LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Shahid Rashid
AssignmentProject Human ResourceHuman Resource Plane
of National Program AJ&K
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
NAME OF THE PROGRAM
National Program for Family Planning and Primary Health Care (NP-FP&PHC)
“The Lady Health Workers’ Program” (LHWP)(launched -- july1994)
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
ROLES & RESPONSIBILITIES• Sponsoring. Federal Government/
Planning Commission
• Execution. AJK Health Department
and District Health Offices.
• Operation & maintenance Department of Health
• Concerned Federal Ministry Planning Commission KA & GB/Planning
Commission
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
REGIONAL PROFILE
• Total population 4.2 (million) - Urban 12 (%)– Rural 88 (%)
• Total population Coverage 60 (%)• Target population Coverage
– Urban 40 (%)– Rural 62 (%)
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
OrganogramDirector General Health (Chairman)
Regional Coordinator (Officer of DGH office on additional charge)
District Health Officer (Chairman of District)
District Coordinator
(Officer of District on additional charge)
Assistant District Coordinator (FMO or Senior LHVs on additional charge)
Account Supervisor (Contract employee of
program)
Lady Health Supervisor(LHS) ------ FLCFs
Lady Health Worker (LHW)
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
DistrictsAllocation of
LHWs No. of LHW
WorkingAllocation of LHSs
No. of LHS Working
Bagh 466 431 23 19Kotli 498 466 25 23Mirpur 240 233 12 12Muzaffarabad 550 515 28 15Poonch 400 357 20 19Sudhnuti 223 217 11 11Bhimber 312 310 15 14Neelum 217 204 11 10Haveli 167 163 08 8Hattian 173 173 09 6
Total 3246 3069 162 137
Staff Disterbution
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
(Contd….)• Expansion of the program withhold from 27th
August.2010 due to flood.
Office Memorandum of 18th dec.,2012• Post that may become vacant as a result of
resignation, losing jobs or otherwise shall stand abolished for the purpose of federal funding and recruitment w.e.f 1-7-2011 will b financed by the provincial governments. Like wise, any new creation of posts/appointments or future need be financed by the provinces from their own budget/resources.
• AJK,FATA,GB and ICT shall not create any new posts and recruit against existing vacancies w.e.f 1-7-2011 without prior approval of the finance division.
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
FACILITIES INVOLVED IN NATIONAL PROGRAM
Districts No. of FLCF involved
Bagh 22Kotli 20Mirpur 12Muzaffarabad 30Poonch 16Sudhnuti 11Bhimber 15Neelum 12Haveli 10Hattian 10
Total 158
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
• The National Program for FP & PHC has become an important element of govt. plan to raise the health status of women and children in villages and poor urban areas.
• In AJK 2.4 million population is receiving FP & PHC services from the LHWs.
• AJK is Polio Free-Key contribution of LHWs.• Role of LHWs in emergency relief activities in
disaster situations.• Poverty Reduction• Notification for regularization of LHWs Program
Staff (number=3368) is under process at Finance Department AJK.
Major Achievements
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Progress 1994-2013
Year 1994 2013
Population coverage 5% 60%
No.of LHWs 500 3069
No.of LHSs 35 137
No.of Trainers 20 314
Stipend of LHW 1200 7000 (Now in scale 5)
Stipend of LHS 3300 7000 (Now in scale 7)
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Comparison of Indicators
Indicator % 2009 2010 2011 2012
CPR 46% 51% 51% 51%
TT 94% 95% 97% 97%
Deliveries through SBA
72% 73% 72% 72%
IMR 34/1000 LB 34/1000 LB 32/1000 LB 32/1000 LB
MMR 139/100000LB 135/100000LB 130/100000LB 125/100000LB
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Comparison of Indicators
Indicator Multiple Cluster Survey (2007-08)
AJK-DHS 2010
CPR 32% 41.3%TT 57% 63.5%
SBA 40% --
EPI 44.5% 45.6%ANC at least one visit 69% 81.5% PNC visit within 24 hours of delivery
-- 39.3%
EBF 44% 35.3%IMR 62/1000 L.B --
MMR 201/100000 L.B --
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
PROGRAM EVALUATION
• The program is evaluated four times by the third party the last in 2008 by the Oxford Policy Management group.
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Comparison of antenatal care and family planning measures in served and un-served areas (rural areas)
49 43 39
67
30 27 26
45
01020304050607080
Who took irontablets during last
pregnancy
Births attendedby doctor, nruse
or LHV
Births deliveredat health facility
(Institutionaldeliveries)
New bornexamined with in24 hours of Birth
Antenatal care and delivery (%)
2008 Served HHs
2008 UnservedAreas
Quantitative Survey Report Oxford Policy Management August 2009
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Comparison of antenatal care and family planning measures in served and un-served areas (rural areas)
74
26
61
28
53
1430
13
01020304050607080
Who had atleastone antenatal
consultation at aHealth Facility
Who had 5 ormore antenatal
consultation at aHealth Facility
Who had atleast2 tetnus toxoidinjection in thelasst pregrency
Who had atleast2 tetnus toxoidinjection in live
(offering life timeprotection)
Antenatal care and delivery (%)
2008 Served HHs
2008 UnservedAreas
Quantitative Survey Report Oxford Policy Management August 2009
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Comparison of antenatal care and family planning measures in served and un-served areas (rural areas)
Family Planning (%) (Currently married women aged 15-49)
89
49
25
77
28
10
0102030405060708090
100
Have ever used anymethod of contraception
Using any method ofcontraception (CPR)
Using any modren methodof contraception
2008 Served HHs2008 Unserved areas
Quantitative Survey Report Oxford Policy Management August 2009
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Comparison of Immunization in served and un-served areas (rural areas)
Immunisation (%)
64
46
010203040506070
Children age 12-35 months fullyvaccinated (based on recall and
record)
2008 Served HHs
2008 Unservedareas
Quantitative Survey Report Oxford Policy Management August 2009
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Financial Status FY 2012-13• Budget requirement =Rs.421.850m +Rs. 39.141m*
=Rs.450.091m• Allocation =Rs.330 m• Release to date =Rs.240 m• Short fall =Rs.120.091 m
• Requirement of funds for regularization
= Rs.745.65 – Rs.330 m = Rs.415.65 m
* pending liability FY2011-12= salary +others = Rs.34.865 m + Rs.4.276 m
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Utilization of Funds July 2012 to date• Salary pay & allowances = Rs. 238.922 m (99.55%) • Medical Charges = Rs. 0.048 m• Electricity Charges = Rs. 0.054 m• Telephonic Charges = Rs. 0.025 m• Courier = Rs.0.007 m• POL = Rs.0.245 m• Rent of Building = Rs. 0.240 m• Repair of vehicle = Rs.0.119 m• TADA = Rs.0.199 m• Pension Contribution = Rs.0.106 m• Other = Rs. 0.005 m• Repair of hardware = Rs. 0.005 m• Stationary = Rs. 0.025 m
Total = Rs. 240 m
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
ISSUES
• Delayed Salaries • Insufficient Release• No Budget for medicines, stationary,
monitoring & supervision.• Notification for regularization is still
awaited.
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
Health Education Session
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health
LHW Programme, Ministry of Health