,000
Furniture and misc Equipment 51 15,000.00 7,65,000
Window Server 1 50,000.00 50,000
Stationery 10,000.00 10,000
Steel Rack 2 15,000.00 30,000
Steel Almirah 1 15,000.00 15,000
Air Condition 2 1,00,000.00 2,00,000
Microphone & Cordless
Microphone 2 10,000.00 20,000
Speakers 1 1,00,000.00 1,00,000
MS-Office 2007 1 20,000.00 20,000
Sub-Total 50,18,000.00
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65
LAN Installation for Computer Lab. at RHFWTC
L3 Switch 48 port 2 1,50,000.00 3,00,000.00
Rack 9u wall mount 2 18,000.00 36,000.00
Cable cat6 5 7,500.00 37,500.00
Single IO with SMB having
shutter facilty
51 300.00 15,300.00
CAT6 UTP Patch Cord-1m 51 500.00 25,500.00
48 Port CAT6 UTP Jack Panel
with Cable Manager
2 10,000.00 20,000.00
Conduit Pipe per m-5.08cm(2.0
inch)
1500 250.00 3,75,000.00
fixing of rack/ Jack Panel 2 2,000.00 4,000.00
Cable installation(per meter) 1500 100.00 1,50,000.00
Fixing of IO 51 300.00 15,300.00
Total 11,16,300.00
Telephone Connection for HMIS division
Connection 1 3,000.00 3,000
Handset (with intercom facility) 1 10,000.00 10,000
Sub-Total 13,000.00
Hardware & Software Procurement for NRHM office
Printer & Scanner (All in 1) 2 15,000.00 30,000.00
Colour Printer 1 15,000.00 15,000.00
Digital Still Camera 1 30,000.00 30,000.00
Projector Screen 2 10,000.00 20,000.00
Sub-Total 68,000.00
Grand Total 62,15,300.00
2.2 Internet Connectivity.
Item Units Approx. Rate Budget(In
Rupees)
2. Internet Connection for Computer Lab. at RHFWTC
Broadband Connection 3,000.00 3,000.00
Telephone Connection 4,000.00 4,000.00
Internet Bill (per month) 12 3,000.00 36,000.00
Sub-Total 43,000.00
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2.3 Annual Maintenance Contract (AMC for SPMU & DPMU Office)
Item Units Approx.
Rate
Budget(In Rupees)
State Unit (12 months) 1 5,00,000.00 5,00,000.00
For District Unit (12 months) 7 1,000.00 7,000.00
For Block Unit (12 months) 39 10,000.00 3,90,000.00
Total 8,97,000.00
3.2 Printing & Computer Stationary
District Unit 7 3,00,000.00 21,00,000.00
State Unit 1 10,00,000.00 10,00,000.00
Total 31,00,000.00
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67
Mother and Child Tracking System (MCTS)
A. Objective
It has been decided to have a MCTS tracking system (being put in place by Government
of India, MoHFW) whereby pregnant women and children can be tracked for their ANCs
and immunisation along with a feedback system for the ANM, ASHA etc to ensure that
all pregnant women receive their Ante-Natal Care Check-ups (ANCs) and post-natal care
(PNCs); and further children receive their full immunisation.
B. Data to be captured
1. The information to be captured for pregnant women for their ANC and PNC checkups is
specified in Annexure-I and for child immunisation in Annexure-II. A soft copy of the
formats in MS-Excel format is also available on the MCTS Portal at http://www.nrhm-
mis.nic.in under the “Downloads” section. An online module for the name based tracking
system is being developed and is to be integrated with the MCTS web portal. Till such
time, the states may capture the relevant data as per the enclosed format which is already
in an Excel template available on the MCTS web portal. Till the data is uploaded to the
MCTS Portal, each District shall send the data in a soft copy to the State and the Ministry
for record.
C. Reference Date and Coverage
2. The Reference Date for capturing information will be as follows:
a. All new Pregnancies detected/being reMCTStered from 1st December, 2009 at
the first point of contact of the pregnant mother with the health facility/health
provider
b. All Births occurring from 1st December, 2009 also need to be captured
This is to be followed by capturing and entering data for all pregnant women and births
from 1st April 2009. This data is already available in the reMCTSters being maintained
by the ANM/Health facilities at various levels.
3. All pregnancies and births will be captured irrespective of where (place) the ANC
checkups are being given or the place of delivery. Thus details of all deliveries taking
place either at home, public or private institution is to be captured irrespective of the fact
whether the mother is a JSY beneficiary or not.
D. Training Institutions for training on MCTS and Use of Data
The States may entrust a training institution in the State, say, the State Institute for Health
& Family Welfare (SIHFW), RHFWTC, SHSRC or at the District level, to take up
responsibilities for imparting training on the following:
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68
(i) Technical support for the name based tracking of pregnant women and child
immunization at the District and Sub District level.
(ii) Data capturing on the MCTS Portal, preparation of Reports, analysing data (both
MCTS and Survey data) and using it for local action and planning. This would
include populating the facility masters, mapping of health facilities and data
capture at the Sub-District/Facility level on the MCTS Portal.
(iii) Data capturing for the National Health Programmes and FMRs from the District
level
(iv) Steps to be taken for improving the quality of data at various levels.
The assistance required from the Ministry or NHSRC for capacity building at the
State/District level may also kindly be indicated.
4. Potential Offshoots/Benefits
Better control on estimates of infant and maternal mortality
Off-take of JSY benefits
Improved supply chain management of vaccines and drugs
Focussed deployment of personnel based on the case load
Improvement in ReMCTStration of births
Used as basis for ICDS, Primary education, Adolescent health
Better data analysis for preparation of Block/District health action plans and State
PIPs with realistic/accurate denominators.
5. Related Issues
Information from Private Sector Hospitals, Nursing Homes, Clinic etc
Ethical use of information
Privacy and Data Sharing Issues
Standards
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69
Process - Project Implementation
1. Installation: Deploy the MCTS application in all PHC/Blocks in computers at the
aggregation levels (the first point of digitization of paper reports as decided by the state)
2. Capacity building: training (at all levels – state/district/block/PHC/sub-centre) on Name
based formats issued by MOHFW of staff with focus on hands on training – using
MCTS, filling name based data set, sending reports, generating reports, making data
quality checks, validation, generating reports and sending feedback
3. Information flow: defining information flow of sub-centre data is most crucial in
implementation, which will describe the data which will then be aggregated into state
MCTS
4. Integration of MCTS reporting into state MCTS application in DHIS2 at all levels
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70
5. Implementation and Technical Support : provide ongoing support to the MCTS
implementation and technical trouble-shooting for at least one year
6. Evaluation & Scaling: Conduct qualitative interviews with the MCTS users to take their
feedback on parameters such usability, additional functionalities required, and
incorporating feedback wherever possible
Implementation Process
PHASE – I: Pre-implementation preparation
1. MCTS formats issued by MOHFW to be printed and distributed to all health facilities
(sub-centre/PHCs)
2. If the state needs to customize the formats, to be done before printing, with formats
issued by MOHFW as point of departure (customization could be data from ASHA
diaries and other primary reMCTSters or whatever state finds appropriate)
3. Establishing the required infrastructure – computers, internet, servers etc.
PHASE II: Field implementation
1. Information Flow:
Establishing the information flow guidelines including:
a. How and who fills the tracking formats.
b. How does this data get verified.
c. How does the formats flow to the PHC or Block where the computer is hosted
d. Who does the data entry
e. How do the reports required for the ANM flow from the computer to the ANM
2. Capacity building
Level Capacity Building Content
State Level MCTS formats and application – working and integration with
main MCTS
Strengthening institutional support mechanisms
Creating team of Master Trainers
District Level MCTS formats and application – working and integration with
main MCTS
MCTS application – installation, reporting sub-centre data,
application working, troubleshooting, nodal unit for technical
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71
Level Capacity Building Content
support to field units
Creating team of Master Trainers
Block Level MCTS formats and application – working and integration with
main MCTS
MCTS application – installation, reporting sub-centre reports into
state application at block level, troubleshooting, providing
technical support
Sub-centre Datasets, information flow
Creating team of Master Trainers
PHC Level MCTS formats and application – working and integration with
main MCTS
MCTS application – installation, reporting sub-centre reports into
state application at block level, troubleshooting, providing
technical support
Sub-centre Datasets, information flow
MCTS Sub-centre Datasets, information flow and compiling PHC
aggregate report, providing confirmation & feedback to ANMs
Sub-Centre -
ANM
MCTS formats
MCTS Application – using application for filling sub-centre
MCTS format, sending report through SMS, report confirmation
Sub-centre MCTS Formats, information flow
Status of Implementation:
1. MCTS online Portal is in place but updation of Master data still in the process.
2. The MCTS URL has been registered:- url – “nrhm-mcts.nic.in” for Meghalaya.
3. MCTS tracking card is designed and printed.
4. 39 Block Data Managers has been appointed in the 39 Blocks of the State for facility
level data entry.
5. 39 Computers for the Block Data Managers at the Block Level has been provided.
6. District level trainings (DM&HO‟s, MO, DPM, BPM) has been conducted.
7. Block level trainings (ANM, SN,PHN, LHV, HE, CHO etc has been conducted
8. House Hold Survey to be conducted by February, 2011
9. Printing of Modified MCH registers as per MCTS Excel Sheet provided by MOHFW,
New Delhi in process.
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Major Head Minor Head
Budget
in Rs. Details Remarks
Workshop &
Trainings
Workshops/Training on
MCTS
1.1 62,20,000.00 Enclosed
Procurement
of HW/SW
and Other
Equipments
H/W equipments 2.1 54,15,000.00 Enclosed
Internet connectivity 2.2 23,66,400.00
Operationalisi
ng
MCH tracking
Printing and reproducing
Registers/ Forms 2.3 10,00,000.00
Others (A-B)
A. Household survey
for MCTS 3.1 80,00,000.00
B. Data Entry on
MCTS Portal. 3.2 30,00,000.00
Sub-Total 1,10,00,000.00
Grand Total 2,60,01,400.00
(Rupees Two Crore Sixty lakhs One Thousand Four hundred only)
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1.1 Workshops/Training on MCTS
Item Cost per
Participan
ts
Number of
Participant
s
No of
days
No. of
Trainin
gs
Total in Rupees
2 days hands-on training on MCTS application to conducted by at the State Headquarter
Office for DPMU & BPMU Staff
TA/DA 2000 110 2 4 17,60,000.00
Honorarium for
Resource Person 1,500 2 - - 3,000.00
Food and
refreshment 300 110 2 4 2,64,000.00
Hiring of Conference
Hall, (Martin Luther
Christian University,
Conference Hall,
Shillong).+ Sound
System
Arrangement.
Cost = 10,000 2 4 80,000.00
Accommodation 2,000 110 3 4 26,40,000.00
Hiring of Generator 5,000 3 2 4 1,20,000.00
Sub-Total 48,67,000.00
Workshops/Training on MCTS Block Level
Item Cost per
Participan
ts
Number of
Participant
s
No of
days
No. of
Trainin
gs
Total in Rupees
2 days training at Block level by SPMU & DPMU staff on MCTS Formats for
ASHA/Link Workers for Household surveys
TA/DA 100 6250 2 1 12,50,000.00
Honorarium for
Resource Person 1,500 2 - - 3,000.00
Food and
refreshment 200 6250 2 1 25,00,000.00
Accommodation 1000 39 2 1 78,000.00
Sub-Total 38,31,000.00
Grand Total 86,98,000.00
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2.1 Hardware / Software Procurement for CHC‟s and PHC‟s.
Item Units Approx.
Rate
Budget(In Rupees)
Desktop 57 45000 25,65,000.00
UPS 57 8000 4,56,000.00
Furnitures 57 15000 8,55,000.00
Scanner 57 12000 6,84,000.00
Printers 57 15000 8,55,000.00
Total 54,15,000.00
2.2 Internet connectivity
Item Units Approx.
Rate
Budget(In Rupees)
Cell One Data Card for CHC 29 3,000.00 87,000.00
Cell One Data Card for PHC Units 107 3,000.00 3,21,000.00
Cell One Data Card for CHC &
PHC (12 months) 136x12 1,200.00 19,58,400.00
Total 23,66,400.00
2.3 Printing & Computer Stationary
District Unit 7 1,00,000.00 7,00,000.00
State Unit 1 3,00,000.00 3,00,000.00
Total 10,00,000.00
3.1 Household survey for MCTS.
Item Units Approx.
Rate
Budget(In Rupees)
Household survey by ASHA/Link
Workers for implementation of
MCTS
6,00,000
households 10 60,00,000.00
Printing of MCTS formats for
Household survey 10,00,000 copies 2 20,00,000.00
Total 80,00,000.00
3.2 Data Entry on MCTS Portal.
Item Units (forms) Approx.
Rate
Budget(In Rupees)
Outsource to external Agency 6,00,000 5 30,00,000.00
Total 30,00,000.00
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First Phase implementation of State Procurement Management
Information System and Inventory Control
Status of Implementation:
State Portal for Drugs Procurement Management Information System (SProMIS) and Inventory
Control has been initiated to the Ministry to develop the Portal for Meghalaya State, resembling
that of Procurement Management Information System (ProMIS) a Portal on Central Procurement
for Vaccines and Logistics with inputs from Directorate of Health Services, Meghalaya. Survey
by the Ministry on Specific State requirement for State Procurement Management Information
System (SProMIS) will be conducted by the Ministry on January, 2011 during Second round
training on Procurement Management Information System (ProMIS) on central Procurement by
the Ministry.
The project for implementation of State Procurement Management Information System
(SProMIS) will be initially upto District level. This will enable us to monitor stocks and also
enable us to check Stock in, stock out at District levels and strictly to follow FEFO.
It is therefore proposed that pilot roll out of the project be initiated during the 2011-12 plan
period.
Major Head Minor Head Budget
in Rs. Details Remarks
Trainings
Workshops/Training on ProMIS
Warehouse Information System 1.1 8,00,000.00 Enclosed
Workshops/Training on SProMIS
Management Information Systems 1.2 10,30,000.00 Enclosed
Sub Total 18,30,000.00
Procurement
of
HW/SW and
Other
Equipments
Hardware / Software Procurement
State Procurement Management
Information System portal
2.1 4,03,700.00 Enclosed
Cost of Developing State
Procurement Management
Information System (SProMIS)
2.2 50,00,000.00 Enclosed
Warehouse Requirement 2.3 12,20,000.00 Enclosed
District Warehouse requirement 2.4 24,20,000.00 Enclosed
Internet Connectivity 2.5 3,36,000.00 Enclosed
Sub-Total 93,79,700.00
Warehouse Modernization of Warehouses
at State & District Level/Ramp
Construction at State Warehouse
3.1 2,59,64,000.00 Enclosed
Grand Total 3,71,73,700.00
(Rupees Three Crores Seventy One Lakhs Seventy Three Thousand & Seven Hundred only)
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1.1 Workshops/Training on ProMIS Warehouse Information System
Item
Cost
per
person
Number of
person
No of
days
Total in
Rupees
3rd
Round Training 2 days Management
Development Programme on
Procurement Management Information
System (ProMIS) to be conducted by
Ministry Resource persons at Shillong
for Nodal Officers, Logistics Manager,
Store Keepers
(UIP,RCH,RNTCP,Malaria,MCH) and
SPMU Officials/Staff including TA/DA
5,000.00 80 2 8,00,000.00
Honorarium for Resource Person 1,500 2 - 3,000.00
Total 8,03,000.00
1.2 Workshops/Training on SProMIS Warehouse Information System
Item Cost per
person
Number
of
person
No of
days
Total in
Rupees
1. 2 days Oreintation Workshop on State
Procurement Information System
(SProMIS) to be imparted by resource
persons from MOHFW, New Delhi at
the State Headquarter for Store
Keeper, Assistant Store Keeper, DEO,
SPMU Staff including TA/DA.
2. 2 days Workshop on Warehouse
Information System on SProMIS to be
conducted by State TOT‟s for 4
Districts (EKH,WKH,JH,RB) at
Shillong including TA/DA.
3. 2 days Workshop on Warehouse
Information System on SProMIS to be
conducted by State TOT‟s for
remaining 3 Districts
(EGH,WGH,SGH) at Tura including
TA/DA.
5000
2000
2000
80
30
20
2
2
2
8,00,000.00
1,20,000.00
80,000.00
Honorarium for Resource Person for 3
Trainings 1,500 2 - 9,000.00
Stationary / printing of Banners, handouts
etc. 300.00 100 1 30,000.00
Total 10,39,000.00
Grand Total 18,42,000.00
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77
2.1 Hardware Requirements (DGS&D Rate Contract) Rate Unit Total in
Rupees
Server Computer A. Server Intel Xeon two Processor
Quad Core Tower configurations. 3,50,000 1 3,50,000.00
Line Interactive UPS
APC/BR 1500 IN
Rated KVA: 1.5,Minimum VAH:
600 10,000 1 10,000.00
HP Laser Printer 3005DN Resolution in dpi: Mono
600x600,Paper Size:A4,Print Speed
in PPM (A4 Size): 32
34,000 1 34,000.00
Computer Table Godrej 6,300 1 6,300.00
Computer Chair Godrej 3,400 1 3,400.00
Total 4,03,700.00
2.2 Cost of Developing State Procurement Management
Information System (SProMIS)
Rate Unit Total in
Rupees
State Procurement
Management Information
System Portal
Developing and Customization to be
design and developed company who
design and developed ProMIS on
Central Procurement for Ministry of
Health & Family Welfare for
Meghalaya State.
50,00,000 1 50,00,000.00
Total 50,00,000.00
2.3 Warehouse Requirement Rate Unit Total in
Rupees
Stationeries for State Warehouse 1,50,000 1 1,50,000.00
Electricity bill for State Warehouse 1,50,000 1 1,50,000.00
Warehouse Maintenance 5,00,000 1 5,00,000.00
Xerox Machine (CANON Copier)
for State Warehouse 2,50,000 1 2,50,000.00
Miscellaneous for State Warehouse 70,000 1 70,000.00
Furniture/Almirah 20,000 5 1,00,000.00
Total 12,20,000.00
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78
2.4 District Warehouse Requirement Rate Unit Total in
Rupees
Xerox Machine Canon Copier 2,50,000 7 17,50,000.00
Stationeries 1,00,000 1 1,00,000.00
Electricity bill 1,00,000 1 1,00,000.00
Furniture/Almirah 20,000 7 × 3 4,20,000.00
Miscellaneous for State Warehouse 50,000 1 50,000.00
Total 24,20,000.00
2.5 Internet Connectivity Rate Unit Total in
Rupees
Telephone Connection/Broadband Internet Connectivity for State
Warehouse/District Warehouse 3,36,000 1 3,36,000.00
Total 3,36,000.00
3.1 State Warehouse and District Warehouse. Rupees Unit Total in
Rupees
Installation of Heavy
Duty Racking System
Modernization of State Warehouse 31,68,000 1 31,68,000.00
Modernization of District
Warehouse
31,68,000 7 2,21,76,000.00
Trolley for lifting Medicines 30,000 4 1,20,000.00
Construction of Ramp for State
Warehouse
5,00,000 1 5,00,000.00
Total 2,59,64,000.00
Status of Implementation:
1. 2 days Trainings on ProMIS was conducted on 23rd
and 24th
September, 2010 by
Resource persons from MOHFW, New Delhi for SPMU staff/DMPU staff/ Store Keeper/
Asst Store Keeper.
2. 2nd
Round training for ProMIS will be conducted for Store Keeper/Asst Store
Keeper/DEO(UIP/MCH/RCH/ Malaria/RNTCP) State and District Warehouse Staff in
February 2010.
3. Data Entry started on ProMIS.
4. State Procurement Management Information System proposed to GoI for customization.
Officials from MOHFW, New Delhi will come to Meghalaya State for survey as per
State specific requirement on February 2011.
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GIS Mapping of Facilities
Recent advances in geographical information and mapping technologies have created
new opportunities for public health administrators to enhance planning, analysis, monitoring and
management of health systems. Since much of the data used and generated by health and social
service agencies has a spatial dimension, geographic information system (GIS) is particularly
useful to health professionals and administrators in planning and day-to-day management. A
typical GIS comprises an organised collection of computer hardware, software, geographic data
and personnel, designed to efficiently capture, store, update, analyse and display all forms of
geographically referenced information. Each piece of information is related in the system
through specific geographical coordinates (e.g. latitude and longitude) to a geographical entity
(e.g. health centre, school, dam, drainage, village or state). The information can be displayed in
the form of maps, graphs, charts and tables. Despite tremendous potential of GIS, the health
sector in India has not fully explored it. Majority of the health departments and research
organisations in India do not have the hardware, software or trained staff that would enable them
to apply GIS technology. However, the interest in GIS has increased during the late 1990s. Many
health organisations, such as Malaria Research Centre, DANLEP and Vector Control Research
Centre, are exploring its potential utility in medical research and disease control.
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Advantages of GIS
GIS has several advantages over conventional methods used in health planning, management and
research. Data management: GIS can be used to capture, store, handle and geographically
integrate large amounts of information from different sources, programmes and sectors;
including epidemiological surveillance, census, environment and others. Surveillance of diseases
requires continuous and systematic collection and analysis of data. A GIS can eliminate the
duplication of effort involved in data collection across an organisation, and hence substantially
reduce the cost involved in it. GIS serves as a common platform for convergence of multi-
disease surveillance activities. Each data record has to be georefenced to a desired level of
accuracy. GIS provides access to additional information from a wide variety of sources. Global
positioning systems (GPS) can be used to obtain locations of point features on a map, such as
wells or septic tanks, precisely
Applications of GIS in Health
GIS is being used by public health administrators and professionals, including policy makers,
statisticians, epidemiologists, regional and district medical officers (Weekly Epidemiological
Record, 1999). Some of its applications in public health are mentioned below:
1. Find out geographical distribution and variation of diseases
2. Analyse spatial and temporal trends
3. Identify gaps in immunisations
4. Map populations at risk and stratify risk factors
5. Document health care needs of a community and assess resource allocations
6. Forecast epidemics
7. Plan and target interventions
8. Monitor diseases and interventions over time
9. Manage patient care environments, materials, supplies and human resources
10. Monitor the utilisation of health centres
11. Route health workers, equipments and supplies to service locations
12. Publish health information using maps on the Internet
13. Locate the nearest health facility.
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81
GIS aids in faster and better health mapping and analysis than the conventional methods. It gives
health professionals quick and easy access to large volumes of data. It provides a variety of
dynamic analysis tools and display techniques for monitoring and management of epidemics.
GIS has a vital role to play in the future. The possibilities that can be explored are limitless,
depending on the skill and imaginative use of the researchers and the willingness of health sector
management to resource its implementation. Health administrators, professionals and researchers
need training and user support in GIS technology, data and epidemiological methods in order to
use GIS properly and effectively.
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82
Status of Implementation:
Major Head Minor Head Budget
in Rs. Details Remarks
Workshop &
Trainings
Workshops/Training
on GIS
1.1 67,59,000.00 Enclosed
Procurement of
HW/SW and
Other
Equipments
Hardware / Software
Procurement for GIS 2.1 52,60,000.00 Enclosed
Others 2.5 5,00,000.00
Site
preparation,
furniture etc
Total 1,25,19,000.00
(Rupees One Crore Twenty five lakhs Nineteen thousand only)
1.1 Workshops/Training on GIS
Item Cost per
Participants
Number of
Participants
No of
days
No. of
Trainings Total in Rupees
3 days hands-on training on GIS application to conducted by at the State Headquarter Office
DPMU & BPMU Staff
TA/DA 2,000 110 3 4 26,40,000.00
Honorarium for
Resource Person 1,500 2 - - 3,000.00
Food and
refreshment 300 110 3 4 3,96,000.00
Hiring of Conference
Hall, (Martin Luther
Christian University,
Conference Hall,
Shillong).+ Sound
System
Arrangement.
Cost = 10,000 3 4 1,20,000.00
Accommodation 2,000.00 110 4 4 35,20,000.00
Hiring of Generator 5,000 - 4 4 80,000.00
Total 67,59,000.00
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83
2.1 Hardware and Software Procurement for GIS
Item Units Approx.
Rate
Budget(In
Rupees)
Hardware Procurement for GIS.
Processor: Intel Xeon Quad
Core,Configuration: Rack, Item: 36/72 GB
DAT Drive, 1GB DDR2 533/667 Registered
FBDIMM With ECC for 2P/4P Quad Core X 100000 1 1,00,000.00
Desktop Computer With: Intel Pentium Dual
Core Processor with large flat screen monitor 50000 2 1,00,000.00
Plotter 400000 1 4,00,000.00
GPS 30000 2 60,000.00
Sub Total 6,60,000.00
Software Procurement for GIS
ArcView/ArcMap 1000000 1 10,00,000.00
Additional Extensions 300000 2 6,00,000.00
ArcIMS 1200000 1 12,00,000.00
Sub Total 28,00,000.00
IMAGES
Satellite Imagery 12,00,000.00
Maps 6,00,000.00
Sub Total 18,00,000.00
Grand Total 52,60,000.00
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84
HOSPITAL MANAGEMENT INFORMATION SYSTEM
(HosMIS)
For implementation of the Hospital MIS, NIC has shown patial capacity of implementation in the
five (5) Civil Hospitals, in Meghalaya by deployment of some modules only. The Hospital needs
further assistance in scaling up the project and become fully online.
The State Unit of NIC has submitted a detailed Project Financial and Technical evaluation report
for replicating HosMIS in all five District Hospitals of the State in the Phase-1 and Phase-2 with
this the implementation of HosMIS in Meghalaya would be complete and hence HosMIS in the
five hospitals will be fully functional.
It is proposed that the following Districts be taken up simultaneously for project implementation
during 2011-2012 with judicious budgetary constrains as detailed in the subsequent Project
Reports enclosed.
Phase - 1
District Facility Budgetary Support required
Nongstoin Civil Hospital 10,97,781.00
Nongpoh Civil Hospital 10,97,063.00
Shillong Civil Hospital 21,19,071.00
Tura Civil Hospital 14,99,466.00
Williamnagar Civil Hospital 10,97,063.00
Total (i) 69,10,444.00
Phase – 2
District Facility Budgetary Support required
Nongstoin Civil Hospital 15,75,643.00
Nongpoh Civil Hospital 11,42,120.00
Shillong Civil Hospital 28,18,787.00
Tura Civil Hospital 17,19,924.00
Jowai Civil Hospital 26,57,554.00
Williamnagar Civil Hospital 11,78,026.00
Total (ii) 1,10,92,054.00
Project Roll Out 1,92,192.00
Grand Total (Phase -I + Phase -2+ Project Roll
Out) 1,81,94,690.00
(Rupees One Crore Eighty One Lakhs Ninety Four Thousand Six Hundred Ninety only)
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Discussions with NIC, Meghalaya Unit it was understood as in the first phase that the Supply of
Software, Installation and Training would be done free of cost by NIC, Shillong. The cost born
by the SPMU NRHM would be for Site preparation (Electricals, rooms) Computer Hardware
(Database Server, PC, Power backup, accessories, cabling, switches) Internet Connectivity Staff
(System Administrator) perhaps one per hospital The above proposed expenditure has been
included in the Monitoring & Evaluation (M&E) PIP 2011-12 which includes salary of
monitoring staff, procurement of hardware etc.
PHASE – 1 IMPLEMENTATION OF HosMIS
Shillong Civil Hospital
Quantity Price
(Rs.)
Amount
(Rs.)
Hardware
Server Intel Xeon Two Processor Quad
Core 2 103798 207596
HDD SAS,3x144 GB 10K Hot Plug,In lieu
of: 3x72 GB
2 700 1400
Combo 16x10x24 CD R/W and 8xDVD
ROM,In lieu of: 8x DVD ROM
2 280 560
Desktop Intel Pentium Dual Core Processor 39 27140 1058460
LJ Printer 7 5475 38325
DM Printer 32 5973 191136
Scanner 1 2724 2724
Online UPS 3 KVA (60 mins) 1 56600 56600
LI UPS VA 0.65 VAH 168 39 3083 120242
1677043
Software
RHEL 1 54504 54504
Networking
24 Port Switch 7 8904 62328
48 Port Switch 1 8904 8904
24 Port Jack Panel 9 3606 32451
19" Rack 8 5329 42632
LI UPS VA 0.65 VAH 168 8 3083 24665
500MHz CAT6 UTP Cable roll with 305m
length 16 4680
74880
Conduit Pipe per m-5.08cm(2.0 inch) 2196 29 63948
Single Information Outlet 146 94 13666
CAT6 UTP Patch Cord-1m 39 94 3650
CAT6 UTP Patch Cord-2m 39 114 4462
Cable Installation 4880 11 53680
Fixing of Rack 8 90 720
Fixing of IO 146 9 1314
Fixing of Jack Panel 9 25 225
387524
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Total Shillong Civil Hospital 2119071
Nongstoin Civil Hospital
Quantity
Price
(Rs.)
Amount
(Rs.)
Hardware
Server Intel Xeon Two Processor Quad
Core 2 103798 207596
HDD SAS,3x144 GB 10K Hot Plug,In lieu
of: 3x72 GB
2 700 1400
Combo 16x10x24 CD R/W and 8xDVD
ROM,In lieu of: 8x DVD ROM
2 280 560
Desktop Intel Pentium Dual Core Processor 19 27140 515660
LJ Printer 5 5475 27375
DM Printer 14 5973 83622
Scanner 1 2724 2724
Online UPS 3 KVA (60 mins) 1 56600 56600
LI UPS VA 0.65 VAH 168 19 3083 58579
954117
Software
RHEL 1 54504 54504
Networking
24 Port Switch 2 8904 17808
16 Port Switch 1 2415 2415
24 Port Jack Panel 2 3606 7211
19" Rack 2 5329 10658
LI UPS VA 0.65 VAH 168 2 3083 6166
500MHz CAT6 UTP Cable roll with 305m
length 3 4680
14040
Conduit Pipe per m-5.08cm(2.0 inch) 412 29 11997
Single Information Outlet 45 94 4212
CAT6 UTP Patch Cord-1m 19 94 1778
CAT6 UTP Patch Cord-2m 19 114 2174
Cable Installation 915 11 10065
Fixing of Rack 2 90 180
Fixing of IO 45 9 405
Fixing of Jack Panel 2 25 50
89160
Total Jowai Civil Hospital 1097781
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87
Nongpoh Civil Hospital
Quantity
Price
(Rs.)
Amount
(Rs.)
Hardware
Server Intel Xeon Two Processor Quad
Core 2 103798 207596
HDD SAS,3x144 GB 10K Hot Plug,In lieu
of: 3x72 GB
2 700 1400
Combo 16x10x24 CD R/W and 8xDVD
ROM,In lieu of: 8x DVD ROM
2 280 560
Desktop Intel Pentium Dual Core Processor 19 27140 515660
LJ Printer 5 5475 27375
DM Printer 14 5973 83622
Scanner 1 2724 2724
Online UPS 3 KVA (60 mins) 1 56600 56600
LI UPS VA 0.65 VAH 168 19 3083 58579
954117
Software
RHEL 1 54504 54504
Networking
24 Port Switch 2 8904 17808
16 Port Switch 1 2415 2415
24 Port Jack Panel 2 3606 7211
19" Rack 2 5329 10658
LI UPS VA 0.65 VAH 168 2 3083 6166
500MHz CAT6 UTP Cable roll with 305m
length 3 4680
14040
Conduit Pipe per m-5.08cm(2.0 inch) 412 29 11997
Single Information Outlet 38 94 3557
CAT6 UTP Patch Cord-1m 19 94 1778
CAT6 UTP Patch Cord-2m 19 114 2174
Cable Installation 915 11 10065
Fixing of Rack 2 90 180
Fixing of IO 38 9 342
Fixing of Jack Panel 2 25 50
88442
Total Nongpoh Civil Hospital 1097063
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88
Tura Civil Hospital
Quantity
Price
(Rs.)
Amount
(Rs.)
Hardware
Server Intel Xeon Two Processor Quad
Core 2 103798 207596
HDD SAS,3x144 GB 10K Hot Plug,In lieu
of: 3x72 GB
2 700 1400
Combo 16x10x24 CD R/W and 8xDVD
ROM,In lieu of: 8x DVD ROM
2 280 560
Desktop Intel Pentium Dual Core Processor 26 27140 705640
LJ Printer 7 5475 38325
DM Printer 19 5973 113487
Scanner 1 2724 2724
Online UPS 3 KVA (60 mins) 1 56600 56600
LI UPS VA 0.65 VAH 168 26 3083 80161
1206494
Software
RHEL 1 54504 54504
Networking
24 Port Switch 5 8904 44520
16 Port Switch 1 2415 2415
24 Port Jack Panel 5 3606 18028
19" Rack 5 5329 26645
LI UPS VA 0.65 VAH 168 5 3083 15416
500MHz CAT6 UTP Cable roll with 305m
length 10 4680
46800
Conduit Pipe per m-5.08cm(2.0 inch) 1373 29 39982
Single Information Outlet 50 94 4680
CAT6 UTP Patch Cord-1m 26 94 2434
CAT6 UTP Patch Cord-2m 26 114 2974
Cable Installation 3050 11 33550
Fixing of Rack 5 90 450
Fixing of IO 50 9 450
Fixing of Jack Panel 5 25 125
238469
Total Tura Civil Hospital 1499466
Williamnagar Civil Hospital
Quantity Price
(Rs.)
Amount
(Rs.)
Hardware
Server Intel Xeon Two Processor Quad
Core 2 103798 207596
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89
HDD SAS,3x144 GB 10K Hot Plug,In lieu
of: 3x72 GB
2 700 1400
Combo 16x10x24 CD R/W and 8xDVD
ROM,In lieu of: 8x DVD ROM
2 280 560
Desktop Intel Pentium Dual Core Processor 19 27140 515660
LJ Printer 5 5475 27375
DM Printer 14 5973 83622
Scanner 1 2724 2724
Online UPS 3 KVA (60 mins) 1 56600 56600
LI UPS VA 0.65 VAH 168 19 3083 58579
954117
Software
RHEL 1 54504 54504
Networking
24 Port Switch 2 8904 17808
16 Port Switch 1 2415 2415
24 Port Jack Panel 2 3606 7211
19" Rack 2 5329 10658
LI UPS VA 0.65 VAH 168 2 3083 6166
500MHz CAT6 UTP Cable roll with 305m
length 3 4680
14040
Conduit Pipe per m-5.08cm(2.0 inch) 412 29 11997
Single Information Outlet 38 94 3557
CAT6 UTP Patch Cord-1m 19 94 1778
CAT6 UTP Patch Cord-2m 19 114 2174
Cable Installation 915 11 10065
Fixing of Rack 2 90 180
Fixing of IO 38 9 342
Fixing of Jack Panel 2 25 50
88442
Total Williamnagar Civil Hospital 1097063
State Level
Project Rollout (12 months)
Asst. Programmer 1 16016 192192
Total State Level 192192
Grand Total 7102637
Total Sanctioned 7127283
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90
PHASE – 2 IMPLEMENTATION OF HosMIS
Phase II
Shillong Civil Hospital
Quantity
Price
(Rs.)
Amount
(Rs.)
Hardware
Desktop Intel Pentium Dual Core Processor 37 27140 1004180
LJ Printer 13 5475 71175
DM Printer 24 5973 143352
Scanner 1 2724 2724
LI UPS VA 0.65 VAH 168 37 3083 114075
1335506
Networking
24 Port Switch 1 8904 8904
16 Port Switch 1 2415 2415
24 Port Jack Panel 2 3606 7211
19" Rack 2 5329 10658
LI UPS VA 0.65 VAH 168 2 3083 6166
CAT6 UTP Patch Cord-1m 37 94 3463
CAT6 UTP Patch Cord-2m 37 114 4233
Fixing of Rack 2 90 180
Fixing of Jack Panel 2 25 50
43281
Manpower
Technical Assistant (for 3 years) 1 12000 432000
Data Entry Operator (for 3 years) 4 7000 1008000
1440000
Total Shillong Civil Hospital 2818787
Nongstoin Civil Hospital
Quantity Price
(Rs.)
Amount
(Rs.)
Hardware
Desktop Intel Pentium Dual Core Processor 17 27140 461380
LJ Printer 6 5475 32850
DM Printer 11 5973 65703
Scanner 1 2724 2724
LI UPS VA 0.65 VAH 168 17 3083 52413
615070
Networking
24 Port Switch 1 8904 8904
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91
24 Port Jack Panel 1 3606 3606
19" Rack 1 5329 5329
LI UPS VA 0.65 VAH 168 1 3083 3083
CAT6 UTP Patch Cord-1m 17 94 1591
CAT6 UTP Patch Cord-2m 17 114 1945
Fixing of Rack 1 90 90
Fixing of Jack Panel 1 25 25
24573
Manpower
Technical Assistant (for 3 years) 1 12000 432000
Data Entry Operator (for 3 years) 2 7000 504000
936000
Total Nongstoin Civil Hospital 1575643
Jowai Civil Hospital
Quantity Price
(Rs.)
Amount
(Rs.)
Hardware
Server Intel Xeon Two Processor Quad
Core 2 103798 207596
HDD SAS,3x144 GB 10K Hot Plug,In lieu
of: 3x72 GB
2 700 1400
Combo 16x10x24 CD R/W and 8xDVD
ROM,In lieu of: 8x DVD ROM
2 280 560
Desktop Intel Pentium Dual Core Processor 35 27140 949900
LJ Printer 13 5475 71175
DM Printer 22 5973 131406
Scanner 1 2724 2724
Online UPS 3 KVA (60 mins) 1 56600 56600
LI UPS VA 0.65 VAH 168 35 3083 107909
1529271
Software
RHEL 1 54504 54504
Networking
24 Port Switch 3 8904 26712
16 Port Switch 1 2415 2415
24 Port Jack Panel 3 3606 10817
19" Rack 3 5329 15987
LI UPS VA 0.65 VAH 168 3 3083 9249
500MHz CAT6 UTP Cable roll with 305m
length 5 4680
23400
Conduit Pipe per m-5.08cm(2.0 inch) 686 29 19976
Single Information Outlet 47 94 4399
CAT6 UTP Patch Cord-1m 35 94 3276
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92
CAT6 UTP Patch Cord-2m 35 114 4004
Cable Installation 1525 11 16775
Fixing of Rack 3 90 270
Fixing of IO 47 9 423
Fixing of Jack Panel 3 25 75
137779
Manpower
Technical Assistant (for 3 years) 1 12000 432000
Data Entry Operator (for 3 years) 2 7000 504000
936000
Total Jowai Civil Hospital 2657554
Nongpoh Civil Hospital
Quantity Price
(Rs.)
Amount
(Rs.)
Hardware
Desktop Intel Pentium Dual Core Processor 12 27140 325680
LJ Printer 5 5475 27375
DM Printer 7 5973 41811
Scanner 1 2724 2724
LI UPS VA 0.65 VAH 168 12 3083 36997
434587
Networking
24 Port Switch 1 8904 8904
24 Port Jack Panel 1 3606 3606
19" Rack 1 5329 5329
LI UPS VA 0.65 VAH 168 1 3083 3083
CAT6 UTP Patch Cord-1m 12 94 1123
CAT6 UTP Patch Cord-2m 12 114 1373
Fixing of Rack 1 90 90
Fixing of Jack Panel 1 25 25
23533
Manpower
Technical Assistant (for 3 years) 1 12000 432000
Data Entry Operator (for 3 years) 1 7000 252000
684000
Total Nongpoh Civil Hospital 1142120
Tura Civil Hospital
Quantity Price
(Rs.)
Amount
(Rs.)
Hardware
Desktop Intel Pentium Dual Core Processor 14 27140 379960
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LJ Printer 3 5475 16425
DM Printer 11 5973 65703
Scanner 1 2724 2724
LI UPS VA 0.65 VAH 168 14 3083 43164
507976
Networking
24 Port Switch 1 8904 8904
24 Port Jack Panel 1 3606 3606
19" Rack 1 5329 5329
LI UPS VA 0.65 VAH 168 1 3083 3083
CAT6 UTP Patch Cord-1m 14 94 1310
CAT6 UTP Patch Cord-2m 14 114 1602
Fixing of Rack 1 90 90
Fixing of Jack Panel 1 25 25
23949
Manpower
Technical Assistant (for 3 years) 1 12000 432000
Data Entry Operator (for 3 years) 3 7000 756000
1188000
Total Tura Civil Hospital 1719924
Williamnagar Civil Hospital
Quantity Price
(Rs.)
Amount
(Rs.)
Hardware
Desktop Intel Pentium Dual Core Processor 13 27140 352820
LJ Printer 6 5475 32850
DM Printer 7 5973 41811
Scanner 1 2724 2724
LI UPS VA 0.65 VAH 168 13 3083 40081
470286
Networking
24 Port Switch 1 8904 8904
24 Port Jack Panel 1 3606 3606
19" Rack 1 5329 5329
LI UPS VA 0.65 VAH 168 1 3083 3083
CAT6 UTP Patch Cord-1m 13 94 1217
CAT6 UTP Patch Cord-2m 13 114 1487
Fixing of Rack 1 90 90
Fixing of Jack Panel 1 25 25
23741
Manpower
Technical Assistant (for 3 years) 1 12000 432000
Data Entry Operator (for 3 years) 1 7000 252000
Page 94
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684000
Total Williamnagar Civil Hospital 1178026
Grand Total 8434501
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B.19. Procurement
1. Drugs
State Health Society placed supply order for procurement of drugs under NRHM through
bidding process open tender for the medicines as per the approved list of medicines. NRHM will
further strengthen the logistics and supply of medicine by strengthening the warehouse in the
districts and providing advance training for the existing staff at district to handle medicines and
supplies. All Civil Works related to District warehouses has been completed and all staff are
trained and they are in place. The logistic system and management of drug chain will be installed
to avoid stock out of drugs at periphery including contraceptives and supplies. The state is now
gearing up with the implementation of ProMIS to ensure the systematic supply chain
mechanisms.
The medicines, drug and consumables are being procured based on the requirements submitted
from all districts, hospitals and other health establishments, as per the list of essential drugs
procured by the central warehouse.
To strengthen the logistics and ensuring the availability of essential drugs as per IPHS, following
activities have been proposed:
Budget:
Activities Total No. Rate (Rs.) Total Budget (Rs.)
Essential Drugs for SCs, PHCs, CHCs and DHs
as per IPHS norms.
7,50,00,000
Total for 2011-12 7, 50, 00, 000
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96
2. STRENGTHENING THE LOGISTICS
Meghalaya government has a drug warehouse at Shillong which was not sufficient and for the
Directorate of Health Services (MCH&FW) there was no drug warehouse of its own till 2008.
During 2008-09 one space is rented as drug warehouse and construction of a state was completed
this year the state now has the capacity to store all the drugs for all the seven districts before
dispatching to the respective district.
At the PHCs and CHCs a room is designated as a store room. Most do not have proper racks as a
result most of the drugs and other equipment are placed on the floor.
State has already recruited full time trained manpower for the warehouse they will be continued
and similar full time trained manpower at the district levels also is required.
4 district warehouses were constructed this year which we need the manpower for making it
operationalise by April 2010. Furniture, computer, printers, UPS and furniture, storage racks etc
will be required, the budget provision has been projected.
Finally, considering the urgency of medicine and other consumables and supplies to the far-flung
district HQ, at present there is difficulty experience for transportation of them and their reach on
time. Periodic hiring of mini truck or certain vehicle, at the usual trip once a month in all the 6
districts has been the way the medicines are supplied, without this regular hiring of vehicle the
purpose of efficient store management and distribution will be defeated, therefore, mobility and
movement expenditure for store and accompanying Asstt store keeper. The State has recently
procure two trucks for transportation of the required medicines to the districts at the earliest. The
POL for the same has been budgeted .
To streamline the Storage, Supply and Distribution System, at all the health facilities throughout
the state, following activities have been proposed:
Activities:
Software for Drugs Procurement Management Information System and Inventory Control has
been developed by National Informatics Center, Shillong with inputs from Directorate of Health
Services, Meghalaya.
The pilot project has already been test run in Central Drug Warehouse to enable testing of the
software. Further minor revisions in report generation are required before full scale
implementation at District facility level.
As the software is web based and on Open Source platform the cost of implementation of the
same is for manpower, training and IT infrastructure.
It is therefore proposed that pilot roll out of the project be initiated during the year 2010 plan
period and for CHC/PHCs be planned during 2010-2011.
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(Separate budget for implementing ProMIS has been projected in M&E)
The staffing of Warehouse:
a. Store Keeper: 1 no. @ Rs.22000/- pm
(D Pharma with knowledge of handling Stores in computerized inventory system)
b. Asstt. Store Keeper: 1 no. @ Rs. 12000/- pm
(D. Pharma with knowledge of handling stores)
c. Clerical Asstt: 1 no. @ Rs.10000/- pm
(Graduate with working knowledge of MS Office)
d. Helpers: 5nos. @ Rs.8000/- pm
(Class VIII Pass having working experience in warehouse)
e. Cleaner: 1 no. @ Rs. 4000/- pm
Office Expenses:
Office Stationary @ Rs.10000/- pm
Electric Charges @ Rs.10000/- pm
Miscellaneous @ Rs.10000/- pm
Contingency:
a) Curtain & Carpets for Office Rs. 30000/-
b) POL for dropping Medicines to Districts Rs. 3,60,000/-
c) Labour charge for loading and undloading of Medicines Rs 18,000/-
At the district level also a district warehouse for three districts will be complete soon and will
be operational from 2009-10 and for the remaining 4 district space will be rented and operation
will start for each of the 7 districts. Construction of district warehouse for 4 districts will start
soon in 2009-2010.
The District warehouse will be manned by a Store Assistant, recruited on contractual basis
from NRHM.
The entire district warehouse will be supplied with adequate equipments and furniture.
Training will be imparted to the newly recruited personnel at the district level.
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Budget:
Cost for state warehouse for salary and office expenses
Activities Total
No.
Rate
(Rs.)
Total
(Rs.)
State warehouse (Continuation of activity)
Salary of Store Keeper @ 22000 per month 1 x12 17250 207000
Salary of Asst. Store Keeper @ 12000 per month 1 x12 11500 138000
Salary of Clerical Asst. @ 10000 per month 1 x12 9200 110400
Salary of Helper @ 8000 per month 5 x12 8050 483000
Salary of Chowkidar cum Peon 1 x12 6000 72000
Sub Total 1010400
Office Expenses for state warehouse (Continuation of activity)
1. Office Stationary @ Rs.10000/- pm 12 10000 120000
2. Electric Charges @ Rs.10000/- pm 12 10000 120000
3. Miscellaneous @ Rs.10000/- pm 12 10000 120000
Contingency for State warehouse
a) Curtain & carpets 30000
b) POL for dropping Medicines to 7 Districts 12 30000 360000
c) Labour charge for loading and unloading of Medicines 12 1500 18000
Modification of upper stairs of the warehouse for smoother loading 200000
Equipments & Furnitures for the State warehouse
Computer 1 40000 40000
Trolley for lifting Medicines 5 5000 25000
Sub Total 1033000
Total for State Ware House (Continuation of activity) 20,43,400
Page 99
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BUDGET FOR STRENGTHENING THE LOGISTICS for 7 Districts (2010-11)
Sl.
NO
Activity Unit Quantity Rate (Rs) Total Amount
Rs.
1 Salary of Store Keeper @ Rs. 12000/- 7 12 13800.00 1159200
2 Salary of Clerical Asst.@ Rs. 8000/- 7 12 9200.00 772800
3 Salary of Helper @ Rs. 7000/- 14 12 8050.00 1352400
4 Chowkidar Cum Peon (District
Warehouse) Rs.6000
7 12 6900.00 579600
5 Office expenditure calculated @ 12000
pm
7 12 12000 1008000
6 15 KWA generator for all the district
warehouse
7 1 275000 1925000
Total 6797000
Construction and furniture for the newly constructed district warehouses:
Activities Total
No.
Rate
(Rs.)
Total (Rs.)
Furniture for three district warehouses (New activity proposed in 2010-2011)
Big Steel Rack 5 14000 56000
Steel Almirah 3 7500 22500
Deep Freezer 1 40000 40000
Refrigerator 365 ltrs 2 22000 44000
Office Table 2 3000 6000
Office Chair 3 2000 6000
Visitors Chair 3 1500 4500
Wooden Bench 2 2000 4000
Steel Stairs 2 3500 7000
Computer System 1 35000 35000
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100
Computer Printer 1 9000 9000
Contingency (5%) 12500
Sub Total (New activity proposed in 2010-2011) 246500
For 4 Dist. Warehouses total amount is 246500 x 4
(New activity proposed in 2010-2011)
986000
Grand Total for strengthening of 7 District warehouses (A + B)
(Not Budgeted – Carried Forward Activity)
7783000
Total for Regional Warehouse: Rs. 9850800/-
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B.27. Programme Management
1. Salary
Block Level PMU Actual Proposed Total
B.27.1 Block Programme Manager 39 15000.00 17250.00 8073000.00
B.27.1 Block Accounts Manager 39 12000.00 13800.00 6458400.00
B.27.1 Block Data Manager 39 10000.00 11500.00 5382000.00
B27.1 Mobility fund for BPMU @ 10,000/- per block 39 4680000.00
B27.1 Contingencies @ 8,000/- per BPMU 39 3744000.00
District Level
B.27.2 District Vaccine and Logistic Handler 7 6000.00 6900.00 579600.00
B.27.2 District Warehouse Store Keeper - Pharmacist 7 12000.00 13800.00
Budgeted under Strengthening of Logistics
B.27.2 District Warehouse Clerical Assistant 7 8000.00 9200.00
Budgeted under Strengthening of Logistics
B.27.2 District Warehouse Helper 14 7000.00 8050.00
Budgeted under Strengthening of Logistics
B.27.2 District Warehouse Chowkidar cum Peon 7 6000.00 6900.00
Budgeted under Strengthening of Logistics
State Level
B.27.3 NGO Coordinator 1 20000.00 23000.00 276000.00
B.27.3 Communication Officer 1 20000.00 23000.00 276000.00
B.27.3 IEC consultant 1 20000.00 23000.00 276000.00
B.27.3 Demographer 1 20000.00 23000.00 276000.00
B.27.3 Manager (HR & Admin) 1 20000.00 23000.00 276000.00
B.27.3 Accountant (Ganesh Das Hospital) 1 20000.00 240000.00
B.27.3 State Warehouse Storekeeper - Pharmacist 1 15000.00 17250.00
Budgeted under Strengthening of Logistics
B.27.3 State Warehouse Assistant Store Keeper 1 10000.00 11500.00
Budgeted under Strengthening of Logistics
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B.27.3 State Warehouse Clerical Assistant 1 8000.00 9200.00
Budgeted under Strengthening of Logistics
B.27.3 State Warehouse Helper 1 7000.00 8050.00
Budgeted under Strengthening of Logistics
B.27.3 State Warehouse Chowkidar cum Peon 1 6000.00
Budgeted under Strengthening of Logistics
B.27.3 Computer Assistant 1 8000.00 9200.00 110400.00
Audit Fees Put Up Under Strengthening Of Financial System
B27.4 Statutory Audit & associated activities 700000.00
Concurrent Audit system Put Up Under Strengthening Of Financial System
B27.5 Concurrent Audit system 3600000.00
Other Management Cost
B.27.8 PHC Accountants 118 9000.00 10350.00 14655600.00
B.27.8 Mobility & Contingency fund for PHC Accountant @ Rs. 2000 pm
2832000.00
B.27.8 Office Expense - SPMU 1500000.00
B.27.8 Mobility - SPMU 7500000.00
B.27.8 Office Expense - DPMU 840000.00
B.27.8 Mobility - DPMU 1680000.00
Other Expenses
B.28 Sponsorship for 4 candiadtes for PG Diploma in Management Course at IIPH, New Delhi @ 2.5 lakh per candidate
1000000.00
Total 64955000
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2. Bio-Medical Waste Management System- (Carried forward to 2011-12)
1. INTRODUCTION
The scope of the proposal is to ensure a safer management of the solid wastes generated by
Health Care Units in urban, peri-urban, and rural areas of Meghalaya. More specifically options
for the safe disposal of wastes at the level of a Health Care Unit are outlined below.
It is the intention of this proposal to establish infrastructure and a bio-medical waste management
system at 100 centers distributed as follows:
State Capital: 3 centers
District Headquarters: 8 centers
Block Headquarters: 39 centers
Rural Centers: 50 centers
Type of Bio-Medical Waste
The wastes from healthcare facilities are differentiated into at least four major categories. There
are additional sub-categories, but in general it can be grouped as:
a. General Solid Waste: This is the majority of all wastes found in health care facilities
and is similar to wastes generated by other businesses and institutions (mostly paper), restaurants
(organic wastes and packaging), hotels (general trash), godowns (packaging), construction
wastes and other wastes commonly found in the general municipal waste stream.
b. Infectious Waste: The wastes generated in direct patient treatment or diagnosis that are
suspected to contain pathogens (bacteria, viruses, parasites, or fungi) in sufficient concentration,
quantity and virulence that they could cause disease in a susceptible host. This includes cultures
and stocks from labs, blood, sharps, and pathological waste. Infectious Sharps consist of syringe
or other needles, blades, infusion sets, broken glass or other items that can cause direct injury.
Infectious non-sharps include materials that have been in contact with human blood, or its
derivatives, bandages, swabs or items soaked with blood, isolation wastes from highly infectious
patients (including food residues), used and obsolete vaccine vials, bedding and other
contaminated materials infected with human pathogens. Human excreta from patients are also
included in this category.
c. Hazardous Chemical Waste: Large numbers of hazardous chemicals are used in
hospitals to disinfect, clean, operate equipment, treat and diagnosis disease. These range from
genotoxic chemicals used in cancer treatment to oils and solvents used to operate boilers.
d. Radioactive Waste: Used in treatment and diagnosis.
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Table 1: Approximate percentage of waste type per total waste in a Health Care Unit
Non-infectious waste 80%
Pathological waste and infectious waste 15%
Sharps waste 1%
Chemical or pharmaceutical waste 3%
Pressurized cylinders, broken thermometers less than 1%
2. IMPERATIVES IN REGARD TO MANAGEMENT OF BIO-MEDICAL WASTE
Poor management of health-care waste can cause serious disease to health-care personnel, to
waste workers, patients and to the general public. The greatest risk posed by infectious waste is
accidental needle stick injuries, which can cause hepatitis B and hepatitis C and HIV infection.
There are however numerous other diseases which could be transmitted by contact with
infectious health-care wastes.
2.1 Occupational Risks
During the handling of wastes, injuries occur when syringe-needles or other sharps have not been
collected in rigid puncture proof containers. Inappropriate design and/or overflow of existing
sharps container and moreover unprotected pits increase risk exposure of the health care workers,
of waste handlers and of the community at large, to needle stick injuries.
2.2 Risk to general public:
The reuse of infectious syringes represents a major threat to public health. WHO estimates that,
based on previous estimates and recent updates, worldwide injections undertaken with
contaminated syringes caused about 23 million infections of Hepatitis B and Hepatitis C and
HIV annually.
Such situations are very likely to happen when health-care waste is dumped on un-controlled
sites where it can be easily accessed by the public: children are particularly at risk to come in
contact with infectious wastes. The contact with toxic chemicals, such as disinfectants may cause
accidents when they are accessible to the public. The results of a WHO assessment conducted in
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22 developing countries showed that the proportion of health care facilities that do not use proper
waste disposal methods range from 18% to 64% .
There is a further possibility of risk to the general public that occur in three ways:
Accidental exposure from contact with wastes at municipal disposal bins
Exposure to chemical or biological contaminants in water;
Exposure to chemical pollutants (e.g., mercury, dioxin) from incineration of the wastes
2.3 Risk for the environment:
In addition to health risks derived from direct contact, health-care waste can adversely impact
human health by contaminating water bodies during waste treatment and by polluting the air
through emissions of highly toxic gases during incineration.
When wastes are disposed of in a pit which is not lined or close to water sources, the water
bodies may become contaminated.
If health-care waste is burned openly or in an incinerator with no emission control (which is the
case with the majority of incinerators), dioxins and furans and other toxics air pollutants may be
produced. This would cause serious illness in people who inhale this air.
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3. FUNCTIONAL ELEMENTS OF BIO MEDICAL WASTE MANAGEMENT
The following are the basic elements of solid waste management as they apply to the
management of waste generated Health Care Unit. These elements cover the “waste stream”
from its generation to its final disposal. Each functional element is described in detail below:
WASTE STREAM
Minimization
Segregation
Codification
Handling
Transportation
Treatment
Disposal
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1. FINANCIALS
5.1. HEALTH CARE CENTRE LOCATED AT STATE CAPITAL
Units: 3 Nos
Sl Equipment Unit Cost in INR Type of Waste
1 Hydroclave 1 3000000.00 Biodegradable Infectious Waste
2 Microwave 1 696000.00 Infected Plastic Waste
3 Autoclave 1 38500.00 For Infectious Waste
4 Plastic Shredder 1 250000.00 Plastic Waste after disinfection
5
Syringe cutters and needle
destroyers LS 25000.00
Disinfection and mutilation of
injection equipment
6 Drums and Containers
Plastic drums 50 150000.00 For segregated collection
Metal drums for kerb side 20 40000.00
7 Consumables - Annual Cost Per Year 500000.00 Plastic Liners and Disinfectants
8 Safety Equipment and Clothing LS 30000.00
9 Transportation Vehicles
Handcarts 10 25000.00 For transportation of
biomedical waste Specialized ACE Vehicle 1 500000.00
TOTAL COST 5254500.00
GRAND TOTAL 15763500.00 Multiplied by 3 Units
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BUDGET SUMMARY FOR NRHM:
Component Amount (Lacs) ASHA 64580000.00 VHSC 63060000.00 Untied Funds 45225000.00 Annual Maintenance Grant 12600000.00 Rogi Kalyan Samiti 18800000.00 Hospital Strengthening 302700000.00 AYUSH 46560000.00 IEC - Health Mela 4200000.00 Medical Mobile Unit 17493000.00 Referral Transport - High Focus Districts 12120000.00 Manpower - Additional Contractual Staff 112756800.00 PPP - NGO 19847552.00 PPP - EMRI 101699000.00 Training under NRHM 30587672.00 Training of Mos - IIM 4950000.00 Incentive to Staff - Difficult Areas 34450000.00 Monitoring & Evaluation - HMIS 112722090.00 Procurement - Medicines 75000000.00 Strengthening of Logistics 9850800.00 Programme Management 64955000.00 Bio Medical Waste 15763500.00 TOTAL NRHM 1169920414.00
Rupees. One Hundred Sixteen Crores, Ninety Nine Lakhs Twenty Thousand
Four Hundred and Fourteen Only.
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