State PIP - STATE HEALTH SOCIETY-----BIHAR

STATE PROGRAMME IMPLEMENTATION PLAN
Government of Bihar
NATIONAL RURAL HEALTH MISSION
2009-10
February 2009

State PIP, Bihar 2008-09
National Rural Health Mission
Abbreviations
ANM
ASHA
AWC
AWW
BCC
BPL
BEmOC
CBO
CDR
CEO
CEmOC
CMR
DHS
DPT
GO
GoB
GoI
HIV
ICDS
IEC
IMR
MMR
NFHS I
NFHS II
NFHS III
NGO
O & M
OP
OPD
RCH
PHC
PPP
PIP
PRI
RKS
SHC
SIHFW
TB
TFR
Auxiliary Nurse Midwife
Accredited Social Health Activist
Aaganwadi Centre
Aaganwadi Worker
Behaviour Change Communication
Population Below Poverty Line
Basic Emergency Obstetric Care
Community Based Organization
Crude Death Rate
Chief Executive Officer
Comprehensive Emergency Obstetric Care
Crude Mortality Rate
Directorate of Health Services
Diphtheria, Pertusis and Tetanus vaccine
Government Order
Government of Bihar
The Government of India
Human Immunodeficiency Virus
Integrated Child Development Services
Information Education Communication
Infant Mortality Rate
Maternal Mortality Rate
National Family Health Survey I
National Family Health Survey II
National Family Health Survey III
Non-Governmental Organizations
Operation and Maintenance
Out-Patient (section or department of a hospital)
Out-Patient Department
Reproductive and Child Health
Primary Health Centre
Public Private Partnership
Program Implementation Plan
Panchayati Raj Institutions
Rogi Kalyan Samiti
Sub Health Centre
State Institute of Health & Family Welfare
Tuberculosis
Total Fertility Rate
2

State PIP, Bihar 2008-09
National Rural Health Mission
Preface
National Rural Health Mission offers unprecedented opportunity to improve the health of
the people of Bihar. The Public Health System of Bihar, through its more than 10000
ANMs, 75000 of ASHAs, 70000 of Aaganwadi Workers and thousands of doctors
reaches out to the people living in more than 80000 villages. The Public Health
infrastructure, particularly PHCs/CHCs and other Government hospitals ought to be the
institutions where people can put their trust for good and affordable quality health
services as per needs.
Though the role of Public Health system is primarily important, NRHM heralds a new
beginning where the health of the people will be placed in their own hands and
government will play a role of facilitator providing all round support and ensuring access
to health services.
The PIP has been prepared through consultation with block and district level
functionaries. The plans have been prepared on the needs identified and has addressed
lots of critical issues to implement the programme.
The plan is aimed at improving the access to comprehensive quality health care by
improving the public health infrastructure to desired standards and placing the health of
the people in their hands. Government will play the role of a facilitator and undertake
new initiatives.
As planned here the capacity to manage the programme in the state is going to be
significantly strengthened. The Programme Management Support Units at the block level,
HMIS and the support systems shall also be strengthened. This year also a number of PPP
initiatives is taken to reach out services to the people through varied channels.
It is expected that for the state of Bihar, this will be the turning point for accelerated
improvement in health.
3

State PIP, Bihar 2008-09
National Rural Health Mission
Table of Contents
Chapter Content Page No.
Preface 3
1 Executive Summary 9-11
2 Process of Plan Preparation 12
3. Background and Current Status
3.1 Demographic and Socio-Economic Features at State and District 12-16
Levels
3.2 Administrative Divisions 17-20
3.3 RCH Outcome and Service Utilization 20-23
3.4 Public Health Infrastructure 24-25
3.5 Private and NGO Health Service 26
3.6 Donor Assisted Programme in the State 26-27
3.7 Institutional Arrangements and Organizational Development 27
3.8 Program Finance 27
Part A Reproductive & Child Health-II
4 Situation Analysis
4.1 Maternal Health 29-30
4.2 Child Health 30-31
4.3 Family Planning 31-33
4.4 Adolescent Health 33-36
4.5 District/Sub District Variations 36-39
4.6 Health Infrastructure and Facilities 40-45
4.7 Human Resource Development including Training 45-46
4.8 Inequity/ Gender; Vulnerable Groups Including Urban Slums &
Tribal
4.8.1 Inequity and Gender 46-47
4.8.2 Urban Slums 47
4.9 Logistics 47-48
4.10 HMIS and Monitoring & Evaluation 48-49
4.11 Behaviour Change Communication 49
4.12 Convergence/Coordination 49-50
4.13 Finance 50
5 Progress and Lessons learnt from RCH II Implementation of 05-
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State PIP, Bihar 2008-09
National Rural Health Mission
08
5.1 Major achievement during 2005-08 51-52
5.2 Programme Management 52-53
6 RCH II PROGRAMME OBJECTIVES AND STRATEGIES
6.1 Vision Statement 54
6.2 Technical Objectives, Strategies and Activities
1 Maternal Health 55-61
2 Child Health 61-70
3 Family Planning 71-77
4 Adolescent Reproductive and Sexual Health 78-81
5 Urban Health 81-83
6 Vulnerable Groups (Health Camps in Maha Dalit Tola) 84
7 Tribal Health 84
8 Innovations
8.1 PNDT Act 85
8.2 Muskaan Programme 86-87
9 Strengthening of SIHFW 88
9.1 Fast Track Training Cell in SIHFW 88
9.2 Filling Vacant Position at SIHFW/Hiring Consultant at SIHFW 88
10 Infrastructure and Human Resource 89
11 Institutional Strengthening 90-92
12 Training 93-97
13 IEC/BCC 98-107
14 Procurement of Equipments/ Instruments and Drugs/Supplies 108-109
16. Programme Management 110-120
17. Convergence and Coordination 121
18. Role of State, District & Blocks 121
19. Monitoring and Evaluation 121-126
20. Synergie with NRHM Additionalities 127
21. Sustainability 128
22. Extra inclusions in RCH 129-130
23. Work Plan (Annexure - 3d) 131
24. Budget (Annexure- 3c & 3e) 131
Part B NRHM Additionalities
1. Decentralisation 133
5

State PIP, Bihar 2008-09
National Rural Health Mission
1.0 ASHA 134-145
1.1 Untied Funds for Health Sub-Centre, APHC & PHCs 146
1.2 Village Health & Sanitation Committee 147
1.3 Seed Money for Rogi Kalyan Samiti 147-148
2. Infrastructure Development
2.1 Construction or establishment of Health Sub-Centre 149
2.2 Construction of PHC 150
2.3 Upgradation of Community Health Centre (CHC) 151
2.4 Infrastructure & Service Improvement as per IPHS in 48 (District 152
& Sub-Divisional) Hospitals for
accreditation/ISO 9000 Certification of Health
facilities
2.5 Upgradation of Infrastructure of ANM Training Schools 152-154
2.6 Annual Maintenance Grant 154
3. Contractual Manpower
3.1 Incentive, Contractual Salaries and Bonus 154-155
3.2 Block Programme Management Unit 155-156
3.3 Additional Manpower for State Health Society Bihar 156-157
3.4 Additional Manpower under NRHM 157
4. PPP Initiative in State
4.1 102- Ambulance Service 158
4.2 Dial 1911 - Doctor on Call & Samadhan 158-159
4.3 Additional PHCs Management by NGOs 159
4.4 AAPIO 160
4.5 State Health Resource Centre 160
4.6 Services of Hospital waste treatment and Disposal in all 160-162
Government Health facilities upto PHCs in Bihar
(IMEP)
4.7 Dialysis Unit in Government Hospital of Bihar 162-163
4.8 Setting up of Ultra Modern Diagnostic Centre in RDCs and all 163-164
Government Medical College Hospitals
4.9 Providing Telemedicine Services in Government Health facilities 165-168
4.10 Outsourcing Pathology & Radiology Services from PHCs to 168-169
District Hospital
4.11 Operationalising Mobile Medical Unit 169-171
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State PIP, Bihar 2008-09
National Rural Health Mission
4.14 Monitoring and Evaluation 171-172
4.15 Generic Drug Shop 173
4.16 Nutrition Rehabilitation Centres (NRCs) for Treatment of sever 173-174
and acute malnutrition
4.17 Hospital Maintenance 174
4.18 Providing Ward Management Services in Govt. Hospitals 175
4.19 Provision of HR Consultancy Services 175-176
4.20 Advanced Life Saving Ambulances (ALS) 176
7. Mobilisation and Management support for Disaster Management 177-178
8. Health Management Information System (HIMS) 178-181
9. Strengthening of Cold Chain 182-183
12 Main streaming AYUSH under NRHM 183-187
Summary Budget of NRHM Part- B 188-190
Part C Immunization
1 Routine Immunization 191-225
Part D National Disease Control Programmes
1 IDSP 227-229
2 IDD 230-236
3 NPCB 237-251
4 NLEP 252-285
5 TB 287-319
NVBDCP
5 Kalazar 321-351
6 Malaria 352-364
7 Dengu & Chikungunya 366-368
8. JE 369-371
9. Filaria 372-380
Part E Intersectoral Convergence
1 Intersectoral Convergence 382-392
BUDGET
1 NRHM Part A RCH II 393
2 NRHM Part B - Additionalities 394-396
3 NRHM Part C - Immunization 397
4 NRHM Part D NDCP 397
5 NRHM Part E - Convergence 397
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State PIP, Bihar 2008-09
National Rural Health Mission
6 Summary of Budget 398
Annexures
Annexure 3a Self Appraisal of State PIP against Appraisal Criteria
Annexure 3b Targets for goals, outcomes, outputs and inputs
Annexure 3d Work plan RCH
Annexure 3e Details of Budget of RCH- II (Part-A)
Annexure 4 IMNCI
Annexure 5 IFA
Annexure 6 IUD Training
Annexure 7 MTP Training
Annexure 8 CTP (Comprehensive Training Programme)
Annexure 9
Annexure 10
Annexure 11
Annexure 12
Annexure 13
Annexure 14
Annexure 15
Annexure 16
Annexure 17
Annexure 18
Annexure 19
Annexure 20
Annexure 21
Pilot Health Financing Scheme for Safe Maternity to BPL/SC/ST beneficiaries in
accredited private facilities
Incentive for Cesarean Section, Pregnancy testing, Safe Abortion & IUCD in
Bihar
Procurement
School Health
List of 27x7
Pregency Kit
MAPEDIR
Training Details
Mahadalit Tola Report
IEC Budget Breakup
NSV Kit
Minilap Set
FRU Report
8

State PIP, Bihar 2008-09
National Rural Health Mission
Executive Summary Chapter 1
Executive Summary
Introduction
The State Health Society, Government of Bihar is committed towards promoting the right of
every woman, man and child to enjoy a life of health and equal opportunity and is making all
round efforts in this direction. SHSB under the aegis of Department has taken steps to bring about
outcomes as envisioned in the Millennium Development goals, RCH II / NRHM programme and
Vision 2010 Bihar. It aims at minimizing regional variations in the areas of Reproductive and
Child Health including population stabilization through an integrated, focused and participatory
programme. Meeting unmet demands of the target population, and provision of assured,
equitable, responsive quality services are central to the programme strategies. Based on
experience gained during the implementation of RCH II, the Department anticipates that current
RCH programme implementation would produce equitable reproductive and child health
outcomes and contribute to raising the status of the girl child.
The Goal
The goal is to improve quality of life of the people by:
(Goals mentioned below are for the period of RCH-II i.e. to be achieved by 2010)
ê reducing Maternal Mortality Ratio (MMR) from 371 to 100 per 1,00,000 live births,
ê reducing Infant Mortality Rate (IMR) from 61 to 30 per 1000 live births,
ê Reducing Total Fertility Rate (TFR) 1 from 4.3 to 2.1 for population stabilization with
enhanced satisfaction of clients with medical services.
The Department is making all out efforts to reduce the IMR and has initiated an innovative program
‘MUSKAAN’ for the same cause and so as to also reach the poorest of the poor with effective,
quality and equitable health services. Simultaneously taking steps to effectively implement national
health programme while creating synergy and convergence with RCH II.
1 NFHS-3
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State PIP, Bihar 2008-09
National Rural Health Mission
Status and Situation
Important RCH indicators such as MMR, IMR and TFR are showing declining trends whereas
institutional deliveries, complete ANC, contraceptive use in the state has increased. The state has
mapped poorly performing districts and is now extensively focusing on them.
Status of Important RCH indicators in the state are as follows:
Declined
ê MMR has declined from 389 (1998) to 371 (SRS 2003-05)
ê IMR has declined from 63 (Census 2001) to 61 per 1000 live births (SRS 2006-07)
ê Total Fertility Rate (TFR) has decreased from 4.3 to 4.0 (NFHS III 2005-06) to 3.9 (SRS 8)
ê Percentage of children under age 3 who are underweight has marginally declined from 48
percent to 47 percent.
Increased
é Institutional deliveries have increased from 12.1 (NFHS-I 1992-93) percent to 22 percent
(NFHS-III 2005-06) to 27.7 percent (DLHS-III 2007-08)
é Antenatal Care has increased from 15.9 percent (NFHS-II 1998-99) to 16.9 percent (NFHS-
III) to 45% (DLHS-III 2007-08)
é % Full Immunization coverage has increased from 10.7 (NFHS-I 1992-93) percent to 41.4
percent (DLHS-III 2007-08)
é Contraceptive use has increased from 23.1 percent (NFHS-I 1992-93) to 34.1 percent (NFHS-
III)
é Sex ratio from 825 to 871 (CRS 2006-07)
Strategic Direction
The entire State Health Society Bihar team is working in a mission mode to achieve goals set-in
for the state and is effectively dealing with the challenges. The Department has set the strategic
direction that encompasses year wise objectives, technical strategies; interventions include
program and services for improving maternal health, child health, family planning, adolescents'
health etc. The complete programme has been bifurcated into institutional and cross cutting
programme strategies as well as specific core programmatic strategies for taking effective actions.
These institutional and cross cutting strategies have impact on all the components of RCH viz.
maternal health, child health, family planning, adolescent health etc whereas specific core
programme strategies have wider impact on the specific programme component. It has been
recognized that all these strategies should converge and go hand-in-hand to achieve the
programme outcome. The state considers that strengthening institutional mechanisms,
infrastructural development, ensuring adequately trained human resources etc. are fundamental
requirements for getting better programme outcomes. Accordingly, the document is presented with
backward linkages from core programme strategies to institutional framework. Convergence of
strategies and progress is as described below:
i) Core Programme Strategies
‣ Special schemes such as Muskaan, MAMTA addressing child health, incentives to health staff.
ii) Cross Cutting Programmatic Strategies
‣ Capacity building, PPP, quality assurance, gender mainstreaming, community participation,
serving vulnerable community through mobile units etc. Resource planning for all the sectors
will be also done.
iii) Strengthening Institutional Framework and Governance Mechanisms
‣ Recruitment and placement of qualified human resource
‣ Structures: Functional, accountable State/District Health Mission with Governing and
Executive Board; Integrated Organizational Structure of Department of Health; Functional
10

State PIP, Bihar 2008-09
National Rural Health Mission
SPMU, DPMU, BPMU; Constitution of RKS and Village Health and Sanitation Committee
for bringing in transparency and accountability by involving the community.
‣ Infrastructure Development and ensuring consistent logistics support.
Strategies RCH Components Goals
Maternal Health
Reduction in MMR
Institutional framework
and Governance
mechanism
Cross Cutting
Strategies
Core Programme
Strategies
Child Health
Family Planning
Adolescent Health
Vulnerable
Community
Reduction in IMR
Reduction in TFR
Services to each
adolescent
Ensuring equitable
healthcare delivery
SUMMARY of BUDGET
PART
HEAD
BUDGET 2009-10
(Rs. In lakhs)
In Cr.
%
A RCH II 48495.00 484.95 37.89
B NRHM Additionalities 43568.00 435.68 34.04
C Immunization 3193.08 31.93 2.49
D NDCP 7,133.84 71.34 5.57
E Intersectoral Convergence 2172.70 21.72 1.70
TOTAL 104562.62 1045.62 81.70
PPI Operational Cost 76.97 6.01
Infrastructure Maintenance
(Treasury Fund) 157.22 12.28
GRANT TOTAL 1279.81 100.00
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State PIP, Bihar 2008-09
National Rural Health Mission
Process of Plan Preparation Chapter 2
Information collected from the District and Block level is the key in preparing the State
PIP. At the block level, consultation was done which was further sent to the District. With
the information gathered from the block, district has further held consultations and
prepared their priorities and requirements, which are being reflected in the District Health
Action Plans, still being prepared in the districts.
The method of data collection is both primary and secondary in the preparation of the
Plan. The secondary data were collected by reviewing records, registers and annual
reports. The data were also collected from DLHS, SRS and NFHS surveys to support
the background information. For primary data, the procedure involved focus group
discussions, interactions and meetings in different districts. This was done to have
opinion of all the programme officers, health staff, grass root workers and private
partners.
Based on the feedback received from the districts state programme officers have
discussed and finalized the SPIP requirements. The state has considered the
requirement of the district thoroughly and provision has been made in the PIP as per
their need.
The SPMU team was thoroughly involved in the process and their critical inputs were
incorporated to make this plan more holistic, realistic and achievable. The Plan was
further reviewed by the Executive Director, SHSB and the CEO-cum-Secretary, Health,
Deptt.of Health, Govt. of Bihar.
It should be mentioned that the plan has been prepared keeping in mind that private
party can simultaneously complement the role of the Government machinery in
delivering the health care services in the state.
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State PIP, Bihar 2008-09
National Rural Health Mission
Background & Current Status Chapter 3
3.1 Demographic and Socio-Economic Features at State and District Levels
Bihar with a population of 82.9 million is the second most populous state in India, next only to
Uttar Pradesh. Despite efforts in the last few decades to stabilise population growth, the states
population continues to grow at a much faster rate (28.43%) than the national population
(21.34%). The state is densely populated with 880 persons per square kilometre as against the
country average of 324.The sex ratio of the state at 919 is also less favourable than the national
average of 933.
Table 3.1.1: Bihar: Demographic, Socio-Economic and Health Indices
Characteristics Bihar India
Area
94,163 Sq. Km
Demographic Indicators
Population 828.8 Million 1027.0 Million
Population Density (Population / km2) 880 324
Sex Ratio 919 933
% decadal growth rate 28.43% 21.34%
Socio-Economic Indicators
Per Capita Income (Rs.) for year 2003-04
At constant1993-94 prices 3707 10964
At current prices 6861 20292
% decadal growth in Per capita Income ~ zero ~ 45%
Proportion of population below poverty line 42% 26%
Level of Urbanization 10.5% 27.8%
Literacy 47.5% 65.4%
Source: Census 2001, Ministry of Statistics and Program Implementation
Among the 38 districts of the state, West Champaran is the largest in terms of area (5228.00 sq.
km) while the smallest is Sheikhpura (605.96 sq. km). In terms of population, Patna is the largest
at 4.72 millions followed by East Champaran that has a population of 3.94 millions. Sheohar and
Sheikhpura have the smallest population of 0.52 millions and 0.53 millions respectively. In terms
of Sex Ratio, while districts such as Siwan (1031) and Gopalganj (1001) have a favourable ratio,
other districts like Munger (872), Patna (873) and Bhagalpur (876) have a less favourable ratio.
13

State PIP, Bihar 2008-09
National Rural Health Mission
Bihar has a total SC population of around 15.07%. However, SC population in certain districts
like Gaya (29.6%) and Nawada (24.1%) is much higher than the state average. On the other hand,
districts such as Kishanganj (6.6%) and Arwal (8.9%) have a relatively low proportion of SC
population. After the bifurcation of the state in 2002, most of the areas with large ST population
have been included in the state of Jharkhand. Therefore, the state has less than 1% ST population.
In terms of key health indicators, Bihar is among the low performing states. Though the state
fares reasonably well in terms of its Infant Mortality Rate (61) as against the national average
(58), it continues to be among the poorer performing states in terms of other indicators such as
TFR, MMR and NMR.
In terms of socio-economic indices too the district level variation is obvious. For literacy rates,
districts such as Arwal (26%), Jehanabad (29.3%), Kishanganj (31.1%), Araria (35%) and
Katihar (35.1%) are much below the even state average of 46.4%. However, there are districts -
Aurangabad (57%), Bhojpur (59%), Munger (59.5%), Patna (62.9%) and Rohtas (61.3%) -that
have performed better than the state average with literacy rates close to 60%. Similarly
performance of districts on percentage of people living below the poverty line is varied with
districts such as Araria faring the worst at 80.3%. Other poor performing districts are Bhagalpur,
Madhubani, Purnea, Sitamarhi, Supaul and Sheohar, where close to 70% of the population
continues to live below the poverty line. Despite such a large number of districts having a
significant proportion of their population living below poverty line, the state average of 46.2%
(among the lowest in the country) is largely due to the fact that there are some districts such as
Kaimur, Saharsa, Samastipur, Arwal, Jehanabad and Gopalganj where close to 80% of the
population are living above the poverty line. (See table 2.1.2 for district-wise detailed data).
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State PIP, Bihar 2008-09
National Rural Health Mission
Table 2.1.2: Bihar: Key Demographic and Socio-economic Indicators of Districts
Sl No Districts
Area in Sq. Population
BPL SC ST Sex Literacy
Km Rural Urban Total (%) (%) (%) Ratio Rates
1 2 3 4 5 6 7 8 9 10 11
1 Araria 2830.00 2026257 132351 2158608 80.3 13.6 1.4 913 35.0
2 Aurangabad 3305.00 1842998 170057 2013055 61.7 23.5 0.1 934 57.0
3 Arwal 761.12 659270 52458 711728 23.36 8.9 0.05 929 26.0
4 Banka 3019.56 1552353 56420 1608773 63.4 12.4 4.7 908 42.7
5 Begusarai 1918.00 2241743 107623 2349366 65.4 14.5 0.1 912 48.0
6 Bhagalpur 2569.44 1970745 452427 2423172 70.2 10.5 2.3 876 49.5
7 Bhojpur 2474.17 1930730 312414 2243144 55.3 15.3 0.4 902 59.0
8 Buxar 1623.83 1273422 128974 1402396 46.6 14.1 0.6 899 56.8
9 Champaran (E) 3968.00 3688687 251086 3939773 54.1 13.0 0.1 897 37.5
10 Champaran (W) 5228.00 2733907 309559 3043466 47.4 14.3 1.5 901 38.9
11 Darbhanga 2279.00 3028441 267348 3295789 60.0 15.5 0.0 914 44.3
12 Gaya 4976.00 2997479 475949 3473428 69.8 29.6 0.1 938 50.4
13 Gopalganj 2033.00 2022048 130590 2152638 37.6 12.4 0.3 1001 47.5
14 Jehanabad 807.88 743433 59154 802587 26.34 10.0 0.05 929 29.3
15 Jamui 3098.27 1295552 103244 1398796 63.4 17.4 4.8 918 42.4
16 Kaimur 3361.90 1247299 41775 1289074 15.4 22.2 2.8 902 55.1
17 Katihar 3057.00 2174361 218277 2392638 49.1 8.7 5.9 919 35.1
18 Khagaria 1486.00 1204027 76327 1280354 48.8 14.5 0.0 885 41.3
19 Kishanganj 1884.00 1167340 129008 1296348 58.0 6.6 3.6 936 31.1
20 Lakhisarai 1299.01 684485 117740 802225 62.3 15.8 0.7 921 48.0
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State PIP, Bihar 2008-09
National Rural Health Mission
Sl.No.
Districts
Area
sq.k.m
in
Population
Rural Urban Total
BPL (%) SC (%)
ST
(%)
Sex
Ratio
Literacy Rate
1 2 3 4 5 6 7 8 9 10 11
21 Madhepura 1788.00 1458679 67967 1526646 55.4 17.1 0.6 915 36.1
22 Madhubani 3501.00 3450736 124545 3575281 72.4 13.5 0 942 42.0
23 Munger 1418.76 819950 317847 1137797 53.0 13.3 1.6 872 59.5
24 Muzaffarpur 3372.00 3398361 348353 3746714 55.9 15.9 0.1 920 48.0
25 Nalanda 2367.00 2016899 353629 2370528 53.8 20.0 0.0 914 53.2
26 Nawada 2494.00 1671253 138443 1809696 62.0 24.1 0.1 946 46.8
27 Patna 3202.00 2757060 1961532 4718592 48.1 15.5 0.2 873 62.9
28 Purnia 3229.00 2321544 222398 2543942 70.0 12.3 4.4 915 35.1
29 Rohtas 3851.10 2123942 326806 2450748 56.8 18.1 1.0 909 61.3
30 Saharsa 1701.65 1383015 125167 1508182 14.2 16.1 0.3 910 39.1
31 Samastipur 2904.0 3271338 123455 3394793 19.5 18.5 0.1 928 45.1
32 Saran 2641.0 2950064 298637 3248701 54.1 12.0 0.2 966 51.8
33 Sheikhpura 605.96 444189 81313 525502 59.5 19.7 0.0 918 48.6
34 Sheohar 442.99 494699 21262 515961 69.8 14.4 0.0 885 35.3
35 Sitamarhi 2200.01 2529407 153313 2682720 67.1 11.8 0.1 892 38.5
36 Siwan 2219.0 2564860 149489 2714349 51.0 11.4 0.5 1031 51.6
37 Supaul 2410.35 1644370 88208 1732578 74.6 14.8 0.3 920 37.3
38 Vaishali 2036.00 2531766 186655 2718421 41.1 20.7 0.1 920 50.5
State Total 94363.00 74316709 8681800 82998509 46.2 15.07 0.9 919 46.4
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3.2 Administrative Divisions
Bound by Uttar Pradesh in the west, West Bengal on the east, Nepal on the north and Jharkhand
on the south, Bihar covers an area of 94,363 square kilometers. The state has 38 districts divided
into 9 administrative divisions. The number of districts in each division is detailed below -
Table 3.2.1: Administrative Divisions
Sl . Divisions Districts
1 Patna Patna, Nalanda, Bhojpur, Rohtas, Kaimur, Buxar
2 Magadh Gaya, Jehanabad, Arwal, Aurangabad, Nawada
3 Tirhut Muzaffarpur, Sitamarhi, Vaishali, Champaran East, Champaran West, Sheohar
4 Saran Saran, Siwan, Gopalganj
5 Darbhanga Darbhanga, Madhubani, Samastipur
6 Munger Begusarai, Jamui, Khagaria, Lakhisarai,Munger, Sheikhpura
7 Kosi Saharsa, Madhepura, Supaul
8 Bhagalpur Bhagalpur, Banka
9 Purnea Purnia, Araria, Kishanganj, Katihar
In addition, the state has 101 sub-divisions, 534 community development blocks, 9 urban
agglomerations, 130 towns (125 statutory towns and 5 non-statutory census towns) and 37,741
villages.
Table 3.2.2: Community Development Blocks
Sl.
Districts
Community Development Blocks
Total
Block Name
1 Araria 9 Narpatganj, Forbesganj, Bhargama, Raniganj, Araria, Kursakatta, Sikti,
Palasi, Jokihat
2 Arwal 3 Karpi, Kurtha, Makhdumpur
3 Aurangabad 11 Daudnagar, Haspura, Goh, Rafiganj, Obra, Aurangabad, Barun,
Nabinagar, Kutumba, Deo, Madanpur
4 Banka 11 Shambhuganj, Amarpur, Rajaun, Dhuraiya, Barahat, Banka, Phulidumar,
Belhar, Chanan, Katoria, Bausi
5 Begusarai 18 Khudabandpur, Chhorahi, Garhpura, Cheria Bariarpur, Bhagwanpur,
Mansurchak, Bachhwara, Teghra, Barauni, Birpur, Begusarai, Naokothi,
Bakhri, Dandari, Sahebpur Kamal, Balia, Matihani, Shamho Akha
Kurha
6 Bhagalpur 16 Narayanpur, Bihpur, Kharik, Naugachhia, Rangra Chowk, Gopalpur,
Pirpainti, Colgong, Ismailpur, Sabour, Nathnagar, Sultanganj, Shahkund,
Goradih, Jagdishpur, Sonhaula

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
7 Bhojpur 14 Shahpur, Arrah, Barhara, Koilwar, Sandesh, Udwant Nagar, Behea,
Jagdishpur, Piro, Charpokhari, Garhani, Agiaon, Tarari, Sahar
8 Buxar 11 Simri, Chakki, Barhampur, Chaugain, Kesath, Dumraon, Buxar, Chausa,
Rajpur, Itarhi, Nawanagar
9 E. Champaran 27 Raxaul, Adapur, Ramgarhwa, Sugauli, Banjaria, Narkatia, Bankatwa,
Ghorasahan, Dhaka, Chiraia, Motihari, Turkaulia, Harsidhi, Paharpur,
Areraj, Sangrampur, Kesaria, Kalyanpur, Kotwa, Piprakothi,
Chakia(Pipra), Pakri Dayal, Patahi, Phenhara, Madhuban, Tetaria, Mehsi
10 Champaran W 18 Sidhaw, Ramnagar, Gaunaha, Mainatanr, Narkatiaganj, Lauriya,
Bagaha, Piprasi, Madhubani, Bhitaha, Thakrahan, Jogapatti, Chanpatia,
Sikta, Majhaulia, Bettiah, Bairia, Nautan
11 Dharbhanga 18 Jale, Singhwara, Keotiranway, Darbhanga, Manigachhi, Tardih,
Alinagar, Benipur, Bahadurpur, Hanumannagar, Hayaghat, Baheri,
Biraul, Ghanshyampur, Kiratpur, Gora Bauram, Kusheshwar Asthan,
Kusheshwar Asthan Purbi
12 Gaya 24 Konch, Tikari, Belaganj, Khizirsarai, Neem Chak Bathani, Muhra, Atri,
Manpur, Gaya Town CD Block, Paraiya, Guraru, Gurua, Amas, Banke
Bazar, Imamganj, Dumaria, Sherghati, Dobhi, Bodh Gaya, Tan Kuppa,
Wazirganj, Fatehpur, Mohanpur, Barachatti
13 Gopalganj 14 Katiya, Bijaipur, Bhorey, Pach Deuri, Kuchaikote, phulwaria, Hathua,
Uchkagaon, Thawe, Gopalganj, Manjha, Barauli, Sidhwalia,
Baikunthpur
14 Jahanabad 12 Arwal, Kaler, Sonbhadra Banshi Suryapur, Ratni Faridpur, Jehanabad,
Kako, Modanganj, Ghoshi, Hulasganj
15 Jamui 10 Islamnagar Aliganj, Sikandra, Jamui, Barhat, Lakshmipur, Jhajha,
Gidhaur, Khaira, Sono, Chakai
16 Kaimur 11 Ramgarh, Nuaon, Kudra, Mohania, Durgawati, Chand, Chainpur,
Bhabua, Rampur, Bhagwanpur, Adhaura
17 Katihar 16 Falka, Korha, Hasanganj, Kadwa, Balrampur, Barsoi, Azamnagar,
18 Khagaria
Pranpur, Dandkhora, katihar, Mansahi, Barari, Sameli, Kursela,
Manihari, Amdabad
7 Alauli, Khagaria, Mansi, Chautham, Beldaur, Gogri, Parbatta
18

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
19 Kishanganj 7 Terhagachh, Dighalbank, Thakurganj, Pothia, Bahadurganj,
Kochadhamin, Kishanganj
20 Lakhisarai 6 Barahiya, Pipariya, Surajgarha, Lakhisarai, Ramgarh Chowk, Halsi
21 Madhubani 21 Madhwapur, Harlakhi, Basopatti, Jainagar, Ladania, Laukaha, Laukahi,
Phulparas, Babubarhi, Khajauli, Kaluahi, Benipatti, Bisfi, Madhubani,
Pandaul, Rajnagar, Andhratharhi, Jhanjharpur, Ghoghardiha, Lakhnaur,
Madhepur
22 Madhepura 13 Gamharia, Singheshwar, Ghailarh, Madhepura, Shankarpur,
Kumarkhand, Murliganj, Gwalpara, Bihariganj, Kishanganj, Puraini,
Alamnagar, Chausa
23 Munger 9 Munger, Bariarpur, Jamalpur, Dharhara, Kharagpur, Asarganj, Tarapur,
Tetiha Bambor, Sangrampur
24 Muzaffarpur 17 Sahebganj, Baruraj (Motipur), Paroo, Saraiya, Marwan, Kanti, Minapur,
Bochaha, Aurai, Katra, Gaighat, Bandra, Dholi (Moraul), Musahari,
Kurhani, Sakra
25 Nalanda 20 Karai Parsurai, Nagar Nausa, Harnaut, Chandi, Rahui, Bind, Sarmera,
Asthawan, Bihar, Noorsarai, Tharthari, Parbalpur, Hilsa, Ekangarsarai,
Islampur, Ben, Rajgir, Silao, Giriak, Katrisarai
26 Nawada 14 Nardiganj, Nawada, Warisaliganj, Kashi Chak, Pakribarawan, Kawakol,
Roh, Gobindpur, Akbarpur, Hisua, Narhat, Meskaur, Sirdala, Rajauli
27 Patna 23 Maner, Dinapur-Cum-Khagaul, Patna Rural, Sampatchak, Phulwari,
Bihta, Naubatpur, Bikram, Dulhin Bazar, Paliganj, Masaurhi, Dhanarua,
Punpun, Fatwah, Daniawan, Khusrupur, Bakhtiarpur, Athmalgola,
Belchhi, Barh, Pandarak, Ghoswari, Mokameh
28 Purnia 14 Banmankhi, Barhara, Bhawanipur, Rupauli, Dhamdaha, Krityanand
Nagar, Purnia East, Kasba, Srinagar, Jalalgarh, Amour, Baisa, Baisi,
Dagarua
29 Rohtas 19 Kochas, Dinara, Dawath, Suryapura, Bikramganj, Karakat, Nasriganj,
Rajpur, Sanjhauli, Nokha, Kargahar, Chenari, Nauhatta, Sheosagar,
Sasaram, Akorhi Gola, Dehri, Tilouthu, Rohtas
30 Saharsa 10 Nauhatta, Satar Kataiya, Mahishi, Kahara, Saur Bazar, Patarghat,
Sonbarsa, Simri Bakhtiarpur, Salkhua, Banma Itahri
19

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
31 Samastipur 20 Kalyanpur, Warisnagar, Shivaji Nagar, Khanpur, Samastipur, Pusa,
Tajpur, Morwa, Patori, Mohanpur, Mohiuddinagar, Sarairanjan,
Vidyapati Nagar, Dalsinghsarai, Ujiarpur, Bibhutpur, Rosera, Singhia,
Hasanpur, Bithan
32 Saran 21 Mashrakh, Panapur, Taraiya, Ishupur, Baniapur, Lahladpur, Ekma,
Manjhi, Jalalpur, Revelganj, Chapra, Nagra, Marhaura, Amnour, Maker,
Parsa, Dariapur, Garkha, Dighwara, Sonepur
33 Sheikhpura 6 Barbigha, Shekhopur Sarai, Sheikhpura, Ghat Kusumbha, Chewara,
Ariari
34 Sitamarhi 17 Bairgania, Suppi, Majorganj, Sonbarsa, Parihar, Sursand, Bathnaha,
Riga, Parsauni, Belsand, Runisaidpur, Dumra, Bajpatti, Charaut, Pupri,
Nanpur, Bokhara
35 Sheohar 5 Purnahiya, Piprarhi, Sheohar, Dumri Katsari, Tariani Chowk
36 Siwan 19 Nautan, Siwan, Barharia, Goriakothi, Lakri Nabiganj, Basantpur,
Bhagwanpur Hat, Maharajganj, Pachrukhi, Hussainganj, Ziradei,
Mairwa, Guthani, Darauli, Andar, Raghunathpur, Hasanpura,
Daraundha, Siswan
37 Supaul 11 Nirmali, Basantpur, Chhatapur, Pratapganj, Raghopur, Saraigarh,
Bhaptiyahi, Kishanpur, Marauna, Supaul, Pipra, Tribeniganj
38 Vaishali 16 Vaishali, Paterhi Belsar, Lalganj, Bhagwanpur, Goraul, Chehra Kalan,
Patepur, Mahua, Jandaha, Raja Pakar, Hajipur, Raghopur, Bidupur,
Desri, Sahdai Buzurg, Mahnar
3.3 RCH Outcome and Service Utilization
The government and its concerned agencies have initiated various programmes to address the
health related issues of the state. However, there is considerable scope of improvement. One of
the reasons for limited achievements of the programs has been the lack of quality of services. The
State Health Society has paid special attention to the quality of services and aims at meeting the
needs of the population leading to widespread acceptance of the services. The goal is to provide
integrated reproductive health care services, including addressing the unmet need for
contraception in order to improve the situation by the year 2012.
The program has made positive impact on the indicators in the state but there is still a long way to
go. The current situation of the selected indictors based on NFHS-3 shows that overall the state is
moving towards achieving the goals. The recent NFHS-3 has shown the improvements in health
indicators in the State. IMR has reduced from 78 to 62, MMR from 389 to 371. However TFR
has risen from 3.7 to 4.
20

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Important indicators reviewed during NFHS-3:
Total Fertility Rate (TFR) has increased from 3.7 to 4
Contraceptive use has increased from 24 % to 34 %
Antenatal Care has not improved at all
Institutional deliveries have increased from 15 % to 22%
IMR has declined from 78 to 62 per 1000 live births
Percentage of children under age 3 who are underweight has increased 54.3 to 58.4%
Though the State has achieved some progress in terms of output indicators, the maternal
mortality, child mortality and population growth continues to be a cause of serious concern to the
state's development efforts. Moreover, floods in some parts of the state make the State vulnerable
to communicable diseases. Besides, the health infrastructure is inadequate to cater to the needs of
the people and the upkeep of the already existing facilities is quite challenging.
Human resource is another major issue where the State health system is struggling. The paucity
of medical professionals especially the specialists limits the public health facilities in providing
much required higher level of care to the needy. A mismatch exists in the State between the
available medical and Para medical professionals and the demand for their services. More
medical graduates and Para medical professionals are required to fill up this gap. Moreover
despite number of trainings held, rationalization of manpower is yet to take place. To overcome
this, the State has initiated public private partnerships, out sourcing health facilities and
programmes to private sector and NGOs, contracting specialists for specialized care, etc. There is
also dearth of well-trained public health professionals and managers to effectively steer the public
health and family welfare programs. Another issue which the state is encountering is a declining
sex ratio. Several initiatives like advocacy, intensive IEC programs and enforcement of PNDT
aimed at reversing the existing sex ratio will be initiated this year.
In the coming years, the state envisions a system, which provides all the individuals specially the
BPL population the ability to access health care at an affordable price by tackling the existing
problems and build on its strengths and address its weaknesses.
21

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
3.4 Public Health Infrastructure
District wise Availability of Health Centres of Bihar State
Sl.
Name of
Districts
No.
of
DH
New
Constr
uction
Total
DH
No. of Sub
Divl
Hospitals
exist
New
Constr
uction
No. of
Referral
Hospital
upgraded
in Sub Div
Hospitals
Total
Sub
Div
Hospi
tals
No. of
Referral
Hospitals
exist
previousl
y
No. of
Referral
Hospitals
exist
Presently
No. of
PHCs
exist
New
Constr
uction
No. of
APHCs
upgrade
d into
PHCs
Total
No. of
PHCs
No. of
APHCs
exist
previosly
No. of
APHCs
exist
presently
No. of
HSCs
1 Araria 1 1 1 1 2 3 2 9 9 30 30 200
2 Arwal 1 1 0 3 3 23 23 46
3 Aurangabad 1 1 1 1 3 3 11 11 58 58 207
4 Banka 1 1 1 1 3 3 10 1 11 24 24 227
5 Begusrai 1 1 1 1 2 2 1 11 7 2 18 31 29 288
6 Bhagalpur 1 1 1 1 2 2 2 11 5 2 16 46 44 280
7 Bhojpur 1 1 1 1 2 2 12 2 1 14 20 19 284
8 Buxar 1 1 1 1 2 7 4 1 11 20 19 158
Champaran
9 (E) 1 1 1 2 3 3 1 20 7 3 27 46 43 315
Champaran
10 (w) 1 1 1 1 2 2 2 16 2 18 25 25 389
11 Darbhanga 1 1 2 2 13 6 4 19 51 47 261
12 Gaya 1 1 1 1 2 2 1 19 6 4 25 49 45 439
13 Gopalganj 1 1 1 1 3 3 10 4 2 14 22 20 186
14 Jamuai 1 1 1 1 3 3 7 2 2 9 21 19 166
15 Jhanabad 1 1 1 1 2 2 4 5 2 9 25 23 81
16 Kaimur 1 1 1 1 2 2 1 9 2 1 11 40 39 107
17 Katihar 1 1 2 2 3 1 11 5 2 16 32 30 257
18 Khagaria 1 1 0 1 1 6 1 1 7 18 17 151
19 Kishanganj 1 1 1 1 2 2 7 7 8 8 136
20 Lakhisarai 1 1 1 1 1 1 4 2 6 13 13 102
21 Madhapura 1 1 1 1 1 7 6 4 13 23 19 115
22 Madhubani 1 1 1 1 1 3 2 1 19 19 76 76 430
22

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
23 Munger 1 1 1 1 1 6 3 3 9 13 10 123
24 Muzaffarpur 1 1 0 1 1 14 2 16 47 47 473
25 Nalanda 1 1 1 1 2 3 2 12 8 7 20 36 29 302
26 Nawada 1 1 1 1 2 2 10 4 3 14 27 24 129
27 Patna 3 1 1 5 4 3 16 7 6 23 70 64 418
28 Purniea 1 1 1 1 2 2 1 11 3 3 14 34 31 278
29 Rohtas 1 1 1 1 2 1 1 13 6 5 19 17 12 186
30 Saharsa 1 1 1 1 7 3 10 33 33 152
31 Samastipur 1 1 3 1 4 1 1 14 6 4 20 59 55 354
32 Saran 1 1 1 1 3 2 15 5 3 20 45 42 413
33 Sheikhpura 1 1 1 1 1 1 3 3 6 18 18 74
34 Sheohar 1 1 1 1 1 1 3 1 4 7 7 34
35 Sitamarhi 1 1 1 1 1 1 13 5 2 18 38 36 213
36 Siwan 1 1 1 1 2 2 15 4 2 19 34 32 370
37 Supaul 1 1 1 1 2 1 1 9 2 1 11 28 27 178
38 Vaishali 1 1 1 1 2 2 11 6 3 17 36 33 336
Total 25 11 36 23 20 15 58 70 55 398 135 73 533 1243 1170 8858
23

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Table : Bihar: Public Health Infrastructure – Personnel
Sl.
No
Districts
MO ANM LHV MHW Staff Nurse AWW
Sanct. Working Sanct. Working Sanct Working Sanct. Working Sanct. Working Sanct. Working
1 Araria 117 98 273 177 41 12 102 40 17 9 1778 1631
2 Aurangabad 188 91 342 319 23 17 110 75 12 3 1430 1390
3 Arwal 62 24 78 105 4 4 59 34 0 0 631 631
4 Banka 97 84 275 213 45 25 124 49 12 6 1352 1044
5 Begusarai 117 73 352 351 24 16 33 11 8 8 1314 1296
6 Bhagalpur 162 127 387 385 48 27 34 32 8 8 1512 1347
7 Bhojpur 132 105 370 368 26 20 106 42 8 1 1658 1646
8 Buxar 89 77 212 212 15 11 42 19 2 2 1139 1139
9 Champaran (E) 237 135 364 355 35 23 48 28 12 1 2901 2895
10 Champaran (W) 145 74 427 308 43 19 60 5 19 15 2263 2252
11 Darbhanga 172 152 363 296 29 19 131 96 8 5 2563 2315
12 Gaya 231 197 575 563 41 33 245 159 8 1 2427 2385
13 Gopalganj 106 95 250 249 20 8 30 3 12 2 1816 1592
14 Jehanabad 119 92 59 56 5 5 31 18 13 8 604 599
15 Jamui 85 61 222 222 25 12 70 31 12 8 1156 1138
16 Kaimur 93 74 146 146 19 11 64 20 19 9 996 993
17 Katihar 121 106 238 211 56 31 33 1 12 7 1716 1637
18 Khagaria 73 61 190 191 31 18 18 5 4 2 967 965
19 Kishanganj 56 37 169 115 31 15 64 27 11 5 1052 963
20 Lakhisarai 72 51 131 131 20 14 40 28 10 9 671 608
21 Madhepura 81 51 223 93 35 9 22 4 4 0 962 588
22 Madhubani 233 124 487 380 37 15 54 43 34 16 3437 2852
23 Munger 141 91 157 157 30 28 51 30 23 23 645 644
24 Muzaffarpur 241 223 594 592 29 21 140 82 4 4 2822 2610
25 Nalanda 178 167 402 402 30 30 36 21 0 0 1785 1761
26 Nawada 115 87 207 207 24 11 30 21 25 17 1249 1235
27 Patna 289 205 434 434 32 30 49 6 16 13 2481 2465
28 Purnia 126 100 356 275 56 29 126 67 8 2 1464 1424
29 Rohtas 158 129 286 270 29 12 136 48 20 10 1712 1628
30 Saharsa 97 55 192 169 33 15 18 1 26 21 932 825
31 Samastipur 192 183 475 470 30 20 29 18 4 4 2692 2512
24

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
32 Saran 185 133 512 386 33 29 46 17 27 10 2455 2218
33 Sheikhpura 53 36 109 109 16 6 18 4 4 1 357 339
34 Sheohar 52 34 46 26 4 1 38 13 9 1 265 265
35 Sitamarhi 147 127 299 289 27 9 130 82 17 13 2064 1920
36 Siwan 151 126 465 298 31 25 102 56 13 9 2099 1934
37 Supaul 85 70 206 111 44 8 60 34 2 0 1376 1230
38 Vaishali 126 105 421 414 25 24 33 28 8 3 1844 1608
5124 3860 11294 10055 1126 662 2562 1298 451 256 60587 56524
25

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
3.5 Private and NGO Health Service
The State has a wide network of private health facilities in the urban areas providing Health
services. In general, these private health facilities are run either by individuals/organizations for
profit or by Non-profit Charitable organization/NGOs. However, exact data on the number of these
health facilities are not available with the State as in the State, the registration of private clinics and
nursing homes has not yet started although the Clinical Establishment Act has been passed last year.
Presently these health facilities are also not regulated by the DoH & F.W. However under PNDT
Act, the private clinics and nursing homes undertaking ultra sonography have been regulated and
these facilities are being monitored. There is an urgent need to create a comprehensive database for
private health service providers and develop appropriate regulatory mechanism for them.
NGOs
The state has only 12 Mother NGOs (MNGOs) covering 22 of the 38 districts of Bihar. However
the state does not have a structured procedure to assess the working of MNGOs. There is a need to
improve coordination between the NGOs and the Government at all levels i.e. state, districts and
sub-district levels in order to make them effective.
Further analysis of information related to NGOs in the state revealed that there are many NGOs that
are engaged in the health service delivery. Although no attempts have been made to assess the
functioning of these NGOs, it is important to take initiative to develop efficient NGO network in the
State.
3.6 Donor Assisted Programmes in the State
UNICEF
Unicef is supporting the state for immunization, maternal health, nutrition and trainings. Unicef has
already initiated the implementation of IMNCI programme and is supporting the operationalization
of Nutritional Rehabiltization Centres. Extensive support is provided by them in the health sector
especially during flood seasons. Unicef is providing technical support in operationlising ANM
training centres, procurement of equipments related to child health etc.
NIPI - Norwegian India Partnership Initiative
Under NIPIs Child Health Initiatives, a voluntary health worker called Mamta has been engaged at
all the District Hospitals and Sub Divisional Hospitals. A District Training Resource Centre wil be set
up in Nalanda district. In three NIPI focus districts namely Jehanabad, Nalanda and Sheikhpura for
operationzation of SNCUs, technical support and training of doctors and paramedical staffs are
26

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
being provided. Home Based Newborn Care is being implemented in three NIPI focus districts
through ASHAs. SPMU, DPMU and Block Programme Management Units shall be supported by
provision of consultants. At the State level Child Health Consultant, Finance Analyst and Data
Assistant, at the district level District Child Health Managers, at District Hospitals and Sub
divisional level Child Health Supervisors and Dy. Child Health Supervisors and at the block level
Junior Child Health Managers shall be placed.
The detailed fund allocation has been annexed.
WHO-NPSP
WHO is supporting the state in Pulse Polio Immunization Programme.
UNFPA
UNFPA is collaborating with SHSB from financial year 08-09 and is providing technical support in
Maternal Health.
3.7 Institutional Arrangements and Organizational Development
Along with Health department the ICDS, PHED and Panchayat are helping in implementing the
NRHM Programme. The coordination has been placed at State level, District Level and Block
Level. At the Grassroot level linkage between ASHA, ANM with AWW has been strengthened.
PHED department has taken up the training of ASHA.
Trainings are being regularly conducted under different programmes in the state. The state has
already started the trainings of IMNCIs. With the Unicef support the State has initiated to
operationlise 22 ANM schools in 2009-10. Repair and renovation of these schools are already in
progress and are expected to be operationalised in this year. Most of the districts have their own
warehouse.
The state has a unique system of collecting data from each PHC level. The state has established a
data centre in the state and has centres in District and at PHC. These data centres collect data from
each PHC through mobile phone and feed in the computer. The computerized data is later given to
the respective Programme Officers.
3.8 Program Finance
Governments Of Indias funds are released to the state through two separate channels, i.e; through
the state budget and directly through the State Health Society. Further the Departments outlay for
the procurement of vaccines, drugs, equipments etc; is spent centrally and assistance to the state has
been in the form of kind.
27

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
PART- A
RCH Flexible Pool
2009-2010
28

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Situational Analysis Chapter 4
4.1 Maternal Health
Improving the maternal health scenario by strengthening availability, accessibility and utilization of maternal
health services in the state is one of the major objectives of RCH. However, the current status of maternal
health in the state clearly shows that the programme has not been able to significantly improve the health
status of women. There are a host of issues that affect maternal health services in Bihar. The important ones
are listed below:
· Shortage of skilled frontline health personnel (ANM, LHV) to provide timely and quality ANC and PNC
services.
· The public health facilities providing obstetric and gynecological care at district and sub-district levels
are inadequate.
· Mismatch in supply of essential items such as BP machines, weighing scales, safe delivery kits, Kit A
and Kit B, etc and their demand.
· Shortage of gynecologists and obstetricians to provide maternal health services in peripheral areas.
· Inadequate skilled birth attendants to assist in home-based deliveries
· Weak referral network for emergency medical and obstetric care services
· Lack of knowledge about antenatal, perinatal and post natal care among the community especially in
rural areas
· Low mean age of marriage resulted in pregnancy and difficult deliveries.
· Low levels of female literacy resulted unawareness on maternal health services.
· High levels of prevalence of malnutrition (anemia) among women in the reproductive age group
· Poor communication because of bad roads and a law and order situation.
One of the very good things happen to maternal health is introduction JBSY.
In 2008-09, 16 MOs trained in CEmOC and 59 MOs in Life Saving Anesthetic Skills who are now managing
complicated cases at their respective place of postings. Bihar is the first state to have formally evaluated the LSAS
examinees and issued certificates of practice for the obstetric anesthesia.
29

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
A quality monitoring cell at the state level housed in State Institute of Health & Family Welfare is
monitoring all the trainings. The cell has members drawn from SIHFW faculty, medical colleges,
retired faculty members, officials from State Health Society and officials from partner agencies as
its members. Their initial focus is to monitor the quality of various trainings being undertaken under
NRHM like IMNCI, SBA, Minilap etc. In the year 2009-10, the role shall be expanded to include
the monitoring of quality of critical care services. (details in annexure)
4.2 Child Health
The child health indicators of the state reveal that the state's IMR is lower than the national average but the
NMR is disproportionately high. Morbidity and mortality due to vaccine-preventable diseases still continues
to be significantly high. Similarly, child health care seeking practices in the case of common childhood
diseases such as ARI and Diarrhoea are not satisfactory. The child health scenario is worse for specific
groups of children, such as those who live in rural areas, whose mothers are illiterate, who belong to
Scheduled Castes, and who are from poor households is particularly appalling.
Issues affecting child health are not only confined to mere provision of health services for children, but other
important factors such as maternal health and educational status, family planning practices and
environmental sanitation and hygiene have enormous bearing on child health. This is more than evident in
the case of Bihar where child health continues to suffer not only because of poor health services for children
but due to issues such as significantly high maternal malnutrition, low levels of female literacy, early and
continuous childbearing, etc. The specific issues affecting child health in the state are listed below.
Maternal Factors
· High levels of maternal malnutrition leading to increased risk pre-term and low -birth weight babies that
in turn increase risk of child mortality.
· Low levels of female literacy, particularly in rural areas.
Family Planning Services
· The Family Planning programme has partially succeeded in delaying first birth and spacing births
leading to significantly high mortality among children born to mothers under 20 years of age and to
children born less than 24 months after a previous birth.
Child Health Services
· The programme has not succeeded fully in effectively promoting colostrum feeding immediately after
birth and exclusive breastfeeding despite almost universal breastfeeding practice in the state. In the State
majority of mother breast feed children beyond six months. However both State and Unicef have taken
initiative to generate awareness among mothers for exclusive breast feeding.
30

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
· High levels of child malnutrition, particularly in rural areas and in children belonging to disadvantaged
socio-economic groups leading to a disproportionate increase in under five mortality.
· Persistently low levels of child immunisation primarily due to non-availability of timely and quality
immunisation services.
· Lack of child health facilities, both infrastructure and human resource, to provide curative services for
common childhood ailments such as ARI, Diarrhea, etc.
· Inadequate supply of drugs, ORS packets, weighing scales, etc.
· Lack of knowledge of basic child health care practices among the community.
· Failure to generate community awareness regarding essential sanitation and hygiene practices that impact
on the health of children.
Since these factors are inter-linked and synergistic, any effort to improve the health of the children in the
state needs to address child health issues in a holistic manner.
IMNCI Training: IMNCI training has successfully started in the State. The Pilot project has also successfully
completed in the district of Vaishali. The project is being monitored and managed by Unicef. In 2008-09
IMNCI Training is being scaled up in thirteen districts. In phase wise rest of districts will be completed.
In 2008-09, a pilot project done through SHSB on Nutritional Rehabilitation Centre. In this project special
nutritious food provided to the severely malnutrition children.
4.3 Family Planning
RCH emphasizes on the target-free promotion of contraceptive use among eligible couples, the provision to
couples a choice of various contraceptive methods (including condoms, oral pills, IUDs and male and female
sterilization), and the assurance of high quality care. It also encourages the spacing of births with at least
three years between births. Despite RCH and previous programmes vigorously pursuing family planning
objectives, fertility in Bihar continues to decline at much lower rates than the national average. Although the
total fertility rate has declined by about half a child in the six-year period between NFHS-1 and NFHS-2, it
has increased in NFHS-3 and is far from the replacement level. Furthermore, certain groups such as rural,
illiterate, poor, and Muslim women within the population have even higher fertility than the average.
The persistently high fertility levels point to the inherent weakness of the state's family planning programme
as well as existing sociodemographic issues. High TFR is reflected by a dismal picture of women in Bihar
31

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
marrying early, having their first child soon after marriage, and having two or three more children in close
succession by the time they reach their late-20s. At that point, about one-third of women get sterilized. Very
few women use modern spacing methods that could help them delay their first births and increase intervals
between pregnancies.
The major issues affecting the implementation of the Family Planning programme in Bihar are as follows.
· Lack of integration of the Family Planning programmes with other RCH components, resulting in
dilution of roles, responsibilities and accountability of programme managers both at state and district
levels.
· Failure of the programme to effectively undertake measures to increase median age at marriage and first
childbirth.
· Inability of the programme to alter fertility preferences of eligible couples through effective behavior
change communication (BCC).
· Over emphasis on permanent family planning methods such as, sterilization ignoring other reversible
birth spacing methods that may be more acceptable to certain communities and age groups. (Overall,
sterilization accounts for 82 percent of total contraceptive use. Use rates for the pill, IUD, and condoms
remain very low, each at 1 percent or less).
· Due to high prevalence of RTI/STD, IUDs are not being used by majority of women.
· Continued use of mass media to promote family planning practices despite evidently low exposure to
mass media in Bihar, leading to lower exposure of family planning messages in the community,
particularly among rural and socio-economically disadvantaged groups.
· Weak public-private partnerships, social marketing to promote and deliver family planning
services.(Public Private Partnership is improved since 2008-09. 102 Nursing homes in 20 districts are
accredited to conduct Family planning operations . In 2008-09 accredited private Nursing homes are
expected to conduct more than 50-60 thousand family planning operations in the state. From April,
2008, 223000 sterilization conducted till Jan, 2009 of which 40,000 are conducted by the accredited
private Nursing Homes. Details in Annexure)
The issues mentioned above are closely interlinked with the existing sociodemographic conditions
of the women, specially rural, poor and illiterate. Comprehensive targeted family planning
programme as well as intersectoral co-ordination on an overall female empowerment drive is
needed to address the factors responsible for persistently high fertility levels in Bihar.
32

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
The state has quality assurance committee for family planning both at State and District level. The committee
sits quarterly and report is sent to state. Also, 102 private hospitals and Clinics are accredited by the District
Quality Assurance Committees for conducting sterilization in 20 districts.These private facilities are
monitored by the QAC on sterilization conducted in the facilities. Family planning Insurance scheme is also
being implemented in the state with ICICI Lombard . Most of the Sterilizations are conducted in the last
two quarters due to existing sociodemographic and programmatic reasons as evident from the graph-
Month wise comparison of Sterilization
2007-08 & 2008-09
100000
90000
80000
88,000
85473
81105
70000
60000
50000
40000
42008
45673
49750
2007-
08
2008-
09
30000
20000
10000
0
6130
7505
2394
1693
3759
3338
7815
9857
1835
1275
2593
13951
4190
6728 18210
Apr May June July Aug Sep Oct Nov Dec Jan Feb Mar
Efforts are being made
to offer fixed day family planning services at District hospitals, Sub divisional
hospitals, FRUs and accredited private facilities. Later on this will be extended to the PHCs.
4.4 Adolescent Reproductive & Sexual Health
The World Health Organization (WHO) defines adolescence as the period between 10 and 19 years of age,
which broadly corresponds to the onset of puberty and the legal age for adulthood.
33

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Commencement of puberty is usually associated with the beginning of adolescence. In some societies,
adolescents are expected to shoulder adult responsibilities well before they are adults; in others, such
responsibilities come later in life.
Although it is a transitional phase from childhood to adulthood, it is the time that the adolescents experience
critical and defining life events first sexual relations, first marriage, first childbearing and parenthood. It is
a critical period which lays the foundation for reproductive health of the individuals lifetime. Therefore,
adolescent reproductive and sexual health involves a specific set of needs distinct from adult needs.
The reproductive health needs of adolescents as a group has been largely ignored to date by existing
reproductive health services. Many adolescents in India face reproductive and other health risks. Poor
nutrition and lack of information about proper diets increase the risk of iron-deficiency anemia for adolescent
girls. Young women and men commonly have reproductive tract infections (RTIs) and sexually transmitted
infections (STIs), but do not regularly seek treatment despite concerns about how these infections may affect
their fertility.
India also has one of the highest rates of early marriage and childbearing, and a very high rate of irondeficiency
anemia. The prevalence of early marriage in India poses serious health problems for girls,
including a significant increase of maternal or infant mortality and morbidities during childbirth. The
following facts will help understand the situation objectively.
· The median age of marriage among women (aged 20 to 24) in India is 16 years.
· In rural India, 40 percent of girls, ages 15 to 19, are married, compared to only 8 percent of boys the
same age.
· Among women in their reproductive years (ages 20 to 49), the median age at which they first gave
birth is 19.
· Nearly half of married girls, ages 15 to 19, have had a least one child.
· India has the worlds highest prevalence of iron-deficiency anemia among women, with 60 percent
to 70 percent of adolescent girls being anemic.
Underlying each of these health concerns are gender and social norms that constrain young people
especially young womens access to reproductive health information and services.
Motherhood at a very young age entails a risk of maternal death that is much greater than average, and the
children of young mothers have higher levels of morbidity and mortality. Early child bearing continues to be
an impediment to improvements in the educational, economic and social status of women in India. Overall
for young women, early marriage and early motherhood can severely curtail educational and employment
opportunities and are likely to have a long-term, adverse impact on their and their childrens quality of life.
In many societies, adolescents face pressures to engage in sexual activity. Young women, particularly lowincome
adolescents are especially vulnerable. Sexually active adolescents of both sexes are increasingly at
high risk of contracting and transmitting sexually transmitted diseases, including HIV/AIDS; and they are
typically poorly informed about how to protect themselves.
To meet the reproductive and sexual health needs of adolescents, information and education should be
provided to them to help them attain a certain level of maturity required to make responsible decisions. In
particular, information and education should be made available to adolescents to help them understand their
sexuality and protect them from unwanted pregnancies, sexually transmitted diseases and subsequent risk of
34

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
infertility. This should be combined with the education of young men to respect womens self-determination
and to share responsibility with women in matters of sexuality and reproduction.
Information and education programs should not only be targeted at the youth but also at all those who are in
a position to provide guidance and counseling to them, particularly, parents and families, service providers,
schools, religious institutions, mass media and peer groups. These programs should also involve the
adolescents in their planning, implementation and evaluation.
Being a sensitive and often, controversial area, adolescent reproductive and sexual health issues and
information are very often difficult to handle and disseminate. Furthermore, the contents do not only deal
with factual and knowledge-based information but more importantly, need to deal with attitudinal and
behavioral components of the educational process.
Thus it can be conclusively stated that adolescents are a diverse group, and their diversity must be considered
when planning programs.
Adolescents, the segment of the population in the age group of 15 -19 years, constitute about 23% of the
population of the state. This group is critical to the success of any reproductive and sexual health programme,
as it would remain in the reproductive age group for more than two decades.
Early marriages seem to be still a key problem. Percentage of boys who are married before attaining 21 years
in consistently high in most districts. The mean age of marriage for girls is 16.9. 25% pregnant mothers in
the state are in the age group of 15-19 years. This is due to the reason that most of the girls married before
18 years.
The various anecdotal evidences emerging from the community level participatory planning exercises and
opinions voiced by the various levels of health officials during consultation exercise indicate that there is
lack of a cohesive ARSH strategy at the state level. Possibility of bifurcating the total target into school
going and out of school going adolescents have not been examined as a strategy option. Hence the current
school health program by and large lacks any adolescent oriented interventions.
In the consultations with the Bihar State AIDS Control Society, it had emerged that they have several
adolescent targeted intervention including using special adolescent counselors currently going actively
implemented. The possibility of convergence between the RCH II program priorities and NACP priorities
require to be integrated.
Specific capacity building initiatives to orient the health providers at various levels to specific necessities of
the ARSH program like adolescent vulnerability to RTI/STI/HIV /AIDS, communication with adolescents,
gender related issues, designing adolescent friendly health services, body and fertility awareness,
35

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
contraceptive needs etc have not been actively taken up the state health department to prepare itself to tackle
the problems / issues of this important segment.
4.5 District/Sub District Variations
Key indicators related to Maternal and Child Health (MCH) and Family Planning clearly show the poor
status of RCH in Bihar. However, close examination of data reveals that there exist wide inter-district
variations for almost all the key indicators.
36

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
DLHS-3 Data for Bihar
S.no.
State/district
% of households with low
standard of living
% girls marrying below legal
18 age at marriage
Birth order 3 and above
Any Method
Any Modern Method
Female Sterilization
Male Sterilization
Unmet need for family
planning
% women received at least
three visits for ANC
Institutional Birth
Delivery at home assisted
by a doctor/nurse/LHV/ANM
% of children (age12-23
months) received full
immunization
Children breastfed within
one hour of birth
% women aware of HIV/AIDS
1 Banka 92.0 59.9 50.4 25.0 22.7 20.4 0.0 39.2 31.5 24.7 12.6 32.9 15.1 42.3
2 Aurangabad 85.4 38.7 46.9 34.5 31.0 29.4 0.3 37.9 18.9 30.6 5.0 56.5 14.4 48.3
3 Araria 93.7 41.4 58.2 31.5 29.0 27.8 0.4 36.1 41.2 13.7 6.0 35.8 18.2 29.5
4 Bhagalpur 74.0 27.8 53.1 40.3 35.0 29.3 0.5 36.4 20.4 30.4 14.7 49.6 22.6 57.5
5 Muzaffarpur 81.4 35.7 50.5 33.1 32.2 28.9 0.1 36.9 20.4 23.0 3.3 57.4 15.5 46.0
6 Nalanda 73.0 46.6 47.8 30.9 27.2 21.2 0.5 40.7 25.2 39.3 7.0 54.2 30.2 73.7
7 Nawada 87.1 65.3 51.6 24.3 21.9 18.7 0.7 39.9 23.6 31.1 3.7 48.9 9.9 53.0
8 Champaran W 89.2 57.8 58.7 32.3 27.8 26.3 0.2 36.9 32.4 24.9 2.4 30.2 9.8 36.6
9 Patna 50.9 34.0 45.7 43.7 40.2 33.6 0.2 31.0 20.7 58.8 3.7 43.8 21.3 84.6
10 Champaran E 88.0 54.9 48.1 27.7 23.6 20.8 0.7 34.7 36.0 27.1 1.7 41.3 7.2 19.9
11 Buxar 78.0 49.8 47.9 31.2 26.9 23.7 0.2 36.8 22.1 48.0 4.8 27.7 23.4 65.0
12 Begusarai 83.7 46.2 54.2 28.0 25.2 23.4 0.2 39.0 28.3 26.8 4.6 40.3 9.4 23.8
13 Munger 61.7 30.5 42.6 41.4 33.9 30.3 0.4 31.6 36.8 48.6 10.5 36.3 19.3 79.0
14 Madhubani 88.4 39.5 53.1 96.3 34.9 28.2 0.0 40.3 35.6 16.0 4.0 42.1 7.9 30.3
15 Madhepura 90.6 55.3 53.5 35.0 31.0 29.2 0.4 35.9 20.0 17.7 3.9 39.7 11.1 39.4
37

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
16 Lakhisarai 79.8 54.7 48.0 31.2 28.2 25.1 0.5 41.6 25.3 32.5 6.3 36.0 13.7 32.2
17 Darbhanga 83.5 39.1 51.4 31.8 30.4 27.9 0.1 36.3 29.0 15.1 2.9 41.8 15.3 44.2
18 Gaya 80.2 50.4 50.8 30.5 26.7 23.3 0.3 34.0 23.9 20.7 6.6 31.8 20.6 55.1
19 Gopalganj 82.0 35.9 48.4 12.8 22.1 20.4 17.0 0.0 31.8 36.5 6.6 52.4 10.5 31.0
20 Jamui 91.2 72.9 49.4 27.4 20.7 18.3 0.3 44.2 27.1 17.6 8.0 17.4 14.8 41.7
21 Jehanabad 83.8 56.7 46.1 28.2 24.1 20.1 0.6 39.8 30.6 42.5 10.6 47.2 18.6 66.8
22 Kaimur 84.4 56.1 51.5 29.9 24.8 21.3 0.2 34.9 23.7 42.6 6.8 21.9 30.9 60.2
23 Katihar 88.1 43.7 53.0 26.0 20.3 16.6 0.0 43.7 32.5 12.4 3.9 32.6 13.4 37.6
24 Khagaria 84.8 49.3 51.3 31.1 27.5 25.2 0.3 37.3 26.4 25.3 6.7 45.8 9.8 54.3
25 Kishanganj 90.7 32.1 57.0 27.2 23.5 16.0 0.6 38.1 28.5 17.8 3.8 26.6 12.8 38.9
26 Purnia 87.0 40.4 53.6 10.4 27.5 25.7 23.3 41.2 19.4 21.6 2.9 37.4 13.8 28.8
27 Bhojpur 78.8 48.1 45.5 35.3 30.2 25.5 0.6 39.9 17.2 40.4 12.5 31.2 20.1 57.2
28 Saharsa 87.3 54.4 47.9 32.6 29.8 27.8 0.2 37.5 13.9 20.0 8.8 43.4 15.8 46.3
29 Samastipur 87.6 51.4 52.7 34.8 28.9 26.6 0.4 36.3 23.9 27.6 3.1 51.1 10.9 38.1
30 Saran 81.9 31.0 51.5 29.1 25.2 20.9 0.3 43.7 22.7 22.4 6.1 65.1 15.4 59.8
31 Sheikhpura 79.0 53.5 52.1 26.7 23.4 20.2 0.6 39.0 43.2 41.6 5.0 38.3 10.5 51.4
32 Sheohar 89.0 54.8 57.0 27.4 22.3 20.4 0.1 42.6 18.9 11.9 3.4 28.3 8.3 31.8
33 Sitamarhi 86.8 44.4 56.3 18.1 25.3 23.7 22.1 41.2 22.9 16.4 4.7 39.1 12.5 40.7
34 Siwan 78.4 27.6 46.0 24.0 20.4 17.2 0.2 39.7 33.4 33.5 8.2 52.4 13.3 50.2
35 Vaishali 81.3 41.2 46.9 43.6 39.8 35.0 0.6 32.7 16.0 28.2 9.6 53.3 33.8 81.5
36 Supaul 92.0 44.2 51.5 43.1 41.6 40.1 0.1 29.8 21.2 23.2 2.4 39.5 13.3 38.2
38

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Focus Districts:
As per the guidelines issued by the Ministry of Minority Affairs, GoI regarding districts with higher
percentage of the minority population, the SPIP for NRHM, attempts to provide adequate resources.
Bihar has got seven districts Araria, Kishanganj, Purnia, Katihar, Sitamarhi, West Champaran, Darbhanga in
category-A which have both socio-economic and basic amenities parameters below national average while
allocating available resources to the districts, we've tried to give priority to these Category-A districts. The
District Magistrates of 3 (three) of these districts i.e. Araria, Purnea and Katihar have been made members of
State Health Mission headed by CM. This year the rest 4 will also be included, so that the specific problems
of these districts may be brought into fore.
39

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
4.6 Health Infrastructure and Facilities
The delivery of services could only be improved if facilities are within reach and have minimum basic physical infrastructure to provide the basic
services. There seemed a major challenge in construction of the health care facilities. Lack of clear guidelines sometimes delayed the process.
To make the BEmOCs and CEmOCs functional, adequate staff, essential equipments and infrastructure (OT, Labour rooms, new born care area,
blood storage and blood storage units) are to be taken up as a priority area.
District wise Availability of Health Centres of Bihar State
No. of No. of No. of
Referral Referra Referra
No. of New
Total
No.
No. of Total No. of No. of
Hospital l l
No.
No. New Tota Sub Const
Sub
of New APHCs No. APHCs APHCs
Sl Name of
upgrade Hospit Hospit
of
of Constr l Divl r
Div
PHC Constr upgrad of exist exist
. Districts
d in Sub als als
HSC
DH uction DH Hospital uctio
Hosp
s uction ed into PHC previos present
Div
exist exist
s
s exist n
itals
exist
PHCs s ly ly
Hospital previou Present
s
sly ly
1 Araria 1 1 1 1 2 3 2 9 9 30 30 200
2 Arwal 1 1 0 3 3 23 23 46
Aurangaba
3 d 1 1 1 1 3 3 11 11 58 58 207
4 Banka 1 1 1 1 3 3 10 1 11 24 24 227
5 Begusrai 1 1 1 1 2 2 1 11 7 2 18 31 29 288
6 Bhagalpur 1 1 1 1 2 2 2 11 5 2 16 46 44 280
7 Bhojpur 1 1 1 1 2 2 12 2 1 14 20 19 284
40

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
8 Buxar 1 1 1 1 2 7 4 1 11 20 19 158
Champaran
9 (E) 1 1 1 2 3 3 1 20 7 3 27 46 43 315
1 Champaran
0 (w) 1 1 1 1 2 2 2 16 2 18 25 25 389
1
1 Darbhanga 1 1 2 2 13 6 4 19 51 47 261
1
2 Gaya 1 1 1 1 2 2 1 19 6 4 25 49 45 439
1
3 Gopalganj 1 1 1 1 3 3 10 4 2 14 22 20 186
1
4 Jamuai 1 1 1 1 3 3 7 2 2 9 21 19 166
1
5 Jhanabad 1 1 1 1 2 2 4 5 2 9 25 23 81
1
6 Kaimur 1 1 1 1 2 2 1 9 2 1 11 40 39 107
1
7 Katihar 1 1 2 2 3 1 11 5 2 16 32 30 257
1
8 Khagaria 1 1 0 1 1 6 1 1 7 18 17 151
1
9 Kishanganj 1 1 1 1 2 2 7 7 8 8 136
2 Lakhisarai 1 1 1 1 1 1 4 2 6 13 13 102
41

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
0
2
1 Madhapura 1 1 1 1 1 7 6 4 13 23 19 115
2
2 Madhubani 1 1 1 1 1 3 2 1 19 19 76 76 430
2
3 Munger 1 1 1 1 1 6 3 3 9 13 10 123
2 Muzaffarp
4 ur 1 1 0 1 1 14 2 16 47 47 473
2
5 Nalanda 1 1 1 1 2 3 2 12 8 7 20 36 29 302
2
6 Nawada 1 1 1 1 2 2 10 4 3 14 27 24 129
2
7 Patna 3 1 1 5 4 3 16 7 6 23 70 64 418
2
8 Purniea 1 1 1 1 2 2 1 11 3 3 14 34 31 278
2
9 Rohtas 1 1 1 1 2 1 1 13 6 5 19 17 12 186
3
0 Saharsa 1 1 1 1 7 3 10 33 33 152
3
1 Samastipur 1 1 3 1 4 1 1 14 6 4 20 59 55 354
3 Saran 1 1 1 1 3 2 15 5 3 20 45 42 413
42

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
2
3
3 Sheikhpura 1 1 1 1 1 1 3 3 6 18 18 74
3
4 Sheohar 1 1 1 1 1 1 3 1 4 7 7 34
3
5 Sitamarhi 1 1 1 1 1 1 13 5 2 18 38 36 213
3
6 Siwan 1 1 1 1 2 2 15 4 2 19 34 32 370
3
7 Supaul 1 1 1 1 2 1 1 9 2 1 11 28 27 178
3
8 Vaishali 1 1 1 1 2 2 11 6 3 17 36 33 336
Total 25 11 36 23 20 15 58 70 55 398 135 73 533 1243 1170 8858
Table : Bihar: Public Health Infrastructure Personnel
Sl.
No
Districts
MO ANM LHV MHW Staff Nurse AWW
Sanct. Working Sanct. Working Sanct Working Sanct. Working Sanct. Working Sanct. Working
1 Araria 117 98 273 177 41 12 102 40 17 9 1778 1631
2 Aurangabad 188 91 342 319 23 17 110 75 12 3 1430 1390
3 Arwal 62 24 78 105 4 4 59 34 0 0 631 631
4 Banka 97 84 275 213 45 25 124 49 12 6 1352 1044
5 Begusarai 117 73 352 351 24 16 33 11 8 8 1314 1296
6 Bhagalpur 162 127 387 385 48 27 34 32 8 8 1512 1347
7 Bhojpur 132 105 370 368 26 20 106 42 8 1 1658 1646
8 Buxar 89 77 212 212 15 11 42 19 2 2 1139 1139
9 Champaran (E) 237 135 364 355 35 23 48 28 12 1 2901 2895
43

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
10 Champaran (W) 145 74 427 308 43 19 60 5 19 15 2263 2252
11 Darbhanga 172 152 363 296 29 19 131 96 8 5 2563 2315
12 Gaya 231 197 575 563 41 33 245 159 8 1 2427 2385
13 Gopalganj 106 95 250 249 20 8 30 3 12 2 1816 1592
14 Jehanabad 119 92 59 56 5 5 31 18 13 8 604 599
15 Jamui 85 61 222 222 25 12 70 31 12 8 1156 1138
16 Kaimur 93 74 146 146 19 11 64 20 19 9 996 993
17 Katihar 121 106 238 211 56 31 33 1 12 7 1716 1637
18 Khagaria 73 61 190 191 31 18 18 5 4 2 967 965
19 Kishanganj 56 37 169 115 31 15 64 27 11 5 1052 963
20 Lakhisarai 72 51 131 131 20 14 40 28 10 9 671 608
21 Madhepura 81 51 223 93 35 9 22 4 4 0 962 588
22 Madhubani 233 124 487 380 37 15 54 43 34 16 3437 2852
23 Munger 141 91 157 157 30 28 51 30 23 23 645 644
24 Muzaffarpur 241 223 594 592 29 21 140 82 4 4 2822 2610
25 Nalanda 178 167 402 402 30 30 36 21 0 0 1785 1761
26 Nawada 115 87 207 207 24 11 30 21 25 17 1249 1235
27 Patna 289 205 434 434 32 30 49 6 16 13 2481 2465
28 Purnia 126 100 356 275 56 29 126 67 8 2 1464 1424
29 Rohtas 158 129 286 270 29 12 136 48 20 10 1712 1628
30 Saharsa 97 55 192 169 33 15 18 1 26 21 932 825
31 Samastipur 192 183 475 470 30 20 29 18 4 4 2692 2512
32 Saran 185 133 512 386 33 29 46 17 27 10 2455 2218
33 Sheikhpura 53 36 109 109 16 6 18 4 4 1 357 339
34 Sheohar 52 34 46 26 4 1 38 13 9 1 265 265
35 Sitamarhi 147 127 299 289 27 9 130 82 17 13 2064 1920
36 Siwan 151 126 465 298 31 25 102 56 13 9 2099 1934
37 Supaul 85 70 206 111 44 8 60 34 2 0 1376 1230
38 Vaishali 126 105 421 414 25 24 33 28 8 3 1844 1608
5124 3860 11294 10055 1126 662 2562 1298 451 256 60587 56524
44

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
District Hospitals: Out of 38 Districts 25 have district hospitals. Most of the district hospitals are not
functioning up to the level due shortage of specialties and Staff Nurses. Construction of 11 District Hospitals
are on full swing and expected to be completed by 2010.
Sub District Hospitals: At present there are 23 Sub District Hospital, 20 new SDH are under construction and
15 Referral Hospital are in the process of up gradation to SDH.
Referral Hospitals: There are 55 referral Hospitals. These referral hospitals get patient from PHCs, APHCs
and are covered by specialised services.
Block PHCs: At present there are 398 PHCs, 135 new PHCs are under construction and will be
operationalised by this year. 73 Adll PHCs will also be upgraded to PHCs. These PHCs require to be
upgraded at CHC level for specialised Services.
Adll PHCs: The total no. of Adll PHC is 1243. These adll PHCs only provide OPD services. All these PHCs
require to functionalise the inpatient for providing deliver services and reduce the load of Block PHCs.
HSCs: At present there are 8858 HSCs in the state. Half of the HSCs are running from the rented place or
Panchayat office. Mostly these HSCs are manned by one ANM only.
Infection Management and Environmental Plan:
Bio medical waste management has emerged as a critical and important function within the ambit of
providing quality healthcare in the country. It is now considered an important issue of environment and
occupational safety. As per the Bio-Medical Waste (Management & Handling) Rules, 1998, all the waste
generated in the hospital has to be managed by the occupier in a proper scientific manner. The GoI has also
issued the IMEP guidelines for SCs, PHCs and CHCs. The state is in the process of outsourcing the Biomedical
Waste Management system for all the hospitals.
4.7 Human Resource Development including Training
Human Resource Development forms one of the key components of the overall architectural corrections
envisaged by both the RCH II and NRHM programs. The Government of Bihar also has spelt out the same as
the number one priority. However the implementation of this vision has been fraught with various obstacles.
Though the state has reasonable number of MBBS doctors, there is an acute shortage of specialized medical
manpower. The shortage of specialists like obstetricians and Anesthetists are obstructing the state plans to
operationalise all district hospitals as First Referral Units. The available specialists in the state cadre is
45

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
concentrated at the state Referral Hospital and hence the same handle bulk of the institutional deliveries state
wide and is the only center capable of providing comprehensive emergency obstetric care services. In 2008-
09, there has been a continuous focus on the capacity building of the existing manpower in the state.
Trainings as per GoI guidelines on Immunization, IMNCI, EmOC, LSAS, SBA and Minilap/MVA etc have
been taken up with full vigour. It is proposed to continue these trainings in 2009-10. In addition, the state
wide training on Immunization for Medical Officers, IPC skills for Breast feeding and basic training of
neonatal resuscitation-shall also be taken up for various levels. (Details of training plan and Budget is given
in the annexure)
4.8 Inequity/ Gender; Vulnerable Groups Including Urban Slums & Tribal
4.8.1 Inequity and Gender
Ensuring Gender Equity
One of the broad indicators for measuring gender disparity is the sex ratio. The sex ratio in Bihar is
unfavorable to women. Analysis of other indicators on the basis of gender reveals widening gaps between the
sexes. While NMR for females is marginally higher than that of males, it widens further for the IMR, and
even further for the under-five Mortality Rate. In conditions of absolute poverty, where resources to food and
health care are severely limited, preference is given to the male child, resulting in higher female malnutrition,
morbidity and mortality.
Gender discrimination continues throughout the life cycle, as well. Women are denied access to education,
health care and nutrition. While the state's literacy rate is 47.5%, that for women in rural areas is as low as
30.03%. Abysmally low literacy levels, particularly among women in the marginalised sections of society
have a major impact on the health and well being of families. Low literacy rate impacts on the age of
marriage. The demand pattern for health services is also low in the poor and less literate sections of society.
Women in the reproductive age group, have little control over their fertility, for want of knowledge of family
planning methods, lack of access to contraceptive services and male control over decisions to limit family
size. According to NFHS data, for 13% of the births, the mothers did not want the pregnancy at all. Even
where family planning methods are adopted, these remain primarily the concern of women, and female
sterilization accounts for 19% of FP methods used as against male sterilization, which is as low as 1%. In
terms of nutritional status too, a large proportion of women in Bihar suffers from moderate to severe
malnutrition. Anemia is a serious problem among women in every population group in the state, with
prevalence ranging from 50% to 87% and is more acute for pregnant women.
46

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
In all the programmes efforts will be made to meet the needs of vulnerable groups and ensure equity. Gender
sensitization shall be made part of each training. The monitoring system too will be geared for this so that we
may get disaggregated data.
The state of Bihar is implementing the PC- PNDT Act at right earnest. The MOs are being trained by the
State Health and Family Welfare Institute. The Civil Surgeons are the nodal person in the district in this
regard. However monitoring of the activity still a big problem and require to improve. The state has
procedures for registering the diagnostic centres and hospitals which comply these institutes to follow the
PC-PNDT Act.
4.8.2 Urban Slums
Urban health care has been found wanting for quite a number of years in view of the fast of urbanization
leading to growth of slums and population as more emphasis is given in rural areas. Most of the Cities and
Towns of Bihar have suffered due to lack of adequate primary health care delivery especially in the field of
family planning and child health services.
At present, there are 12 Urban Health Centres (UHC) in the state. However, as per the GoI guidelines, there
should be one UHC for 50,000 population (outpatient). The Urban Health Centres should provide services of
Maternal Health, Child Health and Family Planning and especially cater to the Urban slums. The
infrastructure condition of the existing Urban Health Centres is not up to the mark and requires some major
renovation work. The staff at each UHC should comprise of 1 Medical Officer (MO), 1 PHN/LHV, 2 ANMs,
1 Lab Assistant and 1 Staff clerk with computer skills.
4.9 Logistics
Validation of equipments and drugs procurement is within the domain of state level decision making. The
Districts generally purchase the requirements and distributed to the other Health institutes mostly Block
PHCs. However stock out of drugs still a problem for concern and require insurability of drug availability in
the health institutes.
There is provision of contingency funds for emergency drugs at the district level and health facilities.
Whenever PHCs/PHSCs run out of drugs, medicines are purchased through contingency fund and supplied to
the PHCs/PHSCs. The general impression is supplies arrive too late and too little. However under NRHM
there is scope for huge and rapid flow of materials from the MOHFW, GOI and the State level. Also under
the decentralization process the CHC, PHCs and HSCs will have larger autonomy to purchase drugs and
47

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
supplies locally as per procurement guidelines to be developed by the State Government under the NRHM.
District and the peripheral institutions need to be strengthened through capacity building for enhancing their
capabilities of indenting, procurement, inventory management and distribution of drugs and supplies and
maintenance of medical equipment and transport.
Cold Chain Vans are available in the districts for distribution of Vaccines to PHCs/ HSCs during vaccination
programs and camps. Generally PHC vehicles are used to collect the drugs and supplies from the district
store. Currently local purchase of drugs and supplies are not approved.
Drugs, consumables, and vaccines are directly supplied by the state to districts for HSCs, PHCs and other
facilities very irregularly. There is need to streamline the process for estimation and indenting of vaccines,
drugs and supply of consumables. The supply system would ensure smooth flow of indented materials as per
guidelines from state to all levels of utilization.
A big leap has been taken in 2008-09 in the field of Procurement concerning Maternal and Child Health
equipments and drugs. One of the key achievements has been the finalization of rate contracting for the state
owned 26 Sick Newborn Care Unit, 533 Neonatal Stabilization Units and essential equipment for
strengthening the labour rooms of the state hospitals. In addition, rate contracting of some important drugs
like Misoprostol has also been ensured.
4.10 HMIS and Monitoring & Evaluation
The National Rural Health Mission has been launched with the aim to provide effective health care to rural
population. The programme seeks to decentralize with adequate devolution of powers and delegation of
responsibilities has to have an appropriate implementation mechanism that is accountable.
In order to facilitate this process the NRHM has proposed a structure right from the village to the national
levels with details on key functions and financial powers. To capacitate the effective delivery of the
programme there is a need proper a proper HMIS system
Regular monitoring, timely review of the NRHM activities should be carried out. The quality of MIES in
State HQ and in districts is very poor. Reporting and recording of RCH formats (Plan and monthly
reporting) are irregular, incomplete, and inconsistent and few districts are not reporting at all. Formats are
not filled up completely at the sub center level. There information is not properly reviewed at the PHC level.
No feedback is provided upon that information.
For overall management of the programme, there is a Mission Directorate and a State Programme
Management Unit in the state. The Unit is responsible for overall monitoring and evaluation of the
48

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
programme in the state and the districts. The data gathering is being facilitated by the State, District and PHC
Data Centres. The numerous formats being used have been reviewed and it is found that data needs to be
compiled only as per RCH, NRHM programme and State needs. Hence the new MIES formats have been
shared with all the health functionaries and it is expected that they shall be reporting in the new formats from
the 3 rd quarter.
At district level, there is a District Health Society who will be responsible for the data dissemination from the
sub-district level to the district level. Data Manager/HMIS expert at the State level and Data Assistant at the
district level will be responsible for management of HMIS.
As such, there is a Monitoring Team constituted each at state and district level to monitor the implementation
of the NRHM activities. The Team comprises of representatives from the Mission Directorate and
Programme Committee for various health programmes. The Team also comprises of representatives from
Govt. of India.
There is a Hospital Management Committee/Rogi Kalyan Samiti at all PHCs and CHCs. The PHC / CHC
Health Committee will monitor the performance of HSC under their jurisdiction and will submit the report
and evaluate the HSC performance, and will be submitted to the District, which will compile and sent it to
the State.
4.11 Behaviour Change Communication
The state does not have any comprehensive BCC strategy. All the programme officers implement the BCC
activity as per their respective programmes.
The IEC logistic is designed, developed and procured at the district level and distributed to the PHC in an ad
hoc manner. However some activity is done at the state level.
There is no credible study available to identify the areas / region specific knowledge, attitudes and practices
pertaining to various focus areas of interventions like breast feeding, community & family practice regarding
handling of infants, ARSH issues etc. At present there is no impact assessment of the IEC and BCC
activities. Its very important to assess the impact of IEC/BCC activities, resources and methods to undertake
mid way corrective measures.
4.12 Convergence/Coordination
Convergence with ICDS has been taken care of to cover immunization and ANC Service. ASHA, AWW and
ANMs together hold monthly meetings with Mahila Mandals under MUSKAAN Programme. Government
of Bihar has decided to merge Village Health and Sanitation Committee with Lok Swasthya Pariwar
Kalyan and Gramin Swaschata Samiti constituted by Department of Panchayat Raj in Bihar. The PHED has
49

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
been entrusted to train ASHAs as per GoI norm. Adolescent councilors are placed in each district from State
AIDS Control Society. The Health department is looking to cooperate with them by giving training to these
councilors for implementing ARSH programme. The State PWD Department has taken care of the
construction of Health Department. All the construction activity for Health Institutions under NRHM has
already been handed over to the PWD department.
4.13 Finance
In 2008-09 the GoI had approved an amount of Rs. 978.61.47 Crores under RCH II.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
5. Progress and Lessons learnt from RCH II Implementation of 05-08
5.1 Major achievements during 2005-09
1. SHSB at State level and District Health Societies (in all 38 districts) formed & registered.
2. ASHA: A total of 67506 ASHAs selected against the total revised target of 87,135.
3. SPMU & DPM: The State Level consultants in SHSB and DPMU staff (3 in each district) have been
recruited in 34 out of 38 districts. The orientation training for all has been completed.
4. Free drug distribution of essential drugs started from 1st July 2006 and 24 hours presence of doctors
ensured in all facilities up to PHC level resulting in unprecedented increase in OPD patients. 10-30
times increase has been reported. Free drug list has been expanded to incorporate 33 OPD and 75
IPD at MCH, 33 OPD and 107 IPD drugs at DH and 33 OPD and 37 drugs IPD at PHC.
5. Routine Immunization: Full immunization percentage increased to 41.4% (DLHS). Use of AD
Syringe increased to 95%.
6. Against a total figure of 11000 posts of ANM (R), appointment of ANM (R) - 5800 posts of
ANM(R) have been filled up.5200 new appointments have to be made.
7. Rogi Kalyan Samitis formed in all health facilities till PHC level, registration of RKS completed rest
in progress, so far 470 RKS have been registered.
8. Training Programmes: Training of EmOC, Life Saving Anesthesia Training, IMNCI, ASHA,
DPMUs, SBA training, Immunization and Neonatal resuscitation started. This includes the regular
monitoring and corrective actions taken.
9. ANM/GNM training Schools-Out of 22 ANM schools and 6 GNM schools, 20 ANM schools were
restarted after a period of more than a decade. Currently approx. 600 students enrolled. In year 2009,
it is being ensured that ANM and GNM schools train students up to their optimum capacity. Besides,
efforts have been made to strengthen the overall structure of these schools in the state.
10. Institutional delivery has increased manifold as evident from the bar diagram below-
1000000
900000
800000
700000
600000
500000
400000
300000
200000
100000
0
117062
838481
902667
2006-07 2007-08 2008-09(till -Dec
08)
Series1
51

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
11. Additionally in the year 2009-10, rate contracting of equipments for Child (SNCU & NSU) and
Maternal Health (Labour room) for District, Sub-Divisional, CHC and PHC hospitals has been
achieved, which will pave the way for procurement and availability of the same in the Districts.
The State Programme Implementation Plan 2009-10 has been framed on the basis of strategies and activities
which worked in last three years. The major bottlenecks have been identified and an attempt has been made
to overcome them through alternative strategies.
5.2 Programme Management
Some of the things which didn't work in last three years are:-
i. Construction & Renovation- Slow progress in Infrastructure
ii. BCC strategy formulation.
iii. High turnover of personnel in programmes.
iv. The quality of training.
v. Keeping up the motivational level of health staff at all levels.
vi. Utilization of trained staff (It is sub optimal now).
vii. Mismatch of personnel and equipment.
viii. Lack of Proper monitoring and evaluation framework.
ix. Quality issues in critical care services (timely use of referral transport by pregnant women,
utilization of EmOC trained doctors )
x. Acceptance of Private Partners t the district level
Following strategies have been adopted to overcome the problem
‣ Slow progress in infrastructure - To overcome the problem of slow progress in infrastructure, a
separate infrastructure cell has been created in State Health Society, Bihar. This year, it is proposed
that two more personnel may be added to this wing to strengthen it. Moreover all the DMs have been
requested to designate an agency for their district that would carry out all infrastructure-related tasks.
‣ Procurement of Equipment- Though essential drugs have been rate contracted so far, the rate contract
of various equipments needed for carrying out RCH activities are still to be completed. Idea of a
TNMSC model of Corporation is also taking shape in the Department to solve the logistic and
procurement problem.
‣ BCC strategy formulation- Even after two and half years of NRHM, Bihar lacks a consolidated BCC
strategy in health due to lack of technical know how. Besides, some other initiatives are planned this
year in areas like promotion of Breast feeding, PNDT and ARSH among others.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
‣ Quality Assurance committees in State and Districts- Quality assurance committees formed in 80 %
of the districts as per Quality Assurance Manual of GoI and in rest of the districts, it will be formed
by 2009 March end. State Quality Assurance Cell has been formed. Quarterly monitoring visits are
planned at the state level and the divisional level to monitor quality of trainings and critical services
including family planning.
‣ Recruitment of Medical officers and paramedics- The process of recruitment is lengthy and takes
about 04-06 months. The number of applicants is quite limited because of dearth of doctors and
paramedics in the state. Moreover the consolidate remuneration is not lucrative enough. Hence from
the previous year incentive for rural postings and specialist services have been provided in the SPIP.
Similarly for ANMs, mobile phone facilities for all ANMs are being provided.
‣ High turnover of Personnel- It is felt that the state needs to restrict the turnover of doctors on
contract and also programme managers. It is proposed that a study may be undertaken to assess the
situation and recommend remedies, however it is assumed that rural and specialist bonus will help to
curb the turnover to same extent.
‣ Quality of training - Monitoring cell has been constituted at the state level in State Institute of Health
& Family Welfare. The trainings are being monitored at regular intervals.
‣ Low motivational level of health staff - The motivational level of health staff at all levels is low.
Continuous communication and feedback by state level programme officers is being done.
‣ Sub optimal utilization of trained staff Regular evaluation and monitoring is being done and
corrective steps are being taken. Placement of trained people at such facilities where infrastructure is
in place. E.g. The government has taken up on priority the placement of the trained EMoC and LSAS
doctors to the FRUs where there is no such facility. Poor monitoring and evaluation framework
Regular monitoring visits by programme officers.
‣ Pilot initiatives in two districts In 2009-10 Maternal and perinatal death enquiry and response is
being initiated in two districts (Kishanganj and Jehanabad). In these districts referral transport money
for JBSY is being linked for payment of referral transport arranged by the pregnant woman through
PHC staff. as a pilot initiative. EmOc services, MTP services, Maternity complex, Newborn corner
are also being strengthened in these two districts in intensive manner. Data collection on maternal
and perinatal death will be done before and after the intervention. If the data collected after the
intervention shows decline in MMR and IMR then the model will be replicated throughout the State.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
6. RCH II Programme Objectives and Strategies
6.1 Vision Statement:
The NRHM seeks to provide universal access to equitable, affordable and quality health care which is
uncountable at the same time responsive to the needs of the people, reduction of child and maternal deaths as
well as population stabilisation, gender and demographic balance in this process. The mission would help
achieve goals set under the National Rural Health Policy and the Millennium Development Goals. To
achieve these goals NRHM will:
· Facilitate increased access and utilization of quality health services by all.
· Forge a partnership between the Central, state and the local governments.
· Set up a platform for involving the Panchayati Raj institutions and community in the management
of primary health programmes and infrastructure.
· Provide an opportunity for promoting equity and social justice.
· Establish a mechanism to provide flexibility to the states and the community to promote local
initiatives.
· Develop a framework for promoting inter-sectoral convergence for promotive and preventive health
care.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
6.2 Technical Objectives, Strategies and Activities
1 Maternal Health
Goals: Reduce MMR from present level 371 (SRS 2001-03) to less than 100
Objectives:
1. To increase 3 ANC coverage from 26.4% to 45% by 2009-10 and to 75% by 2010-11. (DLHS3)
2. To increase the consumption of IFA tablets for 90 days from present level of 9.7% to 20% by 2009-10 and
to 35% by 2010-11. (DLHS-3)
3. To reduce anemia among pregnant mothers from 60.2% to 52% by 2009-10 and to 40% by 2010-11.
4. To increase institutional delivery from 70% to 76% by 2009-10 and to 85% by 2010-11 (MIS data)
5. To increase birth assisted by trained health personnel from 31.9% to 45%. (DLHS-3).
6. To increase the coverage of Post Natal Care from 26% to 40% by 2009-10 and to 55% by 2010-11.
(DLHS-3).
7. To reduce incidence of RTI/STI cases
8. To reduce the no of unsafe abortions
Source of data: DLHS 3, NFHS 3 and MIS Data
Objective No. 1: To increase 3 ANC coverage from 26.4% to 45% by 2009-10 and to 75% by
2010-11.
Strategies and Activities:
1.1. Institutionalization of Village Health and Nutrition Days (VHND)
1.1.1 In collaboration with ICDS, such that the Take Home Ration (THR) distribution and ANC Happens on
the same day
1.1.2 This will require minor changes in the microplans of Health and ICDS
1.1.3 Policy decision and appropriate guideline under convergence between Health and ICDS need to happen
as a priority
1.2 Improved Access of ANC Care
1.2.1 Provision for Additional ANMs in each Sub Centres (Refresher Training to ANMs on Full ANC to
improve the quality of ANC)
1.2.2 Setting up of New Sub Centres to cover more areas
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
1.2.3 Micro planning: Identifying vulnerable groups, left out areas and communities having high percentages
of BPL under each block and incorporating the same into the block micro plans to focus attention on them
for providing Community and Home based ANC to them.
1.2.4 Organizing Monthly Village Health and Nutrition Days in each Aaganwadi Centres
1.2.5 Organizing RCH camp in Each Block PHC areas.
1.2.6 Tracking of Pregnant mothers by ASHAs
1.3 Ensure quality service and Monitoring of ANC Care
1.3.1 Strengthen the monitoring system by checking of ANMs duty rooster and visits of LHVs and MOs.
1.3.2 Involvement of PRIs in monitoring the ANMs service through convergence
1.3.3 Refresher training of ANMs on ANC care
1.3.4 Proper maintenance of ANC Register and Eligible couple register
1.4 Strengthening of Health Sub Centres
1.4.1 Repair and Renovation of Sub Centres
1.4.2 Provide equipments like BP Apparatus, Weighing machines, Heamoglobinometer etc to the Sub
Centers.
1.4.3 Timely supply of Drug Kit A and Kit B
1.5 Generate Awareness for ANC Service
1.5.1 Convergences meeting with AWWs, ASHAs, PRI Members, NGOs at the Gram Panchayat level by
ANMs. These meetings will also attended by MOs from Adll PHCs.
1.5.2 Tracking of Pregnant mothers by ASHA, ANM and AWWs though organizing Mahila Mandals
meeting. Incentive for ASHAs and ANMs to give for the initiative. This initiative is under MUSKAAN
Programme. Incentive for ASHA will be taken care under Intersectoral Convergence.
1.5.3 Counseling by ASHAs and ANMs to the pregnant mothers, mothers and Mother in Laws.
Objective No. 2: To increase the consumption of IFA tablets for 90 days from present level of 9.7% to 20%
by 2009-10 and to 35% by 2010-11. (DLHS-3)
Strategies and Activities:
2.1 Purchase and Supply of IFA Tablets
2.1.1To include IFA under essential drug list
2.1.2 Timely supply of IFA Tablets to the Health Institutions ( Ensuring no stock out of IFA at every level
down to Sub-Centre Level)
2.1.3 District to purchase IFA tablets in the case of stock out
2.1.4 Convergence with ICDS and Education for regular supply of IFA tablets through AWWCs And
Schools for the pregnant and lactating women, children 1-3 years and adolescent girls
2.2 Awareness generation for consumption of IFA Tablets
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
2.2.1 Pregnant mothers will be made aware for consumption of IFA tablets for 90 days
2.2.2 ASHA and AWWs will generate awareness along with ANMs at the Village level
2.2.3 Ensure utilizing the platform of Mahila Mandal meetings being held every third Wednesday
Objective No.3: To reduce anemia among pregnant mothers from 60.2% to 52% by 2009-10 and to 40% by
2010-11.
3.1 Supplementing IFA tablets consumption with other clinical strategies.
3.1.1 Half yearly de-worming of all adolescent girls.
3.1.2 Training of ANM, AWW and ASHA on module on EDPT (Early Diagnosis and Prompt Treatment) of
anemia.
3.1.3 Activities for consumption of IFA tablets as per Objective No. 2
3.2 Other strategies
3.2.1 Refer severely Anemic Pregnant Mothers to referral centers
3.2.2 IPC based IEC campaigns emphasizing on consumption of locally available iron rich foodstuff.
Details given under Special Scheme on Anemia Control in Part B
Objective No. 4: To increase institutional delivery from 70% to 76% by 2009-10 and to 85% by 2010-11
(MIS data) and to increase facilities for Emergency Obstetric Care (EmOC)
Strategies and Activities:
The strategies will lead to up gradation and operationalization of the facilities to increase institutional
deliveries along with providing EmOC and emergency care of sick children. These facilities will also provide
entire range of Family Planning Services, safe MTPs, and RTI/STI Services.
4.1 Upgrading Block PHCs/CHCs in to FRUs
4.1.1 Provision of OT and lab facility by upgrading 76 FRUs
4.1.2 Blood Bank and or Provision of Blood storage, OT and lab facility by upgrading 76 FRUs
1. All district hospitals must have either its own Blood Bank, operational round the clock, or must have
access to one that can be accessed in less than 30 minutes
2. All CHC / PHCs have blood storage facility
4.1.3 Training of MOs on Obs & Gynae and Anesthesia
1. 18-week Life Saving Anesthetic Skills (LSAS) training for MBBS Doctors
2. 16 week -Emergency Obstetric Skill training for MBBS doctors
3. 3 days training of doctors and nurses posted at FRUs for the neonatal stabilization unit
4.1.4 Repair and renovations of FRUs
4.1.5 Appointment of Anesthetist, O&G specialist, Staff Nurses at the FRUs
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
4.1.6 Incentivise the conduct of C section at FRUs @ Rs 1500 per C section for the staff involved at the
FRUs.
4.1.7 Accreditation of FRUs
4.2 Operationalization of 24x7 facilities at the PHC level
4.2.1 Training of MOs and Staff Nurses of PHCs in BEmOC
4.2.2 Appointment of at least 3 Staff Nurse in each PHCs
4.2.3 Repair and renovation of PHCs
4.2.5 Availability of and timely supply of medical supplies and DDK & SBA kits
4.2.5 Training of MOs, Staff Nurses on SBA
4.3 Increase beneficiary choice for institutional delivery through IEC campaign complimented by network of
link workers working on incentive basis for each institutional delivery achieved
4.3.1 Strengthening JBSY Scheme
1. Improving quality: Infrastructural support to high burden facilities to avoid early discharge
following institutional deliveries
2. Mapping of high burden facilities and proving them support for matching infrastructural up
gradation to increase the hospital stay following delivery
3. Identifying districts and blocks and communities within them, where the awareness and reach of
JBSY scheme is poor and to ensure increased service utilization in these areas
4.3.2 Design and implement an IEC campaign focusing on communicating the benefits of institutional
delivery and benefits under JBSY scheme.
4.3.3 Equip the ASHA network to reinforce the IEC messages through IPC interventions at village /
community level.
4.3.4 Provide incentives to ASHA for every institutional delivery achieved in her village / designated area.
4.3.5 Involvement of PRIs for JBSY scheme to monitor and generate awareness for institutional delivery.
4.4 Provision of Referral Support system
4.4.1 Provision of a dedicated referral transport system for the newborns and pregnant women to refer them
from home/HSCs/PHCs to referral centers.
4.4.2 Monitoring of referral transport system
4.4.3 Development of proper referral system between Health Institutions.
4.4.4.Operationalising of Blood Storage Units in 76 FRUs
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Lack of Blood Storage Units in the state make things complicated during emergency hence in 76 FRUs blood
storage units has been proposed. Operationalising of at least one Blood Storage Units in 76 FRUs is proposed
as per IPHS guidelines.
Particulars Qty. Rate (Rs.) Months Amount
Sl.
(3x4x5=6)
1 2 3 4 5 6
1 Salary of One Medical Officer 76 20,000/- pm 12 1,82,40,000/-
2 Salary of 3 Lab Technician @ Rs. 6500/- 228 6,500/- pm
1,77,84,000/-
12
pm
3 Diesel 76 5,000/- pm 12 45,60,000/-
4 Service and Maintenance Charge 76 5,000/- pm 12 45,60,000/-
5 Misc. and Others 76 2,000/-pm 12 18,24,000/-
Total Operational Cost 4,69,68,000/-
Objective No.5: To increase birth assisted by trained health personnel from 31.9% to 45%. (DLHS-3).
Strategies and Activities:
5.1 Ensure safe delivery at Home
5.1.1 Provision of Disposable delivery kits with ANMs and LHVs - Establishing full proof Supply Chain of
the DD Kits
5.1.2 Training of ANMs on SBA
1. Providing SBA with approved drug kits, in order to deal with emergencies, like post-partum
hemorrhage, eclempsia, and puerperal sepsis
2. Ensuring regular supply of these drugs to the SBA
5.1.3 Supply of adequate DD Kits to ANMs, LHVs.
5.2 Provision of delivery at HSC level
5.2.1 Supply of DDkits to HSCs
5.2.2 Delivery tables to be provided to the HSCs
Objective No.6: To increase the coverage of Post Natal Care from 26% to 40% by 2009-10 and to 55% by
2010-11. (DLHS-3).
Strategies and Activities
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
6.1 Ensuring proper practice of PNC services and follows ups at the health facility level.
6.1.1 Refresher sessions for all ANMs on uniform guidelines to be followed for PNC care all delivery cases
to remain at facility for minimum 6 hours after normal delivery and to be recalled to facility for check up
with 4 days and after 42 days.
6.1.2 Ensuring follow up PNC care through out reach services (ANM) for delivery cases where the patient
does not return to facility for follow up check ups.
6.1.3 Referral of all complicated PNC cases to FRU level.
6.1.4 LHV and MO to monitor and report on PNC coverage during their field visits
6.2 Utilizing the ASHA network to strengthen the follow up of PNC services through tracking of cases,
mobilization to facilities and providing IPC based education / counseling.
6.2.1 Utilize ASHA to ensure 3 PNC visits by the ANM for home delivery cases (1 st within 2 days, 2 nd within
4 days and 3 rd within 42 days of delivery) and 2 follow up visits for institutional delivery cases.
6.2.2 Counseling of all pregnant women on ANC and PNC during monthly meetings of MSS and during
VHND.
6.2.3 Linking of ASHAs incentives on institutional deliveries to completion of the PNC follow-ups.
6.3 Basis Orientation of AWWs on identifying Post-partum and neonatal danger signs during her scheduled
visits following delivery
6.3.1 Basic orientation on IMNCI in order to be able to alert the beneficiary and coordinate with ASHA
and ANM (to avoid undue delay)
6.3.2 Basic orientation on identifying post-partum danger signs, specially, for home based deliveries, such
that the she can alert ASHA, ANM or the local PHC towards avoiding undue delay
Objective No. 7: Reduce incidence of RTI/STI
Strategies and Activities
7.1 Ensuring early detection through regular screenings and contact surveillance strategies.
7.1.1 Early diagnosis of RTI / STI through early detection of potential cases through syndromic approach and
referral by ANM and ASHA.
7.1.2 Conducting VDRL test for all pregnant women as a part of ANC services.
7.1.3 Implementing contact surveillance of at risk groups in convergence with Bihar AIDS Control Society.
7.2 Strengthening the infrastructure, service delivery mechanism and capacity of field level staff for handling
of RTI / STI cases.
7.2.1 Conducting community level RTI / STI clinics at PHCs
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
7.2.2 Training to all MOs at PHC / DH level in Management of RTI / STI cases in coordination with Bihar
AIDS control Society.
7.2.3 Training of frontline staff, LHV, ANM and ASHA in identifying suspected cases of RTI / STI in
coordination with Bihar AIDS Control Society.
7.2.4 Strengthening RTI / STI clinic of the District Hospitals
Objective No. 8 Reduce incidence of unsafe abortion
Strategies and activities
8.1 Early diagnosis of pregnancy using Nischay pregnancy testing kits
8.2 Counselling and proper referral for termination of pregnancy in 1st trimester if the woman wishes so
8.2.1 Training of MOs and Nurses/LHV in MTP (MVA)
8.2.2 Procurement and availability of MVA at the designated facilities.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
2. Child Health
Goal: Reduce IMR from 61 (SRS 2005) to less than 30
Objectives:
1. To reduce low birth weight babys by supplementing nutritional support to pregnant mothers
2. To increase exclusive breast feeding from 38.4% to 50% by 2009-10 and to 75% by 2010-11.
3. To reduce incidence of underweight children (up to 3 years age) from 58.4% to 50% by 2009-10 and to
40% by 2010-11.
4. To strengthen neonatal care services in all PHCs/CHCs/SDHs by setting newborn care centers & having
trained manpower therein.
5. To reduce the prevalence of anaemia among children from 87.6% to 77% by 2008-09 and to 60% by 2009-
10.
6. To increase full immunization of Children from 41.4%% to 60% by 2009-10 and then to 70% by 2010-11.
7. To reduce morbidity and mortality among infants due to diarrheoa and ARI
Objective No.1: To reduce low birth weight babys by supplementing nutritional support to pregnant mothers
Strategies and Activities:
1.1 Convergence with ICDS, supplementary diet which is being given by AWW to pregnant mothers may be
improved.
1.1.1 A supplementary diet comprising of rice, dal and ghee will be provided to all pregnant women. This
will be given for the last 3 months to all underweight pregnant BPL mothers. The Scheme will be
implemented in convergence with ICDS.
1.1.2 Joint Monitoring by Block MO i/cs with CDPO for implementation of the scheme.
Objective No. 2: To increase exclusive breast feeding from 27.9% to 35% by 2008-09 and to 50% by 2009-
10
Strategies and Activities:
2.1 Use mass media (particularly radio) to promote breastfeeding immediately after birth (colostrum feeding)
and exclusively till 6 months of age.
2.1.1 Production and broadcast of radio spots, jingles, folk songs and plays promoting importance of correct
breastfeeding practices
2.1.2 Production and broadcast of TV advertisements and plays on correct breastfeeding practices
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
2.1.3 Publication of newspaper advertisements, booklets and stories on correct breastfeeding practices
2.2 Increase community awareness about correct breastfeeding practices through traditional media
2.2.2 Involve frontline Health workers, Aaganwadi Workers, PRIs, TBAs, local NGOs and CBOs in
promoting correct breastfeeding and complementary feeding through IPC, group meetings, folk media and
wall writing.
2.2.3 Educate adolescent girls about correct breastfeeding and complementary feeding practices through
school -based awareness campaign.
3. To reduce incidence of underweight children (up to 3 years age) from 58.4% to 50% by 2008-09 and to
40% by 2009-10
Strategies and Activities:
3.1. Growth monitoring of each child
3.1.1 Supply of spring type weighing machine and growth recording charts to all ASHAs, AWWs. All
ASHAs, Aaganwadi centers and sub centers will have a weighing machine and enough supply of growth
recording charts for monitoring the weight of all children through Untied fund of S/Cs.
3.1.1 Weighing and filling up monitoring chart for each child (0-6 years) every month during VHNDs
Each child in the village will be monitored by weight and height and records will be maintained
3.2 Referral for supplementary nutrition and medical care
3.2.1 Training for indications of growth faltering and SOPs for referral to AWWC for nutrition
supplementation and to PHC for medical care.
3.2.2 Establishment of 10 Nutrition Rehabilitation Centres in Districts having severe problems of
malnutrition and continue of 8 existing Centres (A Special Scheme taken up and put under NRHM B)
Objective No.4: To strengthen neonatal care services in all PHCs/CHCs/SDHs by setting newborn care
centers & having trained manpower therein.
Strategies and Activities:
4.1. Strengthen institutional facilities for provision of new born care
4.1.1. It is planned to develop a model for comprehensive care of the newborn at all levels, from state to the
community level.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
MODEL FOR COMPREHENSIVE CARE OF NEWBORN
District Level
Neonatal Stabilization Unit
PHC Level
Sick Newborn Care Unit (level 2)
Village Level
IMNCI trained worker, community initiatives (BCC
approaches, involving PRI, Self Help groups etc.)
Level Facility Services/Activities Training required Equipment
1. District Level
Near Level II Sick Newborn
Care Unit ( (SNCU) to provide
specialized care services to
sick newborns
2. PHC level
Neonatal Stabilization Unit
with basic care services in
health facilities
Special care of neonates 4 days training Equipment for
SNCU and
refurbishment.
Delivery services
Neonatal Resuscitation
Warmth
1 day training in
essential newborn
care
Neonatal warmer
Oxygen supply
Ambu bag and
Mask
3. Village level
IMNCI Trained workers in
each village to provide
essential child care and
counseling services to
community
Post natal Visits, Counseling
for breastfeeding and newborn
care practices, immunization
Timely identification,
classification and treatment
and referral, if needed
8 days training in
IMNCI
IMNCI
module
Drug Kit
training
Plan of action:
DISTRICT LEVEL: NEAR LEVEL II SICK NEWBORN CARE UNIT
Neonatal mortality accounts for over 60% of Infant mortality. Further reduction in Infant and Child mortality
is critically dependant upon significant decline in Newborn deaths. Although on average 41% of deliveries
are conducted in the institutions, i.e., at P.H.C and district hospitals, there are no separate facilities to manage
sick Neonates in the hospital and health centers, Even at district hospital, the sick Neonates (Home delivered
and Institutional delivered) are generally treated along with the older sick children.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
It has been observed that near level II Neonatal care is
· Needed for 15-20% of all the neonates
· 5000 neonates need special care per million population per year
· Need for 150 special care beds per million population
Establishment of near leveI SNCU (sick newborn care unit) in 13 districts is proposed.
REQUIREMENTS FOR ACCREDITATION
1. Location of the SNCU:
· Should be easily accessible from entrance of the hospital
· Should not be located on top floor
· For units catering both inborn and out born neonates: next to labor ward & delivery room
· For units catering out born neonates only: near children ward
2. Space Requirement:
1200 sq ft area for a 12 bed near Level II SNCU @ 100 sq ft per patient of which:
a. 50 sq ft would be patient care area and
b. 50 sq ft would be added up for ancillary areas
3. Equipments for individual patient care in the Sick Newborn Care Unit:
Item
Requirement for the unit
1. Servo controlled radiant warmer 1 for each bed (essential) +2 Total=14
2. Low reading digital thermometer (centigrade scale) 1 for each bed (essential) Total=14
3. Neonatal stethoscope 1 for each bed (essential) Total=14
4. Neonatal resuscitation kit: 1 set for each bed (essential) Total=14
5. Electrically operated pressure controlled slow suction
machine
1 for 2 beds (essential)
Total=7 (5 electrical, 2 foot operated)
6. Oxygen hood (neonatal or infant size, unbreakable) 1 for each bed (essential) Total=14
7. Non stretchable measuring tape (mm scale) 1 for each bed (essential) Total=14
9. Infusion pump or syringe pump 1 for 2 beds (essential) Total=7
10. Pulse oxymeter 1 for every two beds Total=7
11. Double outlet oxygen concentrator 1 for every two beds Total=7
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
12. Double sided blue light phototherapy 1 for every three beds Total=2
13. Single side blue light phototherapy Total=3
13. AC (1.5 ton) split 8
14. Generator (15 KVA) 1
4. Side Laboratory Equipments:
Item
Requirement for the unit
Microscope with gram and Leishman staining facility 1 (essential)
Microhematocrit centrifuge, capillary tubes and reader 1 (essential)
Billirubinometer 1
Multistix strips (in container) 1
Glucometer with Dextrostix 3
5. STAFF
Manpower
12 bed SNCU
1. Pediatricians 2
2. Medical Officer 4
3. Sister-in-charge / PHN 1
4. Staff Nurse 6
5. ANMs 8
6. Class IV 6
6. Life Saving drugs for Emergency:
This list is not exhaustive for an Emergency situation in any Sick Newborn Care Unit
Item
· Injection adrenaline, naloxone,
· sodium bicarbonate, aminophylline,
phenobarbitone, hydrocortisone,
Requirement for the unit
A stock of 1 set per bed per month
should always be maintained in the
unit
· 10% dextrose,
· normal saline,
· ampicillin with cloxacillin, ampicillin and
cefotaxime and gentamycin etc
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Support establishment of Neonatal Stabilization Units in select 100 high-mortality blocks with personnel and
equipment for neonatal resuscitation, Postnatal Care, Healthy Newborn Care , 35-37 weeks gestation,
Stabilize neonates < 35 weeks
FACILITIES FOR PHC LEVEL: NEONATAL STABLIZATION UNIT
NEONATAL STABILIZATION
· Adequate warming through radiant heat source.
· Facilities for Resuscitation with self inflating resuscitation bag and well fitting neonatal face masks
(at least two sizes).
· Medicines of essential newborn care
1. Supply of bucket type / spring type weighing machines to all sub centres and Anganwadi centres
Many times new borns and infants are not weighed or incorrectly weighed using adult type weighing
machines which are usually available at sub centres and Anganwadi centres. Provision of bucket type or
spring type weighing instruments will improve weight monitoring.
2. Pediatrician will be appointed on contract basis @ Rs.26000 pm.
3. Training of MOs on Paediatrics
4. Training of MOs, Staff Nurses on Facility Based New Born care
Training and operationalization cost will be borne by the UNICEF.
GRASSROOT LEVEL IMNCI TRAINING
Details as per Annexure
4.2 Generation of awareness on new born and infant care (home-based) in community through MSS
4.2.1 Community Awareness on home-based care of new born (skin-to-skin contact, bathing after a week,
not removing vermix, etc.); early recognition of danger signs - ARI, diarrhoea; proper weaning practice
The ASHAs / MPWs / AWWs at every point of contact for ANC and PNC will reinforce tenets of homebased
care of new born as per IMNCI guidelines. The training will be part of IMNCI.
5. To reduce the prevalence of Aneamia among children from 87.6% to 77% by 2008-09 and to 60% by
2009-10.
Strategies and Activities
Details in special programme for Controlling Iron Deficiency Anemia in Bihar under Part B NRHM
Additionalities.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
6. To increase full immunization of Children from 32.8% to 40% by 2008-09 and then to 60% by 2009-10.
Strategies and Activities
6.1 Conduct fixed day and fixed-site immunization sessions according to district micro plans.
6.1.1 Fill vacant ANM posts and appoint additional ANMs in a phased manner to achieve GoI norm of one
ANM for 5000 population by the year 2009-10.
6.1.2 Update district micro plan for conducting routine immunization sessions
6.1.3 Ensure timely and adequate supply of vaccines and essential consumables such as syringes, equipment
for sterilization, Jaccha-Baccha immunization cards, and reporting formats at all levels.
6.1.4 Supply AD Syringes to conduct outreach sessions in select areas.
6.1.5 Enlist help of AWW/ASHA in identification of new-borne and follow-up with children to ensure full
immunization during sessions. New born tracking system to be implemented
6.1.6 Replace all Cold Chain equipment, which is condemned, or more than five years old in a phased
manner by the year 2007-08 and supply new Cold Chain equipment based on analysis of actual need of the
health facilities
6.1.7 Facilitate maintenance of Cold Chain equipment through Comprehensive annual maintenance contract
with a private agency with adequate technical capacity. Tender already floated and decided.
6.1.8 Provide POL support to State and Regional WIC/WIF facilities @ Rs. 15000 per month and @ Rs.
5000 per PHC per month to each PHCs for running of Gensets and minor repair
6.1.9 Issue necessary departmental instructions to re-emphasize provision of ANC services in the job
description of Aaganwadi Workers and ANMs.
6.2 Build capacity of immunization service providers to ensure quality of immunization services.
6.2.1 Provide comprehensive skill up gradation training to immunization service providers (LHVs/ANMs),
particularly in injection safety, safe disposal of wastes and management of adverse effects.
6.2.2 Conduct training to build capacity of Medical Officers, MOICs and DIOs for effective management,
supervision and monitoring of immunization services
6.2.3 Train Cold Chain handlers for proper maintenance and upkeep of Cold Chain equipment
6.3 Form inter-sectoral collaboration to increase awareness, reach and utilization of immunization services
6.3.1 Develop working arrangements with ICDS and PRIs to ensure coordination at all levels
6.3.2 Involve Aaganwadi Workers and PRIs to identify children eligible for immunization, motivate
caregivers to avail immunization services and follow-up with dropouts.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
6.3.3 ASHA, AWW and ANM will hold meeting with Mahila Mandals at each village monthly for increasing
the coverage of Immunization. Incentive to be provided to ASHA and ANM under RCH and AWW under
intersectoral convergence.
6.3.4 Involve ICDS and PRI networks in behavior change communication for immunization.
6.4 Strengthen Supervision and monitoring of immunization services
6.4.1 Build capacity of Medical Officers, MOICs and DIOs in supervision and monitoring of implementation
of immunization services as per the micro-plan.
6.4.2 Provide mobility support to MOICs and DIOs for supervision and monitoring of implementation of
immunization services.
6.4.3 Develop effective HMIS to support supervision and monitoring of implementation of immunization
services.
6.4.5 Coordinate with representatives of PRI to strengthen supervision and monitoring of immunization
services.
6.4.6 Details of Immunization have been incorporated in part- C of PIP.
7. To reduce morbidity and mortality among infants due to Diarrhea and ARI
Strategies and Activities:
7.1 Increase acceptance of ORS
7.1.1 Supply of ORS and ensure availability in all depots and supply of cotrimoxazole tablets.
The ASHA drug kit will have ORS and cotrimoxazole tablets which should be replenished as per need.
Aaganwadi centers should also be given ORS. In the absence of ORS, the use of home-based sugar and salt
solution will be encouraged.
7.1.2 Orientation of ASHA for diarrhea and ARI symptoms and treatment
ASHAs will be specifically trained to identify symptoms of diarrhea and ARI and to provide home-based
care. Danger signs prompting transportation to seek medical care will also be taught to ASHAs.
7.1.3 Organize meetings for ASHAs/AWWs for dissemination of guidelines for Home based care
ASHA and AWW will be trained and provide guidelines for Home based care. The meeting will be held at
Block PHC level.
A detail Action Plan for ORS submitted under Part B of NRHM Additionalities
7.2 Strengthening of referral services for infants seeking care for life threatening diarrhoea and ARI
7.2.1 Availability of referral money @ Rs.500 available for transporting of sick infants to the health institute.
7.2.2 Blood slide examination of all febrile children with presumptive treatment
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
In endemic areas, most children are anemic due to repeated bouts of malaria. Any febrile child needs to be
checked for malaria compulsorily.
7.2.1 Strengthening of PHCs/ referral centers
School Health Programmes
Counseling sessions will be organized in Govt. Schools in collaboration with BSACS. Story lines and
slogans will be published in text books of schools in collaboration with the Education Deptt. Reference
Books on Health Issues and Healthy Life-Style will be published for School libraries. Health Camps will be
organized for health check-ups for school children. Innovative strategies will be adopted to orient school
children about healthy practices.
Details annexed
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
3 Family Planning
Goal: Reduce TFR by 2.1 from present level of 4.3
Objectives:
1. To reduce total unmet need for contraception from 23.1 % to 15%
2. To increase Contraceptive Prevalence Rate (Any Modern Method) from 28.8% to 35% by 2008-09 and to
45% by 2009-10
3. To increase male participation in family planning
4. To increase proportion of male sterilizations from 0.6% to 1.5%.
5. Monitor the quality of service as per GoI guidelines for Sterilization
Objective No.1: To reduce total unmet need for contraception from 23.1 % to 15%
Strategies and Activities
1.1 Plan to organize RCH camp in each PHC/CHC once in two months.
1.1.1. Creating dedicated cadre of skilled manpower
1. Training of MBBS doctors on Minilap and NSV
2. Training of MBBS doctors on Anesthesia
3. Training on IUCD: MOs, ANMs etc.
1.1.2 One RCH camp will be organize in each PHC/CHC where Laparoscopic Ligation/Mini Lap will be
done
1.1.3 Incentive to acceptors Incentive for LL operations
1.1.4 Training on LL operation, MTP and IUD Insertion
1.1.5 ASHA and MPWs will publicize about the RCH in their area and motivate the eligible women to go for
spacing & terminal methods of family planning.
1.2 Motivate eligible couples who have had their first child for spacing for condoms, OCPs or IUDs
1.2.1 Update EC register with help of ASHAs and AWW
The eligible couple register is presently being updated once a year (usually in April) in a survey
mode. It is done in a hurry and may not have complete information in many cases. With the
involvement of ASHAs and AWWs, updates should be done each month preferably during VHNDs.
This will result in less wastage of time and resources and better recording of information.
1.2.2 Availability of FP services: IUCDs, OCPs, Emergency Pills, Condoms
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
1.2.2.1 Each SDH/CHC/PHC should have static FP cell / corner, with earmarked ANM / LHV responsible,
for providing these services daily as OPD services to clients
1.2.2.2 Community Based Distribution (CBD) of Condoms and Pills: The OCPs and condoms can be
provided to community based motivated volunteers, like members of Self Help Groups (for Pills) and
Husbands of motivated ASHA, Satisfied NSV client, active PRI members etc. (for condoms) for community
based distribution (CBD) of these. The availability of condoms and OCPs with the volunteers and their
geographical responsibilities should be widely known to the potential clients / beneficiaries. Before they are
made the community based distributors, they should be properly trained and mechanism developed to
regularly monitor them and review their performance
1.2.2.3 Public Private Partnership (Social marketing): This can be taken up on an experimental basis in a
couple of districts, or a few blocks in these districts to pilot selling through entrusted community based
institutions, volunteers, market mechanisms (like the popular pharmacist of the village, or grocery shop
owner or the like) condoms and OCPs at normal or subsidized rates. This should be properly preceded by
adequate awareness generation of the availability of these for price in the community itself and that the
clients or the community members could buy these from specified vendors (volunteers etc.). The research has
shown that the services, drugs, supplies etc. bought for fee are valued more by the user and they use them
more.
1.2.2.4 Organize monthly IUD Camps in PHCs/CHCs/SDHs IUD camps will be organize in each
PHC/CHC/SDH every month. ANM and ASHA will be informed the dates on which the camp will be held
in the concern HIs.
1.2.3 Ensure follow up after IUD and OCP for side effects and treatment
Many of the drop outs for IUD and OCP occur due to side effects and lack of proper attention to take care of
these. Follow-ups after IUD insertion and starting of OCPs and provision of medical care to mitigate side
effects will help in continuing with the service and also create further demand.
1.2.4 Organize Contraceptive update seminars at the district level twice in a year.
The seminar for contraceptive updates will be organized at the district level twice in a year. All the
healthcare providers from the district will attend the seminar.
1.3 Motivate eligible couples for permanent methods in post partum period specifically after second and third
child
Efforts will be made by the service providers to motivate parents to adopt permanent methods after the birth
of the second or third child.
1.3.1 Update EC register with help of ASHAs and AWW
Every event will be recorded in the EC register and thus the register will be updated. This can be done after
every event has occurred or reported to have occurred or during the VHNDs visit each month to a village.
1.3.2 Motivate couple after second child in Post Partum period to go in for tubectomy / NSV
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
After the second child is born, the couple will be motivated to adopt a permanent method of family planning
preferably NSV. For this communication materials will be prepared and distributed.
1.3.2 Follow up after tubectomy /NSV for side effects and treatment
Each tubectomy / NSV will be followed up for side effects and their treatment. This will provide positive
reinforcement and motivate others to adopt family planning.
1.4 Making available MTP Services in all Health Institutions.
Since 8% of maternal mortality continues to be attributed to unsafe abortion, therefore, availability of and
accessibility to quality abortion services / MTP services acquire greater importance. There is a need to
identify, map and train the providers, both in public and private sectors on abortions / MTP services. There is
also a need to ensure availability of medical abortion drugs; this can be done by including these drugs into
the state procurement list. The latest guidelines on this can be had from GoI. Revisions in MTP Act are
underway; once done, systematic orientation of entire cadre of health personnel on this is required.
1.4.1 MTP Services in the state is not fully operational in all the hospitals of the state. Training of MOs have
been under taken during RCH-1. To further strengthen the skill of the doctors for MTP training, training shall
be taken up during the year. 100 MOs will be trained in 2008-09.
1.4.2 Plastic MVAs will utilize and state will made purchase for availability in health institutions.
Objective No.2: To increase Couple Protection Rate
Strategies and Activities
2.1 Awareness generation in community for small family norm
2.1.1 Preparation of communication material for radio, newspapers, posters
Communication materials highlighting the benefits of a small family will be prepared for radio, TV and
newspapers.
2.1.2 Meetings with MSS, CBOs
Communication materials to be used for monthly MSS/CBO meetings will be prepared and distributed for
use.
These meetings will be scheduled during or preceding the month family planning camps are scheduled to be
held.
2.2 Regularise supply of contraceptives in adequate amounts
2.2.1 Indent and supply contraceptives for all depots and subcentre/ AWCs and social outlets: Each AWC
and ASHA will have at least one months requirement of condoms and OCPs. Sub centres will have adequate
supplies of IUDs also.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Objective No.3: To increase male participation in family planning
Strategies and Activities
3.1 Promote the use of condoms
3.1.1 Counseling men in villages to demonstrate ease of use of condoms and for prevention of STDs
Male workers will assist the MPWs in addressing the meetings of men in villages to demonstrate the use of
condoms and its benefits in family planning and prevention of STDs. It should be stressed that condoms are
easy to use and is a temporary method. Current methods of family planning which target women are not very
easy to adopt while condoms can be very easily used.
3.1.2 Regular supply of condoms and setting up depots which are socially accessible to all men
It is very essential to supply condoms through depots which can be easily accessible to men and
confidentiality will also be ensured. During the meetings, the sources of condoms in the village will be made
known to all. It will be ensured that the clients identity will not be disclosed. The depot holder will be set up
only on condition that he shall not reveal the identity of clients.
3.2 Promote adopting NSV: as simple and convenient method of hassle free FP methods (however, it must be
told that it doesnt protect from STI/RTI of HIV / AIDS)
Objective No.4: To increase proportion of male sterilizations from 0.6% to 1.5%.
4.1 Increase demand for NSVs (develop a cadre of satisfied NSV Client, who could be the advocates for
NSV in their designated geographical areas. Orient and train them and give them specific geographical
responsibility to give roster based talks etc to identified groups of probable clients. During these talks the
probable clients can be registered and they could be escorted to the nearest static facility or the camp on
designated days for NSV. Once completed the procedures, then these new clients can become advocates for
the same. This entire process must be fully facilitated by respective PHCs and be provided with all logistics
support along with some incentives for the work or activities undertaken by them)
4.1.1 Village level meetings in which men who already underwent NSV share experiences to motivate men
to undergo NSV
All the GP/ADC Villages will be chosen in the district to hold meetings in which men who have undergone
NSV will tell male members of the community about their experience and the benefits of NSV. These
meetings will be repeated each month in the same batch of Gram Panchayat or ADC Villages. NSV will be
conducted on the motivated men. The same men will then be requested to share their experiences in the next
batch of five villages for the next three months.
4.2 Increase capacity for NSV services
4.2.1 Training of doctors for NSV
While demand is being generated, a team of doctors should be trained at all the FRU level to conduct NSVs.
4.2.2 Organize NSV camps at the Sub District Level
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Objective No. 5: Monitor the quality of service as per GoI guidelines for Sterilization
5.1 A quality assurance committee initiated in every district for monitoring the quality of sterilization in the
respective district. The Civil Surgeon is the chairman of the committee with at least one Gynecologist.
5.2 Streamline the contraceptive supply chain & Monitoring
1. Identifications &Renovation of Warehouse State /District/ PHC
2. Budget allocation for transportation at every level
3. Provision for report format printing and their availability at every level
Action Plan for Strengthening Sterilization Services
The activities are segregated into short-term and long-term. They are separately spelled out for the state and
the district.
Short Term Activities
State Level Activities:
1. Service Availability
STATIC SERVICES
i. Ensure that district level facilities are fully equipped with manpower and equipments
ii.Availability of Sterilization services everyday at district hospitals, separately for, Males and Females
iii.Availability of Sterilization services at PHC level on at-least 3 fixed-days a week (these days could be
fixed for the entire state, like the Immunization Days, which are Wednesday and Saturdays)
iv. Demand generation activities: wide dissemination of information on the regular (daily and on fixed days)
availability of the services
1. prominent display
2. workshop of key department functionaries, who in turn would disseminate the same to their line
staff, who in turn will directly inform the public about the availability of services
CAMPS
v. The number of camps needs to be planned and based on the ELA of the districts
a. Districts must plan camps in various PHCs and locations based on the need, in the beginning of the
year; this should be based on the past years records etc., and these must be shared in the beginning of
the year with the state
b. These camps must be planned round the year, they must be evenly distributed through out the year
and wide publicity on the venue and dates of the camps, well in advance must be disseminated
through out the respective catchment areas
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
c. Availability of Providers
d. Line listing of available Providers by Geographical Areas (DHQ, PHCs, SDH etc.)
‣ Gynecologist,
‣ Surgeon
‣ Anesthetist
‣ Nursing Staff
e. Roster for year long Static Services Providers: Based on the above line listing form Surgical Teams
for male and female sterilization separately, the teams then must be provided with earmarked days of
the week at static centres, like the rotation duties in Medical Colleges and big private Nursing
Homes. For example Team 1 will perform on Mondays and Wednesdays; Team 2 on Tuesdays and
Fridays; and Team 3 on Thursdays and Saturdays etc. and on rotation one Team can be on call for
emergencies on holidays etc.
f. Roster for year long Camp Services Providers Similarly, by camps the teams should be identified in
the beginning of the year and their year-long roster be prepared and informed so to them in advance.
The evenness in providers work load should be ensured such that it is not the situation that a few
providers are doing all the surgeries while the remaining are doing none.
g. Identification of Providers for Training: Line Listing of Providers for the same. It must be prepared
for every district and every PHC in the district. Before the training begins for the identified future
providers, their choice must sought as to the posting to the facility they would be interested in; as far as
possible this should be respected. Based on this they should be trained and posted to the pre-identified
facility in a time bound fashion. This exercise should be done in advance and proper notification
regarding the same should be widely publicised and disseminated. This activity should be very closely
monitored by the State Health Society, in order to ensure its full operationalization. Once done, the
training in phased manner should happen in a time bound fashion.
h. Equipping the facilities and keeping the sets of equipments ready for the camps
i. This needs to be ensured as per the guidelines for the facilities: As per the
guidelines, minimum numbers of sets must be available at district and sub-divisional
hospitals
ii. The same needs to be ensured for every camp in advance, such that the quality and
hygiene are not compromised in the camps
i. Monitoring System: Both for Static Services and Camps: To monitor provider out put and progress
in static facilities and camps
i. A check list needs to be developed at State Health Society to monitor the above
ii. A mechanism needs to be developed on this and how the information so gathered
could be used to improve the services and provider output
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
j. Monthly Review of sterilization progress and performance by district and sub-district levels,
specially focusing on high-burdened areas hard to reach areas
i. A fixed agenda and points to be reviewed need to developed in order to make there
review meetings focused and result oriented
District Level Activities:
1. Undertake block-wise analysis of service utilization and work out detailed service provisions: fixed day
roster based static services, camps and their schedules
2. Prepare block wise demand generation activities, separately for static services and camps
3. Prepare a list of providers not providing sterilization services and orient and reorient them and place/post
them as per defined roster to the services: static services and camps
4. Finalize work plan with state to get specific need-based inputs
5. Conduct monthly review of sterilization activities at district level
Long Term Actions
State Level Actions
1. increased trained manpower
2. create dedicated pool of providers exclusively for sterilization, develop a mechanism of incentives for
the high achievers
3. provide appropriate mix of services male and female sterilization at static facilities
4. undertake state level NSV campaign
5. gradually increase static facilities and popularize the availability of the same and similarly gradually
reduce the number of camps proportionately
6. organize state and regional level experience sharing
District Level Actions
1. saturate training of all available providers
2. ensure presence of providers in all static facilities
3. institutionalize sterilization services
4. public private partnership
a. line listing of the same
b. dedicated pool of the same, MBBS doctors (ask them to perform surgeries at government
facilities)
5. orient block level MOs in using data for monthly review and stocktaking
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
4. Adolescent Reproductive and Sexual Health
Objective:
1. To reduce incidence of teenage pregnancies from present 25% to 22% by 2008-09 and to 15% by 2009-10.
2. To ensure the access to information on Adolescent Reproductive & Sexual Health (ARSH) through
services at District Hospitals, SDH, CHCs, PHCs & HSC level.
3. To increase awareness levels on adolescent health issues
Objective No.1: To reduce incidences of teenage pregnancies from present 25% to 22% by 2008-09 and to
15% by 2009-10.
Strategies and Activities:
1.1 Improve access to safe abortions
1.1.1 MTP services made available at all the FRUs initially & at all SDHs in subsequent years, through
training of select medical officers at DH/MC.
MOs will be trained in MTPs
1.1.2 Manpower (Training) & logistic support to private hospital doctors and will also be trained in
conducting safe abortions.
1.2 Ensure availability of condoms/OCPs/Emergency contraceptives
1.2.1 Depot holders among adolescent groups/youth organizations
In addition to the ASHA and the AWW, youth organizations such as football clubs and others will have
depot holders who will provide condoms/OCPs and Emergency contraceptive pills and maintain
confidentiality.
Objective No.2: To ensure the access to information on Adolescent Reproductive & Sexual Health (ARSH)
through services at District Hospitals, SDH, CHCs, PHCs & HSC level.
Strategies and Activities
2.1. Organize regular adolescent clinics/counseling camps at SC/PHC/CHC/SDH/DH
2.1.1 Appointment of 5 nos. Adolescent Counselor for districts setting up Adolescent clinics.
2.1.2 Adolescent health sessions/clinics will be held in each Sub Centre/ PHC / CHC/SDH and DH with
service delivery & referral support
2.1.3 Risk reduction counseling for STI/RTI
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
During the monthly or weekly interactions through health sessions and clinics, counseling for preventing
STI/RTI will be also be done. This will include single partner sex and use of condoms for safe sex.
2.2 ASHA/AWW to act as nodal persons at village level for identifying & referring adolescents in need of
such services.
2.2.1 Training of AWW/ASHA in adolescent health issues
All ASHAs and AWWs will be oriented on problems faced by adolescents, signs and symptoms of the
problems and where to refer these cases.
2.3 Referrals to de-addiction centers for treating alcoholism/drug addiction
2.3.1 Identification of de-addiction centers in the state/district
The state / district will identify NGOs or other de-addiction centres in the state and through the health
workers will refer the cases in need to these centres for treatment.
2.3.2 Circulate information on services provided at these centres and setup referral system
The state/district will have an understanding with the de addiction centre on the process for referring patients
to the de-addiction centres.
Objective No.3: To increase awareness levels on adolescent health issues
Strategies and Activities
3.1 Organizing Behavioral Change Communication campaigns on specific problems of adolescents
3.1.1 IEC activities along with take-home print material to be organized in coordination with MSS, Youth
club
One of the monthly theme meetings with the MSS / CBOs will be related to adolescent health problems,
signs and symptoms, treatment and referrals.
3.1.2 4 monthly health checkups under School Health Programme through PHC medical and paramedical
staff
School Health Programmes (Health Check up under MDM)
As part of the School Health Programme, adolescents in schools will undergo health check ups thrice in a
year. Some counseling related to common adolescent problems will also be given during these check ups.
Children are the asset and future of the Nation. The progress of any country and state depends upon them for
which they must remain healthy. In Bihar there are about 1.5 crore children of 6-14 years age reading in
government primary & middle schools. The health check-up of these children are must atleast once in a year
to detect any serious disease in the early stage, so that preventive and curative measures may be taken at the
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
earliest. For this objective in mind government has decided to do medical health check-up of children
reading in government primary and middle schools.
OBJECTIVE :
· Regular annual health check-up of Children registered in government primary and middle school.
· To detect any defect in progress of health and nutritional deficiencies.
· Early detection of serious illnesses and to refer them in the nearest specialized government health
facilities.
· To develop good habit for better health and hygiene to remain healthy.
· To inculcate through the children habit to remain healthy among Family members and community.
· To improve quality of food supplied to children by adding micronutrients.
Additionally Counseling sessions will be organized in Govt. Schools in collaboration with BSACS. Story
lines and slogans will be published in text books of schools in collaboration with the Education Deptt.
Reference Books on Health Issues and Healthy Life-Style will be published for School libraries. Health
Camps will be organized for health check-ups for school children. Innovative strategies will be adopted to
orient school children about healthy practices.
Details annexed
3.1.3 Orientation of VHSC on adolescent issues
The MPWs will during their routine interactions with the VHSC members apprise them of the
problems and issues related to adolescents and what to do for treatment and referrals. (Budgeted in
RCH Training along with maternal health, Child health and Family Planning)
3.1.4 Premarital counseling of adolescent girls on reproductive health issues at PHC/RH/SDH/DH
This will be part of the adolescent health session/clinics which will be regularly conducted at sub centres,
PHCs and also at youth clubs.
3.2 Dissemination of ARSH Guidelines and Trainings
3.2.1 Organize dissemination of ARSH guidelines at State level.
3.2.2 Training of TOTs on ARSH
3.2.3 Training of MOs, ANMs on ARSH
Proposed Strategies and Activities for Operationalization of ARSH
1. ARSH service delivery through the public health system:
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
a. Actions are proposed at the level of sub-centre, PHC, CHC, district hospitals through routine
OPDs. Separate arrangements should be done for male and female adolescents.
b. Fixed day, fixed time approach could be adopted to deliver dedicated services to adolescents
and newly married couples. A fixed day across the state, either once a month or twice a
month can be declared for ARSH, and the information regarding the same should be
properly disseminated in the community and properly displayed at the facilities.
c. A separate ARSH Cell, comprising of ANM, LHV, Health Educators etc. (perhaps on a
rotatory basis) can be established at these Cells.
d. A separate ARSH Cell can be constituted at every CHCs and Referral Units, with one MO as
its nodal officer (on call, sort of) and two counselors.
2. Interventions to operationalise ARSH
a. Orientation of the service providers: Equipping the service providers with knowledge and
skills is important. The core content of the orientation should be vulnerabilities of
adolescents, need for services, and how to make existing services adolescent friendly.
b. Environment building activities: this should include orienting broad range of gatekeepers,
like district officials, panchayat members, womens group and civil society. Proper
communication messages should be prepared for the same exercise. District, block and subblock
level functionaries should be responsible for this.
c. The MIS should at least capture information on teenage pregnancy, teenage institutional
delivery and teenage prevention of STI.
5 Urban Health
Urban health care has been found wanting for quite a number of years in view of fast urbanization leading to
growth of slums and population as more emphasis is given in rural areas. Most of the Cities and Towns of
Bihar have suffered due to lack of adequate primary health care delivery especially in the field of family
planning and child health services.
Objectives:
1. Improve delivery of timely and quality RCH services in urban areas of Bihar
2. Increase awareness about Maternal, Child health and Family Planning services in urban areas of
the state
At present, there are 12 Urban Health Centres (UHC) in the state which are non-functional. However, as per
the GoI guidelines, there should be one UHC for 50,000 population (outpatient). The Urban Health Centres
are required to provide services of Maternal Health, Child Health and Family Planning. The infrastructure
condition of the Urban Health Centres is not up to the mark and requires some major renovation work. The
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
staff at each UHC should comprise of 1 Medical Officer (MO), 1 PHN/LHV, 2 ANMs, 1 Lab Assistant and 1
Staff clerk with computer skills.
Objectives No. 1: Improve delivery of timely and quality RCH services in urban areas of Bihar
Strategies and Activities
1.1 Identify health service providers of both public and private sectors (including NGOs) in urban areas
and plan delivery of RCH services through them
1.1.1 Mapping of Urban Slums and existing providers of RCH services of both public and private sectors has
been completed
1.1.2 Develop Micro-plans for each urban area for delivery of RCH services, both outreach and facility
based.
1.2 Strengthen facilities of both public and private sectors in urban areas
1.2.1 Establish partnerships with select private health clinics for delivery of facility-based RCH services e.g.
institutional delivery, permanent methods of FP, curative MCH service, etc.
1.2.2 Collaborate with health facilities managed by large public sector undertakings such as Railways, ESIS,
CGHS and Military to provide RCH services to general population from identified urban areas.
1.3 Strengthen outreach RCH services in urban areas through involvement of both public and private
sector service providers
1.3.1 Deliver outreach services planned under RCH through reinforced network of frontline health service
providers (ANMs, LHVs)
1.3.2 Expand outreach of RCH services by adoption of identified under-served or un-served urban areas by
facility-based providers (e.g. adoption of a particular slum by a medical college or private health institute)
1.3.3 Establish 20 Urban Health Centres on a rental basis under PPP in this financial year especially in
districts with DHs having heavy patient load
Objective No. 2: Increase awareness about Maternal, Child health and Family Planning services in
urban areas of the state
Strategies and Activities
2.1 Use Multiple channels for delivery of key RCH messages in urban areas
2.1.1 Utililise various channels of mass media with extensive reach in urban areas such as TV, local cable
networks, radio (particularly Vividh Bharti channels), cinema halls, billboards at strategic locations, etc to
propagate messages related to key programme components of RCH.
2.1.2 Extensive use of print media such as newspapers (particularly local newspapers), journals and
magazines for dissemination of key RCH messages.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
2.2 Broad inter-sectoral coordination to increase awareness and knowledge of key messages under the
RCH programme
2.2.1 Involve representatives from Urban Local Bodies (municipal corporations and municipalities),
commercial associations, sports bodies, voluntary and religious organisations for intensive inter-personal
communication and community-based awareness campaigns.
2.3. Use various channels of mass media for ensuring utilization of services of Urban Health Centres, private
or Government
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
6. Vulnerable Groups
Health Camps in Maha-Dalit Tola
Two camps shall be held in each Maha-Dalit tola where health check-up and counseling shall be done,
followed by distribution of spectacles to reach out to the vulnerable sections of the Society
Projected cost for larger districts Rs.500 x 30 districts x 100 tolas=15.00 lakhs
Projected cost for smaller districts Rs.500 x 8 districts x 50 tolas=02.00 lakhs
Projected cost for spectacles Rs.200 spectacles x 30 people x no. of villages
7. Tribal Health - Deleted
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
8. Innovations
8.1 PNDT Act
Implementation of Medical Termination of Pregnancy Act, 1971 and Pre-natal Diagnostic Techniques
(prohibition) Act, 1994.
In order to arrest the abhorrent & growing menace of illegal termination of pregnancies as well that of prenatal
diagnostic test ascertaining sex-selection, the Medical Termination of Pregnancy Act, 1971 read with
Regulations & Rules 2003 and the pre-natal Diagnostic Techniques (Prohibition of sex selection)Act were
formulated.
The misuse of modern science & technology by preventing the birth of girl child by sex determination before
birth & thereafter abortion is evident also from the fact that, there has been a decline in sex ratio despite the
existing laws.
The Apex court has observed that:-
We may state that there is total slackness by the Administration in implementing the Act. Some learned
counsel pointed out that even though the Genetic Counselling Centre, Genetic Laboratories or Genetic
Clinics are not registered, no action is taken as provided under Section 23 of the Act, but only a warning
issued. In our view, those Centres which are not registered are required to be prosecuted by the Authorities
under the provision of the Act and there is no question of issue of warning and to permit them to continue
their illegal activities .The apex court accordingly directed the central as well as state Governments to
implement the PNDT Act. In Bihar too the concerned authorities have been directed to implement the
provisions of the both the Acts forcefully.
Following actions have been taken and planned in this regard.
A. State, District and block level workshops on PNDT has been planned.
B. Create public awareness against the practice of prenatal determination of sex and female foeticide through
advertisement in the print and electronic media by hoarding and other appropriate means
C. A district wise task force to carry out surveys of clinics and take appropriate action in case of non
registration or non compliance of the statutory provisions. Appropriate authorities are not only empowered to
take criminal action but to search and sieze documents, records, objects etc.
D. Beti Bachao Abhiyaan As female foeticide is a concern both in rural and urban areas, this year, Beti
Bachao Abhiyan will be launched to sensitize people against this heinous practice. Massive awareness drive
with the support of College students, womens organizations and other voluntary associations is planned this
year. Human Chain, rallies, seminars, workshops and press conferences will be organized for the same.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
8.2 MUSKAAN Programme
The state has started a New Programme called MUSKAAN Programme to track pregnant women and New
Born Child. Under this programme ASHA, AWW and ANMs jointly track the pregnant mothers and New
Born Child.
This programme launch in October 2007. Under this programme ASHA, AWW and ANM will hold meeting
with Mahila Mandals in AWWCs. The main objective is to cover ANC coverage and Immunization. A Data
Centre also placed in all the 533 PHCs to monitor this programme.
After the introduction of this programme it has been seen that the coverage of ANC and Immunization
increased. The State wants to continue this programme and requested the GoI to fund the
programme.Infrastructure is one of the important components for upgradation of facility to deliver the quality
service. In the PIP it has been proposed a number of infrastructural corrections for upgrading the facilities.
These are
1. As per RCH Programme operationalisation of 76 First Referral Unit to provide emergency
obstetric and newborn care 24 hrs. a day / 7 days a week. The aim is to ensure atleast two
operational FRUs per district. There are 76 hospitals in the State which have been identified to be
upgraded as FRUs. The main focus initially to provide remedial measures absolutely required to
ensure proper functioning of the facility. Another important aims to provide appropriate specialist in
each of these 76 Hospitals. It is proposed to upgrade 76 Health facilities to FRUs in 2007 2008.
Unit cost of construction at the rate of average of 2 Crores as per RCH norm. The above hospital
will be well equipped with OT, electric supply, water supply, toilet, telephone services, sewerage
system and disposal system for hospital infectious waste.
2. Anesthetist will be hire @ Rs.1000 per case for EmOC. A provision for 50000 cases included in the PIP.
3. Neonatal Intensive care unit will be setup in 13 districts at the district hospitals. Each Neonatal unit will
cost Rs. 39,36,000/-
1 Civil & Electrical Works: Rs. 6,86,000/-
2 Equipments for individual patient Care: Rs. 25,00,000/-
3 General Equipments: Rs. 2,50,000/-
4 Side Lab Equipments: Rs. 2,00,000/-
5 Equipments for disinfection Rs. 1,50,000/-
6 Data Collection & Recording Rs. 1,50,000/-
Total Rs. 39,36,000/-
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
The costs also include provision of equipments at these hospitals either as per IPHS or as required.
4. Newborn Care Unit will be set up in all the 533 PHCs @ Rs. 1,57,400/- . This includes minor civil work
and purchase of Equipments.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
9. Strengthening of SIHFW
9.1 Fast-Track Training Cell in SIHFW
It is also proposed in this budget to have a full time training experts/coordinator to spearhead various
trainings under NRHM. Unless a dedicated Fast-Track Training cell is constituted at state level (at SIHFW),
it will be very difficult to improve the quality of trainings and linkage training with performance. As training
constitutes one of the largest single components of NRHM Budget allocation, this investment in creating the
Fast-Track Training cell at the State level will be very cost effective intervention. Looking at the magnitude
of the work under trainings, it is being proposed that under the training co-coordinator, there should be two
training sub-coordinators, looking after 50% districts each. Additionally, one clerical staff is suggested. This
training cell should be at the SIHFW and will eventually further strengthening SIHFW.
Budget:
(1.) One Training expert/coordinator
= Monthly salary Rs. 30,000/- x 12 months = Rs. 3,60,000/- per annum
(2.) Two Training sub-coordinators
= Monthly salary Rs. 25,000/- x 2 individuals x 12 months = Rs. 6,00,000/- per annum
(3.) One Clerk = Monthly salary Rs. 10,000/- x 12 months =Rs. 1,20,000/- per annum
(4.) Office expenses = Monthly Rs. 5000/- x 12 months =Rs. 60,000/- per annum
Total Annual Budget = Rs. 3,60,000/- + Rs. 6,00,000/- + Rs. 1,20,000/- + 60,000/- = Rs. 11,40,000/-
9.2 Filling Vacant Position at SIHFW/Hiring Consultant at SIHFW
AT the same time, the remaining vacancies of SIHFW can be filled. In order to fast-track the appointments
of these faculties and support staff, the appointments can happen on a contractual basis such that trainings
can be better organized and their quality improved. As part of strengthening SIHFW, a monitoring section
needs to be created at SIHFW to use data on various aspects of training and to improve the quality of
training, to make them need based, to assess if skill enhancement is happening, if program efficiency and
effectiveness are increasing or if the trained staff are being rationally posted etc.
Budget
(1.) 10 consultant/faculties = Monthly
Salary @ Rs. 30,000/- x 10 individuals x 12 months = Rs. 36,00,000/- per annum
(2.) 4 Clerical Staff = Monthly salary Rs. 10,000/- x 4 individuals x 12 months = Rs.4,80,000/- per annum
(3.) Office expenses = Monthly expenses Rs. 15,000/- x 12 months = Rs. 1,80,000/- per annum
(4.) Monitoring Cell (additional expenses for regular reporting within the system = Rs. 5,000,00/- per annum
Total annual budget= Rs. 47,60,000/- per annum
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
10. Infrastructure and Human Resource
Infrastructure is one of the important components for upgradation of facility to deliver the quality service. In
the PIP it has been proposed a number of infrastructural corrections for upgrading the facilities. These are
1. As per RCH Programme operationalisation of 76 First Referral Unit to provide emergency obstetric and
newborn care 24 hrs. a day / 7 days a week. The aim is to ensure atleast two operational FRUs per district.
There are 76 hospitals in the State which have been identified to be upgraded as FRUs. The main focus
initially to provide remedial measures absolutely required to ensure proper functioning of the facility.
Another important aims to provide appropriate specialist in each of these 76 Hospitals. It is proposed to
upgrade 76 Health facilities to FRUs in 2007 2008. Unit cost of construction at the rate of average of 2
crores as per RCH norm. The above hospital will be well equipped with OT, electric supply, water supply,
toilet, telephone services, sewerage system and disposal system for hospital infectious waste.
2. Anesthetist will be hire @ Rs.1000 per case for EmOC. A provision for 50000 cases included in the PIP.
Similarly Gynecologists and Pediatrician will also be hired as per requirement.
3. For follow up and monitoring RCH Coordinators will be hired at Commissionaire level and at SIHFW.
4. Newborn Care Unit will be set up in all the 533 PHCs and DH. This includes minor civil work and
purchase of Equipments.
5. Setting up of Intensive Care Unit in all the District Hospitals
An Intensive Care Unit (ICU) is a specialized department in a hospital that provides intensive care medicine.
Many hospitals also have designated intensive care areas for certain specialties of medicine, as dictated by
the needs and available resources of each hospital. The naming is not rigidly standardized.
In most of the districts do not have Intensive Care Unit in any set up whether it is Private or Public. The
patients have to shift either to the nearest medical colleges or to Patna for Intensive Care. In the process of
transfer most of time it has been seen that patient die on transportation. The distance to the nearest ICU set
up is long and most precious time waste for treatment of the patient.
Setting up of Intensive Care Unit will help to avail patient the facility in all districts so that accessibility for
intensive care can be addressed. The state has proposed to establish 4 bedded ICU in all the 36 District
Hospitals.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
11. Institutional Strengthening
For HRD, training of 10 regular Government doctors is being proposed in Public Health for improving their
administrative skills.
Multi - Skilled Specialist DNB (Family Physician) 3 years course for 20 service doctors from CHCs
SHSB proposes to initiate DNB (Family Physician) 3 years course in select district hospitals. 20 Service
doctors preferably from CHCs who want to undergo DNB courses run by National Board of Examinations
shall be selected based on competitive examination. The course will run via distance education mode for one
and half years followed by another 18 months for hands on experience. There is an option to complete the
course in two parts. After 3 years training, these doctors shall be posted in the CHCs and referral hospitals to
provide caesarean and anesthetist services. The permission of National Board of examination to commence
the DNB Family Medicine course may have to be obtained. To select the suitable young doctors for the
course who will give an undertaking to work in the government health system for 10 years in CHC upwards.
Further more it is proposed that for Multi skilling of Doctors they can be sent to hospitals like Safdarjung etc
in New Delhi for continuing medical education.
Sub-centre rent shall be provided for 20% of the HSCs operational.
Quality Assurance
The state has Quality Assurance Committee for Sterilisation, Birth Control, Maternity Services,
Child Survival Services, Immunization, and Case Management of Diseases in the district
Quality of health care and reproductive health services consists of the proper performance
(according to standards) of interventions that are known to be safe, that are affordable to the society
in question and have the ability to produce an impact on client attraction & satisfaction, belief,
population stabilization, inclination towards the continuation of method(s) etc.
As per the guidelines lay down by the Honorable Supreme Court of India. The State Government is
in the process of constituting Quality Assurance Committees (QACs) at the State and District levels
to ensure that the standards for female and male sterilization and other health services are being
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
followed in respect of preoperative measures, operational facilities and post-operative follow-ups
and other ethical diagnostic and treatment protocols.
The terms of reference for the State / District QAC are as follows:
· The District QAC shall conduct medical audit of all deaths related to sterilization,
maternity deaths and deaths arising out of suspected medical negligence and send reports
to the State QAC office. The State QAC shall deliberate on the report.
· Shall collect information on all hospitalization cases related to complications following
sterilization as well as sterilization failure and maternity deaths and deaths arising out of
suspected medical negligence.
· Shall process all cases of failure, complications requiring hospitalization, and deaths
following sterilization for payment of compensation and will pursue these cases with the
insurance company or otherwise.
· Shall review all static institutions i.e. Government and accredited private/NGOs and
selected camps providing sterilization services and providing maternity, Child survival
and other medical care for quality of care as per the standards laid down, and
recommend remedial action for institutions not adhering to the standards.
· A minimum of three members shall constitute the quorum.
Presently the QAC also looking after the quality of all the trainings done under RCH.
Monitoring of delivery of critical services & NRHM trainings (IMNCI, SBA, Immunization,
EmOC, LSAS, NSU, BCC for promoting Breastfeeding, Minilap, MVA, ASHA).
In Bihar state, there is a quality assurance cell housed in the State Institute of Health & Family
Welfare. The key responsibility of this cell has been to coordinate with multiple stakeholders and
keep a track on the trainings happening in the state. There are members from the SHSB, SIHFW,
Faculty of various medical colleges, retired medical college faculty members, and health officials,
members from the professional organizations, and officials from the development partners are on its
panel. The monitoring visits are proposed to be undertaken by the members to different districts and
sub districts for initial handholding and to ensure quality training. As a part of this, standard
monitoring formats available with the state are to be used. The experience till now has been that
many of the doctor members are reluctant to undertake field visits. This is more so when the
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
trainings happen in such districts from where same day return is not feasible. The key underlining
reason for this has been found out to be the implementation of RCH I TA and DA norms. As it is
well known, these norms were defined more than ten years ago. The different monitors undertaking
field visits tend to spend from their pockets for the monitoring visits. In the last ten years, the cost
of living has gone up substantially and thus it is proposed to review the financial norms for the
disbursement of TA and DA while on official duty.
After discussions with the stakeholders, it is suggested that the following norms may be adopted by
the SHSB/GoB pending more clear guidelines from the GoI.
S No Category Description Honorarium Travel Cost per
monitoring
day
1. State/Division
Government officials
and doctors
With same day
return
2. State/Division
With night stay
Government officials involved
and doctors
3. Medical college With same day
faculty/retired
return
professionals
4. Medical college With night stay
faculty/retired
involved
professionals
5. Free lance professionals With same day
(by invitation)
return
6. Free lance professionals With night stay
(by invitation)
involved
800 per day AC Scorpio/Travera
(@Rs 2000 per day)
2800
1500 per AC Scorpio/Travera 2750
night (@Rs 2000 per day)
800 per day AC Scorpio/Travera 2800
(@Rs 2000 per day)
1500 per
night
AC Scorpio/Travera
(@Rs 2000 per day)
2750
1000 per day AC Scorpio/Travera 3000
(@Rs 2000 per day)
2000 per AC Scorpio/Travera 3000
night (@Rs 2000 per day)
In a month, on an average, 150 monitoring days would be involved for the training monitoring.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
12 Training
Successful Implementation of any programme depends on the capacity building of the personnel engaged. In
RCH II also ,human resource base will be created by enhancing the capacities through training .The
sensitization of health personnel towards various RCH interventions is one of the major focus of the capacity
building initiatives under RCH - II . Various trainings will be provided to State and district level managers,
medical officers, nursing staff, ANMs, AWWs, ASHA and others.
The training will be provided at the State Institute of H & FW , Regional training Institutes , ANM training
schools , District hospital ,PHCs and also in Railways , ESI ,private sector hospitals where there is enough
case load for a proper training. Some of the trainings will be contracted out to the NGOs and private players
also, so that any limitation of State infrastructure is overcome easily. [Available in detail in NGO chapter].
As BCC will be a major training aspect, it has been dealt in a separate chapter.
All the technical training programmes will ensure that.along with the theoretical inputs, proper practical
exposure is also provided. Apart from this each training programme will stress on the managerial aspect and
on the communication with the clients.
The TOTs will ensure that the trainers not only master the contents of the training topic but also aquire skills
as teachers/trainers or facilitators and motivators.The state official, trainers, professionals and functionaries
who excel in implementing training programmes will be recognized through awards and citations. A rational
selection criterion will be used to select the trainees for the trainings where the no. of trainees are limited.
Moreover promotion and posting policy will be linked to training and the functionary will have to undergo
training to avail the promotion. There will be provision for proper rational posting so that the personnel
trained, utilize their training in their day to day work.
A feedback system will be developed to assess the quality of the training. From time to time, presence of
state/regional observers will be ensured to assess the quality of district level trainings and workshops.
Detailed Records and data about personnel undergone training should be available with all concerned at all
levels. SIHFW will coordinate and monitor this with the help of district Data Officers
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Training Institutes
SIHFW
The State Institute of Health and Family Welfare (SIHFW) is the premier training institute in the state of
Bihar. SIHFW needs to be further strengthened as the apex institute in the state of Bihar for co-ordination
and implementation of all capacity building initiatives under RCH II program. SIHFW has the required
infrastructure and facilities, which need to be reinforced further so that it can conduct the various training
programs on continuous basis.
As the nodal agency for training activities in the State, SIHFW will have following major tasks:
· To develop annual training calendars based on the district action plans in close co-ordination with
RHFWTCs and ANMTCs.
· To conduct clinical and non-clinical training programs for medical officers.
· To support RHFWTCs and ANMTCs to conduct timely induction and refresher training programs for
ANMs and LHVs.
· To facilitate ongoing assessment of training needs of functionaries at all levels
· Co-ordinate and implement integrated skill development and specialized skill development training
programs.
· Conducting TOTs with RHFWTCs and ANMTCs
· To co-ordinate with SHSB for need based hiring of resource persons for the training programs
In addition, adequate provisions will be made for the institute to hire need based services of electricians,
plumbers, carpenters, etc. on contract basis.
RHFWTCs
There are Eight Regional Health and Family Welfare Training Centers (RHFWTCs) in the state Three for
male and five for female health staff. All the sanctioned posts of trainers at these institutes are filled.
However, functioning of all RHFWTCs is severely affected due to lack of proper infrastructure. The State
proposes to use the facility Survey to do a detailed assessment of the needs of these training centers. Based
on the report of the facility survey, adequate resources will be provided to all RHFWTCs to upgrade their
respective infrastructure and maintenance support.
Location of the RHFWTCs in the State:
RFWTC Male
Patna (non residential)
Muzaffarpur
Bhagalpur
RFWTC Female
Patna
Gaya
Muzaffarpur
Saran
Purnea
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
The Facility Survey will also assess the need for new Regional Health and Family Welfare Training Centers
(RHFWTCs) in the state.
ANMTCs
There are 22 ANMTCs in Bihar; the training capacity of these institutes varies from 60 to 90 participants per
batch. Most of these training centers were functioning sub-optiminaly in absence of proper infrastructure and
other essential support but after the facility survey was completed with the help of UNICEF, GoB has been
able to restart 20 ANM schools. Based on the report of the facility survey, adequate resources will be
provided for all ANMTCs to upgrade their respective infrastructure and maintenance support. Further status
of faculty positions/trainers and their requirements at ANMTCs would be assessed in course of facility
survey and then adequate provisions will be made to address their needs.
Key Training Activities
The wide range of training activities to be conducted under RCH II program by various agencies and training
institutes is outlined below. The trainings not mentioned in training plan would be taken up with the help of
development partners .Adequate changes will be made to make all the trainings as per GOI guidelines.
Maternal Health
· Provide comprehensive skill up gradation training to frontline ANC service providers (ANMs
and LHVs) to ensure delivery of quality ANC services
· Conduct training to build capacity of LHVs for effective supervision and monitoring.
· Train Aaganwadi Workers and PRI members would help in identification and motivation of
pregnant women for healthy antenatal care practices and for utilization of ANC services.
· Impart refresher training to Gynecologists and Obstetricians on safe delivery practices and
referral procedures
· Train all ANMs, LHVs, and Nurses in identification of danger signs during delivery, referral
procedures and PNC services.
· Train NGOs, Aaganwadi Workers and PRI members in raising community awareness and
knowledge about importance of institutional delivery, safe delivery practices at home, referral
and PNC services.
Child Health
· Train frontline Health workers, Aaganwadi Workers, PRIs, local NGOs and CBOs in correct
breastfeeding and complementary feeding practices
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
· Provide comprehensive skill up gradation training to immunization service providers
(LHVs/ANMs), particularly in injection safety, safe disposal of wastes and management of
adverse effects.
· Conduct training to build capacity of Medical Officers, MOICs and DIOs for effective
management, supervision and monitoring of immunization services
· Train Cold Chain handlers for proper maintenance and upkeep of Cold Chain equipment
· Train Aaganwadi Workers and PRI members in identification of children eligible for
immunisation, in motivation of caregivers to avail immunisation services and in follow-up of
dropouts
· Identify key persons to join IMNCI master training pool
· Train members of master trainer pool in national level course
· Recruit and train district trainers (using state master trainer pool)
· Train all health and ICDS staff in a phased manner
· Train frontline health workers and Aaganwadi workers in health education techniques to build
community capacity for early recognition of childhood illnesses, home-based care and careseeking
Family Planning
· Train partners such as NGO and civil society networks, religious organisations and leaders,
PRIs, ICDS, Education, General Administration, Corporate Associations and Professional bodies
(IAP, IMA) in promotion of Family Planning, at state, district and block levels
· (Re) train frontline health workers, Aaganwadi Workers and PRIs as motivators and counselors
for family planning services through IPC and counseling
· Impart technical skill-enhancement training to existing and newly appointed frontline health
workers on provision of various spacing (Oral contraceptive, condom, IUD insertion, emergency
contraception) and terminal (female and male sterilization) methods of Family Planning.
· Train doctors in various reversible and terminal FP procedures (MTP, Minilap, NSV and IUD).
Adolescent Health
· Conduct annual orientation and training of all health service providers on adolescent health
needs at state, district and block levels
· Train/sensitize community leaders, school teachers, PRIs, NGO networks, Anganwadi Workers,
towards the health needs of the adolescents
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
· Train NGO and civil society networks, religious organisations and leaders, PRI members and
teachers in promotion of safe reproductive health practices and family planning among
adolescents.
· (Re) train frontline health workers and schoolteachers as motivators and counsellors for safe
reproductive health practices and family planning among adolescents through IPC and
counseling
· (Re) train frontline health workers to provide RTI/STI curative services for adolescents
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
13 IEC/BCC
The Annual Action Plan 2009-10 for IEC/BCC has been prepared in the light of the number of
initiatives taken by Dept. of Health, GoB, and State Health Society, Bihar, in the implementation of NRHM.
It follows in essence, form and content, the National Communication Strategy. The National PIP for RCH
and instructions and guidelines received from GoI and GoB from time to time has also been kept in mind.
The selection and implementation of set of behavior change have been adopted with a view to
improve a wide range of family care-giving and care-seeking practices, and enhance supportive
environments for improved household health practices at community, institutional and policy level. The
IEC/BCC Programme will focus on building an environment favoring health seeking practices, preferably
through low cost and no cost interventions, especially for the disadvantaged and the marginalized sections of
society. This outlook will set the tone and tenor of the mobilization process for effectuating a positive change
in the existing socio-cultural mores, systems and processes.
PUBLICITY:
Print & Electronic Media Materials will be developed and publicized on different issues eg. Dial 102
(Ambulance Service), Dial 1911 (Doctors Consultancy), ICU Service, JBSY, Promotion of Breast Feeding,
Family Planning including Non Scalpel Vasectomy, Immunization, Urban Health, Adolescent and Sexual
Reproductive Health, PNDT Act, Role of ASHA under NRHM, Role of Mamta, Importance of Super
Speciality Hospitals and various PPP activities initiated by SHSB etc., through various print and electronic
media. Health Materials will be publicized on Bihar Text Book & Different types of Certificates issued by
Govt. of Bihar and others.
Outdoor Media - Hoardings, Glow Signs, Laminated Board, Flex Banners, posters, etc., on issues related to
RCH and NRHM will be put up at vantage points will be displayed at important locations like at District
Offices, Block Offices, PHCs, Haat points, Bus Stands, Railway stations, etc. Monthly magazine brought out
by the I & P.R. Dept. is being again sponsored by SHSB. Space has been allocated in the magazine for
publicizing about health related programmes. Exhibitions, Melas, Nukkad Natak functions will be organized
in each district from time to time to expand reach of different programmes. Folk Media will also be used as a
tool for publicity. Health related Posters/Banners will be displayed on Mail Van.
At the District/State level - Advocacy Programmes, workshops seminars, press conferences, etc., will be
organised for different target groups including Politicians, Media Personnel, Bureaucrats, NGOs, School
Children, etc.
Mobility Support: Vehicles will be hired on rent on a monthly basis at the State to provide mobility support
to the IEC component.
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BCC/IEC
Bihar is a state with high cultural heterogeneity. It has been a challenging area to address for the issues of
behaviour change in a heterogeneous population. Even if the language of communication in Bihar is
Hindi/maithili/maghahi/angika/bhojpuri etc the use of words and styles differs from area to area. It indicates
that no common strategy is going to work for the entire state as different areas have different dialects of
communication. Use of BCC has been one of the key components in any health sector strategy. It is essential
to modify risk prone life styles and practices to promote healthier lifestyles and practices. In past the state
have had many major rounds of social mobilizations and awareness generation which have helped to take
key health messages to even the most interior of the rural areas. But still there is a lot of space for the
improvement. High prevalence rate of malaria, kalazar. TB, filaria and sickle cell anaemia indicates the
magnitude of the problem in the state which can be reduced through behavior change approach. All these
need area specific strategies for the positive change like to motivate the people through behavior change
communication for the use of bed nets avoid water logging in and around habitation area and collection of
garbage in a common place away from the habitation. The approach would be adopted to impart attention
precise to the existing problems district wise focused manner.
BCC strategy
Development of a service oriented BCC strategy should be based on an assessment of the current status of
knowledge, attitudes, beliefs and practices regarding issues concerned with MMR, IMR, TFR and ARSH;
and factors likely to influence necessary change in behaviour. Creation of awareness of key aspects such as
breast feeding and PNDT act is particularly important. Based on evidence, the strategy should aim to
determine appropriate combination of messages and media and a mechanism for assessing impact at
appropriate stages. The institutional arrangement including role of state and district and strengthening
capacities for BCC is again important.
Behaviour Change Communication:
The Annual Action Plan for 2009-2010 for Behaviour Change Communication has been prepared in the light
of the health priorities of the Government of Bihar and the programmes it is committed to implement under
the NRHM. It draws its approach from the national communication strategy as well as NRHM and RCH
guidelines.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Despite its third year of operation, the NRHM in the state has been implemented without a comprehensive
communication strategy, which is largely due to lack of skilled human resource and professionals within the
State Health Society and Health department to carry out this specialized function of strategic communication.
The action plan therefore proposes certain initiatives that focus on institutional strengthening of the State
Health Society with human resource building consisting of communication professionals. It also lays
emphasis on capacity building of the Programme Managers and the District Managers in strategic
communication in order to ensure that communication activities do not merely remain adhoc interventions
but are based on research, evidence; are local / region specific and are built on a strong monitoring &
evaluation system.
The strategic approach will also ensure that different elements of communication and channels are employed
in a manner they complement and supplement one another leading to greater impact. The interventions will
focus on :
· Improving family care-giving and care-seeking practices
· Enhance supportive environment for improved household practices at community, institution and policy
level
· Promote health seeking practices through low cost and no cost interventions
· Pay attention to disadvantaged and marginalized sections of the society
·
Key Activities for the Year 2009-2010
1. Establishment of BCC Cell in State Health Society
In order to effectively manage the communication interventions for different programme under NRHM, a
teams of experts and professionals need to be built. Under the Mission Director of NRHM i.e. The Executive
Director, State Health Society, the following structure is proposed to be established.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Executive Director –
State Health Society
BCC Cell
BCC Coordinator
Training
Coordinator
Field
Coordinator
M & E
Coordinator
Designer /
DTP Assistant
IEC
Logistics
Assistant
MIS
Assistant
State Health Society will set up the BCC Cell with development of terms of reference, job descriptions,
identification and recruitment of suitable personnel with required skills and expertise as well their
orientation.
The BCC Cell under the leadership and over all direction of the Executive Director, State Health Society,
will then be responsible to manage NRHMs communication activities in the state.
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2. Capacity Building of Programme Managers & District Managers
Communication understanding and sensitivity is essential before any attempt to initiate activities to achieve
goals of BCC under NRHM. Since this discipline is becoming more and more research and evidenced based,
it is necessary for those to understand the concept, tools and advance techniques, who are supposed to
undertake and supervise these activities in the state. It is a well recognized fact that accomplishment of
NRHM goals largely depends upon quality of BCC inputs and its impact on behaviour and social change.
To build the capacities of senior managers and mid-level managers of the health department and that of the
State Health Society, a training workshop will be organiesd. Inputs from tools employed during capacity
assessment of State Health Society and specific need assessment for this training will feed into the design of
the training workshop. The capacity assessment exercise will aim to find :
· individual capacity of officials of SHS to carry out / implement state wide IEC / BCC activitiesexperience
& skill
· capacity in designing and developing appropriate material & programme
· training skill for the use of IEC / BCC material
· capacity in communication monitoring- dissemination and tracking of progress
· capacity for storage and appropriate distribution IEC / BCC material
Besides this, it will contain topics such as
· Understanding of communication as a process
· Multistage thinking
· Frame work and elements of communication research
· Designing a communication campaign
· Elements of an effective communication plan
· Channels and tools for communicating the message
· Multi channel approach
· Skills to use communication material
· Communication monitoring
· Evaluation
All these topics will be dealt in the light of new research and thinking in the area of development
communication.
3. Development of Health Communication Strategy
The health communication strategy for the state will be developed through a participatory process involving
experts, programme managers and government officers and will be consistent to the overall programme
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
strategy for NRHM and RCH. It will aim to reposition different programmes and services under the NRHM
in a health framework -that is, offering good health as the reward for families leading to other economic and
social benefits. The communication strategy will attempt to cover the following :
· Review the current status of NRHM programmes in the state
· Identify potential communication strategies
· Select the most appropriate approach
· Identify primary, secondary and tertiary audience segments
· Introduce the action plan with audience-media-message framework from which will evolve the
communication plan for every programme
The strength of any communication lies in it being is contextual and specific. It is essential to formulate
a state specific communication strategy to reach to the masse with right kind of messages and through
appropriate channels. Bihar is socially and economically backward but culturally very rich. It has many kinds
of festivals associated with agriculture seasons, melas, huge religious congregations, community gathering
etc which provide a unique opportunity to disseminate messages. Can this cultural and traditional richness
become central theme of proposed communication strategy of Bihar? These are kind of questions for which
experts will brainstorm.
SHSB will lead the process of communication strategy development with technical inputs as well as
formations of core groups of national and state level experts for development of Bihar specific
communication strategy. SHSB will work in carrying out a comprehensive formative research and to pilot
some concepts in the identified programme areas that will help in designing the strategy. This research will
include :
‣ review of existing state communication plan, if any,
‣ social and cultural norms, practices & customs,
‣ opportunities for entertainments and festivals, occupation-livelihood, daily life style
‣ socio-economic indicators
‣ available and popular means of communication.
The core group will provide strategic communication recommendations and guidelines. Broadly out come of
this strategy development initiative will be
· Strategic Communication positioning for the state of Bihar
· Communication goals of the state
· Means to achieve communication goals - resources
· SHS's preparedness to accomplish these goals - infrastructure, allocations and capacities
This communication strategy will help the state health planners to
· Increase impact of communication drives / campaigns initiated by the state
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
· Use time, people and resources more efficiently
· Exploit opportunities - use of cultural and traditional richness of Bihar
· Prevent potential problems
4. Communication Plans for Different Programmes under NRHM
While the institutional strengthening and communication strategy development process will be carried out,
communication plans for different programmes under NRHM will be prepared and implemented under the
2009-2010 PIP with technical support from different internal / national agencies and partners.
Broadly, the multimedia communication around the above issues will follow the following approach :
The state and district health communication plans for different programmes / issues will be prepared by the
State Health Society. The communication plan will have following components :
· Identification of issues to be communicated - NRHM's objectives
· Identification and planning regarding communication channels guided by the state communication
strategy
· Capacity building of service providers- IPC, skills to use material and issues
· Distribution and dissemination plan of communication material
· Monitoring and evaluation mechanisms
SHSB will work in the development of communication plans and materials for various programmes covered
under NRHM Part A, B and C of the SPIP.
Inter Personal Communication, counseling by trained functionaries supported with various social
mobilization and mass media activities will be built into communication plan for each programme under
NRHM.
5. Skill Building of Frontline Functionaries
Inter Personal Communication being the core element of the communication package and the lead medium, it
is imperative to build the skills of frontline functionaries who are in direct interface with the communities at
household and / or facility level. SHSB will create a pool of trainers at State, District and Block levels on :
· Use of Interpersonal Communication and counseling techniques to promote health seeking behaviors
in the context of issues identified under RCH II.
· Appropriate and effective use of communication tools and materials
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
In order to build the skills of service providers around a number of issues, State Health Society will develop
and use a training module based on Facts for Life (FFL) framework. A detailed training and monitoring plan
using cascade approach and also SATCOM training technology (on pilot basis) will be developed and
implemented.
6. Institutional Strengthening of IEC Bureau
In order to mainstream strategic communication in all health programmes, revival and strengthening of IEC
Bureau as the nodal body for implementation of all health communication is necessary. State Health
department will review the current status of the Bureau and prepare an action plan plug the gaps in terms of
human resource as well as directives and operational guidelines. This will serve a long term objective of
sustained communication interventions as against the campaign mode of communication activities.
A well planned IEC/BCC strategy and implementation framework is being placed and
District Level IEC plans is being prepared. This year our focus was to make programmes based on this. The
basic constraint here was to reinforce the need to understand the importance of IEC/BCC planning for local
specific and outcome based BCC programmes. The state lacks a rigorous planning unit that conceptualizes
and strategizes the programmes and an implementing team that realizes these programmes to the expected
levels. We are planning for adding this as part of this PIP.Currently, the key strategy adopted by the state is
folk art based on Kalajathas, wall writings, printed posters and handouts, TV/Radio interventions etc, some
innovative strategies were adopted. It has been found that the current state level centralisation of this needs to
be shifted to local level strategies, for which a policy has been formulated. This year, we are also planning to
have specific focus on IEC areas for each month.
Objectives of Behaviour Change Communication:
Empowering the family and individuals to take health related decisions based on information and analysis
Motivating the community to play a proactive role in improving their health status
Effective greater utilization of health services through an improved public understanding of health care
Mainstreaming gender and equity and strengthening governance through BCC strategy
Creating competencies and enabling environment to assist with the above objectives
Key strategy and activities for Behavior Change Communication
Developing IEC materials and designing campaigns for area specific and different age
groups- by social, linguistic and ethnic characteristic
Distributing BCC kit (flip chart, flash cards, resource book on local food,
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
complimentary feeding decision chart, films etc) to the Mitanins and building their
capacity through training for its proper and effective use.
Key areas on RCH behavior
The BCC/IEC cell will be set up at the directorate. To establish BCC/IEC cell will need
to have necessary equipments like computers with adequate software back up fordesigning, printers, printing
materials, stationeries and furniture etc. Strengthening of
the BCC/IEC cell will be done by in sourcing technical experts (3 technical experts) of the subject like
nutrition, communication, medical doctors, graphic artist and designersfor the effective designing of the
communication strategies etc. The function of the BCC cell would be
To design the behaviour matrix- communication strategies and media materials in order to ensure in-house
production.
The in-house materials production (films, radio programs, posters, kalajattha, etc) this will serve as
reference materials on health and will also be used by other department for IEC.
The cell has to make operational framework for BCC.
It will work in coordination with the other relevant departments by incorporating the ideas and components
relevant to the context of the subject.
Intersectoral coordination for BCC on common intervention with W&CD, PHED, Education, Health,
SCERT, Unicef, CGSACS Doordarshan etc
94 Major emphasis would be given on awareness generation on behaviour change. The action planned for
this is to use combination of mediums for the reach and penetration of the messages. Radio would be used as
a strategy at the district level for the penetration of the messages and for the dissemination of the district
specific messages
Comprehensive approach shall be taken up to address the health related problems like imparting life skill
education to the adolescent groups, distributing BCC kit to the ASHAs, using combinations of mediums for
the dissemination of the messages .
Advertising of different programmes of NRHM in different types of certificates issued by
BDO/CO and Block Informatics Centre established by Rural Development Department, Govt. of Bihar
Under the Rural Development Department, GoB in all the 533 blocks, Block Informatic Centres have been
established whose implementation and maintenance has been given to an outsourced agency under PPP for 3
years. Major work of these centres is generation of various certificates to be issued by CO/BDO and SDO.
Various certificates to be issued are Caste certificate, Income Certificate, OBC certificate, Birth and Death
certificate, LPC certificate, Character certificate, Residential proof certificate etc.
Altogether in a day yearly 60,000 certificates are issued, that means 18.00 lakh in a month and about 2.00
crore per annum. These certificates can be a very good medium of advertisement as the certificates are
obtained by people belonging to different status and are preserved properly for a long period of time.
The certificates shall have the certificates on the front side however back side will be blank. The concerned
Department has also authorized the Outsourced agency to generate advertisements for printing on the back
side of the certificate.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
The Proposal
The SHS aims to utilize this opportunity to advertise NRHMs various programmes on these certificates
through which information and benefits of the programmes can reach to nearly 1.5 to 2.00 crore families.
These advertisements shall exist on these certificates for ever and can act as an effective medium for
Governments advocacy.
Budget Expense Estimate:
Coloured advertisement per Certificate cost -Rs.1,50 p and for black and white advertisement Rs.1.00 p.
For advertisements on approximate 2.00 crore certificates, anticipated expenditure would be Rs.3.00 crores.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
14. Procurement of Equipments/Instruments and Drugs/Supplies
Details annexed
Strengthening Life Saving Skills for Anesthesia (LSAS) Part A
Procuring equipment for the Anesthesia departments in six medical colleges
In Bihar state, LSAS training is being undertaken in all six Government Medical Colleges for the
last two years. A total of 55 doctors have been trained in LSAS till now. All the six medical
colleges in the state are imparting this training. Monitoring visits to all Medical Colleges has been
undertaken by UNICEF Health Officer Dr O P Kansal, Dr Himanshu Bhushan from GoI and Dr A
K Tiwari, Programme officer for Anesthesia trainings, in the last one year. An exposure visit was
also organized to Gujarat comprising State Programme Officer, all Heads of the departments of
Anesthesiology and Health officer, UNICEF in April, 2008.
In the last one year, there have been many formal and informal discussions with the heads of the
Anesthesia departments of all the medical colleges. With the technology update taking place all
around, the anesthesia departments in the state need strengthening of the basic infrastructure. The
departmental heads had submitted a proposal to this effect about a year ago. It is proposed to spend
Rs. Nine crore (@Rs One and half crore for each of these colleges) to help them procure the
equipment. This in terms will help the trainees of LSAS training grasp the skills as per the current
technology. A simple indicative list of the equipment required is given in the table below.
S No Equipment Requirement
1 Anesthesia workstation For all colleges
2 Boyles apparatus latest 3 sets for each
model
college
3 Fibreoptic
nasopharyngolarryngoscope
One for each
college
4 Anesthesia emergency One for each
resuscitation kit
college
5 Ethylene Oxide sterlizer One for each
college
It is worth mentioning that the funds to the state medical colleges would be released as per the need
and therefore fresh proposals would be invited from them after the GoI approval.
Additional Suggested Action Points:
1. Third party review of Anesthesia trainings: It is requested to get a review, of the LSAS
training process in Bihar, conducted by Anesthesiologists of National repute already
associated with GoI. Based on the assessment, the State Health Society, Bihar can be
requested to fill in the gaps.
2. Reorientation of Anesthesia trainers: There are two to three Anesthesiologists in each
medical college who were trained in LSAS training about two years ago. A reorientation of
all these trainers, for two days in Patna by GoI identified trainers, can be helpful in adhering
to the standard training protocols and thus improving the quality of the trainings. A tentative
amount of Rs Five lakhs is being proposed for this.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
3. Identification of five district hospitals having good anesthesia facilities where the trainees
may be deputed for 10 weeks during the total training period of 18 weeks.
4. Continuous field monitoring: The State has an established Quality Assurance Cell. Quality
check of LSAS trainings also form a part of this cell activity. A regular (once a month for
each medical college) monitoring visit should be conducted.
5. Immediate posting plans for the LSAS trained doctors in the designated FRUs should also
follow.
6. Infrastructure strengthening process at the FRU level to give requisite working
environment to the LSAS trained doctor should also be completed.
7. Voluntary application/nomination system for the future batches of LSAS trainings should
be proactively encouraged by the state.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
16. Programme Management
Programme management arrangements have been made at state, district and block level. The entire NRHM
including RCH is governed by the highest body i.e. State Health Mission chaired by the Honble CM. The
SHSB functions under the overall guidance of the State Health Mission.
State Health Mission
Composition
· Chairperson : Chief Minister
· Co-Chairperson : Minister of Health and Family Welfare, State Government
· Convener : Principal Secretary/Secretary (Family Welfare)
· Members :
Ministers in charge of Departments relevant to NRHM such as AYUSH, Women and Child
Development, Medical Education, Public Health Engineering, Water and Sanitation,
Panchayati Raj, Rural Development, Social Welfare, Urban Development, Planning,
Finance, etc.
Nominated public representatives (5 to 10 members) such as MPs, MLAs, Chairmen, Zila
Parishad, urban local bodies (women should be adequately represented)
Official representatives: Chief Secretary/Development Commissioners and Principal
Secretaries/Secretaries in-charge of relevant departments such as Women and Child
Development, Public Health Engineering, Panchayati Raj, Rural Development, Tribal
Welfare, Urban Development/Affairs, Finance, Planning and Representative, MoHFW, GoI,
Director (Health Services)/Director (AYUSH).
Nominated non-official members (5 to 8 members) such as health experts, representatives of
medical associations, NGOs, etc
Representatives of Development Partners.
State Health Society
Objectives of the Society
To provide additional managerial and technical support to the Department of H &FW, Government
of Bihar for implementation of National Rural Health Mission which includes RCH II, General
Curative Care, National Disease Control Programme and AYUSH
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Governing Body
Governing Body has following members.
(i.) Development Commissioner, Govt. of Bihar- Chairperson
(ii.) Finance Commissioner, Govt. of Bihar- Deputy Chairperson
(iii.) Secretary, Dept. of Health & Family Welfare, Govt. of Bihar- Chief Executive Officer
(iv.) Secretary, Dept. of Medical Education and ISM, Govt. of Bihar- Member
(v.) Secretary, Dept. of Planning- Member
(vi.) Project Director, BSACS- Member
(vii.) Director, ICDS, Bihar- Member
(viii.) Executive Director, SHSB- Member Secretary
Executive Committee
Executive Committee consists of following members.
(i.) Secretary, Dept. of Health & Family Welfare, Govt. of Bihar To preside .
(ii.) Executive Director, SHSB- Member Secretary
(iii.) Director in Chief, Health Services, Govt. of Bihar- Member
(iv.) Joint Secretary/ Deputy Secretary, Dept. of H & FW, Govt. of Bihar- Member
(v.) Additional Director, Dept. of H & FW, Govt. of Bihar- Member
(vi.) Representative of UNICEF- Member
(vii.) Representative of WHO- Member
(viii.) Representative of European Commission- Member
(ix.) Representative of Ministry of H & FW, GOI- Member
(x.) Regional Director of H & FW, GOI- Member
Project Appraisal Committee (PAC) comprises of
(i.) Executive Director, SHSB
(ii.) Director in Chief, Health Services, Govt. of Bihar
(iii.) State Representative, UNICEF, Bihar
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
(iv.) Regional Coordinator, WHO
(v.) Regional Director, Regional Health Directorate, GOI
(vi.) Programme Officer- SHSB- Tuberculosis
(vii.) Programme Officer- SHSB- Kala Azar
(viii.) Programme Officer- SHSB- Leprosy
(ix.) Programme Officer- SHSB- Blindness
(x.) Assistant Engineer-PWD, Bihar
(xi.) Joint Secretary, Finance Department, Govt. of Bihar
(xii.) A representative of Vigilance Department
‣ A project Appraisal Committee (PAC) shall consider the district plans and other expenditure
proposals.
‣ All proposals will be submitted to the concerned authority having delegated powers provided for
final approval. In case the designated authority does not agree with the recommendations of the
PAC, she/he shall record the reasons for such disagreement and may include the proposal in the full
meeting of the Governing Body which shall have the full powers to accept/ reject the
recommendations of the PAC provided that the reasons for rejecting the PAC recommendations shall
be recorded in the minutes of the GB.
Financial powers of the bodies/office bearers
Type of Expenditure
Extent of powers
A. Approval of District/city plans Full powers to the Governing Body, provided that
the plan(s) have been endorsed by the Project
Appraisal Committee (PAC).
B. Allocations of funds Full powers to the Governing Body.
C. Approving programme and campaign Full powers to the Governing Body.
activities under NRHM
D. Hiring of contractual staff, including sanction
of compensation package
For Staff of Category A &B of Organogram-Full
powers to the Chairperson of the GB provided
the contracts shall be for a period not exceeding
11 months at a time.
112

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
For Staff of Category C of Organogram- Full
powers to the Executive Director subject to the
compensation package approved by the GB,
provided the contracts shall be for a period not
exceeding 11 months at a time.
E. Release of funds for implementation of plans
Full powers to the ED.
approved by GB/EC
F. All related activities in pursuance of State /
Full powers to the ED.
District plan approved by GB, such as
Advertisement charges, Advance to contractors,
Repayment of earnest money/security deposit,
Freight charges, demurrage, Furniture &
fixtures(within Budget limit),stationery,
conveyance, electricity & water charges,
Insurance, legal charges, postage, telephone, Fax,
Repair and maintenance of equipment, Hiring of
taxis, Auditors, all trainings, payment of TA/DA
/Honoraria to resource persons, workshops,
training material, books, TA/DA to society staff,
payment related to documentation etc.
State Level (State Programme Management Unit):
Following are the Support staff of State Programme Management Unit
SL Designation No.
Salary
Pm
Salary
Pa
10%
Total
(E+F)
1 State Programme Manager 1 33000 396000 39600 435600
2 Consultant NRHM 1 30000 360000 36000 396000
3 Data Asstt. Cum System Analysis 1 25000 300000 30000 330000
4 Consultant Cold Chain 1 25000 300000 30000 330000
5 Consultant - Maternal Health 1 25000 300000 30000 330000
6 Consultant-Child Health 1 25000 300000 30000 330000
7 Media Expert 1 20000 240000 24000 264000
8 Consultant Procurement and Logistics 1 25000 300000 30000 330000
Consultant Accounts Manager(Salary
9 Rs.15000/- Pension Rs.Rs.7495.00) 1 7505 90060 9006 99066
10 Accountant 1 15000 180000 18000 198000
113

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
11 Store Keeper 2 8000 192000 19200 211200
12 Clerk cum Steno 1 11000 132000 13200 145200
13 Data Assistant 6 9000 648000 64800 712800
14 Computer Operator 1 8000 96000 9600 105600
15 Accountant 1 15000 180000 18000 198000
16 Executive Assistant 8 9000 864000 86400 950400
17 Computer Operator-cum-Steno 10 8000 960000 96000 1056000
Total 5838060 583806 6421866
A 10% hike in salaries per year has been recommended in the PIP and is part of RCH II budget.
The Overall picture of programme management functioning is as follows
Governing Body
Executive Committee
Secretary Health & family welfare-cum- CEO SHSB
Executive Director, SHSB
State Management Unit
38 District Health Societies
Rogi Kalyan Samitis at the Hospitals till Block levels
District Health Societies
The society shall direct its resources towards performance of the following key tasks:-
· To act as a nodal forum for all stake holders-line departments, PRI, NGO, to participate in
planning, implementation and monitoring of the various Health & Family Welfare Programmes
and projects in the district.
· To receive, manage and account for the funds State level Societies in the Health Sector) and Govt.
of India for Implementation of Centrally Sponsored Schemes in the Districts.
· Strengthen the technical/management capacity of the District Health Administration through
recruitment of individual/ institutional experts from the open market.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
· To facilitate preparation of integrated district health development plans.
· To mobilize financial/non-financial resources for complementing /supplement the NRHM activity
in the district.
· To assist Hospital Management Society in the district.
· To undertake such other activity for strengthening Health and Family Welfare Activities in the
district as may be identified from time to time including mechanism for intra and inter sectoral
convergence of inputs and structures.
Governing body of DHS
1. District Magistrate & Collector Chairperson
2. District Development Commissioner (CEO Zilla Parishad) Vice Chairperson
3. District Social Welfare Officer Member
4. Executive Officer, Municiplity, Saharsa Member
5. Addl. Chief Medical Officer Member
6. District RCH Officer Member
7. Deputy Superintendent of the District Hospital Member
8. Civil Surgeon Member Secretary
Executive Body of DHS
1 Civil Surgeon of the District Chairperson
2 Additional Chief Medical Officer Cum member Sec. DBCS, Member
Saharsa.
3 District RCH Officer, Member
4 District Leprosy Officer, Member
5 District T.B. Officer, Member
6 District Malaria Officer, Member
7 District Programme Manager (ICDS) Member
8 Chief Executive Officers Nagar Nigam, Member
9 Deputy Superintendent, Sadar Hospital Member Secretary
10 Sec. IMA Member
11 Sec. Indian Red Cross Society, Member
115

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
District Programme Management Support unit Consist of Following Personnel:-
1. District Programme Manager
2. District Accounts Manager
3. District Data Asstts
Financial Management
FUND FLOW MECHANISMS AT STATE
Presently the State Health Society is getting Grants-in-Aid from GoI through electronic transfer by crediting
the A/c of SHS. These funds are transferred to District Health Society A/c as Untied funds as per their
respective District Action Plans, which then get flowed to the CHCs, PHCs, district hospitals and RKS for
smooth conduct of the activities of RCH- II.
On the same lines of the GOI regarding transfer of funds, SHS is under the process of implementing the
system of e-transfer of funds to the districts and blocks. This process is likely to be completed very soon.
116

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
FUND FLOW
MOHFW, NEW DELHI
By E-Transfer
STATE HEALTH SOCIETY
BLOCKS
DISTRICT HEALTH SOCIETY
through A/c payee cheques
PHC, CHC
R.K.S
NGOs
OTHER
AGENCIES
OPERATION OF BANK ACCOUNTS
· The Account of State Health Society is being operated as per the delegated powers.
· The persons authorized as per the powers delegated to them are also operating the bank accounts of
DHS.
ACCOUNTING PROCEDURES FOLLOWED
The State is following the Double Entry System of accounting on Cash Basis.
For the sake of convenience in consolidation of accounts districts are also instructed to follow the same
system.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
In addition to this for proper accounting and maintenance of books, a manual cum guidelines had been issued
to the districts. Also the monthly auditor appointed at each district is reporting on the accounting procedures
followed by the districts on a monthly basis, along with the deviations, if any.
FINANCIAL MANAGEMENT AT STATE
The Financial Management group at state consists of the State Finance Consultant and state accounts officer.
Similarly at districts also the DAM is looking after the financial matters
FINANCIAL MONITORING
The financial monitoring is being done through the understated mechanisms-
1. Analysis of SOEs submitted by the districts and its comparison with audited expenditures on
monthly basis and reconciliation of the same by the financial consultant.
2. Training cum discussion meets with all the districts officials at regular intervals.
3. AUDITS:
a) Comprehensive audit (Annual) as per the Directions of GoI. The auditor for the F.Y 2007-08
has been appointed and they have initiated the audit of DHSs accounts.
b) Monthly Audit is being conducted and reports are submitted to state regularly which are then
reviewed.
c) Audit by CGA officials is also going on as on date.
Appointment of CA at SHSB & C.A. Level
Due to increase in funds flow & for maintenance of Accounts as per NRHM guidelines, all the DHS were
directed to appoint C.A. at a monthly cost of Rs.20, 000/- P.M. Similarly; CA. at SHSB level is to be
appointed soon.
Budget:
Activity @ Proposed Budget
Audit of SHSB/DHS by CA for 2009-10 Rs. 6,00,000/-
Appointment of CA at SHSB @25000/- PM x 12months 3,00,000/-
CA at DHS level 20,000x38x12 91,20,000/-
Total 1,00,20,000/-
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Constitution of Internal Audit wing at SHSB:
Internal Audit wing is proposed to be constituted in 2009-10 in which services of 6 retired officers form
Recognised Audit & Accounts Services will be engaged, who will be well versed in Audit work.
Budget:
Activity @ Proposed Budget
Last pay drawn Pension = Approx exp of 20,000x6x12 14,40,000/-
Rs.20,000/-PM
TA/DA for Audit 1000x6x30x12 21,60,000/-
Training of SHSB/DAM/BHM) FM Group Head Quarter
36,00,000
level=6x1500x12=1,08,000/-
DAM=38x1500x4=
2,28,000/-
BHM=538x1500x4=32,28,000/-
Total 1,00,20,000/-
119

CEO
ED
ED Cell
Steno cum CO
PA/DA-1
Clerk cum-Steno E/H -
2
Computer Operator-1
I/C Adm.
Storekeeper
Pharmacist
PO T.B.
PO
Imm
PO
Fi
PO N
POK
POBl
.
POL
PM
P&A
IEC
MCH
CC
DO & SA
MF
M A/C
Tech.
Wing
­
­ ­ ­ ­
­
ind
nes
s
­
Steno cum CO
CP
DA-1
CO-3
Steno cum
CO
FO
Accountant-
3
Astt. Eng.
DA-2
1P & A
- Personnel & Administration
2POBl
- Programme Officer Blindness
3PON
- Programme Officer Nutrition
4POK
- Programme Officer Kala-Azar
5PO Fi
- Programme Officer Filaria
6PO Imm
- Programme Officer Immunization
7MF
- Manager Finance
8MA/C
- Manager Accounts
9PM
- Programme Manager
1FO
- Finance Officer
1CO
- Computer Operator
1DO & SA - Data Officer & System Analyst
1POL
- Program Officer Leprosy
1MCH
- Maternal & Child Health
1CC
- Cold Chain
1Asst. Eng - Assistant Engineer
1CP
- Computer Programmer
1DA
- Data Assistant
1PA
- Private Assistant
Steno cum
CO-1

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
17. Convergence and Coordination
Coordination with other departments such as ICDS, PHED, Education and Panchayat Raj is important for
tackling health issues. The involvement of representative of these departments help the health service
providers in reducing the maternal mortality, Infant Mortality and increase the coverage of Family Planning
Service and Adolescent Health Service. The state would take certain initiatives to ensure a synergistic effort
from the community level to the state level which is defined in part E along with a detailed budget
18. Role of State, District and Blocks
The role of State, District and Block are well defined. The role of each one has been clearly indicated in the
workplan (Annex 3 d) as per activity wise. The decentralization process has given more roles to Districts and
Blocks to perform in executing the various programs. The State mainly looking after Monitoring, Policy
decisions, Centralize capital purchase, technical support etc and help the district in execute the actions
planned.
19. Monitoring and Evaluation
One of the major weaknesses of the RCH program in the Bihar is the absence of an effective Monitoring and
Evaluation system that would provide accurate and reliable information to program managers and
stakeholders and enable them to determine whether or not results are being achieved and thereby assist them
in improving program performance. A triangulated process of Monitoring and Evaluation would enable cross
checking and easy collection, entry, retrieval and analysis of data.
Activities
ü Strengthening and up gradation of monitoring and evaluation cell
ü Mobility support
ü Equipping and furnishing demographic cells
ü Conducting survey and concurrent evaluation
ü Formation of Databank
ü Revised CNAA for all levels would be persuaded and guidelines for preparation district plans
ü Web/internet based computer software for use at district and state level
ü Reporting formats for providing requisite information
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
ü Road map of each health centre for easy communication
ü Triangulation of data
Triangulation Process for Monitoring and Evaluation
Computerized MIS
Community Monitoring
Focused Studies
Monitoring
Key progress
indicators
Evaluation
Input Indicators
· Staff
position,
· Training &
orientation,
· supplies,
· frequency of
immunization
Output
Indicators
· Maternal
Health
Indicators
· Child
Health
Indicators
· Family
Planning
· Adolescent
Key Finanacial
Indicators
· Percentage
funds
received by
state
according to
schedule
· Percentage
funds
disbursed to
districts
Key
Development
Indicators
· MMR
· IMR
· NMR
· TFR
Key Development Indicators
The key development indicators for measuring progress in reaching the overall project development
objectives for the RCH programme in the state are as follows.
· Maternal Mortality Rate
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
· Infant Mortality Rate
· Neonatal Mortality Rate
· Total Fertility Rate
Key progress indicators
Key progress indicators enable the monitoring of delivery of project inputs and the achievement of project
outputs.
Table : Examples of Input Indicators
Institutional
Strengthening:
Infrastructure
Institutional
Strengthening:
Human Resource
· No. of new · No. of health
facilities
personnel
constructed appointed
· No. of new · No. of health
facilities
personnel
upgraded
trained for
· No. of essential capacity
equipment
building
Programme
HMIS
Supervision
management
· No. of programme
managers
appointed at
state/district levels
· No. of programme
managers trained at
state / district
levels
· Number of
operational
equipment such
as computers
supplied to
reinforce HMIS
· Number of new
formats
developed
· Percentage of
work
computerized
supplied
Key financial indicators
Key financial indicators help assess the project's budgetary and financial health.
· Percentage of funds received by state according to schedule
· Percentage of funds disbursed to districts
· Percentage of funds disbursed to districts according to schedule (within 15 days)
Percentage of utilization of funds against allocation by state / districts
The National Rural Health Mission has been launched with the aim to provide effective health care to rural
population. The programme seeks to decentralize with adequate devolution of powers and delegation of
responsibilities has to have an appropriate implementation mechanism that is accountable.
In order to facilitate this process the NRHM has proposed a structure right from the village to the national
levels with details on key functions and financial powers. To capacitate the effective delivery of the
programme there is a need proper a proper HMIS system
Regular monitoring, timely review of the NRHM activities should be carried out. The quality of MIES in
State HQ and in districts is very poor. Reporting and recording of RCH formats (Plan and monthly
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
reporting) are irregular, incomplete, inconsistent and few districts are not reporting at all. Formats are not
filled up completely at the sub center level. There information is not properly reviewed at the PHC level. No
feedback is provided upon that information.
For overall management of the programme, there is a Mission Directorate and a State Programme
Management Unit in the state. The Unit is responsible for overall monitoring and evaluation of the
programme in the state and the districts. The data gathering is being facilitated by the state, District and PHC
data Centres. The numerous formats being used have been reviewed and it is found that data needs to be
compiled only as per RCH, NRHM programme and State needs. Hence the new MIES formats have been
shared with all the health functionaries and it is expected that they shall be reporting in the new formats from
the 3 rd quarter after brief orientation training.
At district level, there is a District Health Society who will be responsible for the data dissemination from the
sub-district level to the district level. Data Manager/HMIS expert at the State level and Data Assistant at the
district level will be responsible for management of HMIS.
As such, there will be a Monitoring Team constituted each at state and district level to monitor the
implementation of the NRHM activities. The Team will comprise of representatives from the Mission
Directorate and Programme Committee for various health programmes. The Team will also comprise of
representatives from Govt. of India.
There is Hospital Management Committee/ Rogi Kalyan Samity at all PHCs and CHCs. The PHC / CHC
Health committee will monitor the performance of SC under their jurisdiction and will submit the report. The
PHC/ CHC health committee will monitor and evaluate the SC performance .and performance will be
submitted to the District, which will compile and sent it to the state.
REPORTS REQUIRED FROM DHS
· Monthly Fund flow statement
· Form -9 (accurate and fully filled)
· ASHA selection and training report
· Mobile Medical unit (if working )
· Janani Evam Baal Suraksha Yojana Reports (no. of institutional deliveries, Deliveries under
JBSY,No. of Pvt Institutions accredited)
· Immunization reports. Vaccine wise coverage
· Training reports of the current trainings being given in the district or being under taken by district
officials
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
· 24 X 7 PHC working, Status of telephones working , No. of ambulance and their usage, monitoring
of doctors and ANMs presence, No. of OPD patients, No. of IPD, No. of referrals, No. of deliveries
being conducted
· Rogi Kalyan Samitis formation and working , meetings of RKS
· Sub centre untied funds, Joint A/c of ANM and Panchayat member (female), UCs of untied funds
· Integration of AYUSH at PHC level
· Availability of essential drugs, Vaccines, AD syringes in DH, SDH, PHC, SC
· Contract Appointment of doctors, ANMs, Staff Nurses and other Staff
· Health melas, No. of beneficiaries
· Family planning services, male steris, female steris , IUD,
· MNGO working (if present)
· Other Special programmes specific to the district
· Quarterly Finance Management Report
The DPM along with the DAM (in financial matters) shall be responsible for compilation and timely
reporting
Table : HMIS Forms
Form No. Information Filled by
Form No.1 General information, no. of births, Cases of complicated ANM
pregnancies and deliveries, sick newborns , RTI/STD cases, oral
rehydration performance data [action plan by ANM or SC]
Form No. 2 Deliveries, MTPs ,RTI/STD, Immunization, need assessment of PHC level
individual ANMs [action plan for PHC]
Form No. 3 Sterilization, ,immunization, services in obstetric care STI/RTI Sub division
[action plan for FRU/Subdivision/DH]
level
Form No. 4 District action plan District
Form No. 5 State action plan State level
Form No. 6 Monthly report by ANM ANM
Form No. 7 Monthly report by PHC PHC
Form No. 8 Monthly report by FRU/Subdivision FRU
Form No. 9 Monthly report by District District
125

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Action plan Forms
Form 5
1. State Staff position,
2. Training & orientation,
3. supplies,
Form 4
District Action Plan
Compilation of Action Plans submitted by all PHCs, FRUs, Sub-Divisional
Hospitals at the District Hospitals and submitted to the State
Form 1
HSC Action Plan
Prepared by: ANM with
the help of DFWO
Submission: Once in a
year, Feb-March
Form 2
PHC Action Plan
Prepared by: PHC, LHVs
& ANMs
Submission: Once in a
Year, Feb-March
Form 3
FRU/SDH Action Plan
Prepared by: Sub
Divisional Hospitals
Submission: Once in a
Year, Feb-March
Reporting Forms
Form-9
Compiled at: District Level
Responsibility: CS/ACMO
Flow of form: District to State
Submission: 25th of each month
Form-8
Form-7
Compiled at: FRU/SDH Level
Responsibility: MOIC
Flow of form: Hospital to District
Submission: Monthly
Compiled at: PHC Level
Responsibility: MOIC
Flow of form: PHC to District
Submission: Monthly
Form-6
Compiled at: HSC Level
Responsibility: ANM
Flow of form: HSC to PHC
Submission: Monthly
126

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
20. Synergie with NRHM Additionalities
The NRHM is an effort to bring about the architectural change to overall program management to enable
rationalization of resources and simultaneously to augment then limited resources so that equity in health is
ensured. The commonality of initiatives in the following areas would be complementing the similar efforts
under NRHM;
• Infrastructures for facility development,
• Manpower recruitment,
• Capacity building through training, program management, institutional strengthening, organizational
development,
• Communitization,
• Promotional efforts for demand generation and
• Improved monitoring & evaluation systems developed under RCH II
• Public Private Partnership
• Convergence & Coordination
.
The convergence approach which was mooted earlier now finds a clear policy initiative and procedural
development by health and all health determinants sectors so that a joint effort is made in tandem from
planning to impact evaluation / outcome to ensure investments in health reach the poor /
unnerved/underserved/excluded segment of the population. These common efforts would also strengthen
gender equity through adolescent and other initiatives of both RCH & NRHM to provide a safety net to
young women and girl children.
127

NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
21. Sustainability
The usage of government services in Bihar has certainly picked up with number of patients increasing
manifolds due to free drugs and availability of doctors at PHC level. Similarly there has been an
unprecedented increase in number of deliveries being conducted at government health facilities under Janani
Baal Suraksha Yojana This can be largely attributed to huge influx of funds under NRHM. To hedge the
growth from lack of funds and for its sustainability Government of Bihar has already applied user charges for
pathology and radiology services. The ambulance user charges are being determined by Rogi Kalyan
Samitis. The state already has paying wards in our medical colleges and GoB is contemplating having such
wards in all district hospitals too.
For sustainability of manpower incentives for specialist services and for postings in rural areas have been
proposed in this Programme Implementation Plan. Government is working on Dynamic ACP and Cadre
division of doctors for providing them better benefits.
Private parties are also being encouraged to make investments in Health sector so that the sector doesnt
become dependent on NRHM funds. However they would be urged to take up mapping of available facilities
and also analysis of demand before investing and providing services so that any duplication may be avoided.
Moreover GoB is also increasing its allocation to health sector. This year the state government proposed to
establish Emergency Medical Service, Dialysis Unit, Telemedicine system under PPP initiative. The state
also increasing the number of Adll PHCs to be outsource to the NGOs.
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
22. Extra Inclusions in RCH
IFA (Details Annexed)
Maternal and perinatal death inquiry and Response:
Maternal and perinatal death inquiry (MAPEDIR) is an operational tool that strengthens community
participation in evidence-based planning. MAPEDIR aims to help healthcare providers and community
members understand the
avoidable factors that underlie maternal and perinatal deaths and to identify ways to prevent these deaths. The
main objective of introducing MAPEDIR is to develop a framework for the assessment of maternal and
perinatal deaths and implementation of effective, high impact strategic interventions through:
1. Sensitizing communities to maternal and perinatal health issues, including the need for birth
preparedness, complication readiness,
2. Identifying maternal deaths and conducting community-based inquiries with close acquaintances of
the women to find ways to prevent maternal deaths;
3. Sharing the findings with communities, helping them interpret the data and develop appropriate
interventions and advocate for improvements in health care-seeking; and
4. Using the findings to advocate with policy makers for improvements in maternal health care.
Maternal and perinatal death inquiry and Response:
In the year 2007-2008, UNICEF has piloted the MAPEDIR in Vaishali District. GoB proposes to take will
take it to scale to 2 more districts (Kishanganj and Jehanabad) in 2009-10 with UNICEF support as part of
the next Annual NRHM State Plan.
Major Activities
Identification of Staff: Supervisors, Interviewers and Notifiers
£ Identification and selection and training of the supervisors and interviewers (ANM and LHVs) will
be conducted supported by UNICEF. Selection of Notifiers (ASHA workers)band their one day
orientation will take place.
Capacity Building of Staff: Supervisors, Interviewers and Notifiers
£ Once the identification process is over, a four day training of the Interviewers and the supervisors
will be conducted to educate them over the entire concept of MAPEDIR and the implementation
process.This training will be conducted with UNICEF support.
£ Once the training of supervisors is over, a one day orientation of the notifiers from the all the
Panchayats of all the blocks will be organized to equip them, with the process of notification of
deaths and reporting to the supervisors
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
Notification of Cases
£ This activity will be taken up by the notifiers once they undergo the orientation program and are
placed in their respective Panchayat. The activity will consist of verifying the information shared by
the informants, Filling-up the Notification Format and Contacting the Supervisors
Interviews
£ Interviews will be conducted by skilled and trained interviewers trained during the 5 day capacity
building program. This activity takes place once the supervisor assigns the case to the interviewer.
The interviewer will visit the household where the death took place and will interview the closest
person who stood when the death took place. The recorded information in the prescribed format will
be submitted to the supervisor who then will verify the recordings and promote it for entry and
analysis.
Data Entry and Analysis of information
£ Data Entry and Analysis will take place only when the above processes of Notification, Interview
and Verification are over. All entry will take place at the District level and analyzed at UNICEF
level
Community Sensitization Program
£ At the monthly Mahila Mandal meetings sensitization of the community members functionaries will
be done for generating awareness on the causes of maternal of death, precautionary measures and
community initiatives. Other forums for the same will be explored.
Orientation and Sensitization of Health Functionaries
£ At the block and District Level one day orientation of the Health Functionaries will be carried out to
develop a consensus on the process.
Advocacy Meetings
£ Finally, the analyzed data are to be utilized for advocacy and policy modification at the district and
state level. These advocacy meetings will be very strategic in nature where decisions regarding
effective service delivery and service effectiveness will be targeted.
Costs incurred per Maternal death investigate/non maternal death notified
Honorarium & Travel
Informants 30 1 30
Notifiers 70 1 70
Interviewers 250 2 500
Supervisors 250 1 250
Total per maternal death investigated Rs. 850
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NRHM STATE PROGRAMME IMPLEMENTATION PLAN- 2008-09
23. Work plan
Annexure 3 d
24. Budget
Annex 3e and 3c
131

PART- B
NRHM Flexible Pool /
NRHM Additiona lities
2009-2010
132

1. Decentralization
For effective decentralization in principle as well as practice, health societies have been established at all levels
of the healthcare delivery structure. Systematic involvement of various stakeholders at all levels through these
societies has helped make healthcare delivery responsive to the needs of the people via participatory planning
and removal of bottlenecks at implementation levels. State Health Society provides overall guidance and
supervision for effective planning and implementation, and also coordinates activities across the board. The
State Health Mission, the Governing Body and the Executive Committee meet at regular intervals and take
decisions regarding all matters. District level activities are taken care of through the District Health Society.
Rogi Kalyan Samitis at PHC, CHC, Sub Divisional Hospitals, District Hospitals and Medical Colleges have
been set up. The formation of societies under NRHM has given a new direction to management and overall
functioning of the health department towards the achievement of its goals.
133

ASHA
One of the key components of the National Rural Health Mission is to provide every village in the country with
a trained female community health activist ASHA or Accredited Social Health Activist. Selected from the
village itself and accountable to it, the ASHA is trained to work as an interface between the community and the
public health system.
Under NRHM, 87135 ASHAs (revised as per the decadal growth in 2008) are to be selected and trained in
Bihar. The previous target was 74313 (as per 2001 census). The first orientation training of seven days has been
completed for about 60,016 ASHAs. The 2nd, 3rd and 4th round /2, 3 & 4th module training is being done by
PHED and its NGOs. The PHED had proposed a total cost of Rs.40.70 cr. which has now been reworked to
Rs.27.15 Crores. A total no. of 76 State Level trainers/Master Trainers were trained till June 2008 and 393
district level trainers/Block resource persons are being trained. The 5 th round/module of training is to be started
just after the completion of 2 nd , 3 rd & 4 th round of training.
A total number of 67506 ASHAs have been selected so far. Orientation training of seven days has been
provided to 60016 till now. The ASHAs are given the copies of each module (Hindi version) and reading
material in the form of flip charts for their better understanding and also dissemination of key health messages
among villagers.
Table 1: ASHA Status (Target, Selection and Training)
Revised Selection Target (As Selected as Trained with
Sl.
District per 2.3 % per annum decadal on Module
No.
growth rate)
01.01.09 1/Phase 1
I II III IV V
1 Araria 2376 2026 2026
2 Arwal 773 652 652
3 Aurangabad 2160 1646 1567
4 Banka 1820 1532 1471
5 Begusarai 2629 2091 1771
6 Bhagalpur 2311 1936 1877
7 Bhojpur 2264 1661 1637
8 Buxar 1493 1086 945
9 Champaran(E) 4326 2910 2130
10 Champaran(W) 3206 2653 2177
134

11 Darbhanga 3550 2357 2250
12 Gaya 3514 2780 2240
13 Gopalganj 2371 2015 1868
14 Jamui 1520 1254 1254
15 Jehanabad 871 769 769
16 Kaimur 1462 1247 1247
17 Katihar 2549 1779 711
18 Khagaria 1412 1001 891
19 Kishanganj 1368 1112 799
20 Lakhisarai 802 581 557
21 Madhepura 1711 1403 1403
22 Madhubani 4046 3034 2751
23 Munger 961 840 820
24 Muzaffarpur 3984 3120 2544
25 Nalanda 2365 2010 2010
26 Nawada 1959 1531 1284
27 Patna 3233 2571 1932
28 Purnia 2723 2113 2000
29 Rohtas 2490 1950 1935
30 Saharsa 1622 765 676
31 Samastipur 3835 3143 3004
32 Saran 3459 2681 2329
33 Sheikhpura 521 426 402
34 Sheohar 580 99 82
35 Sitamarhi 2965 2147 1665
36 Siwan 3008 2538 2327
37 Supaul 1928 1515 1492
38 Vaishali 2969 2532 2521
Total 87135 67506 60016
ASHA is the first port of call for any health related demands of deprived sections of the population, especially
women and children, who find it difficult to access health services and she will provide her service mainly
under the following heads-
135

Table 1: The compensation package of ASHA
Sl. No. Programme & Relevant Task Amount of Compensation
1.
Janani & Bal Suraksha Yojana For Institutional @Rs. 200/-(Only Rs.Two hundred) Per
Delivery and Full Immunization of the New Born Pregnant Woman
2.
Mobilizing all the children of the village for @ Rs. 150/-(Only Rs. One hundred
Immunization
fifty only) Per Month
3. Providing DOTS under Tuberculosis Control Program Rs 250 per patient.
4.
For identifying Patient of Leprosy and accompanying @ Rs. 300/- (Only Rs. Three hundred)
him/her to PHC
Per Patient
5. Training
D.A. Per Day
@ Rs. 100/- (Only Rs. One hundred)
Per Day(During the Training)
T.A. Per Training (To & Fro)
@ Rs. 50/- (Only Rs. Fifty) Per
Meeting
6. To participate in ASHA Divas organized at PHC
@ Rs. 75/- (Only Rs. Seventy Five) Per
Meeting
7. For motivating for Sterilization
@ Rs. 150/- (Only Rs. One hundred
Fifty) on Completion of Surgery
8. For motivating client for vasectomy/ NSV
@ Rs. 200/- (Only Rs. Two hundred)
on Completion of Surgery
9. For 6 no. home visits under HBNC and IMNCI
@ Rs. 200/- (Only Rs. Two hundred)
on Completion of the 6 th visit
Programme Description
1.11 At the State Level
Personnel– The Project Manager and Deputy Project Manager at the State level have been appointed.
Additional personnel including Statistical assistant, data assistant and office attendant have been provided for
effective implementation and execution of different aspects of work.
ASHA Mentoring Group- A Mentoring Group comprising of leading NGOs and well known experts on
community health is under the process of formation, to provide guidance and advice on matter relating to
selection, training and support for ASHA.
Development of IEC and Monitoring Material – For effective documentation, information dissemination and
reporting, ASHA Flip Chart, ASHA Activity Diary, ASHA Register, IEC Material, Monitoring and Reporting
Formats and resource materials for meetings and for Behavior Change Communication will be ensured.
136

Monitoring and Supervision and Operation Research and Documentation: This will ensure basic field
level assessment, working towards the gap identified, analyzing and assessing the outcome and thus eventually
working towards a holistic strategy development. This will include the following components:
a. Periodic Surveys at District Level (once in three months)
b. Operational and Action Research from State Level (every six months)
c. Field Visits every month by the Consultants ASHA
d. Monitoring of the Training being conducted
e. Community monitoring
ASHA Sammelan and exposure visit: ASHA Sammelan will act as a platform where ASHAs accompanied by
Block Health Manager, Block Health Organizer, District Nodal Officer and Senior Nurse of one district/block
meet the ASHAs of another district/block to share their experiences of work with District & Block Health
Officials, Medical staffs and beneficiaries. This will help in networking, information sharing and build a kind of
connectivity between the workers and the State.
Workshop, Seminars and Consultative meetings: - This will involve experts on health from the national level
along with members of ASHA Mentoring Group for analysis of the operation research and monitoring to work
towards further strategy development.
1.12. At the District Level
Additional Personnel
Community Mobilizer/ District Project Manager ASHA – She/He will be appointed in the capacity of
Community Mobilizer and will act as a Nodal Officer at the district level for effective programme management,
implementation and execution.
Data Assistant: She/He will assist the community mobilizer and existing staff of the District PMU in all the
ASHA related work.
ASHA Help Desk: An ASHA help desk will be formed at the district level whose overall in-charge will be the
community mobilizer. This will be expanded to the block level for strengthening of referral support system, to
redress grievances of ASHAs, if any and to work as an information networking and management system.
1.13. At the Block Level
Block ASHA Manager/ Block Level Organizer– An Officer will be appointed as a block level organizer for
effective programme management, implementation and execution and to act as a link and network between the
ASHAs and the District and will be assisted by a facilitator 1 on every 20 ASHAs. The Facilitator will be the
21 st ASHA worker. This will help in building up and developing the necessary skill required for a community
health worker in a sustainable way.
137

ASHA Help Desk: An ASHA Help Desk will be formed also at the block level. Overall in-charge of Block
level ASHA Help Desk will be block level organizer and MOIC. This shall be in network with the District
Level ASHA Help Desk. It will act as a network integrating the Village, Block and the District. It will help in
strengthening referral support system, redress grievances of ASHAs, if any, and work as an information
networking and management system.
1.14. At the Village Level
Community Monitoring and Community Need Assessment: Community-based Monitoring ensures that the
services reach those for whom they are meant, for those residing in rural areas, especially the poor, women and
children. Community Monitoring is also seen as an important aspect of promoting community led action in the
field of health and to understand if the work is moving towards the decided purpose. Although, ASHA hails
from the same village, she may not be having knowledge and information on the health status of the village
population. For this purpose, she will be advised to visit every household and undertake a sample survey of the
residents of the village to understand their health status. In this way she will come to know the villagers, the
common diseases which are prevalent amongst the villagers, the number of pregnant women, the number of
newborn, educational and socio-economic status of different categories of people, the health status of weaker
sections especially scheduled castes/scheduled tribes etc. She will be provided with a simple format for
conducting the surveys. The ASHA Activity Diary will also help her keep a record of the base level. In this she
should be supported by the AWW and the Village Health & Sanitation Committee. Such a review will help to
identify obstacles in the work, so that appropriate changes can be made to cross the obstacles by the team of the
block level organizers.
Networking with VHSC, PRI and SHGs – All ASHAs will be involved in this Village Health and Sanitation
Committee of the Panchayat, as Members. ASHAs will coordinate with Gram Panchayat in developing the
village health plan, along with the Block Level Organizer, Block Medical Officer and Block Facilitator. The
untied funds placed with the Sub-Centre or the Panchayat will be used for this purpose. The SHGs, Womans
Health Committees, Village Health and Sanitation Committees of the Gram Panchayat will be major sources of
support to ASHA. The Panchayat members will ensure secure and congenial environment for enabling ASHAs
to function effectively to achieve the desired goal.
1.15. ASHA Training
The second phase of ASHA training which includes the 2 nd , 3 rd and 4 th modules is being done by PHED and its
NGOs. The State Level ToT has been completed and the district level training is going on. The District resource
person will in turn train the ASHAs at the Block Level. Additionally against the revised ASHA target, the new
incumbents shall have to be provided trainings on Module 1, 2,3 and 4.
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1.16. ASHA Drug Kit and it’s replenishment
To ensure provision of ASHA Drug Kit to 12822 new ASHAs and replenishment as it is one of the key
components of NRHM
1.17. Emergency Services of ASHA
Bihar has been experiencing regular floods which have created havocs in lives of lakhs of people both
economically and psychologically. During the time of floods, health related problems become extremely acute.
In such a situation the role of ASHA becomes extremely crucial. Thus ASHAs will be provided intensive
training/capacity building preferably of three days and would then be deputed in 16 flood prone districts or
similar natural disaster areas.
1.18. Motivations for ASHA
Provision of Two Sarees to ASHA – The provision of Sarees will ensure the following:-
· The availability of Sarees will help in building up of better motivation of the ASHA workers.
· Identification in any work helps in rooting identity for the worker and the work itself. The
availability of Sarees will help in doing so.
· Sarees will help in easy deliverance of work and make the worker more accessible by the
community as it will help in easy identification of the ASHA worker.
· It will help in boosting the morale of the ASHA worker and shall make the relationship stronger
and would help in connecting the ASHA worker and the State.
Provision of One Umbrella to ASHA– The provision of Umbrella will ensure the following:-
· The availability of Umbrella will act as an aid to the ASHA worker in extreme weather conditions,
which will facilitate the health facility/services in a smooth way
· The availability of Umbrella will help her comply with her nature of work
· It will help in building up of motivation of the ASHA worker, enhance her identity.
· It will help in boosting the morale of the ASHA worker and making the relationship stronger and
ensure connectivity between the ASHA worker and the District
1.19. Capacity Building/Academic Support Programme:
a) Enabling ASHA 10 th pass For upgradation of academic strength of ASHA, SHSB will provide examination
fees for the 10 th examination of open schooling mode/Board/IGNOU to 1000 ASHAs in 1 st Phase. Fee for the
same to be provided by SHSB.
b) Training for Help Desk The person/officer involved in operationalising the ASHA help desk at District
level and Block level will be trained.
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1.20. ASHA Divas
ASHA Divas will be held per month. This will include the following componentsü
Monthly Meetings for ASHA Divas of ASHAs, ANMs and AWWs shall provide the necessary
platform to share the work experiences, identify the loop holes and work towards the same.
ü Best ASHA worker and ANM worker felicitation as per their monthly performance at the
ASHA Divas will provide motivation. The performance will be rated as per the ASHA Activity
Diary.
ü Provision of I-Card will be done to the newly selected ASHA workers.
ü Replenishment of ASHA Drug Kit for at least the next two months. This will ensure treatment
of common ailments and first level prompt care and referrals initiated based on symptoms of
necessary cases. For this, effective access to basic drugs in every village should be ensured
through ASHA Drug Kit.
Key Dimension of ASHA Programme:-
· The structural mechanism relating to a support system for ASHAs will ensure the facilitation of
effective service delivery and a clear communication channel from the Block to the State. The Human
resource in form of a strong network system will provide the necessary support for effective
implementation and execution of the ASHA Programme.
· Continued training and capacity building to the ASHAs will facilitate the service delivery and ensure
community broad basing of the programme.
· Inter-sectoral convergence among different health related institutions and individuals will ensure
effective service delivery. The ASHA Help Desk will ensure an extensive and intensive communication
and management system right up to the community level.
· Empowering ASHA through various motivational methods including provision of Sarees and umbrella,
best ASHA felicitation, performance based incentive, capacity building, training, documenting the work
through ASHA activity diary and register, incentive to ASHA for mobilizing ANC and PNC Cases for
check-up and ASHA help desk will assist and facilitate overall development of the worker.
· Additionally, the ASHA being a facilitator at the Block Level will also go in a long way towards
developing the necessary skills of a Community Health Worker, making the whole process sustainable
and empowering the worker and the community itself.
140

· A Community based monitoring system coupled with operational research and continued evaluation
will help in field level analysis and seminars for consultation of the same will help in holistic strategy
development.
Budget:
Sr. No. Particulars Tentative Budget
(A) AT THE STATE LEVEL
1 Personnel on contract
1. Project Manager (MBA/PG in HRD) - Rs.25,000/- per
5,40,000/-
month x12 months = Rs.3,00,000
2. Deputy Project Manager (Master in Social Works)
Rs.20000/- per month x 12= Rs.2,40,000/-
Total of (1)+(2)= Rs.5,40,000/-
3 Development of IEC and monitoring materials (ASHA flip chart,
2,61,40,500/-
ASHA Activity Diary, ASHA Register, IEC material, reporting
format, monitoring formats and resource materials for meetings) =
300 x 87135 = 2,61,40,500/-
4 Monitoring and supervision 2,00,000/-
5 Operation research and documentation 2,00,000/-
6 ASHA Sammelan and exposure visits @ Rs. 150/- per ASHA
1,30,70,250/-
(Rs.100/- Hon. + Rs.50/- TA/DA)= 150 x 87135 = 1,30,70,250/-
7 Workshops, seminars and Meetings 2,00,000/-
8 ASHA Mentoring Group Budget 2,00,000/-
9 Contingency 1,00,000/-
Total (A) 4,06,50,750/-
(B) ASHA Support System at the District Level
1 Strengthening of the District PMU for undertaking ASHA support
system
Additional Personnel
(a) Community Mobilizer/District Project Manager-ASHA (Master
in Social Work) Rs.20,000/- per month x 12 months =
Rs.2,40,000/- who will report to District Nodal Officer
21,60,000/-
141

(b) Data Assistant (Graduate with Basic Computer knowledge) - to
strengthen the District PMU to take additional work. He/She will
assist the existing staff of District PMU in all the work related to
NRHM including ASHA related work. Rs.8,000/- per month x12
months = Rs. 96,000/-
(c) TA/DA to be paid from District Health Society (Programme
Management Cost) for monitoring visits and collection of
information Telephone, fax, computer, stationeries etc to be used
from District PMU (3000 x 12 x 38 = 13,68,000.00)
(d) ASHA Help Desk at the district level (As In-charge Community
Mobilizer) = 1000/- x 38 district x 12 months =4,56,000.00
(C) ASHA Support System at the Block Level
(A) Block ASHA Manager/An officer Block Level Organizer in
all the blocks. (Rs. 12000 x 533 x 12 months = Rs. 7,67,52,000.00)
(B) ASHA Help Desk at the Block Level (as in-charge Block Level
Organizer and MOIC) = 500/- x 533 x 12= 31,98,000/-
(D) ASHA Support System at Village Level
Community Monitoring and Community need assessment
1 (20 ASHA and block facilitator, PRIs, SHG, two beneficiaries and
NGO representative.)(Rs.150/- x 2500 x 12) = 45,00,000/-
(E) ASHA Trainings
1 One day Orientation programme of State Level resource person =
65,000/-
2 12 days training of District Resource Team
(38 district x Rs.2,35,000/-)= 89,30,000/-
3 12 days training of ASHA at Block level (2489 batches x
Rs.1,00,000/-) = 24,89,00,000/-
7,99,50,000/-
45,00,000/-
8,68,95,000/-
(Rs.17.15 crores was made
available in 2008-09, of
which approx. Rs.50.00
142

4 Documentation and Development of IEC materials = 5,00,000/- lakhs has been spent.
Therefore of the total
requirement of Rs.
25,83,95,000/- additional
fund required for 2009-10
is 13,82,92,850/- and the
balance available amount in
SHSB may be ratified for
use in 2009-10)
Total (B+C+D+E) 17,35,05,000/-
(F) ASHA Drug Kit & Replenishment
1 Drug Kit @ Rs. 600/- for 12822 ASHA
7693200
Replensihment of Drug Kit @ 74313 ASHAs x Rs.200/-
1,48,62,600/-
Total 2,25,55800
(G) Emergency Services of ASHA
Deputation/ engagement of ASHA in Flood and other natural
1 calamities for flood prone district (20 days x Rs.100 per day x
approx 3000 ASHA= 60,00,000.00) 66,00,000/-
Capacity Building/Training of ASHA in Flood and other natural
2 calamities for flood prone district ( 2 days x Rs. 100 per day x
approx 3000 ASHA = 6,00,000.00)
(H) Motivation of ASHA
1 Provision of two Sarees to ASHAs (87135 ASHAxRs.600( two
Sarees) =5,22,81,000/- 6,31,72,875/-
2 Provision of one umbrella to ASHAs (87135 ASHAs x Rs.125/-)
=1,08,91,875/-
(I) Capacity Building/Academic Support Programme
1 Approx. 1000 ASHAs in the State to be enrolled into 10 th grade or
Bachelors Preparatory Programme through Open Schools or
IGNOU. Fee for the same to be provided by SHSB. The amount
10,00,000/-
being requested is less, more shall be requested in case of god
response to the proposal.
@ Rs.1000 x 1000 students =10,00,000
2 Training for ASHA Help Desk (1104 x 500/-)= 5,52,000/- Provisioned in IEC
component of Part A
Total (F+G+H+I) 10,47,28,675/-
143

1
(J) ASHA Divas
TA/DA for ASHA Divas @ Rs.75 per ASHAs per month
(Rs. 87135 x 75x12) = 7,84,21,500/-
2 Best performance award to ASHAs at district level. @ Rs.2000 per
block=
3 ASHAs from each block @ Rs.1000 for 1 st , Rs.500 for 2 nd and
Rs. 300 for 3 rd prize, Rs. 200 for Certificate printing and
distribution = Rs. 2000 x 533) = 10,66,000/-
(For this activity the administrative system/procedure shall be
chalked out with support of Development Partners)
3 Identity Card (Rs. 20 x 87135) = 17,42,700/-
8,12,30,200/-
Total (J) 8,12,30,200/-
Grand Total( A+B+C+D+E+F+G+H+I+J) 38,87,14,625/-
Forty nine crores Eighty six lakhs Thirty four thousand Eight hundred and Seventy five Rs. only.
144

Total Budget under ASHA Scheme
Sl Particulars Amount (Rs.)
1 ASHA Support System at State Level 4,06,50,750/-
2 ASHA Support System at District Level 21,60,000/-
3 ASHA Support System at Block Level 7,99,50,000/-
4 ASHA Support System at Village Level 45,00,000/-
5 ASHA Trainings 8,68,95,000/-
6 ASHA Drug Kit & Replenishment 2,25,55,800/-
7 Emergency Services of ASHA 66,00,000/-
8 Motivation of ASHA 6,31,72,875/-
9 Capacity Building/Academic Support Programme 10,00,000/-
10 ASHA Divas 8,12,30,200/-
Total Budget for ASHA 38,87,14,625/-
Work-plan for ASHA Program
Activities 2009-10
Q1 Q2 Q3 Q4
Development for IEC and monitoring material
(IEC material, reporting format, ASHA Flip Chart, ASHA Activity Diary,
ASHA Register, monitoring formats and resource material for meetings)
Monitoring and supervision
Operation research and documentation
ASHA sammelan and exposure visits
Workshops, seminars and Meetings
Trainings
Emergency Services of ASHA
Empowerment of ASHA
Capacity Building
ASHA Divas
145

1.21 Untied Fund for Health Sub Centre, APHC and PHC
The objective of the activity is to facilitate meeting urgent yet discrete activities that need relatively small sums
of money at Health Sub Centers.
The suggested areas where Untied Funds can be used mentioned below:
Þ Cover minor modifications to sub center-curtains to ensure privacy, repair of taps, installation of bulbs,
other minor repairs, which can be done at the local level;
Þ Ad hoc payments for cleaning up sub center, especially after childbirth; transport of emergencies to
appropriate referral centers;
Þ Purchase of consumables such as bandages in sub center;
Þ Purchase of bleaching powder and disinfectants for use in common areas of the village;
Þ Labour supplies for environmental sanitation, such as clearing/ larvicidal measures for stagnant water
Þ Payment/reward to ASHA for certain identified activities.
Budget
Budget Head
Untied Fund
Sub-Heads
@
Proposed Budget
(in Crores)
Untied fund for sub-centre Rs. 10,000 x 8858 no. 8,85,80,000
Untied fund for APHCs 1243 APHC x 25,000 3, 10, 75,000
Untied fund for PHCs 533 PHC x 25,000 133, 25, 000
For meetings at HSC Rs. 2000 x 38 district 76000
PHC level ANMs 533 PHCs x Rs.3000) 15,99,000
Orientation on Guidelines
for Untied Funds for HSC
Quarterly review meeting Rs.1000 per meeting x 4
1,52,000
of the ANMs under the
chairmanship of PHC
Medical Officer to monitor
the usage of the fund
quarter x 38 districts
Total 13,48,07,000
146

1.22 Village Health and Sanitation Committee
Government of Bihar has decided to merge Village Health and Sanitation Committee with “Lok Swasthya
Pariwar Kalyan and Gramin Swaschata Samiti constituted by Department of Panchayat Raj in Bihar.
Budget
Budget Head
Untied Fund for VHSC
Sub-Heads
@
Proposed Budget
(in Crores)
Untied fund for VHSCs 45077 villages x 10,000 450770000
(Fund of Rs.10.00 cr is
available in SHSB, so the
balance amount of
Rs.35,07,70,000/- is
Training of members of
VHSC regarding
functioning mechanism at
the PHC level
required)
533 PHCs x Rs.2500 13,32,500
Total 35,21,02,500/-
1.23 Seed Money for Rogi Kalyan Samitis
Aims and Objectives
The objectives of the RKS is :
» Upgrade and modernize the health services provided by the hospital and any associated outreach
services
» Supervise the implementation of National Health Programme at the hospital and other health
institutions that may be placed under its administrative jurisdiction
» Organize outreach services / health camps at facilities under the jurisdiction of the hospital
» Monitor quality of hospital services; obtain regular feedback from the community and users of the
hospital services
» Generate resources locally through donations, user fees and other means
Functions of the RKS
To achieve the above objective, the Society utilizes its resources for undertaking the following activities/
initiatives:
» Acquire equipment, furniture, ambulance (through, donation, rent or any other means) for the hospital
147

Budget
» Expand the hospital building, in consultation with and subject to any guidelines that may be laid
down by the GoBMake arrangements for the maintenance of hospital building (including residential
buildings), vehicles and equipments available with the hospital
» Improve boarding/lodging arrangements for the patients and their attendants
» Enter into partnership arrangement with the private sector (including individuals) for the
improvement of support services such as cleaning services, laundry services, diagnostic facilities and
ambulatory services etc
» Develop/lease out vacant land in the premises of the hospital for commercial purposes with a view to
improve financial position of the Society
» Encourage community participation in the maintenance and upkeep of the hospital
» Promote measures for resource conservation through adoption of wards by institutions or individuals
» Adopt sustainable and environmental friendly measures for the day-to-day management of the
hospital, e.g. scientific hospital waste disposal system, solar lighting systems, solar refrigeration
systems, water harvesting and water re-charging systems etc.
Budget Head
Rogi Kalyan Samiti
Sub-Heads
@
Proposed Budget
(in Crores)
District Hospitals 27 hospitals X 5 lakhs 1.35
Sub-divisional hospitals 23 hospitals X 5 lakhs 1.15
Referral hospitals 70 hospitals x 1 lakhs 0.70
PHCs 533 PHCs x 1 lakhs 5.33
Sensitization workshop for
RKS members (653 x 3
members =1959) at the
sub-divisional level (TA,
Food, Resource materials,
resource persons etc)
Exposure visit of members
of RKS of 10 nonperforming
districts to
districts where RKS are
performing
217 participants x 9
divisions x Rs.1000=
19,53,000
@ 2 members/RKS x 10
hospitals x 10 districts =200
x Rs.2000=4,00,000
Provisioned in IEC
componet (Part A)
Provisioned in IEC
componet (Part A)
Total 8,53,00,000/-
148

Infrastructure Development
2.1 Construction/Establishment of Health Sub Centre (HSC)
NRHM aims to ensure HSC facility on the Govt. of India population norms of 1 per 5000 population in general
areas and 1 per 3000 populations in tribal areas. As per 2001 Census, population of the Bihar State is
approximately 8,29,98,509. Existing facility of HSCs are 8858 out of total requirement of 16623. To facilitate
the above population the state requires 7765 HSCs additionaly to achieve the total target. It is proposed to create
1553 HSCs every year for next five years.
The revised estimate is @ 9.50 lakhs as per GoI norms. The State proposes to share 25% expenses in the
construction of these HSCs and for land acquisition. The balance 75% the state has put under this PIP for
financial support from NRHM. These Health Sub Centres shall either be constructed or shall be taken up on
rental basis. The cost provided also includes cost of land acquisition if Govt. land is not available. Till such
time construction is complete the state shall take buildings for these facilities on rental also.
NRHM Action - Plan 2009-10
Expected
Details of Budget
Proposed
Proposed Physical Out
Basis of Costing ( No. of Units X Unit Cost )
Budget
Activity Come
2009-10
Creation of
Initiating
Rs. 950.00
Total cost @ Rs 9.50 lakh
Contribution of
Contribution
HSC
construction of
Lakhs
per unit
GoI (75% of
of GOB
100 HSC.
9.50 lakhs i.e
(Rs.9.50-
@7.125 lakhs
7.125 =
per unit )
2.375 lakhs
per unit)
100 x 9.50= Rs. 950.00
Rs. 712.5
Rs.237.5
Lakhs
Lakhs
Lakhs
In the year 2008-09 funds for construction of 1985 HSCs were released to Building Constrution Department,
which has initiated necessary actions. All though construction of 500 HSCs were proposed in 2008-09 and
under NRHM GoI released Rs. 30 Crores. In the year 2009-10 it is proposed to construct buildings of next 100
HSCs where land is available. For this an amount of Rs. 950.00 lakhs is required.
For Construction work two agencies have been identified BCD and District Health Society, Bihar.
149

2.2 CONSTRUCTION OF PHC
NRHM aims to ensure PHCs on the Govt. of India population norm of 1 per 30000 populations in general areas
and 1 per 20000 population in tribal/ remote areas. As per 2001 census, population of Bihar state is
approximately 82958509. The existing facility of PHCs is 1243, whereas the total requirement is 2787 PHCs.
There are 121 PHCs which do not have their own building. Therefore 1665 PHCs buildings require to be setup
by 2010.
Unit cost of construction and land acquisition is 53.15 lacs as per NRHM guidelines. Some of the facilities will
be taken up on a rental basis. The total built-up area of the PHCs will be 63 hundred Sq feet, which will include
1500 sq. ft. for PHC & 4800 sq. ft. for its residential quarters. These PHCs would either be constructed or shall
be taken up on rental basis. The cost provided also includes cost of land acquisition if Govt. land is not available
for construction. Till such time construction is complete the state shall take buildings for these facilities on
rental also. In addition, it is proposed to construct residential quarters for the staff in 500 old APHCs
(previously sanctioned) in an area of 3000 Sq. ft.
Proposed Activity
1. Construction of
residential quarters
of 200 old APHCs
for Staff nurses
NRHM Action - Plan 2009-10
Expected Physical Out
Come
Construction to be done in an
area of 3000 sq. ft. (1000 sq.
ft. x 3 quarters) @ Rs. 30
lakhs per APHCs.
Funds to be released to the
Construction Agency.
Proposed Budget
Rs. 6000.00 Lakhs.
Details of Budget
Basis of Costing
( No. of Units X Unit
Cost)
2. Construction of
building of 51
APHCs where land
is available
Funds to be released to BCD.
An amount of Rs. 2710.65
lakhs is required for the
construction. Against these
Rs. 31 lakhs has already been
released to BCD. Total fund
required in 2009-10 will be
Rs. 3,79,67,000 .00. The rest
to be carried over in 2010-11.
Rs. 3,79,67,000.00 Rs. 3,79,67,000.00
Total – Rs. 63,79,67,000.00
Say Rs. 6379.67 lakhs
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2.3 UPGRADATION OF COMMUNITY HEALTH CENTRE (CHC)
NRHM aims to ensure CHCs on the Govt. of India population norm of 1 per 1.20 Lakhs populations. The Govt.
of Bihar plans to upgrade all its PHCs and Referral Hospitals below the headquarter level to CHC as per IPHS
standards. In the state of Bihar the total no of existing PHCs are 533 and the no of Referral Hospital is 70.
Hence a total of 603 units are needed to be upgraded to CHC standard and converted to 30-bedded hospitals. It
is proposed to upgrade 200 facilities every year. As per NRHM guideline the entire cost of construction would
be borne by GOI.
It is proposed to take up upgradation of 100 PHCs to CHCs in the year 2009-10 and the balance PHCs/Referral
hospitals will be upgraded to CHCs in next year. The unit cost of construction and land acquisition will be
around Rs. 40 lakhs. The upgradation of hospital buildings shall be taken up from funds provided by the State
Govt. The doctors and staff quarters shall be provided under the NRHM. In case adequate land is not available
the fund can also be used for land acquisition. The doctors quarters would also be taken up on rental basis. The
cost provided also includes cost of land acquisition if Govt. land is not available. The costs also include
provision of equipment at these hospitals either as per IPHS standard or as required.
Proposed
Activity
Creation and
Up gradation
of CHCs as
per IPHS
Standard
.
Up gradation of Community Health Centre As Per IPHS
NRHM Action - Plan 2009-10
Expected Physical Out Come
Details of Budget
Proposed
Basis of Costing (No. Of
Budget
Units X Unit Cost)
Preparation and Finalization of Maps. Rs.8040.00 lacs Unit cost @ Rs. 40 lacs
Finalization of Construction Agency &
(Contribution of GOI
Initiating Renovation of CHCs.
100%) @ Rs. 40 lakhs x
Funds to be released for the construction
100 = Rs. 4000.00 Lakhs
agency.
100 CHCs shall be taken up
Quarters for Doctors and Staffs,
for upgradation.
for the Purchase of New Surgical
Rs. 4000 lakhs has already
instruments, Equipments, Furniture,
been approved by the GoI in
2008-09 and has been
received and the amount
shall be expended this year
in 2009-10.
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2.4 Infrastructure and Service improvement as per IPHS in 48 (District and Sub-
Divisional) Hospitals for Accreditation / ISO : 9000 certification of Health
Facilities
The state of Bihar has 25 District Hospitals & 23 Sub Division Hospital at present. Construction for 11 District
Hospitals are under process and have been nearly completed. Most of these District hospitals are 100 to 200
bedded. The state has already appointed one hospital consultancy firm to carryout the situation analysis of these
District Hospitals and prepares a master plan in terms of Infrastructure, Equipment and Manpower for
strengthening these hospitals as per IPHS.
The state with the help of NHSRC is in the process of ISO accreditation/certification for its District Hospital at
Bhojpur. This year Bihar would like to outsource this task through NHSRC or some competent agencies to take
up its 23 DHs and 25 SDHs under ISO certification across the state for addressing quality issues.
The state also intends to develop the hospitals at Rajvanshi Nagar, Rajendra Nagar, Gardiner Road,
Gardanibagh and Guru Govind Singh Hospitals at Patna into super speciality hospitals.
The preparation of Master Plan will be completed within six months after which the state will take up the
strengthening work. The upgradation would include upgradation of Civil Infrastructure as well as provision of
equipment. The cost provided also includes cost of land acquisition if Govt. land is not available. The costs also
include provision of equipment at these hospital either as per IPHS standard or as required. The costs also
include provision of equipment at these hospitals either as per IPHS standard or as required.
Budget:
Activity Amount ( In Rs )
Strengthening/Up gradation of District Hospitals, Sub-Divisional 3,40,00,000/-
Hospitals and Super-Specialty Hospitals as per IPHS Standard
Accreditation/ISO certification for 48 (District Hospitals + SDH) 9,60,00,000/-
x Rs.20.00 lakhs
Total 13,00,00,000/-
2.5 Upgradation of Infrastructure of ANM Training Schools
In year 2008-09, a State coordination committee for the strengthening ANM and GNM schools has been
activated under the chairmanship of the Additional Commissioner, Health. The Executive Director, SHSB,
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officers from the Directorate and SHSB and UNICEF are its members. The committee has chalked a
comprehensive strategy for the rejuvenation of the ANM and GNM schools.
Key decisions made till now include
Streamlining the student intake in all ANM and GNM schools up to their full capacity
Ensuring that the vacant faculty and staff positions in all the schools are filled through
contractual appointments to undertake teaching assignment sas per INC norms
Finalizing five ANM schools in PPP mode
Formulation of the managing committee at respective ANM and GNM schools to look after the
local management affairs
Strengthening the hands of the principals of these institutes
Reviewing the progress on a regular basis
Initiatives have been taken in Operationalisation of 22 ANM schools in terms of -
site assessment,
basic renovation,
provision of kitchen items, audiovisual equipments, lab equipments
provision of study material,
capacity building of faculty,
standard curriculum development for the ANMs and GNMs
Facilitation in accreditation from Nursing Council of India.
It is proposed to upgrade the Infrastructure of 22 ANM and 6 GNM Training Schools. In addition, the state is
willing to open up more ANM and GNM schools as per the GoIs letter in this regard. The approximate cost of
up gradation of each ANM/GNM Training Schools is expected to be Rs 50 lakhs per Unit. It was proposed to
upgrade the Infrastructure of 12 ANM Training Schools in 2008-09 PIP and a fund for the same to the tune of
Rs.3.00 crores is available.
Additional funds are requested for the remaining 9 ANM schools and 6 GNM schools. The state is preparing a
separate proposal to upscale the standards of nursing education. Additionally under PPP 5 ANM schools are
proposed to be operationalised.
M.Sc/B.Sc. nursing faculty for nursing school to be taken from hindi speaking states like MP, Pondicherry, for
which Govt of India shall be approached for coordinating the same.
Budget
S No Description App. cost Duration Total
1 Upgradation of infrastructure of 12 Rs. 600 lakhs Rs. 6,00,00,000/-
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ANM Training School including
provision of furniture & equipment
2 Strengthening of Nursing cell in the
GoB
3 Hiring of additional faculty for all
ANM and GNM schools
(Above fund is already
available from SPIP
2007-08, 08-09)
@Rs 50 lakhs 50,00,000
Rs 50.00 lakhs Every year 50,00,000
Total 7,00,00,000/-
2.6 Annual Maintenance Grant
During the course of up-gradation in setting up of different units in the different health facilities of the state,
maintenance will also be essentially required. It is proposed that all district hospitals and sub divisional hospital
are provided @ Rs.5 lacs and Referrals/PHCs @ Rs.1 lakh. Fund for the same was approved in 2009-10.
Budget
Activities
Disbursement of the Grant at the end of the meeting on the same day to the
respective medical officers (district hospitals (23) and sub divisional hospital
(25) @ Rs.5 lacs, Referrals/PHCs (55+533) @ Rs.1 lakh)
Total purposed
budget
Rs.8,20,80,000
Contractual Manpower
3.1. Incentives, Contractual Salaries and Bonus
As human resources are the most important resource steps shall be taken to motivate them through various
benefits and incentives like Cellphone facility for all ANMs, MOICs, Programme Officers, CDPOs etc. and
rural and specialist incentives. All the doctors posted in the rural area would get an additional incentive of
Rs.3000.
A provision for Rs.50,000/- per PHC per year will be given as incentive to the PHCs for better performing in
services.
All the doctors performing specialist duties including the MBBS doctors trained for specialized tasks e.g. Life
saving Anesthesia skills etc. will get an incentive of Rs.4000.
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Budget:
Sub-Heads
Incentive for PHC doctors & staffs @
Rs. 50,000 for better performance in
implementing programmes
Salaries for contractual Staff Nurses
(2900 existing and 910 new)
Contract Salaries for ANMs (around
8000) in year 2009-10
3500 ANM will be paid by NRHM
(Rest 4500 ANM will be paid by
Treasury Root)
Mobile facility for all health
functionaries
@
Rs. 50,000/ - per year for about 250
PHCs
Rs.7500 per month
Rs.6000 per month (12 Months
Consolidated Salaries for
Contractual ANMs)
District officials, PHC in charge,
CDPOs and ANMs @ 500 per
Proposed Budget
(Rs. In lakhs)
125.00
3439.00
2520.00
month 600.00
Total 6767.02
3.2. Block Programme Management Unit
The state has already established Block Programme Management Unit in all the 398 Block PHCs. This year the
state will establish the next 135 Block Programme Management Unit. Each BPMU consist of One Block Health
Manager and One Accountant.
It has been observed that
after the establishment of BPMUs the implementation of National Programmes has been managed efficiently
and getting improved results.
Budget
A. Recurring Expenses of 533 BPMUs
Sl Particulars Qty Rate (Rs.) Amount (Rs.)
1 Salary of Block Health Manager 1 12000/- pm 1,44,000/-
2 Salary of Block Accountant 1 8000/- pm 84,000/-
3 Mobility and Office Expenses 1 25000/- pm 3,00,000/-
Recurring Expenses Per BPMU per Year 5,28,000/-
Recurring Expenses of 533 BPMUs per Year 28,14,24,000/-
B. Establishment Expenses for 135 BPMUs
155

Sl Particulars Qty Rate (Rs.) Amount (Rs.)
1 Computer System with Printer 1 50,000/- 50,000/-
2 Furniture 1 10,000/- 10,000/-
Establishment Expenses Per BPMU per Year 60,000/-
Establishment Expenses of 135 BPMUs 81,00,000/-
Total Budget for 2009-10 for Block Programme Management Unit (A + B) = Rs. 28,95,24,000/-
3.3. Additional Manpower for State Health Society, Bihar
NRHM being a large programme covering various components, SHSB requires more manpower to run the
programmes. The State Health Society requires additional manpower other than State Programme Management
Support to manage all the Programmes under NRHM umbrella. This year state also proposes to put 2 nos.
Executive Engineers and 1 Bio-Medical engineer under SHSB for monitoring the construction and equipment
activity under NRHM.
The details of Manpower as follows with Budget:
Details of Staff
Sl Post Salary (pm) Salary (pa)
1 Accountant (RNTCP) 15000 180000
2 Pharmacist (RNTCP) 11500 138000
3 Data Assistant (RNTCP) 9000 108000
4 Computer Operator (RNTCP) 8000 96000
5 Accountant (NBCP) 15000 180000
6 Computer Operator/Data Assistant (NBCP) 8000 96000
7 Steno-cum-LDC (NBCP) 8000 96000
8 Computer Programmer (NLEP) 15000 180000
9 Data Officer (Malaria/Kalazar) 15000 180000
10 Computer Operator (Malaria/Kalazar) 8000 96000
11 Store Keeper (Malaria /Kalazar) 8000 96000
12 Accountant (Filaria) 15000 180000
13 Computer Operator (Filaria) 8000 96000
Total Per Annum 1722000/-
10% annual increment as approved by the Governing Body of
SHSB, therefore the total required =
Rs.18,94,200/-
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Details of Programme Officers
For Government officials on deputation new salary slab as such is proposed-
Sl. Name Salary Pm Salary (pa)
1 Administrative Officer- SHSB 34143 409716
2 Programme Office - TB 32983 395796
3 Programme Officer-Kalazar/IDSP 38643 463716
4 Programme Officer -Blindness 29882 358584
5 Programme Officer- IDD/Filaria 35664 427968
6 State Immunization Officer 42108 505296
7 Programme Officer-Malaria 30751 369012
8 Programme Officer - Leprosy 30000 360000
Total Salary of ProgrammeOfficers 274174 32,90,088
Details of Engineers
Sl. Name Salary Pm Salary (pa)
1 Executive Engineer - SHSB 2 no. 30000 x 2
2 Bio-Medical Engineer SHSB 1 no. 25000 x 1 10,20,000
Total Salary for Engineers 85000
-
Total Budget for Additional Manpower at SHSB = Rs. 62,04,288/-
3.4. Additional Manpower under NRHM
Being a big state, Bihar requires more manpower to provide services at various facility levels.
Moreover the infrastructure development is happening at a snails pace. To expedite this, it is proposed to hire 1
Assistant Engineer at each district and 1 Junior Engineer for every four (4) blocks) on contract
Budget
Sl. Name Salary Pm Salary (pa)
1 Hiring of AE on contract
Rs.22,000/- x
38 districts x 9
months 75,24,000
2 Hiring of JE
Rs.15,000 x 9
months x 133
blocks 1,79,55,000
Total Salary 2,54,79,000/-
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PPP Initiatives in State
4.1 Emergency Medical Service /102 – Ambulance Service
The Toll free number 102 was launched during 2006-07 and is running in all the six regional headquarters
successfully. Under this scheme Ambulance for emergency transport is being provided in all the districts of
Bihar. The empanelled ambulance & ambulance available in Govt. institutions are made available on receipt of
calls from the beneficiaries.
This service has been outsourced to a private agency for Operationalisation. The Telephone Charges for the free
toll free number is paid to BSNL by SHSB. The amount required would be for payment of incoming calls
received from the beneficiaries.
In the year 2008-09 (figures till December 2008) 12131 requisitions have been successfully met by this service.
Budget summary of 102 :
Budget Head
102 Emergency Service
Sub-Heads
@
Proposed Budget
(in Crores)
Control Room (including office rent, Rs. 41,000.00 x 6 units = Rs,
40,32,000.00
salary of staff (24x7), stationary,
2 outgoing telephones for compliance
of 102 & for reporting to Headquarter)
246000.00 x 12 months =Rs.
29,52,000.00 + Per Control Room Rs.
15,000.00 pm x 6 = 90,000.00 x 12
months
Total 40,32,000/-
4.2. Doctor on Call & Samadhan: Dial 1911
A scheme is operational in the state wherein patients can dial a number and call for doctors. For this a special
toll free number of 1911 has been provided for w.e.f. 01.3.2008. The objective of the scheme is to give medical
assistance to the patient at their home at any time as well as act as a Samadhan of Rogi Shikayat.
Doctors and Specialists have been empanelled for this scheme. Pathology labs have also been attached to collect
samples for tests from patients home.
Budget summary of 1911:
Budget Head
1911 Doctor on Call service
Sub-Heads
Control room 3,500 per person (Two person) =
7,000.00 per control room is being
@
Proposed Budget
(in Crores)
5,04,000.00
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Telephone bill
Provision of Annual
Maintenance of EPBAX
paid to the outsourced agency. Rs.
7,000.00 x 6 = Rs. 42,000 x 12
months
Each control room is being paid
telephone bill (i) Doctors
conferencing Rs. 1,500.00 x 12
months = 18,000 x 6 control rooms =
1,08,000.00 & (ii) Rogi Jan Shikayat
Rs. 2,000.00 x 12 months = 24,000 x
6 control room = Rs. 1,44,000.00.
Rs. 10,000.00 per annum x 6 control
room
2,52,000
60,000.00
Total 8,16,000/-
4.3. Additional PHC management by NGOs
The state has started to outsource the management of Adll. PHCs to the NGOs. In 2008-09 the state has given 44
Adll PHCs to the NGOs for management. The result was good and it has been observed that the NGOs are
properly managing the PHCs. This year the state proposes to outsource another 56 Adll PHCs to the NGOs for
management.
Last year 44 PHCs were given @ Rs.75,500/- pm per Adll. PHC.
This year the state proposes to provide Rs.1,00,000/- per APHC to additional APHCs.
Budget
Sl No Particulars Amount (Rs.)
1 Recurring Cost for existing 44 Adll PHCs @ 75,500 x 12 3,98,64,000/-
month
2 Cost of New 56 Adll. PHCs @ Rs.75,500/- x 12 months 5,07,36,000/-
(This fund shall be
asked for subject to
evaluation of the
already running
APHCs at pt. 1 above)
Total 3,98,64,000/-
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4.4. American Association of Physicians of Indian Origin (AAPIO)
AAPIO survey on Specific Disease:
The Ministry of Overseas Affairs, Govt. of India and American Association of Physicians of Indian Origin
(AAPIO) signed an MoU at the Pravasi Bharatiya Divas in Jan 2006 to conduct a study on 5 specific diseases.
Thereafter a meeting of Core Committee was held in New Delhi in this regard.
As a follow-up to the above activities this project was included in the Annual Plan of NRHM in 2008-09 and a
provision of Rs.50 lakhs was made in the PIP. The sum of Rs.1.56 Crores for the project has already been
approved.
This year the State again proposes another installment of Rs.56 lakhs in the 2009-10 State PIP.
4.5. State Health Resource Center
State Health Resource Center has been established in State Health Society, Bihar with a two year contract
starting from January 08. M/s HOSMAC has been awarded this work and the total budget cost has been
divided into two parts-
· Retainership Fee
· Amount payable on completion of milestones
A total of Rs. 2.00 crores was approved in previous years PIP and the balance amount available in SHSB of
Rs.1,38,44,799/- shall be utilized in the FY 2009-10.
4.6. Services of Hospital Waste Treatment and Disposal in all Government Health
facilities up to PHC in Bihar (IMEP)
Bio medical waste management has emerged as a critical and important function within the ambit of providing
quality healthcare in the country. It is now considered an important issue of environment and occupational
safety. As per the Bio-Medical Waste (Management & Handling) Rules, 1998, all the waste generated in the
hospital has to be managed by the occupier in a proper scientific manner. The GoI has also issued the IMEP
guidelines for SCs, PHCs and CHCs. The state has outsourced the Biomedical Waste Management system for
all the Government hospitals.
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Strategy/Project Description
State Health Society Bihar is implementing National Rural Health Mission (NRHM) to carry out necessary
architectural correction in the basic health care delivery system. In order to provide quality services to the
public, SHSB has sought Public Private Partnership in providing proper Hospital Waste Treatment and Disposal
Services, in all Health facilities right from Medical Colleges to the PHCs.
Services to be provided
1. Provide Service of Hospital Waste Treatment and Disposal in all Medical Colleges, District Hospitals,
Sub-Divisional Hospitals, Referral Hospitals and PHCs of the State.
2. Install, Operate and maintain appropriate Common Biomedical Waste Treatment facility, as per the
Biomedical Waste (Management & Handling) Rules, 1998 and subsequent amendments in it.
3. Provide one day orientation training to all the health service providers.
4. Maintain the above-mentioned arrangement for a period of minimum 10 years. The Common
Biomedical Waste Treatment facilities are proposed to be established at various locations across the
State
Setting up a Bio-Medical Waste Management System:
1. The state has started a CWTF facility at Indira Gandhi Institute of Medical Sciences, Patna
(autonomous institute). The facility has been approached for undertaking waste treatment for all PHCs
to DHs in all the eight districts of Patna division.
Status Registration of the health facilities with IGIMS and with Bihar State Pollution Control Board
being ensured. Anticipated to be fully functional in all the eight districts by March 2009.
2. As per the rules each CWTF should cater to all facilities in 100 Km radius, keeping this in mind, more
CWTF are to be operationalised in each of the division except Patna (which already has such a facility).
To implement the IMEP in a comprehensive systematic manner, Private Parties have been
invited through National Open Tender. SHSB has already finalized two agencies for undertaking the
BWM project that would set up CBWM Treatment facilities at various locations in the State and cater
to all the PHCs to DHs to MCHs in all the Divisions except Patna.
The agency shall ensure segregation and collection of waste, disinfection, treatment,
transportation, handling and disposal of waste both within and outside the healthcare setting; also
ensure use of protective devices and safety precautions. The objective being to ensure waste
management, waste minimization and infection control.
Trainings to be provided to health care workers and officers in Infection Management and
Environment Plan implementation by the respective agencies. Payment is to be made on a per bed per
day monthly basis to both IGIMS and the Private Agencies.
Status - The project is in the finalization stage, agencies have been finalised and approval of the
Governing Body of SHSB is awaited on the Contract to be signed with both the agencies
161

and further approval of the Bihar State Pollution Control Board is awaited. GOI had approved an
amount of Rs.10.00 crores for the project in PIP 2008-09.
Budget
Activities
Dissemination and Sensitization workshops on IMEP Guidelines at
divisional levels
Training of in-house staff (ANM, Safai Karmacharis, clinical support staff)
on recognizing, segregating and disposing of bio-medical wastes
Operationalization of Biomedical Waste Management @ Rs. 0.08 lacs pm
per PHC (533), Rs. 0.12 lacs per Referral Hospital and SDH (113) and Rs.
0.30 lacs per DH (36) and Rs 0.45 lacs pm per Medical College (6)
Total
Total proposed budget
(in Rs.)
1,00,000/-
10,00,000/-
9,36,16,000/-
9,47,16,000/-
(The fund received
for the activity in
2008-09, may be
approved for
utilization in this FY
of 2009-10)
Work plan
Activities
Dissemination and Sensitization workshops on IMEP Guidelines at
divisional level
Training of in-house staff (ANM, Safai Karmacharis, clinical support
staff) on recognizing, segregating and disposing of bio-medical
wastes
Operationalization of BMW at PHCs, SDH, Referral Hospitals, DHs
and Medical Colleges
2007-08
Q1 Q2 Q3 Q4
4.7. Dialysis Units in various Government Hospitals of Bihar
It is proposed to set up & Operationalising Dialysis Units through Public Private Partnership (PPP) in 25
Hospitals of Bihar. This would require operation, maintenance and reporting 24-hours 7 days a week Dialysis
units in Hospitals.
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The State Government shall provide vacant space in the premises of the Hospital itself with additional space for
washing and RO plant installation (incase it is not in-built). The space provided shall be approx. 750-1000 sq.ft.
including RO plant. The agency has to provide everything from equipments & machine, logistics, consumables
etc to suitable medical personnel to man these units. The agency has to also ensure the installation,
maintenance, functioning with provision of technical manpower round the clock. No rates shall be charged from
the patients.
Tender bids have already been floated for the same and M/s Apollo Hospitals, Chennai have been finalized for
undertaking the task. Government/SHSB shall pay a monthly rental to the agency, based on the monthly cost as
projected by them in the financial bid.
Status Negotiations are on with M/s Apollo on the costing for the Dialysis unit
GOI had approved Rs.3.00 crores for the project in the last PIP.
Budget
Activities
Project cost for one Dialysis unit with 8 Dialysis machines
(covering suitable manpower, power, diesel, water, general medical
indent & consumables, CMC, RO membrane changing, resin
changing, pre-filter changing, activated carbon filter changing,
sedimentation filter changing, insurance of equipments, building
maintenance, administrative expense, contingency, depreciation on
equipments etc)
Total proposed budget
Rs.50.00 lacs x 1 year x 6 units=
Rs.3.00 Crores
(The previously approved Rs.3.00 is
available with the State which may be
ratified for expenditure in 2009-10)
4.8. Setting Up of Ultra-Modern Diagnostic Centers in Regional Diagnostic
Centers (RDCs) and all Government Medical College Hospitals of Bihar
State Health Society Bihar is implementing the National Rural Health Mission (NRHM) to improve the
availability of and access to quality health care for people. Setting up of Ultra-Modern Diagnostic Centres
through Public Private Partnership (PPP) in 9 Regional Diagnostic Centres (RDCs) and 6 Medical College
Hospitals (MCHs) of Bihar has been initiated.
Project Area Regional Diagnostic Centers in Ara, Gaya, Bhagalpur, Munger, Muzaffarpur, Motihari, Purnea,
Saharsa and Chapra.
Government Medical College Hospitals PMCH, NMCH, SKMCH, DMCH, ANMMCH, JLMNCH
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M/s Softline, New Delhi and M/s Doyen Diagnostics, Kolkata have been contracted to set up the Ultra-Modern
Diagnostic Centers.
Project Scope To operate, maintain and report 24-hours Ultra-Modern Diagnostic
Centers in RDCs & MCHs and report the progress to the RDDs (who would be in-charge of
monitoring the RDCs project) and the Superintendents (who would be in-charge of monitoring
the MCH project) and the SHSB.
Project Condition -
The State Government has created the buildings for Regional Diagnostic Centers at all the towns
mentioned in Project Area. In the case of MCHs, space shall be provided in the premises of the MCH
itself at the discretion of the Superintendent of the concerned MCH.
The agency has to provide everything from equipments & machine, logistics, consumables etc to
personnel; the said RDC/MCH will only provide space for the Diagnostic Centre along with space for
storage at a nominal monthly rent payable to the DHS of the concerned district (in the case of RDC) and
the Rogi Kalyan Samiti of the concerned MCH (in the case of MCH) by the agency.
The agency has to ensure the installation, maintenance, functioning with provision of expert technical
manpower round the clock.
Rates (to be charged from the users) shall be applicable as per AIIMS, New Delhi for the basic,
standard and other specialized tests under each Diagnostic head.
The project is on a revenue sharing model
The project is for ten (10) years depending upon performance further extension will be considered.
Facilities that will be provided in RDCs and MCHs areà Pathology- Bio-Chemistry, Radiology Digital x-ray,
CT scan, MRI, ECG, Mammography.
GOI had approved the project in the SPIP 2008-09.
The state requires budget in this regard only for reimbursement to the Private Parties by the RKS of the concerned
hospital for providing free services to BPL patients. All the remaining cost for setting up centers will be borne by
the private providers.
Budget
Activities
Total proposed budget
Reimbursement cost to the Private Parties by the RKS of the Rs.200 x 1000 BPL patients x 12
concerned hospital for providing free services to BPL patients
months x 15 units=
Rs.3.60 Crores
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4.9. Providing Telemedicine Services in Government Health Facilities
SHSB has sought Public Private Partnership in providing Telemedicine Services in Government Hospitals of
Bihar. Additionally the State is also in consultation with ISRO for providing technical support for the same
either based on Gujarat or Orissa model. The project shall be initially piloted in two or three districts.
Project Goal:
The goal of this project is to establish a model for application of Telemedicine to address the issues of
improving accessibility, more efficient use, ensure equitable distribution and enhancing the quality of available
health services across the state.
Project Objectives:
The overall objective of the assignment is to provide a comprehensive model for Telemedicine in the state of
Bihar.
The specific objectives of the assignment are -
· Establish and Provide Telemedicine Network for accessibility of healthcare service facilities in the
State linking 2-3 District Hospitals to Patna Medical College Hospital (PMCH) of the State.
· To reduce the cost of health services by providing specialized service through the network.
· Upgrade the skills of existing Medical staff at the DHs and PMCH.
· To ensure routine Management and Administration of the activities
· To provide timely reports and information to the SHS, Bihar for audit and review
· To ensure Maintenance, Servicing & Up-gradation of the Telemedicine Facility
Project Timeframe- the Project is planned for a period of five years, and after that based on evaluation by the
SHSB the project may be extended.
Scope of Work
The outsourced agency will provide complete technical support in terms of designing the telemedicine network
for DH & PMCH, supply of hardware and software required, installation and operationalization and
maintenance of telemedicine system including necessary training. The agency shall also facilitate defining and
formalizing linkages between DHs and MCH and thus facilitate consultation through telemedicine.
The detailed roles and responsibilities of the private partners to meet the aforesaid objectives are as follows:
‣ Providing the necessary equipment and software for establishment of the above system.
‣ Install, Operate and maintain appropriate Telemedicine facility.
‣ Sufficient bandwidth to transfer Data
‣ Real time videoconferencing with Patient
‣ Transfer of diagnostic data on real time basis or/and Store & Forward basis, as the case may be
through V-sat/Broadband/ISDN
‣ The facility should enable transmission of patients medical records, including images, and provide
a live two-way audio and video link between patient and specialist
‣ Building the capacity at DH as well as associated PMCH to operate and use the system by
providing training.
‣ Technical manpower support to run the system to operationalise the project.
‣ Continued technical back up for maintenance of the system.
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‣ Ensuring Quality Standards
‣ Providing detailed reports of Telemedicine services as per the Proformas provided at the time of
signing of the contract, or as issued by the SHS from time to time.
The Telemedicine framework shall be at the secondary and tertiary levels:
‣ Level 1 District Hospital
‣ Level 2 PMCH
Tele Medicine Equipment
‣ The Software should be able to use any Digital Imaging and Communications in Medical (DICOM
standard compliant) equipment.
‣ Attachments for capturing and transferring DICOM standard images from various available medical
devices, including X Rays; CT Scans; MRIs, and Ultrasound Images
‣ Devices for creating high resolution virtual slides from various Pathological images and transferring
them
‣ The agency shall provide the following equipment at the DHs under this project:-
1. ECG suitable for neonatal, pediatric and adult patients
2. EMG suitable for neonatal, pediatric and adult patients
3. Ultrasound scanner (should be able to do various diagnosis like cardiology, obstetrics &
gynecology, radiology etc)
4. Color Doppler ultrasound scanner
5. Endoscope
6. Digital Microscope
7. Indirect Ophthalmoscope
8. Funds Camera
9. Multipara monitor (ECG, Temp, NIBP, SPO2, Heart rate) suitable for neonatal, paediatric and
adult patients
10. Electronic Stethoscope
11. Pulmonory function test
12. TMT machine
13. ENT Audiometry
14. Mammography
15. Glucometer
16. Fetal Heart Rate Monitor (for measuring the heart rate of foetus)
17. EEG
Note:
1. All the above mentioned instruments would be able to connect to the computer (DICOM compatible)
for obtaining digital data.
2. The hardware/software so installed would also be able to send data generated from Digital X-Ray, CT
scan and MRI mechanism, which may be installed by the Government.
Ailments to be covered under the facility
Software would be capable of handling and transferring any type of medical data which may be text, audio,
video or image.
The Medical areas which would be handled include:
ü Cardiology
ü Radiology
ü Oncology
ü Pathology
ü Ophthalmology
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ü
ü
ü
ü
ü
ü
ü
ü
Nephrology/Diabetes
Urology
Neurology
Psychiatric
Dermatology
Gynaecology
Cosmetic Surgery
Vector borne deceases
The following Telemedicine software package modules would be used
a). Electronic Medical Record (EMR)
b). Tele-Cardiology
c). Tele-Radiology
d). Tele-pathology
e). Tele-dermatology
f). Tele-endoscopies
g). Tele- Ophthalmology
h) Video Conferencing
Indicators for assessment of the utility of telemedicine system
1. Number of Online Consultations
a. Gross Number
b. Timings
i. Routine
ii. Emergency
c. As percentage of total seen
d. How many physically sent
e. How saved the need for transfer
f. Whether any dramatic savings (e.g. Life /death matters) ensued
2. Number of investigations
a. On line Routine / Emergency investigations.
b. Number and type of specialized investigations, waiting time and reporting time
3. Follow up visits
4. Number and type of procedures
a. At PHCs
b. At centers where staff is referred to.
5. Training of Health and paramedical staff in telemedicine.
Expected results:
a. Number
b. Level of skills and confidence.
‣ Speed: Patients can be diagnosed and treated quickly, without the need for a potentially life-threatening
journey to a larger hospital.
‣ Service extended: Referral process strengthened and specialist advice available at PHC level.
‣ Economical: In terms of cost of travel to a hospital for a second opinion and in service itself, once
facility set up.
‣ Improved quality of health services.
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‣ Institutionalize linkages between PHCs and hospitals through formal arrangements to provide instant
consultation to PHCs and also honor referral cases from PHCs.
‣ Builds trust: Patients with low level of education are often suspicious of visiting a city specialist. Teleconferencing
offers frequent consultation with the specialist, building confidence and improving
patients compliance to treatment, thus patient satisfaction will increase
‣ Through linkages with specialists and hospital, PHCs will be able to cater to wider spectrum of
needs/expectations.
Budget
Activities
Operational cost for providing telemedicine
facility in the state in this FY 2009-10
Total proposed budget
Rs.3.00 Crores
Note : GOI had approved the project and budget in
the previous PIP and ratification is solicited for the
same for this FY
Work plan
Activities
Floating of tender, Awarding of contract and finalization of
interactions with ISRO
Pre-Commissioning period
Implementation of the project
2007-08
Q1 Q2 Q3 Q4
4.10. Outsourcing of Pathology and Radiology Services from PHCs to DHs
Under this scheme Pathology and Radiology services have been outsourced to different Private agencies. The
agencies have and/or are in the process of setting up centers/diagnostic labs/collection centers at the
hospitals/facilities. The state has fixed the rates on which the agency charges from the patient. The state has to
only provide space at the hospitals to the agency for running the Pathology and Diagnostic Centre.
However under the project service expansion has been done and Ultrasound facility has to be provided at
various locations at DHs and SDHs. For the purpose of establishment of Central Reporting System (CRS) for
X-ray and Ultrasound Units is being done at IGIMS, Patna. The purpose being CR system will connect all the
Ultrasound and X-ray centers of IGEMS set up in Government Hospitals under this contract, with Teleradiology
in a phased manner.
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The Agency shall provide all necessary hardware, software and manpower for establishing the network between
IGIMS and each of its Radiology unit having X-Ray and Ultrasound facilities for running the Tele-Radiology
service.
SHSB has to provide space in coordination with DoH, GOB; radiologist to report on the ultrasound and x-ray
images (preferably retired persons), telephone line with broad band connection and necessary power
connections.
The state requires budget in this regard only. All the remaining cost for setting up centers and providing
services will be borne by the private providers.
Budget
Activities
Total proposed budget
Telephone line with broad band connection and necessary
Rs.1,00,000 x 12 months =12,00,000
power connections
Sourcing of private radiologists to report on the ultrasound
and x-ray images through the CRS at IGIMS incase of nonavailability
of Government radiologists @Rs.25000 per
25000 x 6 x 12= 18,00,000
month for 6 radiologists
Total 30,00,000/-
4.11. Operationalising Mobile Medical Unit
SHS, Bihar on behalf of the Department of Health, Government of Bihar, has invited Private Service Providers
for providing Mobile Medical Units (each unit fitted with GPS- Global Positioning System) to provide primary
health care facilities in the hard to reach rural areas of various districts of Bihar.
Three agencies have been awarded the contract for operationalising mobile medical units in all the districts.
Scope of Work
Private Service Providers for providing mobile health care services in rural Bihar of curative, preventive and
rehabilitative nature, to be provided by the service provider along with all deliverables like Mobile Clinic (each
unit fitted with GPS- Global Positioning System), professional manpower, and other such services, to provide
and supplement primary health care services for the far flung areas in the various districts of Bihar and to
provide a visible face for the Mission.
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Project Objective
To provide and supplement regular, accessible and quality primary health care services for the farthest areas in
the districts of Bihar and to provide visible face for the mission and the Government, also establishing the
concept of Healthy Living among the rural mass
Project Scope
The detailed roles and responsibilities of the private partners to meet the aforesaid objectives are as follows:
‣ Providing the requisite vehicle and equipments and software for Operationalization of the MMU.
‣ Install, Operate and maintain appropriate GPS facility.
‣ Technical manpower support to run the MMU and provide the services
‣ Continued technical back up for maintenance of the system.
‣ Ensuring Quality Standards
‣ Providing detailed reports and maintain database of information of MMU services as per the
Proformas provided at the time of signing of the contract, or as issued by the SHS from time to
time.
Vehicle Type for MMU
o
o
o
o
o
Brand new GPS fitted, fully Air Conditioned TATA 709 chasis or equivalent vehicle of similar dimension
from reputed manufacturers for MMU
An accompanying vehicle of TATA Sumo or Mahindra Bolero or equivalent specification make vehicle
for Carriage of Medical persons and also to be used as ambulance for transporting patients in case of
emergency. The body of vehicle should be suitably modified to serve this dual purpose.
Mobile Van should be designed keeping in mind the following criteria -ease of deployment, female
privacy, community acceptance and cost.
Web enabled MIS has to be ensured along with a Control room at Patna or Commissioner HQ.
Temporary shed facility shall have to be ensured at the site for the patients in waiting.
Manpower
The manpower to be employed for the program is to be appointed by the Private agency as such-1 Doctor, 1
Nurse, 1 Pharmacist (van supervisor),1 OT assistant , 1 X-ray technician, 1 ANM , 1 Driver (Qualification
requirements annexed)
Equipments to be provided in the MMU
Medical Equipments -Semi Auto-Analyzer, Portable X ray unit, Portable ECG, Microscope, Screen, Stretcher,
O.T Table with standard accessories, Stools, Dressing Trolley/Instrument trolley, Dressing drums, Oxygen
Cylinder, Suction Machine., Ophthalmoscope, Refraction set, Horoscope, Mobile light or Ceiling light (OT
Light),Centrifugal Machine, Hemoglobin meter, Glucometer, Autoclave, Incubator, Urine Analyzer, Vaccine
carrier, Weighing machines-adult and infant, Stethoscope, BP Instrument, Kits like Suture removal kit,
Pregnancy test kit, IUD insertion kit, Starter, Regent kit, HIV testing kit, General Instrument kit, First Aid kit,
various, tests and surgery kits, Normal Ambulance appliances or accessories like foldable furniture, waste
basket, linen, mattress, mackintosh sheets, fire extinguisher etc
Silent DG set, Audio-Visual Equipment with projection system for IEC especially with, 40 LCD, P&A
System, Cell phone
Service Areas
The Medical areas which would be handled include:
1. Free General OPD/ Doctor Consult
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2. Free Drugs - Free dispensation and procurement of medicines as per the Essential Drug List prescribed
by GoB for PHCs (Annexed) has to be ensured by the private agency
3. Emergency Services during epidemics and Disasters
4. Network and referral between PHC/CHC/Private clinics
5. Generating health indicators and monitoring behavioral changes
6. Gynec clinic
7. Antenatal Clinics
8. Post Natal Care
9. Infants and Child Care including immunization with Vitamin A supplementation (support for the same
to be provided by the Government)
10. Diagnosis, Referral and Rehabilitation for Non-communicable diseases eg. Cardiac Diseases,
Hypertension, Diabetes, etc
11. Adolescent and Reproductive Health
12. Other Services like Treatment of Minor Injuries and Burns, Aseptic Dressing, TT immunization,
Treatment of Minor burns, Minor Suturing and removal referral etc
13. Minor lab investigations
14. Eye examination
15. ENT examination
16. HIV testing
17. Promotion of contraceptive services including IUD insertion.
18. Prophylaxis and treatment of Anemia with IFA Tablets.
19. IEC and counseling along with preventive health screening and health awareness programs
20. Service related to different public health programmes.
21. Pathological services.
22. Radiology Services X-ray and Ultra-sound
23. Preventive Health Screening and Health awareness programs
24. Medical camps will have to be conducted whenever emergency need be
Commissioning Period- 2 months from the date of contract signing
Budget
Activities
Total proposed budget (in Rs.)
Projected cost for 1 MMU project at district level
Rs.4.68 lakhs x38 units x 9 months
=16,00,56,000/-
Total 16,00,56,000/-
4.14. Monitoring and Evaluation
State Data Centre
The State has One Data Centre which collects data from all PHCs, Sadar Hospitals & Sub. Div. Hospitals of all
districts on a daily basis through land line phones and mobile phones. The collected data are stored and
maintained in a computerised format and they are sent to respective programme officers according to their
requirements. The collected data includes all the parameters required under RCH/NRHM for monitoring. The
Data Centre has the following facilities:-
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(1) Computer Programmers- 2 (Two)
(2) Supervisor- 2 (Two)
(3) Computer Operators- 20 (Twenty)
(4) Server with UPS - 1 (One)
(5) Computers (including one server) with UPS - 22 (Twenty two)
(6) Fax Machine with Auto Sending & Receiving Facility - 1 (One)
(7) Laser Printers with Fax & Photo Copy Facility - 4 (Four)
(8) Telephone connection (with Broadband connection) - 20 (Twenty)
(9) Invertor - 1 (One)
(10) Software - As Required
(11) EPABX-Telephone Network System - 1 (One)
(12) All necessary furnitures - As Required
District & Block Data Centres
The Data Centers at each and every hospital (PHC, Sadar Hospital, Sub-Divisional Hospital etc.) are being
established through outsourcing. The main purpose of these Data Centers of Hospitals is to gather and maintain
health related data under RCH/NRHM programme in their computer system and they upload the gathered health
related data on the web-server of SHSB on daily basis. The Data Centers contain one computer with UPS, Laser
printer, Phone connection, Internet connection, Computer operator, Misc. etc.The GPRS enabled mobile sets
have been given to each and every data centers. The total no. of Data Centers to be established is 685 and the
estimated cost is Rs. 7500/- per Data Centre per month.
The District/Block Data Centres units would be as such:
ü Primary Health Centre (PHC): 533
ü Sub-Divisional Hospital (SCH): 43 (23+20 (new))
ü District Hospital: 38 (25+13 (new))
ü RDD: 09
ü District Health Society: 38
ü Medical Colleges & Hospitals: 24 (6 x 4)
Total Data Centre: 685
Budget
Activities
Total proposed budget (in Rs.)
State Data Centre (monthly payment of the Data Centre is
Rs. 175000/-, therefore, Rs.175000 x 12
Rs.2100000/-
District & Block Data Centres Rs. 7500/- x 12 x 685 Rs. 61650000/-
Total 6,37,50,000/-
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4.15. Generic Drug Shop
Under the PPP initiative Generic Drug Stores shall be set up at all MCHs, DHs and PHCs. The Private agency
has to keep 188 types of drugs at the store. The state has provided only space for this purpose to the agency and
the agency shares a % revenue share with the Government. The state has also fixed rates for the Generic Drug
as per MRP.
No additional cost is involved.
4.16. Nutrition Rehabilitation Centres (NRCs) for Treatment of Severe and Acute
Malnutrition (SAM)
Child malnutrition extracts a heavy toll on both human and economic development, accounting for more than
50 % of child deaths world wide. The consequences of malnutrition are serious leading to stunting, mental and
physical retardation, weak immune defense and impaired development. More than one-third of worlds
malnourished children live in India.
In India, as revealed by the recent National Survey (NFHS-3, 2005-06), malnutrition burden in children under
three years of age is 46 %. With the current population of India of 1100 million, it is expected that 2.6 million
under-five would be suffering from severe and acute malnutrition which is the major killer of children under
five years of age. It can be direct or indirect cause of child death by increasing the case fatality rate in children
suffering from such common illnesses as diarrhea and pneumonia.
The risk of death in these children is 5-20 times higher compared to well-nourished children. Severe and acute
malnutrition is defined by a very low weight for height, below -3 z* scores of the median WHO growth
standards, presence of visible severe wasting or bipedal Oedema, or mid-upper arm circumference (MUAC)
of

MEASURES TO MANAGE MALNUTRITION:
While mild and moderate forms of malnutrition in the absence of any minor or major illness among children can
be addressed through Anganwadi centres, by supporting mothers to ensure service utilization and appropriate
feeding and care practices at the household level; the treatment of children with severe and acute malnutrition
calls for facility-based treatment by admitting children to a health facility or a therapeutic feeding centre. This is
mainly because these children generally are seen to suffer from acute respiratory infections, diarrhea and
pneumonia. A decision was thus taken to set up Nutrition Rehabilitation Centers which is a unit for the
management of SAM children where they are kept under observation and provided with medical and nutritional
care. In additional to curative care, special focus is given on timely, adequate and appropriate feeding to
children. Efforts are also made to build the capacity of mothers through counseling to identify the nutrition and
health problems in their child.
Initial discussions with UNICEF on establishment of NRCs in the 2007 flood affected districts, resulted to be
extremely productive. It was thought worthwhile to pilot NRCs for treatment of children suffering from severe
forms of malnutrition in 2 flood affected districts with support from UNICEF for supervision and monitoring of
activities, especially in the initial period of management of NRCs.
Thus the NRCs were established in the districts of Muzaffarpur and East Champaran during August-September
2007. The proposal includes the establishment cost and the running cost for the two piloted NRCs in the
management of child malnutrition.
Budget
Activities
Running cost of two NRCs for one month = 2,05,600/- x 2
= 4,11,200/-, therefore for one year, 411200 x 12 months
Total proposed budget (in Rs.)
49,34,400
Total 49,34,400/-
4.17. Hospital Maintenance (Funded by State Govt)
The state has outsourced the maintenance of Hospitals to private agencies. The amount require for this purpose
is borne by the state government.
The activities include
· Maintenance of Hospital Premises.
· Generator Facility.
· Cleanliness of Hospitals.
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· Washing
· Diet.
4.18. Providing Ward Management Services in Government Hospitals
It is proposed to provide Ward Management Services including Ward Boys for about 1900 health facilities in
Bihar like the 100, 300 and 500 bedded District Hospitals, 100 bedded Sub-Divisional Hospitals, 30 bedded
Referal and Primary Health Centres and 6 bedded Additional Primary Health Centers and also Govt. Medical
College Hospitals.
The task shall be done under PPP, wherein the agency shall be responsible for the following services-
· Providing one ward boy for 10 or less than 10 beds and at the rate of one boy per additional 10 beds.
· Ensuring 7x24 hours services of Ward Boys.
· Shall provide one wheel chair for 10 beds or less and @ one wheel stretch for additional 20 beds.
· Deploying all Ward Boys in uniform dress bearing a unique identification no. with name.
· Assisting the nurses in the detoxification unit.
· Attending to the personal hygiene of bed-ridden patients.
· Escorting the patients to labs, other specialists & wards.
· Monitoring the visitors and checking patients for possession of drugs.
· Conducting physical exercises for the patients.
· Assisting in detoxification of toilets and ward etc.
· Daily replacement of used bed-sheets by clean bed-sheets with proper care.
· Any other task related to ward management prescribed by the authority.
Payment shall be made on a per bed per month for all the hospitals. In the FY 2009-10, it is to be piloted in 5
District Hospitals therefore initially fund is required as such -
Budget - @Rs.100/- x 2500 beds x 12 months=30.00 lakhs
4.19. Provision for HR Consultancy services
SHSB has invited offers from Human Resource Consultancy Services for assisting State Health
Society in selection and recruitment of doctors, nurses, paramedical staffs and other managerial and
clerical staff under guidance and direction of State Health Society, Bihar.
Responsibilities of the Human Resources Consultant: The Consultant will be required to prepare
panel of names for selection for the post as per reservation roster. Applications would be invited
through open advertisements. Selection process may include open written test or interview or marks
obtained or combination of these processes in the qualifying examination depending upon the no. of
applicants and urgency. The mode of selection to be adopted will be the sole discretion of the State
Health Society.
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To achieve this objective, Human Resources Consultant shall be responsible for the following
services:-
· Will have to set up an office for this purpose.
· Will be providing all office equipments and professional manpower for this purpose. SHSB shall
provide only space.
· All works like processing, data entry, scrutiny, selection, panel formation as per reservation roaster
and recruitment etc.
· Any other task related to Human Resources Consultancy Services prescribed by the authority.
4.20 Advanced Life Saving Ambulances
Budget – Rs.22,50,000/- per year
SHSB is endeavoring to provide prompt quality pre hospital care to patients, trauma victims, pregnant women,
for the purpose of which Emergency Network service is being piloted under PPP in Patna District.
The objective is to save lives of Road Traffic Accidents, cardiac emergencies, fire victims and other emergency
cases.
Description
There will be 5 Advance Life saving Ambulances (Trauma, Critical & Cardiac Care) & 5 Basic Life saving
Ambulances which will run within Patna Municipal Corporation area and its sub urban areas. Every Ambulance
shall be manned by a Driver, an Emergency Medical Technician and trained Helper to provide basic care during
transportation of patients.). For each trip made by the Ambulance to anywhere within the limits of Patna
Municipal Corporation and its sub-urban areas, a charge of Rs. 300/- shall be collected by the outsourced
agency from the patients. The agency has to set up a Control Room in Patna which would operate for 24 hours
in a minimum of 3000 sq. ft. area through dedicated toll free three digit telephone numbers (102). The agency
has to provide 10 parallel lines with hunting facilities. The Control Room will receive emergency calls related
to Medical Services and from Police and Fire Fighting Services to cater to Medical Emergencies. The agency
shall provide GIS (Geographic Information System) maps, GPS (Global positioning systems) / AVLT
(Automatic Vehicle Location Track) and all the other necessary hardware/software for Computer Telephonic
Integration. The agency shall keep a record of the contact numbers and location of each of the 10 Ambulances,
all Hospitals of city which can provide medical emergency, all the Police Stations, Police Control Room, Police
Head-quarters and Fire Services in the city. The agency shall bear all expenses relating to hire of space, water,
electricity charges, furniture, furnishing etc in running the Control Room. The Control Room shall also keep
battery / generator backup facility so that services could be provided un-interrupted round the clock.
Support activities- The agency has to also undertake the following-listing of Govt and private hospitals which
can provide emergency services round the clock. Necessary training of hospital personnel to take up
Emergency cases. Dissemination of the scheme and the toll free numbers for police, fire, health, education and
general public so that this service can be utilized.
Budget-
Items
Amount (Cost/month)
Cost of Emergency service network in 989000.00 x 9= 8901000
Patna (annual cost for running 10
ambulances)
Total 89,01,000
IEC of the project, dissemination, 25 lakhs being provisioned in IEC, Training (Part
monitoring and training
A budget)
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7. Mobilisation and Management Support for Disaster Management
In Bihar, the northern part is extremely flood prone. Due to the confluence of many rivers as well as its
proximity to the hills of Nepal, the population living in about twenty two districts in Bihar suffers from floods
every year. In the year 2007, the floods have been among the most devastating in decades. East Champaran,
Darbhanga and Madhubani districts of Bihar, have been affected by floods most of the years and face floods
almost every year, only the extent and the intensity vary. In 2007 however, over 24 million people in some
8,500 villages in 22 districts in Bihar (including 2.5 million children below 5 years) were affected by floods. As
per the department of disaster management, over 800 people lost their lives. The most affected districts are
Muzaffarpur, Sitamarhi, East Champaran, Saharsa, Supaul, Madhubani, Darbhanga, Katihar, Samastipur,
Sheohar, Khagaria, Madhepura, Araria, Begusarai, Gopalganj and West Champaran. There is a need to
strengthen local capacities and develop the community potential to tackle the flood moving towards early
recovery. There are essentially two types of the vulnerable affected in need of immediate assistance: a) those
who are displaced; b) those who are in original locations but cut off.
In year 2008, the floods were mainly due to the rivers, in Kosi region, changing their course, which was an
outcome of a major breach in the eastern embankment of Kosi River in Kusha (Indo-Nepal) border in mid-
August 2008. The Department of Disaster Management, Bihar has estimated that 2.95 million people across 979
villages are facing the perils of present floods in the five districts-Araria, Supaul, Saharsa, Madhepura and
Purnea. About 1.18 lakh are expected to be the vulnerable segment of pregnant and nursing women and about
4.4 lakhs are likely to be children less than 5 years of age.
Preparedness is the best response: Global and National experience in disaster situations indicates that
immediate and appropriate response mitigates the agony of affected population. In flood related disaster, due to
several factors, such as, the timing of flooding, the magnitude of floods, large number of people affected, scope
of displacement, and low awareness among the affected on the health hazards, there has been an acute risk of
outbreaks of water borne and vector borne diseases, such as gastroenteritis, malaria, dengue fever, leptospirosis
and diarrhoea in the flood affected areas. Children under five, pregnant mothers, elderly and patients are at the
highest risk of becoming victims to epidemics. Another factor which increases vulnerability is the socioeconomic
profile of the affected. A large majority of them belong to socially marginalized communities who are
poor as well. Providing clean potable water, protecting the area from epidemics, Safe delivery options for the
pregnant mothers, rehydrating the diarrhea affected people of all age groups with ORS, immunizing children
from 6 months-10 years in the affected area with measles vaccine, essential treatment for the sick etc are some
of the absolute priorities for the health personnel during a disaster.
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To protect the health of the affected population based on the past experience, it is proposed to preposition
certain important health response supplies during the current year at State level. These supplies can be sent to
the affected populace at the earliest to provide relief. The calculations are being done assuming the affected
population to be 20 million and based on last years initiatives and expenditure by the state-
With the experiences of the last year the state would like to propose a revolving fund for the preparedness and
relief for the flood affected people in the State:
Budget:
Activity Unit Rate Amount
( In Rs )
Setting up of State Health Disaster Management 1 58,750 x 12 7,05,000
Cell in Health Department, GoB
months
Mobilizing medical teams from Non flooded 50 25900 ( a team 12,95,000
districts for one week
of two Doctors
and two
paramedics for
7 days)
Transportation ,Mobility & Monitoring state &
Rs.5.00 lakhs
8000000
district level for 16 districts
per district
Total 1,00,00,000/-
8. Health Management Information System
(1) Web Server System
The State Health Society has established one web-server with 512 kbps leased-line connection for on-line
uploading and reporting of Health related data through web-server application of State Health Society, Bihar.
The following system shall be introduced in parallel to the existing system of Data centers:
1. Online uploading of Health related data directly from Data Centers of PHC/Hospitals.
2. Compilation and reporting of Health related data through developed application software in very less
time.
3. The reports will be more accurate and consistent.
4. The DM/CS/DHS can view the different reports of Health services of their own district in on-line
mode, therefore proper action can be taken quickly.
5. The officers/staff of state level can view the reports of Health services of all districts in online mode,
therefore proper action can be taken promptly.
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6. According to requirement, any new report can be added and the information can be obtained from
PHC/Hospitals in online mode quickly.
7. More security and safety of Health related database.
Therefore further up-gradation and maintenance of web-server are required in coming financial year like
blade server (more storage capacity and very high speed processing), maintenance support of web-server
etc.
The website for all 38 districts are also required to be designed, created and maintained along with the
renovation of website of State Health Society, Bihar.
Budget
S. No Items Amount (Rs.)
1 Leased Line(512 KBPS) Rs. 287642/-
2 Up gradation of Leased Line - (1MBPS) Rs. 200000/-
3 Antivirus (No. of antivirus-3) Rs. 15000/-(Rs. 5000 x 3)
4 Web-site: (Design, Creation, Maintenance, Registration, Rs. 500000/-
Hosting of state and all 38 districts)
5 Blade Server(One Blade) Rs.300000/-
6 One Additional Blade Rs.135000/-
7 Maintenance Rs. 50000/-
8 Software development Rs. 500000/-
Total Rs. 19,87,644/-
(2) HMIS Reports
As we know that NRHM aims to continuously improve and refine its strategies based on the inputs and
feedback received from the State and from various review missions. One of our priorities is to build a robust
Health Management Information System (HMIS) that is used for improving, planning and programme
implementation at all levels. NRHM has introduced Revised HMIS formats and they are as follows:
SN Form No. Form Name Used at Frequency
1 NRHM/HSC/3/M
Monthly format for SCs and
Monthly (5 th of
HSC
equivalent facilities
following month)
2 NRHM/PSC/3/M
Monthly format for PHCs and
Monthly (5 th of
PSC
equivalent facilities
following month)
3 NRHM/CSC/3/M
Monthly format for CHCs and
Monthly (5 th of
CSC
equivalent facilities
following month)
4 NRHM/SDH/3/M
Monthly format for SDH and
Monthly (5 th of
SDH
equivalent hospitals
following month)
5 NRHM/DH/3/M
Monthly format for DH and
Monthly (5 th of
DH
equivalent hospitals
following month)
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6 NRHM/DHQ/3/M Monthly format for District DHQ
Monthly (10 th of
following month)
7 NRHM/DHQ/2/Q Quarterly format for District DHQ Quarterly (10 th )
8 NRHM/DHQ/1/A Annual format for District DHQ Annual (5 th )
9 NRHM/SG/2/Q Quarterly format for State HQ State HQ Quarterly (20 th )
10 NRHM/SG/1/A Annual format for State HQ State HQ Annual (15 th April)
11 NRHM/GOI/3/M Monthly Consolidated State HQ/DHQ
Monthly (20 th of
following month)
12 NRHM/GOI/2/M Quarterly Consolidated State HQ/DHQ
Quarterly (20 th of
following month)
13 NRHM/GOI/1/A Annual Consolidated State HQ/DHQ Annual (30 th April)
It is required to implement the Revised HMIS formats up to sub-center level.
(A) Printing of Formats
Sl.No. Form No. No. of
Pages/
Format
Total No. of Pages
used at one Health
Institution
Total No.
of Health
Institution
Total No. of
Pages used at
all
Institution/Yr
Details
1 NRHM/HSC/3/M 4 48(12x4) 11964 574272 11964x48
2 NRHM/PHC/3/M 6 72(12x6) 1905 137160 1905x72
3 NRHM/CHC/3/M 7 84(12x7) 533 44772 533x84
4 NRHM/SDH/3/M 7 84(12x7) 43 3612 43x84
5 NRHM/DH/3/M 7 84(12x7) 38 3192 38x84
6 NRHM/DHQ/3/M 1 12(12x1) 38 456 38x12
7 NRHM/DHQ/2/Q 2 8(4x2) 38 304 38x8
8 NRHM/DHQ/1/A 2 2(1x2) 38 76 38x2
9 NRHM/SG/2/Q 1 4(4x1) 1 4 1x4
10 NRHM/SG/1/A 3 3(1x3) 1 3 1x3
11 NRHM/GoI/3/M 6 72(12x6) 38 2736 38x72
12 NRHM/GoI/2/Q 2 8(4x2) 38 304 38x8
13 NRHM/GoI/1/A 7 7(1x7) 38 266 38x7
Total 767157
Surplus No. of Forms (including wastage and others-10%) 76716
Grand Total of Pages- 843873
Total Printing Cost ( @ Rs. 1.00 per page) Rs. 843873/-
B: Transportation of Formats
No. of pages sent per district= 843873/38 =
22207(approx.)
Transportation Costs per district=Rs. 1000
180

Total Transportation Cost for all 38 districts=38xRs.1000= Rs. 38000/-
C: Training At Block Level (PHCs, District Hospitals, Sub-Divisional Hospitals)
Training on Revised HMIS formats at District Level has been completed, so Training on Revised HMIS
Formats at Block Level (i.e. PHC, District Hospital and Sub-Divisional Hospital levels) has to be performed.
Therefore it is required to train the followings :-
ü Deputy superintendent of District & Sub-Divisional Hospitals
ü MOIC of PHCs
ü BHM
ü BAM
The training has to be performed to improve the quality of data. So the master trainer of each and every district
will train Deputy Superintendent, MOIC, BHM and BAM in their respective district.
Hence Fund require for giving TA/DA to all trainees and for training materials, stationeries and other cost. The
TA/DA given to trainees is Rs. 200/- per trainee (Only one time) and miscellaneous cost is Rs. 50/- per trainee
(Only one time)
Therefore budget calculation is as follows:-
(a) Total no. of trainees = 1680
The details are as follows:-
SN Designation Number
1 Deputy superintendent of District 38 (25+13 (new))
Hospital
2 Deputy superintendent of Sub- 43 (23+20 (new))
Divisional Hospital
3 MOIC of PHC 533
4 BHM 533
5 BAM 533
Total 1680
Budget
S. No Items Amount (Rs.)
1 Web Server System 19,87,644/-
2 HMIS Reports
A Printing of Formats
8,81,873
B Transportation of Formats
C Training of Formats at Block level (TA/DA Cost = Rs. 200/- 4,20,000
per trainee (only one time) x 1680= Rs. 336000/- + Misc. cost =
Rs. 50/- per trainee (one time) 50 x 1680=84000/-)
Total 32,89,517/-
181

9. Strengthening of Cold Chain
Effective cold chain maintenance is the key to ensuring proper availability and potency of vaccines at all levels.
However the recently concluded Vaccine Management assessment (VMAT) in Bihar in 2008 and the National
Cold chain assessment (July 2008) observed several deficiencies in cold chain storage and management in
Bihar.
With a steadily increasing immunization coverage for Routine Immunization, rise in demand for Immunization
services throughout the state, the consumption of large quantities of vaccines in frequent Supplementary
Immunization activities and the possibility of introduction of newer vaccines in the near future, it is necessary
that the capacity of existing cold chain stores as well as the proper management of immunization related
logistics be strengthened on a urgent basis.
For this there is need for refurbishment of existing cold chain stores at all levels, particularly at the level of the
larger state, 9 regional and 38 district stores. Often there is lack of storage space in the existing health stores
leading to dumping of critical immunization related logistics like AD syringes, vaccine carriers and cold boxes
in the open, exposing them to the vagaries of nature and sometimes leading to their damage. Renovation of
existing stores would help in creating more organized dry space for both proper storage of material as well as
proper loading, packing and unloading of Immunization related logistics. The state store in particular receives
large quantities of materials and a separate ware house is needed to store immunization related logistics.
Provision to hire storage space on arrival of large quantities of material should also exist. In all stores across the
state there is also a need for proper electrification and wiring to ensure longevity of electrical cold chain
equipment and for reducing their frequent breakdown.
The lack of dedicated support manpower for immunization logistics management and for cold chain equipment
repair at all levels was observed during the aforesaid cold chain assessments and it was recommended that At
each of these facilities there should be a full time dedicated store manager. Where the load of operations is high
(SVS and RVS) the store manager should have adequate support staff to help him. (VMAT Bihar 2008) The
National cold chain assessment also recommended that a there should be a cold chain technician along with a
cold chain handler at all district stores and a cold chain handler at all PHCs. Since provision of regular staff in
these positions is not possible it is envisaged that contractual persons be hired for these activities.
Budget
9.1 Infrastructure Strengthening for Cold Chain
Items Units Amount
Refurbishment and integration of existing Warehouse facilities for R.I. as well
as provision for hiring external storage space for (during Immunization
Campaigns) Logistics at State HQ @Rs 15,00,000/-
1 1500000
182

Refurbishment of existing Cold chain room for district stores in all districts
with proper electrification,Earthing for electrical cold chain equipment and
shelves and dry space for non elecrtical cold chain equipment and logistics
@Rs 7 Lakhs per district
38 26600000
Earthing and wiring of existing Cold chain rooms in all PHCs @Rs 10000/-
per PHC
533 5330000
Total 572 3,34,30,000
12. Mainstreaming AYUSH under NRHM
The Indian systems of medicine have age old acceptance in the communities in India and in most places they
form the first line of treatment in case of common ailments. Of these, Ayurveda is the most ancient medical
system with an impressive record of safety and efficacy.
Other components such as Yoga, Naturopathy are being practised by the young and old alike, to promote good
health. Now days, practice of Yoga has become a part of every day life. It has aroused a world wide awakening
among the people, which plays an important role in prevention and mitigation of diseases. Practice of Yoga
prevents psychosomatic disorders and improves an individuals resistance and ability to endure stressful
situation.
Ayurveda, Yoga, Unani, Siddha and Homoeopathy (AYUSH) are rationally recognised systems of medicine
and have been integrated into the national health delivery system. India enjoys the distinction of having the
largest network of traditional health care, which are fully functional with a network of registered practitioners,
research institutions and licensed pharmacies. The NRHM seeks to revitalize local health traditions and
mainstream AYUSH (including manpower and drugs), to strengthen the Public Health System at all levels. It is
decided that AYUSH medications shall be included in the drug kit of ASHA, The additional supply of generic
drugs for common ailments at SC/PHC/CHC levels under the Mission shall also include AYUSH formulations.
At the CHC level two rooms shall be provided for AYUSH practitioner and pharmacist under the Indian Public
Health Standards (IPHS) model. At the same time, it has been decided to place or provision one Ayush doctor
on contract at the APHCs for the purpose and to ensure complete coverage of the population.
Activities
Improving the availability of AYUSH treatment faculties and integrating it with the existing Health Care
Service.
Strategies
‣ Integrate and mainstream ISM &H in health care delivery system including National Programmes.
‣ Encourage and facilitate in setting up of Ayush wings-cum-specialty centres and ISM clinics.
‣ Facilitate and Strengthen Quality Control Laboratory.
183

‣ Strengthening the Drug Standardization and Research Activities on AYUSH.
‣ Develop Advocacy for AYUSH.
‣ Establish Sectoral linkages for AYUSH activities Delivery System
1. Integration of AYUSH services in 1234 APHC with appointment of contractual AYUSH Doctors.
2. Appointment of paramedics where AYUSH Doctors shall be posted.
3. Strengthening of AYUSH Dispensaries with provision of storage equipments.
5. Making provision for AYUSH Drugs at all levels.
6. Establishment of specialized therapy centers/yush wings in District Head Quarter Hospitals & Medical
Colleges.
7. AYUSH doctors to be involved in all National Health Care programmes, especially in the priority areas
like IMR, MMR, JSY, Control of Malaria, Filaria, and other communicable diseases etc.
8. Training of AYUSH doctors in Primary Health Care and NDCP.
9. All AYUSH institutions will be strengthened with necessary infrastructure like building, equipment,
manpower etc.
10. Yoga trainings were held in various District hospitls to provide Yogic therapy for specific diseases and
also as a synergistic therapy to all other systems of treatment.
Integration of AYUSH with ASHA
1. Training module for ASHAs and ANMs has to be updated to incorporate information of AYUSH.
2. Training & capacity building to be undertaken by the Director, SIHFW and necessary training material
for the purpose to be modified and provided accordingly.
3. Drug kit that will be provided to ASHA contains one AYUSH preparation in the form of iron
supplement. But other drugs which are used in the treatment of common diseases control of
communicable diseases as well as drugs promoting the maternal and child health as well as improving
quality of life could be included subsequently.
Drug Management
1. Provision of supply drugs per AYUSH dispensary has been projected as per NRHM norm.
3. Provision of medicines for District AYUSH wings and Specialty Therapy Centres is proposed to be
operated in the State.
Special Initiatives for Mainstreaming and Strengthening of Ayush
(a)
Ayush department in Bihar contain 3 units known as Ayurvedic Unani and Homeopathic.
Government of Bihar running individual dispensary in rural area and a district level joint dispensary
of each 3 units (Ayurvedic, Unani and Homeopathic).
Following details of rural and district dispensary is given with their required fund far medicine,
machines and miscellaneous expenditures.
Sl. Dispensaries
N
o.
1. District Joint
Hospitals
(i) Ayurvedic
No. of
dispensa
ries
Medicine
184
Machines &
equipments
For
miscellaneous
expenditure
26 25,000x26=6,50,000 25,000x26=6,50,000 10,000x26=2,60,000
(ii) Unani 26 25,000x26=6,50,000 2,50,00x26=6,50,000 10,000x26=2,60,000
(iii) Homeopathic 26 25,000x26=6,50,000 25,000x26=6,50,000 10,000x26=2,60,000
2. Rural Dispensaries
(i) Ayurvedic
69 25,000x69=17,25,000 25,000x69=17,25,000 5,000x25=3,45,000

(b)
Sl.
N
o.
(ii) Unani 30 25,000x30=7,50,000 25,000x30=7,50,000 5,000x30=1,50,000
(iii) Homeopathic 29 25,000x29=7,25,000 25,000x29=7,25,000 5,000x29=1,45,000
Total 206 51,50,000.00 51,50,000.00 14,20,000.00
Ayush Units are also functioning in additional primary health centre in general health services. The
details of the APHC (Ayush) and their required medicines, machine and equipments and other
expenses are given as follows:-
Dispensaries
1. APHC(Ayus
h)
(i) Ayurvedic
No. of
dispensari
es
Medicine
Machines &
equipments
For
miscellaneous
expenditure
263 25,000x263=65,75,000 25,000x263=65,75,000 10,000x263=26,30,000
(ii)Unani 77 25,000x77=19,25,000 25,000x77=19,25,000 10,000x77=7,70,000
(iii)
59 25,000x59=1,47,5000 25,000x59=1,47,5000 10,000x59=5,90,000
Homeopathic
Total 399 99,75,000.00 99,75,000.00 39,90,000.00
(c) Ayush treatment facility is required to attach with Allopathic hospitals. For this purpose in each 15 Sadar
Hospital is proposed to open Ayush system of treatment with OPD and IPD of 3 system of medicine,
(Ayurvedic, Unani and Homeopathic).
The following provision is given as follows:-
(i) Contraction and Renovation- 10,00,000.00
(ii) Machines and Equipments- 1,50,0000.00
(iii) Medicine and Diet- 7,00,000.00
(iv) Training of Paramedical staffs- 1,00,000.00
(v) One time miscellaneous expenditure- 2,00,000.00
Total 35,00,000.00
Total required for 15 Sadar Hospitals and 3 units of each (Ayurvedic, Unani & Homeopathic)-
35,00,000 x3 x16=16,80,00,000.00
(d) Strengthening the Quality Control Laboratory
The quantum of Ayurvedic and Homoeopathic medicines used / procured in both public and
private health sectors is huge. There has been wide ranging concern about spurious, counterfeit and sub
standard drugs. In order to prevent the spread of sub standard drugs and to ensure that the drugs
manufactured or sold or distributed throughout the state are of standard quality, drug regulation and
enforcement unit has to be established in the state. The drug regulatory mechanism to be strengthened
at the state level to improve the quality of drugs used in AYUSH and ensure proper standardization.
(e).
Strengthening the Drug Standardisation and Research Activities on AYUSH Standardisation- As
research is an important activity in the process of development of a drug used for preventive and
curative purpose, it has been found that the major drawback in the development of AYUSH is lack of
research and development activity on the drugs used for the System. It is estimated that there are
10,000/- plant species found all over the world having medicinal properties. The following activities
will be undertaken to strengthen the drug standardisation and research activities on AYUSH:
1. It has been proposed to evaluate the chemical, pharmacological and clinical efficacy of the plant drugs.
2. The phytochemical entities responsible for the therapeutic activity of the plant drugs used in AYUSH
system will be evaluated through intensive R & D activity.
185

3. The pharmacologically viable drugs will be screened clinically under WHO guideline to establish the
therapeutic activity.
4. Clinical trial on different diseases like Psoriasis, Liver disorders, Diabetics, Asthma will be conducted
to establish the effect of various drugs used for such diseases.
5. It has also been proposed to conduct literary research like translation of manuscripts and its
publications.
6. Re-vitalisation of the local health traditions and the knowledge of traditional drugs used by experienced
local health traditioners will be gathered and documented.
(f) .
Strengthening of the State and District Management System of AYUSH
1. It is proposed to create necessary Managerial post in the State and District level for effective
supervision and implementation of different activities.
2. Necessary vehicles with supporting manpower has also been proposed to strengthen the supervisory
3. Joint monitoring visits to health centres to be undertaken by both AYUSH and Health Care Officials at
the District levels/State level.
BUDGET
AYUSH - Part A Requirement of the funds from NRHM –
1. Ayurvedic, Unani and Homeopathic dispensaries-
(i) Provision of 1 Ayush doctor at each APHC on contract
@ Rs.20,000/- x 1243 APHC x 9 months 22,37,40,000.00
(ii) Salary of Paramedics 4,36,29,300.00
@ 3900 x 1243 x 9 months
(iii) Salary of Pharmacists 7,27,15,500.00
@6500 x 1243 x 9 months
2. Training of Ayush Doctors & Paramedical staffs w.r.t Ayush wing-4,15,00,000.00
3. IEC 1,00,00,000.00
Grand Total (A) 39,15,84,800.00
AYUSH Part B
I. Requirement of the funds from the Ayush Departments for Ayush Dispensaries
1. For Ayush dispensaries & additional PHCs already existing
(i) For Medicine- 1,51,25,000.00
(ii) Machine and equipments- 1,51,25,000.00
(iii) Other Miscellaneous- 48,10,000.00
Sub-Total 3,50,60,000.00
2.New Ayush OPD and IPD in 15 Sadar Hospital 13,65,00,000.00
Total II – Rs. 171560000/-
II. Requirement of the funds from the Ayush Departments to uplift Ayush Medical Education for
Government Ayush Medical Colleges
1. Government TIBI College & Hospital (Unani), Patna
186

Rs. in Crores
(i) Building construction- 6.40/-
(ii) Machine and equipments- 1.00/-
(iii)Quality Testing Lab- 1.00/-
(iv) Pharmacy- 1.00/-
(v) Herbal Gardian - .20/-
(vi) Medicine and Diet- 0.050/-
Sub-total 9.65/-
2. Government RBTS Homeopathic Medical College, Muzaffarpur
Rs. in Crores
(i) Building construction- 0.35/-
(ii) Machine and equipments- 0.20/-
(iii)Quality Testing Lab- 1.00/-
(iv) Pharmacy- 1.00/-
(v) Medicine and Diet- 0.02/-
Sub-total 2.57/-
3. Government Ayurvedic College, Begusarai
Rs. in Crores
(i) Building construction- 3.00/-
(ii) Machine and equipments- 1.00/-
(iii) Medicine and Diet- 0.02/-
Sub-total 4.02/-
4. Government Ayurvedic College Hospital, Patna
Rs. in Crores
(i) Building construction- 2.668/-
(ii) Machine and equipments- 9.70/-
(iii)Renovation and Beutification- 1.634/-
(iv) Medicine and Diet- 0.50/-
Sub-total 14.502/-
5. Government Ayurvedic College, Patna
Rs. in Crores
(i) Building construction- 3.00/-
(ii) Machine and equipments- 6.75/-
(iii) Quality Testing Lab- 0.80/-
(iv) Herbal Gardan- 0.20/-
(v) Animal House- 0.05/-
Sub-total 10.80/-
Total II – Rs.415420000
Grant total required for teaching institutions and dispensaries (I + II)- 171560000 + 415420000
= Rs.58,69,80,000/-
187

Sl.
No.
Summary Budget of NRHM Part B
Budget Head
Modified
Budget
1 2 6
1 Decentralization
1.11 ASHA Support System at State Level 40650750
1.12 ASHA Support System at District Level 2160000
1.13 ASHA Support System at Block Level 79950000
1.14 ASHA Support System at Village Level 4500000
Available
under
2008-09
1.15 ASHA Trainings 86895000 1715.00
1.16 ASHA Drug Kit & Replenishment 22555800
1.17 Emergency Services of ASHA 6600000
1.18 Motivation of ASHA 63172875
1.19 Capacity Building/Academic Support programme 1000000
1.2 ASHA Divas 81230200
Total ASHA 388714625
1.21 Untied Fund for Health Sub Center, Additional Primary Health Center
and Primary Health Center
134807000
%
1.22 Village Health and Sanitation Committee 352102500 1000.00
1.23 Rogi Kalyan Samiti 85300000
Total Decentralization 960924125 22.06
2 Infrastructure Strengthening
2.1 Construction of HSCs (100 no. x Rs.9.50 lakhs) 95000000
2.2 Construction of PHCs 637967000
2.2a Construction of residential quarters of 200 old APHCs for staff nurses 600000000
2.2b Construction of building of 51 APHCs where land is available 37967000
2.3 Up gradation of CHCs as per IPHS standards (100 CHCs x Rs.40.00
lakhs)
188
400000000 8040.00
2.4 Infrastructure and service improvement as per IPHS in 20 (DH & 130000000
SDH) hospitals for accreditation or ISO : 9000 certification
2.5 Upgradation of ANM Training Schools 10000000 600.00
2.6 Annual Maintenance Grant 82080000
Total Infrastructure strengthening 1355047000 31.10
3 Contractual Manpower
3.1 Contractual Salaries, Incentives and Bonus (PHC doctors and staffs,
contractual staff nurses, ANM ®, mobile services)
676702000
3.1a Incentive for PHC doctors & staffs @ Rs. 50,000 for better performance in 12500000
implementing programmes (Rs. 50,000/ - per PHC per year)
3.1b Salaries for contractual Staff Nurses (2900 existing and 910 new) (Rs.7500 343900000

per month)
3.1c Contract Salaries for ANMsRs.6000 per month x 3500 (12 Months
Consolidated Salaries for Contractual ANMs)
252000000
3.1d Mobile facility for all health functionaries (District officials, PHC in charge, 60000000
CDPOs and ANMs @ 500 per month)
3.2 Block Programme Management Unit 289524000
3.3 Addl. Manpower for SHSB 6204288
3.4 Addl. Manpower for NRHM 25479000
Total Contractual Manpower 997909288 22.90
4 PPP Initiatives
4.1 102-Ambulance service 4032000
4.2 1911- Doctor on Call & Samadhan 816000
4.3 Addl. PHC management by NGOs 39864000
4.4 American Association of Physicians of Indian Origin (AAPIO) 5600000
4.5 SHRC (HOSMAC) 138.44
4.6 Services of Hospital Waste Treatment and Disposal in all Government
947.16
Health facilities up to PHC in Bihar (IMEP)
4.7 Dialysis unit in various Government Hospitals of Bihar 300.00
4.8 Setting Up of Ultra-Modern Diagnostic Centers in Regional Diagnostic
Centers (RDCs) and all Government Medical College Hospitals of
Bihar
36000000
4.9 Providing Telemedicine Services in Government Health Facilities 300.00
4. 10 Outsourcing of Pathology and Radiology Services from PHCs to DHs 3000000
4.11 Operationalising MMU (38 units x Rs.4.68 lakhs x 9 months) 160056000
4.14 Monitoring and Evaluation (State, District, Block Data Centre) 63750000
4.15 Generic Drug Shop No
Funds
required
4.16 Nutritional Rehabilitation Centre 4934400
4.17 Hospital Maintenance
4.18 Providing Ward Management Services in Government Hospitals 3000000
4.19 Provision for HR Consultancy services 2250000
4.2 Advanced Life Saving Ambulance (Rs.9,98,000/- x 9 months) 8901000
Total PPP Initiatives 332203400 7.62
5 Procurement of Supplies
5.1 Delivery kits at the HSC/ANM/ASHA (no.200000 x Rs.25/-) 50,00,000
5.2 SBA Drug kits with SBA-ANMs/Nurses etc (no.50000 x Rs.245/-) 12250000
5.3 Availability of Sanitary Napkins at Govt. Health Facilities
950000
@25000/district/year
5.4 Procurement of beds for PHCs to DHs 70286000
Total Procurement of Supplies 83486000 1.92
6 Procurement of Drugs
6.1 Cost of IFA for Pregnant & Lactating mothers (Details annexed) 50153000
6.2 Cost of IFA for (1-5) years children (Details annexed) 40923000
189

6.3 Cost of IFA for adolescent girls (Details annexed) 63750000
Total Procurement of Drugs 154826000 3.55
7 Mobilisation & Management support for Disaster Management 10000000 0.23
8 Health Management Information System 3289517 0.08
9 Strengthening of Cold Chain (Infrastructure strengthening) 33430000 0.77
Refurbishment of existing Warehouse for R.I. as well as provision for hiring
external storage space for (during Immunization Campaigns) Logistics at
State HQ @Rs 1500000/-
Refurbishment of existing Cold chain room for district stores in all districts
with proper electrification,Earthing for electrical cold chain equipment and
shelves and dry space for non elecrtical cold chain equipment and logistics
@Rs 7 Lakhs per district x 38 districts
Earthing and wiring of existing Cold chain rooms in all PHCs @Rs 10000/-
per PHC x 533 PHCs
10 POL of Generators for cold chain @ Rs. 600 per day per WIC. Rs. 500 per
day per district and Rs. 400 per day per PHC
1500000
26600000
5330000
30000000 0.69
11 Preparation of Action Plan 4100000 0.09
11.1 Preparation of District Health Action Plan (Rs.1 lakh per district x 38) 3800000
11.2 Preparation of State Health Action Plan @ 3 lakhs 300000
12 Mainstreaming Ayush under NRHM 391,584,800 8.99
Total 4,356,800,130 100.00
190

PART- C
Routine Immunization
2009-2010
191

Progress of Routine Immunization in Bihar:
The aim is to immunize all the children and pregnant mothers under Universal Immunization
Programme, in order to reduce IMR, MMR and NMR through routine immunization of all
children and mothers from six vaccine preventable disease in the state. The State of Bihar
has shown excellent Progress over the Years as shown in the Graphs below.
Evaluated % of Fully Immunized Child in Bihar
*** Ongoing Immunization Survey being carried out by SHSB outsourced to FRDS(Formative Research & Development Services) in the 1st
quarter of 2008 (completed in 10 randomly selected districts). In the next quarter another 10 districts are being taken.
100
90
80
70
60
50
40
30
20
10
0
11 11.6
NFHS 2 1998-
99
18.6
32.8
CES 2002 CES 2005 NFHS 3 2005-CES 2006-07DLHS,2008/09 Survey By
06
FRDS ***
38
42
52
Data source- NHFS & CES
Average % of Annual Increase/Decrease in full Immunization from
NFHS-II to NFHS –III
(a comparison among some of the states along with Bihar)
4
3
2.93 3.03
2
1
1.31
2.09
0
-1
Andhra
Pradesh
Punjab
Tamil
Nadu
-1.14
Karnataka Kerala Rajasthan Assam West
Bangal
-0.71 -0.63
Bihar
-2
-1.81 -1.71
-3
Data source –NFHS
192

Antigenwise Reported % of Cumulative
Coverage Bihar (Jan 07 Dec 07)
Some of the initiatives for increasing Immunization-coverage is given below.
‣ Micro-plans have been prepared for each District to ensure full coverage.
‣ Vaccines & Auto-Disposable (AD) Syringes provided free of cost to all
beneficiaries.
‣ Alternate System of Vaccine Delivery has been put in place for delivery of
Vaccines at Immunization sites (@ Rs 50/- per session site).
‣ Support is being provided for POL to PHCs/Districts/WICs/WIFs for maintenance
of Cold Chain on a daily basis.
‣ Mobility support is given to all the Diistricts and all DIO`s for Supervision of R.I .in
the field.
‣ Alternate Vaccinators are hired @1400/- per month where ever there is a shortage in
the Districts.
‣ All the Electrical Cold-chain Equipment in the Field are Under Annual Maintenance
Contract, which is out-sourced by the State Health Society.
‣ Generator are also out-sourced in all the PHC for un-Interrupted Power Supply to all
the PHCs /ILR Points.
‣ Fund has been provided for the Construction of Safety-Pits in every Block-PHC for the
safe disposal of AD-Syringes.
‣ All the H.W. (ANM) is being trained based on the Health Workers Immunization
Module in phases for Improving Immunization all across the State.
‣ Special Post Flood catch up Immunization Campaign in the Five Most Flood Affected
Districts of Bihar has been conducted following the massive floods.
193

No. of R.I. Session Site Monitored
45000
40000
35000
30000
25000
20000
15000
10000
5000
0
38304
18579
11031
4891
2005 2006 2007 2008
Muskan…Ek Abhiyan
It has been decided by the Government of Bihar to attain 100% immunization of infants and
pregnant women, for which tracking of pregnant women and infants are being undertaken
through MuskanEk Abhiyaan .
Objective:
‣ To achieve 100% immunization of Infants and Pregnant Women
Muskan … Operational Strategy
‣ Convergence with ICDS and Health for our-reach-service delivery.
‣ For Routine Immunization Aaganwadi Centers are acting as the service
delivery unit as well as Headquarters for AWWs and ASHAs
‣ For 8 10 AWWs , ANM are designated as Team Leader
194

Components:
‣ Tracking of all Pregnant Women and Newborns.
‣ House-to-house survey.
‣ Registration of all Pregnant Women and Children from 0 2 yrs age group
‣ Immunization sessions at Anganwadi Centers on each Friday.
‣ Field Verification in the form of Supportive Supervision by both MO`s
& CDPO`s are also planned under Muskan to Improve Immunization coverage
in the Blocks
‣ Due List register to Track and Identify Due Beneficiaries for every RI-Session.
‣ Mahila Mandal Meetings in the AWC to improve Health & Nutrition, in the
Village.
Percentage of Sessions Held Vs Planned
100
90
80
70
60
50
40
30
20
10
0
91 93 92 91
2005 2006 2007 2008
195

% Presence of ANM / AWW / ASHA at Session Sites
100
90
80
70
60
50
40
30
20
10
0
91
94
96
95
62
68
82
88
54
57
52
75
0
14
55
64
ANM Presence
Mobilizer
Presence
ICDS
Presence
ASHA
Presence
2005 2006 2007 2008
* Note : Year 2005 - Aug’2005 to Dec’2005 (5 months) : N - 4891
Year 2006 - Jan’2006 to Dec’2006 (12 months) : N - 11031
Year 2007 - Jan’2007 to Dec’2007 (12 months) : N - 18579
Year 2008 - Jan’2008 to Nov’2008 (11 months) : N - 38304
Catch –up round for Immunization, Health and Nutrition improvement
Of children and pregnant women
In Flood Affected districts in Bihar Oct 2008
Background and Objective.
Following a breach in the river embankment at Kusha in Nepal On 18 th August 2008, river Kosi had
changed its course and shifted over120 km eastwards. As a result, large areas of Supaul, Madhepura,
Purnea, Saharsa and Araria in Bihar were inundated. For over two months normal activity was
disrupted and access to many areas impossible. However, with waters slowly receding and with the
advent of normalcy the Department of Health, Government of Bihar, launched a post flood health
and nutrition Catch up Round from October 20 th -27 th , 2008, in the five flood-affected districts of
Bihar. The round aimed at providing appropriate focused interventions for health and nutrition to
vulnerable populations such as expecting mothers and children previously displaced or living in
hitherto inaccessible areas and at catching-up and thereafter restoring routine health services like
immunization throughout the flood-affected districts.
Interventions:
The interventions identified for delivery during the round were as follows:
Intervention Role Age group
Catch-up Routine Proven to decrease morbidity and mortality Pregnant women and children
immunization through 6 vaccine preventable diseases. as per EPI schedule
196

Catch–up
Vitamin A doses
De-worming
tablets
Low osmolarity
ORS
Zinc
Proven to prevent diarrhea as well as used to
prevent measles and its complications
Effective against intestinal parasites
Prevention and treatment of dehydration due
to diarrhea
Prevention of pneumonia and prevents as well
as limits diarrhea incidence
9 months to 5 years
2 years to 5 years
All children affected with
diarrhea; 6 months to 5 years
Along with ORS
The Coverage achieved during the Catch-up round were 768754 vaccine doses for routine
immunization, 1347604 vitamin A doses (91.8% of total 1479642 estimated eligible children),
817197 tablets of Albendazole (65.75% of 1242858 estimated eligible children) and 53532 courses
of Zinc and ORS for children with diarrhea.
Primary vaccine coverage (coverage of infants with EPI vaccines schedule by 1 completed year) was
targeted against the estimated population of infants and pregnant women eligible for vaccine doses in a
two-month period (two months being the duration of disruption of routine immunization services due
to floods) and the following percent coverage was achieved for various antigens.
% Coverage Achieved during Catchup Round
91.1
70.6
71.0
71.0
60.3
65.8
33.2
22.1
38.3
38.6 36.7
38.7 36.8
25.6
TT1
TT2+B
BCG
OPV0
OPV1
OPV2
OPV3
DPT1
DPT2
DPT3
Measles
Fully
Immunized
Vitamin A*
Deworming
tablet*
% S e s s i o n s h e l d o u t o f t h o s e p l a n n e d d u r i n g c a t c h - u p r o u n d
9 5
9 2
9 9 9 7 9 5 9 6
A r a r i a M a d h e p u r a P u r n e a S a h a r s a S u p a u l 5 f l o o d a f f e t c e d
d i s t r i c t s
Catch-up Round Antigen Wise % Coverage achieved
(of 2 monthly estimated target) for Pregnant women & Children#
197

District
Pregnant
women Infants (birth to 1 year) 9m-5y 6m-5y
TT1
TT2+
B
BCG
OP
V0
OPV
1
OPV
2
OPV
3
DPT
1
DPT
2
DPT
3
Msls
Full
Imnzed
Vit A*
Deworm
tablet*
ARARIA 33.5 24.0 81.6 44.0 75.6 45.2 43.9 75.4 45.5 43.6 61.0 39.3 98.5 91.4
MADHEPUR
A
29.8 14.6 66.0 39.4 57.4 28.2 29.3 57.3 28.1 29.1 57.8 29.2 83.4 70.3
PURNEA 33.7 24.5 59.5 35.8 70.3 40.1 35.5 72.5 39.8 36.1 51.5 19.0 92.5 40.6
SAHARSA 39.3 26.7 86.0 38.1 83.7 43.3 38.2 80.3 44.4 38.6 71.4 10.7 90.2 74.5
SUPAUL 29.9 19.1 64.2 34.4 67.5 33.4 34.8 67.4 33.1 34.4 64.7 28.4 87.1 60.6
Grand Total 33.2 22.1 70.6 38.3 71.0 38.6 36.7 71.0 38.7 36.8 60.3 25.6 91.1 65.8
* Annual targets are taken for VitA and Deworming tablets as biannual supplementary dose was administered during Catch-up round
Catch-up Round Coverage Report Antigen Wise#
District ARARIA MADHEPURA PURNEA SAHARSA SUPAUL Grand Total
Session Planned 1775 1122 2658 1468 1325 8348
Session Held 1686 1035 2620 1446 1257 8044
of TT1 5048 3223 6068 4195 3700 22234
TT2 3345 1420 4142 2529 2322 13758
TTB 270 154 268 322 40 1054
BCG 11174 6482 9749 8350 7225 42980
OPV 0 6027 3875 5856 3697 3865 23320
OPV 1 12332 7055 12824 10550 8751 51512
OPV 2 7339 3275 6980 5343 4162 27099
OPV 3 7537 3507 6380 4861 4471 26756
DPT 1 12257 7014 13098 9948 8755 51072
DPT 2 7392 3286 6997 5364 4160 27199
DPT 3 7546 3509 6461 4941 4431 26888
Measles 11665 8806 9981 12916 13064 56432
Fully Immunized 7887 2873 5303 1640 3300 21003
Vitamin 'A' 320427 201623 388835 234736 201983 1347604
Deworming 251244 141507 144313 163970 116163 817197
ORS & Zinc 14894 7840 21243 6816 2739 53532
# Provisional reports
Future Plans
In order to ensure full-immunization status of infants in the flood affected areas, it is necessary that
coverage of subsequent doses of OPV and DPT (2 nd and 3 rd doses) also be achieved at a level similar
to that of the first dose. Two more catch-up rounds with the vaccination component in these districts
spaced 4-6 weeks apart would give opportunity to achieve this.
Bundling of a number of interventions had led to greater acceptability of services by the beneficiaries,
empowering of the village level service provider and closer monitoring by multiple stakeholders
198

involved in the various program components followed in the catch-up strategy. This approach could be
scaled up to cover a larger geographical area during regular sessions of Routine Immunization.
199

Introduction
Strategic Plan for
Measles Mortality Reduction In Bihar 2009
Vaccine preventable diseases still remain major causes of morbidity, disability and mortality,
with an estimated 40000 deaths (Chart 1 below) occurring annually in the Bihar State. This
document outlines measles control acceleration strategies that Governments and stakeholders in
immunization in the Bihar State will implement from 2009 onwards.
Chart 1: Estimated Measles Mortality by Indian State 2006
(Source: Preliminary results from a workshop held at NPSU, New Delhi, May 2007)
70,000
60,000
Measles Deaths
50,000
Measles Deaths
40,000
30,000
20,000
10,000
-
LAKSHADWEEP
A&N ISLANDS
D&N HAVELI
PONDICHERRY
GOA
SIKKIM
DAMAN & DIU
HIMACHAL PRADESH
CHANDIGARH
MIZORAM
KERALA
DELHI
TAMIL NADU
ARUNACHAL PR.
MANIPUR
JAMMU & KASHMIR
TRIPURA
MEGHALAYA
NAGALAND
PUNJAB
UTTARANCHAL
HARYANA
KARNATAKA
CHHATTISGARH
MAHARASHTRA
GUJARAT
ORISSA
ANDHRA PRADESH
WEST BENGAL
ASSAM
JHARKHAND
MADHYA PRADESH
RAJASTHAN
BIHAR
UTTAR PRADESH
State Health Society, Bihar- is proposing this strategic plan aimed at guiding measles mortality
reduction in Bihar. As a resource mobilization tool, the plan summarizes the requirements for measles
control including routine measles immunization, supplemental immunization activities and Measles
surveillance, as well as the projected State Health Society, Bihar support needs. For the purpose of
monitoring progress with implementation, a set of milestones is included.
Measles related Morbidity and mortality in Bihar
200

U5MR
110
100
90
80
70
60
50
40
B
i
h
a
r
Non-Measles Mortality Rate Measles Mortality Rate Target for Child Mortality
Potential Contribution of Accelerated Measles Control to Achieving MDG4 in India, 2006
Reduction of Measles associated mortality would be a key intervention for Bihar to achieve the 4 th
Millennium development goal. About half of the goal would be achievable just by reducing the
measles deaths in the state.
Of all the states in India, Bihar is poised to benefit most from Measles SIA leading to Measles
mortality reduction.
Measles outbreaks in Bihar
In the year 2008-2009 (till Jan), Fourteen measles outbreaks were investigated in Bihar and the
following age distribution of cases was determined. There were 485 cases (Age distribution of 394
cases available) and 26 deaths reported from these outbreaks (Case Fatality rate 5.36). One outbreak
was confirmed with laboratory diagnosis and the remaining was through clinical examination.
88 % of the cases were between one and nine completed years justifying the age bracket to be covered
during measles catch-up round.
201

S
No
Measles outbreaks in Bihar 2008-2009 (status till 30th Jan 2009)
Age distribution
Number
Month of Number
120-
District
of 0-11 12-59 60-119
outbreak of cases
deaths
179
months months months
months
>179
months
1 Champaran East March 13 0 1 5 3 4 0
2 Patna April 7 0 0 6 1 0 0
3 Patna April 33 0 2 7 9 6 0
4* Patna April 23 0
5 Supaul November 37 2 0 29 7 1 0
6 Bhagalpur November 5 0 0 4 0 1 0
7* Madhubani December 52 3
8 Madhepura December 51 7 0 28 19 1 0
9 Madhepura December 10 1 0 8 0 0 0
10 Madhepura December 27 0 0 10 12 3 0
11
Champaran
West
December 33 5 0 20 13 0 0
12 Darbangha December 136 5 0 65 52 11 8
13 Vaishali January 23 1 4 10 8 1 0
14 Champaran East January 35 2 1 21 8 5 0
Bihar total 485 26 8 213 132 33 8
1. BIHAR Strategic Action Plan for Measles Mortality reduction
Strategies
It is envisaged that the State Health Society, Bihar with the support of other partners realize the stated
measles control goal and objective using the following strategies
1. Strengthen routine immunization (EPI) to raise routine measles coverage to 80% and above.
2. Establish measles surveillance
3. Establish a measles laboratory network for the confirmation of cases/epidemics.
4. Provide a second opportunity for measles vaccination
a. Initially through a catch up supplementary mass campaigns for the children aged 9
months to 9 completed years
202

. Follow up SIAs every 3-5 years for successive birth cohorts and
c. Introducing second dose of Measles vaccine in EPI schedule when the evaluated
routine coverage of the first dose goes above 80% in all districts throughout the
state.
5. Improve the clinical management of measles cases through the IMNCI approach.
Implementation Roles
The Department of Health and State Health Society, Bihar will implement phased activities for
measles control in the context of systems strengthening and development. This will require the
collaboration of various stakeholders in the field of immunization.
Role of Govt of India
The primary responsibility for the realization of this plan lies with the Ministry of Health Govt of
India. The key roles will include:
· Adoption of the National strategies, and developing appropriate national plans related to
Measles morbidity reduction.
· Securing funds, vaccines and supplies for immunization and providing the same to the State of
Bihar.
· Developing modules for training and program communication for Measles Supplementary
Immunization
· Providing guidelines and support for surveillance of measles and setting up of Mealses
laboratories.
Role of partners
The State Health Society Bihar will form a Measles Technical Advisory group, Bihar headed by the
Executive Director and comprised of the State Program Officer Immunization and IDSP and
representatives of the UNICEF, NPSP-WHO, IMA, IAP and NIPI. This task force will be the focal
committee for day-to-day implementation of the plan. Besides implementing the plan, the task force
will prepare guidelines for district activities, budget norms, reporting forms tally sheets, monitoring
checklists for measles campaign and other control activities.
UNICEF:
Member of technical advisory group on Measles Mortality reduction
Measles Surveillance
· Support during the initial phase of sentinel surveillance
· State level coordinator
For the Supplementary Catch-up immunization campaign
203

· Trainings and capacity building
· Micro planning
· Monitoring
· Social Mobilization and IEC
· Logistics and cold chain monitoring
· Ensuring safe injection practices
· Data compilation analysis
· Post coverage surveys
NPSP-WHO
Member of technical advisory group on Measles Mortality reduction
Role in surveillance
· Support in outbreak based surveillance
· Setting up laboratories for serological confirmation of Measles.
Role in SIA catch-up
· Trainings and capacity building
· Micro planning
· Monitoring of activity
NIPI, IAP, IMA
Members of Measles Technical Advisory group.
Logistics and vaccine requirement for Measles SIA
Logistics and vaccine requirement for Measles Mortality reduction activities
Item Requirement details Requirement Units
1 Measles vaccine 1 dose per child with 1.33 wastage factor with 100% coverage 35453109 doses
2 Measles diluent 1 dose per child with 1.33 wastage factor with 100% coverage 35453109 doses
3 0.5 ml AD syringe 1 Per child vaccinated with 10% wastage 38998419 syringes
4 5 ml Disposal syringes 1 per 5 dose vial with 10% wastage 7799684 syringes
5 Hubcutters 1 per team with 10% buffer 18700 hubcutters
6 Mealses Eliza kits 100 per lab with 10% buffer 990 kits
Timeline for activity
Development of strategy and
POA
Adoption of strategy by TAG
Mealses Bihar
Initiation of vaccine
procurement activities
Measles campaign activity timeline
2008 2009
Dec Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
204

Development of guidelines
and forms etc.
Review and planning for
districts
Planning workshop for
districts (at region)
Provision of Logistics and
finance support
District planning and
preparation activities
Campaign in districts
Evaluation of campaign
Measles surveillance
Pulse Polio Programme (P.E. Progress in the State)
In the last one and half years several initiatives have been taken by the Government of Bihar for
eradication of Polio form the state. It has been observed that majority of P1 cases was restricted to the
most inaccessible areas of Kosi river, covering 20 blocks and 10 districts. A Kosi Operational-Plan
was developed for intensification of overal Polio.Eradication. Activities in these high risk Areas(both
SIA & Surveillance), the salient features of the plan are :
‣ Intensification of human resources in Kosi areas
‣ New Geo political boundaries were formed respective of districts boundaries called grids
for implementation of Kosi Operational Plan.
‣ Intensified Monitoring of the Polio rounds by WHO, UNICEF and State Monitors.
Bihar has shown excellent progress till 2008, as regards IEAG Observation for India is concerned.
Among the three kind of Polio Virus, Bihar has eradicated P-2 Polio Virus since 1999, and the
Endemic Transmission of P-1 cases, which is the most dreaded & Virulent of the three, has stopped
circulating in Bihar since, June/08 with multiple mOPV-I SIA Rounds. Circulation of P-3 Cases has
also declined in the State after completion of few effective SIA`s with mOPV III rounds in Bihar in
2007/08. With the highest ever sensitivity of AFP-Surveillance in the State, Bihar is very close to the
Goal of Polio Eradication in the Country.
205

A. Baseline information
S.No.
Beneficiaries
Target
2008-09 2009-10
1 Pregnant Women 3527925 3154129
2 0 to 1yr infants 3207205 2980338
3 1-2 yr 2178312
4 2-5 yr 6930990
5 5 yr 3366484
6 10 yr 4554652
7 16 yr 1980283
S.No. Routine Immunization Sessions 2008-09 2009-10
1 Session planned in Urban Areas 25668 43236
2 Session planned in Rural Areas 1288920 1450032
3 Total Sessions Planned 1314588 1493268
4 No. of session with hired vaccinators* 17950
5 No. of hired vaccinators* 4488
* No. of sessions and vaccinators hired in 2008-09 and planned in for 2009-10
B. Trend of IMR
S.No. Year IMR of the State/UT
1 2003 60
2 2004 61
3 2005 61
4 2006 62
5 2007 60
206

C. District - Wise Coverage reports ( in Numbers)
S.No.
Name of
District
Yearly Target (2007-
08)
Infants
Pregnant
Women
Yearly Target (2008-
09)
Infants
Pregnant
Women
Measles
TT2+Booster
BCG
2007-08 2008-09 2007-08 2008-09 2007-08 2008-09
1 Araria 75850 83435 82154 90369 71426 55609 53438 47376 26677 12928
2 Arwal 19217 21139 25472 28019 19565 5669 14789 9148 10529 6938
3 Aurangabad 65134 71647 77520 85272 52364 35407 48171 38046 28221 22825
4 Banka 58425 64268 62202 68422 46155 41364 38572 36155 26956 22651
5 Begusarai 75853 83438 90589 99648 46940 86326 37747 94721 28142 43146
6 Bhagalpur 83025 91328 93966 103363 70542 46374 69425 51503 51671 35857
7 Bhojpur 71750 78925 86353 94988 53933 36959 45413 36403 33791 19553
8 Buxor 46993 51692 54263 59689 33675 28643 26963 28907 17496 17018
9
Champaran
(E) 117276 129004 152090 167299 70001 73579 60447 58879 30398 37633
10
Champaran
(W) 101475 111623 117656 129422 77754 43653 79741 42504 31035 19026
11 Darbhanga 83907 92298 127029 139732 87533 64465 63845 58303 36848 38408
12 Gaya 112762 124038 133970 147367 151760 61691 130348 129237 39018 28515
13 Gopalganj 73581 80939 83102 91412 54838 27312 48730 32190 33009 19888
14 Jahanabad 32062 35268 54032 59435 28967 21503 24536 21313 16375 12971
15 Jamui 49255 54181 35744 39318 48062 25995 49440 25278 43799 17070
16 Kaimur 46873 51560 49667 54634 32271 22748 18911 23284 14322 20404
17 Katihar 94855 104341 92389 101628 55404 37521 40871 40612 27264 22284
18 Khagaria 53351 58686 49361 54297 50086 7397 44528 9891 23457 2780
19 Kishanganj 59225 65148 50034 55037 35090 28746 20087 20871 17295 17239
20 Lakhisarai 28210 31031 30977 34075 19125 14522 13162 13768 11360 7835
21 Madhepura 53710 59081 58947 64842 49054 27609 46257 33712 21758 8452
22 Madhubani 130872 143959 138056 151862 100567 72245 113280 72977 47531 46782
23 Munger 39975 43973 43903 48293 33349 21498 28382 22333 21718 14118
24 Muzaffarpur 130086 143095 144752 159227 103512 72154 92585 66242 65311 39724
25 Nalanda 78829 86712 91569 100726 64187 33585 58584 31321 42918 18267
26 Nawada 56888 62577 69960 76956 46188 23562 40682 22012 26618 16821
27 Patna 145232 159755 182102 200312 78638 37002 65957 40147 49809 21395
28 Purnia 87110 95821 98237 108061 86243 55908 62194 54418 41808 29232
29 Rohtas 55022 60524 94679 104147 55552 35765 43020 38884 27413 21074
30 Saharsa 56396 62036 58244 64068 45777 40598 36431 47480 22735 18717
31 Samastipur 98400 108240 131976 145174 86296 50565 76510 62626 49677 32835
32 Saran 120540 132594 125715 138287 89463 48408 71949 41714 54525 26130
33 Sheikhpura 16796 18476 20304 22334 17344 13443 15333 13079 12207 8461
34 Sheohar 11685 12854 19884 21872 12379 8009 8288 6741 5367 3193
35 Sitamarhi 74005 81406 103229 113552 61276 50567 49249 51735 31339 27179
36 Siwan 92250 101475 104735 115209 89098 48294 74734 58978 27177 14491
37 Supaul 60846 66931 67471 74218 43812 24064 32206 28283 22471 15850
38 Vaishali 100085 110094 104872 115359 86155 48126 69468 48643 46751 26351
Total 2757806 3033592 3207205 3527925 2254381 1476885 1914273 1559714 1164796 814041
207

S.N
o.
C. District - Wise Coverage reports ( in Numbers)
Yearly
Target
(2007-08)
Name of
District
Yearly
Target
(2008-09) OPV- 1 OPV -3
DPT - 1 DPT -3
Infants Infants 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09 2007-08 2008-09
1 Araria 75850 82154 59879 74065 59545 51039 71754 55904 62947 49000
2 Arwal 19217 25472 14550 6155 24537 7732 19840 5176 16125 7101
3 Aurangabad 65134 77520 54718 38166 59748 37157 55180 32933 56008 33270
4 Banka 58425 62202 33293 28200 56833 26089 45935 24489 40969 23189
5 Begusarai 75853 90589 37604 102068 57878 86499 46867 77730 36710 82272
6 Bhagalpur 83025 93966 62763 46865 104013 43848 70735 40690 71323 36737
7 Bhojpur 71750 86353 43680 33676 68999 27371 52223 30829 47746 26411
8 Buxor 46993 54263 29459 31024 38683 27783 35845 22475 28417 20160
9 Champaran (E) 117276 152090 64373 70184 62735 54274 75905 60587 62036 43997
10 Champaran (W) 101475 117656 61242 44049 70240 39906 94102 32488 73716 31036
11 Darbhanga 83907 127029 79661 58985 81172 51689 87601 51385 68768 45394
12 Gaya 112762 133970 121371 132357 83802 120782 146805 103865 136817 111767
13 Gopalganj 73581 83102 44496 28971 69954 27189 55801 22333 54359 22313
14 Jahanabad 32062 54032 24612 17758 34451 16625 28402 13988 25152 12476
15 Jamui 49255 35744 39570 25023 86350 23835 45336 18443 45512 18914
16 Kaimur 46873 49667 20675 17329 31803 14952 29698 18132 20485 15988
17 Katihar 94855 92389 52604 38036 58862 37465 56604 24719 44750 24470
18 Khagaria 53351 49361 43962 5385 52575 6874 46225 4851 38936 5911
19 Kishanganj 59225 50034 32484 27580 39978 20109 35215 23216 23142 16577
20 Lakhisarai 28210 30977 20112 11895 23679 9502 20619 9270 16119 8473
21 Madhepura 53710 58947 56024 31007 47220 22119 57863 31495 44020 21886
22 Madhubani 130872 138056 76267 60326 106131 57643 93150 57141 75225 54793
23 Munger 39975 43903 35504 21381 46483 15767 33777 16572 27595 15891
24 Muzaffarpur 130086 144752 102314 80085 135174 67798 110341 59591 101213 53129
25 Nalanda 78829 91569 51802 31432 89200 27695 65339 27309 61177 25419
26 Nawada 56888 69960 39436 24967 56818 19624 45730 18589 44816 15896
27 Patna 145232 182102 67150 33242 106010 32091 82834 30084 71447 29383
28 Purnia 87110 98237 78157 56320 93199 48572 84139 47317 68317 40384
29 Rohtas 55022 94679 50661 27362 59608 22090 55683 23149 47779 19912
30 Saharsa 56396 58244 43989 44188 49546 31915 47684 69658 39628 30544
31 Samastipur 98400 131976 84207 46018 111419 42649 100249 41324 80768 40646
32 Saran 120540 125715 79048 48527 115303 37780 89646 42784 84162 40080
33 Sheikhpura 16796 20304 18192 11430 24620 12763 18178 11362 16524 12645
34 Sheohar 11685 19884 11236 6205 10850 4475 13278 6259 9212 4631
35 Sitamarhi 74005 103229 53647 48770 70514 45445 63711 41876 53008 38648
36 Siwan 92250 104735 121737 97860 58362 52905 122454 97860 71808 53004
37 Supaul 60846 67471 41117 27285 52335 24409 43897 27471 33646 22366
38 Vaishali 100085 104872 68343 41068 93229 35621 82176 34296 78170 30220
Total 2757806 3207205 2019939 1575244 2491858 1332081 2330821 1357640 1978552 1184933
208

S.N
o.
C. District - Wise Coverage reports ( in
Numbers)
Name of
District
Yearly
Target
(2007-08)
Infants
Yearly
Target
(2008-
09)
Infants
Hep B- Birth Hep B-1 Hep B-3
2007
-08
2008
-09
2007-
08
2008-
09
2007-
08
2008-
09
JE-routine
(Wherever
applicable
2007
-08
2008-
09
Vit A- Ist Dose
2007-08 2008-09
1 Araria 75850 82154
37985 30909
2 Arwal 19217 25472 11342 7752
3 Aurangabad 65134 77520 38293 31881
4 Banka 58425 62202 16174 16923
5 Begusarai 75853 90589 13181 51987
6 Bhagalpur 83025 93966 50095 41790
7 Bhojpur 71750 86353 31980 25849
8 Buxor 46993 54263 12529 21475
9 Champaran (E) 117276 152090 31507 38343
10 Champaran (W) 101475 117656 37820 20901
11 Darbhanga 83907 127029 29540 36335
12 Gaya 112762 133970 94657 47870
13 Gopalganj 73581 83102 33997 27698
14 Jahanabad 32062 54032 11863 12937
15 Jamui 49255 35744 26521 36879
16 Kaimur 46873 49667 17332 17037
17 Katihar 94855 92389 20849 19329
18 Khagaria 53351 49361 22537 4604
19 Kishanganj 59225 50034 14249 14962
20 Lakhisarai 28210 30977 4708 7149
21 Madhepura 53710 58947 24777 27396
22 Madhubani 130872 138056 72472 63159
23 Munger 39975 43903 14868 17487
24 Muzaffarpur 130086 144752 58300 51145
25 Nalanda 78829 91569 31565 19016
26 Nawada 56888 69960 21076 14319
27 Patna 145232 182102 41274 27527
28 Purnia 87110 98237 37126 30051
29 Rohtas 55022 94679 25145 33176
30 Saharsa 56396 58244 22464 32437
31 Samastipur 98400 131976 34012 33770
32 Saran 120540 125715 60809 39062
33 Sheikhpura 16796 20304 11124 10560
34 Sheohar 11685 19884 4160 4358
35 Sitamarhi 74005 103229 26174 31930
36 Siwan 92250 104735 48292 27350
37 Supaul 60846 67471 12838 13981
38 Vaishali 100085 104872 50466 44826
Total 2757806 3207205 1154101 1034160
Not Applicable
209

S.No.
D. District - wise VPD reports in 2008-09 ( in numbers)
Teta
nus
Dipthe Pertus N (oth
Polio
Name of District ria is Tetanus er) Measles -P1
Cases
Deaths
Cases
Deaths
Cases
Deaths
Cases
Deaths
1 Araria 6
2 Aurangabad 1
3 Banka 0 1
4 Begusarai 12
5 Bhagalpur 5 6
6 Champaran (E) 13 8
7 Champaran (W) 33 5 3
8 Darbhanga 136 5 23
9 Gaya 1
10 Jamui 1 2
11 Katihar 5
12 Khagaria 22
13 Kishanganj 1
14 Lakhisarai 1
15 Madhepura 88 8 13
16 Madhubani 52 3 0 10
17 Munger 2
18 Muzaffarpur 14
19 Nalanda 7
20 Nawada 5
21 Patna 63 9
22 Purnia 9
23 Saharsa 1 15
24 Samastipur 0 30
25 Saran 1 2
26 Sheikhpura 2
27 Sitamarhi 7
28 Siwan 2
29 Supaul 37 2 4
30 Vaishali 23 1 6
Grand Total As on Jan 09 450 24 3 229
Cases
Deaths
Cases
Deaths
Polio-
P3
Cases
Deaths
Cases
AES
Deaths
210

VPDs
No. of
Outbreaks
reported
2007-
08
E. Total VPD outbreaks in State/UT
No. of
OutbreaksInvestigated
2008-
2007-
# 2007-08 2008-09#
09 08
No. of cases
in Outbreaks
2008- 2007-
09 # 08
No. of
Deaths in
Outbreaks
2008-
09 #
Measures
Taken
Remarks
Diphtheria 34
Pertusis 786
Measles 12 11 741 23
AES
Outbreak
response, Vit-A
supplementation,
treatment of
cases
# Report for 2008-09 till Dec '08
F. District Wise - AEFI Surveillance
S.No.
Name of District
AEFI Committee
constituted
( Y/N)
Serious AEFI
Cases
( till Dec ' 08)
AEFI Deaths
(till Dec'08)
No. of
FIRs sent
No. of
PIRs sent
No. of
DIRs sent
Remarks
1 Araria Yes
2 Arwal Yes
3 Aurangabad Yes
4 Banka Yes
5 Begusarai Yes
6 Bhagalpur Yes
7 Bhojpur Yes
8 Gaya Yes 1
9 Gopalganj Yes
10 Kaimur Yes
11 Khagaria Yes
12 Kishanganj Yes
13 Lakhisarai Yes
14 Madhubani Yes 3
15 Munger Yes 2
16 Nalanda Yes
17 Nawada Yes
18 Saharsa Yes
19 Sheikhpura Yes
20 Sitamarhi Yes
21 Siwan Yes
22 Vaishali Yes 1
23 Darbhanga 1
24 Samastipur 1
25 Katihaar 1
Total 10 10 2 1
211

G. RIMS status
S.No. Name of District
RIMS Installed Computer
RIMS uploaded*
& Operational Assistant Apr'08 May'08 Jun'08 Jul'08 Aug'08 Sep'08 Oct'08 Nov'08 Dec'08
1 Banka Yes Yes Yes No Yes Yes Yes Yes Yes Yes
2 Bhagalpur Yes
3 Bhojpur Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
4 Buxar Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
5 Champaran-W Yes
6 Darbhanga Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
7 Gopalganj Yes Yes Yes
8 Kaimur Yes Yes Yes Yes Yes Yes Yes Yes
9 Kishanganj Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
10 Madhubani Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
11 Munger Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
12 Saharsa Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
13 Samastipur Yes
14 Saran Yes
15 Sheikhpura Yes
16 Sheohar Yes
17 Sitamarhi Yes
18 Siwan Yes
19 Supaul Yes
STATE / UT ** Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
*Write Yes/No for the month the district has uploaded RIMS data of district
**Write Yes /No for the month the State/UT has uploaded State/UT level data
212

Item
H. Vaccine , Cold Chain and Other logistics
Requirement
Stock
( Functional)**
2009-10 2010-11
Cold Chain Equipments-
WIC 10 9 4
WIF 3 2 1
ILR-140 L (Small) 772 355 50
ILR-300 L (Large) 92 82 20
DF-140 L (Small) 467 175 25
DF-300 L (Large) 162 128 20
Cold Boxes L 3914 1190 1000
Cold Boxes S 1769 1050 800
Vaccine Carriers 59127 22950 15000
Ice Pack 68530 197500 100000
Vaccine Van 46 Not Required
Vaccine stock and requirement ( including 25% wastage and 25% buffer)
TT 2169245 2386170
BCG 2860780 3146858
OPV 919353 1011288
DPT* 2398384 2638222
Measles 984374 1082811
Hep B
JE(Routine)
Remarks
Including 5 replacements
& 4 New for 2009-10
Replacement out of 1 and
One new
Syringes including wastage of 10% and 25% buffer
0.1ml 396956 4070720 4681328
0.5ml 2571222 33379913 38386900
Reconstitutional
Syringes
126864 6931501 7971226
New ANM recruitment in
Hub Cutters
Very few
process & further
15800 8000
functional
additional Hubcutter
needed.
** As on 31st Dec '08 * Note : DPT is to be given instead of DT at 5 yrs w.e.f. 2009 - 10
213

District wise and Head wise allocation of budget for Routine Immunization activities in Year 2009-10
SL No. Name of District P.W. ANM
State Total
Allotment for
the year
2009-10
Number
of
Alternate
immunis
Vaccinator
ation
Site
District Profile used for calculation of Budget
AWC ASHA HSC APHC BPHC Reffral
+ SDH
District
Hospital/
Metarnit
y
Hospital
WIC
+
WIF
Slums
Under
served
Areas
1 Araria 81600 285 257 497 2125 2026 424 73 9 4 1 60 95
2 Arwal 21941 128 128 558 653 64 26 5 0 0 0
3 Aurangabad 78966 436 446 2004 1842 207 58 11 4 1 1 86 15
4 Banka 63106 546 546 1609 1552 265 32 10 4 0 33 138
5 Begusarai 92920 568 598 2308 2245 289 25 18 2 1 50 119
6 Bhagalpur 97221 611 611 2215 1966 280 41 16 3 1 1 133 70
7 Bhojpur 86372 650 665 2104 2049 355 27 14 4 1 83 400
8 Buxar 54528 374 15 374 1403 1318 287 47 11 1 1 92 110
9 Champaran - E 153031 921 921 3897 2686 315 46 20 3 1 1 71 225
10 Champaran - W 110256 454 38 465 2980 2734 377 30 17 3 1 52 127
11 Darbhanga 118172 440 440 3231 2357 261 36 18 2 0 1 162 117
12 Gaya 136251 877 877 3334 2997 541 73 25 2 3 265 241
13 Gopalganj 93400 281 281 2158 2022 186 23 14 4 1 42 15
14 Jahanabad 36264 257 257 925 769 104 32 7 3 1 82 0
15 Jamui 54467 354 354 1397 1296 212 22 9 4 1 68 350
16 Katihar 107722 469 472 2215 2174 257 25 16 3 1 28 154
17 Kaimur 47962 307 307 1286 1247 196 19 10 4 1 150 94
18 Khagaria 51331 382 382 1276 1204 193 24 7 1 1 45 63
19 Kishanganj 66857 144 36 149 1296 1027 136 9 7 3 1 75 32
20 Lakhisarai 31713 205 205 802 581 126 19 6 2 0 71 61
21 Madhepura 60096 107 383 107 1526 1459 386 39 13 1 1 46 150
22 Madhubani 162344 450 127 450 3569 3034 430 57 18 5 1 52 64
23 Munger 44272 306 306 1074 951 227 33 9 1 1 86 17
24 Muzaffarpur 159262 892 50 892 3669 3398 751 121 14 2 1 1 254 50
25 Nalanda 80504 650 650 2319 1980 467 68 20 4 1 96 40
26 Nawada 71303 424 40 424 1810 1810 338 56 14 3 1 85 44
27 Patna 192249 888 893 3937 2634 418 60 23 6 0 4 771 316
28 Purnia 94684 535 120 535 2482 2263 511 74 14 3 1 2 50 220
29 Rohtas 91939 526 526 2309 2160 308 94 19 4 1 141 165
30 Saran 128215 600 77 600 3178 3178 508 69 20 3 1 1 45 50
31 Samastipur 17542 777 777 3438 3143 354 45 20 4 1 48 374
32 Saharsa 60505 225 225 1428 676 152 15 10 0 1 1 102 109
33 Sheikhpura 21005 179 179 526 439 85 17 6 2 0 44 0
34 Sheohar 18997 35 31 35 513 495 34 7 5 2 0 25 16
35 Siwan 90359 597 607 2618 2618 439 55 19 3 1 0 49
36 Sitamarhi 106514 326 426 2557 2529 213 36 13 1 1 16 94
37 Supaul 67163 119 133 119 1744 1538 178 19 11 3 0 56 300
38 Vaishali 103096 576 640 2672 2532 337 30 17 2 1 0 16
39 RDD/State
State Total 3154129 16901 1307 17366 80492 71582 11211 1582 515 105 32 13 3565 4500
214

Mobility Support
Cold chain maintenance
Mobility
support to
District Officials
Rs. 50000 per
district (38) .
Mobility
support for
supervision at
state level @
Rs. 100000 per
year.
machine per
year for 2200
machine
( DF+ILR) and 10
WIC and 3 WIF
@ Rs. 10000
per year and
maintenance of
vaccine vans
@Rs.25000 per
van for 47 vans.
* 22,00,000 for
AMC given at
State level to
one agency for
repair of
existing ILR &
DF has been
deducted from
Rs. 50,00,000
alloted and the
remaining
28,00,000 is
divided for
WIC/WIF
maintainance of
Vaccine vans as
per approved
rates. the final
remaining
amount of
1430000 could
be utilised for
Minor Repair
for district and
regional Cold
chain stores
among the
districts. @ Rs
1900000 100000 5000000
WIC/WIF Vaccine Van Minor Repair
50000 25000 25859
50000 25000 15515
50000 10000 50000 31031
50000 25000 28445
50000 25000 49132
50000 10000 50000 43960
50000 25000 38788
50000 25000 31031
50000 10000 50000 54304
50000 25000 46546
50000 10000 50000 49132
50000 25000 67233
50000 25000 38788
50000 25000 20687
50000 25000 25859
50000 25000 43960
50000 25000 28445
50000 25000 20687
50000 25000 20687
50000 25000 18101
50000 25000 36203
50000 25000 49132
50000 25000 25859
50000 10000 50000 38788
50000 25000 54304
50000 25000 38788
50000 40000 50000 62061
50000 20000 50000 38788
50000 25000 51718
50000 10000 50000 54304
50000 25000 54304
50000 10000 50000 28445
50000 25000 18101
50000 25000 15515
50000 25000 51718
50000 25000 36203
50000 25000 31031
50000 25000 46546
100000 65002 2200000
1900000 100000 195002 1175000 3629998
215

Focus on slum & underserved areas in
urban areas:
for 3565 slums and 14385
underserved areas @ Rs. 350
per month per slum for one
session
* Slums @10000 population (
Each AWC in a slum has 1500
population therefore 7 slums
=10000 population
Alternate vaccinators
honorarium
(details in separate sheet)
Mobilization of children through
ASHA or other mobilizers
@ Rs. 150 per month per per
worker for 80000 sessions per
month for remaining 5
months as the State has
budget the same under
Muskan in RCH PIP . The state
has projected this for month
incase the same is not
extended beyond Oct.09
Alternative vaccine delivery in hard to reach areas
Alternative vaccine delivery in
hard to reach areas in 4500
session per month @ Rs. 100
per session
Alternative Vaccine Deliery in
other areas @ Rs. 50 per
session for session- 17000
ANMs for 104 days.
75390000 60000000 5400000 88400000
651000 4478600 1519500 114000 2470400
0 98000 489750 0 665600
424200 145600 1381500 18000 2301200
718200 376600 1164000 165600 2673600
709800 295400 1683750 142800 2966800
852600 322000 1474500 84000 3093200
2028600 397600 1536750 480000 2978000
848400 478800 988500 132000 1812800
1243200 702800 2014500 270000 4519200
751800 792400 2050500 152400 2265600
1171800 259000 1767750 140400 2147600
2125200 473200 2247750 289200 4271200
239400 67200 1516500 18000 1443200
344400 144200 576750 0 1336400
1755600 198800 972000 420000 1420800
764400 201600 1630500 184800 2269600
1024800 233800 935250 112800 1483600
453600 270200 903000 75600 1910800
449400 630000 770250 38400 736400
554400 103600 435750 73200 992800
823200 6463800 1094250 180000 376400
487200 2258200 2275500 76800 2263200
432600 196000 713250 20400 1570800
1276800 1269800 2548500 60000 4578400
571200 347200 1485000 48000 3332000
541800 984200 1357500 52800 2152000
4565400 515200 1975500 379200 4264400
1134000 2374400 1697250 264000 2518000
1285200 336000 1620000 198000 2537200
399000 1621200 2383500 60000 3060000
1772400 449400 2357250 448800 3591600
886200 70000 507000 130800 1039200
184800 92400 329250 0 930800
172200 530600 371250 19200 162800
205800 565600 1963500 58800 3097600
462000 177800 1896750 112800 2102400
1495200 2304400 1153500 360000 258800
67200 273000 1899000 19200 3308800
4197892 6313500 3496800
38070892 31498600 60000000 5400000 88400000
216

Computer Assistants support Printing and dissemination Review meetings
Computer Assistants support for
State level @ Rs. 12000 per person
per month for 2 persons
Computer Assistants support for
District level @ Rs. 8000 per person
per month for one computer
assistant in each 38 districts
Printing and dissemination of
Immunization cards, tally sheets,
monitoring forms etc. @ Rs. 5
beneficiaries for 3469542
beneficiaries with 10% buffer.
Support for Quarterly State level
review meetings of district officer @
Rs. 1250/-/participant/day (
CMO/DIO/Dist Cold chain Officer) for
30 participants per meeting.
Quarterly review meetings exclusive
for RI at district level with one Block
Mos, CDPO, and other stake holders
@ Rs. 100 per participants for 5
participants per per PHCs 515
Quarterly review meetings exclusive
for RI at block level @ Rs. 50/- PP as
honorarium for ASHAs and Rs. 25 per
persons for meeting expenses for
80000 ASHAs
288000 3648000 17347710 570000 1030000 24000000
96000 448800 18000 607800
96000 120676 10000 195900
96000 434313 22000 552600
96000 347083 20000 465600
96000 511060 36000 673500
96000 534716 32000 589800
96000 475046 28000 614700
96000 299904 22000 395400
96000 841671 40000 805800
96000 606408 34000 820200
96000 649946 36000 707100
96000 749381 50000 899100
96000 513700 28000 606600
96000 199452 14000 230700
96000 299569 18000 388800
96000 592471 32000 652200
96000 263791 20000 374100
96000 282321 14000 361200
96000 367714 14000 308100
96000 174422 12000 174300
96000 330528 26000 437700
96000 892892 36000 910200
96000 243496 18000 285300
96000 875941 28000 1019400
96000 442772 40000 594000
96000 392167 28000 543000
96000 1057370 46000 790200
96000 520762 28000 678900
96000 505665 38000 648000
96000 705183 40000 953400
96000 96481 40000 942900
96000 332778 20000 202800
96000 115528 12000 131700
96000 104484 10000 148500
96000 496975 38000 785400
96000 585827 26000 758700
96000 369397 22000 461400
96000 567028 34000 759600
288000 570000 2525400
217

288000 3648000 17347718 570000 1030000 24000000
218

Trainings (separate annexure attached with details)
Microplanning
District level orientation for 2
days for ANMs MPHW, LHV
Health Assistants Nurse, Mid
wife Bees and other specialist
as per traning norm of RCH
for 9000 persons in 600
batches
three days training of Mos on
RI for 5000 persons in a group
of 30 person per batch.
One day refresher training of
distict Computer assistants on
RIMS/HIMS and
immunization formats for 40
persons in two batch.
One day cold chain handlers
training for block level cold
chain hadlers by State and
district cold chain officers in
28 batchs. For 542 cold chain
handlers
One day training of block
level data handlers by DIOs
and District cold chain officer
for 542 person.
To develop microplan at subcentre
level @ Rs 100/- per
sub - centre
For consolidation of
microplans at block level @
Rs. 1000 per block/ PHC(515)
and at district level @ Rs.
2000 per district for38
districts.
2183000 11271800 62000 704825 704825 1700000 591000
68400 12800 10150 28500 11000
82700 8000 6750 12800 7000
143600 15200 11850 43600 13000
366500 14000 11000 54600 12000
287500 23800 17800 56800 20000
313400 21400 16100 61100 18000
386000 18800 14400 65000 16000
221400 15200 11850 37400 13000
680200 26200 19500 92100 22000
89100 22600 16950 45400 19000
164300 23800 17800 44000 20000
419700 32200 23750 87700 27000
68400 18800 14400 28100 16000
142300 10400 8450 25700 9000
195400 12800 10150 35400 11000
117700 21400 16100 46900 18000
229100 14000 11000 30700 12000
253800 10400 8450 38200 9000
15200 10400 8450 14400 9000
103400 9200 7600 20500 8000
59300 17600 13550 10700 15000
164300 23800 17800 45000 20000
192800 12800 10150 30600 11000
376900 18800 14400 89200 16000
338000 26200 19500 65000 22000
181200 18800 14400 42400 16000
375600 29800 22050 88800 25000
242100 18800 14400 53500 16000
327600 25000 18650 52600 21000
300400 26200 19500 60000 22000
436500 26200 19500 77700 22000
68400 14000 11000 22500 12000
93000 9200 7600 17900 8000
7400 8000 6750 3500 7000
179900 25000 18650 59700 21000
174700 17600 13550 32600 15000
60600 15200 11850 11900 13000
266700 22400 16950 57600 19000
11271800 62000
8193500 11271800 62000 696800 532750 1690100 591000
219

220

POL for vaccine delivery Consumables Injection safety
POL for vaccine delivery
from State to district and
from district to
PHC/CHCs @ Rs. 100000
per district for 38
districts.
Consumables for
computer including
provision for internet
access for RIMs Rs. 400
per month per district
for 38districts.
Red/Black plastic bags
etc. @ Rs.
2/bags/session for
17000
(@ Rs 2 per bag for 2
bags a month per ANM
Bleach / Hypochlorite
solution @ Rs. 500 per
PHC/CHC per year for
515 PHC
Twin bucket @ Rs. 400
per PHC/CHC per year
for 515 PHCs
3800000 182400 1279500
100000 4800 13680 4500 3600
100000 4800 6144 2500 2000
100000 4800 20928 5500 4400
100000 4800 26208 5000 4000
100000 4800 27264 9000 7200
100000 4800 29328 8000 6400
100000 4800 31200 7000 5600
100000 4800 17952 5500 4400
100000 4800 44208 10000 8000
100000 4800 21792 8500 6800
100000 4800 21120 9000 7200
100000 4800 42096 12500 10000
100000 4800 13488 7000 5600
100000 4800 12336 3500 2800
100000 4800 16992 4500 3600
100000 4800 22512 8000 6400
100000 4800 14736 5000 4000
100000 4800 18336 3500 2800
100000 4800 6912 3500 2800
100000 4800 9840 3000 2400
100000 4800 5136 6500 5200
100000 4800 21600 9000 7200
100000 4800 14688 4500 3600
100000 4800 42816 7000 5600
100000 4800 31200 10000 8000
100000 4800 20352 7000 5600
100000 4800 42624 11500 9200
100000 4800 25680 7000 5600
100000 4800 25248 9500 7600
100000 4800 28800 10000 8000
100000 4800 37296 10000 8000
100000 4800 10800 5000 4000
100000 4800 8592 3000 2400
100000 4800 1680 2500 2000
100000 4800 28656 9500 7600
100000 4800 15648 6500 5200
100000 4800 5712 5500 4400
100000 4800 27648 8500 6800
4752
3800000 182400 816000 257500 206000
221

State specific requirement.
POL of Generators for
cold chain @ Rs. 600
per day per WIC. Rs.
500 per day per district
and Rs. 400 per day per
PHC.
Catch Up campaigns for
flood prone areas @ Rs.
4813386 per district for
5 districts.
Ticklers bags for RI card
counter foil @ rs. 250
per bags per AWC for
91703 workers
Taken Rs 170 per bag
for 80492 AWC
Measles Mortality
Reduction @ Rs. 45000
per district year year for
19 districts.
Pits construction
TOTAL
0 0 13755450 0 319308510
361250 11123639
94860 2093995
340680 6220002
273530 7001766
392360 8185766
376550 8187854
357680 9754964
238510 5849847
662490 12366973
506600 8532396
549270 8096018
566780 12669790
366860 5285836
157250 3514125
237490 6302560
376550 7280893
218620 5291542
216920 5128614
220320 3901733
136340 3114653
259420 10436287
606730 10440354
182580 4244223
623730 13200875
394230 8104406
307700 6979507
669290 15269995
421940 10379920
392530 8375311
540260 10602547
584460 11250591
242760 3918483
89420 2329491
87210 1936389
445060 8334259
434690 7149768
296480 7156170
454240 8130012
71810 31166956
13755450 319308510
222

223

S.no. District Name
ANM -
C
Total
Training
load
Health Workers training on Routine Immunization - Consolidated Budget 2009-10
Total No. of
training
Batches ( 25
person per
batch)
No of
trainers
per
batch
Honorarium + TA
to Participants
@Rs 400 per
participants
224
Honararium for
trainers/faculty
@600 per day (
subject to atleast 2
lectature per guest
faculty per day) for
2 days
Working lunch &
Refreshments Rs 200
per participants +
faculty per day for 2
days
Incidential Exp for
Photocopy , Job
aids, flip charts,
T.V./LCD hiring etc
@ 250 per
participants per
days for 2 days
Grand Total
1 Araria 48 48 2 3 19200 3600 21600 24000 68400
2 Arwal 59 59 2 3 23600 3600 26000 29500 82700
3 Aurangabad 104 104 4 3 41600 3600 46400 52000 143600
4 Banka 269 269 11 3 107600 3600 120800 134500 366500
5 Begusarai 211 211 8 3 84400 3600 94000 105500 287500
6 Bhagalpur 230 230 9 3 92000 3600 102800 115000 313400
7 Bhojpur 284 284 11 3 113600 3600 126800 142000 386000
8 Buxar 162 162 6 3 64800 3600 72000 81000 221400
9 Champaran - E 502 502 20 3 200800 3600 224800 251000 680200
10 Champaran - W 63 63 3 3 25200 3600 28800 31500 89100
11 Darbhanga 119 119 5 3 47600 3600 53600 59500 164300
12 Gaya 309 309 12 3 123600 3600 138000 154500 419700
13 Gopalganj 48 48 2 3 19200 3600 21600 24000 68400
14 Jahanabad 103 103 4 3 41200 3600 46000 51500 142300
15 Jamui 142 142 6 3 56800 3600 64000 71000 195400
16 Katihar 85 85 3 3 34000 3600 37600 42500 117700
17 Kaimur 167 167 7 3 66800 3600 75200 83500 229100
18 Khagaria 186 186 7 3 74400 3600 82800 93000 253800
19 Kishanganj 8 8 1 3 3200 3600 4400 4000 15200
20 Lakhisarai 74 74 3 3 29600 3600 33200 37000 103400
21 Madhepura 41 41 2 3 16400 3600 18800 20500 59300
22 Madhubani 119 119 5 3 47600 3600 53600 59500 164300
23 Munger 140 140 6 3 56000 3600 63200 70000 192800
24 Muzaffarpur 277 277 11 3 110800 3600 124000 138500 376900
25 Nalanda 248 248 10 3 99200 3600 111200 124000 338000
26 Nawada 132 132 5 3 52800 3600 58800 66000 181200
27 Patna 276 276 11 3 110400 3600 123600 138000 375600
28 Purnia 177 177 7 3 70800 3600 79200 88500 242100
29 Rohtas 240 240 10 3 96000 3600 108000 120000 327600
30 Saran 220 220 9 3 88000 3600 98800 110000 300400
31 Samastipur 321 321 13 3 128400 3600 144000 160500 436500
32 Saharsa 48 48 2 3 19200 3600 21600 24000 68400
33 Sheikhpura 66 66 3 3 26400 3600 30000 33000 93000
34 Sheohar 2 2 1 3 800 3600 2000 1000 7400

35 Siwan 131 131 5 3 52400 3600 58400 65500 179900
36 Sitamarhi 127 127 5 3 50800 3600 56800 63500 174700
37 Supaul 42 42 2 3 16800 3600 19200 21000 60600
38 Vaishali 195 195 8 3 78000 3600 87600 97500 266700
Total 5975 5975 241 114 2390000 136800 2679200 2987500 8193500
Rates for training as per GOI guideline vide letter no. D.O.No.A-11033/101/2007-Trg dated 20.10.08
S.no. District Name No. of PHCs
Cold Chain Handler training on Routine Immunization - Consolidated Budget 2009-10
No. of Cold
Chain
Handler (2
per PHC & 2
per district)
Total
Training
load
Total No. of
training
Batches ( 25
person per
batch)
225
No of
trainers
per batch
Honorarium + TA
to Participants
@Rs 400 per
participants
Honararium for
trainers/faculty @600
per day ( subject to
atleast 2 lectature per
guest faculty per day)
for 1 days
Working lunch &
Refreshments
Rs 200 per
Grand Total
participants +
faculty per day
for one day
1 Araria 9 20 20 1 1 8000 600 4200 12800
2 Arwal 5 12 12 1 1 4800 600 2600 8000
3 Aurangabad 11 24 24 1 1 9600 600 5000 15200
4 Banka 10 22 22 1 1 8800 600 4600 14000
5 Begusarai 18 38 38 2 1 15200 600 8000 23800
6 Bhagalpur 16 34 34 2 1 13600 600 7200 21400
7 Bhojpur 14 30 30 1 1 12000 600 6200 18800
8 Buxar 11 24 24 1 1 9600 600 5000 15200
9 Champaran - E 20 42 42 2 1 16800 600 8800 26200
10 Champaran - W 17 36 36 2 1 14400 600 7600 22600
11 Darbhanga 18 38 38 2 1 15200 600 8000 23800
12 Gaya 25 52 52 2 1 20800 600 10800 32200
13 Gopalganj 14 30 30 1 1 12000 600 6200 18800
14 Jahanabad 7 16 16 1 1 6400 600 3400 10400
15 Jamui 9 20 20 1 1 8000 600 4200 12800
16 Katihar 16 34 34 2 1 13600 600 7200 21400
17 Kaimur 10 22 22 1 1 8800 600 4600 14000
18 Khagaria 7 16 16 1 1 6400 600 3400 10400
19 Kishanganj 7 16 16 1 1 6400 600 3400 10400
20 Lakhisarai 6 14 14 1 1 5600 600 3000 9200
21 Madhepura 13 28 28 1 1 11200 600 5800 17600
22 Madhubani 18 38 38 2 1 15200 600 8000 23800

23 Munger 9 20 20 1 1 8000 600 4200 12800
24 Muzaffarpur 14 30 30 1 1 12000 600 6200 18800
25 Nalanda 20 42 42 2 1 16800 600 8800 26200
26 Nawada 14 30 30 1 1 12000 600 6200 18800
27 Patna 23 48 48 2 1 19200 600 10000 29800
28 Purnia 14 30 30 1 1 12000 600 6200 18800
29 Rohtas 19 40 40 2 1 16000 600 8400 25000
30 Saran 20 42 42 2 1 16800 600 8800 26200
31 Samastipur 20 42 42 2 1 16800 600 8800 26200
32 Saharsa 10 22 22 1 1 8800 600 4600 14000
33 Sheikhpura 6 14 14 1 1 5600 600 3000 9200
34 Sheohar 5 12 12 1 1 4800 600 2600 8000
35 Siwan 19 40 40 2 1 16000 600 8400 25000
36 Sitamarhi 13 28 28 1 1 11200 600 5800 17600
37 Supaul 11 24 24 1 1 9600 600 5000 15200
38 Vaishali 17 36 36 1 1 14400 600 7400 22400
Total 515 1106 1106 52 38 442400 22800 231600 696800
Rates for training as per GOI guideline vide letter no. D.O.No.A-11033/101/2007-Trg dated 20.10.08
UNICEF will provide one trainer and all training materials for participants
S.no.
District Name
No. of
PHCs
Block level Data Handler training on Routine Immunization - Consolidated Budget 2009-10
Honararium for
Total No. of
trainers/faculty
Honorarium + TA
Total training No of
@600 per day (
to Participants
Training Batches ( 25 trainers
subject to atleast 2
@Rs 400 per
load person per per batch
lectature per guest
participants
batch)
faculty per day) for
1 days
No. of Data
Handler (1
per PHC & 2
per district)
226
Working lunch
& Refreshments
Rs 200 per
participants +
faculty per day
for one day
Incidential Exp for
Photocopy , Job
aids, flip charts,
T.V./LCD hiring
etc @ 250 per
participants per
days for one day
Grand Total
1 Araria 9 11 11 1 1 4400 600 2400 2750 10150
2 Arwal 5 7 7 1 1 2800 600 1600 1750 6750
3 Aurangabad 11 13 13 1 1 5200 600 2800 3250 11850
4 Banka 10 12 12 1 1 4800 600 2600 3000 11000
5 Begusarai 18 20 20 1 1 8000 600 4200 5000 17800
6 Bhagalpur 16 18 18 1 1 7200 600 3800 4500 16100
7 Bhojpur 14 16 16 1 1 6400 600 3400 4000 14400
8 Buxar 11 13 13 1 1 5200 600 2800 3250 11850
9 Champaran - E 20 22 22 1 1 8800 600 4600 5500 19500

10 Champaran - W 17 19 19 1 1 7600 600 4000 4750 16950
11 Darbhanga 18 20 20 1 1 8000 600 4200 5000 17800
12 Gaya 25 27 27 1 1 10800 600 5600 6750 23750
13 Gopalganj 14 16 16 1 1 6400 600 3400 4000 14400
14 Jahanabad 7 9 9 1 1 3600 600 2000 2250 8450
15 Jamui 9 11 11 1 1 4400 600 2400 2750 10150
16 Katihar 16 18 18 1 1 7200 600 3800 4500 16100
17 Kaimur 10 12 12 1 1 4800 600 2600 3000 11000
18 Khagaria 7 9 9 1 1 3600 600 2000 2250 8450
19 Kishanganj 7 9 9 1 1 3600 600 2000 2250 8450
20 Lakhisarai 6 8 8 1 1 3200 600 1800 2000 7600
21 Madhepura 13 15 15 1 1 6000 600 3200 3750 13550
22 Madhubani 18 20 20 1 1 8000 600 4200 5000 17800
23 Munger 9 11 11 1 1 4400 600 2400 2750 10150
24 Muzaffarpur 14 16 16 1 1 6400 600 3400 4000 14400
25 Nalanda 20 22 22 1 1 8800 600 4600 5500 19500
26 Nawada 14 16 16 1 1 6400 600 3400 4000 14400
27 Patna 23 25 25 1 1 10000 600 5200 6250 22050
28 Purnia 14 16 16 1 1 6400 600 3400 4000 14400
29 Rohtas 19 21 21 1 1 8400 600 4400 5250 18650
30 Saran 20 22 22 1 1 8800 600 4600 5500 19500
31 Samastipur 20 22 22 1 1 8800 600 4600 5500 19500
32 Saharsa 10 12 12 1 1 4800 600 2600 3000 11000
33 Sheikhpura 6 8 8 1 1 3200 600 1800 2000 7600
34 Sheohar 5 7 7 1 1 2800 600 1600 1750 6750
35 Siwan 19 21 21 1 1 8400 600 4400 5250 18650
36 Sitamarhi 13 15 15 1 1 6000 600 3200 3750 13550
37 Supaul 11 13 13 1 1 5200 600 2800 3250 11850
38 Vaishali 17 19 19 1 1 7600 600 4000 4750 16950
Total 515 591 591 38 38 236400 22800 125800 147750 532750
Rates for training as per GOI guideline vide letter no. D.O.No.A-11033/101/2007-Trg dated 20.10.08
S.no. District Name PHC PHC x
5
Calculation for Alternate Vaccinator (requirement and Honorarium - 2009-10
APHC HSCs Total
ANM -
R
ANM -
C
227
Total
ANM
Diff of
Personnel
Altern
ate
Vaccin
ator
require
d
Honararium
for Alternate
vaccinator @
Rs 1400/- per
month
No. of
Contractu
al ANM
One month
Honararium for
Break period for
Contractual
ANM @ Rs
1400/- per ANM
Grand Total
1 Araria 9 45 73 424 542 170 115 285 257 257 4317600 115 161000 4478600

2 Arwal 5 25 26 64 115 58 70 128 -13 70 98000 98000
3 Aurangabad 11 55 58 207 320 332 104 436 -116 104 145600 145600
4 Banka 10 50 32 265 347 277 269 546 -199 269 376600 376600
5 Begusarai 18 90 25 289 404 357 211 568 -164 211 295400 295400
6 Bhagalpur 16 80 41 280 401 381 230 611 -210 230 322000 322000
7 Bhojpur 14 70 27 355 452 366 284 650 -198 284 397600 397600
8 Buxar 11 55 47 287 389 212 162 374 15 15 252000 162 226800 478800
9 Champaran - E 20 100 46 315 461 419 502 921 -460 502 702800 702800
10 Champaran - W 17 85 30 377 492 344 110 454 38 38 638400 110 154000 792400
11 Darbhanga 18 90 36 261 387 255 185 440 -53 185 259000 259000
12 Gaya 25 125 73 541 739 539 338 877 -138 338 473200 473200
13 Gopalganj 14 70 23 186 279 233 48 281 -2 48 67200 67200
14 Jahanabad 7 35 32 104 171 154 103 257 -86 103 144200 144200
15 Jamui 9 45 22 212 279 212 142 354 -75 142 198800 198800
16 Katihar 16 80 25 257 362 325 144 469 -107 144 201600 201600
17 Kaimur 10 50 19 196 265 140 167 307 -42 167 233800 233800
18 Khagaria 7 35 24 193 252 189 193 382 -130 193 270200 270200
19 Kishanganj 7 35 9 136 180 126 18 144 36 36 604800 18 25200 630000
20 Lakhisarai 6 30 19 126 175 131 74 205 -30 0 74 103600 103600
21 Madhepura 13 65 39 386 490 86 21 107 383 383 6434400 21 29400 6463800
22 Madhubani 18 90 57 430 577 361 89 450 127 127 2133600 89 124600 2258200
23 Munger 9 45 33 227 305 166 140 306 -1 0 140 196000 196000
24 Muzaffarpur 14 70 121 751 942 585 307 892 50 50 840000 307 429800 1269800
25 Nalanda 20 100 68 467 635 402 248 650 -15 0 248 347200 347200
26 Nawada 14 70 56 338 464 201 223 424 40 40 672000 223 312200 984200
27 Patna 23 115 60 418 593 520 368 888 -295 0 368 515200 515200
28 Purnia 14 70 74 511 655 279 256 535 120 120 2016000 256 358400 2374400
29 Rohtas 19 95 94 308 497 286 240 526 -29 0 240 336000 336000
30 Saran 20 100 69 508 677 366 234 600 77 77 1293600 234 327600 1621200
31 Samastipur 20 100 45 354 499 456 321 777 -278 0 321 449400 449400
32 Saharsa 10 50 15 152 217 175 50 225 -8 0 50 70000 70000
33 Sheikhpura 6 30 17 85 132 113 66 179 -47 0 66 92400 92400
34 Sheohar 5 25 7 34 66 28 7 35 31 31 520800 7 9800 530600
35 Siwan 19 95 55 439 589 193 404 597 -8 0 404 565600 565600
36 Sitamarhi 13 65 36 213 314 199 127 326 -12 0 127 177800 177800
37 Supaul 11 55 19 178 252 69 50 119 133 133 2234400 50 70000 2304400
228

38 Vaishali 17 85 30 337 452 381 195 576 -124 0 195 273000 273000
Total 515 2575 1582 11211 15368 9916 6700 16901 -1533 1307 21957600 6815 9541000 31498600
229

PART- D
National Disease Control Programmes
(NDCP)
2009-2010
230

IDSP (Integrated Disease Surveillance Program)
Surveillance is essential for the early detection of emerging (new) or re-emerging
(resurgent) infectious diseases. In the absence of surveillance, disease may spread
unrecognised by those responsible for health care or public health agencies, because
many individual health care workers would see sick people in small numbers. By the time
the outbreak is recognized, it may be too late for intervention measures. Continuous
monitoring is essential for detecting the early signals of outbreak of any epidemic of a
new or resurgent disease. For disease surveillance to prevent emerging epidemics, the
time taken for effective action should be short.
Integrated Disease Surveillance Program (IDSP) is intended to be the backbone of public
health delivery system in the state. It is expected to provide essential data to monitor
progress of on- going disease control programs and help in optimizing the allocation of
resources. It will be able to detect early warning signals of impending outbreaks and help
initiate an effective and timely response. IDSP will also facilitate the study of disease
patterns in the state and identify new emerging diseases. It will play a crucial role in
obtaining political and public support for the health programs in the state.
Profile of Bihar : Bihar is located in the North East of India. It has a land with a covered
area of 94,163 Sq. Km. It is mainly divided into two regions known as North of Ganges,
and south of Ganges regions. The State is geographically classified into 38 districts and 72
Sub divisions and 533 blocks. The population of Bihar as per 2001 Census is 828.8 million
with a urban population of 8681800 as the density population per Sq. Km. is 880 against
national figure of 324. There are 32 towns with a population of 50,000 or more and having
about 40,000 villages in the state. The present sex ratio is 919 females per 1000 males
(India Figure 933). The total literacy rate is 46.4%. It is mainly a rural inhabited state. The
percentage of rural population is 66.08% against the Indias population of 72.2%.
Diseases conditions under the surveillance program
(i) Regular Surveillance:
Vector Borne Disease:
Malaria & Kala-azar
Water Borne Disease: Acute Diarrhoeal Disease (Cholera) &
Typhoid
Respiratory Diseases:
Tuberculosis
Vaccine Preventable Diseases: Measles
Diseases under eradication: Polio
Other Conditions:
Road Traffic Accidents
231

Table 2: Integrated
IDSP (Integrated Disease Surveillance Program)
S.N. Heads Units Unit Cost Total
1 Infrastructure
a State Surveillance Cell at DMS & DHS 1 1,500,000 1,500,000
b District Level Laboratory 39 100,000 3,900,000
c Manuals 1 500000 500,000
2 Laboratory
a Equipment 39 100000 3,900,000
b Reagents and consumables 39 200000 7,800,000
3 Communication
a Telephone & Fax 39 10000 390,000
4 Salary
a Data Entry Operator 39 6000 234,000
b Accounts Assistant 39 5000 195,000
5 Social Mobilization 39 30000 1,170,000
6 Training 39 100,000 3,900,000
7
Biological Waste Management, 5%
overhead expenses 39 917,000
GRAND TOTAL 24,406,000
(24406000 – 11400000 = 13006000)
An amount One Crore Forteen lakhs (Rs. 1,14,00,000/-) was released to to State. Hence
balance fund requirment will be Rs. 1,30,06,000/- lakhs (One crore Thirty lakhs six
thousands only).
232

IDSP (Integrated Disease Surveillance Project)
SL No Name of District District Level IDSP Fund State Level IDSP Fund
1 2 3 4
1 Araria 574513.00
2 Arwal 574513.00
3 Aurangabad 574513.00
4 Banka 574513.00
5 Begusarai 574513.00
6 Bhagalpur 574513.00
7 Bhojpur 574513.00
8 Buxar 574513.00
9 Darbhanga 574513.00
10 East Champaran 574513.00
11 Gaya 574513.00
12 Gopalganj 574513.00
13 Jamui 574513.00
14 Jehanabad 574513.00
15 Kaimur 574513.00
16 Katihar 574513.00
17 Khagaria 574513.00
18 Kishanganj 574513.00
19 Lakhisarai 574513.00
20 Madhepura 574513.00
2574513.00
21 Madhubani 574513.00
22 Munger 574513.00
23 Muzaffarpur 574513.00
24 Nalanda 574513.00
25 Nawada 574513.00
26 Patna 574513.00
27 Purnia 574513.00
28 Rohtas 574513.00
29 Saharsa 574513.00
30 Samastipur 574513.00
31 Saran 574513.00
32 Sheikhpura 574513.00
33 Sheohar 574513.00
34 Sitamarhi 574513.00
35 Siwan 574513.00
36 Supaul 574513.00
37 Vaishali 574513.00
38 West Champaran 574513.00
39 Unit Cost State Level
Total 21,831,494.00 2,574,513.00
Note- (i) District Level IDSP fund 21831494.00
(ii) State Level IDSP Fund 2574513.00
Total 24406007.00
(24406007 - 11400000 = 13006007)
233

An amount One Crore Forteen lakhs (Rs. 1,14,00,000/-) was released to State. Hence, balance fund requirement will be Rs.
1,30,06,007/- lakhs (One Crore Thrity lakhs Six thousands Seven only),
234

Iodine Deficiency Disorder
Addressing Iodine Deficiency Disorders in Bihar.
Introduction:
Iodine deficiency is a world wide public health problem. It is the major cause of brain damage loss
of energy, learning disability, poor motivation, poor human resource development and child
survival. Thus, it remains a major threat to the health and development of school children and
pregnant women. Children with iodine deficiency have intelligence (I.Q) 13.5 points less than that
of children from areas where there is no iron deficiency. The only solution to this is simple and
affordable, which is consumption of iodised salt. IDD elimination Programme was launched in the
late 1960s. By 1988 legislative measures were put in place to ban the sale of non-iodised salt in the
entire state.
During the United Nations General Assembly Special Session for Children (2002), India has
committed to eliminate IDD by 2005. Although, in national policy commitments, India commits to
eliminate IDD by 2010, there is an urgent need to accelerate the strategy in India, especially when a
decreasing trend, 49% to 37% (1998-99 to 2002-03), has been seen in households consuming
adequately iodised salt.
Iodine Deficiency Disorders in Bihar:
In Bihar the northern part of the state lies in the sub-Himalayan region in which the existence of
severe to moderate iodine deficiency in this region is well established. A recent study was
undertaken in Bihar with support from UNICEF for Government of Bihar, to track progress towards
sustainable elimination of IDD from the state. The results of the study reveal that iodine deficiency
continues to be a public health problem. A high proportion of population (31.5%) has very low
urinary iodine excretion suggesting existence of severe iodine deficiency in many pockets. Only
40.1% of the households consume adequately iodised salt.
The findings of this study warrant instituting corrective measure on a war footing to ensure that the
population of Bihar has access to adequately iodised salt and at least 80% of the households receive
and use adequately iodised salt.
Major Objectives:
· Creating universal demand for iodised salt at consumption level
· Strengthening the monitoring system at the production level
Role of Each Department:
Awareness generation among consumers is a corner stone of the strategy and all possible means to
disseminate information about the benefits of consuming iodised salt and to trigger behaviour
change among the population. This surely requires the contribution of stakeholders outside the
Health Department. In this regard the ICDS with its extended network of AWCs is a strong link
through which the vulnerable population groups in the community can be reached out
235

The priority of Iodine Deficiency Disorders should also be shouldered by the Education department.
Schools provide an excellent infrastructure for promotional activities to reach out to masses thru
children. Teachers can be trained for encouraging students to influence their families in purchasing
iodised salt highlighting the benefit of IQ difference in children with iodine deficiency. Thus, a
series of activities could be organized for awareness creation among children, who in turn can be
expected to serve as change agents for influencing their families.
Health:
Health is the nodal department, while ICDS and Education will be the collaborating
Departments. These have been specified under the role of departments of ICDS and Higher
Education. To begin with the district will form a co-ordination Committee to take decisions on
priority actions and review the progress of work once every quarter.
However, the State Health Department will ensure the following:
- Formation of District Co-ordination Committee to prioritize actions and review progress
quarterly.
Functions of District Co-ordination Committee:
1. To facilitate Orientation and Planning Meetings for awareness generation
and to strengthen monitoring of salt quality
2. To support organization and implementation of awareness campaigns
through schools and AWCs to reach out to the communities.
3. To monitor campaigns/activities under the 3 departments and prepare
district reports
4. To institute follow-up actions in blocks areas with low or no iodine salt
sale and consumption.
- Directives to be issued to medical colleges and district hospitals and super specialty
hospitals, for using iodised salt in cooking meals for the patients.
- Civil Surgeon to hold meetings of lab technician and Food Inspectors in his district.
- State Nutrition cell to ensure the following to districts and districts to distribute to AWCS,
through CDPOs and to Schools through BEOs.
- Reporting format
- Distribution of STKs
- Distribution of IEC material
- Financial Support.
ICDS:
- Same Letter signed by Civil Surgeon, DPO and DSE for co-ordination by the functionaries
of three district departments to organize and conduct joint training of ANMs and AWWs.
- Directives to be re-issued as a reminder for use of iodised salt in supplementary food
AWCs.
236

- DPOs/DWOs to plan and conduct the orientation of CDPOs and LS.
- CDPOs/LS to organize and carryout block level training of AWWs and their ANM along
with MOICs and BEO
- MOIC/CDPO to ensure supply of ST Kits, IEC materials, cash assistance etc to AWCs
- Prepare a monitoring plan and carry out monitoring of the planned activities jointly in the
village or community by involving the leaders, youth or school children.
- Every AWW to prepare an Activity Report including a report on monitoring of salt
- MOIC and CDPO to conduct joint review meetings with ANMs and AWWs in her/his block
on 25th of every month.
- DPO/CSEO to hold meeting of BEOs on 28 th of every month and receive reports for all
schools in his district by 28 th of every month.
- These meetings also to be utilized for planning activities for the next month with time line
budget and role specificity.
- MOIC and CDPO to facilitate organizing of activities in villages/tolas, AWW to take the
lead.
- ANM and AWW to prepare a joint report of activities to CS and DWO /DPO.
- A copy of the report will be given to DSM.
- DSM will forward a copy to RSM.
- CS will forward a copy to MIS Cell of State Nutrition Cell.
- MIS Cell will share a district-wise compiled report with UNICEF.
Education:
- Directives from DEO using iodised salt only in MDM in schools.
- District DEO to facilitate and complete training of BEOs on IDD/USI
- BEO to conduct training of Nodal Teachers along with MOIC/CDPO at the Block
- Support Nodal Teachers to prepare a plan of activities and budget for the schools.
- Submit a copy of plan and the budget of schools to DEOs office.
- All students in the school to be sensitized with the problem of IDD and the benefits of
iodised salt.
Sensitizing School Children on IDD/IS
School teacher shall take a 30 minutes class, and would explain to children why iodine is important,
causes of iodine deficiency disorder, and consequences of IDD with emphasis on physical and
mental development. Explain that iodised salt helps bring back iodine to the body. Thus iodised salt
is important, but both iodised and non-iodised salt is available. Give emphasis to the difference in
the IQ points up to 13, in children with iodine deficiency thus affecting leaning and school
performance which further reflects on workout put and productivity. Thus good health can be
ensured only with daily consumption of iodised salt.
237

Activities within the school:
- Essay/Story competition -Poetry Writing
- Exhibitions -Play/Skits
- Slogan writing -Songs
-All children participating, to get a certificate and the best child/ children to get a prize)
Monitoring salt for iodine content in the class room:
All children requested to bring few pinches of salt from their homes
Teacher to supervise the testing of salt using the kit, by each child. Children would be
classified into two groups.
Group 1 will have children with salt samples tested with adequate iodine.
Group II will have children with salt samples tested with no iodine or inadequate iodine.
Counseling to Group I: Your salt is of good quality and would allow you to perform well
in school if you continue consuming iodised salt as you are and pay attention to your
studies in the school. Insist that your parents always buy iodised salt only.
Counseling to GroupII. Your salt does not contain iodine. Your are being left out from
its benefits. If this continues, you are likely to face some serious risks. Your growth can
be retarded and at the same time your school performance would be negatively affected.
This can happen to your brothers and sisters, as they are also consuming the same salt
without iodine or less amount of iodine that is required by the body. When we have the
same session repeated next month, your salt test should show blue colour which means
you have convinced your parents to buy salt which is iodised.
In general, the Teacher should say, we want to see all children in group I and none in the
other group. So our class should have children all using iodised salt.
- BEOs to ensure supply of ST Kits, IEC materials, cash assistance etc to schools
- Prepare a monitoring plan and carry out monitoring of the planned activities in the school
along with MOICs and CDPOs.
- Head Masters to facilitate organizing of activities within and outside school, Nodal Teacher
to take the lead.
Activities outside the school:
- Organize Salt monitoring for advocacy in the community
- Each Nodal Teacher to choose 20 children living in different localities
- Each student to visit 15-20 houses and shops around them for monitoring and advocacy.
- Slogans to be used for Prabhat Pheri
- Human Chain
- Marathon/Bicycle Race
- All children to get a certificate, and the best performer to get a prize.
238

- Each nodal teacher to prepare report for her class.
- Every school to prepare an Activity Report including a report on monitoring of salt
- BEO to conduct review meetings with Head Masters/Nodal Teachers on 25 th and collect the
report for all schools in his block 25 th of every month.
- DEO to hold meeting of BEOs on 28 th of every month and receive reports for all schools in
his district by 28 th of every month.
- These meetings also to be utilized for planning activities for the next month with time line
budget and role specificity.
Monitoring and Reporting:
The monitoring of the activities will be done by the block level officers of all three departments. A
plan for monitoring will be ensured and will prepared during the planning meetings.
Each AWC/ANM will prepare a report and forward it to MOIC, CDPO BDO. The schools will
prepare the activity report and forward it to BEO and BDO. The MOICs will compile and send the
report to CS while, the CDPO will compile and send the report to DPO/DWO with a copy to CS.
The BEO will compile for all schools in the block and forward it to DEO with a copy to CS.
Civil Surgeon Office will prepare a final compiled report for the district and forward it to State
Nutrition Cell, copy to Directorate ICDS and Education, Government of Bihar, Patna.
State Nutrition Cell and UNICEF along with Directors of respective departments will hold review
meetings to discuss progress and strengthen efforts in low consumptions areas.
State Nutrition Cell with support from UNICEF will also facilitate State Task Force Meeting in end
September to take stock of achievements and future course of actions.
_______________________________________________
239

Budget for Intensified IDD / USI Activities in 38 District of Bihar
Sl No. Name of District No. of PHC
Training @
Rs.1000
Awareness @
Rs. 500
Activities in
School @ 1000
Activates at
AWC &
Communities
@ 500
IEC Material
@ Rs.435
1 ARWAL 5 5000 2500 5000 2500 2176
2 AURANGABAD 11 11000 5500 11000 5500 4786
3 BANKA 10 10000 5000 10000 5000 4351
4 BEGUSARAI 19 19000 9500 19000 9500 8267
5 BHAGALPUR 12 12000 6000 12000 6000 5221
6 BHOJPUR 13 13000 6500 13000 6500 5656
7 BUXAR 7 7000 3500 7000 3500 3046
8 DARBHANGA 18 18000 9000 18000 9000 7832
9 EAST CHAMPARAN 21 21000 10500 21000 10500 9137
10 GAYA 24 24000 12000 24000 12000 10443
11 GOPALGANJ 14 14000 7000 14000 7000 6092
12 JAHANABAD 8 8000 4000 8000 4000 3481
13 JAMUI 11 11000 5500 11000 5500 4786
14 KAIMUR 11 11000 5500 11000 5500 4786
15 KATIHAR 17 17000 8500 17000 8500 7397
16 KHAGARIA 8 8000 4000 8000 4000 3481
17 KISHANGANJ 8 8000 4000 8000 4000 3481
18 LAKHISARAI 6 6000 3000 6000 3000 2611
19 MADHUBANI 19 19000 9500 19000 9500 8267
20 MUNGER 12 12000 6000 12000 6000 5221
21 MUZAFFARPUR 15 15000 7500 15000 7500 6527
22 NALANDA 23 23000 11500 23000 11500 10008
23 NAWADA 15 15000 7500 15000 7500 6527
24 PATNA 28 28000 14000 28000 14000 12183
240

25 ROHTAS 19 19000 9500 19000 9500 8267
26 SAMASTIPUR 15 15000 7500 15000 7500 6527
27 SARAN 16 16000 8000 16000 8000 6962
28 SEOHAR 5 5000 2500 5000 2500 2176
29 SHEIKHPURA 7 7000 3500 7000 3500 3046
30 SITAMARHI 14 14000 7000 14000 7000 6092
31 SIWAN 16 16000 8000 16000 8000 6962
32 VAISHALI 16 16000 8000 16000 8000 6962
33 WEST CHAMPARAN 17 17000 8500 17000 8500 7397
34 Supaul 13 13000 6500 13000 6500 5656
35 Saharsa 11 11000 5500 11000 5500 4786
36 Purnia 15 15000 7500 15000 7500 6527
37 Madhepura 15 15000 7500 15000 7500 6527
38 Araria 10 10000 5000 10000 5000 4351
Total 524 524000 262000 524000 262000 228000
Particulars Rate Total Amount in
Rs.
Sl No.
1 Training Rs. 1000 / PHC 524000
2 Awareness Generation Rs. 500 / PHC 262000
3 Activities in School Rs. 1000 / PHC 524000
4 IEC Material Rs. 400 / PHC 228000
5 Activities in AWC & Communities Rs. 500 262000
Grand Total 1800000
Total Eighteen Lakh.
241

PROJECT IMPLEMENTATION PLAN
FOR
NATIONAL PROGRAMME FOR
CONTROL OF BLINDNESS
2009 – 2010
243

PROJECT IMPLEMENTATION PLAN
FOR
NATIONAL PROGRAMME FOR
CONTROL OF BLINDNESS
2009 – 2010
244

Introduction
National Programme for Control of Blindness (NPCB) was launched in the
year 1976 as a 100% centrally sponsored scheme with the goal of reducing
the prevalence of blindness. The goal set for the terminal year of the 10th
Plan is to reduce the prevalence of blindness to 0.8% by 2007 prevalence of
Blindness is 1% (2006-07 Survey) and 0.3% of population by 2020.
The four pronged strategy of the programme is:
strengthening service delivery,
developing human resources for eye care,
promoting outreach activities and public awareness and
developing institutional capacity.
NATIONAL POLICY :
One of the basic human right is ‘THE RIGHT TO SIGHT’ we
have to ensure that no citizen goes blind needlessly, or bring
blind does not remain so, if by reasonable skill and resources
his sight can be prevented from deteriorating, of if already lost
can be restored.
245

National Programme for Control of Blindness
(Financial Year 2009-2010)
There are two main Programmes under National Programme
for Control of Blindness:
(1) Cataract Operation
(2) School Eye Screenings Programme:
Cataract Operation:- Cataract Operations are being done in
district Hospitals against the target fixed by state. In addition
in the NGOs governed hospitals under the monitoring of
District Health Society- Blindness Division.
The following table shows the last six year’s physical
record of Cataract Operation:-
Sl. No. Year Target Achievement Percentage
1. 2003-04 140000 90405 64.58
2. 2004-05 140000 102531 73.24
3. 2005-06 140000 131860 94.19
4. 2006-07 140000 129064 92.19
5. 2007-08 140000 137685 98.35
6. 2008-2009
Till Feb,09
150000 82106
School Eye Screening Programme :- Teachers are being
trained, to conduct eye screening of the school children and to
advise for using proper spectacles by the needy children with
defective eyes is one of the main activities of the Programme.
In addition to this free distribution of spectacles among the
families belonging to below Poverty Line (BPL) is also a major
component of the activities.
246

The following table shows the last four year’s physical
record of SES :-
Sl.
No.
Year
No. of school children underwent
Eye Screening
1. 2005-06 2,97,278
2. 2006-07 2,43,095
3. 2007-08 284398
4. 2008-2009
up to June,08
55387
Review Meeting: - A Two days Review Meeting of Additional
Chief Medical Officer who is also the District Programme Officer
of National Programme for Control of Blindness is proposed in
near feature in which representative of Govt. of India shall also
be requested to attend.
State Level Workshop:- Three days State Level Workshop of
Eye specialist/Eye surgeon of district level is also proposed in
which representative of Govt. of India shall also be invited to
attend.
Vision Centre:- In remote rural areas where there is no facility
of eye care , Govt. of India has provision for setting up vision
centre
made available.
by the NGOs where all facilities for eye care shall be
Training :- Under the NPCB training to Medical Officer of PHC,
PMOAs and Nurses shall be imparted. Medical Officers shall be
trained for three days, PMOAs for five days and
training to the Nurses as per Govt. of India guideline.
28 days
IEC:- In order to make aware the people about how to take care
of their eyes to acquaint them where to report for eye check up
247

in case of any vision problem through hand bill, pump let,
poster, banner, cable net work, hoarding and Doordarshan etc.
Causes of Blindness in Bihar State :
Following is the table showing the causes of blindness
according to their magnitude of importance in the overall
situation of blindness problem.
F Cataract
F Refractive Errors
F Corneal Blindness
F Glaucoma
F Surgical Complications
F Posterior segment disorders
F Others
Emerging Causes of Blindness :
F Diabetic retinopathy
F Glaucoma
F Childhood blindness
248

Comparison of Prevalence of Blindness National Surveys
Parameter
Estd. Prevalence of
Blindness
(Visual Acuity

Plan of action and Budgetary requirements during 2009-2010
Sl. No. Name of Activity Estimated Cost.
(Rupees in
Lakhs)
1. Remuneration, other activities & contingencies (Annex-A) 15.00
2. Grant-in-Aid other Components-) 473.75
3. Cash Grant for Salaries & SOC 30.00
TOTAL:- 518.75
Budgetary requirement during 2009-2010
Annexure-A
Sl.No. Particulars Cost p.a.
1. Review Meeting 80,000
2. Flexi pool fund (for staff remuneration & other ) 10,80,000
3. TA/DA for Staff 96,000
4. POL/Vehicle Maintenance 72,000
5. Stationary and Consumables 52,000
6. State level Workshop 120,000
Total 15,00,000
Annexure-B
Grant in Aid other components-
1. Recurring GIA for Eye Donation 150,000
2. Vision Centre ( 50 @ 25,000/- per vision centres ) 625,000
3. Eye Bank 5,00,000
4. Eye Donation Centre 1,00,000
5. Training 5,00,000
6. IEC ( Schedule A) 5,00,000
7. GIA for free Cataract Operation for 38/ DHS-Blindness
4,40,00,000
Division
8. GIA for School Eye Screening for 38 DHS- Blindness Division 10,00,000
Total:- 4,73,75,000
250

Schedule :- 1
IEC CAMPAIGN: PROPOSED BUDGET FOR IEC ACTIVITES DURING 2009-2010
Sl.No. IEC Materials Tentative Quantity Rate
(approx)
Estimated
Cost (Rs.)
1. Hand Bill (For Eye) 1 Lakh 0.25/- piece 25,000
2. Hand Bill (For Children)1 Lakh 0.25/- piece 25,000
3. Leaflet 50 thousand 0.50/- piece 25,000
4. Poster 40 thousand 1.25/- piece 50,000
5. Banner 1000 (Five thousand) (38 District 80/- piece 80,000
& Head Quarter)
6. Cable Head Quarter 3500/- 61,000
7. Hoarding (38 District & Head Quarter 39 6000/- 2,34,000
TOTAL 5,00,,000.00
251

Sl.
No.
Plan of Action and Budgetary requirements during 2009-2010
Recurring Grants in Aid to NGOs for performing free Cataract
Operation and other Intra Ocular Surgeries.
Name of Dist. Target Total fund allocated by
GOI for Cataract Operation
for 38 DHS-Blindness
Division during 2009-2010
(Rs. in lacs)
Total fund allocated by GOI
for School Screening
Programme for 38 DHS-
Blindness Division during
2009-2010 (Rs. in lacs)
Remarks
Fund directly
allocated by GOI
for DHS
1. Araria 2000 - Do -
2. Arwal 500 - Do -
3. Aurangabad 3000 - Do -
4. Banka 1500 - Do -
5. Begusarai 4000 - Do -
6. Bhagalpur 6000 - Do -
7. Bhojpur 6000 - Do -
8. Buxar 3000 - Do -
9. Darbhanga 6000 - Do -
10. E.Champn. 2500 - Do -
11. Gaya 23000 - Do -
12. Gopalganj 2000 - Do -
13. Jamui 1500 - Do -
14. Jehanabad 2000 - Do -
15. Kaimur 2000 - Do -
16. Katihar 4000 - Do -
17. Khagaria 1500 - Do -
18. Kishanganj 2000 - Do -
19. Lakhisarai 1000 - Do -
20. Madhepura 1000 - Do -
21. Madhubani 1500 - Do -
22. Munger 2000 - Do -
23. Muzaffarpur 11000 - Do -
24. Nalanda 11000 - Do -
25. Nawada 3000 - Do -
26. Patna 22000 - Do -
27. Purnia 4000 - Do -
28. Rohtas 2000 - Do -
29. Saharsa 2000 - Do -
30. Samastipur 2000 - Do -
31. Saran 3000 - Do -
32. Sheikhpura 500 - Do -
33. Sheohar 500 - Do -
34. Sitamarhi 1000 - Do -
35. Siwan 2500 - Do -
36. Supaul 1000 - Do -
37. Vaishali 3500 - Do -
38. W.Chamn. 3000 - Do -
Total 150000 -
252

Recurring Grants in Aid to NGOs for performing free Cataract Operation and other Intra Ocular Surgeries.
Sl.N Name of Target ICCE @500/- ECCE/IOL@ 750/- Phaco
Total
o. Dist.
(20%)
(80%)
1. Araria 2000 200,000.00 1,200,000.00 - 1,400,000.00
2. Arwal 500 50,000.00 300,000.00 - 350,000.00
3. Aurangabad 3000 300,000.00 1,800,000.00 - 2,100,000.00
4. Banka 1500 150,000.00 900,000.00 - 1,050,000.00
5. Begusarai 4000 400,000.00 2,400,000.00 - 2,800,000.00
6. Bhagalpur 6000 600,000.00 3,600,000.00 - 4,200,000.00
7. Bhojpur 6000 600,000.00 3,600,000.00 - 4,200,000.00
8. Buxar 3000 300,000.00 1,800,000.00 - 2,100,000.00
9. Darbhanga 6000 600,000.00 3,600,000.00 - 4,200,000.00
10. E.Champn. 2500 250,000.00 1,500,000.00 - 1,750,000.00
11. Gaya 23000 2,300,000.00 13,800,000.00 - 16,100,000.00
12. Gopalganj 2000 200,000.00 1,200,000.00 - 1,400,000.00
13. Jamui 1500 150,000.00 900,000.00 - 1,050,000.00
14. Jehanabad 2000 200,000.00 1,200,000.00 - 1,400,000.00
15. Kaimur 2000 200,000.00 1,200,000.00 - 1,400,000.00
16. Katihar 4000 400,000.00 2,400,000.00 - 2,800,000.00
17. Khagaria 1500 150,000.00 900,000.00 - 1,050,000.00
18. Kishanganj 2000 200,000.00 1,200,000.00 - 1,400,000.00
19. Lakhisarai 1000 100,000.00 600,000.00 - 700,000.00
20. Madhepura 1000 100,000.00 600,000.00 - 700,000.00
21. Madhubani 1500 150,000.00 900,000.00 - 1,050,000.00
22. Munger 2000 200,000.00 1,200,000.00 - 1,400,000.00
23. Muzaffarpur 11000 1,100,000.00 6,600,000.00 - 7,700,000.00
24. Nalanda 11000 1,100,000.00 6,600,000.00 - 7,700,000.00
25. Nawada 3000 300,000.00 1,800,000.00 - 2,100,000.00
26. Patna 22000 2,200,000.00 13,200,000.00 - 15,400,000.00
27. Purnia 4000 400,000.00 2,400,000.00 - 2,800,000.00
28. Rohtas 2000 200,000.00 1,200,000.00 - 1,400,000.00
29. Saharsa 2000 200,000.00 1,200,000.00 - 1,400,000.00
30. Samastipur 2000 200,000.00 1,200,000.00 - 1,400,000.00
31. Saran 3000 300,000.00 1,800,000.00 - 2,100,000.00
32. Sheikhpura 500 50,000.00 300,000.00 - 350,000.00
33. Sheohar 500 50,000.00 300,000.00 - 350,000.00
34. Sitamarhi 1000 100,000.00 600,000.00 - 700,000.00
35. Siwan 2500 250,000.00 1,500,000.00 - 1,750,000.00
36. Supaul 1000 100,000.00 600,000.00 - 700,000.00
37. Vaishali 3500 350,000.00 2,100,000.00 - 2,450,000.00
38. W.Chamn. 3000 300,000.00 1,800,000.00 - 2,100,000.00
Total 150000 15,000,000.00 90,000,000.00 - 105,000,000.00
253

(Details of GIA for strengthening /expansion of eye care units in NGOs sector, Eye bank,
eye donation Centres, IEC ,Training etc. under NPCB during 2008-2009.
Sl.no
Grant in Aid for various
schemes.
Balance
available
as on
1.4.2008
Fund received
from GOI
during 2008-09
fund utilised/
disbursed
Balance
as on
31.12.2008
-
1
Cataract Operation (for DBCS)
- 7,000,000.00 7,000,000.00 -
2 School Eye Screening 28,000.00 1,000,000.00 - 1,028,000.00
3 Eye Donation 100,000.00 250,000.00 - 350,000.00
4 Vision Centre - 563,000.00 - 563,000.00
5 Eye Banks - - -
6 Eye Donation Centres 150,000.00 - - 150,000.00
7 Training 222,736.00 250,000.00 - 472,736.00
8 IEC Activities 184,631.00 450,000.00 - 634,631.00
9 SBCS remuneration and other activities (108,620.35) 800,000.00 132,166.00 559,213.65
10 Cash Grant - - -
11 Non recurring GIA to NGOs - - -
Total:- 576,746.65 10,313,000.00 7,132,166.00 3,757,580.65
Note:- Grant in aid of central assistance received from GOI,MH& FW, New Delhi vide letter no. T.12012/11/2006-BC
dated 18.3.2008 for implementation of the following various new scheme under NPCB during 2007-2008. Received in
Financial year 2008-2009 through ECS dt. on 3.4.2008
Name of Activities:
254
F/Y 2007-2008
fund received on
3.4.2008
Fund
received from
GOI during
F/Y 2008-
2009
Total fund received
during
the F/Y 2008-2009
from
GOI
Cataract Operation (for DBCS)
7000000 7000000
School Eye Screening 500000 500000 1000000
Recurring GIA for Eye donation 250000 0 250000
Non recurring GIA for Vision Centre 563000 0 563000
Training Activities 250000 0 250000
IEC Activities 250000 200000 450000
SBCS staff remuneration and other
activities 500000 300000 800000
Total: 2313000 8000000 10313000

Sl.No
a)
Details of GIA for Procurement of Ophthalmic Equipments under NPCB during 2008-2009
Grant in Aid for
various Schemes
1 Procurement
for Ophthalmic
equipments (DBCS)
2 Medical Colleges:_
Balance
available
as on
1.4.2008
Budget
Allocated
GIA
released by
GOI
Expenditure/
Disbursed
7,991,500.00 - - -
Balance
as on
31.12.2008
0
7,991,500.00
S.K. Medical
College & Hospital,
Muzaffarpur - 3,000,000.00 3,000,000.00 - 3,000,000.00
Total:- 7,991,500.00 3,000,000.00 3,000,000.00 - 10,991,500.00
255

Schedule :- 2
Fund allocated to DHS as per PIP allocation during the financial year 2009-2010
Sl.No. Name of
District
Year Target GIA for
free cataract
operation for
38 DHS
of Rs.
4,40,00,000
GIA for
School Eye
Screening
for 38 DHS
of Rs.
10,00,000
Fund allocated
to DHS as per
PIP allocation
Total Rs.4,50,00,000
1 Araria 2009-2010 2000 600,000.00
2 Arwal 2009-2010 500 150,000.00
3 Aurangabad 2009-2010 3000 900,000.00
4 Banka 2009-2010 1500 450,000.00
5 Begusarai 2009-2010 4000 1,200,000.00
6 Bhagalpur 2009-2010 6000 1,800,000.00
7 Bhojpur 2009-2010 6000 1,800,000.00
8 Buxar 2009-2010 3000 900,000.00
9 Darbhanga 2009-2010 6000 1,800,000.00
10 E.Champn. 2009-2010 2500 750,000.00
11 Gaya 2009-2010 25000 7,500,000.00
12 Gopalganj 2009-2010 2000 600,000.00
13 Jamui 2009-2010 1500 450,000.00
14 Jehanabad 2009-2010 2000 600,000.00
15 Kaimur 2009-2010 2000 600,000.00
16 Katihar 2009-2010 4000 1,200,000.00
17 Khagaria 2009-2010 1500 450,000.00
18 Kishanganj 2009-2010 2000 600,000.00
19 Lakhisarai 2009-2010 1000 300,000.00
20 Madhepura 2009-2010 1000 300,000.00
21 Madhubani 2009-2010 1000 300,000.00
22 Munger 2009-2010 2000 600,000.00
23 Muzaffarpur 2009-2010 11000 3,300,000.00
24 Nalanda 2009-2010 11000 3,300,000.00
25 Nawada 2009-2010 3000 900,000.00
26 Patna 2009-2010 22000 6,600,000.00
27 Purnia 2009-2010 4000 1,200,000.00
28 Rohtas 2009-2010 2000 600,000.00
29 Saharsa 2009-2010 2000 600,000.00
30 Samastipur 2009-2010 2000 600,000.00
31 Saran 2009-2010 3000 900,000.00
32 Sheikhpura 2009-2010 500 150,000.00
33 Sheohar 2009-2010 500 150,000.00
34 Sitamarhi 2009-2010 1000 300,000.00
35 Siwan 2009-2010 2500 750,000.00
36 Supaul 2009-2010 1000 300,000.00
37 Viashali 2009-2010 3000 900,000.00
38 W.Chamn. 2009-2010 2000 600,000.00
Total 150000 45,000,000.00
( Rupees four Crore fifty lac(s) only.)
256

Sl.
No.
Budget summary for Year 2009-2010
Name of activities DHS (Blindnes )
SHSB
(Blindness)
Remarks
1
2
3
4
5
6
7
8
9
10
Remuneration,other
activities & contingencies ( Annex.-A) - 1,500,000.00 SHSB,level
Recurring GIA for Eye donation - 150,000.00
Vision Centre - 625,000.00
Eye Bank - 500,000.00
Eye Donation Centre - 100,000.00
Disbursement
of fund to DHS
after approval .
Training 500,000.00 SHSB,level
IEC 500,000.00 SHSB,level
Fund
GIA for Cataract Operation 44,000,000.00
disbursement
to DHS
GIA for SES 1,000,000.00
after approval .
Cash grant for salaries & SOC 3,000,000.00 SHSB, level
Total:- 45,000,000.00 6,875,000.00 51,875,000.00
257

ACTION PLAN
(2009 – 2010)
National Leprosy Eradication
Programme
(NLEP) – BIHAR
258

Executive Summary:
National Leprosy Eradication Programme
(11 th five Year Plan 2007 – 2012)
State Action Plan 2009 – 2010
BIHAR
· Even though new case detection rate and prevalence rate are going
down, yet new cases continue to come up in large numbers in
state.
· The promotion of self reporting is now crucial to case detection, as
case finding campaigns become less and less cost effective. It is
important to identify and remove barriers that may prevent new cases
coming forward and a greater emphasis on the assessment of disability
at diagnosis, so that those at particular can be recognized and
managed appropriately.
· Leprosy being a disease associated with poverty, it is presumed there
are still hidden cases in the SC and among the underprivileged in
other categories, in both rural and urban areas.
· Under special initiatives, to promote self reporting, focus will be on
wide dissemination of key messages of leprosy i.e. curable, early
signs, no need to be feared and support, in the urban and rural areas.
This will reduce stigma & discrimination against persons affected
with leprosy. The key messages along with proactive involvement of
the community will bring about health behavior at individual,
household and community level.
· The out come of strategy will be promote further integration with
general health care system by providing operational and technical on
the job training. The better equipped and motivated GHC system will
provide quality leprosy services on all working days to the affected
communities, following the principles of equity and social justice.
259

Background:
· National Leprosy Control Programme was started by Govt. of India in
1955 based on Dapsone Monotherapy through units implementing
survey, education and treatment activities. It was only in 1970s that a
definite cure was identified in the form of Multi Drug Therapy. The
MDT came into wide use from 1982, following the recommendation
by WHO study Group, Geneva in October 1981. Government of India
established a high power committee under chairmanship of Dr. M. S.
Swaminathan in 1981 for dealing with the problem of leprosy. Based
on its recommendations the National Leprosy Eradication Programme
(NLEP) was launched in 1983 with objective to arrest the disease
activities in all the known cases of leprosy.
· In order to strengthen the process of eradication, the World Bank
supported the project in two phases. The first phase was started in
1993 94 and ended on 31st March 2000. The second phase started in
year 2001 2002 and ended on 31 st December 2004. Now since 2005
the project is being continued with GOI funds. The cost of
infrastructure is borne by the state funds. Additional support is
received from World Health Organisation and ILEP (International
Federation of Anti-Leprosy Associations). Multi Drug Therapy
(MDT) was supplied free of cost by Novartis through WHO.
· In Bihar whole state was covered under MDT in November 1996.
· In Bihar till date more than 15 lakhs patients treated with leprosy.
· The PR reduced to 14.2/10000 populations in year 1999.
· Integration of leprosy services in to general health care system started
in 2000 01 and fully integrated in 2003 -04.
· Five rounds of Modified Leprosy Elimination Campaigns (MLECs)
and four rounds of Block Level Awareness campaigns have been
already successfully conducted in the state during the period 1998 to
2008. These activities resulted in detection of more than 4 lakh cases.
260

MDT in Bihar:
· MDT started in Bihar in phased manner.
· In composite state of Bihar, first phase MDT was started in two
districts in 1982 (Bhagalpur & Rohtas).
· 13 more districts added in 1994.
· MDT was launched in whole state in 1996 97.
Current status:
· From 1996 97 onwards when entire state was brought under MDT, a
steady decline in PR was recorded. The PR of 17.3/10000 populations
in 1996-97 declined to 1.04/10000 populations on 31 st March 2008.
· Now state is at the verge of elimination considering PR 1.04/10000
populations on March 2008.
· 15 districts reached elimination and 23 districts have PR between 1 to
2 as on 31 st March 2008.
· At present the NLEP is fully integrated into General Health Care
System from subcentre to District Hospitals/Medical Colleges.
· District Nucleus is formed at 36 out of 38 districts to monitor and
supervise the programme.
· The IEC activities including Inter Personal Communication are
continued and therefore stigma has significantly come down. At
present most of leprosy affected deformed patients are living with
their family and leprosy patients are coming at health institutions
voluntarily.
261

STATE PROFILE
Bihar is the third largest populated state in the country. There are 38
districts in the state. Bihar is divided in two geographical areas- North
and south areas
POPULATION (2001 census)*
*Estimated Population as on March
2008
829988509
98516843
MALES 43243795
FEMALES 39754714
SEX RATIO (females/1000 males) 921
DENSITY OF POPULATION (Persons/
Square Km)
880
URBAN POPULATION % 10.47
LITERACY RATE (census 2001) in % 47
MALE LITERACY in % 59.7
MALE LITERATE in numbers 20644376
FEMALE LITERACY in % 33.1
FEMALE LITERATE in numbers 10465201
BIRTH RATE (PER 1000) 30.9
DEATH RATE (PER 1000) 7.9
District Hospital 24
Sub- Divisional Hospital 23
Referral Hospital 71
Primary Health Centre (PHCs) 484
Additional Primary Health Centre
(APHCs)
1243
Health Sub-Centre 8858
No. of Villages 45100
262

Situational Analysis – As on September 2008/ Districts/Blocks/Urbans
Indicators recommended by GOI for Monitoring & Supervision:
The Government of India has recommended the following three indicators:-
(I) Major indicators:
(1) Annual New Case Detection Rate(ANCDR) per 100000 population
(2) Treatment Completion Rate
(3) Prevalence Rate
(II) Additional Indicators:
(1) Proportions of Grade I disability among new cases
(2) Proportions of Grade II disability among new cases
(3) Proportions of child cases among new cases
(4) Proportions of female cases among new cases
(5) Proportions of MB cases among new cases
(III) Indicators for patient management and follow up:
(1) The proportion of new cases correctly diagnosed
(2) The proportion of treatment defaulters
(3) Number of relapse reported during year
(4) The proportion of patients who develop new or additional disabilities
during MDT.
263

Shift in focus from PR to ANCDR:
Since 2008-09 a shift in focus from PR to ANCDR was introduced, as it is a
better indicator for epidemiological analysis.
Sl. No.
District
Active
Balance
case at the
end of
September
2008
PD
Ratio
Female
(%)
New Visible
Deformity
(%) Grade
II
Child % MB %
PR/
10,000
NCDR per
100,000
1 Aurangabad 294 0.60 29.26 1.85 15.93 34.07 1.23 20.4
2 Bhojpur 239 0.51 32.57 3.21 22.02 33.94 0.90 13.7
3 Buxar 168 0.61 29.68 0.65 15.48 41.29 1.01 17.5
4 Bhagalpur 396 0.89 34.84 3.97 15.86 38.53 1.37 12.2
5 Banka 339 0.6 35.60 0.00 0.31 35.60 1.77 26.9
6 Darbhanga 474 0.7 46.87 0.25 21.55 45.11 1.21 17.3
7 Katihar 288 0.78 39.92 2.52 14.29 39.08 1.01 12.9
8 Muzaffarpur 522 0.58 49.71 2.16 14.93 29.47 1.17 20.2
9 Nawadah 378 0.56 42.12 2.99 17.66 32.88 1.76 23.3
10 Patna 702 0.55 30.88 2.28 17.19 51.23 1.25 25.8
11 Purnia 344 0.59 39.93 2.83 15.90 33.92 1.14 18.6
12 Kishanganj 285 0.56 31.1 00 19.79 47.00 1.85 29.9
13 Araria 466 0.64 33.49 1.19 17.10 23.28 1.84 29.2
14 Rohtas 778 0.6 32.33 2.09 27.09 32.33 2.67 42.08
15 Kaimur 425 0.41 30.00 0.00 15.48 45.81 2.78 26.2
16 Siwan 520 0.47 43.43 3.43 18.79 25.66 1.61 22.3
17 Sitamarhi 352 0.5 44.19 1.45 20.35 25.00 1.11 16.8
18 Sheohar 101 0.70 29.09 0.00 12.73 40.00 1.65 20.3
19 W.Champaran 371 0.6 24.24 3.33 19.39 33.33 1.03 17.2
20 Begusarai 287 0.53 34.47 4.17 11.74 42.05 1.03 13.7
21 E.Champaran 547 0.5 36.56 0.97 16.25 27.85 1.17 26.0
22 Gaya 730 0.55 40.06 1.02 21.93 31.43 1.77 25.1
23 Gopalganj 348 0.52 44.02 0.58 21.28 28.28 1.36 18.6
24 Jehanabad 269 0.5 37.85 5.58 17.53 45.02 2.44 31.0
25 Arwal 153 0.49 35.71 1.43 21.43 40.71 2.20 33.8
26 Khagaria 120 0.78 33.33 0.00 7.78 45.56 0.79 10
27 Madhubani 768 0.55 44.34 2.41 16.14 42.23 1.81 22.05
28 Madhepura 226 0.56 45.86 3.01 11.28 48.12 1.25 17.2
29 Munger 203 0.68 45.63 4.38 16.88 33.75 1.50 22.5
264

30 Sheikhpura 88 0.61 36.90 00 14.29 47.62 1.41 21.6
31 Jamui 175 0.66 31.29 0.00 12.93 41.50 1.05 18.9
32 Lakhisarai 187 0.72 33.92 0.00 16.37 46.78 1.96 20.4
33 Nalanda 474 0.6 39.60 0.66 21.24 38.72 1.68 26.2
34 Saharsa 171 0.59 46.81 4.26 17.02 34.75 0.95 15.9
35 Supaul 197 0.5 39.64 1.18 9.47 35.50 0.95 17.8
36 Samastipur 433 0.61 36.90 4.79 14.08 39.44 1.07 15.7
37 Saran 524 0.43 29.10 1.23 15.98 44.88 1.36 26.2
38 Vaishali 422 0.68 39.72 1.99 8.28 49.34 1.31 17.2
Total 13764 0.54 37.52 1.96 17.64 36.98 1.40 20.9
ANCDR: (20.9/100000)
ANCDR(quarterly) of 21 districts is > 20/100000 of population. These
districts are Aurangabad, Banka, Muzaffarpur, Nawada, Patna, Kishanganj,
Araria, Rohatas, Kaimur, Siwan, Seohar, East Champaran, Gaya, jahanabad,
Arawal, Madhubani, Munger, Sheikhpura, Lakhisarai, Nalanda and Saran.
Therefore overall ANCDR of state is also > 20/100000 population
265

Treatment Completion Rate- (2007-08):
S.N. Districts Treatment Completion Rate(%)
Rural(%) Urban(%) Total(%)
1. Patna 98.9 88.6 94.8
2 Bhojpur 96.2 100 96.6
3 Buxar 94.9 97.2 95.1
4 Aurangabad 98.9 100 98.9
5 Arawal 92.9 No urban 92.9
6 Gaya 96.5 93.7 96.3
7 Nalanda 97.3 98.7 97.4
8 Nawada 94.3 00 94.2
9 Rohtas 97.4 97.9 97.4
10 Vaishali 87.2 47.3 83.5
11 Bhagalpur 97.7 73.08 95.3
12 Banka 95.6 92.7 95.5
13 Khagaria 94.08 100 94.2
14 Muzaffarpur 93.5 98.08 93.8
15 Samastipur 91.07 90.7 91.05
16 East Champaran 95.02 100 95.06
17 Sitamarhi 94.9 92.9 94.9
18 Seohar 87.2 00 87.2
19 Gopalganj 94.5 100 94.7
20 Saran 88.5 67.3 86.06
21 Araria 98.3 100 98.4
22 Saharsa 95.7 88.0 94.9
23 Supaul 100 100 100
24 West Champaran 93.8 100 94.03
25 Siwan 93.2 91.7 93.6
State 94.7 87.4 94.03
· TCR -2007-08 of Bihar state is more than 90% but in urban areas of few
districts TCR is less than 90% and these districts are Patna, Bhagalpur,
Saran, Saharasa. TCR of urban Vaishali is very less 47.3%.
266

SWOT analysis:
After analysis following are strengths, weaknesses, opportunities and threats
in state.
Strengths:
1. trained district nucleus
2. Trained experienced & motivated staff
3. Better awareness and reduced stigma
4. Adequacy of MDT
5. Adequacy of fund form GOI and ILEP
6. Better comprehensive infrastructure from subcentre to
Medical college
7. Integration of leprosy services with GHCs staff
8. Training materials are available
9. Regular NLEP staff meetings and monitoring
10. Good coordination State Health System, WHO &
ILEP
11. Enough people willing to work for the cause.
Weakness:
1. Large state with many districts
2. Reduction in ILEP support
3. No WHO zonal coordinators
4. Complicated procedures for fund utilization for leprosy
work at district level
5. Inadequacy of fund for vehicle operation and
complicated procedure for hiring of vehicle
6. Less support from public opinion leaders
7. Poor POD services
8. Leprosy being last priority of health programme
9. Inadequate funds for rehabilitation and mobility aids
10. Inadequate coordination between staff
11. Vehicles Using in other programmes by DM and Civil
Surgeons
12. Inadequate training of NGOs/local practitioners
13. incomplete data of deformities
14. Less effective counseling
267

Opportunities:
1. Integration with NRHM
(a) Support from ASHA
(b) Additional flexible funds
(c) Better monitoring and supervision
(d) Better infrastructure and man power
2. Integration with GHS
3. Involvement of Medical Colleges/Hospitals/NGOs
4. Full utilization of dermatologists, physicians and
orthopaedic surgeons for diagnosis and rehabilitation
5. Support of ILEP/NGOs/WHO
Threats:
1. Complacency among staff and less political commitment
2. Priority to other programmes
3. Transfer of programme officers at state and district
4. Public stigma
5. No self dependence of sufferer
State will use this SWOT analysis for making strategies and plans in NLEP.
National Leprosy Eradication Programme
(11 th five year plan 2007 – 2012)
Objectives:
· To further reduce the leprosy burden
· Provision of high quality leprosy services for all persons affected by
leprosy, through general health care system including referral services for
complications and chronic care.
· Enhanced Disability prevention and Medical Rehabilitation (DPMR)
services for deformity in leprosy affected persons.
· Enhanced advocacy in order to reduce stigma and stop discrimination
against leprosy affected persons and their families.
268

· Capacity building among health service personal in integrated setting
both for rural and urban areas.
· Strengthen the monitoring and supervision component of the surveillance
system.
Strategy:
(1) Integrated Leprosy Services and Special initiatives.
(2) Disability Prevention and Medical Rehabilitation (DPMR)
(3) Information, Education and Communication
(4) Training and capacity building.
(5) Supervision, monitoring and review.
(6) Infrastructure maintenance
Activities as per objectives and strategy:
1. Integrated Leprosy Services and Special initiatives –
1.1 Integrated Leprosy Services through all Primary Health Care facilities
will continue to be provided in the rural areas.
1.2 All the urban areas will be covered under urban leprosy control
programme integrating services from all the partners available in the
areas, including private practitioners.
1.3 Involvement of multipurpose health functionaries, ASHA in villages,
and selected NGOs in urban areas are to be engaged for case follow up
during treatment to ensure regular MDT collection and consumption, so
that all the cases put under treatment gets cured in shortest possible time.
1.4 Emphasis will be laid on providing best quality leprosy services through
the GHC system. This means easy availability of services on all working
days to all patients, correct diagnosis and adequate counseling to patients
269

and family members, provide MDT to patients whenever approached,
regular monitoring of patient during treatment. Treatment completion by
all under treatment patients will be desired outcome of the programme.
1.5 The system of referral of difficult cases to the district hospital for
diagnosis and management, which has already been started, will eb
further strengthened with capacity building of persons involved at PHC
as well district Hospital level.
1.6 The laboratory facilities at District Hospitals for smear examination to
diagnose difficult cases will be strengthened.
1.7 Desegregated data for female, schedule tribe and schedule caste patients
are to be maintained.
1.8 Regular monitoring and surveillance at state, District and Block level
will be continued to locate weak areas, so that needed plan for corrective
action can be taken in time.
Services through ASHA:
After sensitization of ASHA in Leprosy they will be involved to refer a
suspected case of leprosy from their villages for diagnosis at PHC and after
diagnosis to follow up the patients for completion of their treatment, ASHA
will be entitled to receive incentive as below-
(i) On confirmed diagnosis of cases brought by them Rs 100/-
(ii) On completion of full course of treatment within specified
time
PB Leprosy case Rs. 200/-
MB Leprosy case Rs. 400/-
Number of new leprosy cases detected cases in 2007-08 19041
45% MB cases 8568
55% PB cases 10473
(It is expected that 50% of new MB and new PB cases will be brought by
ASHA.
50% of PB new cases = 5236
50% of new MB cases = 4284)
270

Budget:
For MB cases = Rs.500.00*4284 cases
= Rs. 2142000.00
For PB cases = Rs. 300.00*5236
= Rs. 1570800.00
Total Cost of services through ASHA = Rs.3712800.00
Urban Leprosy Control :
· Total number of town ships selected for ULCP 24
· Total number of medium city(I) selected for ULCP 6
· Budget Rs.75000/- for one town ship x 24 = 1800000/-
Rs.150000/- for one medium city(I) x 6 = Rs.900000/-
Total cost of Urban Leprosy Control = 2700000/-
2. Disability Prevention and Medical Rehabilitation -
More emphasis will be given on Disability prevention among new leprosy
cases and RCS services for deformed persons due to leprosy.
2.1 Prevention of Disability:
· Health workers will suspect cases of leprosy reaction, relapse, insensitive
hands and feet and refer to PHC for diagnosis. They will also empower
patients with self care procedure for prevention of deformity.
· All PHC Medical Officers will diagnose cases of reaction/neuritis,
provide counseling and treat them. Severe reaction/neuritis cases will be
referred to the District Hospital if not responded within two weeks of
starting treatment.
· Service and care for impairment such as ulcers, cracks and wounds,
septic hand or feet etc. will be available from all the health facilities
routinely. Complicated ulcer cases will be referred to District Hospital.
271

· Microcellular Rubber (MCR) footwear are to be provided to all needy
patients ( under treatment and RFT) by the District nucleus staff at the
concerned health facility. An appropriate system of need assessment,
procurement and supply will be maintained and improved.
· PHC will provide follow up treatment to all patients referred back by the
secondary and tertiary level units for reaction, complication or post
surgery care.
· Operational guidelines on DPMR for primary and secondary level have
been distributed to all districts and PHCs.
2.2 Medical Rehabilitation:
· Enlisting of disability cases has been completed in 24 districts and in
remaining 14 districts enlisting is under process.
· In districts the patients fit for RCS are being referred to identified RCS
units(Department of PMR at PMCH, Patna and DMCH Darbhanga).
· An estimated 200 RCS will be done during this year. Budget for RCS
support and patient welfare for 200 patients is kept.
· In addition to this TLM Hospital Muzaffarpur will continue to do RCS
with ILEP support.
· It is planned to start RCS in Magadh Medical college, Gaya in this year
Incentive to patients undergoing RCS:
· Provision to patients undergoing RCS @ Rs. 5000.00 to offset wage loss
to BPL families as recommended by GoI. It is proposed that the above
provision may be applied for for surgical Nerve Decompression also.
Further it is suggested that leprosy is a disease associated with poverty,
the provision of Rs. 5000.00 to offset wage loss may be given to all
leprosy patients undergoing RCS/Nerve decompression surgery.
Incentive to Institutions:
· Provision to support Government Medical Colleges/PMR centres in the
form of Rs. 5000.00 per RCS case has been kept for procurement of
supply and material and other ancillary expenditure.
272

Need based supply of MCR footwear to the needy patients will continue
during year through District Societies, NGOs and concerned institutions.As
grade I patients with insensitive feet have been included under DPMR plan
for MCR supply the number of foot wear requirement will increase.
Budget:
(1) Provision to compensate wage loss to BPL persons affected with
leprosy undergoing Reconstructive/Nerve Decompression surgery
around 200 persons are expected to be operated. The reimbursement
of Rs. 5000.00 is sought to be provided for
Incentive @ Rs.100.00 per person*2*20 days = Rs. 4000.00
Transportation for 2 persons(4-5 times) = Rs. 1000.00
Total (one RCS) = Rs. 5000.00
For 100 RCS- 5000.00*100
= Rs.500000.00
(2) Provision of incentive to Govt. institutions-
For 100 RCS 5000.00*100 = Rs. 500000.00
(3) MCR foot wear- 2280 pairs of MCR foot wears @ Rs.250.00
2280*Rs.250.00 = Rs. 1938000.00
Total cost of DPMR = 3413000.00
3. Information, Education & Communication:
Introduction –
Leprosy is an age old disease. As there was no known remedy for the disease
in the earlier days, the viciousness of disease, disfigurement and disability
caused by the disease resulting in making the affected persons heavily, led to
a number of myths, misconceptions, apprehensions and inhibitions in the
minds of people. This resulted in to developing such a high degree of stigma
against the disease that the community wanted to avoid all contacts with
such persons. The leprosy affected persons were forced to leave their home
273

and live in segregated areas. This is the only disease where sufferer had to
live in separate colonies, villages and in distant islands.
At present the situation has changed to a greater extent. Now there is
cure for leprosy and patient can live in their home during treatment. Because
of early treatment deformities and disabilities have reduced. Many
discriminatory laws have been repealed all over the world. Yet there is
discrimination against the person affected by leprosy, which need to be
removed from the public mind, so that these persons can lead normal life
like any other human being.
Determinants of stigma:
Stigma is perpetuated by (1) Lack of knowledge (2) Attitude (3) Fear (4)
Blame & shame
Intervention strategies:
Spreading awareness: Spread the demystifying messages and its
interpretations, mainly regarding nature of disease, whether leprosy cases are
untouchable, role of immunity in occurrence of leprosy, what is burnt case
and so on. However, mere information and education, to all and sundry
about the signs and symptoms of leprosy and its curability, shall not work. It
is imperative to break the barrier between persons affected by leprosy and
the rest of the society, by appealing to the peoples emotions and their ability
to empathies with those they feared and shunned.
With reducing number of leprosy cases in community, awareness about
curability of disease, lessening number of deformity due to leprosy, stigma
associated with the disease has become slightly less. The effective way to
deal with this difficult challenge of stigma removal is to embark on intensive
inter personal communication (IPC) with the target groups
The strategy involves, coordinates and facilitated by (1) civil societies (2)
social activists (3) Health service providers (4) Community/opinion leaders
(5) Corporate sectors (6) Media (7) Institutions under NRHM such as ASHA
and other health functionaries, Rogi Kalyan Samities and Village Health &
Sanitation Committees, Health Melas at district and block level etc.
An IEC campaign towards achieving Leprosy free India recommended by
GOI will be followed on following concept
274

· The effort to further reducing leprosy burden in the communities have to
be prioritized so that visible deformity in newly detected cases is reduced
to minimum.
· Early reporting and complete treatment of leprosy cases prevent
disability.
· Quality of services provided to leprosy affected persons be at optimum
level to reduce suffering and prevent consequences in all cases put on
treatment.
· Leprosy patients will not be stigmatized and discriminated and would
lead to a socially and economically productive life.
Budget and norms for IEC:
Mass media-
Electronic Media Rs.200000.00
Print media Rs.100000.00
Out door media-
Rallies(including banners) @ Rs.5000/- per district.
Budget Rs.5000.00 x 38 districts
= 190000/-
Rural Media:
School quiz @ Rs.500/- for one quiz.
In each block 5 school quiz will be conducted.
Budget Rs.500.00 x 484 blocks x 5
= Rs.1210000/-
Sensitisation meeting with PRI members-Rs.4000/- per meeting at
each block
Rs.4000/. * 484 blocks
= 1936000/.
Total cost of IEC = Rs.3826000/-
275

4. Training Plan(training and capacity building):
4.1 Leprosy training to GHC staff(new entrants)
To improve quality of leprosy diagnosis, complications management, DPMR
and programme monitoring the key medical and paramedical staffs will be
provided trainings.
1400 newly appointed contractual MOs will be provided four days modular
training on leprosy and NLEP(including DPMR).
Budget
Venue District head quarter training hall.
Trainers(2trainers) TA/DA @ Rs.300/- per day for two days
Rs.300.00 x 2 days x 2 trainers = Rs.1200/-
TA for trainees @ Rs.80/- per day for 30 trainees for 2 days
Rs.80.00 x 30 trainees x 2 days = Rs.4800/-
DA for trainees @ Rs.80/- per day for 30 trainees for 2 days.
Rs.80.00 x 30 trainees x 2 days = Rs.4800/-
Working lunch & tea @ Rs.150/- for 35 persons for 2 days
Rs150.00 x 2 days x 35 = Rs.10500/-
Learning materials, stationary etc @ Rs.250/- per head for 30 trainees.
Rs.250.00 x 30 = 7500/-
Miscellaneous Rs.2500/- per batch.
Total expenditure for 2 days training of new MOs for one batch
= Rs.31300/-
Total number of batches in all districts of Bihar 47
Total Expenditure – Rs.31300.00 x 47 batches
= Rs.1471100/-
4.2 One days refresher training of PHC medical officers:
Total number of regular MOs in position 2712
Total number of batches 90(batches distributed districtwise)
90 batches x Rs 27300.00
Total expenditure =Rs. 2457000/-
276

Consumables:
· For SHS(leprosy) Rs.28000/- and for DHS(leprosy) Rs.14000/- per
district will be provided.
Office expenses:
· For SHS(leprosy) Rs.38000/- and for DHS(leprosy) Rs.18000/- per
district will be provided.
Vehicle Operation & Hiring:
· Vehicle operation/POL/Hiring for SHS(leprosy) Rs.85000/- for two
vehicles and for DHS(leprosy) Rs.75000/- one vehicle for one district
will be kept.
Drugs, Materials & supplies:
· For supportive medicine Rs.25000/- per district.
· For laboratory reagents- Rs.12000/- per year per district.
· For patient welfare Rs.6000/- per year per district.
Printing:
· Required numbers of DPMR registers, formats and other formats will be
printed at state head quarter and supplied to districts.
(State Officers and WHO/ILEP Coordinators will also monitor the supply
of different logistics at each level)
Professional Services:
· Audit fees will be met by State Health & FW Society for centralized
audit of 38 DLS & SLS head quarter for preparation of consolidation
Audit Report.
277

Contractual Services:
· As per annexure 1
NLEP Monitoring and Review:
· Monitoring of:
- NCDR,TCR,PR & other NLEP indicators
- Regularity of treatment & timely RFT
- Reports(MPR,MDT indents,Tour reports etc)
- Implementation of DPMR trainings with support of ILEP, RCS &
other referral & IEC activities.
- On the job training on DPMR formats, modified SIS & MDT stock
management up to subcentre level
· DPMR/SIS/MDT management & monitoring of
-MDT stock situation in patient month BCPs
-MDT indenting
-MDT supply
-Availability of prednisolone at PHCs.
· Review Meetings of DLOs and members of District nucleus four
times in one year
278

STATE HEALTH SOCIETY (Leprosy), BIHAR
Budget for Year 2009-2010
Anexxure 1
1
Sl. No.
1.1
Category of Expenditure : Component & Sub
Component wise
Under SHS(Leprosy) NLEP contractual
services(staff)
40 Drivers for 38 districts & for State Leprosy Cell
@Rs.4500/-PM
DLS
SHSB
(Leprosy)
2052000 108000.00
Total of
activities
1.2 DEO at State Leprosy Cell @ Rs.8000/- 96000.00
1.3
Honorarium @ Rs.400/- PM for 38 DLS for account
work of Leprosy
182400
1.6 Audit Fees @ Rs.6000/- x 39(38 DHS + 1 SHS -L) 228000.00 6000.00
Total contratual services(1.1 to 1.6) 2462400.00 210000.00 2672400.00
2 Office expences
2.1
2.2
SHS(leprosy) for rent,telephone,electricity, P & T
charges, miscellaneous-Rs.38000/- per year
DLS(leprosy) for rent,telephone,electricity, P & T
charges, miscellaneous-Rs.18000/- per district/ year
684000.00
38000.00
Total - Office expences(2.1 to 2.2) 684000.00 38000.00 722000.00
3 Consumables
3.1
3.2
Consumables for DHS(leprosy) : Stationery etc.@ Rs.
14000/- per dist/year
Consumables for SHS(leprosy) : Stationery etc.@ Rs.
28000/- per year
532000.00
28000.00
Total - Consumables(3.1 to 3.2) 532000.00 28000.00 560000.00
4 Vehicle operation/hiring & POL/ Maintenance
4.1
One vehicle for each DHS(leprosy)-Rs.75000.00 per
vehicle/district
2850000.00
4.2 Two vehicles for SHS(Leprosy)-Rs.85000/- per vehicle 170000.00
Total - Vehicle operation(4.1 to 4.2) 2850000.00 170000.00 3020000.00
5 Drugs, materials & supplies
5.1 Supportive medicines-Rs. 25000/-per district/year 950000.00
279

5.2
Laboratory reagents & equipments -Rs.12000/-per
district/year
456000.00
5.3 Patient welfare-Rs.6000/- per district/year 228000.00
5.4 Printing of forms/DPMR registers etc 600000.00
Total - Drugs,materials & supplies(5.1 to 5.4) 1634000.00 600000.00 2234000.00
6 IEC
6.1 Mass media:
6.11 Electronic media-Radio/Doordarshan 500000.00
6.12 Print media-News papers 200000.00
6.2 Out door media:
6.21
Sensitisation meeting with PRI members-Rs.4000/- per
meeting at each block
1936000.00
6.3 Rural media:
6.31
6.32
School quiz-Rs.500/-per quiz (10quiz per block for 484
blocks))
Health Mellas/Fairs-Rs.5000/- per Mela(one Health
mela/district)
2420000.00
190000.00
Total -IEC 4546000.00 700000.00 5246000.00
7 Training
7.1
7.2
7.3
2 days modular training of new entrant MOs-Rs.27300/-
per batch for 47 batches
1 days reorientation training for 2700 Mos-Rs.13650/-
per batch for 90 batches
Training of ASHA(half day)-for 659 Batches (40 ASHA /
Batch)
1283100
1228500.00
2108800.00
Total - Training(7.1 to 7.6) 4620400 0.00 4620400
8
Disability Prevention and Medical Rehabilitation
(DPMR)
8.1 MCR & other footwears-4560 pairs @ Rs.250/- per pair 1140000.00
8.2 Aids & appliances-Rs.12500/- per district 475000
8.3
8.4
Welfare allowance for RCS patients @ 5000/- per
patient for 120 patients
Incentive to institution for RCSRs.5000/ - per RCS for
80 RCS
600000.00
400000.00
280

Total - DPMR(8.1 to 8.4) 475000.00 2140000.00 2615000.00
9
9.1
9.2
Services through ASHA(performance based
incentive to ASHA)
For PB new cases-4840(PB cases) @ Rs.300/- per
case
For MB new cases-3872(MB cases) @ Rs.500/- per
case
1452000.00
1936000.00
Total - Services through ASHA(9.1 to 9.2) 3388000.00 3388000.00
10 Urban Leprosy Control Programme:
10.1 For 24 townships-Rs.75000/- per town 1800000.00
10.2 For 6 medium I cities-Rs.150000/- per medium city 900000.00
Total -Urban leprosy control(10.1 to 1 0.2) 2700000.00 2700000.00
11
Review meetings of DLOs four times in a year-
Rs.30000/- per meeting
120000.00 120000.00
Grand Total 27897800.00
(Rs. Two Crore sevety eight lac ninety seven thousands & eight hundred only)
281

Fund Allocation to State Leprosy Cell 2009-2010
Sl.
Expenditure Under SHS (Leprosy) Component & Sub Component w ise
No.
Amount Rs.
1 Two Driver's Remuneration for State Leprosy Cell @ Rs. 4500/- 108000.00
2 DEO at State Leprosy Cell @ Rs. 8000/- 96000.00
3 Audit Fee for State Leprosy Cell 6000
4 Telephone, Fax, P &T charges , Miscellaneous @ Rs. 38000/- per year 38000
5 Consumables : Stationery etc. @ Rs. 28000/- per year 28000
6 Two vehicles for SHS (Leprosy) @Rs. 85000/- Per vehicle / year 170000
7 Printing of Forms / DPMR registers et. 600000
8 Electronic media-Radio / Doordarshan 500000
9 Print media-News papers 200000
10 MCR & other Footwears- 4560 pairs @ Rs.250/- per pair 1140000
11 Review meeting of DLOs four times in a year @ Rs. 30000/- per meeting 120000
Total 3006000
282

Fund Allocation to District Health Society (Leprosy) 2009-2010
Contractual services
Sl.
No.
District
Populatiom March 2008 (Est.)
Number of Block PHC
PD Ratio
Number of ASHAs
Driver's Remuneration @
Rs. 4500/ - per month
Honorarium for Accounts work
of Leprosy @ Rs. 400/ - per month
Audit Fee @ Rs. 6000/ -
DLS(leprosy) for
rent,telephone,electricity,
P & T charges, miscellaneous -
Rs.18000/- per district/ year
Consumable Expenses (Stationery &
etc.) @ Rs. 14000/ - per year
Vehicle Operation / hirin g,
POL & Maintenance
@ Rs. 75000/ - per vehicle / district
1 Aurangabad 2383268 11 1552 54000 4800 6000 18000 14000 75000
2 Bhojpur 2654828 13 1621 54000 4800 6000 18000 14000 75000
3 Buxar 1668275 8 1074 54000 4800 6000 18000 14000 75000
4 Bhagalpur 2888900 13 1971 54000 4800 6000 18000 14000 75000
5 Banka 1912332 10 1535 54000 4800 6000 18000 14000 75000
6 Darbhanga 3905394 18 2890 54000 4800 6000 18000 14000 75000
7 Katihar 2840403 13 1866 54000 4800 6000 18000 14000 75000
8 Muzaffarpur 4450244 14 2848 54000 4800 6000 18000 14000 75000
9 Nawada 2150838 14 1591 54000 4800 6000 18000 14000 75000
10 Patna 5598533 23 2549 54000 4800 6000 18000 14000 75000
11 Purnea 3020199 11 2263 54000 4800 6000 18000 14000 75000
12 Kishanganj 1538234 7 1024 54000 4800 6000 18000 14000 75000
13 Araria 2525757 9 2026 54000 4800 6000 18000 14000 75000
14 Rohtas 2910808 19 2030 54000 4800 6000 18000 14000 75000
15 Kaimur 1526956 10 1247 54000 4800 6000 18000 14000 75000
16 Siwan 3219960 15 2538 54000 4800 6000 18000 14000 75000
17 Sitamarhi 3173657 14 2221 54000 4800 6000 18000 14000 75000
18 Sheohar 611327 3 464 54000 4800 6000 18000 14000 75000
19 W.Champaran 3617222 18 2494 54000 4800 6000 18000 14000 75000
20 Begusarai 2785077 18 2091 54000 4800 6000 18000 14000 75000
21 E.Champaran 4675857 20 2756 54000 4800 6000 18000 14000 75000
22 Gaya 4118776 22 2440 54000 4800 6000 18000 14000 75000
23 Gopalganj 2554894 14 1846 54000 4800 6000 18000 14000 75000
24 Jehanabad 1100835 7 743 54000 4800 6000 18000 14000 75000
25 Arwal 695751 5 658 54000 4800 6000 18000 14000 75000
26 Khagaria 1517568 7 967 54000 4800 6000 18000 14000 75000
27 Madhubani 4244381 18 3034 54000 4800 6000 18000 14000 75000
28 Madhepura 1812266 7 1459 54000 4800 6000 18000 14000 75000
29 Munger 1349751 9 820 54000 4800 6000 18000 14000 75000
30 Sheikhpura 624223 6 439 54000 4800 6000 18000 14000 75000
31 Jamui 1661158 6 1270 54000 4800 6000 18000 14000 75000
32 Lakhisarai 952343 4 568 54000 4800 6000 18000 14000 75000
33 Nalanda 2815197 20 2017 54000 4800 6000 18000 14000 75000
34 Saharsa 1790658 12 777 54000 4800 6000 18000 14000 75000
35 Supaul 2074339 11 1533 54000 4800 6000 18000 14000 75000
36 Samastipur 4057475 23 3214 54000 4800 6000 18000 14000 75000
37 Saran 3864981 15 2825 54000 4800 6000 18000 14000 75000
38 Vaishali 3224178 17 2532 54000 4800 6000 18000 14000 75000
Total 98516843 484 0 67793 2052000 182400 228000 684000 532000 2850000
283

Drugs, materials &
supplies
Training
Sl.
No.
District
Supportive medicines @ Rs. 25000/ -
per year
Laboratory reagents & equipments
@ Rs. 12000/ - per year
Patient welfare @ Rs. 6000/ - per
year
School quiz @ Rs. 500/- per quiz
(10 quiz per Blocks)
Sensitisation meetings with PRI
members @ Rs. 4000/- per
meeting at block level
Health Melas / Fairs @ Rs.
5000/- per mela (One Health
Mela / District)
Two days modular
training of new
entrant MOs @
Rs.27300/- per
batch for 47 batch
No.of
Batch
Amount
One day reorientation
training of MOs @
Rs. 13650/- batch
for 90 batches
No. of
Batch
Amount
1 Aurangabad 25000 12000 6000 55000 44000 5000 1 27300 2 27300
2 Bhojpur 25000 12000 6000 65000 52000 5000 2 54600 3 40950
3 Buxar 25000 12000 6000 40000 32000 5000 1 27300 2 27300
4 Bhagalpur 25000 12000 6000 65000 52000 5000 2 54600 3 40950
5 Banka 25000 12000 6000 50000 40000 5000 1 27300 2 27300
6 Darbhanga 25000 12000 6000 90000 72000 5000 2 54600 3 40950
7 Katihar 25000 12000 6000 65000 52000 5000 1 27300 2 27300
8 Muzaffarpur 25000 12000 6000 70000 56000 5000 2 54600 3 40950
9 Nawada 25000 12000 6000 70000 56000 5000 1 27300 2 27300
10 Patna 25000 12000 6000 115000 92000 5000 2 54600 7 95550
11 Purnea 25000 12000 6000 55000 44000 5000 1 27300 2 27300
12 Kishanganj 25000 12000 6000 35000 28000 5000 0 0 1 13650
13 Araria 25000 12000 6000 45000 36000 5000 1 27300 2 27300
14 Rohtas 25000 12000 6000 95000 76000 5000 1 27300 2 27300
15 Kaimur 25000 12000 6000 50000 40000 5000 1 27300 1 13650
16 Siwan 25000 12000 6000 75000 60000 5000 1 27300 2 27300
17 Sitamarhi 25000 12000 6000 70000 56000 5000 1 27300 3 40950
18 Sheohar 25000 12000 6000 15000 12000 5000 0 0 1 13650
19 W.Champaran 25000 12000 6000 90000 72000 5000 1 27300 3 40950
20 Begusarai 25000 12000 6000 90000 72000 5000 2 54600 2 27300
21 E.Champaran 25000 12000 6000 100000 80000 5000 2 54600 4 54600
22 Gaya 25000 12000 6000 110000 88000 5000 2 54600 3 40950
23 Gopalganj 25000 12000 6000 70000 56000 5000 1 27300 2 27300
24 Jehanabad 25000 12000 6000 35000 28000 5000 1 27300 2 27300
25 Arwal 25000 12000 6000 25000 20000 5000 1 27300 1 13650
26 Khagaria 25000 12000 6000 35000 28000 5000 1 27300 1 13650
27 Madhubani 25000 12000 6000 90000 72000 5000 1 27300 3 40950
28 Madhepura 25000 12000 6000 35000 28000 5000 1 27300 2 27300
29 Munger 25000 12000 6000 45000 36000 5000 1 27300 2 27300
30 Sheikhpura 25000 12000 6000 30000 24000 5000 1 27300 2 27300
31 Jamui 25000 12000 6000 30000 24000 5000 1 27300 1 13650
32 Lakhisarai 25000 12000 6000 20000 16000 5000 1 27300 1 13650
33 Nalanda 25000 12000 6000 100000 80000 5000 2 54600 3 40950
34 Saharsa 25000 12000 6000 60000 48000 5000 1 27300 2 27300
35 Supaul 25000 12000 6000 55000 44000 5000 1 27300 2 27300
36 Samastipur 25000 12000 6000 115000 92000 5000 2 54600 5 68250
37 Saran 25000 12000 6000 75000 60000 5000 1 27300 3 40950
38 Vaishali 25000 12000 6000 85000 68000 5000 2 54600 3 40950
Total 950000 456000 228000 2420000 1936000 190000 47 1283100 90 1228500
284

Sl. No.
District
Training
Training of ASHA
(half day) @ Rs.
3200/- per Batch
of 40
No. of
Batch
Amount
DPMR
Aids & appliances
@ Rs.12500/- per
district
Services through ASHA
(performance based
Incentive to ASHA, 10 PB
& 8 MB / BLOCK / YEAR)
Urban Leprosy Control
Programme
Number of RCS
RCS
Welfare allowance
for RCS patients
(Rs. 5000/- / RCS)
Incentive to
Institution for RCS
(Rs. 5000/- / RCS)
1 Aurangabad 20 64000 12500 77000 75000
2 Bhojpur 15 48000 12500 91000 75000
3 Buxar 10 32000 12500 56000 75000
4 Bhagalpur 20 64000 12500 91000 150000
5 Banka 15 48000 12500 70000 0
6 Darbhanga 25 80000 12500 126000 150000 5 25000 25000
7 Katihar 20 64000 12500 91000 75000
8 Muzaffarpur 25 80000 12500 98000 150000 40 200000
9 Nawada 15 48000 12500 98000 75000
10 Patna 25 80000 12500 161000 150000 75 375000 375000
11 Purnea 20 64000 12500 77000 150000
12 Kishanganj 10 32000 12500 49000 75000
13 Araria 25 80000 12500 63000 0
14 Rohtas 20 64000 12500 133000 75000
15 Kaimur 10 32000 12500 70000 0
16 Siwan 25 80000 12500 105000 75000
17 Sitamarhi 20 64000 12500 98000 75000
18 Sheohar 15 48000 12500 21000 0
19 W.Champaran 20 64000 12500 126000 75000
20 Begusarai 15 48000 12500 126000 75000
21 E.Champaran 25 80000 12500 140000 75000
22 Gaya 25 80000 12500 154000 150000
23 Gopalganj 15 48000 12500 98000 75000
24 Jehanabad 10 32000 12500 49000 75000
25 Arwal 10 32000 12500 35000 0
26 Khagaria 10 32000 12500 49000 0
27 Madhubani 25 80000 12500 126000 75000
28 Madhepura 15 48000 12500 49000 75000
29 Munger 10 32000 12500 63000 75000
30 Sheikhpura 10 32000 12500 42000 0
31 Jamui 10 32000 12500 42000 75000
32 Lakhisarai 10 32000 12500 28000 0
33 Nalanda 15 48000 12500 140000 75000
34 Saharsa 15 48000 12500 84000 75000
35 Supaul 14 44800 12500 77000 75000
36 Samastipur 25 80000 12500 161000 75000
37 Saran 25 80000 12500 105000 75000
38 Vaishali 20 64000 12500 119000 75000
Total 659 2108800 475000 3388000 2700000 120 600000 400000
285

Activity Chart for Action Plan 2009-10 (Gantt Chart) Annexure - 2
Sl.
No.
Activity
Persons
responsible
Time
Frame
Jan 09 Feb 09 Mar 09 Apr 09 May 09 Jun 09 Jul 09 Aug 09 Sep 09 Oct 09 Nov 09 Dec 09 Jan 10 Feb 10 Mar 10
I
Planning of Activities
1.1
Development of Action Plan for
2009-10 and its submission to GOI
after aproval of SHS, Bihar
1.2 Approval of State Action Plan GOI
1.3
1.4
State Leprosy
Officer,
WHO/ILEP
Coordinators
Development of budgetary and State Leprosy
operational guidelines for each and Officer,
every activity as per approved WHO/ILEP
action plan
Coordinators
Briefing of CS and DLOs on Action
Plan and development of detialed
districtwise operational plan with
specific time frame in the first
review and planning meeting at
State HQ
State Leprosy
Officer,
WHO/ILEP
Coordinators,
CS and DLOs
By 19th Jan.
2009
By 30th Jan.
2009
By 10th May
2009
By 15th May
2009
1.5
Budgetary allocation for each
district
State Health
Society & SLO
By 20th May
2009
1.6
Approval of District Action Plan and
its budget in District Health Society
CS and DLO
By
30th May
2009
Statrt activities as per the action
plan and continue activities on
routine
Concern
officers at
State, Dist and
PHC level
1st June
2009 to 31st
March 2010
II
Prcurement Plan
2.1 Purchase of logistics such as
286

2.2
2.3
MCR Chappals (Through a State
level committee)
Supportive Medicine
e.g.Prednisolone
2.4 Splint, Crutches, Lab reagents
2.5 Printing of Formats
III Training
3.1
3.2
3.3
3.4
3.5
4 day training for MOs a batch of
30 MOs x 47 batches
2 days reorientation training for
Medical Officers at Distt./PHC a
batch of 30 Mos x 90 batches
Refreshal training for one day for
Health
Supervisors/LHV/Pharmacists a
batch of 30 x 50 batches
5 days training of lab technicians a
batch of 15 LTs x 3 batches
1 day training of 'A'Grade nurses in
48 batches
3.6 Half day training of 50000 ASHA
State Leprosy
Officer
CS and DLO
State Leprosy
Officer
State Leprosy
Officer
State Leprosy
Officer,
WHO/ILEP
Coordinators,
DLOs By
making 5 State
level teams
June/July
2009
May/June
2009
June/July
2009
By July
2009
Aug. 2009
to Dec.
2009
Sept. 2009
CS, DLO,
to Dec.
District Nucleus
2009
Sept. 2009
CS, DLO,
to Dec.
District Nucleus
2009
ILEP
State Leprosy
Officer,
WHO/ILEP
Coordinators
In October
2009
Aug. 2009
to Dec.
2009
CS,DLO,District May 2009
Nucleus & to Aug.
BPHC staff 2009
IV
Disability Prevention and
Medical Rehabilation (DPMR)
287

4.4
RCS - 200 operations at Dept of
PMR, Patna Medical College,
Patna and operations at
Darbhanga Medical College,
Darbhanga & TLM Muzaffarpur
DLO
Patna,DLO
Darbhanga,
April 2009
DLO
to March
Muzaffarpur,
2010
District Nucleus
and Medical
Collages
V
Information, Education,
Communication (IEC)
5.1 Radio Spots/Doordarshan
5.2
Meeting (Political Advocacy, for
MLA, MLC )
5.3 Hoarding
5.5 Posters
5.6 Cable Spot
5.7 Wall panting
5.8 Rallies (including banners etc.)
State Leprosy
Officer
State Leprosy
Officer,
WHO/ILEP
Coordinators
DLS - CS,
DLO, District
Nucleus
DLS - CS,
DLO, District
Nucleus, PHC
staff
DLS - CS,
DLO, District
Nucleus
DLS - CS,
DLO, District
Nucleus, PHC
staff
DLS - CS,
DLO, District
Nucleus, PHC
staff
June 2009
to March
2010
During
Winter
session
June 2009
to Aug.
2009
June 2009
to Aug.
2009
June 2009
to March
2010
June 2009
to Dec.
2009
Antileprosy
Week
288

5.9 Quiz
5.10 Cinema slides
5.12 Meeting with Zilla Parishad
5.13
Orientation camp for NGO and
Mahila Mandals
5.14 Press Advertisement
5.16 Health Mellas/Fairs
5.18 Monitoring & Supervision
DLS - CS,
DLO, District
Nucleus, PHC
staff
DLS - CS,
DLO, District
Nucleus
DLS - CS,
DLO, District
Nucleus, PHC
staff
DLS - CS,
DLO, District
Nucleus
DLS - CS,
DLO, District
Nucleus, PHC
staff
DLS - CS,
DLO, District
Nucleus, PHC
staff
DLS - CS,
DLO, District
Nucleus, PHC
staff
In January
2010
June 2009
to March
2010
Oct. 2009
to Dec.
2009
Jan. 2009 to
Febr. 2010
Jan. 2010
to Feb.
2010
June 2009
to Sept.
2009
October 09
to March
2010
VI
Epidemiological Situation
Analysis
6.1
Status of Implementation of Action
Plan for 2009-10
6.2 MDT Stock Situation Analysis
A State NLEP Every
Coordination month from
Committee April 2009
under the to March
chairmanship of 2010
289

6.3
Districtwise analysis based on the
field observations of DLOs,
WHO/ILEP Coordinators and State
Officers involving 6 DLOs in a
month on rotation
6.4 Quality of Diagnosis
Regularity of treatment and timely
6.4.1
RFT
Quality of information and
6.4.2
implementation of SIS
Availability of MDT stock and other
6.4.3
logistics
Capacity of GHCS staff and
6.4.4
integration
Implementation of Action Plan
6.4.5
2009-10 including DPMR
Briefing of Executive Director, SHS
on the minutes of State NLEP
6.4.6 Coordination Meeting and sharing
the same with Director in Chief,
Secretary Health, DDGL, etc.
Additional
Director and
State Leprosy
Officer, Leprosy
will
continuously
monitor the
programme at
each level and
do analysis in
State NLEP
Coordination
Meeting at
State HQ
Following will
be the
members of
committee
Additional
Director Health
Services,State
Leprosy Officer
and Controlling
Officer, Bihar
State
Coordinator
(WHO/GOI),
NLEP, Bihar
ILEP Members
Representative
from PMCH,
Patna
DLOs from
identified
districts on
rotation
Epidemiologist
SSAU
290

6.5 Reviews
State NLEP
Coordination
Committee
Every
month from
April 2009
to March
2010
VII
7.1
7.2
7.3
7.4
7.5
A review meeting of all DLOs will
be called at State HQ every quarter
to review all the activities in detail.
Zonal review meetings at each
zone
District will review NLEP in routine
monthly meetings
Block will review NLEP in routine
weekly meetings
DLOs and District Nucleus will
participate in weekly PHC meeting
on rotation and review NLEP at that
level
Please tick mark in the square
when the activity is completed and
mark a question mark when due
date is passed
Executive
Director, SHS,
Add. Director,
State Leprosy
Officer,
WHO/ILEP
Coordinators,
State Leprosy
Officer Add.
Director,
WHO/ILEP
Coordinators,
May,
August,
November,
February in
2009-2010
Alternate
month
Every
CS, DLO, month from
District Nucleus Apr. 2009 to
Mar. 2010
I/C MO PHC
Every week
from Apr.
2009 to
Mar. 2010
Every week
DLO and
from Apr.
District Nucleus
2009 to
on rotation
Mar. 2010
291

293

Annual Plan for Programme Performance & Budget for the year
1 st April 2009 to 31 st March 2010
State: Bihar (GFATM)
Objectives:
3.1.To achieve and maintain a cure rate of at least 85% among newly detected infectious (new
sputum smear positive) cases, and
4.2. To achieve and maintain detection of at least 70% of such cases in the population
Formatted: Bullets and Numbering
This action plan and budget have been approved by the STCS.
Signature of the STO__________
Name Dr.N.M. Sharma
_______
Section-A – General Information about the State
1 State Population (in lakh) GFATM Districts 670.23
2 Number of GFATM districts in the State 30
3 Urban population 50.46
4 Tribal population 8
5 Hilly population 6
6 Any other known groups of special population for specific interventions
(e.g. nomadic, migrant, industrial workers, urban slums, etc.)
(These population statistics may be obtained from Census data /State Statistical Dept/ District plans)
No. of districts without DTC: 3
No. of districts that submitted annual action plans, which have been consolidated in this state plan:
30
Organization of services in the state:
S.
No.
Name of the
District
Projected
Population
(in Lakhs)
Please indicate number
of TUs of each type
Govt NGO Public
Sector*
294
Please indicate no. of DMCs of
each type in the district
NGO
Private
Sector^
Araria 24.42 5 0 12 1 5
Arwal 7 1 0 5 0 0
Aurangabad 23.04 5 0 14 2 2
Banka 18.49 3 1 11 1 3
Begusarai 26.93 5 0 18 1 3
Bhagalpur 27.94 5 0 21 1 3
Bhojpur 25.67 5 0 21 0 3
Buxar 16.13 3 0 14 0 1
Darbhanga 37.77 7 0 20 1 4
Gaya 39.83 8 0 28 1 3
Gopalganj 24.70 5 0 20 0 2
Jamui 16.06 4 1 15 0 2
Jehanabad 10.37 2 0 8 0 1
Kaimur 14.76 2 1 12 0 1

Khagaria 14.67 3 0 13 0 1
Kisanganj 14.87 2 1 10 0 2
Lakhisharai 9.21 2 0 6 0 1
Madhepura 17.52 3 0 14 1 1
Madhubani 41.04 8 0 23 1 2
Nalanda 27.22 5 0 20 0 3
Nawadah 20.80 4 0 15 0 2
W.Champaran 34.98 6 1 20 0 3
Rohtas 28.15 5 0 20 2 2
Saharsa 17.31 4 0 11 0 3
Saran 37.38 6 0 29 0 3
Sheikhpura 6.03 1 0 4 0 0
Sheohar 5.91 1 0 4 0
Sitamarhi 30.69 6 0 26 0 3
Siwan 31.14 6 0 20 0 3
Supaul 20.06 4 0 11 0 2
126 5 465 12 64
*Public Sector includes Medical Colleges, Govt. health department, other Govt. department and PSUs i.e. as defined in PMR
report
^ Similarly, Private Sect or includes Private Medical College, Private Practitioners, Private Clinics/Nursing Homes and
Corporate sector
295

RNTCP performance indicators:
Important: Please give the performance for the last 4 quarters i.e. Oct ___ to September _____
Name of the
District (also
indicate if it is
notified hilly or
tribal district
Total
number of
patients
put on
treatment
*
Annualised
total case
detection
rate
(per lakh
pop.)
No of new
smear
positive
cases put
on
treatment
*
Annualised
New smear
positive case
detection rate
(per lakh
pop)
Cure rate for
cases
detected in
the last 4
correspondin
g quarters
Plan for the next year
Annualized
NSP case
detection
rate
Araria
Arwal
Aurangabad
Banka 1744 94.78 919 94.49 75 70 85
Begusarai 3141 116.12 870 33.05 69.64 70 85
Bhagalpur 3908 138.48 1396 51.07 85.8 70 85
Bhojpur 1128 450 60 70 85
Buxar 708 235 70 85
Darbhanga 3015 82.37 1173 32.04 81.87 70 85
Gaya 70 85
Gopalganj 70 85
Jamui 1172 64.04 506 30.4 58.6 70 85
Jehanabad 1058 50.25 473 61.85 75.65 70 85
Kaimur 70 85
Khagaria 836 14.67 356 24.26 63.63 70 85
Kisanganj 1233 41.4 715 65 79 70 85
Lakhisharai 651 56 248 35 83 70 85
Madhepura 998 61 551 45.33 87.33 70 85
Madhubani 2135 53.67 1051 26.42 74.29 70 85
Nalanda 1928 49.85 946 46.7 89.78 70 85
Nawadah 1068 53.52 531 35.48 88.74 70 85
W.Champaran 2269 64 1093 31 72 70 85
Rohtas 1995 71.97 890 42.81 78.21 70 85
Saharsa 70 85
Saran 70 85
Sheikhpura 505 110 76 70 85
Sheohar 70 85
Sitamarhi 2588 85.07 1234 40.96 58.66 70 85
Siwan 2093 57 739 27 50 70 85
Supaul 70 85
Cure rate
Total
* Patients put on treatment under DOTS regimens only are to be included.
296

Section B – List Priority areas at the State level for achieving the objectives planned:
S.No. Priority areas Activity planned under each priority area
1
1 a)Filling up of all State and District level Contractual Staff .
Human Resource 1 b) Filling up the posts of DTOs & MOTCs,
2 a) Training of untrained DTOs & MO TCs at National & state
level and also of STS, STLS , LTs
2 Training 2 b) Training and Refresher trainings of MOs & Para Medical
Staff
2 c) Training of ASHA as DOT providers
2 d)Training and retraining of All contractual staff of RNTCP
3 IEC 3 a) Printing of IEC Materials for the State
3 b)Involvement of masses through generating awareness via the
print and electronic Media.
4 Involvement of other
sectors/ NGOs/PP
3 c) Sensitisation of local MLAs and PRI members, empowering
the community by making them aware of the RNTCP facilities
4 a) Sensitisation workshop for other sectors, NGOs and PPs.
On the revised schemes
5 Strengthening of IRL, Lab
network and
Implementation of EQA
4 b) Increased involvement of Faith Based and community based
organisations.
4 c) Involving IMA in RNTCP in the State
5 a)Starting more DMCs especially in the APHCs with the help of
NGOs
6 Minimizing Initial
Defaulters
5 c)Visit of IRL to all the 38 districts with at least one OSE and
One Panel Testing.
6 a) Ensuring in all districts line listing of all sputum smear +ve
patients diagnosed on regular basis
6 b) Regular data exchange for feedback within district regarding
referral for treatment.
297

Priority Districts for Supervision and Monitoring by State during the next year
Activity
S No District Reason for inclusion in priority list
1 Supaul Low case Detection
2 Buxar Low case Detection
3 Bhojpur Low case Detection
4 Gaya Low case Detection
5 Madhepura Low case Detection
6 Kaimur Low case Detection
7 Saran Low case Detection
Section C – Consolidated Plan for Performance and Expenditure under each head,
including estimates submitted by all districts, and the requirements at the State Level
1. Civil Works
No. required
as per the
norms in the
state
No.
already
upgraded/
present in
the state
No. planned
to be
upgraded
during next
financial
year
Pl provide justification
if an increase is planned
in excess of norms (use
separate sheet if
required)
Estimated Expenditure on
the activity
Quarter in which
the planned
activity expected
to be completed
(a) (b) (c) (d) (e) (f)
STDC/
IRL
SDS
DTCs 30 27 3 Upgradation of DTCs 3 rd Quarter
2009
TUs 130 114 13 Up gradation of TUs
+
Maintenance of TUs
DMCs 650 513 74 Up gradation of
DMcs +
maintenance civil
works of DMCs
TOTAL Rs 4266000/-
3 rd Quarter
2009
4 th Quarter
2009
298

2. Laboratory Materials
Activity
Purchase of Lab
Materials by Districts
Amount
permissible as
per the norms in
the state
Amount
actually
spent in the
last 4
quarters
Procurement
planned
during the
current
financial year
(in Rupees)
Estimated
Expenditure for
the next
financial year
for which plan is
being submitted
(Rs.)
(a) (b) (c) (d) (e)
1,00,53,000 2240090 7800000 1,10,50,000
Justification/
Remarks for (d)
Lab materials for EQA
activity at STDC
3. Honorarium
Activity
Honorarium for DOT
providers (both tribal
and non tribal
districts)
Honorarium for DOT
providers of Cat IV
patients
Amount
permissible as
per the norms
in the state
Amount
actually
spent in
the last 4
quarters
Expenditure
(in Rs)
planned for
current
financial
year
Estimated Expenditure
for the next financial
year for which plan is
being submitted
(Rs.)
Justification/
Remarks for
(d)
(a) (b) (c) (d) (e)
18,76,000 332375 1540000 2,60,00,000/-
Community volunteers in all
the districts*
No. presently involved in RNTCP
1315 40,000
Additional enrolment proposed for the next
fin. Year
* These community volunteers are other than salaried employees of Central/State government and
are involved in provision of DOT e.g. Anganwadi workers, trained dais, village health guides,
ASHA, other volunteers, etc.
299

4. IEC/Publicity:
Permissible budget for State and all Districts as per Norms: Rs. 50,26,500
Estimated IEC budget for all Districts, as per action plans (please enclose consolidation summary): Rs.
_________
Estimated IEC activities and Budget at the State level (excluding districts) for the next financial year
proposed as per action plan detailed below: Rs. _____________________
Target
Group/
Objective
Patients
and
General
public /
for
awareness
generation
and social
mobilizati
on
Activity
(All activities to be
planned as per local
needs, catering to the
target groups
specified)
Outdoors:
- wall paintings
- Hoardings
- Tin plates
- Banners
- others
Outreach activities:
- Patient provider
interaction
meetings
- Community
meetings
- Mike publicity
- Others
Activities Planned at State Level
No. of
activities
held in
last 4
quarters
No of activities proposed in the
next financial year, quarterwise
Apr-
Jun
July-
Sep
Oct-
Dec
Jan-
Mar
Total
activitie
s
propose
d
during
next fin.
year
Estima
ted
Cost
per
activit
y unit
Total
expenditure
for the
activity
during the
next fin.
Year
20,00,000
1200000
Puppet shows/ street
plays/etc.
School activities
Print publicity
- Posters
- Pamphlets
- Others
2,20,000
Media activities on
Cable/local channels
Radio
Any other activity
Opinion
leaders/
NGOs for
advocacy
Sensitization
meetings
Media activities
Power point
Presentations / one to
one interaction
Information
Booklets/ brochures
300

Health
Care
providers
public
and
private
Any Other
Activities
proposed
World TB Day
activities
Any other public
event
- CMEs
- Interaction
meetings
- one to one
interaction
meetings
- Information
Booklets
- Any other
Communication
Facilitators (each for
5-6 districts)
12,00000
76700
13,32000
Total Budget 60,28,700/-
Item
5. Equipment Maintenance:
Computer
Photocopier
Fax
Binocular Microscopes
No.
actually
present
in the
state
Amount
actually
spent in
the last 4
quarters
Amount Proposed
for Maintenance
during current
financial yr.
Estimated Expenditure for the
next financial year for which
plan is being submitted
(Rs.)
(a) (b) (c) (d) (e)
30 140393 750000 22,00,000
28
27
504 15,25,000
(RNTCP)
STDC/ IRL Equipment 11,00,000
Any Other (pl. specify)
TOTAL 4825000/-
Justification/
Remarks for (d)
301

6. Training:
Activity
Training of DTOs (at
National level)
Training of MO-TCs
Training of MOs (Govt +
Non-Govt)
Training of LTs of DMCs-
Govt + Non Govt
Training of MPWs
Training of MPHS,
pharmacists, nursing staff,
BEO etc
Training of Comm
Volunteers
Training of Pvt
Practitioners
Other trainings #
No.
in
the
state
No.
already
trained
in
RNTCP
No. planned to be trained in
RNTCP during each quarter
of next FY (c)
Q1
Q2 Q3 Q4
Expenditure
(in Rs)
planned for
current
financial
year
Estimated
Expenditure
for the next
financial
year
(Rs.)
(a) (b) (d) (e) (f)
4000 3000 1500 2500
2000 4000 6000 1000
500 1000 1500 200
Justification/
remarks
Re- training of MOs 400 400 400 200
Re- Training of LTs of
50 25 55 25
DMCs
Re- Training of MPWs
Re- Training of MPHS,
500 600 800
pharmacists, nursing staff,
BEO
Re- Training of CVs
Re-training of Pvt
Practitioners
TB/HIV Training of MO-
TCs and MOs
TB/HIV Training of STLS,
LTs , MPWs, MPHS,
Nursing Staff, Community
Volunteers etc
TB/HIV Training of STS
Provision for Update
Training at Various Levels
#
Review Meetings at State
Level
800 700 400 200
Any Other Training Activity
# Please specify TOTAL Rs.52,41,000/-
302

7. Vehicle Maintenance:
Type of Vehicle
Number
permissible
as per the
norms in the
state
Number
actually
present
Amount spent
on POL and
Maintenance
in the
previous 4
quarters
303
Expenditure
(in Rs)
planned for
current
financial
year
Estimated
Expenditure for the
next financial year
for which plan is
being submitted
(Rs.)
(a) (b) (c) (d) (e) (f)
Four Wheelers
Two Wheelers 131 113 1082209 3000000 41,71,000/-
TOTAL 41,71,000/-
Hiring of
Four
Wheeler
8. Vehicle Hiring*:
Number
permissible as
per the norms in
the state
Number actually
requiring hired
vehicles
Amount
spent in
the prev. 4
qtrs
Expenditure (in
Rs) planned for
current financial
year
Estimated Expenditure
for the next financial
year for which plan is
being submitted (Rs.)
Justification/
remarks
Justification/
remarks
(a) (b) (c) (d) (e) (f)
For STC/
STDC 95,29,600/-
For DTO 30 30 1132699 4800000
For MO-
TC
TOTAL 95,29,600/-
* Vehicle Hiring permissible only where RNTCP vehicles have not been provided
9. NGO/ PP Support:
Activity
No. of
currently
involved
in RNTCP
in the
state
Additional
enrolment
planned for this
year
Amount spent
in the
previous 4
quarters
Expenditure (in
Rs) planned for
current financial
year
Estimated
Expenditure for the
next financial year
(Rs.)
(a) (b) (c) (d) (e) (f)
NGOs involvement
scheme 1 3 19 0 Rs.161000
NGOs involvement
scheme 2 5 76 0 Rs.454000
NGOs involvement
scheme 3 2 5 0 0
NGOs involvement
scheme 4 3 15 0 Rs.300000
NGOs involvement
scheme 5 1 5 0 Rs.425313
NGOs involvement
unsigned
Private practitioners
scheme 1 0 160 10 Rs.10000
Private practitioners
scheme 2 134 527 0 Rs.71000
Private practitioners
scheme 3A 0 59 0 0
Private practitioners
scheme 3B 0 250 0 0
Prvt Pract. scheme
4A 0 3017 0 Rs.10000
Justification/
remarks

Pvt Pract. Scheme 4B
TOTAL Rs70,00,000/-
NGO/ PP Support: (New schemes w.e.f. 01-10-2008)
Activity
No. of
currently
involved
in RNTCP
Additional
enrolment
planned for
this year
Amount
spent in
the
previous
4
quarters
ACSM Scheme: TB
advocacy, communication,
and social mobilization
SC Scheme: Sputum
Collection Centre/s
Transport Scheme:
Sputum Pick-Up and
Transport Service
DMC Scheme: Designated
Microscopy Cum
Treatment Centre (A & B)
LT Scheme: Strengthening
RNTCP diagnostic
304
Expenditure
(in Rs)
planned for
current
financial
year
Estimated
Expenditure for
the next financial
year for which
plan is being
submitted
(Rs.)
Justification/
remarks
(a) (b) (c) (d) (e) (f)
3 10 0 75000
0 20 0 0
services
Culture and DST Scheme:
Providing Quality Assured
Culture and Drug
Susceptibility Testing
Services
Adherence scheme:
Promoting treatment
adherence
Slum Scheme: Improving
TB control in Urban
Slums
Tuberculosis Unit Model 2 1 0 530000
TB-HIV Scheme:
Delivering TB-HIV
interventions to high HIV
Risk groups (HRGs)
3 0 0
TOTAL 20,78,000/-
* orZeku esa NGO/PPP ds dk;Zjr cy ds vuqlkj 2768250-00 dh jkfk iz;kZIr gksxhA
10. Miscellaneous:
Activity* Amount
permissible as
e.g. TA/DA,
per the norms in
Stationary, the state
etc
Amount spent in
the previous 4
quarters
Expenditure (in
Rs) planned for
current financial
year
Estimated
Expenditure for
the next
financial year
(Rs.)
(a) (b) (c) (d) (e)
10053000 908919 5200000 90,84,000
Justification/ remarks

11. Contractual Services:
TOTAL 90,84,000/-
* Please mention the main activities proposed to be met out through this head
Category of
Staff
No.
permissible
as per the
norms in the
state
No.
actually
present
in the
state
No. planned
to be
additionally
hired during
this year
Amount spent
in the previous
4 quarters
Expenditure (in
Rs) planned for
current fin. year
(a) (b) (c) (d) (e)
TB/HIV Coord.
Urban TB Coord.
MO-STCS
State Accountant
State IEC Officer
Pharmacist
Secretarial Asst
MO-DTC 6 4 2 40431072 4800000
STS 134 110
STLS 134 113
TBHV 49
DEO 30 20 10
Accountant – part 30 18 12
time
Contractual LT 290 182
Driver
Any other
contractual post
approved under
RNTCP
Estimated
Expenditure for
the next financial
year
(Rs.)
TOTAL 4,57,47,500/-
Justification
/ remarks
* orZeku esa Contractual Staff ds dk;Zjr cy ds vuqlkj 40336000-00 dh jkfk
iz;kZIr gksxhA
12. Printing:
Activity
Printing-State
level:*
Amount
permissible
as per the
norms in the
state
Amount
spent in
the
previous 4
quarters
Expenditure (in
Rs) planned for
current
financial year
Estimated Expenditure for
the next financial year for
which plan is being
submitted
(Rs.)
(a) (b) (c) (d) (e)
10053000 93,02,000/-
Justification/
remarks
305

Printing- Distt.
Level:*
* Please specify items to be printed in this column
* foxr o"kZ esa gq, NikbZ dk;Z dks ns[krs gq, 1026500-00 dh jkfk iz;kZIr gksxhA
13. Research and Studies (excluding OR in Medical Colleges): Rs. 6,00,000/-
Any Operational Research projects planned (Yes/No) ______________________________________
(If yes, enclose annexure providing details of the Topic of the Study, Investigators and Other details)
Whether submitted for approval/ already approved? (Yes/No) _______________________________
Estimated Total Budget ____________________________________________
306

14. Medical Colleges
Activity
Contractual Staff:
• MO-Medical College (Total
approved in state 3
• STLS in Medical Colleges (Total no
in state 3 )
• LT for Medical College (Total no in
state 3 )
• TBHV for Medical College (Total
no in state 3)
Amount
permissible as
per norms
Estimated Expenditure
for the next financial
year(Rs.)
(a) (b) (c)
Rs.12,96,000/- Rs.12,96,000/-
Justification/
remarks
Research and Studies:
1,00,000/-
• Thesis of PG Students
• Operations Research*
Travel Expenses for attending
STF/ZTF/NTF meetings
IEC: Meetings and CME planned 7,00,000/-
Equipment Maintenance at Nodal Centres
* Expenditure on OR can only be incurred after due approvals of STF/ STCS/ZTF/CTD (as applicable)
15. Procurement of Vehicles:
Equipment
4-wheeler **
2-wheeler
No. actually
present in
the state
No. planned
for
procurement
this year (only
if permissible
as per norms)
Estimated Expenditure for the
next financial year for which
plan is being submitted (Rs.)
(a) (b) (c) (d)
8,85,000/-
Justification/
remarks
** Only if authorized in writing by the Central TB Division
307

16. Procurement of Equipment:
Equipment
Office Equipment
(Computer, modem,
scanner, printer, UPS
etc.)
Any Other
No. actually
present in the
state
No. planned
for this year
(only as per
norms)
Estimated Expenditure
for the next financial
year for which plan is
being submitted (Rs.)
(a) (b) (c) (d)
30 0
22
5 395000
19
11 165000
560000
Justification/ remarks
308

Section D: Summary of proposed budget for the state –
Category of Expenditure Budget estimate for the coming FY 2009
- 2010
(To be based on the planned activities and
expenditure in Section C)
1. Civil works 4266000
2. Laboratory materials 11050000
3. Honorarium 26000000
4. IEC/ Publicity 6028700
5. Equipment maintenance 4825000
6. Training 5241000
7. Vehicle maintenance 4171000
8. Vehicle hiring 9529600
9. NGO/PP support 9078000
10. Miscellaneous 9084000
11. Contractual services 45747500
12. Printing 9302000
13. Research and studies 600000
14. Medical Colleges 2096000
15. Procurement vehicles 885000
16. Procurement equipment 560000
14,84,63,800/-
TOTAL
** Only if authorized in writing by the Central TB Division
309

Annual Plan for Programme Performance & Budget for the year
1 st April 2009 to 31 st March 2010
State: BIHAR (World Bank)
Objectives:
1.3. To achieve and maintain a cure rate of at least 85% among newly detected infectious (new sputum
smear positive) cases, and
2.4. To achieve and maintain detection of at least 70% of such cases in the population
Formatted: Bullets and Numbering
This action plan and budget have been approved by the STCS.
Signature of the STO__________
Name : Dr. N.M.Sharma
_______
Section-A – General Information about the State
1 State Population (in lakh) (World Bank Districts) 282.57
2 Number of districts in the State (World Bank Districts) 8
3 Urban population 36.16
4 Tribal population 0.87
5 Hilly population 0
6 Any other known groups of special population for specific interventions
(e.g. nomadic, migrant, industrial workers, urban slums, etc.)
1.55
(These population statistics may be obtained from Census data /State Statistical Dept/ District plans)
No. of districts without DTC: None
No. of districts that submitted annual action plans, which have been consolidated in this state plan: 8
Organization of services in the state:
S.
No.
Name of the
District
Projected
Population (in
Please indicate number of
TUs of each type
Please indicate no. of DMCs of
each type in the district
Lakhs) Govt NGO Public
Sector*
NGO Private
Sector^
1 Katihar 27.47 5 0 21 1 1
2 Purnia 29.20 5 0 25 0 0
3 Samstipur 39.24 7 1 20 0 0
4 E. Champaran 45.22 8 0 42 8 2
5 Muzaffarpur 43.04 7 0 16 0 0
6 Patna 54.14 10 0 9 2 0
7 Vaishali 31.18 5 0 23 0 3
8 Munger 13.05 2 0 28 1 0
Total 282.57 49 1 184 12 6
*Public Sector includes Medical Colleges, Govt. health department, other Govt. department and PSUs i.e.
as defined in PMR report
310

^ Similarly, Private Sector includes Private Medical College, Private Practitioners, Private Clinics/Nursing
Homes and Corporate sector
RNTCP performance indicators:
Important: Please give the performance for the last 4 quarters i.e. Oct 07 to September 08
Section B – List Priority areas at the State level for achieving the objectives planned:
Name of the District
(also indicate if it is
notified hilly or tribal
district
Total
number of
patients
put on
treatment*
Annualised
total case
detection rate
(per lakh
pop.)
No of new
smear
positive
cases put
on
treatment *
Annualised
New smear
positive case
detection rate
(per lakh
pop)
Cure rate
for cases
detected in
the last 4
correspondi
ng quarters
Plan for the next year
Annualized
NSP case
detection
rate
Cure rate
Katihar 2390 43.01 1395 68.3 78 70 85
Purnia 3016 113.32 1447 54.14 82.2 70 85
Samstipur 4132 53.52 1561 54.73 79.36 70 85
E. Champaran 2731 62 1160 26 85 70 85
Muzaffarpur 6173 6173 1992 53 87 70 85
Patna 471 471 173 45.85 87.98 70 85
Vaishali 3215 3215 892 29 56 70 85
Munger 1460 1460 70 85
Total
* Patients put on treatment under DOTS regimens only are to be included.
S.No. Priority areas Activity planned under each priority area
1
1 a)Filling up of all State and District level Contractual
Human Resource
Staff .
311

1 b) Filling up the posts of DTOs & MOTCs,
2 Training 2 a) Training of untrained DTOs & MO TCs at National
& state level and also of STS, STLS , LTs
2 b) Training and Refresher trainings of MOs & Para
Medical Staff
2 c) Training of ASHA as DOT providers
2 d)Training and retraining of All contractual staff of
RNTCP
3 IEC 3 a) Printing of IEC Materials for the State
3 b)Involvement of masses through generating awareness
via the print and electronic Media.
4 Involvement of other sectors/
NGOs/PP
3 c) Sensitisation of local MLAs and PRI members,
empowering the community by making them aware of
the RNTCP facilities
4 a) Sensitisation workshop for other sectors, NGOs and
PPs.
On the revised schemes
4 b) Increased involvement of Faith Based and
community based organisations.
4 c) Involving IMA in RNTCP in the State
5 Strengthening of IRL, Lab network
and Implementation of EQA
5 a)Starting more DMCs especially in the APHCs with
the help of NGOs
5 b)Construction of IRL and initiation of DOTS Plus
action plan.
5 c)Visit of IRL to all the 38 districts with at least one
OSE and One Panel Testing.
6 Minimizing Initial Defaulters 6 a) Ensuring in all districts line listing of all sputum
smear +ve patients diagnosed on regular basis
6 b) Regular data exchange for feedback within district
regarding referral for treatment.
Priority Districts for Supervision and Monitoring by State during the next year
S No District Reason for inclusion in priority list
1 Vaishali No contractual Supervisory Staff in the District
312

(STS/STLS)
Section C – Consolidated Plan for Performance and Expenditure under each head, including
estimates submitted by all districts, and the requirements at the State Level
1. Civil Works
Activity
No.
required
as per
the
norms
in the
state
No.
already
upgraded/
present in
the state
No.
planned
to be
upgraded
during
next
financial
year
Pl provide
justification if an
increase is
planned in excess
of norms (use
separate sheet if
required)
Estimated
Expenditure on the
activity
Quarter in which the
planned activity
expected to be
completed
(a) (b) (c) (d) (e) (f)
STDC/ 1 1 1 IRL civil work By 3 rd Quarter 2009.
IRL
SDS 1 1 1 Inadequate
Storage space
By 2 nd Quarter of
2009
DTCs 8 8 0 - - -
TUs 56 50 6 Up gradation By 2 nd Quarter of
2009
DMCs 282 202 20 Up gradation By 2 nd Quarter of
2009
TOTAL 32,46,000
313

2. Laboratory Materials
Activity
Amount
permissible
as per the
norms in
the state
Purchase of Lab
Materials by
Districts
Lab materials for
EQA activity at
STDC
Amount
actually
spent in
the last 4
quarters
Procurement
planned
during the
current
financial
year (in
Rupees)
Estimated
Expenditure for
the next financial
year for which
plan is being
submitted
(Rs.)
Justification/ Remarks
for (d)
(a) (b) (c) (d) (e)
42,375,00 10,244,34 3213066 62,07,000/- Project increase in
Case detection and
also increase in cost of
Lab Consumables
3. Honorarium
Activity
Honorarium for
DOT providers
(both tribal and
non tribal
districts)
Honorarium for
DOT providers
of Cat IV
patients
Amount
permissible
as per the
norms in
the state
Amount
actually
spent in
the last 4
quarters
Expenditure
(in Rs)
planned for
current
financial
year
Estimated Expenditure
for the next financial
year for which plan is
being submitted
(Rs.)
Justification/
Remarks for
(d)
(a) (b) (c) (d) (e)
791000 139925 651075 60,00,000* Committed
honoraria to
DOT
Providers
Community
volunteers in all the
districts*
No. presently involved in Additional enrolment proposed for the
RNTCP
next fin. year
1243 10,000
* These community volunteers are other than salaried employees of Central/State government and are
involved in provision of DOT e.g. Anganwadi workers, trained dais, village health guides, ASHA, other
volunteers, etc.
* orZeku esa Dot Privder dk;Zjr cy ds vuqlkj 10-00 yk[k dh jkfk iz;kZIr gksxhA
4. IEC/Publicity:
Permissible budget for State and all Districts as per Norms: Rs.(10,00,000 + 21,187,50)
314

Estimated IEC budget for all Districts, as per action plans (please enclose consolidation summary):
Rs.23,00,000
Estimated IEC activities and Budget at the State level (excluding districts) for the next financial year
proposed as per action plan detailed below: Rs. 23,00,000
Target
Group/
Objective
Patients
and
General
public /
for
awareness
generation
and social
mobilizati
on
Activity
(All activities to be
planned as per local
needs, catering to the
target groups
specified)
Outdoors:
- wall paintings
- Hoardings
- Tin plates
- Banners
- others
Outreach activities:
- Patient provider
interaction
meetings
- Community
meetings
- Mike publicity
- Others
Activities Planned at State Level
No. of
activities
held in
last 4
quarters
No of activities proposed in the
next financial year, quarterwise
Apr-
Jun
July-
Sep
Oct-
Dec
Jan-
Mar
Total
activitie
s
propose
d
during
next fin.
year
Estima
ted
Cost
per
activit
y unit
Total
expenditur
e for the
activity
during the
next fin.
Year
14,00,000
Puppet shows/ street
plays/etc.
School activities 3,00,000
Print publicity
- Posters
- Pamphlets
- Others
Media activities on
Cable/local channels
Radio
Any other activity
8,00,000
12,00,000
Opinion
leaders/
NGOs for
advocacy
Sensitization
meetings
Media activities 2,00,000
Power point
Presentations / one to
one interaction
Information
2,00,000
Booklets/ brochures
World TB Day
2,00,000
activities
315

Health
Care
providers
public
and
private
Any Other
Activities
proposed
Any other public
event
- CMEs
- Interaction
meetings
- one to one
interaction
meetings
- Information
Booklets
- Any other
Communication
Facilitators (each for
5-6 districts)
2,65,000
Total Budget 45,65,000
Item
5. Equipment Maintenance:
Computer
(maintenance includes AMC,
software and hardware upgrades,
Printer Cartridges and Internet
expenses)
No.
actually
present
in the
state
Amount
actually
spent in
the last 4
quarters
Amount
Proposed for
Maintenance
during
current
financial yr.
Estimated
Expenditure for
the next
financial year
for which plan
is being
submitted
(Rs.)
Justification/
Remarks for (d)
(a) (b) (c) (d) (e)
8 81,808 58,000 3,40,000 Upgradation of
Computers for
Windows based
Epicenter +AMC
Binocular Microscopes (RNTCP) 220 0 1,12,500 4,80,000
STDC/ IRL Equipment 95,000
Any Other ( Fax & OHP )
TOTAL 9,15,000
6. Training:
Activity
Training of DTOs (at
National level)
Training of MO-TCs
Training of MOs
(Govt + Non-Govt)
Training of LTs of
DMCs- Govt + Non
No.
in
the
state
No.
already
trained
in
RNTCP
No. planned to be trained
in RNTCP during each
quarter of next FY (c)
316
Expenditure
(in Rs)
planned for
current
financial
year
Estimated
Expenditure
for the next
financial
year
(Rs.)
Q1 Q2 Q3 Q4
(a) (b) (d) (e) (f)
7 9 2 2
15 15 15 15
30 15 10 5
Justification/
remarks

Govt
Training of MPWs
Training of MPHS,
pharmacists, nursing
staff, BEO etc
Training of Comm
Volunteers
Training of Pvt
Practitioners
Other trainings #
Re- training of MOs
Re- Training of LTs of
DMCs
Re- Training of
MPWs
Re- Training of
MPHS, pharmacists,
nursing staff, BEO
Re- Training of CVs
Re-training of Pvt
Practitioners
150 150 150 150
1000 1500 2000 4000
75 100 80 120
TB/HIV Training of
40 40 40 40
MO-TCs and MOs
TB/HIV Training of
STLS, LTs , MPWs,
MPHS, Nursing Staff,
Community
Volunteers etc
TB/HIV Training of
STS
Provision for Update
Training at Various
Levels #
Review Meetings at
State Level 1 1 1 1
Any Other Training
Activity
# Please specify TOTAL 28,60,000
7. Vehicle Maintenance:
Type of Vehicle Number
permissible
as per the
norms in
the state
Number
actually
present
Amount
spent on
POL and
Maintenance
in the
previous 4
quarters
Expenditure
(in Rs)
planned for
current
financial
year
Estimated
Expenditure for the
next financial year
for which plan is
being submitted
(Rs.)
(a) (b) (c) (d) (e) (f)
Four Wheelers 8 4 5,00,000
Two Wheelers 56 49 2,53,026 9,71,974 17,77,000
TOTAL 22,77,000
Justification/
remarks
317

8. Vehicle Hiring*:
Hiring of Number
Four permissible
Wheeler as per the
norms in the
state
Number
actually
requiring
hired
vehicles
Amount
spent in
the prev.
4 qtrs
Expenditure
(in Rs)
planned for
current
financial year
Estimated
Expenditure for the
next financial year
for which plan is
being submitted (Rs.)
(a) (b) (c) (d) (e) (f)
For STC/ 1 1 0 0
STDC
For DTO 4 4 1,88,628 6,51,372
For MO-
TC
Justification/
remarks
50 50 Proposed to
increase the
no. Of TUs
TOTAL 45,06,000/-
* Vehicle Hiring permissible only where RNTCP vehicles have not been provided
9. NGO/ PP Support:
Activity
No. of
currently
involved
in
RNTCP
in the
state
Additional
enrolment
planned
for this
year
Amount
spent in
the
previous
4
quarters
Expenditure
(in Rs)
planned for
current
financial
year
Estimated
Expenditure
for the next
financial year
(Rs.)
(a) (b) (c) (d) (e) (f)
NGOs involvement scheme 1 0 4 0 75000 Rs.100000/-
NGOs involvement scheme 2 9 11 0 205000 Rs.450000/-
NGOs involvement scheme 3
NGOs involvement scheme 4 1 18 0 300000 Rs.265000/-
NGOs involvement scheme 5 0 1 0 0 Rs.480000/-
NGOs involvement unsigned 32 0 0 600000 Rs.0/-
Private practitioners scheme
1 0 84 0 20000 Rs.81200/-
Private practitioners scheme
2 0 334 0 8000 Rs.160500/-
Private practitioners scheme
3A
Private practitioners scheme
3B
Prvt Pract. scheme 4A
Pvt Pract. Scheme 4B
TOTAL 1,01,25,000/-
NGO/ PP Support: (New schemes w.e.f. 01-10-2008)
Justification/
remarks
Activity
ACSM Scheme: TB
advocacy,
communication, and
social mobilization
No. of
currently
involved
in
RNTCP
Additional
enrolment
planned
for this
year
Amount
spent in
the
previous
4
quarters
318
Expenditure
(in Rs)
planned for
current
financial
year
Estimated
Expenditure for
the next
financial year
for which plan is
being submitted
(Rs.)
Justification/
remarks
(a) (b) (c) (d) (e) (f)

SC Scheme: Sputum
Collection Centre/s
Transport Scheme:
Sputum Pick-Up and
Transport Service
DMC Scheme:
Designated Microscopy
Cum Treatment Centre
(A & B)
LT Scheme:
Strengthening RNTCP
diagnostic services
Culture and DST
Scheme: Providing
Quality Assured
Culture and Drug
Susceptibility Testing
Services
Adherence scheme:
Promoting treatment
adherence
Slum Scheme:
Improving TB control
in Urban Slums
Tuberculosis Unit
Model
TB-HIV Scheme:
Delivering TB-HIV
interventions to high
HIV Risk groups
(HRGs)
1 5 0 75,000
15 0 0
9 5 0 18,00,00
1 0 0 2,65,000
6 0 0
TOTAL 79,11,000/-
* orZeku esa NGO/PPP ds dk;Zjr cy ds vuqlkj 25-00 yk[k dh jkfk izkIr gksxhA
10. Miscellaneous:
Activity*
e.g. TA/DA,
Stationary, etc
Amount
permissib
le as per
the norms
in the
state
Amount
spent in
the
previous 4
quarters
Expenditure
(in Rs)
planned for
current
financial
year
Estimated
Expenditure
for the next
financial year
(Rs.)
(a) (b) (c) (d) (e)
State Level 7,00,000 7,00,000
District Level 42,37,500 2,08,047 10,50,000 45,14,000
Justification/ remarks
TOTAL 52,14,000
* Please mention the main activities proposed to be met out through this head
319

11. Contractual Services:
Category of Staff
No.
permissible
as per the
norms in the
state
No.
actuall
y
present
in the
state
No.
planned to
be
additionall
y hired
during this
year
Amount
spent in
the
previous
4
quarters
Expendit
ure (in
Rs)
planned
for
current
fin. year
(a) (b) (c) (d) (e)
TB/HIV Coord. 1 0 0 0 0
Urban TB Coord.
MO-STCS 1 0 0 0 0
State Accountant 2 0 0 0 0
State IEC Officer 1 0 0 0 0
Pharmacist 1 0 0 0 0
Secretarial Asst 1 0 0 0 0
MO-DTC
STS 50 45 5
STLS 50 43 7
TBHV 30 2 28
DEO Districts 8 6 2
DEO State 2 0 2 0 0
Accountant – part 8 4 8
time
Contractual LT 120 88 32
Driver 8 5 3
Any other
contractual post
approved under
RNTCP
Estimated
Expenditure
for the next
financial
year
(Rs.)
TOTAL 2,90,82,000/-
Justificatio
n/ remarks
12. Printing:
Activity
Printing-State level:*
(All
Modules,Guidelines,For
ms,registers,IEC
materials)
Printing- Distt. Level:*
Amount
permissible
as per the
norms in
the state
Amount
spent in
the
previous
4
quarters
Expenditure
(in Rs)
planned for
current
financial year
Estimated Expenditure for
the next financial year for
which plan is being
submitted
(Rs.)
Justification/
remarks
(a) (b) (c) (d) (e)
4237500 777337 45,74,000/- No printing
carried out in
the new
formats,No IEC
material at
state /district
* Please specify items to be printed in this column
* foxr o"kZ esa gq, NikbZ dk;Z dks ns[krs gq, 20-00 yk[k dh jkfk iz;kZIr gksxhA
320

13. Research and Studies (excluding OR in Medical Colleges): Rs. 6,00,000/-
Any Operational Research projects planned (Yes/No) ______________________________________
(If yes, enclose annexure providing details of the Topic of the Study, Investigators and Other details)
Whether submitted for approval/ already approved? (Yes/No) _______________________________
Estimated Total Budget ____________________________________________
14. Medical Colleges
Activity
Contractual Staff:
• MO-Medical College
• STLS in Medical Colleges
• LT for Medical College
• TBHV for Medical College
Research and Studies:
• Thesis of PG Students
• Operations Research*
Travel Expenses for attending
STF/ZTF/NTF meetings
IEC: Meetings and CME planned
Equipment Maintenance at Nodal
Centres
Amount
permissible as
per norms
Estimated Expenditure
for the next financial
year(Rs.)
(a) (b) (c)
3
3
3
3
Total:28,47,200/-
Justification/
remarks
15. Procurement of Vehicles:
Equipment
No.
actually
present in
the state
No. planned for
procurement this
year (only if
permissible as per
norms)
321
Estimated
Expenditure for the
next financial year for
which plan is being
submitted (Rs.)
Justification/
remarks
(a) (b) (c) (d)
4-wheeler **
2-wheeler 43 26
13,00,000/-
** Only if authorized in writing by the Central TB Division
16. Procurement of Equipment:
Equipment
Office Equipment
(Computer,
Photocopier
No. actually
present in the
state
LCD projector 2
No.
planned
for this
year (only
as per
norms)
Estimated
Expenditure for the
next financial year
for which plan is
being submitted (Rs.)
(a) (b) (c) (d)
3
3 7,80,000/
Justification/
remarks

Section D: Summary of proposed budget for the state
Category of Expenditure
Budget estimate for the coming FY
2009 - 2010
(To be based on the planned activities
and expenditure in Section C)
1. Civil works 3246000
2. Laboratory materials 6207000
3. Honorarium 6000000
4. IEC/ Publicity 4565000
5. Equipment maintenance 915000
6. Training 2860000
7. Vehicle maintenance 2277000
8. Vehicle hiring 4506000
9. NGO/PP support 18036000
10. Miscellaneous 5214000
11. Contractual services 29082000
12. Printing 4574000
13. Research and studies 600000
14. Medical Colleges 2847200
15. Procurement vehicles 1300000
16. Procurement equipment 780000
TOTAL 9,30,09,200/-
** Only if authorized in writing by the Central TB Division
322

Printing Details
Sr No
1
Items name
TB Register
Quantity (No of
copies)
No of pages for print
including cover
(back and front)
334 200 + 2
2
Lab Register
1696 200 + 2
3 Treatment Card 258552 2
4 Identity Card 129276 2
5 Lab form for Sputum Examination 692550 1
6 TB Transfer form 6464 1
7 Referral for treatment form 12928 1
8 CF TU qtrly report 2672 1
9 SC TU qtrly report 2672 1
10 RT TU qtrly report 2672 1
11 PMR TU qtrly report 2672 4
12 PHI monthly Report 24422 2
13
14
15
Supervisory Registers (triplicate paging no)
Desk Referance
RNTCP at a glance
1272 7 + (80 x 3) = 247
18468 1
18468 26 + 2
16
EQA coding (blinding) register
76 100 + 2
17
EQA - RBRC roaster for STLSs rechecking and
umpire rechecking 38 100 + 2
18
EQA - Register for Quality control of prepared
reagents 76 100 + 2
19 EQA reporting format - annexure M (for TU) 15264 1
20
EQA reporting format - annexure M (for district)
1170 1
21
EQA reporting format - annexure E (for district)
1170 1
22 EQA reporting format - annexure B 20352 1
23 EQA reporting format - Annexure C 20352 1
24 EQA reporting format - Annexure D 20352 1
25 EQA reporting format - checklist for STLS 20352 7
26 EQA reporting format - annexure F 380 1
27 EQA - IRL visit to DTC - OSE 100 10
28 District Issue voucher (DIV) 16032 1
29
District worksheet for Reporting Drug Requirement
(WRDR) 16032 1
30 TU report for Reconstitution of Drugs 1670 1
31 Drug Stock Register 410 200 + 2
32 Line list of VCTC 9120 1
33 VCTC monthly report 912 1
34 Health provider guide (Local language) 18468 1
35
PP module
9234 76
323

36
Revised Strategy for monitoring and supervision
281 74 + 2
37
EQA Module - RNTCP Laboratory Network
guidelines for Quality Assurance of smear
microscopy for diagnosing TB.B60 256 91 + 2
38 Mycobacterial Culture Sensitivity forms 6464 1
39 NGO Guidelines 334 40 + 2
40 PP guidelines+B20 334 40 + 2
41 District Drug Store Manual 410 89 + 2
42
Reconstitution Register
38 200 + 2
43 Additional Drug Request 380 1
44
Referral for treatment Register
205 200 + 2
45
RNTCP Modules with Exercise book and answer
book for training of MO (1-4 Module) 4617 190 + 2
46
RNTCP MO training Exercise (E1, E2, E3) and
answer books (EA1-3) 167
(13+2) + (19+2) +
(22+2) + (32+2) = 94
47
RNTCP Modules for training of MO-TC (5-9
Module) 167 254 + 2
48
RNTCP Modules for training of STS with
Exercise book 167 (131+2) + (26+2)
49 RNTCP Modules for training of STLS 167 120 + 2
50 RNTCP Modules for training of LT 923 74 + 2
51
RNTCP Modules for training of Medical college
faculty 1150
52 RNTCP Modules for training of MPWs 18468 54 + 2
53 Modules for training in TB-HIV of MO 668 97 + 2
54 Modules for training in TB-HIV of STS & STLS 334 63 + 2
55
Modules for training in TB-HIV of VCTC
counsellor 200 66 + 2
56 District PMR report 760 6
57
Strategy document for the supervision and
monitoring 281 85 + 2
58
Guidelines for quality assuarance of smear
microscopy for diagnosing tuberculosis 334 91 + 2
59 Technical & operational guidelines 923 150 + 2
60 One page Display for DOT Provider 18468 1
61 One page Display for DOT Provider pead PWB 18468 1
62
Financial Management Manual for state & district
societies norms and basis of costing 190 83 + 2
63 Pages for Training in pediatric PWBs (Hindi) 18468 3
64 Pages for Training in pediatric PWBs (English) 3040 3
65 Programme review checklist for DMs & CMOs 950 2
66 Quarterly report - Medical College 96 3
67
IE - Form 1: Review of TU reports and TB
registers & Worksheet for form 1 200 1
68 IE - Form 1: Worksheet for form 1 500 1
69 IE - Form 2: Data collection at the district level 200 3
70 IE - Form 3: Data collection at the DMC level 500 1
71 IE - Form 4: Data collection at the DOT Centre 1000 1
324

72 IE - Form 5:Patients Interview 500 1
73 IE - Form 6 :Triangulation 200 1
74
75
76
77
IE - Form 8: Form for interview of non-NSP
patients 200 1
IE - Form 9: Form for observations at the TU Drug
store 100 1
IE - Form 11: for review of the Medical College
during Internal Evaluation 25 1
IE - Form 12: Check List For Financial
Management 500 1
78 Physical Verification Sheet (PVS) 430 1
79 Adequacy of Drug Stocks (ADS) 430 1
80 Expiry Age Analysis of Drug Stocks (EAADS) 430 1
81 Training certificates 2770 1
82 Enrolment certificate (NGOs & PPs) 462 1
83 Certificate of appreciation 308 1
84 Pamphlets 92340 1
85 Posters (Sputum Microscopy) 4617 1
86 Posters (diagnosis) 9234 1
87 Posters (Treatment) 9234 1
88 Posters (DOTS) 9234 1
89
Plastic digital printed boards for Approved DOT
centers 9234 1
90
Plastic digital printed boards for designated Pvt
Sputum Microscopy centre 114 1
91 Table Flip type calendars 2770 24
92 Flip charts 2884
93 Banners for workshop 38 1
94 Banners for training 38 1
95 Digital printed banners DOTS 4617 1
96 Digital printed banners diagnosis 4617 1
97 Digital printed banners Treatment 4617 1
98
RNTCP diary
4617 200
99 Car bumper stickers Plastic coated 9234 1
325

Bihar SPIP 2009-10
Malaria
Filaria
Kalazar
326

i=kad -KA/R-12/08 @
izs"kd% &
MkWñ vkjñ,uñ ik.Ms;]
la;qä funs'kd&lg&jkT; dk;ZØe inkf/kdkjh]
eysfj;k@dkyktkj] fcgkj] iVukA
lsok esa]
funs'kd]
jk"Vªh; oSDVj tfur jksx fu;a=.k dk;ZØe]
22] 'kkeukFk ekxZ] fnYyh & 54 iVuk] fnukad % ----------------------------------
fo"k;% iqu% lkksf/kr dkyktkj fu;a=k.kkFkZ foÙkh; o"kZ 2009&10 la'kksf/kr ctV izkôyuA
egk'k;]
mi;qZä fo"k;d v/kksgLrk{kjh ia=kd KA/R-12/08-57 fnukad 07-02-09 }kjk Hksts x;s ctV
izkDyu ij Hkkjr ljdkj }kjk mBk;s x;s fcUnqvks ds laca/k esa vko';d izo`f"V djrs gq, la'kksf/kr
ctV izkDyu Hkstk tk jgk gSA ctV izkdyu esa dkyktkj ds 2010 Elemination y{; dh izkfIr gsrq
fujks/kkRed] mipkjkRed] jkT; eq[;ky; lqn`

miyC/k gS rFkk 'ks"k 11 ftyksa esa vko';drk ls vf/kd MhñMhñVhñ miyC/k gSA orZeku foÙkh;
o"kZ esa Hkkjr ljdkj }kjk 440 ehñVu MhñMhñVhñ vkiwfrZ dh tk jgh gS ftls mUgh ftyksa esa
vkiwfrZ djus gsrq Hkkjr ljdkj ls vuqjks/k fd;k x;k gS] tgk¡ vko';drk ls de MhñMhñVhñ
miyC/k gSA
5- 31 dkyktkj izHkkfor ftyk ls fNM+dko midj.kksa ds laca/k esa tks lwpuk izkIr gqbZ mls layXu
fooj.kh ,usDpj & III esa fn[kk;k x;k gSA fooj.kh ds voyksdu ls fofnr gksxk fd dk;Z;ksX;
,oa ejEefr ;ksX; midj.kksa dks feykdj vko';drk ds vuqlkj midj.k miyC/k gSaA fQj Hkh
dqN ftyksa esa ;fn midj.kksa dh deh gksxh rks oSls ftyas tgk¡ vko';drk ls T;knk midj.k
miyC/k gS] fopyu }kjk fNM+dko midj.kksa dh vkiwfrZ dh tk,xhA ejEefr ;ksX; midj.kksa ds
ejEefr gsrq jkf'k dk izko/kku ctV esa fd;k x;k gSA
6- fNM+dko ij gksus okys O;; dk enokj fooj.k bl izdkj gS % &
¼ I ½ Js"B {ks=kh; dk;ZdÙkkZ & 1782 ¼etnwjh @ Rs. 113 izfrfnu dh nj ls 60 fnu dk
etnwjh½ & 1782 X 60 X 113 =Rs. 1,20,81,960
{ks=kh; dk;ZdÙkkZ & 8910 ¼etnwjh @ Rs. 92 izfrfnu dh nj ls 60 fnu dk
etnwjh½ & 8910 X 60 X 92 = Rs. 4,91,83,200
dqy etnwjh Rs.
&6]12]65]160
¼ftykokj fooj.kh ifjf'k"V II LraHk & 13 -------- n`"VO;½
tgkW rd Deligation of Power of Payment for spraying at district level dk iz'u gS
rks fNM+dko gsrq ftyks dks jkf'k miyC/k djk;h tkrh gS mldk mi;ksx @ O;; ftyk
dk;Zdze inkf/kdkjh }kjk gh fu;ekuqlkj fd;k tk;sxkA O;; esa ftyk LokLF; lfefr ds
inkf/kdkjh dk vuqeksnu fy;k tk;sxkA
fNM+dko esa dk;Z djusokys etnwj foxr o"kksZa esa Hkh fNM+dko fd;s gS] vr% fNM+dko
etnwjksa dh fNM+dko dh rduhdh tkudkjh gS] fQj Hkh etnwjksa dks fNM+dko ds iwoZ
,d fnu dk izf'k{k.k fn;k tkrk gSA lacaf/kr ftyksa ds ftyk dk;ZØe inkf/kdkjh
fNM+dko ds iwoZ ,d fnu dk if'k{k.k lqfuf'pr djsaxsA bl esa izf'k{k.k dks fNM+dko
vof/k ds ekuo fnol esa x.kuk fd;k tk,xkA
¼II½ dk;kZy; O;; ,oa vkDlfedrk % &
izR;sd fNM+dko ny esa fNM+dko dk;Z esa iz;ksx gksus okys vko';d lkekuksa ;Fkk xs: feêh]
jftLVj] lknk dkxt] isu] Nék ds fy, diM+k] XyOl bR;kfn ds fufer izfr fNM+dko ny
#i;s 150@& dk;kZy; O;; en es ,ao #i;s 150@& vkDlfedrk en esa jkf'k dk izko/kku
fd;k x;k gSA ftyk dk;ZØe inkf/kdkjh] izR;sd fNM+dko ny dks mijksä lkexzh miyC/k
djkuk lqfuf'pr djsaxsA bl en ls ftyk eq[;ky; esa iz;ksx gksusokys LVs'kujh Ø; dk Hkh
izko/kku gS % &
dk;kZy; O;; & fNMdko ny X 150 ¼1782X 150½ & 267300 #i;s
vkDlfedrk &fNMdko ny X 150 & ¼1782X150½&#i;s 2]67]300@&
dqy & #i;s 5]34]600@&
¼ftykokj fooj.kh ifjf'k"V II LraHk & 14 ,oa 15 n`"VO;½
¼III½ fNM+dko gsrq MhñMhñVhñ dh

ftyk eq[;ky; ls iz[k.M rd @ Rs. 1,000/-
izfr izHkkfor iz[k.M dh nj ls ¼310 X 1]000½ & #i;s 3]10]000@&
iz[k.M eq[;ky; ls LFky rd @ Rs. 500/-
izfr izHkkfor iz[k.M dh nj ls ¼310 X 500½ & #i;s 1]55]000@&
dqy &#i;s 4]65]000@&
¼ftykokj fooj.kh ifjf'k"V II LraHk & 16 ,oa 17 n`"VO;½
¼IV½ fNM+dko esa O;ogkj gksusokys fNM+dko midj.kksa ¼ejEefr ;ksX; midj.kksa ds½ ejEefr
gsrq] fNM+dko ds nkSjku fNM+dko midj.kksa ds ejEefr ,oa LVhji iEi gsrq pqVdh oklj]
xSyu lqrk bR;kfn ds fy, jkf'k dk izko/kku izfr fNM+dko ny #i;s 100@& ,oa
uksty VhIl ds Ø; gsrq izfr izfr fNM+dko ny #i;s 400@&dh nj ls jkf'k dk
izko/kku fd;k x;k gSA C;; C;ksjk bl izdkj gS % &
¼d½ fNM+dko midj.kksa dh ejEefr ,oa oklj bR;kfn ds Ø; gsrq
izfr fNM+dko ny #i;s 100@& 1782 X100 & Rs. 1]78]200@&
¼[k½ uksty VhIl ds fy, izfr fNM+dko ny #i;s 400@&
1782X400&Rs. 7]12]800@&
dqy &Rs. 8]91]000@&
¼ftykokj fooj.kh ifjf'k"V IV dkWye 5 rFkk 6 n`"VO;½
ftyksa ls izkIr fNM+dko midj.kksa dh miyC/krk dk ftykokj fooj.k ifjf'k"V III esa
n'kkZ;k x;k gSA fNM+dko ds vuqlkj mä ifjf'k"V III eas LVhji iEi] okYVh] xSyu
estj] ikS.M Ekstj rFkk uksty VhIl dh vko';drk rFkk ftyksa eas miyC/k midj.kksa
dk C;kSjk n'kkZ;h xbZ gSA fooj.kh ds voyksdu ls Li"V gksxk fd vf/kdka'kr% ftyksa esa
vko';drk ls T;knk midj.k miyC/k gS ftu ftyksa esa ejEefr ds mijkar Hkh
vko';drk ls de midj.k miyC/k gksaxs] mu ftyksa esa fopyu }kjk vU; ftysa ¼tgk¡
vko';drk ls vf/kd midj.k gS½ ls fNM+dko midj.k miyC/k djk;k tk,xkA
¼V½ i;Zos{k.k % & jkT; ds 31 dkyktkj izHkkfor ftyksa ds foxr ik¡p o"kksZ esa dkyktkj
ls izHkkfor lHkh xzkeksa esa fNM+dko djk;k tkuk gSA fNM+dko ds lQy lapkyu ,oa
xq.koÙkk iw.kZ fNM+dko dh n`f"V ls i;Zos{k.k ,oa ewY;kadu vko';d gSAi;Zos{k.k ftyk
Lrj ,oa iz[k.M Lrj ds inkf/kdkjh ,oa deZpkjh }kjk fd;k tkrk gSA
31 ftyksa esa ls 20 ftyksa esa ftyk eysfj;k inkf/kdkjh dk in l`ftr gS] 'ks"k
11 ftysa esa in l`ftr ugha gSA bu ftyksa esa ek=k i;Zos{k.k dk nkf;Ro ftysa ds vij
eq[; fpfdRlk inkf/kdkjh dks fn;k tk jgk gSA bl fufer ftyk Lrj ij vij eq[;
fpfdRlk inkf/kdkjh@ftyk eysfj;k inkf/kdkjh dh xkM+h gsrq jkf'k miyC/k djkbZ tk
jgh gSA e/ksiqjk rFkk [kxfM+;k ftys ds flfoy ltZu }kjk i;Zos{k.k dk;Z fd;k
tk,xkA
ifjf'k"V I ds LraHk 13 ds voyksdu ls Kkr gksxk fd dqN ftyksa esa izHkkfor
xzkeksa dh la[;k vf/kd gS rks dqN ftyksa esa de gSA vr% i;Zos{k.k gsrq jkf'k izHkkfor
xzkeksa dks vk/kkj eku dj fn;k tk jgk gSaA izR;sd inkf/kdkjh ,d fnu ¼Hkze.k ds fnu½
esa de&ls&de 6 xzkeksa ds fNM+dko dk i;Zos{k.k lqfuf'pr djsaxsA
ftu ftyksa esa xkM+h miyC/k gS] mu ftyksa esa jkf'k dk mi;ksx xkM+h esa mi;qä
gksus okys bZa/ku ij fu;ekuqlkj fd;k tk,xkA ftu ftyksa esa xkM+h miyC/k ugha gS os
ftys HkkMs+ ij xkM+h ¼jkT; Lokñ lfefr] fcgkj iVuk }kjk fu/kkZfjr nj ij½ ysdj
i;Zos{k.k dk;Z djsaxsA
iz[k.M Lrj ij i;Zos{k.k gsrq iz[k.M ds fpñinkñ izfr izHkkfor xzke dh nj ls
jkf'k miyC/k djkbZ tk,xhA iz[k.M ds fpñinkñ Hkze.k dh frfFk dks de&ls&de 6
xzke dk i;Zos{k.k lqfuf'pr djsaxsA bl fufer vko';drk ds rgr~ HkkM+s ij Hkh ogu
fy;k tk ldrk gS] tSlk fd Åij mYys[k fd;k x;k gSA
9 ftyksa ds vij eq[; fpñinkñ ,oa 2 ftys [kxfM+;k] e/ksiqjk ds flfoy ltZu &
¼izHkkfor xzke X100½ 1783X 100 & 1]78]300@&
20 ftyksa ds ftñ eñinkñ &
329

¼izHkkfor xzke X100½ 9031X 100 & 9]03]100@&
31 ftyksa ds iz[k.M fpñinkñ &
¼izHkkfor xzke X 50½ 10814X50 & 5]40]700@&
dqy &Rs. 16]22]100 @&
iz[k.M Lrj dh jkf'k ftyk dk;ZØe inkf/kdkjh }kjk iz[k.M fpñinkñ dks miyC/k
djkbZ tk,xhA ¼ftyk fooj.kh ifjf'k"V IV LraHk 8]9 ,oa 10 nz"VO;½
¼VI½ i;Zos{kh inkf/kdkjh@deZpkjh dk nSfud HkÙkk % &
ek=k MhñMhñVhñ fNM+dko esa layXu i;Zos{kh inkf/kdkjh ,oa deZpkjh dks nSfud HkÙkk
¼fu;ekuqlkj½ fn;k tk,xkA bl fufer izfr dkyktkj izHkkfor iz[k.M ds fy, #i;s
1]000@& dh nj ls jkf'k dk vkdyu fd;k x;k gSA pw¡fd iz[k.M ds ek= izHkkfor
xzkeksa dk gh fNM+dko fd;k tk jgk gSA iwjs iz[k.M dk ughaA bls eísutj j[krs gq, gh
jkf'k dk vkdyu fd;k x;k gSA izLrkfor jkf'k &izHkkfor izk- Lok- dsUnz dh la[;k
X1]000 & 310X 1]000 & #i;s 3]10]000@&
¼ftyk fooj.kh ifjf'k"V IV LraHk 11 nz"VO;½
(VII) vkbZñbZñlhñ % & fNM+dko ds iwoZ tu lk/kkj.k esa fNM+dko ds Qk;ns fNM+dko ds frfFk
dh tkudkjh dh n`f"V ls bl en esa izfr izHkkfor iz[k.M #i;s 1]000@& dh nj ls
jkf'k dk izko/kku fd;k x;k gSA ftyk Lrjh; dk;ZØe inkf/kdkjh iksLVj]bR;kfn ds
ek/;e ls izpkj&izlkj djk;saxsA bl en dh jkf'k iz[k.M fpñinkñ dks #i;s 500@&
izfr iz[k.M dh nj ls miyC/k djkbZ tk,xhA iz[k.M fpñinkñ izHkkfor xzkeksa esa
fNM+dko ds iwoZ

Øe
lañ
lHkh izos{kh inkf/kdkjh ,oa deZpkjh dks vko';d funsZ'k fn;k tk;sxkA jkT; Lrj ds
izosZ{kh inkf/kdkjh }kjk ftyksa ds Hkze.k ds nkSjku bl ij dM+h fuxjkuh j[kh tk;sxhA
lcaf/kr {ks=h; eysfj;k inkf/kdkjh ,oa ftyk dk;Zdze inkf/kdkjh dks fNM+dko dh
'kr izfr'kr xq.koÙkk lqfuf'pr djkus dk nkf;Ro fn;k tk;sxkA
Qjojh&ekpZ] 2009 esa dkyktkj MhñMhñVhñ fNM+dko gsrq izLrkfor ctV dk ljka'k % &
Ekn jkf'k ftyk dk;ZØe inkñdks dkyktkj
izHkkfor ftyksa ds fooj.kh
vuqlkj
1- etnwjh 6]12]65]160@& rFkSo
2- ¼i½ dk;kZy; O;;
2]67]300@& rFkSo
¼ii½ vkDlfedrk O;;
2]67]300@&
3- MhñMhñVhñ

tgkW rd Hkkjr ljdkj QSeyh odZj dks izksRlkgu jkf'k nsus laca/kh izLrko
nsus dk lq>ko gS] rks bl fufer vk'kk dk;ZdÙkk dks izksRlkgu jkf'k nsus dks
izko/kku ctV esa fd;k x;k gSA blds vfrfjDr vU; Health activist }kjk
dkyktkj ds lEHkkfor jksxh yk;s tkus ij jksxh dks dkyktkj jksx lEiq"V
gksus ds mijkUr iq.kZ fpfdRlksijkUr izksRlkgu jkf'k fn;k tk;sxkA
¼2½ {kfriwfrZ jkf'k % &
dkyktkj ds vf/kdka'k jksxh xjhc oxZ ds gksrs gS] tks etnwjh dj viuk thou fuokZg
djrs gSA ,sls yksx >qXxh&>ksiM+h esa lqnwj nsgrh bykdksa esa jgrs gS] tgk¡ ls bykt gsrq
ljdkjh vLirkyksa eas vkus esa dfBukbZ ds vfrfjä bykt djkus ds fy, ljdkjh
vLirky esa fpfdRlk ds nkSjku 20&30 fnuksa rd jguk iM+rk gSA ftlls mudk nSfud
etnwjh ckf/kr gks tkrk gS vkSj mUgsa vkfFkZd ladV dh nksgjh ekj gks tkrh gSA nSfud
etnwjh rks ugha feyrh] vyx ls bykt ij Hkh O;; gks tkrk gSaA ifj.kkeLo:I
dkyktkj ds ,sls jksxh ljdkjh laLFkkuksa esa fpfdRlk vof/k ¼vf/kdre 30 fnu½ rd
Je {kfriwfrZ jkf'k nh tk,xhA
izLrkfor jkf'k & dkyktkj jksfx;ksa dh la[;k×fpfdRlk vof/k×{kfriwfrZ jkf'k
¾33]000X30X50¾Rs. 4]95]00]000@& ¼ifjf'k"V V LraHk 6 nz"VO;½
¼3½ iz[k.M vLirky es 'k';k dk foLrkj % &
{ks=k Hkze.k ds nkSjku ,slk ik;k x;k gS fd izkñLokñ dsUnz ds vLrirkyksa esa 'k';k dh
deh ds dkj.k dkyktkj ds ejhtksa dks tehu ij foLrj yxkdj bykt fd;k tkrk
gS] tks fpfdRlk dh n`f"V ls mfpr ugha gSA dkyktkj jksx ds lHkh jksfx;ksa dks 'k';k
miyC/k gks ldsa bl n`f"V ls izR;sd izkñLokñ dsUnz ds vLirkyksa esa vfrfjä nl 'k';k
yxk;k tk;A fnukad 29&30 fnlEcj] 2008 dks vk;ksftr cSBd esa Hkh bl fcUnq ij
lgefr cuh FkhA
bl fufer ,d 'k';k ds fy, vuqekfur jkf'k 1]000@& #i;s izfr 'k';k ¼Bed with
Mattress) dk izko/kku fd;k x;k gSA
izLrkfor jkf'k & dkyktkj izHkkfor iz[k.Mksa dh la[;k×'k';k ×nj ¾
310X10 X1]000 ¾Rs. 31]00]000@& ¼ifjf'k"V V LraHk 7 nz"VO;½
¼4½ iosZ{k.k % &
Dkyktkj ds fu;a=k.k esa iosZ{k.k ,d egRoiw.kZ fgLlk gSA ;fn iwjs o"kZ esa ftyk Lrj ,oa
iz[k.M Lrj ls l{ke iosZ{k.k fd;k tk, rks dkyktkj ds fu;a=k.k dk y{; izkIr fd;k
tk ldrk gSA iosZ{k.k ds rgr~ MhñMhñVhñ fNMdko] jksfx;ksa dk fpfdRlk] vuqJo.k]
izfrosnuksa dk lle; izs"k.k bR;kfn vkrs gSA o"kZ esa nks pØ MhñMhñVhñ fNMdko vof/k
vFkkZr~ 4 ekg ds iosZ{k.k dk ctV izko/kku vkbñvkjñ ,lñ ds rgr~ fd;k x;k gSA 'ks"k
vkB ekg ds iosZ{k.k gsrq mipkjkRed dkjZokbZ esa izko/kku fd;k tkuk gSA
iosZ{k.k dk nkf;Ro ftyk Lrj ij ftyk dk;ZØe inkf/kdkjh ,oa iz[k.M Lrj ij
iz[k.M fpfdRlk inkf/kdkjh dk gSA jkT; ds 31 dkyktkj izHkkfor ftyksa eas ek=k 20
ftysa esa gh ftyk eñinkf/kdkjh dk in l`ftr gS 'ks"k 11 ftyksa esa bUgha ftyk eysfj;k
inkf/kdkjh ds v/khu vkrs gSA lQy iosZ{k.k dh n`f"V ls izR;sd ftyk esa ,d ftyk
Lrjh; ios{k.kh inkf/kdkjh gksuk pkfg,A bl fufer 20 ftyksa ds iosZ{k.k dk nkf;Ro
ftyk eysfj;k inkf/kdkjh dks] 9 ftyksa ds vij eq[; fpfdRlk inkf/kdkjh dks rFkk
'ks"k nks ftysa ¼[kxfM+;k vkSj e/ksiqjk½ ds flfoy ltZu fn;k tk jgk gSA
fNM+dko vof/k ¼pkj ekg½ esa iosZ{k.k ds fy, jkf'k dk izko/kku layXu ifjf'k"V IV esa
fn;k x;k gSA 'ks"k vkB ekg ds fy, jkf'k dk izko/kku layXu ifjf'k"V V esa fd;k x;k
gSA ifjf'k"V V ds LraHk 8 esa flfoy ltZu e/ksiqjk ,oa [kxfM+;k dks 3]000@& izfr
ekg dh nj ls ifjf'k"V V ds LraHk 9 eas vij eq[; fpfdRlk inkf/kdkjh ¼vjfj;k]
vjoy] ckadk] cDlj] tgkukckn] fd'kuxat] y[khljk;] f'kogj ,oa lqikSy½ dks #i;s
10]000 @& #i;s izfr ekg dh nj ls rFkk 'ks"k 20 ftyksa ds ftyk eysfj;k
inkf/kdkjh dks #i;s 10]000@& izfrekg dh nj ls jkf'k dk izko/kku fd;k x;k gSA
332

eysfj;k ,oa dkyktkj ;kstuk ds lQy lapkyu esa ;kstuk esa dk;Zjr eysfj;k
fujh{kdksa dh vge~ Hkwfedk gksrh gSA izR;sd ftysa eas inkLFkkfir eysfj;k fujh{kd ds nks
;k rhu iz[k.Mksa ds dk;Z dk nkf;Ro gSA vr% iz[k.M Lrj ij iosZ{k.k gsrq eysfj;k
fujh{kd dks eksVj lkbZfdy miyC/k djkus dk izko/kku fd;k tk jgk gSA jkT; ds
dkyktkj izHkkfor 31 ftyksa esa 21 ftyk es eysfj;k inkf/kdkjh dk;kZy; vofLFkr gSA
bu 21 ftyksa eysfj;k inkf/kdkjh dk;kZy; esa ls 18 ftyksa esa inLFkkfir eysfj;k
fujh{kd izfr ftyk nks eksVj lkbZfdy rFkk 3 ftyk ¼lgjlk] iwf.kZ;k rFkk eqaxsj½ dks
izfr ftyk 3 dh nj ls eksVjlkbZfdy nsus dk izLrko fn;k tk jgk gSA bl rjg dqy
¼18×2+3×3½ ¾ 45 eksVj lkbZfdy ds Ø; dk izLrko gSA ,d eksVlkbZfdy dh dher
50]000@ & #i;s j[kk x;k gSA
eysfj;k fujh{kd dks eksVj lkbZfdy ij izfrekg 30 yhVj izfr eksVj lkbZfdy
izfrekg dh nj ls nsus dk izLrko gSA ftlds fy, #i;s 50@& izfr yhVj dh nj ls
jkf'k dk vkdyu ifjf'k"V V esa fd;k x;k gSA
blds vfrfjDr i;Zos{k.k gsrq Hkkjr ljdkj }kjk izR;sd dkyktkj izHkkfor ftyks esa
dkyktkj rdfudh ¼KTS½ dk 6 in l`ftr djus dk funs'k fn;k x;k gSA bl rjg
31 dkyktkj izHkkfor ftyks esa 186 ¼KTS½ ds in ds l`tu ,oa fu;qfDr ifdz;kUrxZr
gS ¼KTS½ dks izfrekg 10]000@& :i;s osru fn;k tk;sxkA ftlds fy, jkf'k dk
izko/kku fd;k tk jgk gSA pwfd fo'o cSd }kjk ¼KTS½ dks dkyktkj dk;Zdze esa j[kk
tk jgk gS vr% blij gksus okys O;; dk ogu fo'o cSd }kjk djus dk izko/kku gSA
izLrkfor jkf'k bl izdkj gS % &
¼a½ nks flfoy ltZu dks #i;s 3]000@&
izfrekg dh nj ls vkB ekg ds fy, &
¼b½
¼c½
¼d½
¼e½
¼3]000 ×2×8½ ¾ 48]000@&
9 ftyksa ds vij eq[; fpfdRlk inkf/kdkjh
dks #i;s 3]000@& izfrekg dhnj ls vkB
ekg ds fy, ,oa 20 ftyksa dks ftyk
eysfj;k inkf/kdkjh dks & 29 ×10]000×8 ¾ 23]20]000@&
eysfj;k fujh{kd ds eksVj lkbZfdy Ø; gsrq
izfr eksVjlkbZfdy #i;s
50]000@& dh nj ls 45 ×50]000 ¾ 22]50]000@&
eksVjlkbZfdy ds fy, isVªkWy [kjhn gsrq
izfr eksVjlkbfdy izfrekg 30 yhVj #i;s 50@&izfryhVj
45 ×30×50×12 ¾ 8]10]000@&
186 dkyktkj rduhdh i;Zsos{kd dks
:i;s 10]000@&izfrekg dh nj ls 12 ekg ds fy,
186X10]000X12
= 2]23]20]000@&
dqy ;ksx
= 2]77]48]000@&:i;s
¼5½
¼ifjf'k"V V LraHk 8] 9] 10 rFkk 11 nz"VO;½
eksVj lkbZfdy ds Ø; ds mijkar ,d c"kZ ds lfoZfalax bR;kfn dh xkjaVh dEiuh }kjk
nh tkrh gSA vr% o"kZ 2009&10 esa j[k&j[kko ds fy, jkf'k dk izko/kku ugha fd;k
x;k gSA
dkyktkj dh nok ,EQksVsjhlhe ohñ dk HkaMkj.k O;oLFkk % &
dkyktkj jksfx;ksa ds fpfdRlk gsrq Hkkjr ljdkj }kjk ,lñ,lñthñ ,EQkVsjhlhu oh
dh nok dh vkiwfrZ dh tkrh gSA ,EQkVsjhlhu nok dh ,d fu/kkZfjr rkiØe ¼2 ls 8 0
C½ ij j[kk tk tkuk gS] vU;Fkk nok dh {kerk dsa Ðgkl gksus dh laHkkouk gSA
fu/kkZfjr rkiØe ij nok HkaMkj.k ds fy, 'khr J`[kyk@'khrx`g gh mi;qä gSA
333

ftu ftyksa esa 'khr J`[kyk miyC/k gS bu ftyksa ds flfoy ltZu nok dks 'khr J`[kyk
esa j[ksaxsA ftu ftyksa esa 'khr J`[kyk miyC/k ugha gS mu ftyksa esa 'khr x`g ¼Cold
Storage½ esa nok j[kus dk izLrko gSA bl fufer izR;sd ftys dks mä nok HkaMkj.k
gsrq ¼'khr J`[kyk miyC/k ugaha jgus ij dksYM LVksjst HkkM+s ij ysus gsrq½ #i;s
500@& izfrekg dh nj ls ,d o"kZ ds fy, jkf'k dk izko/kku fd;k x;k gSA jkT;
Lrj ij ¼jkT; dk;ZØe inkf/kdkjh½ Hkh mä nok ds HkaMkj.k gsrq 'khr x`g dh
vko';drk gS] ftlds fy, #i;s 1500@& izfr ekg dh nj ls jkf'k dk izko/kku
fooj.kh V LraHk 12 esa esa fd;k x;k gSA
izLrkfor jkf'k &
¼1½ ftyk Lrj ij HkaMkj.k gsrq #i;s 500 @& izfrekg
dh nj ls ,d o"kZ ds fy, 31 X 500X 12 ¾ #i;s 1]86]000@&
¼II½ jkT; Lrj ij HkaMkj.k gsrq #i;s 1]500 @& izfrekg
dh nj ls ,d o"kZ ds fy, 1]500X 12 ¾ #i;s 18]000@&
¼ifjf'k"V V LraHk 12 nz"VO;½
6- fpfdRlk dkMZ % &
dkyktkj jksfx;ksa ds fpfdRlk ds Øe esa nh tkusokyh nok ds [kqjkd dk
ys[kk&la/kkj.k ,oa fpfdRlk C;ksjk ds fy, fpfdRlk dkMZ dk mi;ksx fd;k tkuk
vko';d gS orZeku esa fpfdRlk dkMZ dk mi;ksx ftyk Lrj ds vLirky ls ysdj
iz[k.M Lrj ij ugha fd;k tk jgk gS] ftlds dkj.k rduhdh ewY;kadu eas dfBukbZ
gksrh gSA 'kh"kZ Lrj ij Hkh fpfdRlk dkMZ la/kkj.k ugha fd;s tkus ij fpark trkbZ xbZ
gSA
vr% fpfdRlk dkMZ ds mi;ksx dh egÙkk dks ns[krs gq, izfr jksxh 2 izdkj ds dkMZ dh
vko';drk gksxhA ,d dkMZ dh NikbZ eas vuqekfur #i;s 2-50 O;; gksxkA bl rjg
,d ¼,d jksxh ds fy, nks dkMZ ds fglkc ls ½ izfr jksxh ij 5@& #i;s O;; gksxkA
ifjf'k"V V LraHk 4 esa o"kZ 2009 ds laHkkfor jksfx;ksa dh la[;k ds vuqlkj LraHk 13
esa ftykokj jkf'k dk vkdyu fd;k x;k gSA
izLrkfor jkf'k & jksfx;ksa dh la[;k nj ¼33]00X 5½ ¾ #i;s 1]65]000@&
¼ifjf'k"V V LraHk 13 nz"VO;½
7- dkyktkj jksfx;ksa dk lwpuk la/kkj.k iath % &
dkyktkj jksfx;ksa ds foLr`r lwpuk ds la/kkj.k ,oa {ks=kh; Je {kfriwfrZ Hkkx ds
la/kkj.k gsrq izR;s dkyktkj izHkkfor iz[k.M esa nks jftLVj j[kus dk izko/kku fd;k
x;k gS rkfd 'kh"kZ Lrj ds inkf/kdkjh }kjk Hkze.k ds nkSjku jksfx;ksa dh foLr`r lwpuk
,oa nSfud Je {kfriwfrZ jkf'k dk ewY;kdau fd;k tk ldsaA bl fufer izR;sd dkyktkj
izHkkfor ftys ds dkyktkj izHkkfor izk- Lok- dsUnz dks nks jftLVj ¼,d ftLrk dk½
vuqekfur dher #i;s 50@& ¼nks jftLVj½ dh nj ls jkf'k dk vkdyu fd;k x;k
gSA
izLrkfor jkf'k & 31 ftyk ds dkyktkj izHkkfor izk- Lok- dsUnz dh la[;k × nj
310X50 ¾ 15]500@&
¼ifjf'k"V V LraHk 14 nz"VO;½
8- MhñMhñVhñ dk Hk.Mkj.k % &
MhñMhñVhñ fNM+dko ds fy, Hkkjr ljdkj }kjk ftyksa esa MhñMhñVhñ dh vkiwfrZ dh tkrh
gSA ftyksa es MhñMhñVhñ ds Hk.Mkj.k dh leqfpr O;oLFkk ugha jgus ds dkj.k MhñMhñVhñ
{kfrxzLr ¼/kwi ,oa ikuh ls½ gksus dh laHkkouk gSA leqfpr Hk.Mkj.k O;oLFkk dks eísutj
j[krs gq, ;k rks Hk.Mkj] HkkM+s ij fy;k tk; ;k ftyksa ds miyC/k jkT; HkaMkj fuxe
ds xksnke esa j[kk tk;A
Pkw¡fd ftyksa dks HkkM+s ij HkaMkj ysus esa fu;ekuqlkj iz'kklfud Lohd`fr ysus es dkQh
dfBukbZ gksrh gSA Qyr% tc rd HkaMkj.k dh O;oLFkk ugha gksrh gSA rc rd
334

MhñMhñVhñ dks ;=&r= j[kuk iM+rk gSA bl fufer HkkM+s ij xksnke ysus vFkok jkT;
HkaMkj fuxe ¼ftldk nj ljdkj }kjk vuqeksfnr gS½ ds xksnke esa HkaMkj.k gsrq izfr
ftyk izfr ekg #i;s 5]000@& dh nj ls iwjs o"kZ ds fy, jkf'k dk izko?kku fd;k
x;k gSA
izLrkfor jkf'k & 31X 5000X 12 ¾ 18]60]000@&
¼ifjf'k"V V LraHk 15 nz"VO;½
9- dkyktkj [kkst Ik[kokjk& dfri; dkj.kks ls lHkh dkyktkj ds jksxh dk iÙkk ugh
py ikrk gS ftlls dkyktkj mUewyu y{; izkIr ugh gks jgk gSA dkyktkj o"kZ
fnlEcj esa 15 fnuks dk [kkst Ik[kokjk eukus dk izLrko gSA[kkst Ik[kokjk jkT; ds 31
dkyktkj izHkkfor ftyks ds lHkh iz[k.Mks esa euk;k tk;sxkA
[kkst i[kokjk ds egRrk dks vke tu ds tkudkjh gsrq [kkst Ik[kokjk ds iwoZ pkj fnu
izpkj xkM+h lHkh iz[k.Mks esa Hkstdj izpkj izlkj fd;k tk;sxk blds vfrfjDr lHkh
iz[k.Mks esa iksLVj] iEiysV] cSuj bR;kfn ds }kjk Hkh [kkst i[kokjk ds laca/k esa izpkj
izlkj fd;k tk;sxkA bl fufer vko';d jkf'k dk izko/kku otV izkdDyu esa fd;k
x;k gSA izpkj xkM+h gsrq :i;s 750@& izfr izk0Lok0dsUnz dh nj ls 4 fnuks ds fy,
jkf'k dk izko/kku fd;k x;k gSAizkLrkfor jkf'k bl izdkj gS%&
izpkj okgu gsrq 338 iz[k.Mks ds fy, :i;s 750@&
izfr okgu dh nj ls 4 fnuksa ds fy,& ¼338X750X4½ & 10]14]000@&
iksLVj] iEiysV cSuj gsrq izfr izk0Lok0 dsUnz :i;s 1000@&
dh nj ls &¼338X1000½ & 3]38]000@&
dqy
& 13]52]000@&
10- Arrest Cases of Kalazar & o"kZ 2010 rd dkyktkj Elemenation y{; dks izkIr
djus ds fy, lHkh dkyktkj jksfx;ks dks iw.kZ mipkj fd;k tk;sxk rFkk izHkkfor {ks=ks
esa fujks/kkRed dkjokbZ ds rgr o"kZ esa nks okj Mh0Mh0Vh0 fNM+dko djk;k tk;sxkA
blds vfrfjDr [kkst Ik[kokjk ds }kjk dkyktkj jksfx;ks dh [kkst dj fpfdRlk dh
tk;sxhA vk'kk dk;ZdÙkkZ dks dkyktkj ds lEHkkfor dks ljdkjh vLirky esa ykdj]
dkyktkj ds jksx lEiq"V gksus ,oa iw.kZ fpfdRlk ds mijkUr izksRlkgu jkf'k nh tk;sxhA
bl rjg dkyktkj dsl dks lekIr fd;k tk ldrk gSA
11- izLrkfor jkf'k dk enokj fooj.k % &
1- izksRlkgu jkf'k & 33]00]000@&ftyk dk;ZØe inkñ dks
2- nSfud Je {kfriwfrZ jkf'k 4]95]00]000@& rFkSo
3- iz[k.M vLirky ds 'k';k foLrkj 31]00]000@& rFkSo
4- IkosZ{k.k 2]77]48]000@& rFkSo
5- nok dk Hk.Mkj.k 1]86]000@& rFkSo
18]000@& jkT; dk;ZØe inkñ dks
6- fpfdRlk dkMZ 1]65]000@& ftyk dk;ZØe inkñ dks
7- lwpuk la/kkj.k iath 15]500@& rFkSo
8- MhñMhñVhñ dk HkaMkj.k 18]60]000@& rFkSo
9- dkyktkj [kkst i[kokjk 13]52]000@&
dqy ;ksx 8]72]44]500@&
¼vkB djksM+ cgrj yk[k pkSvkfyl gtkj ik¡p lkS #i;s ek= ½
¼ifjf'k"V V nz"VO;½
335

(x) jkT; Lrjh; dEiksusUV
(jkT; dk;Z e inkf/dkjh dk;kZy; ds fy,)
1- jkT; LVh;jhx dfeVh %& dkyktkj ds liQy lapkyu dh n‘f"V ls le;&le; ij ’kh"kZ Lrjh;
inkfŁkdkfj;ksa ds ijke’kZ dh vko’;drk gksrh gSA bl n‘f"V ls jkT; jkT; ij ,d State Stearing
Committee ds xBu dh vko’;drk eg’kwl dh xbZ gS A bl dfeVh esa fodkl vk;qDr] LokLF;
vk;qDr] funs’kd izeq[k Lok- lsok;s] jkT; dk;Zdze ink- rFkk Hkkjr ljdkj ds ’kh"k ink- Hkh ’kkfey
jgsxs A
le;&le; ij mDr xfBr dfeVh ds cSBd vk;kstu djus ,oa cSBd ds vk;kstu esa
gksus okys O;; dh n‘f"V ls jkf’k dk izko/ku fd;k x;k A dfeVh dh cSBd o"kZ esa de ls de rhu
ckj djkus dk izLrko gS A
izLrkfor jkf’k & Rs. 30,000/-
(Rs. 10,000 izfr cSBd × 3 )
[ foij.kh VI dafMdk 1 nz"VO; ]
2. czkaM ,sEcsLMj
dkyktkj ds jksdFkke dh n‘f"V ls le;&le; ij ekuuh; iz/ku ea=kh @ eq[; ea=kh @ vU; x.kekU;
usrk @ vfHkusrk }kjk izpkj dk;Z vko’;d izrhr gksrk gS A bl fufer jkf’k dk izLrko gS ftldks O;;
izpkj dk;Z ij gksxk A
izLrkfor jkf’k & Rs. 50,000/-
[ fooj.k VI dafMdk&2 nz"VO; ]
3. dEI;wVj
jkT; dk;Z e ink- dk;kZy; esa dk;Z e laca/h dk;Z ds lqpk: :i ls fu"iknu dh n‘f"V ls ,d MsLd
VkWi dEI;wVj (;w-ih-,l- ds lkFk) dh vko’;drk gS A bl fufer jkf’k izLrko gS A
izLrkfor jkf’k & Rs. 50,000/-
[ fooj.kh VI dafMdk&3 nz"VO; ]
4. ySi VkWi
jkT; Lrj ij vofLFkr jkT; dk;Z e ink- esa rhu ink- ;Fkk jkT; dk;Z e ink-] mi eq[; eysfj;k
ink- ,oa lgk;d funs’kd dkyktkj inLFkkfir gS ftuds }kjk dk;Z e dk lapkyu fd;k tkrk gSA bu
rhuksa inkfd/kjh dks l le; lHkh rjg dh lwpuk j[kus @ ’kh"kZ inkf/dkfj;ksa dks lwpuk miyC/
djkus gsrq rhu ySi VkWi dh vko’;drk gS A ftlds fy, jkf’k dk izLrko gS A izfr ySi VkWi Rs.
50,000/- dh nj ls ; dk izLrko izLrkfor jkf’k Rs. 50,000 × 3 -------Rs. 1,50,000/-
[ fooj.kh VI dafMdk 4 nz"VO; ]
5. eksckby iQksu
dkyktkj dk;Z dh lqxerk ,oa deZpkjh ink- ds chp lh/k lEidZ dh n‘f"V ls eksckby iQksu ds ;
dk djus dk izLrko gS A jkT; dk;Zdze ink- dk;kZy; esa dk;Zjr rhu ink-] rduhdh ’kk[kk esa pkj]
LVksuks ,d iz/ku fyfid ,oa ys[kkiky ,d (dqy nl) eksckby iQksu ds ; dk izLrko gSA izfr
eksckby Rs. 2000/- dh nj ls jkf’k dk izko/ku fd;k x;k gSA
eksckby ds e ds mijkUr izfrekg dqiu ij gksus okys O;; ij izfr eksckby Rs. 337/- dh nj ls
12 ekg ds jkf’k dk izLrko gSA
336

izLrkfor jkf’k &
nl eksckby ; ---------- 10 × 2000---------- Rs 20,000/-
eksckby ij ekfld O;;------- 10 × 337 × 12 ------ Rs.40,440/-
dqy Rs. 60,440/-
[ fooj.kh VI, dafMdk & 5 ]
6. ystj izhaVj
jkT; eq[;ky; vofLFkr jkT; dk;Z e ink- dk;kZy; gsrq ystj izhaVj ftlds rgr iQksu] iQSDl] Ldsuj
lfgr] ; dk izLrko gS A ftlds ; gsrq jkf’k dk izLrko gS A
izLrkfor jkf’k---------------------- Rs. 25,000/-
[ fooj.kh VI, dafMdk& 6 ]
7. iQksVks dkWih e’khu
jkT; eq[;ky; esa iQksVks dkWih e’khu miyC/ ugha gS A ;kstuk ds dk;Z lEiknu esa iQksVks dkWih djkuk
iM+rk gS ftls LFkkuh; cktkj ls djk;k tkrk gS A bls [kpZ Hkh vf/d gksrk gS lkFk gh dfBukbZ Hkh A
vr% dk;Z lqyHkrk dh n‘f"V ls jkT; eq[;ky; gsrq ,d iQksVks dkWih e’khu dh vko’;drk gS ftlij
gksus okys O;; dk izko/ku ctV esa fn;k tk jgk gS A
izLrkfor jkf’k------------------- Rs. 1,50,000/-
8. jkT;Lrj ij cSBd vk;kstu
dk;Z e ds lapkyu esa ftyk dk;Z e ink- ds lkFk leh{kkRed cSBd djuk vko’;d gksrk gS A
cSBd esa dk;Z e ds laca/ esa ftykokj foLr‘r leh{kk dh tkrh gS rFkk dk;Z e ds lapkyu ds laca/
esa vxzrj dkjZokbZ gsrq Hkh fn’kk funs’k r; fd;k tkrk gS A
jkT; Lrj o"kZ esa de ls de rhu ckj cSBd vk;ksftr djus dk izLrko gS A izR;sd cSBd esa Rs.
10,000/-O;; gksus dh laHkkouk gS A bl fufer jkf’k dk izko/ku ctV esa fd;k x;k gS A
izLrkfor jkf’k -------------------- 3 × 10,000 --------------------- Rs. 30,000/-
9. bUVjusV lqfo/k
jkT; eq[;ky; es a vofLFkr dEI;wVj esa bUVjusV lqfo/k vko’;d gS A blds vfrfjDr dk;kZy; ds
dEI;wVj ds j[k j[kko ij Hkh O;; gksxk A vr% bUVjusV lqfo/k ,oa dEI;wVj ds j[k j[kko ij gksus
oyks O;; ds fy, ctV esa jkf’k dk izLrkfor fn;k tk jgk gS A
izLrkfor jkf’k----------------------- Rs. 30,000/-
10. iosZ{k.k
ftyk Lrj ds dk;Z e ink- ds ios Z{k.k gsrq ctV [k.M ^d* esa vkbZ-vkj-,l- es a pkj ekg ds fy, rFkk
ctV [k.M ^[k* esa vkB ekg ds fy, jkf’k izLrkfor gS A
jkT; Lrj ij ds inkf/dkfj;ksa ds ios Z{k.k ij gksus okys O;; ds fy, vko’;d jkf’k dk izko/ku ctV
esa fn;k tk jgk gS A jkT; Lrj ij jkT; dk;Z e ink- dk;kZy; esa inLFkkfir rhu ink- }kjk dk;Z e
dk ios Z{k.k fd;k tkuk gS A jkT; eq[;ky; es a ek=k ,d xkM+h gS og Hkh pkyq gkyr esa ugha gS A vr%
miyC/ xkM+h ds ejEerh ,oa HkkM+s ij xkM+h ysdj iosZ{k.k fd;k tk;xk A ftlds fufer izfr inkizfrekg
fd Rs. 2500 dh nj ls jkf’k dk izLrko gS A
izLrkfor jkf’k---------------------------- 3 × 2500 ×12 -------------------- Rs. 90,000/-
xkM+h ejEerh gsrq------------------------------------------------------------------- Rs. 10, 000/-
337

[ fooj.kh VI dsfMdk----------------- 10 nz"VO; ] dqy Rs. 1,00,000/-
11. tsujsVj lqfo/k
jkT; eq[;ky; esa fctyh ckf/r gksus ij dk;Z dk lEiknu can gks tkrk gSA bl fufer ,d tsujsVj
; dk izLrko gS A tsujsVj ds ; ,oa izfrekg mlds fy, ba/u ij gksus okys O;; ds fy, ctV esa
jkf’k dk izko/ku fd;k x;k gS A
izLrkfor jkf’k--------------------------------------------------- Rs. 50, 000/-
tsujsVj ds ba/u gsrq Rs. 4000/- izfr
ekg dh nj ls (12 × 400) --------------------------- Rs. 48,000/-
;ksx Rs. 98,000/-
(fooj.kh VI ---- dafMdk 11 nz"VO;)
12. izpkj&izlkj
le;&le; ij dkyktkj ds laca/ esa tula/kj.k esa tudkjh nSfud lekpkj i=k] jsfM;ks] Vh-ohbR;kfn
ds ekŁ;e ls nsuk vko’;d gS A lHkh ftyks ds dkyktkj izHkkfor xkoks esa fNM+dko dh frfFk
dh lwpuk LFkkuh; yksdfiz; nSfud lekpkj Ik=kks esa nks fnu izdkf’kr fd;k tk;sxkA bl fufer ctV
esa jkf’k dk izko/ku fd;k x;k gS A
dqy izLrkfor jkf’k---------------------------------------------- Rs. 4,00,000/-
(fooj.kh VI--- dafMdk& 13 nz"VO;)
13. {ks=kh; eysfj;k dk;kZy; gsrq
eysfj;k ;kstuk esa iwjs jkT; esa pkj {ks=kh; eysfj;k ink- dk dk;kZy; gSA {ks=kh; e- ink- }kjk vius
{ks=kk/hu feyksa ds liQy iosZ{k.k dh n‘f"V ls HkkM+s ij xkM+h ysus gsrq jkf’k dk izLrko gS ftlds rgr
izfr {ks- e- ink- 20]000@& dh nj ls jkf’k dh izko/ku fd;k tk jgk gS A
blds vfrfjDr {ks=kh; eysfj;k dk;kZy; esa ,d&,d dEI;wVj ; dk Hkh izLrko gS ftlls lacaf/r
{ks- e- ink- vius v/huLFk ftyksa dk v|ru fLFkfr dk O;ksjk j[ksxs rFkk izR;sd lIrkg fLFkfr ls
jkT; eq[;ky; dks voxr djk;sxs A
izLrkfor jkf’k &
ios Z{k.k ------------------------- 20,000 × 4 ------------------ 80,000/-
dEI;wVj ;----------------- 50,000 × 4 ------------------ 2,00,000/-
dEI;wVj ds j[k j[kkc---- 5000 × 4 ------------------ 20,000/-
dqy 3,00,000/-
izLrkfor ctV dk enokj fooj.kh
1- jkT; LVh;jhx dfeVh -------------------------- Rs. 30,000/- jkT; dk;Z ; ink- gsrq
2- czkaM ,EosLMj ------------------------- Rs. 50,000/- ]]
3- dEI;wVj ------------------------- Rs. 50,000/- ]]
4- ySi VkWi ------------------------ Rs. 1,50,000/- ]]
5- eksckby iQksu ------------------------ Rs. 60,440/- ]]
6- ystj izhVj ------------------------ Rs. 25,000/- ]]
7- iQksVks dkWih e’khu ------------------------ Rs. 1,50,000/- ]]
338

8- cSBd (jkT; Lrjh;) ------------------------- Rs. 30,000/- ]]
9- bUVjusV lqfo/k ------------------------- Rs. 30,000/- ]]
10- iosZ{k.k ------------------------- Rs. 1,00,000/- ]]
11- tsujsVj ------------------------- Rs. 98,000/- ]]
12- izpkj&izlkj ------------------------- Rs. 4,00,000/- ]]
13- {ks- e- ink- dk;Zy; gsrq ------------------------- Rs. 3,00,000/- ]]
dqy;ksx Rs. 14,73,440/-
(?k) izf’k{k.k & dkyktkj Elemination y{; 2010 dh izfIr dh n‘f"V ls jkT; ds lHkh Lrj ds LokLF;
foHkkx esa inLFkkfir fp- inkf/dkfj;ksa] eysfj;k ;kstuk esa dk;Zjr lHkh Lrj ds ikjk esfMdy dfeZ;ksa
dk izf’k{k.k vko’;d izrhr gksrk gS rkfd fujks/kRed ,oa mipkjkRed dkjZokbZ esa mudk lf ;
lg;ksx fey lds A blds vfrfjDr LokLF; loxZ ds dqN vU; ikjk esfMdy dfeZ;ksa iapk;fr jkT;
ds lnL;ksa ,oa cgqnsf’k; dk;Z kk (vk’kk) Hkh fujks/kRed ,oa mipkjkRed dkjZokbZ ds fy, izf’kf{kr
djuk vko’;d izrhr gksrk gSA
bl n‘f"V dks.k ls Hkkjr ljdkj }kjk fn;s x;s fn’kk funs’k ds vuqlkj izf’k{k.k dk;Z e dh :ijs[kk
rS;kj dh xbZ gS] ftls layXu ifjf’k"V VII esa ns[kk tk ldrk gS A ifjf’k"V VII esa ftykokj eysfj;k
;kstuk ljdkjh vLirky ds fpfdRldks ,oa vU; LokLF; lEoxZ ds ikjk esfMdy dfeZ;k iapk;rh
jkT; ds lnL;ksa ds izf’k{k.k dk ctV izkdyu rS;kj fd;k x;k gS A izf’k{k.k izLrko foLr‘r fooj.k
bl izdkj gS &
1. eysfj;k ;kstuk ds eysfj;k fujh{kdksa dk izf’k{k.k
jkT; ds 31 dk;kZy; izHkkfor ftyksa esa dqy 114 e- fu- dk;Zjr gS A Hkkjr ljdkj ds fn’kk funs’kd
ds vuqlkj 20 izf’k{k.kkfFkZ dks ,d oS/ esa izf’k{k.k fn;k tk;xk A bl rjg dqy 6 cSp gksxs A
izf’k{k.k vof/ 1 fnuksa dh gksxh A
o"kZ esa nks ckj izf’k{k.k nsus dk izLrko gS A ,d cSp ds izf’k{k.k ij dqy O;; 69,500/- :- gksxkA
bl rjg iwjs o"kZ esa 6 cSp dks nks okj izf’k{k.k ij dqy O;;
2 × 6 × 69, 500/-------------- Rs. 8,34,000/-
(ifjf’k"V VII LrEHk 4 nz"VO;)
2. iz;ksx’kkyk izkosf/d
eysfj;k ;kstukUrxZr 31 dkyktkj izHkkfor ftyksa esa dqy 47 iz;ksx’kkyk izkoSf/d dk;Zjr gS A 20
izf’k{k.kFkksZ ds fglkc ls dqy 2 cSp dks 10 fnuksa dk izf’k{k.k fn;k tk;xk A ,d cSp ds izf’k{k.k
ij dqy O;; 1,25,000/- gksxk A
ifjf’k{k.k ij izLrkfor O;;------------ 2 × 1,25, 000@&------------ Rs. 2,50,000/-
iz;ksx’kkyk izkosfNd dks Re Orientation izf’k{k.k Hkh fn;k tk;xk A ftlesa 2 cSp ds izf’k{k.kkFkksZ
dks 5 fnuksa dk izf’k{k.k fn;k tkuk gS A ,d cSp ds izf’k{k.k ij 75,620/- O;; gksxk A
Orientation dkslZ ij izLrkfor ;-------- 2 × 75, 620 ------------ Rs. 1,51,240/-
iz;ksx’kkyk izkoSfNd ds izf’k{k.k ij dqy O;; ----------- Rs. 4,01,240/-
(ifjf’k"V VII LrEHk 6] 7 nz"VO;)
3. cqfu;knh Lok- fujh{kd ,oa fuxjkuh fujh{kd
jkT; ds 31 dkyktkj izHkkfor ftyksa esa eysfj;k ;kstuk ds 118 cqfu;knh Lok- fujh{kd ,oa 18
339

fuxjkuh fujh{kd dk;Zjr gS A bl rjg 136 izf’k{k.kFkhZ dks 27 izfr cSp vuqlkj 5 oSp esa izf’k{k.k
fn;k tk;xkA ;g izf’k{k.k nks fnuksa dk gksxk A izf’k{k.k ij izfr oSp 30,000 :- O;; dk izLrkohr
gS A
izLrkfor jkf’k------------------- 5 × 30, 000 ----------- Rs. 1,50,000/-
(ifjf’k"V VII LrEHk 11 n‘"VO;)
4. Lok- dk;Zd kkZ dk izf’k{k.k
jkT; ds eysfj;k ;kstukUrxZr 31 dkyktkj izHkkfor ftyksa esa dqy 103 cqfu;knh Lok- dk;Zd kkZ] 33
fuxjkuh dk;Zd kkZ] 43 {ks=kh; dk;Zd kkZ rFkk 19 Js- {ks- dk;Zd kkZ dk;Zjr gSA bl rjg dqy 198
dk;Zjr dks izf’kf{kr fd;k tkuk gS A 25 izf’k{k.kkFkhZ izfr oSp dh nj ls 8 oSp esa izf’k{k.k fn;k
tk;xkA izf’k{k.k vof/ nks fnuksa dh gksxh A izf’k{k.k ij izfr oSp 30,000/- :- O;; gksxk A
izLrkfor jkf’k & 30,000 × 8 Rs. 2,40,000/-
(ifjf’k"V VII LrEHk 16 n"VO;)
5. fpfdRlk ink- dk izf’k{k.k
jkT; ds 31 dkyktkj izHkkfor ftyksa ds lHkh Lrj ds vLirkyksa esa dk;Zjr fpfdRlk inkf/dkfj;ksa ds
izf’k{k.k dk izLrko gS A lHkh Lrj ds vLirkyksa esa inLFkkfir fpfdRlk inkf/dkfj;ksa dk ftysokj
la[;k layXu ifjf’k"V VIII ds LrEHk 3 ls 8 esa n’kkZ;k x;k gS A lHkh Lrj ij inLFkkfir fp- inkdh
dqy la[;k 502 gS A 25 izf’k{k.kkFkhZ izfr oSp ds vuqlkj 20 oSp esa izf’k{k.k dk izLrko gS A
izf’k{k.k vof/ rhu fnuksa dh gksxh ,d oSp ds izf’k{k.k ij dqy 1,20,000/- :- O;; izLrkfor gS A
fp- iznk- ds izf’k{k.k dqy izLrkfor O;; 20 × 1,20,000--------- Rs. 24,00,000/-
(ifjf’k"V VIII LrEHk 9 n‘"VO;)
6. iapk;rh jkT; ds lnL;ksa dk izf’k{k.k
jkT; esa iapk;rh jkT; ds ykxw gks tkus ls blds lnL;ksa dks ljdkjh dk;Z ds ns[k&js[k dk nkf;Ro
fn;k x;k A dkyktkj ds djhc 90 izfr’kr jksxh xzkeksa ls gh vkrs gSa vr% iapk;r Lrj ds lnL;ksa dks
dkyktkj ds fujks/kRed ,oa mipkjkRed dkjZokbZ ls :&c&: voxr djkus dh n‘f"V ls izf’k{k.k dk
izLrko fn;k tk jgk gS A layXu ifjf’k"V IX ds LrHk 3 ls 5 esa iapk;rh jkTk ds lnL;ksa dk ftysokj
vkadM+k fn;k x;k gS ftUgs a izf’k{k.k dk izLrko gS A
ifjf’k"V ds voyksdu ls fofnr gksxk fd iapk;rh jkt ds dqy 13860 lnL;ksa dks izf’k{k.k nsus dk
izLrko gS A 50 lnL; izfr oSp dh nj ls dqy 277 oSp esa izf’k{k.k fn;k tk;xkA izfr oSp dks 1
fnu dk izf’k{k.k fn;k tk;xk A ,d oSp ds izf’k{k.k ij 2000 :- O;; gksxk A
izLrkfor O;;---------------- 277 × 2000 -------------------------------------- Rs. 5,54,000/-
(ifjf’k"V IX LrEHk 6 nz"VO;)
7. fNM+dko dkfeZ;ksa dk izf’k{k.k
jkT; ds dkyktkj izHkkfor 31 ftyksa ds foxr ik¡p o"kksZ esa dkyktkj izHkkfor xzkeksa ds dqy 32-39
feyh;u tula[;k dks vPNkfnr djus esa dqy 1782 Js"B {ks- dk;Zd kkZ rFkk 8910 {ks- dk;Zd kkZ
layXu fd;s x;s A iwoZ esa fNM+dko ds ,d fnu iwoZ fNMdko dfeZ;ksa dks izf’kf{kr fd;k tkrk FkkA
orZeku esa Hkkjr ljdkj }kjk fu/kZfjr uhfr ds rgr dqy (1782 $ 8910) 10692 fNM+dko dfeZ;ksa
dks izf’k{k.k fn;k tkuk gSA
rnuqlkj 50 fNM+dko dehZ izfr oSp dh nj ls dqy 214 oSp esa 1 fnu dk izf’k{k.k fn;k tk;xkA
340

,d fnu ds izf’k{k.k esa ,d oSp ij dqy 2000@& :- O;; dk izLrkfor gS A
dqy izLrkfor O;; ------------------- 214 × 2000 --------------------------- Rs. 4,28,000/-
(ifjf’k"V X LrEHk 5 n‘"VO;)
8. cgq sf’k; dk;Zd kkZ (vk’kk) dk izf’k{k.k
dk;Z e ds lapkyu esa vk’kk dk;Zd kkZ dks Hkh ’kkfey fd;k x;k gS vr% dkyktkj ds mipkjkRed
dkjZokbZ ds laca/ esa izf’k{kr fd;k tkuk gS A ifjf’k"V X ds LrEHk 6 esa ftykokj vk’kk dk;Zd kkZ dh
la[;k n’kkZ;h xbZ gS A dqy 52]065 vk’kk dk;Zd kkZ dks 50 izf’k{k.kkFkhZ izfr oSp dh nj ls 1041
cSp esa izf’k{k.k nsus dk izLrko gS A izfr oSp dks ,d fnu dk izf’k{k.k fn;k tk;xkA ftlij 2000@&
:- (izfroSp) dh nj ls O;; gksxk A
dqy izLrkfor O;; -------------- 1041 × 2000 ---------------------- Rs. 20,82,000/-
(ifjf’k"V X LrHk 7 n‘"VO;)
9. izf’k{k.k ij dqy O;; dk lkjka’k
1- eysfj;k fujh{kd -------------------------- Rs. 8,34,000/-
2- iz;ksx’kkyk izkoSf/d ------------------------- Rs. 4,01,240/-
3- cq-Lok- fu- ,oa fu- fu- ------------------------- Rs. 1,50,000/-
4- Lok- dk;Zd kkZ ------------------------ Rs. 2,40,000/-
5- fp- ink- ------------------------ Rs. 24,00,000/-
6- iapk;rh jkt ------------------------ Rs. 5,54,000-
7- fNM+dko dehZ ------------------------ Rs. 4,28,000/-
8- cgq sf’k; dk;Z kkZ (vk’kk) ------------------------- Rs. 20,82,000/-
dqy Rs. 70,89,240/-
;kstuk ctV dk lkjka’k
[k.M d & fujks/kRed dkjZokbZ & Rs. 13,10,85,720=00
[k.M [k & mipkjkRed dkjZokbZ & Rs. 8,72,44,500=00
[k.M x & jkT; eq[;ky; dk lqn‘

izfrfyfi {ks=kh; funs’kd] Lok- ,oa i- d- foHkkx] Hkkjr ljdkj] bfUnjk Hkou] ikWpoka eafaty] csyh jksM]iVuk]
dks vuqyXud lfgr lwpukFkZ ,oa vko’;d dkjZokbZ gsrq izf"kr A
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
342

Name of
Districts
State & District Wise Fund Allocation - Kala-Azar, Bihar 2009-2010
One Round Amount
From Annex. II From Annex. IV
Total Amount For One
Round
343
Two Round Amount
Total Amount For Two
Round Spray i.e (Anneex.II+
Annex.IV)
From Annex. V Total ( Column 6+7)
1 2 3 4 5 6 7 8
1 Araria 4,105,740.00 161,450.00 4,267,190.00 8,534,380.00 5,072,950.00 13,607,330.00
2 Arwal 73,860.00 9,700.00 83,560.00 167,120.00 1,008,250.00 1,175,370.00
3 Banka 36,180.00 2,800.00 38,980.00 77,960.00 1,016,150.00 1,094,110.00
4 Begusarai 1,923,900.00 86,250.00 2,010,150.00 4,020,300.00 2,119,550.00 6,139,850.00
5 Bhagalpur 287,940.00 27,300.00 315,240.00 630,480.00 1,289,100.00 1,919,580.00
6 Bhojpur 429,660.00 42,000.00 471,660.00 943,320.00 1,136,650.00 2,079,970.00
7 Buxar 214,080.00 13,400.00 227,480.00 454,960.00 1,066,400.00 1,521,360.00
8 Darbhanga 3,072,840.00 140,250.00 3,213,090.00 6,426,180.00 3,686,450.00 10,112,630.00
9 E.Champaran 5,023,920.00 234,550.00 5,258,470.00 10,516,940.00 4,493,000.00 15,009,940.00
10 Gopalganj 1,332,840.00 78,150.00 1,410,990.00 2,821,980.00 3,068,500.00 5,890,480.00
11 Jehanabad 76,860.00 16,400.00 93,260.00 186,520.00 1,052,400.00 1,238,920.00
12 Katihar 2,177,160.00 148,450.00 2,325,610.00 4,651,220.00 2,298,150.00 6,949,370.00
13 Khagaria 667,920.00 39,350.00 707,270.00 1,414,540.00 2,005,550.00 3,420,090.00
14 Kishanganj 1,361,520.00 79,950.00 1,441,470.00 2,882,940.00 1,503,800.00 4,386,740.00
15 Lakhisarai 211,080.00 11,350.00 222,430.00 444,860.00 1,050,350.00 1,495,210.00
16 Madhepura 2,750,220.00 111,100.00 2,861,320.00 5,722,640.00 4,254,350.00 9,976,990.00
17 Madhubani 2,662,680.00 128,900.00 2,791,580.00 5,583,160.00 2,952,400.00 8,535,560.00
18 Munger 217,080.00 22,800.00 239,880.00 479,760.00 1,178,800.00 1,658,560.00
19 Muzaffarpur 5,188,320.00 293,450.00 5,481,770.00 10,963,540.00 6,976,700.00 17,940,240.00
20 Nalanda 606,060.00 44,150.00 650,210.00 1,300,420.00 1,321,050.00 2,621,470.00
21 Patna 2,035,440.00 124,300.00 2,159,740.00 4,319,480.00 1,628,050.00 5,947,530.00
22 Purnea 4,319,820.00 202,600.00 4,522,420.00 9,044,840.00 4,410,900.00 13,455,740.00
23 Saharsa 2,646,180.00 108,850.00 2,755,030.00 5,510,060.00 5,044,850.00 10,554,910.00
24 Samastipur 3,662,400.00 185,650.00 3,848,050.00 7,696,100.00 4,248,200.00 11,944,300.00
25 Saran 2,762,220.00 159,050.00 2,921,270.00 5,842,540.00 3,941,250.00 9,783,790.00
26 Sheohar 419,160.00 17,200.00 436,360.00 872,720.00 1,202,850.00 2,075,570.00
27 Sitamarhi 3,452,820.00 140,450.00 3,593,270.00 7,186,540.00 2,721,650.00 9,908,190.00
28 Siwan 2,830,080.00 144,850.00 2,974,930.00 5,949,860.00 2,647,200.00 8,597,060.00
29 Supaul 1,577,100.00 81,250.00 1,658,350.00 3,316,700.00 1,168,800.00 4,485,500.00
30 Vaishali 3,935,340.00 191,150.00 4,126,490.00 8,252,980.00 5,650,550.00 13,903,530.00
31 W.Champaran 2,204,340.00 86,000.00 2,290,340.00 4,580,680.00 6,011,650.00 10,592,330.00

Total 62,264,760.00 3,133,100.00 65,397,860.00 130,795,720.00 87,226,500.00 218,022,220.00
State Level Activity
1 Training At State Level From Annex. VII,VIII,IX & X 7,089,240.00
2 State Level Activity From Annex. VI 1,473,440.00
3 SPO & ZMO Mobility During Spray Period 145000.00 x2 =290000.00 290,000.00
4 Storage of Amphoteracin B.At State Level 18,000.00
Grand Total Of Kala-Azar Programme ,BIHAR 226,892,900.00
344

District Infrastructure of Kala-Azar Affected Districts
Anexure - I
Sl. No. Name of Districts
PHC HSC Block Panchyat
Total No. of
Revenue
Village
Urban
Ward
345
Total No. of Affected
Population PHC HSC Panchyat Village Ward Population
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Araria 9 109 9 221 757 54 2,670,845 9 88 165 563 0 2,153,592
2 Arwal 3 64 0 0 335 0 651,717 3 7 0 18 0 41,144
3 Banka 10 0 11 185 1681 40 0 1 1 1 2 0 12,719
4 Begusarai 11 288 18 257 1064 36 2,900,088 11 51 154 245 0 999,274
5 Bhagalpur 11 280 17 242 1929 62 2,948,451 7 0 0 62 0 145,797
6 Bhojpur 12 304 14 228 1457 100 2,292,652 9 64 0 120 0 210,106
7 Buxar 7 167 11 142 993 60 1,458,493 4 16 0 16 0 104,052
8 Darbhanga 14 306 19 306 1522 48 3,442,496 14 206 206 455 0 1,602,617
9 E.Champaran 20 318 27 387 1716 20 46,78,325 20 268 302 817 0 2,620,283
10 Gopalganj 10 186 14 234 1499 12 2,398,707 10 107 0 261 0 693,562
11 Jehanabad 5 81 12 161 947 52 1,029,742 5 15 0 36 0 37,257
12 Katihar 18 257 16 238 1737 45 2,687,203 18 192 0 543 0 1,134,049
13 Khagaria 6 0 7 129 306 18 0 6 0 0 119 0 348,271
14 Kishanganj 7 79 7 118 761 28 1,554,007 6 36 63 323 0 712,592
15 Lakhisarai 4 102 7 80 496 18 895,678 2 19 19 29 18 101,437
16 Madhepura 7 196 13 170 838 41 1,669,001 7 139 0 384 0 1,431,240
17 Madhubani 18 430 21 399 1072 75 4,094,575 18 294 294 366 0 1,376,642
18 Munger 6 134 9 101 837 104 1,349,751 6 33 30 52 0 97,035
19 Muzaffarpur 14 527 16 387 1937 49 4,561,521 14 459 0 1273 0 2,703,171
20 Nalanda 12 0 20 249 1183 122 0 11 0 0 91 0 315,421
21 Patna 16 0 23 331 1455 72 4,062,216 16 244 0 422 0 1,060,285
22 Purnea 14 151 14 237 1075 0 3,174,330 13 107 191 764 0 2,258,220
23 Saharsa 7 152 10 164 435 43 1,802,298 7 130 0 379 0 1,381,124
24 Samastipur 14 0 20 381 1250 61 3,860,729 14 331 329 701 0 1,904,426
25 Saran 15 413 20 0 1813 0 3,551,306 15 0 0 597 0 1,437,022
26 Sheohar 2 0 5 54 207 15 0 2 0 0 48 0 212,868
27 Sitamarhi 13 0 17 273 846 79 3,009,938 13 186 212 433 38 1,807,046
28 Siwan 15 351 16 293 1458 51 3,100,210 14 219 0 509 0 1,481,302
29 Supaul 11 178 11 180 688 0 1,968,535 11 0 0 245 0 809,393
30 Vaishali 11 339 16 292 1680 45 3,250,683 11 0 278 751 0 2,054,842
31 W.Champaran 16 369 18 354 2220 121 3,495,552 13 140 123 190 0 1,147,023
Total 338 5,781 438 6,793 36,194 1,471 67,880,724 310 3,352 2,367 10,814 56 32,393,812

Sl.
No.
Name of
Districts
Dist. Wise Sqad,DDT,Wages,Office Exp.,Contigency,Transportation of DDT For Kala Azar Spray One Round
Total No. of Total No. of DDT 50% Status (In Meric
Total No. of Affected
Sqad (55 Workers
Ton)
Sqad /10
Lakhs
PHC Population SFW FW Require. Available Balance
Population
Require.
SFW(Rs. 113/-
Per SFW For
60 Days)
WAGES
FW(Rs.92/-Per
FW For 60
Days)
Total
Office
Expense
s (@ Rs
150/-Per
Sqad
Contigenc
y (@ Rs.
150/- Per
Sqad
Annexure -II
Transportation of DDT
PHC To
Village(R
Total
s.500/-
PHC)
District To
PHC(RS.
1000/- Aff.
PHC)
Grand Total
(13+14+15+
18)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
1 Araria 9 2,153,592 118 118 590 80.76 46.99 33.77 800,040 3,256,800 4,056,840 17,700 17,700 9,000 4,500 13,500 4,105,740
2 Arwal 3 41,144 2 2 10 1.54 0.29 1.25 13,560 55,200 68,760 300 300 3,000 1,500 4,500 73,860
3 Banka 1 12,719 1 1 5 0.48 0.00 0.48 6,780 27,600 34,380 150 150 1,000 500 1,500 36,180
4 Begusarai 11 999,274 55 55 275 37.47 29.76 7.71 372,900 1,518,000 1,890,900 8,250 8,250 11,000 5,500 16,500 1,923,900
5 Bhagalpur 7 145,797 8 8 40 5.47 5.20 0.27 54,240 220,800 275,040 1,200 1,200 7,000 3,500 10,500 287,940
6 Bhojpur 9 210,106 12 12 60 7.88 25.00 -17.12 81,360 331,200 412,560 1,800 1,800 9,000 4,500 13,500 429,660
7 Buxar 4 104,052 6 6 30 3.90 5.00 -1.10 40,680 165,600 206,280 900 900 4,000 2,000 6,000 214,080
8 Darbhanga 14 1,602,617 88 88 440 60.10 132.00 -71.90 596,640 2,428,800 3,025,440 13,200 13,200 14,000 7,000 21,000 3,072,840
9 E.Champaran 20 2,620,283 144 144 720 98.26 85.70 12.56 976,320 3,974,400 4,950,720 21,600 21,600 20,000 10,000 30,000 5,023,920
10 Gopalganj 10 693,562 38 38 190 26.01 0.00 26.01 257,640 1,048,800 1,306,440 5,700 5,700 10,000 5,000 15,000 1,332,840
11 Jehanabad 5 37,257 2 2 10 1.40 0.02 1.38 13,560 55,200 68,760 300 300 5,000 2,500 7,500 76,860
12 Katihar 18 1,134,049 62 62 310 42.53 19.00 23.53 420,360 1,711,200 2,131,560 9,300 9,300 18,000 9,000 27,000 2,177,160
13 Khagaria 6 348,271 19 19 95 13.06 4.60 8.46 128,820 524,400 653,220 2,850 2,850 6,000 3,000 9,000 667,920
14 Kishanganj 6 712,592 39 39 195 26.72 38.61 -11.89 264,420 1,076,400 1,340,820 5,850 5,850 6,000 3,000 9,000 1,361,520
15 Lakhisarai 2 101,437 6 6 30 3.80 2.05 1.75 40,680 165,600 206,280 900 900 2,000 1,000 3,000 211,080
16 Madhepura 7 1,431,240 79 79 395 53.67 0.50 53.17 535,620 2,180,400 2,716,020 11,850 11,850 7,000 3,500 10,500 2,750,220
17 Madhubani 18 1,376,642 76 76 380 51.62 157.30 -105.68 515,280 2,097,600 2,612,880 11,400 11,400 18,000 9,000 27,000 2,662,680
18 Munger 6 97,035 6 6 30 3.64 15.75 -12.11 40,680 165,600 206,280 900 900 6,000 3,000 9,000 217,080
19 Muzaffarpur 14 2,703,171 149 149 745 101.37 62.94 38.43 1,010,220 4,112,400 5,122,620 22,350 22,350 14,000 7,000 21,000 5,188,320
20 Nalanda 11 315,421 17 17 85 11.83 33.26 -21.43 115,260 469,200 584,460 2,550 2,550 11,000 5,500 16,500 606,060
21 Patna 16 1,060,285 58 58 290 39.76 58.90 -19.14 393,240 1,600,800 1,994,040 8,700 8,700 16,000 8,000 24,000 2,035,440
22 Purnea 13 2,258,220 124 124 620 84.68 132.29 -47.61 840,720 3,422,400 4,263,120 18,600 18,600 13,000 6,500 19,500 4,319,820
23 Saharsa 7 1,381,124 76 76 380 51.79 30.00 21.79 515,280 2,097,600 2,612,880 11,400 11,400 7,000 3,500 10,500 2,646,180
24 Samastipur 14 1,904,426 105 105 525 71.42 20.85 50.57 711,900 2,898,000 3,609,900 15,750 15,750 14,000 7,000 21,000 3,662,400
25 Saran 15 1,437,022 79 79 395 53.89 20.33 33.56 535,620 2,180,400 2,716,020 11,850 11,850 15,000 7,500 22,500 2,762,220
26 Sheohar 2 212,868 12 12 60 7.98 3.80 4.18 81,360 331,200 412,560 1,800 1,800 2,000 1,000 3,000 419,160
27 Sitamarhi 13 1,807,046 99 99 495 67.76 35.93 31.84 671,220 2,732,400 3,403,620 14,850 14,850 13,000 6,500 19,500 3,452,820
28 Siwan 14 1,481,302 81 81 405 55.55 16.40 39.15 549,180 2,235,600 2,784,780 12,150 12,150 14,000 7,000 21,000 2,830,080
29 Supaul 11 809,393 45 45 225 30.35 21.50 8.85 305,100 1,242,000 1,547,100 6,750 6,750 11,000 5,500 16,500 1,577,100
30 Vaishali 11 2,054,842 113 113 565 77.06 41.00 36.06 766,140 3,118,800 3,884,940 16,950 16,950 11,000 5,500 16,500 3,935,340
31 W.Champaran 13 1,147,023 63 63 315 43.01 46.64 -3.63 427,140 1,738,800 2,165,940 9,450 9,450 13,000 6,500 19,500 2,204,340
Total 310 32,393,812 1,782 1,782 8,910 1,215 1,092 123 12,081,960 49,183,200 61,265,160 267,300 267,300 310,000 155,000 465,000 62,264,760
346

Sl.
No.
Name of
Districts
Total No.
of Sqad
(55 Sqad
/10 Lakhs
Population
Dist. Wise Status of Spray Equipments pf Kala Azar DDT Spray
Required
Districwise Status of Spray Equipment of K..A D.D.T Spray
Annex. III
Stirrup Pump Bucket Gallan Measure Pound Measure Nosal Tip
Available
in Good
Condition
Repairable
Balance
Required
Required
Available
in Good
Condition
Repairable
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 Araria 118 236 237 80 -1 472 319 0 153 118 115 0 3 118 120 0 -2 590
2 Arwal 2 4 0 0 4 8 0 0 8 2 0 0 2 2 0 0 2 10
3 Banka 1 2 0 0 2 4 0 0 4 1 0 0 1 1 0 0 1 5
4 Begusarai 55 110 258 0 -148 220 508 0 -288 55 107 0 -52 55 85 0 -30 275
5 Bhagalpur 8 16 250 40 -234 32 400 9 -368 8 140 5 -132 8 140 0 -132 40
6 Bhojpur 12 24 40 193 -16 48 450 50 -402 12 100 10 -88 12 100 10 -88 60
7 Buxar 6 12 0 0 12 24 0 0 24 6 0 0 6 6 0 0 6 30
8 Darbhanga 88 176 294 0 -118 352 279 0 73 88 127 0 -39 88 127 0 -39 440
9 E.Champaran 144 288 286 177 2 576 507 138 69 144 197 23 -53 144 193 20 -49 720
10 Gopalganj 38 76 234 20 -158 152 438 40 -286 38 97 20 -59 38 97 20 -59 190
11 Jehanabad 2 4 234 20 -230 8 438 40 -430 2 97 20 -95 2 97 20 -95 10
12 Katihar 62 124 180 104 -56 248 354 120 -106 62 142 0 -80 62 142 0 -80 310
13 Khagaria 19 38 110 50 -72 76 200 116 -124 19 79 0 -60 19 79 0 -60 95
14 Kishanganj 39 78 50 50 28 156 240 0 -84 39 56 0 -17 39 42 0 -3 195
15 Lakhisarai 6 12 40 58 -28 24 150 46 -126 6 49 0 -43 6 49 0 -43 30
16 Madhepura 79 158 252 0 -94 316 324 0 -8 79 81 0 -2 79 81 0 -2 395
17 Madhubani 76 152 526 0 -374 304 820 0 -516 76 225 0 -149 76 225 0 -149 380
18 Munger 6 12 140 0 -128 24 200 0 -176 6 40 0 -34 6 40 0 -34 30
19 Muzaffarpur 149 298 375 0 -77 596 647 0 -51 149 186 0 -37 149 175 0 -26 745
20 Nalanda 17 34 257 3 -223 68 502 10 -434 17 100 0 -83 17 130 0 -113 85
21 Patna 58 116 293 130 -177 232 519 112 -287 58 193 20 -135 58 172 2 -114 290
22 Purnea 124 248 190 80 58 496 413 50 83 124 130 0 -6 124 82 0 42 620
23 Saharsa 76 152 150 20 2 304 350 20 -46 76 75 0 1 76 75 0 1 380
24 Samastipur 105 210 224 0 -14 420 300 0 120 105 90 0 15 105 90 0 15 525
25 Saran 79 158 135 101 23 316 425 135 -109 79 105 0 -26 79 105 0 -26 395
26 Sheohar 12 24 0 0 24 48 0 0 48 12 0 0 12 12 0 0 12 60
27 Sitamarhi 99 198 105 65 93 396 295 68 101 99 111 0 -12 99 117 0 -18 495
28 Siwan 81 162 124 104 38 324 439 60 -115 81 178 5 -97 81 170 5 -89 405
29 Supaul 45 90 0 0 90 180 0 0 180 45 0 0 45 45 0 0 45 225
30 Vaishali 113 226 217 49 9 452 362 59 90 113 115 4 -2 113 102 0 11 565
31 W.Champaran 63 126 280 105 -154 252 380 65 -128 63 120 7 -57 63 118 4 -55 315
Total 1,782 3,564 5,481 1,449 -1,917 7,128 10,259 1,138 -3,131 1,782 3,055 114 -1,273 1,782 2,953 81 -1,171 8,910
Balance
Required
Required
Available
in Good
Condition
Repairable
Balance
Required
Required
Available
in Good
Condition
Repairable
Balance
Required
Required
347

Sl.
No.
Name of
Districts
Statement Showing The Expenditure ,Repair,Mobility, DA Supervision & IEC For Kala Azar Spray
Total No. of
Affected
PHC
Village
Total No. of
Sqad (55
Sqad /10
Lakhs
Population
Repair of Spray Equipments
Including Nozal Tips
Repai
r(RS.1
00/-
Per
Sqad)
Purch
ase(
Per
Sqad
Rs.40
0/)
Total
District
MobilityFor
ACMO Vehicle
@ Rs.100 Per
Affected Village
District Mobility
DMO Vehicle
@ Rs.100 Per
Affected
Village
Mobility
For PHC
MO.@
RS.50 Per
Aff. Vill.
DA For
Supervision @
Rs. 1000 Per
Affected PHC
Annex. IV
IEC @ Rs.
1000/- Per
Affected
PHC per
Round
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15
1 Araria 9 563 118 11800 47200 59000 56,300 0 28150 9000 9000 161,450
2 Arwal 3 18 2 200 800 1000 1,800 0 900 3000 3000 9,700
3 Banka 1 2 1 100 400 500 200 0 100 1000 1000 2,800
4 Begusarai 11 245 55 5500 22000 27500 0 24,500 12250 11000 11000 86,250
5 Bhagalpur 7 62 8 800 3200 4000 0 6,200 3100 7000 7000 27,300
6 Bhojpur 9 120 12 1200 4800 6000 0 12,000 6000 9000 9000 42,000
7 Buxar 4 16 6 600 2400 3000 1,600 0 800 4000 4000 13,400
8 Darbhanga 14 455 88 8800 35200 44000 0 45,500 22750 14000 14000 140,250
9 E.Champaran 20 817 144 14400 57600 72000 0 81,700 40850 20000 20000 234,550
10 Gopalganj 10 261 38 3800 15200 19000 0 26,100 13050 10000 10000 78,150
11 Jehanabad 5 36 2 200 800 1000 3,600 0 1800 5000 5000 16,400
12 Katihar 18 543 62 6200 24800 31000 0 54,300 27150 18000 18000 148,450
13 Khagaria 6 119 19 1900 7600 9500 11,900 0 5950 6000 6000 39,350
14 Kishanganj 6 323 39 3900 15600 19500 32,300 0 16150 6000 6000 79,950
15 Lakhisarai 2 29 6 600 2400 3000 2,900 0 1450 2000 2000 11,350
16 Madhepura 7 384 79 7900 31600 39500 38,400 0 19200 7000 7000 111,100
17 Madhubani 18 366 76 7600 30400 38000 0 36,600 18300 18000 18000 128,900
18 Munger 6 52 6 600 2400 3000 0 5,200 2600 6000 6000 22,800
19 Muzaffarpur 14 1273 149 14900 59600 74500 0 127,300 63650 14000 14000 293,450
20 Nalanda 11 91 17 1700 6800 8500 0 9,100 4550 11000 11000 44,150
21 Patna 16 422 58 5800 23200 29000 0 42,200 21100 16000 16000 124,300
22 Purnea 13 764 124 12400 49600 62000 0 76,400 38200 13000 13000 202,600
23 Saharsa 7 379 76 7600 30400 38000 0 37,900 18950 7000 7000 108,850
24 Samastipur 14 701 105 10500 42000 52500 0 70,100 35050 14000 14000 185,650
25 Saran 15 597 79 7900 31600 39500 0 59,700 29850 15000 15000 159,050
26 Sheohar 2 48 12 1200 4800 6000 4,800 0 2400 2000 2000 17,200
27 Sitamarhi 13 433 99 9900 39600 49500 0 43,300 21650 13000 13000 140,450
28 Siwan 14 509 81 8100 32400 40500 0 50,900 25450 14000 14000 144,850
29 Supaul 11 245 45 4500 18000 22500 24,500 0 12250 11000 11000 81,250
30 Vaishali 11 751 113 11300 45200 56500 0 75,100 37550 11000 11000 191,150
31 W.Champaran 13 190 63 6300 25200 31500 0 19,000 9500 13000 13000 86,000
Total 310 10,814 1,782 178,200 712,800 891,000 178,300 903,100 540,700 310,000 310,000 3,133,100
Total
Remarks
348

Sl. No.
Name of
Districts
Total No. of PHC
Total No. of Affected PHC
Budget Provision For Qurative Measures of Kala Azar
Mobility For Officers & MI,POL &
Maintenance
Mobili
ty For
CS
Mobility Of
Khaga
MI
riya &
Mobility Purchage
Madh
For DMO Of 1
epura
For Motorcycle
@ Rs.
Max.RS
Estimated ProjectedCase For 2009 -2010
Incentive
ASHA(Rs.
100/-Per
Projected
Case For
Complete
Treatment)
Loss Of
Wages
Rs.50/-For
30 Days
Per
Projected
Case
During
Treatment
Period
Strengthin
g Of Bed
(10 Beds
Per
Effected
PHC @ Rs.
1000/-Bed
With
Mattress)
3000/-
Per
Month
For 8
Month
s(
Exclu
ding
Spray
Period
)
10,000/-Per
Month for
8 Months (
Excluding
Spray
Period)
349
Per District
@ Rs.
50,000/-Per
Motorcycle
(Except 2
Motorcycle
For
Selected
Districts)
POL For
Motorcy
cle @30
Litres
Per
Months
@
Rs.50/-
For 12
Months
Storage Of Drugs
Emphot
eracin
Storage
In
District
Level @
Rs. 500/-
Per
Month
For 12
Months
Treatme
nt Card
@Rs.
2.50 Per
Treatme
nt Card
For 2
Diff.Typ
es of
Each
Card For
Projecte
d Case
Register
For Line
Listing /
Loss Of
Wages
Record
@
Rs.50/-
For 2
Register
Per
Eff.PHC
Annex. V
Hiring of
Warehous
e at Dist.
Level for
Storage of
DDT @ Rs.
5000/-Per
Month For
12 Months
Kala Azar
Forthnight
Programm
e
(@Rs.4000
/-Per PHC
Monthly
Emoulmen
t of KTS 6
KTS For
31 Dist. @
Rs.
10,000/-
Per Month
For 12
Months
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
1 Araria 9 9 2,500 250,000 3,750,000 90,000 0 80,000 50,000 18,000 6,000 0 12,500 450 60,000 36,000 720,000 5,072,950
2 Arwal 3 3 20 2,000 30,000 30,000 0 80,000 50,000 18,000 6,000 0 100 150 60,000 12,000 720,000 1,008,250
3 Banka 10 1 20 2,000 30,000 10,000 0 80,000 50,000 18,000 6,000 0 100 50 60,000 40,000 720,000 1,016,150
4 Begusarai 11 11 600 60,000 900,000 110,000 0 80,000 100,000 36,000 6,000 0 3,000 550 60,000 44,000 720,000 2,119,550
5 Bhagalpur 11 7 150 15,000 225,000 70,000 0 80,000 50,000 18,000 6,000 0 750 350 60,000 44,000 720,000 1,289,100
6 Bhojpur 12 9 40 4,000 60,000 90,000 0 80,000 50,000 18,000 6,000 0 200 450 60,000 48,000 720,000 1,136,650
7 Buxar 7 4 40 4,000 60,000 40,000 0 80,000 50,000 18,000 6,000 0 200 200 60,000 28,000 720,000 1,066,400
8 Darbhanga 14 14 1,550 155,000 2,325,000 140,000 0 80,000 100,000 36,000 6,000 0 7,750 700 60,000 56,000 720,000 3,686,450
9 E.Champaran 20 20 2,000 200,000 3,000,000 200,000 0 80,000 100,000 36,000 6,000 0 10,000 1,000 60,000 80,000 720,000 4,493,000
10 Gopalganj 10 10 1,200 120,000 1,800,000 100,000 0 80,000 100,000 36,000 6,000 0 6,000 500 60,000 40,000 720,000 3,068,500
11 Jehanabad 5 5 30 3,000 45,000 50,000 0 80,000 50,000 18,000 6,000 0 150 250 60,000 20,000 720,000 1,052,400
12 Katihar 18 18 650 65,000 975,000 180,000 0 80,000 100,000 36,000 6,000 0 3,250 900 60,000 72,000 720,000 2,298,150
13 Khagaria 6 6 650 65,000 975,000 60,000 24,000 0 50,000 18,000 6,000 0 3,250 300 60,000 24,000 720,000 2,005,550
14 Kishanganj 7 6 300 30,000 450,000 60,000 0 80,000 50,000 18,000 6,000 0 1,500 300 60,000 28,000 720,000 1,503,800
15 Lakhisarai 4 2 50 5,000 75,000 20,000 0 80,000 50,000 18,000 6,000 0 250 100 60,000 16,000 720,000 1,050,350
16 Madhepura 7 7 2,000 200,000 3,000,000 70,000 24,000 0 100,000 36,000 6,000 0 10,000 350 60,000 28,000 720,000 4,254,350
17 Madhubani 18 18 1,100 110,000 1,650,000 180,000 0 80,000 50,000 18,000 6,000 0 5,500 900 60,000 72,000 720,000 2,952,400
18 Munger 6 6 100 10,000 150,000 60,000 0 80,000 50,000 18,000 6,000 0 500 300 60,000 24,000 720,000 1,178,800
Emphot
eracin
Storage
In State
Level @
Rs.
1500/-
Per
Month
For 12
Months
=Rs.
18,000/-
Grand
Total

19 Muzaffarpur 14 14 3,600 360,000 5,400,000 140,000 0 80,000 100,000 36,000 6,000 0 18,000 700 60,000 56,000 720,000 6,976,700
20 Nalanda 12 11 100 10,000 150,000 110,000 0 80,000 100,000 36,000 6,000 0 500 550 60,000 48,000 720,000 1,321,050
21 Patna 16 16 250 25,000 375,000 160,000 0 80,000 100,000 36,000 6,000 0 1,250 800 60,000 64,000 720,000 1,628,050
22 Purnea 14 13 2,050 205,000 3,075,000 130,000 0 80,000 50,000 18,000 6,000 0 10,250 650 60,000 56,000 720,000 4,410,900
23 Saharsa 7 7 2,500 250,000 3,750,000 70,000 0 80,000 50,000 18,000 6,000 0 12,500 350 60,000 28,000 720,000 5,044,850
24 Samastipur 14 14 1,900 190,000 2,850,000 140,000 0 80,000 100,000 36,000 6,000 0 9,500 700 60,000 56,000 720,000 4,248,200
25 Saran 15 15 1,700 170,000 2,550,000 150,000 0 80,000 100,000 36,000 6,000 0 8,500 750 60,000 60,000 720,000 3,941,250
26 Sheohar 2 2 150 15,000 225,000 20,000 0 80,000 50,000 18,000 6,000 0 750 100 60,000 8,000 720,000 1,202,850
27 Sitamarhi 13 13 1,000 100,000 1,500,000 130,000 0 80,000 50,000 18,000 6,000 0 5,000 650 60,000 52,000 720,000 2,721,650
28 Siwan 15 14 900 90,000 1,350,000 140,000 0 80,000 100,000 36,000 6,000 0 4,500 700 60,000 60,000 720,000 2,647,200
29 Supaul 11 11 50 5,000 75,000 110,000 0 80,000 50,000 18,000 6,000 0 250 550 60,000 44,000 720,000 1,168,800
30 Vaishali 11 11 2,800 280,000 4,200,000 110,000 0 80,000 100,000 36,000 6,000 0 14,000 550 60,000 44,000 720,000 5,650,550
31 W.Champaran 16 13 3,000 300,000 4,500,000 130,000 0 80,000 100,000 36,000 6,000 0 15,000 650 60,000 64,000 720,000 6,011,650
*** State Level 0 0 0 0 0 0 0 0 0 0 0 18000 0 0 0 0 0 18,000
Total 338 310 33,000 3,300,000 49,500,000 3,100,000 48,000 2,320,000 2,250,000 810,000 186,000 18,000 165,000 15,500 1,860,000 1,352,000 22,320,000 87,244,500
350

Annex- VI
Sl.No. State Level Component Activity Financial Cost
1 State Stearing Committee 30,000.00
2 Brand Ambassador 50,000.00
3 Computer Desktop One 50,000.00
4 Laptop Three (One For SPO, One For Dy. CMO, One For AD Kala-Azar) 150,000.00
5 Mobile Phone For Officer & Staff At State Level Office 60,440.00
6 Laser Printer (Phone+Fax +Scanner included) 25,000.00
7 Xerox Machine 150,000.00
8 Meeting With Officers Of Dist. Level Alternate Month 30,000.00
9 Strengthininh Of Computer & Internet Facility 30,000.00
10 Supervision Of Dist. At State Level 100,000.00
11 Strengthininh Of ZMO Office ( All Four ZMO) 300,000.00
12 Generator with fuel 98,000.00
13 IEC 400,000.00
14 Total 1,473,440.00
351

State - Bihar Kala -Azar Action Plan 2009-2010 , Training Part I Annexure --VII
Sl. No. Name of Districts
Training Of Malaria
Inspector
Total
No. Of
MI
TRG Cost Of
MI
TwoRounds
Total No.of Malaria Inspectors114 .Total Provision of Training of 114 MI . Provision
of 20 Participant in each Batch =12 Batches (TwoRound) @0.695 Lakhs per Batch
=8.34 Lakhs As Per NVBDCP Guideline. Two Round.
Training (Induction & Re-Orientation) Of LT Training Of Health Supervisor Training Of Health Worker
Total No.
Of LT
TRG Cost
Of LT
(Induction
TRG)
Total No.of 47 Lab Technecian .Total Provision of Induction Training of 47 Lab
Technecian. Provision of 20 Participant in each Batch =2 Batches @1.25 Lakhs per
Batch for 10 Days =2.5 Lakhs As Per NVBDCP Guideline .One Time
TRG Cost Of
LT (Re-
Orientation
TRG)
TRG of all 47 Lab Technecian Induction .Total Provision of Induction Training of 47
Lab Technecian. Provision of 20 Participant in each Batch =2 Batches
@0.7562Lakhs per Batch for 5 Days =1.5124 Lakhs As Per NVBDCP Guideline .One
Time
Grand Total
Induction &
Reorientation
TRG of all 47 Lab Technecian Induction & Re-Orientation Grand Total. As Per
NVBDCP Guideline .One Time
352
Total No.
Of BHI
Total
No. Of
SI
TRG Cost
Of Health
Supervisor
Total No.of BHI =118 +SI 18 Total 136 .Total Provision of Training of 136 Health
Supervisor . Provision of 25 Participant in each Batch =5 Batches For 2 Days @
0.30 Lakhs per Batch =1.50 Lakhs As Per NVBDCP Guideline. One Round.
Total
No. Of
BHW
Total
No. Of
SW
Total No.
Of FW
Total No.
Of SFW
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1 Araria 0
0
0 0
0 0 0 0
2 Aurangabad 4 0 1 0 3 0 1 0
3 Arwal 0 0 0 0 0 0 0 0
4 Banka 0 0 0 0 0 0 0 0
5 Begusarai 3 1 3 0 7 0 1 2
6 Bhagalpur 2 1 11 1 6 0 1 2
7 Bhojpur 5 1 8 0 1 0 4 2
8 Buxar 0 0 0 0 0 0 0 0
9 Darbhanga 4 0 4 2 4 2 4 0
10 E.Champaran 7 2 12 1 5 5 1 2
11 Gaya 4 8 8 0 7 0 3 1
12 Gopalganj 2 2 0 0 0 0 3 1
13 Jamui 0 0 0 0 0 0 0 0
14 Jehanabad 0 0 0 0 0 0 0 0
15 Kaimur 0 0 0 0 0 0 0 0
16 Katihar 3 0 2 0 6 0 0 0
17 Khagaria 0 0 0 0 0 0 0 0
18 Kishanganj 0 0 0 0 0 0 0 0
19 Lakhisarai 0 0 0 0 0 0 0 0
20 Madhepura 0 0 0 0 0 0 0 0
21 Madhubani 8 0 5 6 0 9 2 0
22 Munger 5 3 4 3 11 5 2 0
23 Muzaffarpur 4 1 7 0 3 0 3 0
24 Nawada 2 2 1 1 0 1 2 0
25 Nalanda 3 3 8 0 2 0 3 0
26 Patna 10 11 11 0 9 0 5 2
27 Purnea 9 0 6 1 7 0 3 0
28 Rohtas 6 1 1 2 9 5 0 0
29 Saharsa 6 3 6 0 3 0 0 0
30 Samastipur 5 1 3 0 0 0 0 1
31 Saran 6 1 6 0 4 0 0 1
TRG Cost
Of Health
Worker
Total No.of BHW =103 +SIW= 33 +FW=43 +SFW=19 Total 198 .Total Provision of
Training of 198 Health Worker . Provision of 25 Participant in each Batch =8
Batches For 2 Days @ 0.30 Lakhs per Batch =2.40 Lakhs As Per NVBDCP Guideline.
One Round.

32 Sheikhpura 0 0 0 0 0 0 0 0
33 Sheohar 0 0 0 0 0 0 0 0
34 Sitamarhi 3 2 4 0 3 0 0 0
35 Siwan 3 1 3 0 6 0 1 1
36 Supaul 0 0 0 0 0 0 0 0
37 Vaishali 5 1 4 0 5 0 3 2
38 W.Champaran 5 0 0 1 2 6 1 2
ZMO Office (All 4) 0 2 0 0 0 0 0 0
Total 114 834,000 47 250,000 151,240 401,240 118 18 150,000 103 33 43 19 240,000
353

Sl.
Name of Districts
No.
Training of Medical Officer
TRG OF MEDICAL OFFICERS
Govt.Medical
Referal
Sub.
Govt.Hospital
Sadar Hospital
College
Hospital
Hospital
PHC
TRG Cost of MO
1 2 3 4 5 6 7 8 9
1 Araria 0 0 3 0 1 9
2 Aurangabad 0 0 3 1 0
3 Arwal 0 0 0 0 0 3
4 Banka 0 0 3 0 1 10
5 Begusarai 0 0 2 1 0 11
6 Bhagalpur 1 0 2 1 1 11
7 Bhojpur 0 0 2 0 0 12
8 Buxar 0 0 0 0 1 7
9 Darbhanga 1 0 2 0 0 14
10 E.Champaran 0 0 3 1 0 20
11 Gaya 1 0 2 1 0
12 Gopalganj 0 0 3 1 1 10
13 Jamui 0 0 3 0 1
14 Jehanabad 0 0 2 1 0 5
15 Kaimur 0 0 2 0 1
16 Katihar 0 0 3 1 0 18
17 Khagaria 0 0 1 1 0 6
18 Kishanganj 0 0 2 0 1 7
19 Lakhisarai 0 0 1 0 1 4
20 Madhepura 0 0 1 1 0 7
21 Madhubani 0 0 2 1 1 18
22 Munger 0 0 1 1 0 6
23 Muzaffarpur 1 0 1 1 0 14
24 Nawada 0 0 2 1 0
25 Nalanda 0 0 3 1 1 12
26 Patna 2 7 4 0 3 16
27 Purnea 0 0 2 1 0 14
28 Rohtas 0 0 1 1 1
29 Saharsa 0 0 0 1 0 7
354
TRG of all Govt. Medical College Medical Officer @ 2 MO For 6 Med.Coll
=12,Gont.Hospital @ 2 x 7= 14,Referal Hospital@1x7=70, Sadar Hospital @
2x24 =48, Sub Divisional Hospital @ 1x22 =22, PHC @1x336=336 .Total
Provision of Training of 502 Medical Officers.Provision of 25 particepents
in each batch =20 Batch @ 1.2 Lakhs p er Batch for three days =24.0 Lakhs
as per NVBDCP Guide line ,One Time
Annexure VIII

30 Samastipur 0 0 1 1 3 14
31 Saran 0 0 3 1 0 15
32 Sheikhpura 0 0 1 0 1 0
33 Sheohar 0 0 1 0 1 0
34 Sitamarhi 0 0 1 1 0 13
35 Siwan 0 0 2 1 0 15
36 Supaul 0 0 1 0 1 11
37 Vaishali 0 0 2 1 0 11
38 W.Champaran 0 0 2 1 1 16
ZMO Office (All 4) 0 0 0 0 0 0
Total 6 7 70 24 22 336 2,400,000
355

Training of PRI Members
Sl. No. Name of Districts Advocasy Workshop & Training of PRI
Annexure -IX
Block
Panchyat
Zila Parishad Members( Per Dist.15
Members)
Total Cost Of PRI
Members
1 2 3 4 5 6
1 Araria 9 221 15
2 Aurangabad 0 0 0
3 Arwal 0 0 15
4 Banka 11 185 15
5 Begusarai 18 257 15
6 Bhagalpur 17 242 15
7 Bhojpur 14 228 15
8 Buxar 11 142 15
9 Darbhanga 19 329 15
10 E.Champaran 27 387 15
11 Gaya 0 0 0
12 Gopalganj 14 234 15
13 Jamui 0 0 0
14 Jehanabad 12 161 15
15 Kaimur 0 0 0
16 Katihar 16 238 15
17 Khagaria 7 129 15
18 Kishanganj 7 118 15
19 Lakhisarai 7 80 15
20 Madhepura 13 170 15
21 Madhubani 21 399 15
22 Munger 9 101 15
23 Muzaffarpur 16 387 15
24 Nawada 0 0 0
25 Nalanda 20 249 15
26 Patna 23 331 15
27 Purnea 14 246 15
28 Rohtas 0 0 0
29 Saharsa 10 164 15
30 Samastipur 20 381 15
31 Saran 20 0 15
32 Sheikhpura 0 0 0
33 Sheohar 5 54 15
34 Sitamarhi 17 273 15
35 Siwan 16 293 15
36 Supaul 11 180 15
37 Vaishali 16 292 15
38 W.Champaran 18 354 15
ZMO Office (All 4) 0 0 0
Total No.of Blocks =438 x15 BDC Members Per Blocks=6570 Persons +Total No. Of Panchyats =6825 = 6825 Mukhiya +31 Districts
x15 Zila Parishad Members =465 Members= Total 13860 Members .Total Provision of Training of PRI Members 13860 . Provision of
50 Participant in each Batch =277 Batches For 1 Days @ 0.02 Lakhs per Batch =5.54 Lakhs As Per NVBDCP Guideline. One Round .
Total 438 6,825 465 554,000
356

Training of Spray Worker & ASHA Annexure -X
Sl. No.
Name of
Districts
Training Of Spray Worker
Training Of MPW (ASHA)
Contractual
Total
No. Of
SFW
Total
No. Of
FW
TRG Cost Of
Spray Worker
Total No. Of
ASHA
TRG Cost Of
MPW (ASHA)
1 2 3 4 5 6 7
1 Araria 118 590
2026
2 Arwal 2 10 644
3 Banka 1 5 1455
4 Begusarai 55 275 2018
5 Bhagalpur 8 40 1877
6 Bhojpur 12 60 1621
7 Buxar 6 30 1074
8 Darbhanga 88 440 2890
9 E.Champaran 144 720 2686
10 Gopalganj 38 190 1868
11 Jehanabad 2 10 769
12 Katihar 62 310 1486
13 Khagaria 19 95 967
14 Kishanganj 39 195 648
15 Lakhisarai 6 30 568
16 Madhepura 79 395 1403
17 Madhubani 76 380 2751
18 Munger 6 30 820
19 Muzaffarpur 149 745 2544
20 Nalanda 17 85 2017
21 Patna 58 290 2549
22 Purnea 124 620 2002
Total No.of Spray Worker FW=8910 +SFW=1782 Total 10692 .Total Provision
of Training of 10692 Spray Worker . Provision of 50 Participant in each
Batch =214 Batches For 1 Days @ 0.02 Lakhs per Bat ch =4.28 Lakhs As Per
NVBDCP Guideline One Round.
23 Saharsa 76 380 777
24 Samastipur 105 525 3214
25 Saran 79 395 2289
26 Sheohar 12 60 426
27 Sitamarhi 99 495 464
28 Siwan 81 405 1665
29 Supaul 45 225 2538
30 Vaishali 113 565 1477
Total No.of MPW(ASHA)Contractual 52065.Total Provision of Training of
52065 MPW(ASHA)Contractual . Provision of 50 Participant in each Batch
=1041 Batches For 1 Days @ 0.02 Lakhs per Batch =20.8 2 Lakhs As Per
NVBDCP Guideline One Round.
31 W.Champaran 63 315 2532
Total 1,782 8,910 428,000 52,065 2,082,000
357

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ftys gS aA bu ftyksa esa fujks/kRed dkjZokbZ ds rgr Mh-Mh-Vh- fNM+dko dk izLrko gSA
mijksDr lkr eysfj;k izHkkfor ftyksa ds ftyk eysfj;k ink- ls miyc/ dk;Z
;kstuk dh ekax dh xbZ Fkh A uoknk ftys dks NksM+dj vU; N% ftyksa ls fNM+dko dk;Z
;kstuk izkIr ugha gqbZ A lEHkor% jkT; esa 7-01-09 ls py jgs vjktif=kr deZpkfj;ksa ds
gM+rky ds dkj.k dk;Z ;kstuk vizkIr gSA ,slh fLFkfr esa ftysokj fNM+dko ds fy, yf{kr
tual[;k bR;kfn nsuk laHko ugha gS] iyr% jkT; eq[;ky; Lrj ij miyC/ lwpuk ds
vuqlkj ctV izLrko rS;kj fd;k x;k gS A
fcgkj jkT; dh dqy vkcknh 10]00]00]000 gS ftles a eysfj;k izHkkfor lkr ftyksa
dh dqy tula[;k 1]66]66]603 (vFkkZr~ 16-66 feyh;u gS) eysfj;k izHkkfor lkr ftyksa
ds (1-925) feyh;u tula[;k dks fNM+dko ls vkPNkfnr djus dk izLrko gSA fooj.kh I
esa 7 eysfj;k izHkkfor ftyksa dk ftysokj tula[;k bR;kfn dk fooj.k fn;k x;k gS A
358

(d) fujks/kRed dkjZokbZ
jkT; ds lkr eysfj;k izHkkfor ftyksa ds vuqekfur 2 feyh;u tul[a;k esa
fNM+dko gsrq fNM+dko ny rFkk Mh-Mh-Vh- dk vko’;drk bl izdkj gS &
fNM+dko o ny & ,d feyh;u tula[;k esa eysfj;k i…fr ls fNM+dko gsrq
dqy 44 fNM+dko ny 75 fnuksa ds fy, izko/ku gS A izR;sd o"kZ 2 p fNM+dko djk;k
tkuk gS A ;g fNM+dko ebZ ls flrEcj rd djkuk gS A bl rjg dqy &
(a) fNM+dko ------------------- 44 × 2 ------------------- 88
Js- {ks- dk;Zjr fNM+dko ny dh la[;k X 1---------- 88
{ks- dk;Zjr dk;Zjr fNM+dko ny dh la[;k X 5--------- 440
(b) Mh-Mh-Vh& ,d fefy;u tula[;k ds fy, 75 eh-Vu ,d p ds fy,
dqy Mh-Mh-Vh- dh vko’;drk & 2 × 75 = 150 eh- Vu ,d p esa
orZeku esa eysfj;k ;sktuk esa 15 eh- Vu Mh-Mh-Vh- miyC/ gS rFkk 210 eh- Vu Mh-Mh-Vh-
Hkkjr ljdkj }kjk miyc/ djk;k tk jgk gS A bl rjg dqy 225 eh- Vu Mh-Mh-Vhmiyc/
gS tks ,d p fNMdko ds fy, i;kZIr gS A
1. Je ,oa fu;kstu foHkkx }kjk fNM+dko etnwjksa ds fy, la’kksf/r etnwjh nj [
S.F.W. @ Rs. 113/- izfrfnu rFkk F.W. @ Rs. 92/- izfrfnu dh nj ls etnwjh dk vkdyu
fd;k x;k gS A etnwjh en dk izLrkfor jkf’k bl izdkj gS &
,d p vFkkZr~ 75 fnuksa ds fy,
Js- {ks- dk;ZdrkZ dk etnwjh& 88 × 75 × 113 Rs. 7,45,800
{ks- dk;ZdrkZ dk etnwjh & 440 × 75 × 92 Rs. 30,36,000
dqy etnwjh Rs. 37,81,800
2. Mh-Mh-Vh-

ftyksa esa Mh-Mh-Vh- ds HkaMkj.k dh leqfpr O;oLFkk ugha gS vr% Mh-Mh-Vh- dks jkT;
Hk.Mkj fuxe ds xksnke ftl ftyksa esa jkT; HkaMkj ftyk dk xksnke ugha gS] ogk¡
fu;ekuqlkj HkkM+ s ij xksnke ysus gsrq) izfr ftyk izfrekg Rs. 500/- dh nj ls HkaMkj.k
’kqYd dk izko/ku fd;k x;k gS A
izLrkfor jkf’k & 7 × 500 × 12 Rs. 42,000/-
dqy Rs. 2,17,000/-
3. dk;kZy; O;; & fNM+dko esas mi;ksx gksus okys xs: feV~Vh] NUuk ds fy, diM+k]
jftLVj] lknk dkxt bR;kfn izR;sd fNM+dko ny dks miyC/ djk;k tkuk gS A ftlds
fy, izfr fNM+dko ny Rs. 300/- dh nj ls jkf’k dk izko/ku fd;k x;k gSA ftyk
eq[;ky; esa Hkh LVs’kujh bR;kfn ds fufer Rs. 2000/- izfr ftyk dks jkf’k dk izko/ku
fd;k x;k gS A
izLrkfor jkf’k & fNM+dko ny gsrq & fNM+dko ny × 300
88 × 300 - Rs. 26,400/-
ftyk eq[;ky; gsrq 7 × 2000 - Rs. 14,000/-
dqy Rs. 40,400/-
4. fNM+dko midj.kksa dh ejEerh rFkk vko’;d ikVZl dk ; &
ftyk esa fNM+dko midj.kksa dh ejEerh ,oa LVhji iEi ds fy, oklj xSyu] lqrk]
pqVdh oklj] ,oa vU; ikVZl ds fy, izfr fNM+dko ny Rs. 100/- rFkk uksty VhIl ds
; gsrq izfr fNM+dko ny 400/- dh nj ls jkf’k dk izko/ku fd;k x;k gSA
izLrkfor jkf’k & midj.kksa dh ejErh ,oa ikVZl ; ds fy,
(fNM+dko ny × 100) 88 × 100 -Rs. 8,800/-
uksty VhIl ; gsrq - 88 × 400- Rs. 35,200/-
5. iQkWfxx& eysfj;k izHkkfor ftyksa esa eysfj;k egkekjh dh fLFkfr esa ekykfFk;ku dk
iQkfxax djkuk vko’;d izrhr gksrk gS rkfd eysfj;k dk jksdFkke izHkkoh

ds iQkfxax dk ctV dk izko?kku fd;k x;k gSA izR;sd ftys esa nl yk[k izfr ftyk ds nj
nj ls & 4 ftyk X 10 yk[k = 40 yk[k dk izLrko gSA
6. i;Zos{k.k & Mh-Mh-Vh- fNM+dko ds liQy i;Zos{k.k ,oa xq.koDrk iw.kZ fNM+dko dh
n‘f"V ls i;Zos{k.k fd;k tkuk gS A ftu ftyksa esa xkM+h miyC/ gS] mu ftyksa dks xkM+h ds
fy, bZ/u] ejEerh (fu;ekuqlkj) ds fy, jkf’k rFkk ftu ftyksa esa xkM+h miyC/ ugha gS
39 ftyksa dks jkT; Lok- lfefr }kjk vuqeksfnr nj ij ,d p fNM+dko ds fy, jkf’k
dk izLrko gS A izR;sd ekg 20 fnu ds i;Zos{k.k ds dk;Z lEiknu djus gsrq ,d p ds
fy, 50 fnuksa ds i;Zos{k.k gsrq jkf’k dk vkdyu fd;k x;k gS A
izLrkfor jkf’k& 7 × 650 × 50 -Rs. 2,27,500/-
eysfj;k ;kstuk esa 5 ekg ds fNM+dko vof/ esa i;Zos{k.k gsrq jkf’k fujks/kRed
dkjZokbZ ls miyC/ djk;k tk jgk gS A ’ks"k 7 ekg ds i;Zos{k.k gsrq dkyktkj ;kstuk ls
x;k ,oa eqxsaj ds ftyk eysfj;k ink- dks jkf’k miyc/ djk;k x;k gS A ’ks"k ikWp ftys
;Fkk teqbZ ,oa dSeqj ds vij eq[; fpfdRlk inkf/dkjh dks] (ftyk eysfj;k inkf/dkjh
dk in ;gkW Lohd‘r ugh gS) jksgrkl] uoknk] vkSjxkckn ftys ds ftyk eysfj;k
inkf/dkjh] dqy ikWp ftyks dks 10 gtkj :i;k izfrekg dh nj ls lkr ekg ds fy;s
dqy &
5 ftyk X 10 gtkj :i;s x 7 ekg = 3]50]000 :i;s dk izko/ku j[kk x;k gSaA
7- izpkj&izlkj & fNM+dko ds iwoZ fNM+dko ds laca/ esa turk dks tkudkjh fn;k
tkrk gS rkfd os fNM+dko ds fy, l&le; rS;kj jgs A bl fufer iksLVj] iEiysV]

4- fNM+dko midj.k& Rs. 44, 000.00
5- i;Zos{k.k & Rs. 2,27,500.00
6- izpkj&izlkj & Rs. 1,05,000.00
,d p fNM+dko ds fy, dqy izLrkfor jkf’k Rs. 44,15,700.00
nks p fNM+dko ds fy, dqy izLrkfor jkf’k Rs. 88,31,400/-
7. iQkfxax& Rs. 40,00,000/-
8. ftyk eysfj;k dk;Zy; ds lkr ekg dk i;Zos{k.k&
Rs. 3,50,000/-
dqy 1,31,81,400/-
(,d djksM- ,drhl yk[k ,dklh gtkj pkj lkS :i;s )
([k) mipkjkRed dkjZokbZ &
eysfj;k ds jksxh ds igpku ds fy, Toj fifM+r jksfx;ksa dk jDriV tkWp fd;k
tkrk gSA jDriV dh deh ds dkj.k foxr o"kksZ esa jDriV laxzg y{; ds vuqlkj ugha
gqvk] iQyr% eysfj;k jksfx;ksa dk lgh vkdM+k miyC/ ugha gks ik;k A bl fufer LykbM
,oa fj,tsUV ; dk izLrko gSA
1- Hkkjr ljdkj ls izkIr fn’kk funs’k ds vuqlkj dqy vkcknh dk 10» jDriV laxzg
okf"kZd fd;k tkuk gS A fcgkj dh dqy vkcknh nl djksM+ (yxHkx) gS A vr% jDriV
laxzg ,d djksM+ gksuk pkfg, A lkr eysfj;k izHkkfor ftyksa dk dqy tula[;k
1]66]66]603 gS A
ftyksa ls izkIr lwpukuqlkj foxr o"kksZ esa djhc 1]25]000 jDriV laxzg fd;k x;k
gSA vr% orZeku esa 5 yk[k jDriV ; dk izLrko gS A ,d jDriV ds ; ds fy,
Rs. 1/- O;; gksxk A
dqy 5]00]000 jDriV ds ; ij dqy O;; & Rs. 5,00,000/-
362

jDriV lxazg ds fy, fizfdax fufMy] :bZ] LizhV rFkk fj,tsUV dh vko’;drk
gksxhA bl fufer 5]00]000 fizfdax fufMy dk ; dk izLrko gS A izfr fizfdax fufMy
:- 1-50 dh nj ls dqy O;; :- 7]50]000@& dkVu] LizhV rFkk fj,tsUV ds ; ij :-
4@& izfr LykbM dh nj ls O;; dk vkdyu fd;k x;k gS A vr% 5 yk[k LykbM ds
fy, dkVu] LizhV rFkk fj,tsUV ij dqy 5,00,000 × 4 = 20,000,00/- O;; gksxk A bl rjg
jDriV ; ,oa fj,tsUV bR;kfn ij dqy O;; & 5]00]000 $ 7]50]000 $ 20]00]000
:- 32]50]000 O;; gksxk A
2. i;Zos{k.k & i;Zos{k.k dh n‘f"V ls eysfj;k izHkkfor ftyksa ds eysfj;k fujh{kd dks
izfr ftyk nks eksVj lkbZfdy ; dk izLrko gS rkfd i;Zos{k.k dk;Z lqpk: ,oa fu;fer
fd;k tk ldsA ,d eksVj lkbfdy ds ; ij :- 50]000@& O;; gksxk A bl rjg 7
ftyksa eysfj;k izHkkfor ftyksa esa ls ek=k uoknk] vkSjaxkckn] jksgrkl ftyksa dks izfr ftyk 2
eksVj lkbfdy ds
dkyktkj ;kstuk ls eksVjlkbfdy
; dk izLrko gS ’ks"k 4 eysfj;k izHkkfor ftyksa x;k] eaqxsj dks
inkf/dkjh ds vf/uLFk ftys s dkyktkj ls izHkkfor gS A
; dk izLrko gS A eqaxsj ,oa x;k ftyk eysfj;k
izLrkfor jkf’k & 3 × 2 × 50,000 - 3,00,000/-
eksVjlkbfdy ds fy, ba/u gsrq izfr eksVj lkbfdy 30 yhVj izfr ekg dh nj ls
12 ekg ds fy, jkf’k dk izko/ku fd;k tk jgk gSA (izfr yhVj isV“kWy :- 50@& dh nj
ls)
dqy izLrkfor jkf’k 6 × 30 × 50 × 12 - Rs. 1,08,000/-
dqy Rs. 4,08,000/-
3. eysfj;k ls cpko ds fy, osMusV &
& dqy 7 ftyksa esa izHkkfor tula[;k & 20 yk[k
& 5 O;fDr ds vk/kj ij 1 ifjokj dh
x.kuk djus ij dqy ifjokj dh la[;k & 4 yk[k
& ,d ifjokj esa 2 osMusV dk izko/ku
j[kus ij dqy osMusV dh vko’;drk & 8 yk[k
363

ysfdu dsoy ch-ih-,y- xHkZorh efgyk dks izkFkfedrk ds vk/kj ij osMusV
miyC/ djk;k tk;xk A ;g Epidemic out Break okys ftyksa dks gh eqgS;k djkus dk
izLrko gS A bl rjg dqy 1 yk[k osMusV dh vko’;drk dk vkdyu fd;k x;k gS] tks
Hkkjr ljdkj }kjk miyC/ djk;k tk;xk A
izLrko gS A
&
4. izf’k{k.k &
osMusV dh vkiwfrZ es a

(?k)- Lok- dk;ZorkZ dk izf’k{k.k &
lkr eysfj;k izHkkfor ftyksa esa dqy 30 cqfu;knh Lok- fujh{kd] 11 fuxjkuh dk;ZdrkZ] 8
{ks=kh; dk;ZdrkZ rFkk 1 Js"B {ks=kh; dk;ZdrkZ gS A bl rjg dqy 50 dk;ZdrkZ dks izf’kf{kr
fd;k tkuk gS A 25 izf’k{k.kkFkhZ izfr oSp dh nj ls nks oSp esa izf’k{k.k dk izLrko gS A
izf’k{k.k vof/ 2 fnuksa dh gksxh A izf’k{k.k ij izfr oSp fd 30]000@& dh nj ls O;;
dk izLrko gS A
dqy izLrkfor jkf’k & 2 × 30,000 60,000/-
bl rjg izf’k{k.k ij dqy O;; &
(d) e- fu- ds izf’k{k.k & 1]39]000@&
([k) iz;ksx’kkyk izkoSf/d & 200]620@&
(x) cq- Lok- fu- ,oa fu- fujh{kd & 30]000@&
(?k) Lok- dk;ZdrkZ & 60]000@&
vuqyXaud lyaXu
dqy & 4,29,620/-
365

NAMMIS
National Anti Malaria Management Information System (NAMMIS) ds rgr lHkh
ftyksa dks Web based NAMMIS Software dk;Z e ls Internet ds ekŁ;e ls tksM+uk ,oa
Report ladfyr fd;k tkuk gS A 2009-10 ds Action Plan ds rgr fuEuor ctV izLrko gS
&
1- lHkh ftyksa esa miyC/ djk, x, Computer esa CD/DVD Writer ugh yxk gSA vr% lHkh
40 computer esa CD/DVD writer yxkus gsrq izfr CD/DVD writer 1500/- :- izfr dh nj
ls dqy 40 dEI;wVj gsrq & 40 × 1500 Rs. = 60,000.00 dk izLrko gSA
2- eq[;ky; esa yxs nks Computer System gsrq 2GB RAM, 250 GB Hard Disk dk izLrko
gS A vHkh System esa 256 MB RAM ,oa 40 GB Hard Disk yxk gS tks eq[;ky; esa
dk;Z dks ns[krs gq, de gS A blesa 2GB RAM dh dher vuqekfur 3000-00 :-
gS rFkk vfrfjDr nks 250 GB Hard Disk dh vuqekfur dher 3500-00 :- gS] dk
izLrko gS A dqy 6500@& :- dk izLrko gSA
3- lHkh 40 dEI;wVj gsrq ikVZl lfgr AMC (Annual Maintence Cost) dk izLrko gSA blesa
izfr dEI;wVj izfr o"kZ AMC dk vuqekfur ykxr yxHkx 6]000@& (N% gtkj :i;s
ek=k) dh nj ls 40 × 6,000/- :- 2]40]000@& (nks yk[k pkyhl gtkj :i;s ek=k)
yxus dh laHkkouk gS] izLrko gS A
4- NAMIS dks dk;kZfUor djus gsrq lHkh 40 dEI;wVj esa Internet dh lqfo/k gsrq Broad
Band/USB Broad Band yxkuk vfuok;Z gS A blds rgr Broad Band dk nj izfrekg
vuqekfur :-800@& = 800 × 12 ekg 9]600@& okf"kZd ,oa Broad Band ds Installation
charge yxHkx 4500@& :- izfr System yxkus dh laHkkouk gSA dqy vuqekfur ykxr &
1]80]000 :-
9600 + 1,80,000 = 1,89,600 = 00 yxus dh laHkkouk gS A
5- lHkh ftyk eysfj;k dk;kZy; esa Basic Telephone dh lqfo/k iwoZ ls gh miyC/ gSA
Internet dh lqfo/k gsrq Telephone dh ekfld fcy vuqekfur :i;k 500@& izfr
ftyk dh nj ls 38 ftys gsrq 38 × 500 = 19,000.00 :i;s × 12 ekg 2]28]000-00
366

:i;s ,oa jkT; Lrjh; eq[;ky; gsrq 1000 :i;s izfr ekg dh nj ls 12 ekg gsrq 12]
000@& :i;s] dqy& 2]28]000 00
12]000 00
2,40,000 00 :- yxus dk ctVh; izLrko gSA
6- lHkh ftyksa dks Comptuer ds Cartridage, CD/DVD, Xerox Paper, UPS ds cSV“h ,oa vU;
vko’;d oLrqvksa dh [kpZ gsrq vuqekfur 5]000@& :i;s dh nj ls 38 ftyk ×
5000.00 = 1,90,000.00 ,oa jkT; Lrjh; eq[;ky; ij 20]000-00
dqy & 2]10]000-00 :- [kpZ gksus dh laHkkouk gS A
7- NAMMIS dks dk;kZfUor djus gsrq lHkh ftys dks ftyk eysfj;k inkf/dkjh dqy
la[;k&24] lHkh ftyksa ds ACMO = 14, 24 ftyksa ds dfeZ;ksa 48 ,oa vU; l{ke
O;fDr dks izf’k{k.k fn;k tkuk t:jh gS A blesa dqy vuqekfur & 100 O;fDr;ksa dks
izf’k{k.k fn;k tkuk gS A jkT; Lrj ls nks dfeZ;ksa dks Master Trainer ds :i esa
NVBDCD }kjk izf’k{k.k fn;k tk pqdk gS A ;s TOT lHkh lacaf/r O;fDr;ksa dks
izf’k{k.k] nsus gsrq izf’k{kq ,oa izf’k{kd dk ekuns; ,oa vU; vk/kjHkwr lqfo/kvksa gsrq
10 O;fDr izfr cSp nks fnu dh nj ls 10 cSp (100 O;fDr;ksa gsrq) @ 25,000/- =
dqy 2]50]000@&:- yxus dh laHkkouk gS A
NAMMIS ds izf’k{k.k ds vykok lkjk [kpZ State Component Plan esa j[kk x;k gS
dqy [kpZ dafMdk&
1- 60]000-00
2- 6]500-00
3- 2]40]000-00
4- 1]89]600-00
5- 2]40]000-00
6- 2]10]000-00
7 2]50]000-00
11]96]100-00
367

l rjg ;kstuk dk dqy O;;
1- fujks/kRed 1]31]81]400-00
2- mipkjkRed 37]08]000-00
3- izf’k{k.k 429]620-00
4- ukfel gsrq 11]96]100-00
1,85,15,120.00
5. ,d yk[k csMusV @ 250 Rs./ izfr csMusV = 2]50]00]000@& :i;s
dqy ctV dk izko?kku &
4,35,15,120@&
nks vuqyXaud layXu
fo’oklHkktu
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
Kkikad---------------------------------@ iVuk fnukad-----------------------------
izfrfyfi iz/ku lfpo] Lok- ,oa i- d- foHkkx] fcgkj iVuk] funs’kd izeq[k Lok- lsok;sa
fcgkj] dk;Zikyd funs’kd] jkT; Lok- lfefr] iVuk dks vuqyXud lfgr lwpukFkZ ,oa
vko’;d dkjZokbZ gsrq izf"kr A
Kkikad---------------------------------@ iVuk fnukad-----------------------------
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
izfrfyfi {ks=kh; funs’kd] Lok- ,oa i- d- foHkkx] Hkkjr ljdkj] bfUnjk Hkou] ikWpoka
eafaty] csyh jksM]iVuk] dks vuqyXud lfgr lwpukFkZ ,oa vko’;d dkjZokbZ gsrq izf"krA
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
368

Sl.
No.
Name of
Districts
Dist.Wise Malaria Affected Population , No. of Sqad,DDT Requirement ,Wages,Contegency,Equipment Repair,Mobility & Transportation of DDT of Malarial DDT Spray for 2009-2010
Total No. of Malaria
Affected
PHC HSC Populatio
n
Total
No. of
Sqad
(44
Sqad
/10
Lakhs
Popula
tion
Total No. of
Workers
SF
W
FW
DDT 50%
Status (In
Meric Ton )
Require.
Available
SFW(Rs.
113/-Per
SFW Per
Day For
75 Days)
WAGES
FW(Rs.92/-
Per FW Per
Day For 75
Days)
Total
Office
Expen
ses (@
Rs
300/-
Per
Sqad
EXPENDETURE FOR I ROUND
Contigen
cy At
Dist.
Level (@
Rs. 2000/-
Per Dist.
Repair
of
Spray
Equip
ments
Includi
ng
Nozal
Tips @
Rs.
500/-
Per
Sqad
District
Mobility
DMO
Vehicle
@
Rs.650/-
Per
Affected
Dist. For
50 Days
Transportation of
DDT
For @ Rs.
25,000 /-
Per Dist.
Storage of
DDT @
RS. 500/-
Per Month
For 12
Months
IEC @
Rs.15000/
- Per Dist.
Total
(Column No.
13 to 20)
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 22
1 Munger 1 26 154,135 8 8 40 12 10 67,800 276,000 343,800 2400 2000 4000 32500 25000 6000 15000 430,700 861400
100
000 0 1861400
0
2 Jamui 5 47 548,070 24 24 120 42 30 203,400 828,000 1,031,400 7200 2000 12000 32500 25000 6000 15000 1,131,100
100
700
2262200 000
00
0
3332200
3 Nawada 2 11 106,942 5 5 25 5 50 42,375 172,500 214,875 1500 2000 2500 32500 25000 6000 15000 299,375 598750 0
700
00
668750
4 Rohtas 2 15 192,106 9 9 45 15 30 76,275 310,500 386,775 2700 2000 4500 32500 25000 6000 15000 474,475 948950
5 Kaimur 2 12 153,035 7 7 35 12 30 59,325 241,500 300,825 2100 2000 3500 32500 25000 6000 15000 386,925 773850
6 Aurangabad 1 3 630,194 28 28 140 48 40 237,300 966,000 1,203,300 8400 2000 14000 32500 25000 6000 15000 1,306,200 2612400 0
700
00
2682400
7 Gaya 5 12 140,000 7 7 35 11 20 59,325 241,500 300,825 2100 2000 3500 32500 25000 6000 15000 386,925 773850 0 0 773850
Total 18 126 1,924,482 88 88 440 145 210 745,800 3,036,000 3,781,800 26,400 14,000 44,000 227,500 175,000 42,000 105,000 4,415,700
EXPEN
DETUR
E FOR II
ROUND
8,831,40
0
FO
GGI
NG
100
000
0
100
000
0
MO
BAL
ITY
FOR
SEV
EN
MO
NTH
700
00
700
00
GRAND
TOTAL
2018950
1843850
4,00
350,
0,00 13,181,400
000
0
STATE LEVEL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
Purchage of Blood Slide & Reagent 3,250,000
1 Curarive Purchase of Motorcycle for Supervision 408,000
Transportation & Purchase of Bednets 25,050,000
MI 139,000
2 Training
LT 200,620
BHI & SI 30,000
Health Worker 60,000
3 NAMMIS 1,196,100
Grand Total Of Malaria Programme 43,515,120
369

Dist.Wise Malaria Training of Malaria Inspector,Lab Technecian,health Supervisor & Health Worker for 2009-2010
Annexure II
Sl.
No.
Name of
Districts
Training Of Malaria
Inspector
Training (Induction & Re-Orientation) Of LT
Training Of Health
Supervisor
Training Of Health Worker
Total
No. Of
MI
TRG Cost Of
MI
TwoRounds
Total
No. Of
LT
TRG Cost
Of LT
(Induction
TRG)
TRG Cost Of
LT (Re-
Orientation
TRG)
Grand Total
Induction &
Reorientation
Total
No. Of
BHI
Total
No.
Of SI
TRG Cost Of
Health
Supervisor
Total
No.
Of
BHW
Total
No. Of
SW
Total
No. Of
FW
Total
No. Of
SFW
TRG Cost Of
Health Worker
1 2 OK OK OK OK OK OK OK
1 Aurangabad 4
Total No.of Malaria Inspectors 21 .Total
Provision of Training of 21 MI . Provision of
20 Participant in each Batch =1Batches
(TwoRound) @0.695 Lakhs per Batch = 1.39
Lakhs As Per NVBDCP Guideline. Two Round.
0
Total No.of 14 Lab Technecian .Total Provision
of Induction Training of 14 Lab Technecian.
Provision of 20 Participant in each Batch = 1
Batches @1.25 Lakhs per Batch for 10 Days
=1.25 Lakhs As Per NVBDCP Guideline .One
Time
TRG of all 14 Lab Technecian Induction .Total
Provision of Induction Training of 14 Lab
Technecian. Provision of 20 Participant in
each Batch =1 Batches @0.7562La khs per
Batch for 5 Days =0.7562 Lakhs As Per
NVBDCP Guideline .One Time
TRG of all 14 Lab Technecian Induction & Re -
Orientation Grand Total. As Per NVBDCP
Guideline .One Time
1 0
2 Gaya 4 8 8 0
3 Jamui 0 0 0 0
4 Kaimur 0 0 0 0
5 Munger 5 3 4 3
6 Nawada 2 2 1 1
7 Rohtas 6 1 1 2
Total 21 14 15 6
Total No.of BHI =15 +SI 6 Total 21 .Total
Provision of Training of 21 H ealth Supervisor
. Provision of 25 Participant in each Batch =1
Batches For 2 Days @ 0.30 Lakhs per Batch
=0.30 Lakhs As Per NVBDCP Guideline. One
Round.
3 0 1 0
7 0 3 1
0 0 0 0
0 0 0 0
11 5 2 0
0 1 2 0
9 5 0 0
30 11 8 1
Total No.of BHW =30 +SW= 11 +FW= 8
+SFW=1 Total 50 .Total Provision of Training
of 50 Health Worker . Provision of 25
Participant in each Batch =2 Batches For 2
Days @ 0.30 Lakhs per Batch =0.60 Lakhs As
Per NVBDCP Guideline. One Round.
370

i=kkad----------------------------------
izs"kd]
MkW- vkj-,u-ik.Ms;]
la;qDr funs’kd lg jkt; dk;Z e inkeysfj;k@dkyktkj]
fcgkj] iVuk
lsok esa]
funs’kd]
jk"V“h; oSDVj tfur jksx fu;a=k.k dk;Z e
22&’kkeukFk ekxZ] fnYyh&54
iVuk] fnukad----------------
fo"k;& iqu% la’kksf/r Msaxq ,oa fpdquxhfu;k dh jksdFkke ds fy, fo kh; o"kZ
2009-10 gsrw ctV izLrko A
egk’k;]
mi;q ZDr fo"k; Ms axq ,oa fpdquxhfu;k dh jksdFkku ,oa mipkjkRed mik; gsrw jkT;
ds NMCH, iVuk dks Sentival Surveillance Hospital ds :i esa /;fur dk izLrko gS]
Sentinel Site ds Laboratory Strengthening gsrq NVBDEP Guide Line ds vkyksd esa "One
time financial grant Rs. 25.00 Lakhs will be provided to each ARLS (Apex Referral
Laboratories) for the infrastructure development. In addition, recurring expenditure to the
tune of Rs. 1.00 lakh to each ARL and Rs. 0.50 Lakh to each SHs (Approved by
GO1/will be provided to meet the contingency expenditure of the Laboratory" dk izko/ku
fd;k tk ldrk gS A fcgkj esa Msxq dk dsl o"kZ 2008&09 esa dsoy ,d ik;k x;k gS tks
dSeqj ftys dk gSA Chikungunya dk dsl o"kZ 2008&09 esa Reported ugh gSA Hkfo"; esa
Dengu & Chikungunya mipkjkRed ,oa fujks/kRed gsrq 10 yk[k :i;s dk ctVh;
izko/ku gS A dqy Dengu & Chikungunya dk ctVh; izko/ku = 25.00 Laks + 1.00 Lakhs
+ 0.50 Lakhs + 10.00 Lakh = 36.50 Lakh.
fo’oklHkktu
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
372

Kkikad---------------------------------@ iVuk fnukad-----------------------------
izfrfyfi iz/ku lfpo] Lok- ,oa i- d- foHkkx] fcgkj iVuk] funs’kd izeq[k Lok- lsok;sa
fcgkj] dk;Zikyd funs’kd] jkT; Lok- lfefr] iVuk dks vuqyXud lfgr lwpukFkZ ,oa
vko’;d dkjZokbZ gsrq izf"kr A
Kkikad---------------------------------@ iVuk fnukad-----------------------------
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
izfrfyfi {ks=kh; funs’kd] Lok- ,oa i- d- foHkkx] Hkkjr ljdkj] bfUnjk Hkou] ikWpoka
eafaty] csyh jksM]iVuk] dks vuqyXud lfgr lwpukFkZ ,oa vko’;d dkjZokbZ gsrq izf"krA
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
373

Dengu & Chikungunia Dist.Wise Plan 2009-2010
Sl.No.
Name of
Dist.
Curative &
Presumptive
Measures
Fogging of JE @ Rs.
10.00 Lakhs / Dist.
Sentinal Survillance
Hospital
Grand Total
1 HQ. 1000000 -- 0 0
2 Patna 0 0 2650000 2650000
Total 1000000 0 2650000 3650000
Note-
Amount for Curative & Presumptive Measures & Sentinal Survillance Hospital for PMCH
Patna kept in State Level Office.
374

i=kkad----------------------------------
izs"kd]
MkW- vkj-,u-ik.Ms;]
la;qDr funs’kd lg jkt; dk;Z e inkeysfj;k@dkyktkj]
fcgkj] iVuk
lsok esa]
funs’kd]
jk"V“h; oSDVj tfur jksx fu;a=k.k dk;Z e
22&’kkeukFk ekxZ] fnYyh&54
iVuk] fnukad----------------
fo"k; & iqu% la’kksf/r Japanese Encephalitis dh jksdFkke ds fy, fo kh; o"kZ
2009-10 gsrw ctV izLrko A
egk’k;]
1- mijksDr fo"k;d foÙkh; o"kZ 2009&10 gsrq x;k] floku]eqtIQiqj ,oa if'pe pEikj.k ftys esa
Vaccination izLrko gSA blds iwoZ 2007 eqtQjiqj esa yxHkx 41-00 yk[k dk ,oa csfr;k esa yxHkx
48-00 yk[k #i;s dk ctVh; izko/kku FkkA bl foÙkh; o"kZ esa x;k gsrq 50-00 yk[k dk cTkVh; izko/kku
j[kk x;k gSA
dqy pkj ftys x 50 yk[k = 2 djksM- :i;s
2- J.E ds fy, Sentinal Surveillance Hospital ds :Ik esa SKMCH es eqtQjiqj]
ihŒ,eŒlhŒ,pŒ] iVuk ,oa ANMCH, x;k dks j[kk x;k gSA NVBDCP ds Guide ds
vkyksd esa izfr Sentinal Surveillance Hospital gsrq 26-50 dk nj fu/kkZfjr gSA vr% dqy
26.50 X 3 = 79.50 yk[k #i;s dk ctVh; izko/kku gSA
3- Sentinel Site ds Laboratory Strengthening gsrq NVBDEP Guide Line ds
vkyksd esa "One time financial grant Rs. 25.00 Lakhs will be provided to
each ARLS (Apex Referral Laboratories) for the infrastructure development.
In addition, recurring expenditure to the tune of Rs. 1.00 lakh to each ARL
and Rs. 0.50 Lakh to each SHs (Approved by GO1/will be provided to meet
the contingency expenditure of the Laboratory"
4- J.E ds jksdFkke gsrq mÙkj izns'k ls lVs fcgkj ds ftys ;Fkk csfr;k] eksfrgkjh] eqtQjiqj] lhoku]
xksikyaxt rFkk tsŒbZŒ ls izHkkfor vU; ftys ;Fkk&x;k] uoknk] vkSjaxkckn] tgkukckn ,oa vjoy
esa QkWfxax dk izLrko gSA bu 10 ftyksa esa vuqekfur 10 yk[k #Πizfr ftyk dh nj ls 1 djksM-
#i;s dk ctVh; izLrko j[kk x;k gSA
JE dk dqy cTkV &
375

(i) Vaccination - 200.00 yk[k
(ii) Sentinal Surveillance Hospital - 79.50 yk[k
(iii) Fogging - 100.00 yk[k
379-50 yk[k
fo’oklHkktu
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
Kkikad---------------------------------@ iVuk fnukad-----------------------------
izfrfyfi iz/ku lfpo] Lok- ,oa i- d- foHkkx] fcgkj iVuk] funs’kd izeq[k Lok- lsok;sa
fcgkj] dk;Zikyd funs’kd] jkT; Lok- lfefr] iVuk dks vuqyXud lfgr lwpukFkZ ,oa
vko’;d dkjZokbZ gsrq izf"kr A
Kkikad---------------------------------@ iVuk fnukad-----------------------------
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
izfrfyfi {ks=kh; funs’kd] Lok- ,oa i- d- foHkkx] Hkkjr ljdkj] bfUnjk Hkou] ikWpoka
eafaty] csyh jksM]iVuk] dks vuqyXud lfgr lwpukFkZ ,oa vko’;d dkjZokbZ gsrq izf"krA
la;qDr funs’kd lg jkT; dk;Z e inkeysfj;k@dkyktkj
fcgkj] iVuk
376

Sl.No.
Name of Dist.
JE Dist.Wise Plan 2009-2010
Vaccination of JE @
Rs. 50.00 Lakhs /
Dist.
Fogging of JE @ Rs.
10.00 Lakhs / Dist.
Sentinal Survillance
Hospital
Grand Total
1 Gaya 5000000 1000000 2650000 8650000
2 Siwan 5000000 1000000 0 6000000
3 Muzaffarpur 5000000 1000000 2650000 8650000
4 W.Champaran 5000000 1000000 0 6000000
5 Nawada 0 1000000 0 1000000
6 Aurangabad 0 1000000 0 1000000
7 Jehanabad 0 1000000 0 1000000
8 Arwal 0 1000000 0 1000000
9 East Champaran 0 1000000 0 1000000
10 Gopalganj 0 1000000 0 1000000
11 Patna 0 0 2650000 2650000
Total 20000000 10000000 7950000 37950000
Note-
Amount for Sentinal Survillance Hospital for ANMMCH,Gaya,SKMCH,Muzaffarpur,PMCH Patna kept
in State Level Office.
377

i=kkad----------------------------------
izs"kd]
MkW- vkj-,u-ik.Ms;]
la;qDr funs’kd lg jkt; dk;Z e inkiQysfj;k]
fcgkj] iVuk
lsok esa]
funs’kd]
jk"V“h; oSDVj tfur jksx fu;a=k.k dk;Z e
22&’kkeukFk ekxZ] fnYyh&54
iVuk] fnukad----------------
fo"k; & la’kksf/r iQysfj;k fnol eukus gsrq fof k; o"kZ 2009-10 gsrw ctV
izkDdyu Hkstus ds laca/ esaA
egk’k;]
mi;qDr fo"k;d o"kZ 09&10 dk ctV izkDdyu (vkSicf/d) bl i=k ds lkFk
layXu fd;k tk jgk gSA jkT; esa deZpkfj;ksa ds gM+rky ds dkj.k ftyksa ls iw.kZ vkWadM+k
ugh izkIr gks ldk gSA iQyLo:Ik vkSicf/kd ctV izkDdyu Hkstk tk jgk gSA iw.kZ lwpuk
izkIr gksus ds ckn ctV izkDdyu esa la’kks/u lHkao gSA o kZeku ctV izkDdyu
6]52]83]000@& (N% djksM- ckou yk[k rsjklh gtkj :i;s) dk gSA
izkDdyu dk fuekZ.k dk vko’;drk ,oa vk/kkj dk fuEu :Ik esa inokj vkadyu
fd;k x;k gSA
ctV izkDdyu dqy izkFkfed LokLF; dsUnzks 398 ,oa ftyk eq[;ky;ksas 38 esa jg
jgs yxHkx 10 djksM+ tula[;k dks iQkbZysfj;k fu;a=.k dk;Zdze ds rgr vPNkfnr djus ds
mn~ns’; ls rS;kj fd;k x;k gS] ftlds vUrxZr ,d fu/kZfjr frfFk dks mez ds fglkc ls
fu/kZfjr ek=k esa Mh0 bZ0 lh0 f[kykus ds dk;Z e djk;k tk;sxk ,oa mDr fnol dks NqVs
gq, tuekul dks vxys nks fnu rd ekSi&vi p pykus dk dk;Z e rS;kj fd;k x;k
gSA ctV izkDdyu jkT; Lrj ,oa ftyk Lrj ij O;; gksus okyh jkf’k ds vk/kj ij rS;kj
fd;k x;k gS A
(d) jkT; Lrj
378

(1) ftyk Lrjh; inkf/dkjh dk izf’k{k.k%& blds rgr dqy 1]52]000@& jkf’k dks
vkadfyr fd;k x;k gS a A iQkbysfj;k fnol dks iw.kZ lqxerk ls lapkyu gsrq izR;sd
ftyk ls ,d&,d inkf/kdkjh dks izf’kf{kr fd;s tkus dk dk;Z e gSA
izf’k{k.k ,d fnolh; gksxk rFkk 19&19 dh la[;k esa izf’k{k.kkfFkZ;ksa dks izf’kf{kr
fd;s tkus dk y{; j[kk x;k gS] tks izf’k{k.kksijkUr ftyk Lrjh; izf’k{k.k ds
izf’k{kd dk dk;Z djsxsaA (ctV vkadyu dafMdk 6 nz"VO;)
(2) izpkj izlkj%& jkT; Lrj ij izpkj izlkj gsrq 10]00]000@& :i;s vkadfyr fd;k
x;k gS] ftlds rgr nwjn’kZu] jsfM;ksa] lekpkj i=k ds lans’k nsuk ,oa izpkj&izlkj
lkexzh;ksa dk eqnz.k djkuk lfEefyr gSA (ctV vkadyu dafMdk 7 nz"VO;)
(3) jkT; Lrj ij izf’k{k.k gsrq 60]000@& :i;sA
(4) jkT; Lrj ij ikjkesfMdy LVkiQ dk izf’k{k.k 1]50]000@& :i;sA
(5) ih0vks0,y0%& bl en esa 3]00]000@& :i;s dk vkadyu fd;k x;k gS] ftlds
rgr jkt; eq[;ky; ls lHkh ftyksa ds fy;s Hksts tkus okys I;Zos{kh inkf/kdkjh ds
Hkze.k gsrq ckgu dh lqfo/k miyC/ djkus ,oa bZ/u vkfn esa O;; fd;k tk;sxkA
(ctV vkadyu dafMdk 14 ekad 1 nz"VO;)
([k) ftyk Lrj ij O;; gksus okyh jkf’k dk vkadyu
(6) ,d ftyk leUo; lfefr dh cSBd gsrq izfr ftyk 15]00]000=00 dh nj ls
dqy 5]70]000 (ikWp yk[k lRrj gtkj :i;s) ek=k dk vkadyu fd;k x;k gSA
bl jkf’k ls iQkbZysfj;k fnol ds liQy lapkyu gsrq fofHkUu foHkkxksa ds
inkf/dkfj;ks a dh leUo; cSBd dk vk;kstu fd;k tk;sxkA(ctV vkadyu dafMdk
8 nz"VO;)
(7) izpkj izlkj en%& bl en esa ftyksa dh tula[;k ,oa izkFkfed LokLF; dsUnzks dh
la[;k ds vk/kj ij ctV izkDdyu dafMdk 9 esa nZ’kk;h x;h gS rFkk bl en esa
dqy 14]55]000@& :i;s vkadfyr dh x;h gSA lEcfU/kr ftyk bl en dh jkf’k
ls cSuj @iksLVj ,oa vU; la’kk/uks ls iQkbZysfj;k fnol ds lEcU/ esa vke turk ds
chp izpkj izlkj dk dk;Z djsxsaA
(8) ftyk Lrjh; fpfdRlk inkf/dkfj;ks a dk izf’k{k.k%& bl en esa ctV izkDdyu
dafMdk 10 esa dqy 22]05]000@& (ckbZl yk[k ikWap gtkj) :i;s dks vkadfyr
379

fd;k x;k gSA jkT; Lrj ij izf’kf{kr fpfdRlk inkf/dkjh ftyk Lrj izkFkfed
LokLF; dsUnzks ds fpfdRlk inkf/dkjh dks izf’kf{kr djsxsaA izf’k{k.k ,d fnolh;
gksxkA
(9) ikjkesfMdy dehZ dk izf’k{k.k% ctV izkDdyu dafMdk 11 esa ftyksa ds ikjk
esfMdy LVkiQ dk izf’k{k.k iz[k.M Lrj ij dk;Zjr ikjk esfMdy LVkiQ dks mDr
iz[k.M ds izf’kf{kr fpfdRlk inkf/dkjh }kjk izf’kf{kr fd;k tk;sxkA bl en esa
mDr dafMdk esa ftyksa ds uke ds lkeus jkf’k dk vkadyu fd;k x;k gSA vkadfyr
jkf’k 18]85]000@&:i;k gSA
(10) ykbZu fyfLVax % ctV izkDdyu ds dafMdk 12 esa dqy 15]20]000@& (iUnzg yk[k
chl gtkj) :i;s izkDdfyr gSA
(11) ftyk Lrj ij isV“ksy ywcjhdsV gsrq en esa 11]98]000@&(X;kjg yk[k vuBkuos
gtkj :i;s)A
(12) jkf=k jDr iV laxzg% ctV izkDdyu ds dafMdk 13 esa dqy 5]74]546@& (ikWp
yk[k pkSgrj gtkj ikWp lkS fN;kyhl) :i;s vkadfyr dh x;h gS A
(13) nok forj.k d kkZ dk izf’k{k.k en% bl en esa dqy 2]62]410@& (nks yk[k oklB
gtkj pkj lkS nl nok forj.k d kkZ dks 92-00 (ckuos) :i;s ds nj ls ,d fnu
ds fy;s dqy 2]41]41]720@& (nks djksM+ ,drkyhl yk[k ,drkyhl gtkj lkr
lkS chl ) :i;s ek=k izkDdfyr gSA
(14) nok forj.k d kkZ ekuns; jkf’k% bl en esa ctV izkDdyu ds dafMdk 7 esa nks
yk[k cklB gtkj pkj lkS nl nok forj.k d kkZ dks 92 :i;s dh nj ls ,d fnu
ds fy, dqy 2]41]41]720@& (nks djksM+ ,drkyhl yk[k ,drkyhl gtkj lkr
lkS chl) :i;s ek=k izkDdfyr gSA
(15) nok i;Zos{kd dk izf’k{k.k jkf’k% bl en dk ctV izkDdyu ds dafMdk 5 esa
26]239-00 (NCchl gtkj nks lkS mupkfyl lqijckbtj dks 113@& :i;s dh nj
ls ,d fnu ds fy, dqy 2]96]5007@& (nks djksM- fN;kuos yk[k ikWp gtkj
lkr) :i;s izkDdfyr gSA
(16) lqijokbtj dk ekuns; jkf’k% bl en esa ctV izkDdyu ds dafMdk 9 esa 26]239@&
(Nchl gtkj nks lkS mupkfyl dks 113@& :i;s dh nj ls ,d fnu ds fy, dqy
380

2]96]5007@& (nks djksM- fN;kuos yk[k ikWp gtkj lkr :i;s) dk ctV
izkDdfyr gSA
fo’oklHkktu
la;qDr funs’kd lg jkT; dk;Z e inkiQysfj;k
fcgkj] iVuk
Kkikad---------------------------------@ iVuk fnukad-----------------------------
izfrfyfi iz/ku lfpo] Lok- ,oa i- d- foHkkx] fcgkj iVuk] funs’kd izeq[k Lok- lsok;sa
fcgkj] dk;Zikyd funs’kd] jkT; Lok- lfefr] iVuk dks vuqyXud lfgr lwpukFkZ ,oa
vko’;d dkjZokbZ gsrq izf"kr A
Kkikad---------------------------------@ iVuk fnukad-----------------------------
la;qDr funs’kd lg jkT; dk;Z e inkiQysfj;k
fcgkj] iVuk
izfrfyfi {ks=kh; funs’kd] Lok- ,oa i- d- foHkkx] Hkkjr ljdkj] bfUnjk Hkou] ikWpoka
eafaty] csyh jksM]iVuk] dks vuqyXud lfgr lwpukFkZ ,oa vko’;d dkjZokbZ gsrq izf"krA
la;qDr funs’kd lg jkT; dk;Z e inkiQysfj;k
fcgkj] iVuk
381

l0 fu0
,e- Mh- ,- dk izLrkfor la’kksf?kr ctV izkDdyu fof k; o"kZ 2009&10
jk"V“h; iQkbysfj;k fnol 2009&10 ds eukus gsrq fofHkUu enksa dk vyx&vyx rS;kj fd;k
tk jgk gS] ftldk C;kSjk fuEu izdkj gSA
Dzekad en dk uke izLrkfor jkf’k
1. jkT; Lrj ij ftys ds fofdRlk ink0 dk izf’k{k.k gsrq 152000
2. jkT; Lrj ij vkbZ0bZ0lh0 1000000
3. jkT; Lrj ij izf’k{k.k 60000
4. jkT; Lrj ij ikjkesfMdy LVkiQ dk izf’k{k.k 150000
5. jkT; Lrj ij isV“ksy ,oa Y;wcfjdsV gsrq 3,00000
6. ftyk Lrj ij leUo; lfefr dk cSBd nks fnuks dk 570000
7. ftyk Lrj ij vkbZ0bZ0lh0 1455000
8. ftyk Lrj ij fp0ink0 dk izf’k{k.k 2205000
9. ftyk Lrj ij ikjkesfMdy LVkiQ dk izf’k{k.k 1885000
10. ftyk Lrj ij ykbu fyLVhax gsrq 1520000
11. ftyk Lrj ij isV“ksy Y;wcfjdsV gsrq 1198000
12. jkf=k jDr iV laxzg 574546
13. ftyk Lrj ij nok forjdks dk izf’k{k.k gsrq 24141720
14. ftyk Lrj ij nok forjdks dk ekuns; jkf’k 24141720
15. ftyk Lrj ij i;Zos{kdks dk izf’k{k.k jkf’k 2965007
i;Zos{kdks dk ekuns; jkf’k 2965007
Dqy 65,283,000
la- fu- Lok0 lsok,a as lg
jkT; dk;Zdze ink0 iQkbysfj;k
fcgkj] iVukA
382

State- Bihar NAME OF PROGRAMME , MASS DRUG ADMINISTRATION ,BUDGET FOR 2009-2010
Sl.No.
State &
NameOf
District
No. Of
PHC
Dist. HQ
Total
(PHC
Dist.HQ)
Training
Of Dist.
Officer
IEC ( State
Level)
Dist.& Coordination
Meeting(Two
Meeting in
each Dist.)
IEC ( For
Dist. HQ)
Traing For MO
Training For
Para
Medical
Staff
Line Listing
Night
Blood
Survey
POL Total (A) Remarks
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16
1 State Level 0 0 0 152,000 1,000,000 0 0 60,000 150,000 0 0 300,000 1,662,000
2 Araria 9 1 10 0 0 15,000 35,000 55,000 40,000 35,000 16,698 28,000 224,698
3 Aurangabad 11 1 12 0 0 15,000 40,000 55,000 45,000 35,000 16,698 33,000 239,698
4 Arwal 3 1 4 0 0 15,000 30,000 20,000 25,000 20,000 16,698 13,000 139,698
5 Banka 10 1 11 0 0 15,000 35,000 50,000 40,000 35,000 16,698 30,000 221,698
6 Begusarai 11 1 12 0 0 15,000 35,000 50,000 40,000 35,000 16,698 33,000 224,698
7 Bhagalpur 11 1 12 0 0 15,000 40,000 55,000 40,000 40,000 16,698 33,000 239,698
8 Bhojpur 12 1 13 0 0 15,000 40,000 55,000 45,000 40,000 16,698 35,000 246,698
9 Buxar 7 1 8 0 0 15,000 35,000 55,000 40,000 40,000 16,698 23,000 224,698
10 Darbhanga 13 1 14 0 0 15,000 40,000 55,000 60,000 45,000 16,698 38,000 269,698
11 E.Champaran 20 1 21 0 0 15,000 50,000 90,000 90,000 65,000 16,698 55,000 381,698
12 Gaya 19 1 20 0 0 15,000 50,000 90,000 90,000 65,000 16,698 53,000 379,698
13 Gopalganj 10 1 11 0 0 15,000 35,000 55,000 45,000 35,000 16,698 30,000 231,698
14 Jamui 7 1 8 0 0 15,000 35,000 45,000 40,000 40,000 16,698 23,000 214,698
15 Jehanabad 4 1 5 0 0 15,000 25,000 25,000 25,000 20,000 16,698 16,000 142,698
16 Kaimur 9 1 10 0 0 15,000 35,000 45,000 40,000 30,000 16,698 28,000 209,698
17 Katihar 11 1 12 0 0 15,000 40,000 55,000 40,000 40,000 16,698 33,000 239,698
18 Khagaria 6 1 7 0 0 15,000 35,000 55,000 40,000 30,000 16,698 20,000 211,698
19 Kishanganj 7 1 8 0 0 15,000 35,000 55,000 45,000 30,000 16,698 23,000 219,698
20 Lakhisarai 4 1 5 0 0 15,000 25,000 25,000 25,000 20,000 16,698 15,000 141,698
21 Madhepura 7 1 8 0 0 15,000 35,000 55,000 40,000 30,000 16,698 23,000 214,698
22 Madhubani 19 1 20 0 0 15,000 50,000 90,000 90,000 60,000 16,698 53,000 374,698
23 Munger 6 1 7 0 0 15,000 35,000 55,000 40,000 30,000 16,698 20,000 211,698
24 Muzaffarpur 14 1 15 0 0 15,000 45,000 70,000 65,000 45,000 16,698 40,000 296,698
25 Nawada 10 1 11 0 0 15,000 40,000 55,000 40,000 35,000 16,698 30,000 231,698
26 Nalanda 12 1 13 0 0 15,000 40,000 65,000 40,000 45,000 16,698 35,000 256,698
383

27 Patna 16 1 17 0 0 15,000 50,000 90,000 90,000 70,000 16,698 45,000 376,698
28 Purnea 11 1 12 0 0 15,000 40,000 55,000 45,000 40,000 16,698 33,000 244,698
29 Rohtas 13 1 14 0 0 15,000 40,000 55,000 60,000 45,000 16,698 38,000 269,698
30 Saharsa 7 1 8 0 0 15,000 35,000 50,000 45,000 30,000 16,698 23,000 214,698
31 Samastipur 14 1 15 0 0 15,000 45,000 70,000 60,000 50,000 16,698 40,000 296,698
32 Saran 15 1 16 0 0 15,000 45,000 70,000 65,000 50,000 16,698 43,000 304,698
33 Sheikhpura 3 1 4 0 0 15,000 30,000 25,000 25,000 20,000 16,698 13,000 144,698
34 Sheohar 3 1 4 0 0 15,000 25,000 25,000 25,000 45,000 16,698 13,000 164,698
35 Sitamarhi 13 1 14 0 0 15,000 40,000 55,000 65,000 50,000 16,698 38,000 279,698
36 Siwan 15 1 16 0 0 15,000 40,000 70,000 55,000 30,000 16,698 43,000 269,698
37 Supaul 9 1 10 0 0 15,000 35,000 55,000 45,000 40,000 16,698 28,000 234,698
38 Vaishali 11 1 12 0 0 15,000 40,000 55,000 45,000 40,000 16,698 33,000 244,698
39 W.Champaran 16 1 17 0 0 15,000 50,000 90,000 90,000 65,000 16,698 45,000 371,698
Total 398 38 436 152,000 1,000,000 570,000 1,455,000 2,205,000 2,035,000 1,520,000 634,524 1,498,000 11,069,524
384

State- Bihar NAME OF PROGRAMME , MASS DRUG ADMINISTRATION ,BUDGET FOR 2009-2010
Sl.No.
State &
NameOf
District
No. Of
House in
Dist.
No. of Drug
Distri.in Dist
No. of
Supervisior
Training Of
Drug
Distributer in
Dist. (@ Rs.
92 Each)
Honararium Of
Drug Distri.( @
Rs. 92 Each)
Training Of
Supervisior
(113 Each)
Honararium of
Supervision in
Dist. @ Rs.
113/- Each
Toatl (B)
Toatl (A)
( From
Previous
Sheet)
Grand Total
( A+B)
1 2 3 4 5 6 7 8 9 10 11 12
1 State Level 0 0 0 0 0 0 0 0 1,662,000 1,662,000
2 Araria 416,693 8,400 838 772,800 772,800 94,694 94,694 1,734,988 224,698 1,959,686
3 Aurangabad 359,820 7,240 724 666,080 666,080 81,812 81,812 1,495,784 239,698 1,735,482
4 Arwal 99,698 2,000 200 184,000 184,000 22,600 22,600 413,200 139,698 552,898
5 Banka 271,286 5,450 545 501,400 501,400 61,585 61,585 1,125,970 221,698 1,347,668
6 Begusarai 379,947 7,650 765 703,800 703,800 86,445 86,445 1,580,490 224,698 1,805,188
7 Bhagalpur 424,352 8,510 851 782,920 782,920 96,163 96,163 1,758,166 239,698 1,997,864
8 Bhojpur 347,780 7,000 700 644,000 644,000 79,100 79,100 1,446,200 246,698 1,692,898
9 Buxar 213,834 4,300 430 395,600 395,600 48,590 48,590 888,380 224,698 1,113,078
10 Darbhanga 508,044 10,200 1,020 938,400 938,400 115,260 115,260 2,107,320 269,698 2,377,018
11 E.Champaran 538,386 10,750 1,075 989,000 989,000 121,475 121,475 2,220,950 381,698 2,602,648
12 Gaya 563,963 11,300 1,130 1,039,600 1,039,600 127,690 127,690 2,334,580 379,698 2,714,278
13 Gopalganj 345,846 6,930 693 637,560 637,560 78,309 78,309 1,431,738 231,698 1,663,436
14 Jamui 215,571 4,320 432 397,440 397,440 48,816 48,816 892,512 214,698 1,107,210
15 Jehanabad 124,264 2,500 250 230,000 230,000 28,250 28,250 516,500 142,698 659,198
16 Kaimur 199,007 4,000 400 368,000 368,000 45,200 45,200 826,400 209,698 1,036,098
17 Katihar 417,984 8,380 838 770,960 770,960 94,694 94,694 1,731,308 239,698 1,971,006
18 Khagaria 274,709 5,520 552 507,840 507,840 62,376 62,376 1,140,432 211,698 1,352,130
19 Kishanganj 217,089 4,360 436 401,120 401,120 49,268 49,268 900,776 219,698 1,120,474
20 Lakhisarai 134,852 2,700 270 248,400 248,400 30,510 30,510 557,820 141,698 699,518
21 Madhepura 255,280 5,320 532 489,440 489,440 60,116 60,116 1,099,112 214,698 1,313,810
22 Madhubani 563,734 11,300 1,130 1,039,600 1,039,600 127,690 127,690 2,334,580 374,698 2,709,278
23 Munger 187,522 3,750 375 345,000 345,000 42,375 42,375 774,750 211,698 986,448
385

24 Muzaffarpur 573,302 11,500 1,150 1,058,000 1,058,000 129,950 129,950 2,375,900 296,698 2,672,598
25 Nawada 288,581 5,800 580 533,600 533,600 65,540 65,540 1,198,280 231,698 1,429,978
26 Nalanda 330,598 6,620 662 609,040 609,040 74,806 74,806 1,367,692 256,698 1,624,390
27 Patna 679,619 13,600 1,360 1,251,200 1,251,200 153,680 153,680 2,809,760 376,698 3,186,458
28 Purnea 456,118 9,140 914 840,880 840,880 103,282 103,282 1,888,324 244,698 2,133,022
29 Rohtas 394,415 7,900 790 726,800 726,800 89,270 89,270 1,632,140 269,698 1,901,838
30 Saharsa 226,070 4,540 454 417,680 417,680 51,302 51,302 937,964 214,698 1,152,662
31 Samastipur 462,681 9,270 927 852,840 852,840 104,751 104,751 1,915,182 296,698 2,211,880
32 Saran 467,382 9,350 935 860,200 860,200 105,655 105,655 1,931,710 304,698 2,236,408
33 Sheikhpura 85,238 1,710 171 157,320 157,320 19,323 19,323 353,286 144,698 497,984
34 Sheohar 35,956 1,720 172 158,240 158,240 19,436 19,436 355,352 164,698 520,050
35 Sitamarhi 400,483 8,020 802 737,840 737,840 90,626 90,626 1,656,932 279,698 1,936,630
36 Siwan 398,768 8,000 800 736,000 736,000 90,400 90,400 1,652,800 269,698 1,922,498
37 Supaul 288,596 5,790 579 532,680 532,680 65,427 65,427 1,196,214 234,698 1,430,912
38 Vaishali 415,794 8,320 832 765,440 765,440 94,016 94,016 1,718,912 244,698 1,963,610
39 W.Champaran 488,581 9,250 925 851,000 851,000 104,525 104,525 1,911,050 371,698 2,282,748
Total 13,051,843 262,410 26,239 24,141,720 24,141,720 2,965,007 2,965,007 54,213,454 11,069,524 65,282,978
386

PART- E
Intersectoral Convergence
2009-2010
388

Situational Analysis:
Public health peripheral and extension services and its linkage with facility based services
started less than a century in the country. The said services have developed many folds during
the last sixty years initially on the recommendation of the Bhor Committee and subsequently on
the basis of reviews and recommendations of several expert committees. It has achieved
commendable results despite poor funding and lack of a uniform system of command. It is now
increasingly understood larger fund allocation would increase the resources within the health
administrative set up but to achieve the desired outcomes, sectors administering the
determinants of health must work in tandem with common objectives. The NRHM rightly
emphasized the need to develop a convergent system between the Department of Health and
other sectors governing the areas of several health determinants. The NHRM also recognizes
the need to develop ownership of partners / stakeholders in tackling local endemic issues to
ensure better quality of life in all sections of the population. Considering the diversity and
prevailing inequity amongst the people it is rightly considered that leadership must be provided
at every level of governance to solve the health problems amongst the poor and the excluded.
Governance at every level can only be provided by the Rural Local Self Governance and in the
State of Bihar it is the three tiers Panchayat Raj Institution. The other sectors which directly
administer the issues of health determinants are;
· Department Social Welfare administers ICDS
· Department of Education administers school and higher education,
· Public Health Engineering Department and Panchayat administer supply of drinking
water and environmental sanitation including solid waste management.
NRHM also seeks partnership from Indian System of Medicine like Aurveda, Unani, Yoga, Sidda
and Homeopathy now jointly named AUYSH. The NRHM also seeks involvement of Non
Government Organizations (NGO) and For Profit Private Sector as partners in the public health
services by developing local need specific Public Private Partnership schemes. It also visualizes
the need to involve expert consultants and agencies in strengthening the Department of Health
and development of a State Heath Resource Centre to provide Technical Support in carrying
forward the Management of Change for efficient utilization of resources and effective delivery of
health services.
(a) Coordination with Panchayat /Village Council.
The state is undergoing through the process in the decentralisation of Panchayati Raj System.
Thus to strengthen and monitor the performance of the PHSC and PHC, this institution has
been brought under the manifold of the Panchayat president and Zilla Panchayat members of
the respective areas. Further the Panchayat presidents or the members are ex officio chairman
of the Village Health Water and Sanitation committee, to have a direct involvement in the health
issues of the community. Joint bank account of Panchayat president and ANM has been
389

opened for PHSC untied fund. These processes paved the way for taking initiative in
implementation in various health programmes under NRHM
Department has good relationship with the Village Council and through coordination with the
Village Council most of the health programmes are being implemented at the community level
with satisfaction.
(b) Coordination with ICDS
The DPO is a member of the District Health Society & District Core Group (under NRHM) and
thus the health department has been able to utilize his/her services for community mobilization
at the grassroots level. Through coordinated effort of the ANM and the Anganwadi worker
mothers and children are being mobilized for antenatal check up, institutional deliveries and
immunisation. Now the coordination is to be extended to organize VHNDs (Village Health
nutrition Days) at every AWC all over the district every month.
Issues / Areas
Support in School Health
Programme
Support in immunisation
programme for provision
of TT booster at the age
of 10 years.
Support in the adolescent
health programme
Areas of Convergent Action
Due to shortage of manpower in the health department,
plans to examine school children should be prepared
jointly with the education department so that larger
schools are covered first or priority should be set for
village schools which have not been covered recently or
threats/incidences of diseases/malnutrition are more.
During the school health programme visits, the booster
Tetanus Toxoid needs to be given to 10 year olds in the
schools. This should be worked out with the Education
department and visits planned accordingly.
Problem villages to be identified in which ASRH services
can be provided on priority basis.
390

(c) Coordination with PRI
Issues / Areas
Drainage system in
villages
Garbage disposal in
villages
Emergency transportation
services
Convergent actions
List of villages with major drainage problems to be shared
by the Health and ICDS department with the Rural
Development department for annual prioritization of
resources
The system of disposal of garbage (solid waste) needs to
be set up and larger villages prioritized as per list
submitted by ANMs and AWWs. The operational aspects
need to be managed by the VHWSC as per guidelines.
Standard Operation Procedure (SOPs) and operation of
emergency transportation services in villages with
support from the block are in process.
(d) Coordination with AYUSH
There are few practitioners of ISM that are in government employment. The service rules
related to them are not well defined. However, practitioners of traditional systems are there.
Before a strategy can be worked out as to how to mainstream or integrate this, a study need to
be carried out to identify the points of common interest such as rational management of
common diseases, communicable diseases control Programme and disease surveillance
Outcome /Output:
Effective coordination exists between health dept. and other line
departments
Objectively Verifiable Indicators (OVI):
Increased participation of all the line departments with the health
department
1.1 – Strategy :
· Constitute State level inter department standing committee to initiate policy review for
convergence and develop implementation procedures
· Constitute District level inter department committee under the Chairmanship of DM
and involvement of the District Level PRI to ensure PHC level committees are
constituted and implementing the directives of the State Level Standing Committee
· SHRC and TSU can facilitate by providing Technical Assistance and Support
Activities:
1.1.1 Develop convergence platform at all levels with NRHM line
departments by constituting the committees
MoV
Committees
constituted
391

1.1.2 Develop policy framework and procedural guidelines / manual
Guidelines /
manual
1.1.3 Develop linkage with other departments like WCD, Urban & Rural
Development, Education, Panchayat, Youth Affairs, etc at all Minutes of the
levels by ensuring the committees are functioning as per meeting
guidelines
1.1.4 Involve civil society, partners, NGOs in district health society Membership list
1.1.5 Establish convergent committee in all PHCs chaired by BDO
Committees
constituted
1.1.6 PRI s to actively involve in health development activities Membership list
Joint plans and
1.1.7 Joint Action with the line departments at different levels
monitoring and
review documents
1.1.8 Formation and effective functioning of Rogi Kalyan Samiti (RKS)
at PHC level which will also function as convergence committee
RKS constituted
1.1.9 Joint Planning, monitoring, evaluation by ANM, AWW ASHA
FNGO/NGO, VHWSC and PRI representatives in VHWSC
meeting.
1.1.10 Regular information sharing among converging departments and
joint review of progress.
1.1.11 Key officials of NRHM related departments at State level to be
actively involved in monitoring at all levels
1.1.12 Preparation of joint monitoring plan in consultation with all line
departments
1.1.13 Review and monitoring of activities jointly.
Joint plan
documents
Minutes of meeting
Joint monitoring
and review
documents
Joint monitoring
plan document
Joint monitoring
and review
documents
392

Programme wise convergence
Strategies/Activities
1. Maternal Health
1.1 Organize VHNDs at each and every AWC once a month to deliver ANC
services.
1.1 Organize once in two months RCH camps in all PHC and District Hospital
areas within the district.
1.2 Involvement of community representative of Gram Sabha through
VHWSCs & MSS for identifying & referring complicated cases to facilities
1.3 Involvement of AWWs and PRIs to identify and track each pregnant
woman and motivate them to avail ANC services. Regular updation of EC
register and quarterly population survey of her coverage area.
1.4 Collection of blood and urines samples of pregnant women and send it to
PHC for examination and report back with in 24 hours
1.5 ASHA, AWW and ANM to be involved in observed consumption of IFA
tablets by moderately and severely anemic pregnant mothers through
regular home visits and follow ups.
1.6 Observed consumption of Iron Follifer Tabs by Girls students in schools
MoV
Consolidated report
of the PHC &
district hospital
Consolidated report
of PHC & district
Supervision and
monitoring reports
Supervision and
monitoring reports
VHND Report
Monitoring and
supervision report
of LHV/
MO/DRCHO/PRI
School Health
Programme report
1.7 De-worming of all pregnant and adolescents girls (Half Yearly) Programme report
2. Child Health
2.1 Organize VHNDs at each and every AWC once a month to deliver
child health and nutrition services.
2.2 Organize RCH camps once in two months in all PHCs
2.3 Involvement of community representative of Gram Sabha through
VHWSCs & MSS for identifying & referring malnourished cases to
facilities
2.4 Supervision & Monitoring on all VHNDs by PRI representatives
2.5 Regular organization of VHNDs at every AWCs in co-ordination of
ANMs, ASHAs and PRIs
Consolidated report
of the PHC &
district hospital
Consolidated report
of PHC & district
Supervision and
monitoring reports
Supervision and
monitoring reports
Programme report
2.6 Estimation and registration of children under the age group of 0-5 yrs List of children
2.7 Growth monitoring of each child during VHNDs, at PHSC & in other Supervision and
393

facilities monitoring reports
3. Family Planning
of PRIs/Department
3.1 Ensure distribution of OCPs, emergency pills, condoms and IUD
insertion to eligible couple through ASHAs , AWCs and ANMs
4. Adolescents Health
4.1 To provide weekly dose of observed IFA and bi-annual dose of
deworming to adolescents girls in school by teachers
4.2 To provide weekly dose of observed IFA and bi-annual dose of
deworming to adolescents girls in school by AWWs and ASHAs
4.3 Training of school teachers, AWWs, ASHAs and female PRI
representatives on following issues:
· Hygiene and menstrual hygiene and genital cleanliness
· Adolescents growth and development
· Communicating with adolescents
· Sexual and reproductive health concerns of boys and girls
· Nutrition and anemia in adolescents
· Contraception for adolescents
· RTIs/STIs and HIV/AIDS in adolescents
· Child bearing
· Birth preparedness and parenting
· Safe abortion
4.4 Awareness development amongst adolescents girls by school teachers,
AWWs, ASHAs and female PRI representatives on all issues mentioned
above by community
5. Immunization
ASHA , AWW and ANM to conduct Home Visits to trace out the Unimmunized
children and Drop outs
Provision of Immunization during regular VHNDs organized at every
AWCs
Stock Register
List of girls
provided IFA %
deworming
List of girls
provided IFA %
deworming
Report of training
Report
of
counseling session
List of children
Performance report
6. National Disease Control Programme
IDSP
Symptomatic identification of diseases covered under IDSP and refer to
nearest health facility
Report of cases
394

Treatment all referral cases
Performance report
RNTCP
Symptomatic detection of cases by ANMs, AWWs, ASHAs, PRIs and refer
to nearest DOTS centre
Awareness development at community level regarding signs and
symptoms of reportable cases for early detection, isolation and seeking
treatment through mass media,, IPS, & counseling
Developing and dissemination of IEC material, including leaflets and
posters to the community
IPC through convergent approach
report of cases
Report of BCC
activities
Display and
availability of BCC
material
Report of key
functionaries
Blindness
Create awareness at the community level through effective mass media
for screening camps to be organized by BCC activities
Awareness development at community level regarding signs and
symptoms of reportable diseases for early detection and seeking treatment.
Developing and dissemination of IEC material, including leaflets and
posters
IPC through convergent approach
Report of BCC
activities
Report of BCC
activities
Leaflets and
posters in place
Report of key
functionaries
Leprosy
Involving ASHA, AWWs and PRIs to ensure accessible and uninterrupted
MDT services available to all patients through flexible and patient friendly drug
delivery system
Clinic during
conventional timing
6.5 National Vector Borne Disease Control Programme
6.5.1 Convergence with Panchayat/PHED for environmental sanitation and
safe drinking water supply by detecting location with problems
List of sites
6.6 Water borne diseases
6.6.1 Drainage system in villages
List of villages with major drainage problems to be shared by the
Health and ICDS department with the Rural Development department
for annual prioritization of resources
6.6.2 Garbage disposal in villages
The system of disposal of garbage (solid waste) needs to be set up
and larger villages prioritized as per list submitted by ANMs and
AWWs. The operational aspects need to be managed by the VHWSC
as per guidelines.
List of villages
List of villages and
locations
395

Work Plan
Goal:
Effective coordination exists between health dept. and other line departments
Timeline
2009-10 200 2011-
Strategy / Activity
10- 12
Q1 Q2 Q3 Q4
11
Responsibilit
y
State/District
Inter-sectoral Coordination
Strategy: Refer to LFA above
Activities:
1.1.1 Develop convergence platform at all
State
levels with NRHM line departments by
constituting the committees
1.1.2 Develop policy framework and procedural
State
guidelines / manual
1.1.3 Develop linkage with other departments
like WCD, Urban & Rural Development,
State/Distri
ct
Education, Panchayat, Youth Affairs, etc
at all levels by ensuring the committees
are functioning as per guidelines
1.1.4 Involve civil society, partners, NGOs in
District
district health society
1.1.5 Establish convergent committee in all
District
PHCs chaired by BDO
1.1.6 PRIs to actively involve in health
District
development activities
1.1.7 Joint Action with the line departments at
different levels
State/Distri
ct
1.1.8 Effective functioning of Rogi Kalyan Samiti
District
(RKS) at PHC level which will be also
function as convergence committee
1.1.9 Joint Planning, monitoring, evaluation by
District
ANM, AWW ASHA FNGO/NGO, VHWSC
and PRI representatives in VHWSC
meeting.
1.1.10 Regular information sharing among
State/Distri
converging departments and joint review
ct
of progress.
1.1.11 Key officials of NRHM related State
396

Strategy / Activity
Timeline
2009-10 200
10-
Q1 Q2 Q3 Q4
11
2011-
12
Responsibilit
y
State/District
departments at State level to be actively
involved in monitoring at all levels
1.1.12 Preparation of joint monitoring plan in
consultation with all line departments
State/Distri
ct
1.1.13 Review and monitoring of activities jointly.
State/Distri
ct
397

Budget:
Activity Unit Rate Amount
Joint Meeting at the 2 100000 2,00,000
state level with
various Deptt. like PR,
ICDS etc
Joint meeting at the 38 25000 9,50,000
district level
Joint monitoring from 6 20000 x 6 visits 120000
state to districts to
block/phc
Joint meeting at the 60000 AWC Rs 100 pm X 12 7,20,00,000
village level- Mahila
mandal meetings
months
Incentive to AWW for 60000X200X12
14,40,00,000
social mobilization in
Muskan Abhiyan
months
Total 21,72,70,000
398

NRHM PART A : RCH II
Sl. No. Budget Head Rs. lakhs %
1 Maternal Health
1.1 Operationalise facilities (dissemination,
monitoring & quality) (details of infrastructure
& human resources, training, IEC / BCC,
equipment, Drug and supplies in relevant
sections)
14.50
1.1.2 Operationalise Blood Storage units in FRU 469.68
1.2 Referral Transport 0.00
1.3 Integrated outreach RCH services 10.00
1.4 Janani Evam Bal Suraksha Yojana/JBSY 22686.72
Sub total 23180.90 47.80
2 Child Health 4291.09 8.85
3 Family Planning 7432.02 15.33
4 Adolescent Reproductive and Sexual Health 49.05 0.10
5 Urban RCH 134.33 0.28
6 Vulnerable Groups 330.00 0.68
7 Tribal Health 0.00 0.00
8 Innovations 2077.30 4.28
9 Strengthening of SIHFW 0.00 0.00
10 Infrastructure and Human Resource 3783.76 7.80
11 Institutional Strengthening 602.50 1.24
12 Training 1122.32 2.31
13 BCC/IEC (for NRHM Part A, B & C) 1140.89 2.35
14 Procurement of Equipments/Instruments 3385.58 6.98
15 Procurement of Drugs and Supplies 0.00 0.00
16 Programme management 965.25 1.99
TOTAL 48495.00 100.00
399

PART- B
Sl. No. Budget Head Modified Budget %
1 2 6
1 Decentralization
1.11 ASHA Support System at State Level 27694500
1.12 ASHA Support System at District Level 2160000
1.13 ASHA Support System at Block Level 59950000
1.14 ASHA Support System at Village Level 4500000
1.15 ASHA Trainings 82421250
1.16 ASHA Drug Kit & Replenishment 22555800
1.17 Emergency Services of ASHA 2500000
1.18 Motivation of ASHA 63172875
1.19 Capacity Building/Academic Support programme 1000000
1.2 ASHA Divas 81230200
Total ASHA 347184625 7.97
1.21 Untied Fund for Health Sub Center, Additional
Primary Health Center and Primary Health Center
134807000
1.22 Village Health and Sanitation Committee 401332500
1.23 Rogi Kalyan Samiti 85300000
Total Decentralization 621439500 14.26
2 Infrastructure Strengthening
2.1 Construction of HSCs (100 no. x Rs.9.50 lakhs) 95000000
2.2 Construction of PHCs 637967000
2.2a Construction of residential quarters of 200 old
APHCs for staff nurses
2.2b Construction of building of 51 APHCs where land is
available
2.3 Up gradation of CHCs as per IPHS standards (100
CHCs x Rs.40.00 lakhs)
2.4 Infrastructure and service improvement as per IPHS
in 20 (DH & SDH) hospitals for accreditation or ISO :
9000 certification
600000000
37967000
400000000
100000000
2.5 Upgradation of ANM Training Schools 70000000
2.6 Annual Maintenance Grant 82080000
Total Infrastructure strengthening 1385047000 31.79
3 Contractual Manpower
3.1 Contractual Salaries, Incentives and Bonus (PHC
doctors and staffs, contractual staff nurses, ANM ®,
mobile services)
668400000
3.1a Incentive for PHC doctors & staffs @ Rs. 50,000 for
better performance in implementing programmes
(Rs. 50,000/ - per PHC per year)
12500000
400

3.1b Salaries for contractual Staff Nurses (2900 existing
and 910 new) (Rs.7500 per month)
3.1c Contract Salaries for ANMsRs.6000 per month x
3500 (12 Months Consolidated Salaries for
Contractual ANMs)
3.1d Mobile facility for all health functionaries (District
officials, PHC in charge, CDPOs and ANMs @ 500
per month)
343900000
252000000
60000000
3.2 Block Programme Management Unit 289524000
3.3 Addl. Manpower for SHSB 6204288
3.4 Addl. Manpower for NRHM 25479000
Total Contractual Manpower 989607288 22.71
4 PPP Initiatives
4.1 102-Ambulance service 4032000
4.2 1911- Doctor on Call & Samadhan 816000
4.3 Addl. PHC management by NGOs 39864000
4.4 American Association of Physicians of Indian Origin
(AAPIO)
5600000
4.5 SHRC (HOSMAC) 13844000
4.6 Services of Hospital Waste Treatment and Disposal
in all Government Health facilities up to PHC in Bihar
(IMEP)
30000000
4.7 Dialysis unit in various Government Hospitals of
Bihar
4.8 Setting Up of Ultra-Modern Diagnostic Centers in
Regional Diagnostic Centers (RDCs) and all
Government Medical College Hospitals of Bihar
20000000
36000000
4.9 Providing Telemedicine Services in Government
Health Facilities
4. 10 Outsourcing of Pathology and Radiology Services
from PHCs to DHs
4.11 Operationalising MMU (38 units x Rs.4.68 lakhs x 9
months)
4.14 Monitoring and Evaluation (State, District, Block
Data Centre)
20000000
3000000
160056000
63750000
4.15 Generic Drug Shop
4.16 Nutritional Rehabilitation Centre 4934400
4.17 Hospital Maintenance
4.18 Providing Ward Management Services in
Government Hospitals
3000000
4.19 Provision for HR Consultancy services 2250000
4.2 Advanced Life Saving Ambulance (Rs.9,98,000/- x 9
8901000
months)
Total PPP Initiatives 416047400 9.55
5 Procurement of Supplies
401

5.1 Delivery kits at the HSC/ANM/ASHA (no.200000 x
Rs.25/-)
5.2 SBA Drug kits with SBA-ANMs/Nurses etc
(no.25000 x Rs.245/-)
5.3 Availability of Sanitary Napkins at Govt. Health
Facilities @25000/district/year
5000000
6125000
950000
5.4 Procurement of beds for PHCs to DHs 40286000
Total Procurement of Supplies 52361000 1.20
6 Procurement of Drugs
6.1 Cost of IFA for Pregnant & Lactating mothers
(Details annexed)
6.2 Cost of IFA for (1-5) years children (Details
annexed)
23944000
40923000
6.3 Cost of IFA for adolescent girls (Details annexed) 37541000
Total Procurement of Drugs 102408000 2.35
7 Mobilisation & Management support for Disaster
Management
10000000 0.23
8 Health Management Information System 3289517 0.08
9 Strengthening of Cold Chain (Infrastructure
strengthening)
Refurbishment of existing Warehouse for R.I. as well
as provision for hiring external storage space for
(during Immunization Campaigns) Logistics at State
HQ @Rs 1000000/-
36131000 0.83
1000000
Refurbishment of existing Cold chain room for
district stores in all districts with proper
electrification,Earthing for electrical cold chain
equipment and shelves and dry space for non
elecrtical cold chain equipment and logistics @Rs 3
Lakhs per district x 38 districts
Earthing and wiring of existing Cold chain rooms in
all PHCs @Rs 7000/- per PHC x 533 PHCs
POL of Generators for cold chain @ Rs. 600 per day
per WIC. Rs. 500 per day per district and Rs. 400
per day per PHC
11400000
3731000
20000000
10 Preparation of Action Plan 1700000 0.04
10.1 Preparation of District Health Action Plan (Rs.50
thousand per district x 38)
1600000
10.2 Preparation of State Health Action Plan @ 1 lakhs 100000
11 Mainstreaming Ayush under NRHM 391,584,800 8.99
Total 4,356,800,130 100.00
Rs. in Lakh 43568.00
402

NRHM Part: C
Sl Budget Head Total Budget
(Rs. In lakhs)
%
1 Routine Immunization 3193.08 100.00
Total 3193.08 100.00
NRHM PART D – NATIONAL DISEASE CONTROL PROGRAMME
Sl. No.
Programme
Budget 2009-10
(Rs. In Lakhs)
1 IDSP 130.06 1.82
2 T.B. 2,414.73 33.85
3 Leprosy 279.40 3.92
4 Malaria 435.15 6.10
5 Kalazar 2,268.92 31.81
6 Dengu+Chikungunya 36.50 0.51
7 Filaria 652.83 9.15
8 Blindness 518.75 7.27
9 IDD 18.00 0.25
10 JE 379.50 5.32
TOTAL 7,133.84 100.00
%
NRHM Part E : Intersectoral Convergence
Sl. No.
Programme
Budget 2009-10
(Rs. In Lakhs)
%
1 Intersectoral Convergence 2172.70 100
403

SUMMARY of BUDGET
PART
HEAD
BUDGET 2009-10
(Rs. In lakhs)
In Cr. %
A RCH II 48495.00 484.95 37.89
B NRHM Additionalities 43568.00 435.68 34.04
C Immunization 3193.08 31.93 2.49
D NDCP 7,133.84 71.34 5.57
E Intersectoral Convergence 2172.70 21.72 1.70
TOTAL 104562.62 1045.62 81.70
PPI Operational Cost 76.97 6.01
Infrastructure Maintenance
(Treasury Fund) 157.22 12.28
GRANT TOTAL 1279.81 100.00
404