Preface - Government Of Assam, India

1

Preface

NUHM envisages to meet health care needs of the urban population with the focus on urban poor, by

making available to them essential primary health care services and reducing their out of pocket

expenses for treatment. This will be achieved by strengthening the existing health care service delivery

system, targeting the people living in slums and converging with various schemes relating to wider

determinants of health like drinking water, sanitation, school education, etc.

All the services delivered under the urban health delivery system through the Urban-PHCs and Urban-

CHCs will be universal in nature, whereas the outreach services will be targeted to the target groups

(slum dwellers and other vulnerable groups). Empowerment of community through awareness

generation, whereby they are able to demand services from the Health System will be an important

area of emphasis in the NUHM.

NUHM through the urban HWCs will specifically address the peculiarities of urban health needs

through package of services, which constitutes non communicable diseases (NCDs) as a major

proportion of the burden of disease. The primary health care system being envisaged under NUHM

will screen, diagnose and refer the cases of chronic diseases to the secondary and tertiary level through

a system of referral. A major thrust this year will also be on the family planning services like the

IUCD which will go a long way in curbing the uncontrolled population growth and reduce the fertility

rates. Vector control, environmental health, water, sanitation, housing, all require a public health

thrust.

There will also be the implementation of the National programmes like National Vector Borne Disease

Control Programme (NVBDCP), Revised National Tuberculosis Control Programme (RNTCP),

Integrated Disease Surveillance Project ( IDSP) and National Leprosy Elimination Programme

(NLEP)

The standard of services in the urban areas will be ensured through proper training of the service

provider so that the various facility based and the community based outreach programmes like the

UHNDs, special outreach camps, other health camps render highest quality of service.

Hingulas Khakhalary

Urban Health Consultant

NUHM

2

Budget Summary with owner of the FMR Code

Sl.No. FMR Code Activities ROP 2019-20 Approval (Rs.

in Lakhs)

Allocation at State HQ(Rs.

in Lakhs)

Allocation for

District’s(Rs. in Lakhs)

Officer responsible in the State level

U.1 Service Delivery – Facility Based

1 U.1.1.1 Support for control of Communicable Disease

1.85 0 1.85 Dr. Pankaj Sahu, Specialist Community Medicine

2 U.1.3.1 Operational Expenses of UPHCs(excluding rent)

66 0 66 Pranjal Borah, Accounts Manager,

NUHM

3 U.1.3.4 Others(Operational Expenses of

UCHC -excluding rent) 2.4 0 2.4 Pranjal Borah, Accounts Manager,

NUHM

U.2 Service Delivery - Community Based 4 U.2.2.1 Mobility support for ANM/LHV 11.7 0 11.7 Hingulas Khakhalary, Consultant,

NUHM

5 U.2.3.1 UHNDs 5.85 0 5.85 Dr. Pankaj Sahu, Specialist Community Medicine/SCM

6 U.2.3.2 Special Outreach camps in slums/vulnerable areas

9.10 0 9.10 Hingulas Khakhalary, Consultant, NUHM

7 U.2.3.3 Support for control of Communicable Disease

21.69 21.69 0 Dr. Umesh Phangcho, SPO, NVBDCP/ Consultant,NUHM

8 U.2.3.5 Others(Health check Camp for Sanitary workers)

2.05 0 2.05 Dr. Pankaj Sahu, Specialist Community Medicine

U.3 - Community Interventions

9 U.3.1.1.1 Incentives for Routine activities 290.88 0 290.88 Partha Saikia, SCM/ Consultant, NUHM

10 U.3.1.2 ASHA Trainings 9.48 .70 8.78 Partha Saikia, SCM/ Consultant, NUHM

11 U.3.1.3.1 Other Non- Monetary Incentives 5.45 5.45 0 SPM/ SCM

3

Costs(badge, uniform, ID etc)

12 U.3.2.1.1 Training of MAS 74.95 0 74.95 Hingulas Khakhalary, Consultant, NUHM

13 U.3.4.1 Capacity Building 2.47 2.47 0 Hingulas Khakhalary, Consultant, NUHM

U.4 – Untied grants

14 U.4.1.1.1 Government Building 45.50 0 45.50 Consultant(P)/ Finance Manager

15 U.4.1.1.2 Rented Building 29 0 29 Consultant(P)/ Finance Manager

16 U.4.1.2 Untied grants to UCHCs 10 0 10 Consultant(P)/ Finance Manager

17 U.4.1.4 Untied grants to MAS 32.90 0 32.90 Pranjal Borah, AM,NUHM

U.5 – Infrastructure

18 U.5.1.4.1 Rent for UPHC 48.72 0 48.72 Pranjal Borah, AM,NUHM

19 U.5.1.4.2 Any Other 29.64 29.64 0 Consultant, NUHM/ AM, NUHM

20 U.5.2.1 UPHC(New Constructions) 180 180 0 Consultant, NUHM/ Himangshu Kalita, AE

U.6 – Procurement

21 U.6.1.1 Equipment for UPHC 14.19 14.19 0 Sristi Sut, BME

22 U.6.1.2 Equipment for UCHC .53 .53 0 Sristi Sut, BME

23 U.6.5 Procurement(Others) 53.01 53.01 0 Sristi Sut, BME/ Consultant, RKSK

U.8 - Service Delivery - Human Resource

24 U.8 Service Delivery - Human Resource

1234.11 1234.11 0 Consultant, HR

U.9 - Training & Capacity Building

25 U.9.5.1 Training/Orientation of ANM and other paramedical staff

7.73 2.33 5.40 Monikha Buragohain,

SPM-2, NHM

26 U.9.5.2 Training/Orientation of Medical Officers

3 3 0 Dr. Pankaj Sahu, Specialist Community Medicine

4

27 U.9.5.6 Training on Other Disease Control Program

16.15 0 16.15 Dr. Pankaj Sahu, Specialist Community

Medicine/SPO,NCD

28 U.9.5.8 Other Trainings(ULB Members) 4.10 0 4.10 Hingulas Khakhalary, Consultant, NUHM

U.11 - IEC/ BCC 29 U.11.1 Print Media 34.26 34.26 0 SPM-I/ SME

30 U.11.2 Electronic Media 47.18 47.18 0 SME/ Consultant, NUHM

31 U.11.3 IPC 2.38 0 2.38 SME/ Consultant, NUHM

32 U.11.4 Other Media 14.21 0 14.21 SME/ Consultant, NUHM

U.12 – Printing

33 U.12.1 Printing activities 16.69 16.69 0 Deepjyoti Deka, SPM,NHM

U.13 - Quality Assurance

34 U.13.1.1 Quality Assurance 8.82 1.50 7.32 Dr. Rohini Kumar Consultant, Quality Assurance

35 U.13.2.1 Support for Implementation of Kayakalp

15.25 5.05 10.20 Dr. Rohini Kumar Consultant, Quality Assurance

36 U.13.2.2 Swachh Swasth Sarvatra 7.77 2.5 5.27 Dr. Pankaj Sahu, Specialist Community Medicine

U.16 - Programme Management

37 U.16.2.1 QA committees at city level(meetings, workshops etc)

1.12 0 1.12 Dr. Rohini Kumar Consultant, Quality Assurance

38 U.16.8.1 State PMU 18.96 18.96 0 Pranjit Roy, Consultant HR/ Consultant, NUHM

39 U.16.8.2.1 Human Resource 39.30 39.30 0 Pranjit Roy, Consultant HR

40 U.16.8.2.2 Mobility Support 37.80 19.5 18.30 Hingulas Khakhalary, Consultant, NUHM

41 U.16.8.2.3 Administrative expenses(including Review meetings, workshops etc)

25.20 22.20 3 Pranjal Borah, AM,NUHM

TOTAL 2481.39 1754.256 727.134

5

Activity:-Support for control of communicable disease

FMR Code: U.1.1.1

Activity owner

At State level – Dr. Pankaj Sahu, Specialist Community Medicine

At District level – District Urban Health Coordinator, NUHM

Objective: Most of the Leprosy patients in the urban areas are found to be migratory patients. Therefore

conducting active survey to be done in slum areas, brick kiln and construction sites and also in the Schools for

identifying hidden Leprosy cases.

Implementation Guideline:

1. Formation of Survey team

Team should consist of four (4) members including-

One Medical officer (Dist. Nodal Officer)

One Non Medical Assistant (NMA),

One Non medical Supervisor and

One Urban ASHA/link worker will do the survey

2. Identification of survey sites by District Nodal Officer of Leprosy Deptt. with the help of

ASHA/Link worker

3. Survey form is to be collected from District Leprosy Deptt, respective district for survey.

4. Detail action plan to be prepared by the team for conducting the active survey

a. House to house survey should be done in identified area

b. Suspected case is to be registered by the Medical officer under NLEP. The patients will be

given choice of continuing the treatment at the UPHC or the District cell.

c. Record keeping register is to be maintained by the Nodal officer and a copy of the same

should be with District Urban Health Coordinator.

d. ASHA/Link worker will follow-up the positive cases.

e. ASHA/Link worker will claim the incentive from the District leprosy cell.

Detail budget break-up

Sl.

No. Districts. Urban areas

Active Survey

@Rs.5000/- Total (In Rs.)

1. Cachar. Silchar. 3 15000.00

2. Dhubri. Dhubri. 3 15000.00

3. Dibrugarh. Dibrugarh. 5 25000.00

4. Nagaon. Nagaon. 4 20000.00

5. Lakhimpur. North Lakhimpur. 3 15000.00

6. Tinsukia. Tinsukia. 6 30000.00

7. Karimganj. Karimganj. 3 15000.00

8. Kamrup (M) Guwahati City 10 50000.00

GRAND TOTAL 37 1,85,000/-

Note: DUHC will follow up the plan for active Survey Camps in coordination with District Leprosy

Department, in respective district.

6

Operating Expenses

Activity: Operational Expenses of UPHCs (excluding rent)

FMR Code: U.1.3.1

Activity owner

At State level – Pranjal Borah, Accounts Manager, NUHM


Each UPHCs will be given lump sum of Rs. 10000/-per month for one year. Fund should be utilized

for the payment of electricity bill, telephone bill, alternative power supply and stationery items etcfor

smooth functioning of health institutions.

Budget Details as follows:

No. of Unit Unit Cost (Rs) Total Cost (In Rs.) In lakh

55 120000 6600000.00 66.00

SL. NO. Nameof health institution Remarks District Amount (Rs)

1 NATBOMA PHC Govt

Kamrup Metro 4200000

2 SATGAON PHC Govt

3 KHARGHULIi MPHC Govt

4 ODALBAKRA MPHC Govt

5 KHANAPARA SD Govt

6 CAPITAL SD Govt

7 WEST GHY SD Govt

8 EAST GHY SD Govt

9 GARIGAON SD Govt

10 BHETAPARA SD Govt

11 KAMAKHYA SD Govt

12 LOKHARA SD Govt

13 HENGRABARI MU Govt

14 ULUBARI UHC Govt

15 AMINGAON UPHC Rented

16 GARPANDU UPHC Rented

17 PANDU NATH UPHC Rented

18 FERRYGHAT UPHC Rented

19 GOTANAGAR UPHC Govt

20 FATASIL UPHC Rented

21 SERABHATI UPHC Govt

22 GANDHIBASTI UPHC Rented

23 MATHGHARIA UPHC Rented

24 BATAGHULI UPHC Rented

25 BIRKUCHI UPHC Rented

26 HATIGARH CHARIALI Rented

7

27 KAHILIPARA UPHC Rented

28 KOINADHARA UPHC Rented

29 NORTH GHY UPHC Rented

30 CHOONSALI UPHC Rented

31 BASISTHA MANDIR UPHC Rented

32 PANDU UPHC Govt

33 KRISHNANAGAR UPHC Rented

34 PIYALI PHUKAN NAGAR UPHC Rented

35 MEDICAL UNIT, ASSAM

SECRETARIATE, DISPUR Govt

36 KAMPUR UPHC Govt

Nagaon 360000 37 MAHKHULI UPHC Govt

38 DHING GATE, HOIBORGAON Rented

39 WOOD UPHC Govt Sivasagar 240000 40 SONARI UPHC Govt

41 MISSIONPARA UPHC Rented Tinsukia 240000

42 MARGHERITA UPHC Govt

43 JORHAT UPHC Rented

Jorhat 360000 44 MARIYONI UPHC Govt

45 CINAMORA UPHC Govt

46 DIBRUGARH UPHC Govt

Dibrugarh 240000 47 DULIAJAN UPHC Govt

48 BHAWLAGURI UPHC Rented Bongaigaon 120000

49 SILCHAR UPHC Rented Cachar 120000

50 DHUBRI UPHC Rented Dhubri 120000

51 KARIMGANJ UPHC Rented Karimganj 120000

52 JAHAJGHAT UPHC Rented Sonitpur 120000

53 CHAPORIGAON UPHC Rented Lakhimpur 120000

54 GOALPARA UPHC Rented Goalpara 120000

55 DIPHU UPHC Rented KabiAnglong 120000

Total

66,00,000/-

Activity: Others (Operational Expenses of UCHC -excluding rent).

FMR Code: U.1.3.4

Activity owner



2 nos. of UCHCs will be provided Rs.10000/- per month for one year. Fund should be utilized for thepayment of

electricity bill, telephone bill, alternative power supply, stationery items etc.

Budget Details as follows:

No. of Unit Unit Cost(Rs) Total Cost (In Rs.) In lakh

Dhirenpara

CHC 120000

Kamrup

Metro 2,40,000 2.40

Pandu CHC 120000

8

Activity:-Mobility support for ANM/LHV

FMR Code U.2.2.1

Activity owner

At State level – Hingulas Khakhalary,Consultant, NUHM

At District level – DAM/ District Urban Health Coordinator, NUHM

Mobility expenses for ANM @ Rs.500/- per month per ANM. Mobility expenses to ANM should be

paid for organizing and strengthening of Urban Health & Nutrition sessions, Outreach sessions and for

National health Programmes as per actual/ as per Action Plan and program attained and organised.

District Amount Quantity Total

Kamrup Metro 6000 100 600000

Nagaon 6000 15 90000

Sivasagar 6000 10 60000

Tinsukia 6000 10 60000

Jorhat 6000 10 60000

Dibrugarh 6000 10 60000

Bongaigaon 6000 5 30000

Cachar 6000 5 30000

Dhubri 6000 5 30000

Karimganj 6000 5 30000

Sonitpur 6000 5 30000

Lakhimpur 6000 5 30000

Goalpara 6000 5 30000

Karbi Anglong 6000 5 30000

Total

1170000

9

Activity: Urban Health and Nutrition Day (UHND)

FMR Code: U.2.3.1

Activity owner

At State level – SCM/ Dr. Pankaj Sahu, Specialist Community Medicine


The Urban Health and Nutrition Day (UHND) is a platform for the community people to access

services for a package of preventive, promotive and basic curative care.

Guidelines for implementing UHND camps:

Service Package to be provided at UHND:

(a) MATERNAL HEALTH

Early registration of pregnancies.

Provision of full complement of ANC services with quality and accuracy, namely

o Weight measurement

o Abdominal Check-up

o TT injections

o BP measurement

o Haemoglobin Measurement

o Filling up of MCP Card with accurate & complete information

Referral for women with signs of complications during pregnancy and those needing

emergency care.

Referral for safe abortion to approved MTP centres.

Counselling on:

o Education of girls.

o Age at marriage.

o Care during pregnancy.

o Danger signs during pregnancy.

o Birth preparedness.

o Importance of nutrition.

o Institutional delivery.

o Identification of referral transport.

o Availability of funds under the JSY for referral transport.

o Post-natal care. o Breastfeeding and complementary feeding.

o Care of a newborn.

o Contraception.

10

Organizing group discussions on maternal deaths, if any that have occurred during

theprevious month in order to identify and analyse the possible causes.

(b) CHILD HEALTH For Infants up to 1 year:

Registration of new births.

Counselling for care of newborns and feeding

Complete routine immunization.

Immunization for dropout children.

First dose of Vitamin A along with measles vaccine.

Weighing

For Children aged 1-3 years:

Booster dose of DPT/OPV.

Second to fifth dose of Vitamin A.

Tablet IFA - (small) to children with clinical anaemia.

Weighing.

Provision of supplementary food for grades of mild malnutrition and referral for cases of

severe malnutrition.

For all children below 5 years:

Tracking and vaccination of missed children by ASHA and AWW.

Case management of those suffering from diarrhoea and Acute Respiratory Infections.

Counselling to all mothers on home management and where to go in even of

complications.

Provide ORS packets.

Counselling on nutrition supplementation and balanced diet.

Counselling on and management of worm infestations.

(c) FAMILY PLANNING

Information on use of contraceptives.

Distribution - provision of contraceptive counselling and provision of non-clinic contraceptives

such as condoms and OCPs.

Information on compensation for loss of wages resulting from sterilization and insurance

scheme for family planning.

(d) NON COMMUNICABLE DISEASES (NCD) SCREENING

Persons aged more than 30 years to be screened for NCDs, viz. Diabetes Mellitus, Hypertension

and Oral cancer.

Monitoring of Blood Pressure (BP), Random Blood Sugar (RBS) and oral visual examination

(OVE) to be done by ANMs assisted by ASHA.

11

REPRODUCTIVE TRACT INFECTIONS AND OTHER RELATED CONDITIONS

Counselling on prevention of RTIs and STIs, including HIV/AIDS, and referral of cases

for diagnosis and treatment.

Counselling for peri-menopausal and post-menopausal problems

Communication on causation, transmission and prevention of HIV/AIDS anddistribution

of condoms for dual protection.

Referral for VCTC and PPTCT services to the appropriate institutions.

(d) HEALTH PROMOTION

Importance of clean drinking water, safe water handling practices, use of longhandleladle,

and ways to keep the water clean at point-of-use, using chlorine tablets, boiling, water

filters, etc.

Education on Healthy food habits, hygienic and correct cooking practices, and had washing.

Testing of household salt sample for Iodine (using the testing kits supplied under NIDDCP

programme)

Avoidance of breeding sites for mosquitoes.

Mobilization of community action for safe disposal of household refuse and garbage.

Gender issues

Communication activities for prevention of pre-natal sex selection, illegality of pre-natalsex

selection, and special alert for one-daughter families.

Communication on the Prevention of Violence against Women and Children,

DomesticViolence Act, 2006.

Age at marriage, especially the importance of appropriate age at marriage for girls.

Issues of Alcohol and drug abuse, tobacco and gender violence

Nutrition issues

Focus on adolescent pregnant women and infants aged 6 months to 2 years.

Checking for anaemia, especially in adolescent girls and pregnant women; checking,

advising, and referring.

Checking, advising and referring for other deficiency disorders (Vitamin-A,

Iodinedeficiency, Protein Calorie Malnutrition, etc.)

Weighing of infants and children.

Supply of iron supplements, vitamins, and micronutrients

A discussion about and review of the AWC’s daily activities at the centre,supplementary

nutrition services being provided for children and pregnant and lactating mothers, and

growth charts being recorded at AWC.

Sanitation issues

12

Identification of space for community toilets.

Guidance on where to go and who to approach for availing of subsidy for thoseeligible to get the same under

the Jawaharlal Nehru National Urban Renewal Mission (JNNURM).

Frequency: Once in a month at a fixed place and fixed date/day. (1 UHND per ANM per month)

Session site:Micro plane to be prepared by the ANM with the help of AWW/ MAS etcand sessions will

be conducted as per micro plan.

Publicity:1.Publicityto be made for dates, place prior to the session.

2. Prominent display on available services andother strategic points in front of

Aganwadi Centre.

Accountability: The ANMs and Urban ASHAs of the operational area will be jointly

responsible for organizing the event.

Cost per session site: A lump sum amount of Rs. 250/- is proposed for organizing each UHND

session. The expenditure may be incurred in-

Refreshment, Contingency Event management cost like organizing event like quiz, story

writing, drawing, mass meeting, day celebration on maternal health, child health,

Adolescent health, safe water treatment, sanitation etc.

UHND Sites to be fixed as per beneficiary load and micro plan prepared by the ANM. All the Urban

ASHAs and ANMs to have designated area of service. Total no. of 2340 UHNDs at 988 sites to be

covered @ Rs.250/- (per ANM 1 session monthly for 1year).

The session site wise budget break-up for each district is as follows:-

Sl. No. District Quantity Total (Rs)

1 Kamrup

Metro 1200 300000

2 Nagaon 180 45000

3 Sivasagar 120 30000

4 Tinsukia 120 30000

5 Jorhat 120 30000

6 Dibrugarh 120 30000

7 Bongaigaon 60 15000

8 Cachar 60 15000

9 Dhubri 60 15000

10 Karimganj 60 15000

11 Sonitpur 60 15000

12 Lakhimpur 60 15000

13 Goalpara 60 15000

14 Karbi

Anglong 60 15000

Total 2340 585000

13

Urban Health and Nutrition Day Monitoring format:

A. Whether ANM provides following services during a UHND? 1) Routine immunization

2) Antenatal care ( essential diagnostics + counselling)

3) Family planning services and counselling

4) Post natal care ( essential diagnostics+ counselling)

5) Nutrition and health promotion and growth monitoring

6) Is Due list for Routine Immunization, ANC,PNC available with ASHA/ANM 7) Micro plan 8) Growth monitoring in MCP card

B. Are high risk pregnancies identified and separately line-listed at the health facility?

C. Does the ANM function as Treatment Supporter (DOT Provider)?

D. Does she refer case of presumptive TB to nearest microscopy centre for diagnosis?

E. Does she provide IEC and community awareness regarding TB symptoms and availability of free services?

F. Status of Population enumeration and CBAC form.

G. Have ASHAs mobilized individuals of 30 years and age above for NCD screening at SHC / SHC- HWC

H. Did the PW receive all services under Antenatal care?(ANC+1 USG+ Diagnostics,IFA,Calcium, Deworming, counselling etc. according to gestational age) under Antenatal care?

I. Is the PW counseled for Post-partum FP choices including PPIUCD by ASHA/ANM during ANC?

J. Counselling for healthy life style (from ASHAs or ANMs)

K. Availability of essential commodities

-

a Pregnancy testing kit (Nischay kit)

Y/N h MBI kit to test iodine level in salt.

Y/N

b COC (Mala N) Y/N I ORS and Zinc Y/N

c Centchroman (CHHAYA) Y/N J HBNC Kit (Newborn weighing Scale, Digital Thermometer, Baby Blanket & Stopwatch)

Y/N

d ECP (EZY PILL) Y/N K Sanitary napkins Y/N

e Condoms (NIRODH) Y/N l Paracetamol Y/N

m Cotrimoxazole (Syp& Tab.) Y/N n Syrup Amoxycillin Y/N

14

f Availability of IFA with ASHA g Availability of IFA at school/AWCs

I 6 month - 5yrs - IFA syrup (Bi-weekly)

Y/N I 5-10yrs-Tab. IFA (Pink colored sugar coated) WIFS

Y/N

II Pregnant women and Lactating mothers -Red IFA Tab

Y/N II 10-19yrs - Tab. IFA (Blue colored - Enteric coated)

Y/N

Other commodities

Weighing scale-adult, child

Examination table

Bed screen/curtain

Haemoglobin metres,

Kits for urine examination

Gloves

Slides

Stethoscope and blood pressure instrument

Measuring tape

Foetoscope

Vaccine carrier with ice packs

AD syringes in sufficient quantity

IEC material for communication and counseling

Blank MCP card

Urban Health and Nutrition Day performance indicator:

In order to monitor the performance of the UHNDs few impact indicators have been prepared based on which the service delivery through the UHNDs can be assessed on the health outcome in the urban population.

Indicators : 1) % of PW Received TT injections 2) % of PW registered in 1st trimester

15

3) % of PW who completed 4ANCs 4) % of PW Received IFA tablets 5) % of PW and child Weighed 6) % of PW Blood pressure measured 7) % of PW Abdominal check-up done 26.3 32.3 8) % of PW Participated in group meetings/discussion on health issues 9) Number of recently delivered women who participated in VHND 10) % of children fully immunized 11) % of children completely immunized 12) Number of SAM children identified. 13) Number of EC protected.

16

Activity: Special Outreach Camp in slums/ vulnerable areas

FMR Code: U.2.3.2 Activity owner

At State level – Hingulas Khakhalary, Consultant, NUHM


Guidelines for implementing Special Outreach camps:

Urban Health & Nutrition Day (Monthly outreach sessions/UHNDs) S

Special Outreach Sessions

WHO: Population to be covered

Slum and vulnerable population (predominantly women and children) in the catchment areas of the UPHC. The already identified patients needing follow-up may be catered to by providing medicines.

Vulnerable groups; emphasis on the most disadvantaged and hardest to reach (migrant labourers, homeless, etc.) Target population for the specific services i.e. All women in a special outreach session being conducted for screening for breast/cervical cancer.

WHAT: Service Coverage

ANC, Immunisation, Health Education, Child Growth Monitoring, Nutrition Supplementation, Nutrition Counselling, education on Water Sanitation and Hygiene, Use of RDK, Drug Dispensing.

Health check-up/Specific services/set of services (for locally endemic diseases and population sub group with specific problems), screening and follow-up (for chronic and non-communicable diseases), basic laboratory investigations (using portable /disposable kits), and drug dispensing.

WHERE: Site of providing the Service

Anganwadi Centre (AWC) or any other community level structure in slum.

Space or structure at the community level in slum/ near vulnerable population (Community Centre, School which may be near Railway Station, railway tracks, city outskirts, Bus Stand, underpasses, outside place of worship, etc.).

BY WHOM:

ANM supported by team of ASHA, AWW, and MAS members.

Doctors/Specialists, Lab Tech, Pharmacist, physiotherapists, social workers. Supported by MO-UPHC, with ANM and ASHA, MAS members and community volunteers.

WHEN: Frequency

Monthly Periodic (as per the local needs in community).

Budget breakup per camp:

Cost head Amount per session (Rs.)

Doctors and Specialists (outsourced, for paying their

fees)

3000

Other paramedical staff (like Pharmacist, Lab

Technician, etc. for paying their fees/ incentive)

1500

Transportation costs 1000

Publicity 1000

Per Special Outreach Camp/Session 6500

17

The district breakup of camps is as follows-

Sl. No

Name of the

District No. of Camps Remarks

Fund

Amount (Rs)

1 Cachar 8 Per Quarter 2 Camp 52000

2 Dhubri 8 Per Quarter 2 Camp 52000

3 Dibrugarh 8 Per Quarter 2 Camp 52000

4 Goalpara 12 Per Quarter 3 Camp 78000

5 Kamrup Metro 48 Per Quarter 12 Camp 312000

6 Karbi Anglong 4 Per Quarter 1 Camp 26000

7 Sivsagar 8 Per Quarter 2 Camp 52000

8 Jorhat 8 Per Quarter 2 Camp 52000

9 Bongaigaon 4 Per Quarter 1 Camp 26000

10 Nagaon 12 Per Quarter 3 Camp 78000

11 Lakhimpur 4 Per Quarter 1 Camp 26000

12 Sonitpur 4 Per Quarter 1 Camp 26000

13 Karimganj 4 Per Quarter 1 Camp 26000

14 Tinsukia 8 Per Quarter 2 Camp 52000

Total 140 910000

Activity: Others (Health check-up of sanitary workers under GMC).

FMR Code: U.2.3.5

Activity owner



Implementation by: District (Kamrup Metro)

Guideline

For periodic health surveillance of sanitary workers to detect early signs of diseases, a periodic health

check-up camp is to be done to minimize the risk of health hazards in Guwahati, Kamrup Metro district. The

services to be provided are

1. Basic investigations,

2. NCD screening,

3. De-worming will be ensured besides treatment

4. referral and

5. Any other identified disease.

Work to be done by DUHC:-

18

Venue to be fixed, Doctor & Specialist to be arranged along with team.

List of the sanitation workers employed with the ULBs (including contractual) is to be carried

during the camp along with a secondary list of sanitation workers who are self-employed or are

in private employment. In order to track that service delivery is provided to the right

beneficiaries and keep tracking of the drop outs or those who were not present during for the

camp.

Each worker must be linked through the Urban ASHA around the geographical area of the

UPHC closest to his/her residence to follow up of treatment.

Preventive care and referral services to be ensured.

Availability of the drugs to be ensured.

Physical performance and financial expenses to be documented and reported.

Budget break-up per camp as below:-

Total no of Sanitary Worker-950

No. of Zones in Kamrup Metro-4

Zone wise no of Sanitary workers will receive check-ups= 50/day (Considering the duty schedule of

Sanitary Workers)

Total no of Camp =20 Nos.

Sl. No Component

Amount per

session/camp

(Rs.)

1 Doctor & Specialist (for paying their fees) 3000.00

2

Other paramedical staff

(like Pharmacist, Lab Technician, Nurse etc. for paying

their fees)

1500.00

3 Working Lunch( @ Rs.250/ member for 5 members) 1250.00

4 Medicines, drugs and consumables (including

consumables

for rapid diagnostic kits)

3500.00

5 Transportation costs 1000.00

6 Publicity (Booked on IEC/BCC FMR Code: U.11.5).

Total amount for one check-up camp 10250.00

Grand total budget for 20 check-up camp 2,05,000.00

19

Activity:- Incentives for routine activities

FMR Code: U.3.1.1.1

Activity owner

At State level – Partha Saikia, State Community Mobiliser/ Consultant,NUHM

At District level – DCM/District Urban Health Coordinator, NUHM

Guideline for payment of incentives for routine activities of ASHA:

FMR Code Sl No Activity Rate of Incentive

U.3.1.1.1.

1 Mobilizing and attending Urban Health and Nutrition Day

Rs 200/-

2 Convening and guiding monthly Urban Health Sanitation and Nutrition meeting

Rs 150/-

3 Attending PHC Review Meeting Rs 150/-

a) Line listing of household done at beginning of the year and updated after every six months

Rs 500/- (Rs100x5)

b) Maintaining Urban health register and supporting universal registration of births and deaths

c) Preparation of due list of children to be immunized updated on monthly basis

d) Preparation of list of ANC beneficiaries to be updated on monthly basis

e) Preparation of list of eligible couples updated on monthly basis

For activity no 1: The ASHA will organize the UHND on the due date in her area. She will ensure proper clenliness of the AWC before the scheduled date of the UHND. She will also prepare the due list of beneficiaries and ensure particpation of the same on the day of UHND.

The ASHA Supervisor will ensure the proper arrangement of the UHND by the concerned ASHA and she will also verify the due list prepared by ASHA in coordination with the ANM and ensure participation during the day of UHND. She will certify in the prescribed format and forward it to the PHC accountant for payment. The amount should be transfered to the ASHA’s account on the same day.

20

For activity no 2: The ASHA will fix the date of UHSNC meeting every month in consultation with the PRI member. She will prepare the agenda of the meeting on the basis of the need of the village. She will ensure the participation of the PRI member along with other members of the commiittee. The minutes and attendence sheet of the meeting convened should be maintained by the ASHA. The ASHA Supervisor will verify the minute and attendence sheet of the meeting and certify in the prescribed format and forward it to the PHC accountant for payment. The amount should be transfered to the ASHA’s account on the same day.

For activity no 3: The ASHA should attend monthly meeting along with Dairy and HBNC Module. The ASHA Supervisor will maintain the attendance sheet and certify in the prescribed format and forward it to the PHC accountant for payment. The amount should be transfered to the ASHA’s account on the same day.

For activity no 4: a) The ASHA will maintain the linelisting in the dairy provided to her.The ASHA Supervisor will

verify the line listing done by her concerned ASHAs and ensure the same in coordination with

the ANM and PRI member. After verification she will certify the same in the prescribed format

and forward it to PHC accaountant for payment.

b) The ASHA will maintain the village health register on monthly basis and ensure registarion of each case of birth and death. The ASHA Supervisor will verify the village health registers of her concerned ASHAs and ensure the same in coordination with the ANM and PRI member. She will also ensure the registration of birth and death case reported by ASHA. After verification she will certify the same in the prescribed format and forward it to PHC accaountant for payment.

c) The ASHA will prepare the due list of children up to 16 years of age and record it on monthly basis. The due list needs to be presented during VHND and ensure the vaccination as per the due list. The ASHA Supervisor will verify the due list prepared by her concerned ASHAs in coordination with the ANM. After verification she will certify the same in the prescribed format and forward it to PHC accountant for payment.

d) The ASHA will prepare the list of benefiaries (pregnant women) for the ANC to be provided. During VHND she will ensure that the due ANCs are provided and will also follow up of the missed ANCs so that it can be provided at SC. The ASHA Supervisor will verify the list of beneficiaries (pregnant women) prepared by her concerned ASHAs in coordination with the ANM. After verification she will certify the same in the prescribed format and forward it to PHC accountant for payment.

e) The ASHA will prepare the list of eligible couple in her village. It also needs to be ensured that the list is updated every month. The ASHA Supervisor will verify the list of eligible couple prepared by her concerned ASHAs in coordination with the ANM and PRI member. After verification she will certify the same in the prescribed format and forward it to PHC accountant for payment.

Financial:

a) On receipt of the claims form from ASHA supervisor the PHC account BAM will verify the same

and the payment shall be made by DBT.

21

b) Separate register to be maintained for the purpose and all financial guidelines to be follow.

District wise budget break-up:-

Sl.No. District No. of Urban ASHA Amount(Rs)


2 Cachar 81 1944000

3 Dhubri 85 2040000


5 Goalpara 42 1008000

6 Jorhat 55 1320000

7 Kamrup Metro 465 11160000

8 Karbi Anglong 32 768000



11 Nagaon 60 1440000

12 Sivsagar 50 1200000

13 Sonitpur 87 2088000

14 Tinsukia 57 1368000

Total 1212 29088000

Activity:- ASHA Trainings

FMR Code: U.3.1.2

Activity owner

At State level – Partha Saikia, State Community Mobiliser/ Consultant, NUHM

At District level – DCM/District Urban Health Coordinator, NUHM

Guidelines for conducting 1st round, 2nd round, 3rd round and 4th round of ASHA Module 6th& 7th Training for newly selected/ replaced ASHAs

1. The contents of the ASHA training module 6th

& 7th

will be covered in four rounds over 20 days (5+5+5+5). Topics to be

covered under four rounds of training are given in annexure I.

2. As the number of new ASHAs is not very high in the concerned district, hence the training may be conducted at district

level. However the district may decide to conduct it in BPHC level also.

3. All the rounds of training will be of five days each and fully residential. No participant will be allowed to stay outside of

the arranged venue as well as no leave will be granted (Excluding emergencies) during the training period.

4. In case of any emergency the trainee (ASHA) has to get the leave approved by the training in charge with full

justification.

5. The accommodation arrangements for trainers as well as trainees have to be arranged nearby the training venue.

6. ASHA trainers trained at zonal level by State Trainers shall only conduct the ASHA training.

7. Each of the training days will start with recap of the previous day’s activities.

8. Pre-training

8.1 Intimate all the ASHAs about date and venue of training in advance. 8.2 Plan for ASHAS arrival at training venue.

22

8.3 Build a positive environment for training by making comfortable, secure and clean training venue and accommodation.

8.4 Arrange all the materials required for imparting training .(Projector, white board marker, flipchart, cardboard, sketch pen, wiper etc. as per provided checklist)

8.5 Make arrangement for emergency medical facilities. 8.6 Ensure you have all the training materials required for conducting training and handover to trainers and

trainees. 8.7 Make the training session plan and give a copy to all resource Person and Participants. 8.8 Make sure that the batch size should not exceed more than 30 participants

9 During training

9.1 Training will be residential and all ASHAs should be present for all the session of the training which will enable them for practicing their learned skills after the formal session and discuss with their peers.

9.2 Trainers should eat, sit, sing and play with ASHAs. This will give them feeling that they are the members of the group.

9.3 There should be a u-shaped sitting arrangement so that more interaction can be conducted. 9.4 Songs and games should be used as both relaxation techniques but also to inculcate a feeling of

solidarity and oneness with each others. 9.5 Share the training schedule with each participant.

9.6 Trainers should ensure that all the training material required for training is available before starting the

session. 9.7 Considering the educational back ground of ASHA s they are not used to long hour’s class room

teaching .The trainers should learn when the group is losing interest. The trainers should keep group engaged by asking questions which will promote active participation.

9.8 Training should start each day at the stipulated time. 9.9 Plan their departure in advance and make arrangement for payment etc.

10 Post Training :

10.1 ASHAs should be supported in the field by the DCM, ASHA Supervisor, BPM, BCM, LHV, BEE (Especially who have undergone training on module 6 & 7) so that the skill of ASHAs are improved.

10.2 During the monthly meeting of ASHAS at PHC level, ASHAs should be encouraged to raise their doubts and concerns, so that the issues and doubts can be addressed.

11 The Training should be under the supervision of a designated training in charge. NOTE: Those who have been selected & Trained as ASHA module 6

th& 7

th trainers shall only conduct the training.

Agenda 3rd round training of ASHA Module 6th and 7th

Day:1

Sl No Time Topic Facilitator

1 30 minutes Welcome & Introduction

2 1 hr Experience sharing of round 1 & 2 and field visit (Home visit) experience sharing by ASHAs

3 3hr Recap/Revision of contents of 1st and 2nd

23

round training and skill revision (practice by ASHAs)

4 30 minutes Pre-training evaluation

5 30 minutes Planning for day 2

Day:2

1 15 minutes Prayer and recap of previous day

2 45 minutes High risk assessment and the management of LBW/Pre-term babies

Session1: Low Birth Weight/Pre-term and it’s risk

3 1 hr 15 min High risk assessment and the management of LBW/Pre-term babies

Session2: How to care for the LBW/Preterm and Newborn

4 1 hr High risk assessment and the management of LBW/Pre-term babies

Session3: Feeding LBW and Pre-term babies

5 1 hr 30 minutes High risk assessment and the management of LBW/Pre-term babies

Session4: Explaining care of LBW infant to mother

6 1 hr 45 min High risk assessment and the management of LBW/Pre-term babies

Session5: Identifying high risk babies

7 30 min Planning for day 3

Day: 3

15 minutes Prayer and Recap of previous day

1 hr 30 min Birth Asphyxia: Diagnosis and early management with mucus extractor

Session 1: How to identify an asphyxiated baby at birth

2 hr Birth Asphyxia: Diagnosis and early management with mucus extractor

24

Session 2: Managing asphyxia using mucus extractor

2 hr Birth Asphyxia: Diagnosis and early management with mucus extractor

Session 3: Assessment: Diagnosis and early management of birth asphyxia

30 min Planning for day 4

Day 4


1 hr 30 min Neonatal Sepsis: Diagnosis and Management with Cotrimoxazole

Session 1: Diagnosis Neonatal Sepsis


Session 2: Treating Neonatal Sepsis

1 hr Neonatal Sepsis: Diagnosis and Management with Cotrimoxazole

Session 3: Management of newborn with chest withdrawing


Session 4: Filling in the forms


Session 5: Assessment of case study

30 min Planning for day 5

Day 5


1 hr 15 min Women’s Reproductive Health:

Session 1: Safe abortion

25

1 hr Women’s Reproductive Health:

Session 2: Family Planning

1 hr Women’s Reproductive Health:

Session 3: RTI/STDs

1 hr Evaluation of the ASHAs based on the contents taught (Written/oral)

Valedictory

Points to be noted: In between the sessions timings for tea-breaks and lunch break has to be decided and provided to the ASHAs

accordingly.

Showing of IMNCI video and video on chest withdrawing on day 3rd

and on day 4th

respective needs to be

ensured.

Budget Break up for 3rd

round training

Budget details for ASHA Module 6th

& 7th 3rd round training 150 ASHAs

Sl No Component Unit cost Unit Duration Total Amount

( inRs. ) ( inRs.)

1 TA for Participants subject to

actual 200 30 2 12000

2 DA to Participants 100 30 5 15000

3 Honorarium for Resource

Persons 300 3 5 4500

4 Accommodation for the

participants including(L/F) 150 33 5 24750

5

Training Material (folder, note

Pad, Pen, Pencil, Highlighter

etc.)

50 37 1 1850

6 Working lunch, snacks and

Tea 150 33 5 24750

7 Venue hiring Charge 1000 1 5 5000

A Total amount for one batch (in Rs.) 87850

B Total amount for 3rd

round training for 5 batch (150 participants ) 439250

In lakh 4.39

26

Trainings to be organised in the district

Budget breakup:

Sl.N

o

District

Responsible

for

organizing

the training.

ASHAs covered

No. of

Batches

3rd

round

of Module 6

& 7

training(Rs

)

1 Bongaigaon Bongaigaon=20, Dhubri=5, Goalpara=5 1 87850

2 Cachar Cachar=20, Karimganj=10 1 87850

3 Kamrup

Metro

60 2 175700

4 Nagaon Jorhat=5,Nagaon=10,Sivasagar=5,Sonitpur=5,Tinsuk

ia=5 1 87850

Total 5 439250

27

Activity:-4rd round of ASHA Module 6 & 7 training for Urban ASHAs

FMR Code: U.3.1.2

Activity owner

At State level – Partha Saikia, State Community Mobiliser/ Consultant, NUHM

At District level –DCM/ District Urban Health Coordinator, NUHM

Guidelines for conducting 4th

round of ASHA Module 6th

& 7th

Training for Urban ASHAs

Agenda for Round 4 ASHA training

Time

Day 1

9:30 am to10:00 am Welcome and Introduction

10:00am to 12:15 pm Experience Sharing

11: 00pm to 11:15 pm

Tea

12:15pm to1:30 pm Understanding Gender

1:30 pm to 2:15 pm Lunch

2:15 pm to 3:45 pm Understanding Patriarchy

3:30 pm to 3:45 pm Tea

3:45pm to 4:30 pm Cycle of Violence

4:30pm to 5:00 pm Explaining Matrix of Violence and dividing groups

Day 2

9.30 am to 1:00pm Group work on Matrix of Violence

11:00 pm to 11:15 pm

Tea

1:00 pm to 1:45 pm Lunch

1:45 pm to 2:45 pm Presentation of group work on Matrix of Violence and discussion

2:45 pm to 3:15 pm Identifying women who are vulnerable to violence

3:15pm to 3:30 pm Tea

3:30 pm to 4:00pm Signs and symptoms of violence

4:00pm to 4:30 pm Consequences of Violence against Women

4:30 pm to 5:30 pm Role of ASHA in addressing violence against women

Day 3 9:30am to 11:00pm Group work on Intervene in case of Violence against Women

28

Budget Break-up:

Budget details for ASHA Module 6th& 7th 4th round training 150 replaced and absorbed

ASHAs

Sl No Component Unit cost

Unit Duration

Total

Amount

( inRs. ) ( inRs.)

1 TA for Participants subject to actual 200 30 2 12000

11:00 am to 11:15 pm

Tea

11:15 am to 12:00 Intervene in case of Violence against Women- Case Studies presentation and discussion on Role of ASHA

12:00 to 12:30 pm Ensuring safety for yourself

12:30 pm to 1:30 pm Legal measures to prevent Violence against Women

1:45pm to 2:15 pm Lunch

2:15 pm to 4:00 pm Women’s reproductive health (Revision of RTI/ STI, Safe abortion, family planning)

4:00 pm to 4:15 pm Tea

4:15 pm to 5:30 pm Tuberculosis

Day 4

9:30 am to 11: 00 am Malaria

11:00am to 11:15 am Tea

11:15 pm to 5:30 pm Infant and Young Child Feeding and assessment of Malnutrition

Day 5

10.00 am to 1:00 pm Revision of skills for Newborn and sick child (Viewing of Skill CD and practice)

11:15 am to11:30 am Tea

1:00pm to 1:45 pm Lunch

1:45 pm to 3:45 pm Evaluation of skills covered in earlier rounds

3:45 pm to 5:30 pm Evaluation

29


3 Honorarium for Resource Persons 300 3 5 4500

4

Accommodation for the participants

including(L/F) 150 33 5 24750

5

Training Material (folder, note Pad, Pen,

Pencil, Highlighter etc.) 50 37 1 1850

6 Working lunch, snacks and Tea 150 33 5 24750


A Total amount for one batch (in Rs.) 87850

B Total amount for 4th

round training for 5 Batches 439250

Rs. In lakh 4.39


Budget breakup:

Sl.N

o

District

Responsible

for

organizing

the training.

ASHAs covered

No. of

Batches

3rd

round

of Module 6

& 7

training(Rs

)

1 Bongaigaon Bongaigaon=20, Dhubri=5, Goalpara=5 1 87850

2 Cachar Cachar=20, Karimganj=10 1 87850

3 Kamrup

Metro

60 2 175700

4 Nagaon Jorhat=5,Nagaon=10,Sivasagar=5,Sonitpur=5,Tinsuk

ia=5 1 87850

Total 5 439250

30

Activity:2 days capacity building workshop for 6580 MAS members of 658 MAS in 14

districts.

FMR Code: U.3.2.1.1

Activity owner



Guideline on two day orientation of MAS Members

To strengthen the capacity of MAS members in order to improve the community awareness level,

interpersonal communication, monitoring through community a two day orientation programme of the

MAS members needs to be carried out under each Urban PHC of the district. The following criteria

should be followed while conducting the reorientation:

Prior to the reorientation the trainers should sit together and prepare the lessons to be covered

during the reorientation.

The reorientation should be conducted by those trainers who are trained at State level ToT.

While selecting the venue for the reorientation it should be kept in mind that a spacious venue is

taken with round shaped sitting arrangement where exclusive interaction through participation

can be carried out.

One batch of reorientation should be between the strength of 30-40 MAS members comprising

of 3-4 MAS.

A proper agenda of the contents to be covered during the reorientation should be prepared and

shared with all the members.

All the participants should be provided with a folder containing a note-pad, pen etc.

While conducting the reorientation the “manual on MAS member” should be strictly followed.

Participatory learning exercise to be carried out while conducting the reorientation.

Arrangement of food (breakfast, lunch, tea-snacks) should be taken care of.

TA/DA should be provided to the participants based on budget provision that is shared with the

districts.

Agenda

Day 1

Time Topics Facilitator

10.00 a.m. -11.00 a.m.

Welcome and Introduction

11.00 a.m. -11.15 a.m. Tea

11.15 a.m. -12.15 p.m. Roles and responsibility of MAS on social issues

12.15 p.m. -1.00 p.m. Role of the President

1.00 pm to 1.30 pm Lunch

31

1.30 p.m. -2. p.m. Role of the Secretary

2 p.m. -2.30 p.m. Role of the Treasurer

2.30 p.m. -3. p.m. Role of the Other members

3. p.m. -4.00 p.m. Meeting of MAS

Day 2

9.30 a.m. -9.45 a.m. Recap

9.45 a.m. -10.30 a.m. Session on cleanliness and importance of hand washing.

10.30 a.m. -10.45 a.m. Tea

10.45 a.m. -11.15 a.m. Session on Anti- Tobacco and anti- alcohol

11.15 p.m. -12.45 p.m. Session on menstrual hygiene, child marriage

12.45 p.m. -1.30 p.m. Session on Domestic Violence

1.30 p.m. -2.15 p.m. Lunch

2.15 p.m. 2.45 p.m. Session on importance of family planning

2.45 p.m. -3.30 p.m. Session on National Health Programmes

3.30pm - 4.15 pm Integration and Coordination

4.15 pm- 5.00pm

Expected Outcomes and Outputs from the MAS

5.00pm- 5.15pm Conclusion

Training budget Break-up:

Budget details for 2 days capacity building workshop for 6490 MAS members

Sl No Component Unit cost

Unit Duration

Total

Amount

(In Rs.) (In Rs.)

1 TA to participants ( subject to actual ) 200 30 2 12000

32


3 Honorarium for Resource Persons 300 3 2 1800

4 Training Material (Bag, Pad, Pen,

Pencil, Highlighter etc.) 100 30 1 3000

5 Working lunch, snacks and Tea 150 33 2 9900


Total amount for one batch (in Rs.) 34700

Total amount for 2 days capacity building workshop for 216 Batches (

6490 participants) A*216 7495200

No. of training to be organised by the District and budget breakup:

Sl.No District No. of batches Amount (Rs)


2 Cachar 17 589900


4 Dhubri 18 624600


6 Jorhat 12 416400





11 Nagaon 13 451100

12 Sibsagar 4 138800

13 Sonitpur 3 104100

14 Tinsukia 3 104100

Total 216 74,95,200

33

Untied Grants

Activity:-Untied Grants to UPHCs in Government building.

FMR Code: U.4.1.1.1

Activity owner

At State level – Consultant(P)/ Finance Manager

At District level – DAM/District Urban Health Coordinator, NUHM

Suggested areas where untied fund may be used: Group-A: Hospital cleaning: “Maximum” 30% fund of untied grant may be utilised (nothing beyond

this celling will be allowed) 1) Cleaning up of the facility especially in emergency, Labour room, hospital laboratory, OPD, IPD wards and post-

partumareas, cleaning and maintenance of the campus to ensure a pleasing appearance.

2) Outsourcing of non-clinical services, Computer Operator, Attendant/helper, driver of Ambulance only (if regular

man in position are not available)

Group –B Hospital Infrastructure: Up to 30% fund of Untied Grant may be utilised 3) Minor repairs on building & furniture

4) Building/repairing Septic Tanks/toilets

5) Improved signage in the facility

6) Making arrangement for disposal of wastage etc. including bio-medical wastage disposal

7) Purchase/Maintenance of Medical equipment’s

8) Fuel for power breakup/ ambulance (if available)

Group C: Patient amenities: At least 40% fund of Untied Grant shall be utilised 9) Provision of safe drinking water to patients

10) Seating arrangement and separate toilets for patients

11) Transport of emergencies to referral centres/ Referral Transport

12) Transport of laboratories samples during epidemics.

13) Arrangement of stay for poor parents and their attendants.

14) Setting up RogiSahayata Kendra/help desk

15) Providing for medicines and Diagnostics for needy people. (In case not available of EDL drugs or free drugs

services)

16) Arrangement for hygienic environment for washroom and toilets

17) Providing security at Hospital Premises for safety/Security of patients through outsourcing

N.B: a. List of people drawing wages from the Untied Grant shall be submitted on a yearly basis to the respective Jt.

DHS cum Member Secretary, District Health Society.

b. The untied grant shall be utilised with the approval of RKS/HMC

c. No new engagement of support staffs under RKS/HMC will not be done beyond 30% limit above (Group-A)

d. No activity shall be implemented beyond allocated fund provisions

e. The united fund and user charges fund shall be parked in the same A/C as per letter no NHM/Accounts/07-

08/422/Pt-III/2013-14/4584 dtd.22nd May 2015

34

Budget detail as follows-

No. of Unit Unit Cost Total Cost (In Rs.) Rs. in lakh

26 UPHC 1,75,000 4550000 45.50

List of Health Institutes:

Sl. No Name of Institute Type of Institute District

Rs. in

lakh

1 NATBOMA PHC PRIMARY HEALTH CENTRE Govt

Kamrup Metro 29.75

2 SATGAON PHC PRIMARY HEALTH CENTRE Govt

3 KHARGHULIi MPHC PRIMARY HEALTH CENTRE Govt

4 KHANAPARA SD PRIMARY HEALTH CENTRE Govt

5 CAPITAL SD PRIMARY HEALTH CENTRE Govt

6 WEST GHY SD PRIMARY HEALTH CENTRE Govt

7 EAST GHY SD PRIMARY HEALTH CENTRE Govt

8 GARIGAON SD PRIMARY HEALTH CENTRE Govt

9 BHETAPARA SD PRIMARY HEALTH CENTRE Govt

10 KAMAKHYA SD PRIMARY HEALTH CENTRE Govt

11 LOKHARA SD PRIMARY HEALTH CENTRE Govt

12 HENGRABARI MU PRIMARY HEALTH CENTRE Govt

13 ULUBARI UHC PRIMARY HEALTH CENTRE Govt

14 GOTANAGAR UPHC URBAN PRIMARY HEALTH

CENTRE Govt

15 SERABHATI UPHC URBAN PRIMARY HEALTH

CENTRE Govt

16 PANDU UPHC URBAN PRIMARY HEALTH

CENTRE Govt

17

MEDICAL UNIT, ASSAM SECRETARIATE, DISPUR URBAN PRIMARY HEALTH

CENTRE Govt

18 KAMPUR UPHC URBAN PRIMARY HEALTH

CENTRE Govt Nagaon 1.75

19 WOOD UPHC URBAN PRIMARY HEALTH

CENTRE Govt Sivasagar

3.5

20 SONARI UPHC URBAN PRIMARY HEALTH

CENTRE Govt Sivasagar

21 MARGHERITA UPHC URBAN PRIMARY HEALTH

CENTRE Govt Tinsukia 1.75

22 JORHAT UPHC URBAN PRIMARY HEALTH

CENTRE Govt Jorhat 3.5

23 CINAMORA UPHC URBAN PRIMARY HEALTH

CENTRE Govt Jorhat

24 DIBRUGARH UPHC URBAN PRIMARY HEALTH

CENTRE Govt Dibrugarh

3.5

25 DULIAJAN UPHC URBAN PRIMARY HEALTH

CENTRE Govt Dibrugarh

26 SILCHAR UPHC URBAN PRIMARY HEALTH

CENTRE Govt Cachar 1.75

35

Activity: Untied Grants to UPHCs in Rented building.

FMR Code:U.4.1.1.2

Activity owner



The same guideline to be followed as mention above both for Govt. building or rented building (UPHC/CHC)for

the expenses of Untied fund.



29 UPHC 1,00,000 29,00,000.00 29.00


SL. NO.

NAME OF HEALTH INSTITUTION

TYPE OF HEALTH INSTITUTION REMARKS DISTRICT Rs. in

lakh

1 ODALBAKRA MPHC

PRIMARY HEALTH CENTRE Rented

Kamrup Metro 18

2 AMINGAON UPHC URBAN PRIMARY HEALTH

CENTRE Rented

3 GARPANDU UPHC URBAN PRIMARY HEALTH

CENTRE Rented

4 PANDU NATH UPHC URBAN PRIMARY HEALTH

CENTRE Rented

5 FERRYGHAT UPHC URBAN PRIMARY HEALTH

CENTRE Rented

6 FATASIL UPHC URBAN PRIMARY HEALTH

CENTRE Rented

7 GANDHIBASTI UPHC URBAN PRIMARY HEALTH

CENTRE Rented

8 MATHGHARIA UPHC URBAN PRIMARY HEALTH

CENTRE Rented

9 BATAGHULI UPHC URBAN PRIMARY HEALTH

CENTRE Rented

10 BIRKUCHI UPHC URBAN PRIMARY HEALTH

CENTRE Rented

11 HATIGARH CHARIALI URBAN PRIMARY HEALTH

CENTRE Rented

12 KAHILIPARA UPHC URBAN PRIMARY HEALTH

CENTRE Rented

13

KOINADHARA UPHC URBAN PRIMARY HEALTH

CENTRE Rented

14 NORTH GHY UPHC URBAN PRIMARY HEALTH

CENTRE Rented

15 CHOONSALI UPHC URBAN PRIMARY HEALTH

CENTRE Rented

16

BASISTHA MANDIR UPHC

URBAN PRIMARY HEALTH CENTRE Rented

17

KRISHNANAGAR UPHC


18

PIYALI PHUKAN NAGAR UPHC


36

19 MAHKHULI UPHC URBAN PRIMARY HEALTH

CENTRE Rented Nagaon

2 20

DHING GATE, HOIBORGAON


Nagaon

21 MISSIONPARA UPHC

URBAN PRIMARY HEALTH CENTRE Rented Tinsukia 1

22 MARIYONI UPHC


Jorhat 1

23 BHAWLAGURI UPHC

URBAN PRIMARY HEALTH CENTRE Rented Bongaigaon 1

24 DHUBRI UPHC

URBAN PRIMARY HEALTH CENTRE Rented Dhubri 1

25 KARIMGANJ UPHC


Karimganj 1

26 JAHAJGHAT UPHC

URBAN PRIMARY HEALTH CENTRE Rented Sonitpur 1

27

CHAPORIGAON

UPHC

URBAN PRIMARY HEALTH

CENTRE Rented Lakhimpur 1

28 GOALPARA UPHC

URBAN PRIMARY HEALTH CENTRE Rented Goalpara 1

29 DIPHU UPHC


Kabi Anglong 1

Activity:-Untied Grants to UCHCs

FMR Code: U.4.1.2

Activity owner



The same guideline to be followed as mention above both for Govt. building or rented building (UPHC/CHC)for

the expenses of Untied fund.


2 UCHC 5,00,000 10,00,000.00 10.00


1 DHIRENPARA FRU Urban CHC Govt Kamrup Metro

2 PANDU FRU Urban CHC Govt Kamrup Metro

Activity:-Untied Grants to MAS

FMR Code: U.4.1.4

Activity owner

At State level – Pranjal Borah, Account’s Manager, NUHM


The main purpose of the untied fund is not simply to spend it but to use it as a catalyst for community

health planning and for executing the plan.

Untied funds:

37

-Promote decentralization, i.e. allow the slum residents to take decisions about spending on community

health.

-Create opportunities for the community to gain capacity for collective decision making around health.

-Provide support to the MAS in executing a plan of action. Any action plan developed by the MAS to

address local issues would include some activities for which funds are required.

-Untied fund helps to undertake those activities requiring funds.

-Community is also encouraged to contribute a revolving fund to the MAS; which may be in terms of

money or labour.

Principles of Utilization of Untied Fund

The MAS can use these funds for any purpose aimed at improving the health of the slum. Being an

untied fund, it is to be utilized as per decision of the MAS. Nutrition, education, sanitation,

environmental protection, public health measures are key areas where this fund could be utilized.

Decision on the utilization of funds should be taken during the monthly MAS meetings and should be

based on the following principles:

The fund shall be used for activities that benefit the community and not just one or two

individuals

However in exceptional cases such as that of a destitute women or very poor household, the

untied fund could be used for health care needs of the poor household especially for enabling

access to care. For example, MAS identified a suspected pneumonia patient who did not have

money to go to the U- CHC for treatment. MAS provided funds for her treatment at the U- CHC

and one of the members also accompanied her to the U- CHC.

The fund shall not be used for works or activities for which an allocation of funds is already

available through the urban local body or other departments. For example, the fund should not

be used in activities like construction of drainage system or roads as these activities are already

budgeted in the concerned departments like PHED and PWD.

In special circumstances the U-PHC or the City/ District PMU could give a direction or a

suggestion to all MAS to spend on a particular activity, but even then it should be approved first

by the MAS.

MAS will not be directed to contract with specific service providers for specific activities,

regardless of the nature of the activity. For example, if MAS wants to engage someone for

providing emergency transport services in the slum, neither health department staff nor anyone

else can direct it to give the contract to any particular service provider.

All payments from the untied fund must be done by the MAS directly to the service provider

without involvement of any third party.

Indicative list of activities that may be undertaken with the help of untied fund

Slum level public health activities like cleanliness drive, insecticide spraying etc.

Awareness generation in the slum on various govt. schemes for urban poor like JSY, RSBY,

JSSK, BSUP, RBSK etc.

38

Repair/ installation of community water supply points like public taps, stand posts

Minor repair of the community toilets to make them functional

IEC/BCC activities like wall writings, puppet shows, film shows for awareness generation on

MNCHN and WASH related issues

Providing equipments like weighing machine etc. to the Anganwadis

Helping destitute women or very poor slum households in accessing health care

Logistic arrangements for Urban Health and Nutrition Days (UHND)

Paying for emergency transport when 102/108 services are not available

Number of MAS increased by 15 no.s in Dhubri district and 9 no.s in Lakhimpur district, so the number

of MAS increases to 658 and MAS members 6580. (Untied grant to 658 nos. MAS@Rs. 5,000/- per

MAS).



658 MAS 5,000 3290000 32.90

Budget break up:

Sl.No District No. of MAS Amount (Rs)

1 Bongaigaon 14 70,000

2 Cachar 50 250,000

3 Dibrugarh 60 300,000

4 Dhubri 55 275,000

5 Goalpara 56 280,000

6 Jorhat 35 175,000

7 Kamrup Metro 265 1,325,000

8 Karbi Anglong 33 165,000

9 Karimganj 9 45,000

10 Lakhimpur 11 55,000

11 Nagaon 39 195,000

12 Sibsagar 11 55,000

13 Sonitpur 10 50,000

14 Tinsukia 10 50,000

Total 658 3,290,000

39

Activity: Rent for UPHC

FMR Code: U.5.1.4.1

Activity owner



Fund should be utilised for rented buildings for the payment of rent on monthly basis as per

actual(Maximum @14000/ per month).29 nos. rented UPHCs @ Rs.168000.00/ year.

No. of Unit Unit Cost Total Cost (In Rs.) In lakh

29 Rs.168000.00 48,72,000.00 48.72

District Budget Breakup:

Sl. No District No. of HI Amount(Rs)


2 Nagaon 2 336000

3 Tinsukia 1 168000

4 Jorhat 1 168000


6 Dhubri 1 168000


8 Sonitpur 1 168000




Total 29 4872000

40

Activity:-Training on Other Disease control programme (NCD)

FMR Code: U.9.5.6

Activity owner

At State level – SPO, NCD/Dr. Pankaj Sahu, Specialist Community Medicine

At District level – District Urban Health Coordinator, NUHM/ DPO,NCD

Epidemiologic Transition has occurred with Death from the four major NCDs –Cancer, CVD, Diabetes,

and Respiratory Diseases accounting to more than half of the total deaths. Risk factors for NCDs need

action at all levels. Necessitates a focus on primary and secondary prevention- this will need

comprehensive services at Primary care level. For carrying out the preventive, promotive and the

curative services the following trainings are required.

Agenda for 3 days PBS Training on NCDs for ANM under Urban Health

Day 1:

Time Topic

9.30 AM to 10.00 AM Registration

10.00AM to 10.30AM Pre-test

11.30 AM to 1.30 PM Introduction to CPHC and HWC

10.30 AM to 11.30 AM Overview of NCD’s and its Importance

1.30 PM to 2.30 PM Lunch

2.30 PM to 3.30 PM Risk Factors of Non-communicable

diseases.

3.30 PM to 5.00 PM Management of DM and Practical session

of Glucometer

Day 2:

Time Topic

10.00 AM to 10.30 AM Revision of Day-1

10.30 AM to 11.30 AM Management of HTN Practice session of

Glucometer

11.30 AM to 12.00 PM Tea Break

12.00 PM to 1.30 PM Management of Heart Attack and Stroke


2.30 PM to 5.00 PM Screening of cervical cancer and video

session on VIA

Day3:

Time Topic

10.00 AM to 10.30 AM Revision of Day 2

10.30 AM to 11.30 PM Screening of breast cancer and practical

session on CBE

11.30 AM to 12.00 PM Tea Break

12.00 PM to 12.30 PM Screening of oral cancer and practical

session on OVE

12.30PM to 1.30 PM Roles and Responsibility of ANMs


41

2.30 PM to 3.00 PM CBAC form, Record Keeping and

Reporting

3.00 PM to 4.00 PM Health Promotion

4.00 PM to 5.00 PM Evaluation

Budget Break-up details

Training of ANM (Urban) under NCD

Sl

no Component

Unit

cost

Total

Participant

Participants per

batch

Duration per

batch

No of

batch

Total

Amount

1

TA to participants

(on actual) 500 32 32 1 1 16000

2 DA to participants 300 32 32 3 1 28800

3

Accommodation for

participants

including food and

lodging

500 32

32 3

1 48000

4

Training materials

(Folder, pen, pad,

highlighter, etc) 100 32 32 1

1 3200

5

Food cost(Breakfast,

working lunch,

snacks & tea) 250 37 32 3

1 27750

Total 123750

Sl

no Component

Unit

cost

No of Resource

Persons

Duration per

batch

No of

batch

Total

Amount

7

Honorarium to 3

Resource Person @

Rs. 1000/- per

person per batch. 1000 3 3 1 9000

8

Venue cost @ Rs.

3500/- per day on

actual (including

fuel cost for

generator) 3500

1 3500

9 Miscellaneousexp 2500

1 2500

Total 15000

Grand Total 138750

Note:- Only Kamrup(M) should conduct the one batch of 3 days PBS Training on NCDs for ANMs.

42

Agenda for Training of ASHA in Non-Communicable Disease

Day 1

Introduction and Background to the Module 1 Hour

What are Non-Communicable Diseases and why are they important 1 Hour 30 Minutes

Importance of Health Promotion 1 Hour

Risk Factors for NCDs: Tobacco and Alcohol 2 Hours

Day 2

Risk Factors for NCDs: Healthy Diet and Physical Activity 1 Hour 30 Minutes

Risk Factors for NCDs: Stress and Overweight 1 Hour

Role plays on Health Promotion 1 Hour 30 Minutes

Hypertension 2 Hours 30 Minutes

Day 3

Heart Attack and Stroke 1 Hour

Diabetes 2 Hour 30 Minutes

Cervical Cancer 1 Hour 30 Minutes

Oral Cancer 1 Hour 30 Minutes

Day 4

Breast Cancer 3 Hours

Key Tasks of ASHA 1 Hour 30 Minutes

Orientation to Record format and Consent 1 Hour

Disease-specific healthcare services available facility-wise 1 Hour

Day 5 - Joint training with ANM

Orientation to CBAC 1 Hour

Work Flow Process for screening and referral of NCD cases 1 Hour

Facility Visit 3 Hours

Evaluation 1 Hour 30 Minutes

43

Batch wise budget break-up

Training of ASHA's on NCD

Sl

no Component

Unit

cost

Participants

per batch

Duration per

batch

No of

batch

Total

Amount

1

TA to participants (on

actuals) 100 30 2 1 6000

2 DA to participants 100 30 5 1 15000

3

Accommodation for

participants including

fooding and lodging

200

30 5

1 30000

4

Training materials (Folder,

pen, pad, highlighter, etc) 50 30 1 1 1500

5

Food cost(Breakfast,

working lunch, snacks & tea) 150 30 5 1 22500

Total 75000

Sl

no Component

Unit

cost

No of

Resource

Persons

Duration per

batch

No of

batch

Total

Amount

7

Honorarium to 3 Resource

Person @ Rs. 300/- per person

per batch. 300 3 5 1 4500

8

Venue cost @ Rs. 500/- per

day 500 5 1 2500

Total 7000

Grand Total 82000

No. of training to be organised by the District and budget breakup:

Sl.No District No. of batches Amount (Rs)


2 Cachar 1 82000

3 Dibrugarh 1 82000

4 Dhubri 1 82000

5 Goalpara 1 82000

44

6 Jorhat 1 82000


8 Nagaon 1 82000

9 Sibsagar 1 82000

10 Sonitpur 1 82000

11 Tinsukia 1 82000

Total 18 1476000

Activity:-Other training/Orientations Capacity Building workshop for ULB Members

FMR Code: U.9.5.8

Activity owner



Non-Health Departments such as Urban Development, Housing and Urban Poverty Alleviation,

Women and Child Development, School Education, Labour, Water and Sanitation, etc. are also

important stakeholders for successful implementation of NUHM. Thus, these entities must be given a

basic orientation towards urban health issues and NUHM, in order to facilitate identification of areas of

collaboration.

A capacity building workshop cum training is proposed for existing ULB members at district

level for establishment of vibrant community organizations at slum level, under the umbrella of the

urban local body to carry out community based action for public health.

No of batch will be =18. Each batch contains 24 nos participant.

(For Kamrup Metro, 5 batches are proposed as the Guwahati

Municipal Corporation has 6 members).

Total no of participant =431 participants.

The resource person for the program is MO, I/C Urban PHC, DUHC and DCM.

Venue: District

Agenda on Capacity Building workshop for ULB Members Training Agenda

Time Topics

10-10.15 am Welcome address

10.15-10.30 am Tea

10.30-11.00 am Overview of Comprehensive Primary Health Care

11.00-11.30 pm Inception of Health and Wellness Centre

45

11.30-12.30 pm Session on RMNCH+A

12.30-1.30 pm Session on NCD and screening

1.30-2.30 pm Lunch

2.30-3.30 pm Session on NVBDCP and Mental Health

3.30-4.30 pm Session on RNTCP, NTCP and NLEP

4.30-5.30 pm Session on NPCB, NPPCD and conclusion.

Budget Break-up

Sl. No. Component Unit Cost Unit Duration Total (In Rs.)

1 DA to

Participants 400 24 1 9600.00

2 DA for Resource

person 1000 2 1 2000.00

2

Training

Material (Bag,

Pad, Pen, Pencil,

Highlighter etc.)

150 24 1 3600.00

3 Hall Charge 2000 1 1 2,000.00

4 Working lunch,

snacks and Tea 200 28 1 5,600.00

Total amount for one batch (inRs.) 22800.00

Total budget for 18 batches in Rs. 4,10,400.00

Rs. In Lakh 4.10

46

Districts wise budget break-up:

Sl.No District No. of Batch Amount(Rs)


2 Cachar 1 22800

3 Dibrugarh 1 22800

4 Dhubri 1 22800

5 Goalpara 1 22800

6 Jorhat 1 22800



9 Karimganj 1 22800


11 Nagaon 1 22800

12 Sibsagar 1 22800

13 Sonitpur 1 22800

14 Tinsukia 1 22800

Total 18 410400

Activity:-_ Trainings/Orientations of ANM and other paramedical staff


At State level – Monikha Buragohain,SPM-2, NHM / Dr. Pankaj Sahu, Specialist C.M.


Five day district level orientation cum training should be held for ANMs/Staff nurse on interval

IUCD insertion, training should be conducted in collaboration with the Medical Collages by the district

responsible as below:-


Budget breakup:

Sl.N

o

District

Responsible

for

organizing

the training.

ANM/ Staff Nurse to be covered

No. of

Batches

Amount in

Rs.

1 Silchar Cachar=5, Karimganj=5, 1 54000

2 Jorhat Jorhat=4, Sivsagar=4, Karbianglong=2 1 54000

3 Kamrup

Metro

Kamrup=56,Bongaigaon=2, Goalpara=2,Dhubri=2,

Sonitpur=2, Nagaon=6 7 378000

47

4 Dibrugarh Dibrugarh=4, Tisukia=4, Lakhimpur=2 1 54000

Total 10

Session Plan: Five day Comprehensive IUCD Training course on Interval IUCD, Post-

partum IUCD and Post-abortion IUCD for Service Providers

Duration

Title of Session Training/Learning methods Resource Material

Day 1

20 min

• Opening: Welcome &

Introduction, Participants expectations, Group Norms

Goals and objectives

Course Overview

Welcome the participants and organizers would introduce the trainers

Facilitate introduction of all the participants

Share goals and objectives of the training. Introduce each component of the training package.

Explain group norms and emphasize that to accomplish goals and objectives of the training, it is necessary to follow some ground rules throughout the training.

Trainer to put up the norms on flip chart and paste it on a wall of training room.

Provide information related to breaks; facilities, (washroom, drinking water, lunch area, rooms for practice sessions)

Name Badges

Bag/folder

Reference manual for IUCD

Training Package

Prepared Flip Chart with ‘Group Norms’

Tape to put up charts on the wall.

Markers

20 minutes

Pre course Knowledge Assessment

Write the number on each sheet in advance

Distribute Pre-Course Knowledge Assessment sheet to each participant. Explain the importance of Pre course knowledge assessment and ask them to remember the number written on the sheet till the end of the training.

Allow 20 minutes for the Pre-Course Knowledge Assessment and trainer would collect the filled assessment sheets from them.

Pre numbered copies of Pre-Course Knowledge Assessment Sheets

Answer key for trainers

Pre-Course Knowledge Assessment Matrix

60 min Overview of family planning methods including new contraceptives

Ask participants about available family planning methods in public health system. Use slides to explain.

Display samples of FP methods and discuss each method separately. Provide technical details of the method including details of who can use, how to use the method, its effectiveness, benefits and potential side effects.

Summarize the session by showing basket of choice including all commodities for recap. Ask the participants about key messages.

Power Point Slides

Two Samples each of different spacing contraceptives (COC, ECP, IUCD 375 A, IUCD 380, Condom, MPA, centchroman, POP, tubal rings)

45 min

Technical Update of IUCD

Probe the knowledge of participants about IUCD. Share the background of IUCD program in India.

Introduce IUCD 380A and 375 again and mention difference between the two. Distribute samples of IUCD 375 and 380A and discuss both types, their mechanism of action, effectiveness, timing of insertion, life span, removal, advantages, side effects and limitations.

Discuss about the shelf life and tarnishing of IUCD.

Power Point Slides

Two samples of IUCD 375 and 380 A

48

Duration


Probe for prevalent misconceptions and how to deal with them

Explain risk of infection, perforation and expulsion in IUCD. Emphasize that these may be addressed with proper insertion technique

Ask participants to enumerate key messages from the session.

90 minutes

Counselling

clients on family

planning

methods (with

focus on key

messages of IUCD

counselling)

Ask the participants about definition of counselling. Discuss that counselling is aimed to facilitate decision making by the client and address concerns and queries, if any.

Emphasize that provider’s attitude towards clients has an impact on the quality of counselling and service uptake. Explain basic principles of good client provider interaction.

Discuss the process, phases and approach of counselling. Explain the process of counselling starting from general to method specific counselling

Probe the participants about GATHER approach and how to use it during counselling.

Emphasize on the importance of follow up counselling and its need

Inform the participants that they will practice counselling technique using the counselling checklist through role plays. Divide the participants in groups of 3 (one participant would be counsellor, one participants would be client and one would be observer). Ask the groups to enact role plays one by one and remaining participants to provide feedback on each role play.

Conclude by appreciating the efforts of the participants for the role play.

Power point presentation; role-plays written on paper, flip chart, markers.

Counselling kit on FP methods.

45 minutes

Lunch Break

90 minutes

Interval IUCD insertion video

Demonstration: IUCD 380

A Loading using ‘No touch technique’,

Insertion technique of Interval IUCD and removal of IUCD

Play the Interval IUCD insertion video.

Prepare skill stations with necessary humanistic uterine simulation model, equipment and supplies for Interval IUCD insertion and removal.

Divide the participants in two groups. Ask the participants to gather around the skill stations. One trainer at each skill station will make the demonstration. Ask the participants to refer to the checklists for IUCD insertion and removal alongside demonstration.

Conduct a demonstration for loading of IUCD 380A inside the packet using ‘No Touch Technique’

Trainer would demonstrate Interval IUCD insertion with both IUCD 380A and IUCD 375.

Encourage participants to ask questions and assess their understanding of the insertion steps.

Remind the participants that they will have an opportunity to practice these skills with support from the trainers and will be assessed for competency throughout the course.

Video of Interval IUCD

Skill station for Interval IUCD

Checklists for Interval IUCD insertion

120 min

Supervised

practice by

participants on

Ask the participants to practice Interval IUCD insertion on uterine simulation models as demonstrated earlier. The trainers will supervise and resolve queries, if any

Skill station for Interval IUCD

Checklists for Interval IUCD

49

Duration


counselling, IUCD

loading and

insertion

insertion

10 minutes

Care of models Trainers would review the basic steps for care of models and discuss the

same with the participants

10 minutes

Assessment and review of the day

The trainers will summarize the day’s learning for the participants

Day 2

10 minutes

Warm up and Recap of day 1

Trainers would ask the participants to volunteer and recap the learnings from day 1. Add any point, if missed, by the volunteer. Thank the volunteer

60 minutes

Medical eligibility criteria using MEC wheel GOI 2015 and Client Assessment for IUCD

Discuss that once the woman has chosen IUCD or any other method, the provider should make sure that she is eligible for that method. For this purpose, India adopted MEC wheel for contraceptive use may be referred.

Ask the participants if they have ever used India adopted MEC wheel

Explain four categories of WHO MEC. Mention that sometimes providers unknowingly create medical barriers to the use of contraceptive method in conditions where client is otherwise eligible.

Introduce the India adopted MEC Wheel 2015 by giving a brief history of development of MEC wheel (2015) and its usefulness. Explain that the purpose of the MEC is to assist the provider in making decisions about client’s eligibility for contraceptive method based on her medical condition.

Distribute MEC wheel. Explain how it is used while screening the client for IUCD use or any other contraceptive method.

Reiterate the need to rule out pregnancy and demonstrate how that can be done by using pregnancy checklist.

Tell the participants that they will do an exercise on MEC for IUCD. Distribute the exercise with medical conditions written on it. The participants have to answer whether IUCD would be inserted in those conditions or not. Provide correct answers.

Now introduce client assessment for IUCD. Brainstorm and explain components of client assessment

Explain how client assessment is done. Emphasize on important points for PPIUCD and PAIUCD client assessment

Summarize and ask participants to provide key messages of the session

MEC wheel- one for each participant

PowerPoint slides

Reference manual for IUCD

Exercise on MEC

15 minutes

Timing of initiation of PPFP methods

Begin the session by asking participants about FP methods which can be used in postpartum period. Probe and provide correct answers

Discuss timing of initiation of various FP methods in postpartum period.

Power point presentation

45 minute

Technical update on PPIUCD

Start the session by describing how PPIUCD is different. Show PPIUCD insertion forceps


50

Duration


s Discuss the advantages & limitations of PPIUCD. Brainstorm when to provide PPIUCD counselling and timing of insertion.

Initiate discussion on additional MEC for PPIUCD and client assessment. Emphasize that insertion of PPIUCD should not impact active management of third stage of labour.

Discuss follow up, side-effects and potential problems related to PPIUCD.

Conclude by asking the participants to provide key messages of the session.

Reference manual

120 min

Video of PPIUCD insertion technique

Demonstration of PPIUCD insertion technique on simulation models/ clients

Supervised skill practice by participants for PPIUCD/ IUCD

Show video on PPIUCD insertion

Prepare skill stations with necessary supplies, equipment, humanistic uterine simulation models for PPIUCD insertion.

Divide the participants in two groups and ask them to gather around the skill stations where trainer would demonstrate insertion technique (one trainer at each skill station). Ask the participants to refer PPIUCD insertion checklists alongside the demonstration.

Demonstrate PPIUCD insertion technique. Discuss and review step by step the technique using checklists. Emphasize that for PPIUCD insertion technique is same for IUCD 380 A and IUCD 375

Ask questions and assess participants’ understanding of PPIUCD insertion

Now ask the participants to practice PPIUCD insertion technique as demonstrated. Remind them that they will have an opportunity to practice these skills with the support of the trainers

Participants will practice insertion of Interval IUCD/PPIUCD on models for 30 minutes and the trainers will supervise them.

After practicing insertion technique on models, participants along with the trainer will visit labour room and OT to see PPIUCD insertion technique (after normal delivery and C section). If no clients are ready for PPIUCD insertion at this point, take the participants to ANC ward, OPD, PNC ward and allow them to counsel the clients. If there are clients ready for Interval IUCD/ PPIUCD insertion, allow participant to insert Interval IUCD/ PPIUCD under trainer’s supervision.

Video on PPIUCD insertion

Skill station for PPIUCD

Checklists for PPIUCD insertion

45 minutes

Lunch Break

51

Duration


60 minutes

Infection prevention

Introduce the session by discussing the importance of infection prevention for both client and the provider.

Discuss the ‘Standard IP Precautions’ one by one in detail.

Emphasize on the importance of Handwashing. Show the common areas on the hands that are often missed during routine hand wash.

Ask one volunteer to demonstrate the steps of handwashing. Ask other participants if they want to comment on the correctness of steps performed. Demonstrate the correct method of routine hand wash

Explain the need for using barrier Personal Protective Equipment (PPE), especially gloves.

Ask one of the participants to demonstrate the correct method of wearing and removing gloves. Ask participants to comment on the same. Demonstrate the correct method of wearing and removing gloves.

Discuss the steps of instrument processing including decontamination, cleaning, HLD/ sterilization and storage

Demonstrate the correct method of preparation of bleaching solution from bleaching powder/ liquid bleach.

Explain that the sharps need to be handled carefully during procedures so that there is no injury to providers.

Ask the participants about color coded bins and how the waste is segregated in them. Tell the participants about bio medical waste segregation and further management.

Close the session by reiterating that infection prevention is everyone’s responsibility.

PowerPoint slides

IP materials (illustration of tap for handwashing, gloves, colour coded bins, bucket for making hypochlorite solution, bleaching powder/ hypochlorite solution, water, plastic spoon, mug)

30 min Follow up care of clients for IUCD, PPIUCD

Initiate discussion citing the importance of follow up visits.

Explain the schedule of follow up visits after IUCD insertion

Brainstorm and discuss follow up care for all IUCD clients

Explain in detail the warning signs (PAINS). Emphasize that the client must return to the facility immediately if these signs appear


120 minute

s

Supervised clinical skill practice by participants for PPIUCD insertion on simulation models/ clients

Now ask the participants to practice PPIUCD insertion technique again as demonstrated. Remind the participants that they will have an opportunity to practice these skills with the support of the trainers

Participants will practice insertion of Interval IUCD/ PPIUCD on models for 30 minutes and the trainers will supervise them.

After practicing insertion technique on models, the participants along with the trainer will visit labour room and OT to see PPIUCD insertion technique (after normal delivery and C section). If no clients are ready for PPIUCD insertion at this point, take the participants to ANC ward, OPD, PNC ward and allow them to counsel the clients. If there are clients ready for Interval IUCD/ PPIUCD insertion, allow participant to insert Interval IUCD/ PPIUCD under trainer’s supervision and guidance.

Skill station for IUCD/ PPIUCD

Checklists for PPIUCD insertion

52

Duration


10 minutes

Assessment and Review of the day

The trainers will summarise the day’s learning for the participants

Day 3

10 minutes

Warm up and recap of Day 2

Trainers would ask the participants to volunteer and recap the discussions from day 2. Add any point, if missed, by the volunteer. Thank the volunteer

45 minutes

Management of side effects & potential problems related to IUCD

Introduce the session by telling the participants that problems related to IUCD are rare, most of which are associated with poor insertion technique.

Explain that most IUCD related problems may be addressed by reassurance and counselling. However, some problems need management.

Probe and ask the participants about potential problems that can occur during and after IUCD insertion. Then show them the list of potential problems in both scenarios.

Exercise: Tell the participants that they would be doing an exercise. Distribute the exercise to all the participants (with potential problems in column 1 and management in column 2). Ask the participants to match the problems with their probable solutions.

Discuss each potential problem in detail.

Summarize by asking the key messages from the session


Reference manual

Exercise on potential problems and management

60 minutes

Post abortion family planning (PAFP) including technical update on PAIUCD

Share that legalization of abortions in India dates back to 1971 under some parameters. Read out these parameters from slide.

Emphasize that fertility can return quickly after abortions.

Share that PAFP is not a new concept but has taken a backseat in past few years. Discuss the importance of PAFP indicating the contribution of ‘abortions and related complications’ in maternal and infant deaths in India which can be prevented by Family Planning.

Emphasize that until now, there was no structured mechanism for data recording and reporting for PAFP, especially in case of spacing methods.

Share the efforts put in by the MOHFW for revitalization of PAFP.

Ask participants to quickly recapitulate mechanism of action of IUCD.

Now introduce PAIUCD insertion and enumerate its key points.

Emphasize that PAIUCD may only be inserted in health facilities PHC level or above and not at sub center level

Emphasize that only trained medical doctors are allowed to insert PAIUCD in case of second trimester abortions as per GOI guidelines

Explain the steps of client assessment for PAIUCD insertion.

Summarize the session by stating that post abortion family planning needs to be strengthened in the existing program and service provision along with data recording should be equally emphasized.

Power Point Slides

Technical Update on Post Abortion Family Planning

53

Duration


90 min Video on

PAIUCD insertion

Demonstration of 1st trimester PAIUCD insertion technique on simulation models/ clients

Demonstration of 2nd trimester PAIUCD insertion technique on simulation models/ clients

Show video on PAIUCD insertion

Prepare skill stations with necessary supplies, equipment, humanistic uterine simulation models.

Divide the participants in two groups and ask them to gather around skill stations where trainer would demonstrate insertion technique (one trainer at each skill station). Introduce the session by telling the participants that trainers would be demonstrating the technique for PAIUCD insertion in 1st trimester abortion and in 2nd trimester abortion where the size of uterus after completion of abortion is upto 12 weeks. Interval IUCD technique with modifications, will be used in these cases. Ask the participants to refer PAIUCD insertion checklist (when uterine size is less than 12 weeks post abortion) alongside the demonstration.

Also explain that each participant would get an opportunity to practice on the model in the same manner as trainers did. Welcome any queries before proceeding further.

Trainers will demonstrate the steps of PAIUCD insertion while explaining each step

Trainers should mention that use of uterine sound is not recommended (unlike in Interval IUCD insertion) in the immediate post-abortion insertion but within 12 days or after MMA, the sound needs to be used with certain precautions. Mention those precautions.

Welcome queries or concerns and address them, if any.

Now prepare skill stations with necessary supplies, equipment, humanistic uterine simulation models for Demonstration of 2nd trimester PAIUCD insertion technique.

Divide participants in two groups and ask them to gather around the skill stations where trainer would demonstrate insertion technique (one trainer at each skill station) for PAIUCD insertion in those 2nd trimester abortions when uterine size is more than 12 weeks. Also explain that each participant would get an opportunity to practice/demonstrate on the model in the same manner as trainers did. Ask the participants to refer PAIUCD insertion checklists (uterine size more than 12 weeks post abortion) alongside the demonstration. Welcome any queries before proceeding further.

Thereafter, trainers will demonstrate the steps of PAIUCD insertion for uterine size more than 12 weeks while explaining each step to the participants. Trainers should re-emphasize that only medical doctors are allowed to insert PAIUCD after 2nd trimester abortion as per guidelines.

Welcome queries or concerns and address them, if any

Video on PAIUCD insertion

Skill stations for PAIUCD

PAIUCD checklists (uterine size up to 12 weeks)

PAIUCD checklists (uterine size more than 12 weeks)

45 minutes

Lunch Break

120 minutes

Supervised clinical skill practice by participants for Interval IUCD/PPIUCD/PAI

Now ask the participants to practice the PAIUCD insertion technique as demonstrated. Remind the participants that they will have an opportunity to practice these skills with the support of the trainers

Participants will practice insertion of Interval IUCD/PPIUCD/PAIUCD on models and the trainers will supervise and guide them.

54

Duration


UCD insertion

120 minutes

Practice of Counselling and Interval IUCD/ PPIUCD/ PAIUCD insertion and removal skills on simulation model/ clients

After practicing insertion technique on models, the participants along with the trainer visit OPD, labour room and OT to see Interval IUCD/ PPIUCD/ PAIUCD insertion technique. If no clients are ready for IUCD insertion at this point, take the participants to ANC ward, OPD, PNC ward and allow them to counsel the clients. If there are clients ready for Interval IUCD/ PPIUCD/ PAIUCD insertion, allow participant to insert Interval IUCD/ PPIUCD/ PAIUCD under trainer’s supervision and guidance. (The AYUSH providers would only observe PAIUCD insertion)

Trainers will assess the competency of the participants using the checklist.

10 minutes

Assessment and review of the day

The trainers will summarize the day’s learning for the participants

Day 4

10 minutes



120 min

Supervised clinical practice/ assessment of individual participants on Counselling and Interval IUCD/ PPIUCD/ PAIUCD insertion skills on simulation models/ clients

The participants along with the trainer visit the labour room and OT to observe Interval IUCD/ PPIUCD/ PAIUCD insertion technique. If no clients are ready for IUCD insertion at this point, take the participants to ANC ward, OPD, PNC ward and allow them to counsel the clients. If there are clients ready for Interval IUCD/ PPIUCD/ PAIUCD insertion, allow participant to insert Interval IUCD/ PPIUCD/ PAIUCD under trainer’s supervision and guidance. (The AYUSH providers would only observe PAIUCD insertion)

45 min Counselling clients on family planning in post abortion period

Begin by telling the participants that the session focuses on “what to tell” women and how to respond to the concerns of clients about PAFP.

Now discuss the key points of FP Counselling

Revise the GATHER Approach and display the slide on 6 steps of GATHER

Emphasize on the importance and need of PAFP Counselling and mention that it increases the acceptability of PAFP. Also draw the attention of the participants on the fact that confidentiality should be maintained by Counsellor.

Now discuss the timing of PAFP Counselling and follow up Counselling

Enumerate key counselling messages to be given to the woman in post abortion period.

Conclude the session by re-emphasizing the importance of counselling in post abortion period.


45 minute

Lunch Break

55

Duration


s

90 minutes

Supervised clinical practice/ assessment of individual participants on Counselling and Interval IUCD/ PPIUCD/ PAIUCD insertion skills on simulation models/ clients

The participants along with the trainer will visit labour room and OT to see Interval IUCD/ PPIUCD/ PAIUCD insertion technique. If no clients are ready for IUCD insertion at this point, take the participants to ANC ward, OPD, PNC ward and allow them to counsel the clients. If there are clients ready for Interval IUCD/ PPIUCD/ PAIUCD insertion, allow participant to insert Interval IUCD/ PPIUCD/ PAIUCD under trainer’s supervision and guidance. (The AYUSH providers would only observe PAIUCD insertion). Trainers will assess the competency on participants on models using the checklist.

20 minutes

Post-course knowledge assessment

Inform the participants about Post-course assessment. Tell them that it is not an individual knowledge assessment but group knowledge assessment.

Ask the participants to write same number on the sheet that they had written on pre-test.

Ask them to answer each question. Allow 20 minutes for the Post-Course Knowledge Assessment and ask the participants to return the filled assessment sheet to the trainer.

After submission of assessment sheets by participants, co-trainers will grade the papers, matching with answer keys.

Post Course Assessment sheets

Answer sheets for trainers

45 minutes

Programme Determinants and Quality Assurance in IUCD services

Begin by brainstorming on determinants of quality of family planning services. Display the determinants on slides and explain each of them.

Highlight the eligibility criteria for service provider for Interval IUCD, PPIUCD and PAIUCD

Highlight the supply chain management and that regular uninterrupted supply is important for quality services

Discuss what is meant by quality of care and key areas of quality assurance. Explain the performance standards for all the key areas

Summarise and ask participants to provide key messages of the session.

PowerPoint slides

10 minutes

Review of the day The trainers will summarise the day’s learning for the participants

Day 5

10 minutes



20 minutes

Feedback on Post Course assessment and clarification of doubts

Discuss the correct answers to the post-course assessment test and answer any doubts that the participants may have.

Answer sheet for post-course assessment

56

Duration


90 minutes

Record keeping and reporting for Interval IUCD/PPIUCD/PAIUCD

Explain the importance of record keeping and reporting. Discuss how timely reporting helps in monitoring of the program, identification of gaps and effective implementation of the strategies.

Explain the registers that are to be filled up for IUCD services.

Discuss/ demonstrate how to fill client and facility section of IUCD card.

Highlight that written key information on IUCD card should be explained to clients before she leaves the facility and show that there are key information for providers (as reminders) written on the section to be kept in the facility.

Power point slides

IUCD Client Card

IUCD Reference Manual

120 minutes

Assessment of individual participants on counselling and Interval IUCD/ PPIUCD/ PAIUCD insertion skills on simulation models/clients

In this session, participants will practice insertion of Interval IUCD/PPIUCD/ PAIUCD on models and trainers will assess them using standard checklists.

IUCD insertion checklists

45 minutes

Lunch Break

60 minutes

Assessment of individual participants on counselling and Interval IUCD/ PPIUCD/ PAIUCD insertion skills on simulation models/ clients

In this session, participants will practice insertion of Interval IUCD/PPIUCD/ PAIUCD on models and the trainers will assess them using standard checklists.

30 Minutes

Training Evaluation and participant’s feedback

Thank all the participants for participating in the training. Reiterate that quality in services is paramount. Trainers would provide contact information so that the participants can contact them whenever required.

Training Evaluation form

15 minutes

Closing remarks Give closing remarks and thank the organizers

57

Budget Break up:

IUCD Training for Nurses (SN/ANM) in Urban PHC

1. Category of Participants: SN/ ANM

2.Duration of Training: 5 Days

3.Participants per Batch :10 no.s

Estimated Budget per Batch

SL.No

. Component Category

Rate (In Rs.)

No.of Days

Unit Amount in

Rs.

1 DA for Participants SN /ANM 300 5 10 15,000

2 TA for Participants (on Actual) SN /ANM 150 2 10 3,000

3 Honorarium to Resource Person Resource Person 600 5 3 9,000

4 Working Lunch & Tea,Snacks,water bottle etc.

Participants + 6 extra

250 5 16 20,000

5 Stationary (Training materials,Pad,Pen etc.)

Participants 200 1 10 2,000

6 Contingency (Banner ,Hiring of Training Venue if require,LCD Projector,Generator etc.)

5000 5,000

Total Budget for 1 Batch 54,000

Total Budget for 10 batches @ 54000/- per batch 5,40,000/-

58

IEC/BCC

Activity:- Inter Personal Communication.

FMR Code U.11.3 (IPC)

Activity owner

At State level –SME, NHM / Consultant, NUHM

At District level – DME/District Urban Health Coordinator, NUHM

Plan: In order to strengthen the IEC BCC strategy for Inter Personal Communication the following activities are

to be taken up:-

1. One district level strategy development meeting among the District Frontline workers and associated

members. Participants : District Program Management Unit, NUHM officials, ASHA,MAS members,

Urban Local Bodies

2. Street plays to be undertake following issues in slum areas with the help of MAS members:

Issues: Promoting correct behavior, Sanitation & hygiene, Vector born diseases, RTI/ STI, Life style

diseases

Guideline:

Proper strategic meet to be plan by the DUHC’s of the concern district among the officials and associated

members for the National Urban Health Mission. This strategic meet for mapping of the Communication

activities may bring forth an effective dissemination of health messages and programs.

Deliverable:

Increase the first basis of IPC i.e. among the officials and associated members.

Mapping of Communication with respect to locality and challenges

A common platform to discuss the issues related with the functionaries and to solve the same, etc.

Budget break up:

Sl.No District Strengthening of IEC/BCC strategy for Inter

Personal Communication

Unit cost(Rs) Total Cost(Rs)

1 Bongaigaon

5000

5000

2 Cachar 5000

3 Dibrugarh 5000

4 Dhubri 5000

5 Goalpara 5000

6 Jorhat 5000

7 Kamrup Metro 5000

8 Karbi Anglong 5000

9 Karimganj 5000

10 Lakhimpur 5000

11 Nagaon 5000

12 Sibsagar 5000

59

13 Sonitpur 5000

14 Tinsukia 5000

Total 70000

Budget break up:

Sl.No District No. of UPHC/CHC Street Play


1 Bongaigaon 1

3000

3000

2 Cachar 1 3000

3 Dibrugarh 2 6000

4 Dhubri 1 3000

5 Goalpara 1 3000

6 Jorhat 3 9000



9 Karimganj 1 3000

10 Lakhimpur 1 3000

11 Nagaon 3 9000

12 Sibsagar 2 6000

13 Sonitpur 1 3000

14 Tinsukia 2 6000

TOTAL 168000

Activity: Other Media

FMR Code: U.11.4

Activity owner

At State level –SME, NHM/Consultant,NUHM

At District level – DME/District Urban Health Coordinator, NUHM

Plan: District will do outdoor publicity on NUHM through the means of Installation of Glow sign box, Retro

Vinyl Board, Sun pack Sheet ,Leaflet, Poster, Banner. Theme of publicity will be NUHM framework, Mahila

Arogya Samiti& Public participation, Non Communicable diseases, Japanese Encephalitis, Dengue, cleanliness

and sanitation, Safe Sex, Family Planning and other program based IEC etc.

1. Installation of Glow Sign Box and Retro Vinyle Board at prominently visible location nearby Urban

Health Facility under NUHM.

2. Sunpack sheets are cost effective IEC tool for dissemination of short information. The Sunpack sheet

will also be an effective campaign tool for delivering short information like family planning, Slogan for

Behavior Change Communication on cleanliness, Sanitation etc. Proposed size of sunpack sheet is 15 x

15 inch multicolor.

60

A. Budget Break up:

Sl.No District No. of UPHC/CHC Glow Sign Box

Unit cost(Rs) No of Units Total Cost(Rs)

1 Bongaigaon 1

2500

5 12500

2 Cachar 1 5 12500

3 Dibrugarh 2 10 25000

4 Dhubri 1 5 12500

5 Goalpara 1 5 12500

6 Jorhat 3 15 37500

7 Kamrup Metro 36 180 450000

8 Karbi Anglong 1 5 12500

9 Karimganj 1 5 12500

10 Lakhimpur 1 5 12500

11 Nagaon 3 15 37500

12 Sibsagar 2 10 25000

13 Sonitpur 1 5 12500

14 Tinsukia 2 10 25000

TOTAL 280 700000

B. Budget Break up:

Sl.No District No. of UPHC/CHC Retro Vinyle Board


1 Bongaigaon 1

2500

5 12500

2 Cachar 1 5 12500


4 Dhubri 1 5 12500

5 Goalpara 1 5 12500

6 Jorhat 3 15 37500

7 Kamrup Metro 36 180 450000


9 Karimganj 1 5 12500

61


11 Nagaon 3 15 37500

12 Sibsagar 2 10 25000

13 Sonitpur 1 5 12500

14 Tinsukia 2 10 25000

TOTAL 280 700000

C. Budget break up:

Sl.No District No. of UPHC/CHC Sun pack sheet


1 Bongaigaon 1

75

5 375

2 Cachar 1 5 375


4 Dhubri 1 5 375

5 Goalpara 1 5 375

6 Jorhat 3 15 1125

7 Kamrup Metro 36 180 13500


9 Karimganj 1 5 375


11 Nagaon 3 15 1125

12 Sibsagar 2 10 750

13 Sonitpur 1 5 375

14 Tinsukia 2 10 750

TOTAL 280 21000

62

Quality Assurance

Activity: Quality Assurance Implementation

FMR Code: U.13.1.1

Activity owner

At State level – Dr.Rohini Kumar, Consultant, Quality Assurance, NHM


In terms of fire safety, the fire extinguishers should be refilled with proper labelling of expiry

dates on them. No fire extinguishers should be beyond the expiry date.

For the privacy of patients during patient care while conducting physical

examination/procedures by either Doctors/Nurses, these areas should have proper privacy by

the use of partitions and curtains.

Budget break up:-

Sl.No District No. of UPHC

Refill of Fire Extinguisher Curtains, partition in

patient care areas

Unit cost(Rs)

Total Cost(Rs) Unit cost(Rs) Total Cost(Rs)

1 Bongaigaon 1

2000

2000

5555

5555

2 Cachar 1 2000 5555

3 Dibrugarh 2 4000 11111

4 Dhubri 1 2000 5555

5 Goalpara 1 2000 5555

6 Jorhat 3 6000 16665

7 Kamrup Metro 34 68000 188870


9 Karimganj 1 2000 5555

10 Lakhimpur 1 2000 5555

11 Nagaon 3 6000 16665

12 Sibsagar 2 4000 11111

13 Sonitpur 1 2000 5555

14 Tinsukia 2 4000 11111

Total 108000 299973

63

Fire safety measures and mock drills -Mock drills have to be conducted at health facilities. The district

disaster management authority and fire department should be invited for mock drills on disaster and

fire safety. Records of the training have to be maintained at the facility with date and duration of

drills with names of attendees and authorized signature of the trainer and the facility in charge.

Installation of fire extinguishers, fire alarms, directional signage for fire exits, fire exit plan have to be

established. A NOC also has to be obtained from fire safety department. The purpose of fire drills in

hospitals is to ensure that everyone knows how to exit safely as quickly as possible if a fire, smoke,

carbon monoxide or other emergency occurs. People need to recognize the sound of the fire alarm.

Roles and responsibilities of various staff has to be clearly defined during such a disaster.

EQUAS:EQUAS has to be done for in house laboratories mandatorily for DHs, SDCHs CHCs and PHCs.

The laboratory has to be registered with govt approved facilities like CMC Vellore or AIIMS. The

following link can be followed for registering the lab with CMC Vellore for 2019 Jan to Dec cycle.

Online payment/demand draft has to be made after registering; following which samples will be sent

from CMC, Vellore to that particular facility for EQUAS. This website can be followed

https://home.cmcvellore.ac.in/clinqc/aboutRegistration.aspx for online registration by the facility.

Budget break up for Mock Drills and EQUAS.


Mock Drills EQUAS



1 Bongaigaon 1

2000

2000

4000

4000

2 Cachar 1 2000 4000

3 Dibrugarh 2 4000 8000

4 Dhubri 1 2000 4000

5 Goalpara 1 2000 4000

6 Jorhat 3 6000 12000

7 Kamrup Metro 34 68000 136000


9 Karimganj 1 2000 4000

10 Lakhimpur 1 2000 4000

11 Nagaon 3 6000 12000

12 Sibsagar 2 4000 8000

13 Sonitpur 1 2000 4000

14 Tinsukia 2 4000 8000

Total 108000 216000

https://home.cmcvellore.ac.in/clinqc/aboutRegistration.aspx

64

Activity: Support for Implementation of Kayakalp




For Biomedical and general waste management activities, Bins and bin liners of respective color code

should be purchased and used.

Facility should have both proper directional and departmental signage system. The signage should be

uniform throughout the facility.

For safety of the cleaners and sweepers, personal protective equipments namely gum boot, utility

gloves, aprons should be procured in adequate quantity.

Facility management activities especially pest control should be carried out meticulously. Purchase of

rat traps or rodenticides or other pesticides should be done.

A. Budget break up:-


Bin liner Signage’s

Unit cost(Rs) Total Cost(Rs) Unit cost(Rs) Total Cost(Rs)

1 Bongaigaon 1

2800

2800

5000

5000

2 Cachar 1 2800 5000

3 Dibrugarh 2 5600 10000

4 Dhubri 1 2800 5000

5 Goalpara 1 2800 5000

6 Jorhat 3 8400 15000

7

Kamrup

Metro 34 95200 170000

8

Karbi

Anglong 1 2800 5000

9 Karimganj 1 2800 5000

10 Lakhimpur 1 2800 5000

11 Nagaon 3 8400 15000

12 Sibsagar 2 5600 10000

13 Sonitpur 1 2800 5000

14 Tinsukia 2 5600 10000

Total 151200 270000

65

B. Budget break up:-


Gum boots, Utility gloves, Other PPE

Bins

Unit cost(Rs) Total Cost(Rs) Unit cost(Rs) Total Cost(Rs)

1 Bongaigaon 1

3000

3000

5100

5100

2 Cachar 1 3000 5100

3 Dibrugarh 2 6000 10200

4 Dhubri 1 3000 5100

5 Goalpara 1 3000 5100

6 Jorhat 3 9000 15300

7

Kamrup

Metro 34 102000 173400

8

Karbi

Anglong 1 3000 5100

9 Karimganj 1 3000 5100

10 Lakhimpur 1 3000 5100

11 Nagaon 3 9000 15300

12 Sibsagar 2 6000 10200

13 Sonitpur 1 3000 5100

14 Tinsukia 2 6000 10200

Total 162000 275400

C. Budget break-up

Sl.No District No. of UPHC Pest Control


1 Bongaigaon 1

3000

3000

2 Cachar 1 3000

3 Dibrugarh 2 6000

4 Dhubri 1 3000

5 Goalpara 1 3000

6 Jorhat 3 9000



9 Karimganj 1 3000

10 Lakhimpur 1 3000

11 Nagaon 3 9000

12 Sibsagar 2 6000

13 Sonitpur 1 3000

14 Tinsukia 2 6000

Total 162000

66

Activity: Swachh Swasth Sarvatra

FMR Code: U.13.2.2

Activity owner



A day long UPHC level training on Swachh Swasth Sarvatra for Ward members nursing, paramedical and

cleaning staff of urban health facilities should be planned out by the concern DUHC of the district. Resource

person will be the concern MO of the institute.

Objective of the training: To roll out Swachh Swasth Sarvatra in urban areas

Deliverables: Open defecation free urban area, encouraging cleanliness, hygiene etc

Training wise budget break up

District wise budget break up on SSS training:

Sl.No District No. of UPHC Training on SSS


1 Bongaigaon 1

9250

9250

2 Cachar 1 9250

3 Dibrugarh 2 18500

4 Dhubri 1 9250

5 Goalpara 1 9250

6 Jorhat 3 27750



9 Karimganj 1 9250

10 Lakhimpur 1 9250

Sl.

No Component Unit Cost Unit Duration Total (In Rs.)

1 DA to Participants 200 15 1 3000.00

2 Training Material (Bag, Pad, Pen,

Pencil, Highlighter etc.)

150 15 1 2250.00

3 Working lunch, snacks and Tea 200 20 1 4000.00

Total amount for 1 batch (15 nos participant) (in Rs.) 9250.00

Total budget for 57 batches (855 participants ) in lakh. 527250.00

Rs. In Lakh 5.27

67

11 Nagaon 3 27750

12 Sibsagar 2 18500

13 Sonitpur 1 9250

14 Tinsukia 2 18500

Total 527250

68

Programme Management

Activity: QA Committees at city level (meetings,workshops, etc.)



At District level –DQC/ District Urban Health Coordinator, NUHM

In order to improve the quality of facility based service delivery through systematic monitoring and

feed-back, with the goal of improving client satisfaction. Every UPHC will organise meetings/

workshop in presence of DPM, DUHC and District Quality team.

District wise budget break up:

Sl.No District No. of UPHC Meeting on Quality Assurance


1 Bongaigaon 1

2000

2000

2 Cachar 1 2000

3 Dibrugarh 2 4000

4 Dhubri 1 2000

5 Goalpara 1 2000

6 Jorhat 3 6000



9 Karimganj 1 2000

10 Lakhimpur 1 2000

11 Nagaon 3 6000

12 Sibsagar 2 4000

13 Sonitpur 1 2000

14 Tinsukia 2 4000

Total 112000

Activity: Mobility Support

FMR Code: U.16.8.2.2 Activity owner



Mobility support to DPMU @Rs. 10000/per month for 12 months for 13 District and for

Kamrup(Metro) @Rs. 22500/per month. Fund should be utilised for vehicle expenses for field visits/

session visit/special programs and official visits as per NHM norms.

Sl.No District Amount (Rs)

1 Bongaigaon 120,000

69

2 Cachar 120,000

3 Dibrugarh 120,000

4 Dhubri 120,000

5 Goalpara 120,000

6 Jorhat 120,000

7 Kamrup Metro 270,000

8 Karbi Anglong 120,000

9 Karimganj 120,000

10 Lakhimpur 120,000

11 Nagaon 120,000

12 Sibsagar 120,000

13 Sonitpur 120,000

14 Tinsukia 120,000

Total 18,30,000

Activity: Administrative Expenses

FMR Code: U.16.8.2.3 Activity owner

At State level – Pranjal Borah, AM, NUHM


Fund should be utilised for Review meeting, Workshop, Office expenses @ Rs.5000.00/Per Qtr. Bills

should be paid as per NHM norms

District wise break-up

Sl.

No District Unit Cost /Per month qtr Unit Cost /year (Rs)

1 Bongaigaon 5,000 20,000

2 Cachar 5,000 20,000

3 Dibrugarh 5,000 20,000

4 Dhubri 5,000 20,000

5 Goalpara 5,000 20,000

6 Jorhat 5,000 20,000

7 Kamrup Metro 10,000 40,000

8 Karbi Anglong 5,000 20,000

9 Karimganj 5,000 20,000

10 Lakhimpur 5,000 20,000

11 Nagaon 5,000 20,000

12 Sibsagar 5,000 20,000

13 Sonitpur 5,000 20,000

14 Tinsukia 5,000 20,000

Total 3,00,000

-------------XXXX---------------

Date post:	05-Feb-2022
Category:	Documents
Upload:	others
View:	2 times
Download:	0 times

Preface - Government Of Assam, India

Documents